a handbook to medical libraries and health information: for langara students enrolled in libr 2195
TRANSCRIPT
Medical libraries section: a handbook for LIBR 2195 students, 2015
A handbook to medical libraries and health information:
for Langara students enrolled in LIBR 2195
Dean Giustini, UBC Biomedical Librarian
Langara College e-mail [email protected]
https://twitter.com/giustini
“Medical libraries section: a handbook for LIBR 2195 students, 2015” —Page2
Table of Contents
This handbook provides all the background information you need for the medical weeks of LIBR 2195.
Let Dean know if you have any questions [email protected] OR [email protected]
I. An overview of the medical weeks of LIBR 2195, assignments p3
II. Class resources (pathfinder) to help you learn 4
III. Reference services in medical libraries (background) 5-8
Assignment #1 of 3 (Answer five (5) reference questions) 9
IV. Literature searching medicine using PubMed (Medline) and CINAHL 10
Assignment #2 of 3 (Answer two search questions using Medline & CINAHL) 13
V. An introduction to complementary and alternative medicine 14
VI. CAM glossary 15
VII. Glossary of medical library terms 19
Assignment #3 of 3 (Evaluation of CAM website) 20
READ further about medical library topics on the health library wiki
http://hlwiki.slais.ubc.ca/index.php/HLWIKI_International
“Medical libraries section: a handbook for LIBR 2195 students, 2015” —Page3
An overview of the medical section of LIBR2195
Introduction
Welcome to the exciting world of medical libraries. As you know, my name is Dean Giustini, and I work at the UBC biomedical branch library at Vancouver General Hospital (Oak & 12th Ave). This handbook provides information for you to start learning in the medical weeks of LIBR2195. I am committed to doing everything I can to ensure your success in this section of class, but let’s have fun.
Our goals in this part of the course are:
To identify the major sources of information in medical reference To discuss user groups in medical libraries such as doctors, nurses, pharmacists, allied health
professionals such as physiotherapists… To answer basic reference questions while upholding client confidentiality, privacy and safety To learn basic search techniques in Medline (PubMed.gov) and CINAHL (nursing/allied health)
Take the introductory quiz!
The introductory quiz: please complete the intro quiz BEFORE coming to the Feb. 25th class First, review materials in this handbook Then answer the ten (10) questions on the introductory quiz Beforehand, browse the medical terms listed in the glossary at the back of this handbook You can take the quiz as many times as you want but you need to achieve 7/10 to pass Share your insights and comments with others in the social café about the quiz
Instructor`s expectations & three small assignments = 15% value
If you follow my instructions, and do each small assignment (there are three[3] in total in the medical section), you will automatically get 75% (B) for the medical weeks; if you go beyond that, a higher mark is more than likely with some students getting an A or A+
The grade of A+ is given to students who strive for excellence After the introductory quiz, there are three short assignments worth 5 marks each Assignments get more difficult as we move through the medical weeks
Three (3) assignments in medical weeks = 15%
The three short assignments are discussed in this handbook 1. Reference assignment 2. Medline & CINAHL searching and 3. Website evaluation
I provide feedback after each assignment. Usually we have a class discussion about each. Ask questions before or after an assignment is graded. The learning should continue! I promise to grade all of your assignments in a timely way to make sure you learn the material.
Tip: Send a draft of any assignment to me before its due date to get my input/comments
“Medical libraries section: a handbook for LIBR 2195 students, 2015” —Page4
Class resources to help you learn more
PATHFINDER FOR MEDICAL SECTION OF LIBR 2195: http://hlwiki.slais.ubc.ca/index.php/LIBR2195:_Special_Topics,_Medical_Libraries_Section_2015
See the pathfinder and look at the words in the glossary at the back of this handbook. See if you can learn as much as possible about medical libraries and sources of medical information. We only have three weeks! You can look at the glossary to remember terms such as CISTI (see photo right), the National Library of Medicine, MEDLINE and MeSH. If these need more explanation, or if you have questions, please ask. After reviewing materials in this handbook, write the introductory quiz.
Think carefully before answering the questions on the introductory quiz. Post your comments about the quiz in the social cafe for extra marks. To pass the introductory quiz, get 7 correct answers out of 10.
. …Did you know that….Medical information is found in many of BC’s public,
college & university libraries …not to mention medical device and pharmaceutical companies, health
organizations and hospitals? To begin your exploration of medical terminology, take a look at the
dictionaries on the pathfinder.
The first part of LIBR2195 is dedicated to reference services in medicine. This is your opportunity to "sample" medical libraries and examine sources of information in medicine. Library technicians can take on all kinds of useful roles in providing health information. Similar to the practice of law, the best information in medicine is called the evidence: this is where we get the term evidence-based medicine!
Evidence-based medicine is an important part of health care. This is where library technicians come in. You may end up working in a non-health library, but you can learn how to answer simple health questions. This skill is a selling point in job interviews, no matter what library position you end up in. Most public, business, legal and special libraries take requests that require health information.
Any skills you learn in LIBR 2195 will be transferrable to your career. Library professionals play a direct role in helping physicians, nurses and other health workers find answers to improve patient care. This is the starting point for our discussion.
The National Library of Medicine (US)
The National Library of Medicine (U.S.) is the largest biomedical library in the world, and maintains several medical databases, including MEDLINE. Every American and Canadian medical school, nursing, dentistry, veterinary medicine or public health is required to have a medical library to support students. Most medical libraries are located close to the medical schools. The NLM maintains a freely-accessible
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library of journal articles called PubMed Central in addition to PubMed.gov and a consumer health website called MEDLINEplus. Countries like Australia, Canada and the United Kingdom have national medical libraries in medicine, though nothing quite like the size of the US National Library of Me dicine.
Reference services in medical libraries
Medical libraries are also called health libraries, hospital libraries, academic (usually university) health libraries. Medical libraries are located in hospitals and health organizations and try to meet the information needs of physicians, nurses, pharmacists, patients and researchers. Medical library technicians are responsible for the collection, organization and dissemination of health information.
Most if not all medical libraries provide access to PubMed, and teach library users how to search it for medical journal articles. An understanding of medical vocabulary is desirable when working with medical sources of information.
Medical libraries and library associations in Canada
Medical libraries in Canada are often found in universities and schools of medicine, at teaching hospitals and health programs in pharmacy, nursing and physiotherapy. Public libraries may have science departments with medical information. Medical librarians and library technicians in Canada belong to the Canadian Health Libraries Association/Association des bibliotheques de la sante du Canada which was founded in 1976. CHLA/ABSC (Canada) is an active library association with about three hundred (300) members. CHLA/ABSC publishes a journal in called the JCHLA/JABSC.
Powerpoints for February 25th class will be loaded into D2L
“Medical libraries section: a handbook for LIBR 2195 students, 2015” —Page6
REFERENCE QUESTIONS IN MEDICAL LIBRARIES:
Usually you are asked for simple facts, definitions, abbreviations
A diagnosis or a condition is presented; patient or physician wants in-depth information about diseases (and conditions)
User asks “what is” questions; what is this disease? What is this test?
What happens during my medical procedure? test?
Research questions Experimental treatments
Drug information, prescription & over-the-counter
Complementary and alternative medicine; herbal information
CATEGORIES OR TYPES OF REFERENCE QUESTIONS:
Personal health & wellness information Public health concerns (e.g., Ebola) & drug safety Diseases information & lab tests Online and print formats; free and “fee” based medical information Searching for reliable health websites & “Googling” for medical information
PROVIDE INFORMATION TO PATIENTS NOT ADVICE
DON’T PROVIDE ADVICE we provide information in medical libraries, not advice
RESPECT PRIVACY confidentiality in person and online
REFERENCE INTERVIEWS ARE IMPORTANT Be prepared for any emotions that might arise Be aware of the patron’s body language Be empathic, listen closely Use open-ended questions
“…the right information for the right person at the right time”
Anatomy of a question – breaking the ref question down:
Break the question down into parts What facets can you identify?
o Words, terms, roots o Greek & Latin prefixes, suffixes o Subjects, “areas” or domains
At what level is the question aimed? o layperson, low literacy, expert level
What format is needed? Is there anything else you can find out from the patron?
“Medical libraries section: a handbook for LIBR 2195 students, 2015” —Page7
Consumer health information
The consumer health information is part of a movement from the 1980s when citizen groups in the US lobbied for better funding and access to information. These citizen or consumer groups helped to push for more transparency in clinical trials, access to new drugs – and access to information.
Consumer health information makes it possible for consumers and patients to be informed and make better lifestyle choices. Medical librarians believe that information leads to empowerment of consumers and patients. Even though consumer health information is found online a lot of it is found in self-help books and pamphlets in libraries.
Public libraries usually have consumer health information in their collections. Public librarians and library technicians are trained to help find consumer health information. College and university libraries also have consumer health information in their collections.
MedlinePlus is the top consumer health website
http://www.nlm.nih.gov/medlineplus/
MedlinePlus.gov® is the top consumer health website in the world, and it is created by the National Library of Medicine (U.S.). Since 1998, MedlinePlus has provided links to information on diseases, conditions and wellness. It provides access to a medical encyclopedia and information about over-the-counter (OTC) drugs, prescription drugs, herbs and supplements. The site includes interactive tutorials, anatomy and surgery videos, current health news, various directories and links to sites maintained by government agencies and other authoritative sites. With no direct Canadian equivalent, MedlinePlus is a useful source of information for Canadian consumers as well.
Some key online sources for BC Libraries
BC HealthLink http://www.healthlinkbc.ca Cancer.gov - http://www.cancer.gov - From the National Cancer Institute. Extensive information
about types of cancer, clinical trials, statistics, and more.
ClinicalTrials.gov - http://clinicaltrials.gov - the National Library of Medicine's searchable database of clinical trials in which consumers may wish to participate.
FamilyDoctor.org - http://www.familydoctor.org - American Academy of Family Physicians websites for the whole family.
Health Canada – http://www.hc-sc.gc.ca/ Health Canada deals with prevention and health
promotion to improve the quality of life.
KidsHealth - http://kidshealth.org/
Lab Tests Online – http://www.labtestsonline.org MedlinePlus Labs Tests - http://www.nlm.nih.gov/medlineplus/laboratorytests.html
Merck Manual of Diagnosis & Therapy - http://www.merck.com/mmpe/index.html
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Merck Manual of Geriatrics - http://www.merck.com/mkgr/mmg/contents.jsp
NIH Senior Health - http://nihseniorhealth.gov - the National Institutes of Health's web site for seniors and their care givers.
ToxTown - http://toxtown.nlm.nih.gov/ - the National Library of Medicine's web resource for consumers to understand toxins in their environment.
Yucky Discovery - http://yucky.discovery.com
Canadian Portals To Access Medical Information
Easiest literacy & multilingual
BC Health Guide http://www.healthlinkbc.ca
Portals and gateways
Health Canada (French & English) http://www.hc-sc.gc.ca/ Public Health Agency of Canada http://www.phac-aspc.gc.ca/
Food and Drug Administration (FDA) http://www.fda.gov/
Consortia
e-HLBC http://ehlbc.ca/ ELN (B.C.) http://www.eln.bc.ca/dbs/select.php
Association websites
Canadian Health Libraries Association (CHLA/ABSC) http://chla-absc.ca Consumer and Patient Health Information Section http://caphis.mlanet.org/
Condition-specific
Canadian Diabetes Association http://www.diabetes.ca/ Heart and Stroke Foundation http://www.heartandstroke.bc.ca/
See more resources on the “PATHFINDER FOR MEDICAL SECTION OF LIBR 2195” http://hlwiki.slais.ubc.ca/index.php/LIBR2195:_Special_Topics,_Medical_Libraries_Section_2015
“Medical libraries section: a handbook for LIBR 2195 students, 2015” —Page9
Assignment #1—select five reference questions for five (5) marks
Please answer five questions for five marks on assignment #1. Use the pathfinder to examine sources, then select five questions from the list below. Select two resources you used to answer each question.
PATHFINDER FOR MEDICAL SECTION OF LIBR 2195: http://hlwiki.slais.ubc.ca/index.php/LIBR2195:_Special_Topics,_Medical_Libraries_Section_2015
1. I would like to view some human anatomy drawings. Where can I start?
2. I need a definition for anemia. Can you recommend a good print dictionary that defines it?
3. What is the Canadian Institute for Health Information (CIHI), and what does it do?
4. What does body mass index (or BMI) mean anyway?
5. I am concerned about diabetes and whether my father has it. How is it diagnosed?
6. I need a definition for and origin of Down's syndrome. What is it?
7. My grandfather has gout. Can you find information in Chinese?
8. What does it mean when someone has a high hemoglobin level?
9. What does it mean to have high blood pressure? Do I have it?
10. I need information about the HPV vaccine. Is it considered safe?
11. I have insomnia. Are there alternatives to sleeping pills? As in a supplement or tea?
12. My mother is having a hip replacement. Do you have any videos about the surgery?
13. What does melanoma look like? I need some free photos to share with my friend.
14. My doctor says I have early signs of osteoporosis. What treatments are available?
15. My elderly mom needs an overview of ‘shingles’ and it should include photos.
16. Can you help me find some background on “Munchausen’s syndrome by proxy”?
17. What are the benefits of yoga? Does it really lower heart-rate?
18. Who is the current federal Minister of Health?
19. Does Canada have universal health care or not? How can I prove it?
20. What is the name of the journal published by the Canadian Medical Association?
You can always ask me for assistance or get feedback before you hand in an assignment, Dean.
“Medical libraries section: a handbook for LIBR 2195 students, 2015” —Page10
Literature searching in medicine
Powerpoints for March 4th class will be loaded into D2L
Literature searching is the most important activity in a medical library as this is how most physicians upgrade their knowledge. Generally, physicians stay up-to-date with current advances by reading what has just been published in professional medical journals like the big four: the British Medical Journal (BMJ), Lancet, the Journal of the American Medical Association (JAMA), and New England Journal of Medicine (NEJM). Have a look at some articles published in the top four me dical journals.
Some journals are quoted in major news services like Reuters, Google News, Yahoo News and even the CBC. Sometimes patients ask you about medical journals, and how they can find these articles. The medical literature is not only for health professionals nowadays.
Nurses and pharmacists do a lot of browsing of the journal literature. Nurses depend on reading widely, scanning journals, professional websites and textbooks. Nurses may even need to search for information for consumers and patients. Nurses are frequent users of libraries, and are skilled in using the Web.
What is PubMed.gov?
Welcome to the unit on searching for medical articles, sometimes called medical research. Our exploration will help you to learn how to find articles using indexes and databases such as PubMed.gov and CINAHL - two of the most important health information resources. Let's begin with PubMed.gov, a service of the National Library of Medicine (remember NLM from the glossary?) in the United States. PubMed includes over 24 million citations in MEDLINE and other science journals back to the 1940s (and, recently, even farther back due to retrospective indexing). PubMed includes links to full text and other resources, not to mention lots of genetic information (ie. genome information).
Start by reading NLM's helpful PubMed factsheet. Notice that NLM provides links to other useful tools for medical information? PubMed is free of charge and provides coverage of the biomedical literature
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internationally. Notice you can search OLDMEDLINE? We don't discuss it but keep in mind that you can search old medical articles back to 1879! On the factsheet, read the section PubMed is Easy to Use and focus on the first paragraph. Your instructions? Simply type in your keywords. Try a few searches!
Exploration is important when learning how to search for medical articles. A helpful page about PubMed is UBC Library's information page here.
PubMed searching for Library Technicians
Here are the powerpoints for this class (which you can download)
PubMed searching - LIBR2195
Basics of searching - nursing and allied health
Many nurses and allied health professionals - lab technicians, respiratory therapists, physiotherapists and music therapists, etc. - search CINAHL to find medical information. What does CINAHL stand for? Keep in mind that allied health professionals use PubMed, Google Scholar and Google to get a more complete view of their topics. The benefit of free search tools is fast, efficient web searching. They provide nurses and other health professionals with access to websites, useful (some not so useful) information and plenty of material to evaluate. Just don't use the Web for literature reviews. Beware!
The databases that libraries subscribe to contain reliable peer reviewed content.
In Medline, these articles provide access to medical evidence which is used to treat individual patients.
Some search engines like Google and Bing are better suited to answering questions when you need to: 1) find something specific or in locating a known-item (ie. needle-in-a-haystack; and for 2) browsing the Internet. Search engines do not replace medical databases like CINAHL or MEDLINE because they are not properly indexed. Search engines are a good supplement to information found in Medline and CINAHL.
What is CINAHL on EBSCO?
CINAHL provides coverage of the nursing and allied health literature from 1982 to present. It covers 1800+ journals, books, pamphlets, dissertations, audiovisuals, etc. in nursing, allied health disciplines, consumer health, biomedicine, alternative therapy and even health sciences librarianship.
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Langara College Library - and many universities in B.C. and across Canada - purchase CINAHL via the EBSCO platform. What is the difference between a platform and a database? CINAHL on EBSCO provides access to full text from selected journals, standards of practice, practice acts, critical pathways, research instruments, and government publications. Unique CINAHL records include legal cases, drug records, accreditation records, and clinical innovations.
The CINAHL database is multi-disciplinary with over 1,000,000 records and coverage of 18 languages. It's an excellent source of information for nurses and allied health professionals but also for other professionals like psychologists and teachers. For more information about CINAHL read the handout prepared by the Langara College Library here. You may have other questions, once you scan the handout. It is important you read the handout thoroughly and do the various activities for your understanding.
The CINAHL handout will take you through searches by author, title and subject just as we did for PubMed. Notice the links will take you to CINAHL via EBSCO and other databases at Langara Library. Look at some other databases if you have time. Tell me about what you found.
In addition, here is a 4-minute basic CINAHL search tutorial developed by EBSCO to provide you with more assistance. You can also always contact me via e-mail.
As we have learned, Medline is a comprehensive index to journals in medicine and is available to search via PubMed. You can also search Medline via EbscoHost. If you want to try a third interface, try the OVID platform. It's my favourite~! Dean
“Medical libraries section: a handbook for LIBR 2195 students, 2015” —Page13
Assignment #2 – Search assignment (5 marks)
Instructions
For assignment #2, select two (2) questions from the list below State what you believe a doctor or nurse or HR manager needs based on the question
o Once you decide, state the research need as a question and include it on your assignment
List the MOST important search terms for your search in logical order Will you use keywords and/or index terms (MeSH, CINAHL headings) What limits will you use (usually English, humans, abstracts) Will you limit to reviews? randomized controlled trials? Document your search and send it to me as a Word document with the subject LIBR 2195
Search assignment I
Select two (2) of the following for your assignment:
1. A physician comes to see you in the library. He needs randomized clinical trials (RCTs) published since 2010 that show Effexor is an effective drug to treat depression. He isn’t sure what the risks are in prescribing Effexor. Can you find some information to help the physician? Get some background on the pathfinder (tell me what you found) and then focus on searching MEDLINE and CINAHL. Use additional medical databases and Google Scholar if you want.
2. A nurse is doing research on nurse burnout. You suggest a review of the research. She needs American and British research because she has found Canadian research. Supplement your answer by searching one or two nursing websites and then focus on MEDLINE and CINAHL. You can use other medical databases and Google Scholar if you want.
3. An arthritis physician wants to see evidence that acupuncture is effective for arthritis. She wants to know if a “systematic review” (a type of LIMIT or publication type) has been done. To start, use one or two arthritis websites to supplement your answer and then focus on MEDLINE and CINAHL. You can use other medical databases and Google Scholar if you want.
4. The hospital human resources manager needs literature (last three years) to compare costs of ACE Inhibitors (hypertension drugs). You might want to supply background print information on hypertension drugs to supplement your answer (tell me what you found) and then focus on MEDLINE and CINAHL. You can use other medical databases and Google Scholar if you want.
You can always ask me for assistance or get feedback before you hand in an assignment.
Send me an e-mail ~Dean
“Medical libraries section: a handbook for LIBR 2195 students, 2015” —Page14
An introduction to complementary and alternative medicine (CAM)
Welcome to this introduction to complementary and alternative medicine (CAM). I recommend you read this introduction on my wiki. For those interested in National Public Radio, I recommend listening to this this (4 min.) news story on the risks associated with "kava kava", a well-known supplement. It discusses it within the context of a landmark study of the use of CAM.
The area of treatment using complementary and alternative therapies is sometimes viewed unfavourably by doctors. And yet, it is very popular among consumers and patients. For patients with problems that cannot be cured by conventional or Western medicines, CAM gives them some hope for a happier, healthier life. What are some of these alternative practices? Remedies that lie outside the mainstream include acupuncture, aromatherapy, herbal supplements, massage, meditation, reiki, vitamins, yoga and prayer.
An introduction to CAM for Library Technicians
Here are the powerpoints for the March 11th class will be loaded into D2L.
CAM for library technicians: sources of information
Complementary & Alternative Books
This module is intended to introduce you to a variety of print sources of information in complementary and alternative medicine, as well as the major types of CAM therapies (list below). I've selected websites, print and eBooks to review; since you may have some difficulty reviewing these sources physically in libraries or in bookstores, you can follow the links and view some of the pages and bibliographic details instead. Read some of the available sections inside these books via Google Books, Amazon or Barnes and Noble (U.S.) Book reviews, readers' comments, etc.! You can also search for books in Google Print. It is important (and a part of your education) to go to a library and examine some print materials. Try your local public library; look at the access points, subject access, and other information in the catalogue. What types of subject headings are used; popular authors; publishers and call numbers. Do you have some observations that you can share with your classmates? I've included controversial sites such as Male Pregnancy and Bee Sting Therapy. If you get a patron asking for your opinion about some of these controversial websites, what will you do?
The Canadian encyclopedia of natural medicine The complementary and alternative medicine information source book, Alan M. Rees Complementary Medicine for dummies Gale Encyclopedia of alternative medicine The handbook of clinically tested herbal remedies Veterinary herbal medicine Zen shiatsu: how to harmonize yin and yang for better health
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Other helpful CAM websites
BC Cancer Agency Library: Recommended Websites BCCA's Complementary and Alternative Cancer Therapies webpage Health Canada: Reporting Adverse Reaction to Drugs and Other Health Products NCCAM website - good, basic information CAM on PubMed search for clinical trials Nursing Indexes (Langara) MedlinePlus CAM topics - browse for specific topic International database on dietary supplements - free citations
Glossary of CAM terms
Acupuncture ("Ack-you-punk-sure") is a method of healing developed in China 2,000 years ago. Today, acupuncture refers to a range of procedures involving stimulation of anatomical points on the body. American practices of acupuncture incorporate medical traditions from China, Japan, Korea, and other countries. The acupuncture technique most studied scientifically involves penetrating the skin with thin, solid, metallic needles that are then manipulated by the hands or by electrical stimulation.
Aromatherapy ("ah-roam-uh-THER-ah-py"): involves the use of essential oils (extracts or essences) from flowers, herbs, and trees to promote health and well-being.
Ayurveda ("ah-yur-VAY-dah") is a CAM alternative medical system that has been practiced primarily in the Indian subcontinent for 5,000 years. Ayurveda includes diet and herbal remedies and emphasizes the use of body, mind, and spirit in disease prevention and treatment.
Chiropractic ("kye-roh-PRAC-tic") is a CAM alternative medical system. It focuses on the relationship between bodily structure (primarily that of the spine) and function, and how that relationship affects the preservation and restoration of health. Chiropractors use manipulative therapy as an integral treatment tool.
Dietary supplements The U.S. defined "dietary supplement" in the Dietary Supplement Health and Education Act (DSHEA) of 1994. A dietary supplement is a product (other than tobacco) taken by mouth that contains a "dietary ingredient" intended to supplement the diet. Dietary ingredients may include vitamins, minerals, herbs or other botanicals, amino acids, and substances such as enzymes, organ tissues, and metabolites. Dietary supplements come in extracts, concentrates, tablets, capsules, gel caps, liquids, and powders. They have special requirements for labeling.
Electromagnetic fields (EMFs, also called electric and magnetic fields) are invisible lines of force that surround all electrical devices. The Earth produces EMFs; electric fields are produced when there is thunderstorm activity, and magnetic fields are believed to be produced by electric currents flowing at the Earth's core.
“Medical libraries section: a handbook for LIBR 2195 students, 2015” —Page16
Homeopathic ("home-ee-oh-PATH-ic") medicine is a CAM alternative medical system. In homeopathic medicine, there is a belief that "like cures like," meaning that small, highly diluted quantities of medicinal substances are given to cure symptoms, when the same substances given at higher or more concentrated doses would actually cause those symptoms.
Massage ("muh-SAHJ") therapists manipulate muscle and connective tissue to enhance function of those tissues and promote relaxation and well-being.
Naturopathic ("nay-chur-o-PATH-ic") medicine, or naturopathy, is a CAM alternative medical system. Naturopathic medicine proposes that there is a healing power in the body that establishes, maintains, and restores health. Practitioners work with the patient with a goal of supporting this power, through treatments such as nutrition and lifestyle counseling, dietary supplements, medicinal plants, exercise, homeopathy, and treatments from traditional Chinese medicine.
Qi gong ("chee-GUNG") is a component of traditional Chinese medicine that combines movement, meditation, and regulation of breathing to enhance the flow of qi (an ancient term given to what is believed to be vital energy) in the body, improve blood circulation, and enhance immune functi on.
Reiki ("RAY-kee") is a Japanese word representing Universal Life Energy. Reiki is based on the belief that when spiritual energy is channeled through a Reiki practitioner, the patient's spirit is healed, which in turn heals the physical body.
Therapeutic Touch is derived from an ancient technique called laying-on of hands. It is based on the premise that the healing force of the therapist affects the patient's recovery; healing is promoted when the body's energies are in balance; and, by passing their hands over the patient, healers can identify energy imbalances.
Traditional Chinese medicine (TCM) is the current name for an ancient system of health care from China. TCM is based on a concept of balanced qi (pronounced "chee"), or vital energy, that is believed to flow throughout the body. Qi is proposed to regulate a person's spiritual, emotional, mental, and physical balance and to be influenced by the opposing forces of yin (negative energy) and yang (positive energy). Disease is proposed to result from the flow of qi being disrupted and yin and yang becoming imbal anced. Among the components of TCM are herbal and nutritional therapy, restorative physical exercises, meditation, acupuncture, and remedial massage.
“Medical libraries section: a handbook for LIBR 2195 students, 2015” —Page17
Complementary and alternative medicine is popular!
Complementary and alternative medicine (CAM) is a very popular area of medicine and health care. While many benefits exist for patients in using CAM, some problems result from using herbal remedies and alternative treatments. Library technicians need to know about CAM. Many patients buy CAM products without speaking to their health care providers. Some patients will come to the library to ask library staff for help. You will need to know how to help these patrons, and how to find, assess and/or evaluate websites using simple evaluation criteria, which we will examine.
According to the National Center for Complementary and Alternative Medicine, there are five (5) CAM domains. In Canada, we have Health Canada which oversees herbals and supplements via the Drugs and Health Products Directorate.
Many medical professionals encourage patients to visit naturopaths or holistic healers, but some don't (for information about naturopathy, see the BC Naturopathic Association). Some doctors view chiropractors as CAM practitioners and the debate for and against chiropractic care is seen as healthy for the profession.
In terms of supplements, CAM is a multi-billion dollar business in Canada and the U.S. But misleading information is a big problem, especially in unethical promotion and selling of CAM products over the Web. Use the phrase caveat emptor (buyer beware) to remind library patrons about buying products over the Web. (For a good overview and FAQs, see here.)
Some physicians feel that CAM needs independent monitoring. Quackwatch is a well-known site used to alert patients about questionable or suspicious medical practices - known as quackery. Some librarians don't like the overall mission of Quackwatch and say that doctors who operate it are biased and overstate the case against CAM. What do you think? (Here's a typical FDA warning.)
Is CAM always safe? How does the request for information in this area affect libraries?
There are many reasons why consumers and patients use CAM. We explore these during the week's activities. Due to poor quality of many products sold in drugstores and health stores, and few reliable scientific trials, there are problems with policing CAM in Canada. Health Canada is responsible for ensuring all products for sale here are safe for consumers. This is where the principles of evidence -based medicine may help CAM establish scientific credibility, and prevent needless problems for consumers.
Library technicians who encounter reference questions about CAM are advised to be cautious about the web, and to issue disclaimers even with their print collections used in reference. Any consumer taking prescribed medications should inform their doctors about any CAM products or procedures they are using. Some prescription drugs, for example, interact with simple foods like
grapefruit and herbs, and can cause adverse reactions. (Health Canada has a good overview.)
“Medical libraries section: a handbook for LIBR 2195 students, 2015” —Page18
Library technicians should be acquainted with the general issues of CAM that have an impact on consumers and patients. When providing health information in general (and not just specifically CAM) it is important to lead users to the most reliable information. Sometimes, the reference interview includes helping consumers to recognize unsafe practices and dangerous websites. Some CAM practices that promote cures (where none are likely) or sites with miraculous claims may conflict with conventional medicine.
Library technicians can always direct consumers back to their health care professionals for advice and/ or assistance. Library staff have a great fallback position – see your doctor! Or simply “I can get information for –then you need to see your doctor”. Sometimes, due to a diagnosis of a complex (or terminal) illness, patients can be desperate for information. Generally, they want information in an easy to read and understand format. This is why search engines can be problematic for patients if they are in distress, and if they are desperate to find help in the form of information that applies to them.
Similar to what you see in law, the range of reliable (and unreliable) information sources is considerable. It is therefore essential for library techs to know how to help patrons assess and evaluate websites. Helpful tips will enable consumers and patients to use simple evaluation criteria to lead to authoritative, reliable, trustworthy information. This is an important function in a medical library.
We will discuss this in more detail in class.
Glossary of Medical Library Terms
HERE ARE a few useful terms for THE QUIZ! Pay special attention to words in italics.
View this understanding medical words tutorial. (More about medical words here.)
Abbreviations - medicine is full of abbreviations. Some tools decode abbreviations. A database like MEDLINE has abbreviations for many journal names (BMJ for the British Medical Journal), diseases like AIDS, viruses such as HIV, avian flu (H5N1), etc. Trying to find an abbreviation can be a challenge. Look them up Abbreviations including journal abbreviations on the wiki.
For the use of mobiles in medicine, see the wiki: Apple iPad for physicians | Google Android for physicians | Information technology topics | iPhone5 for physicians | mHealth
Article is the main vehicle which is used to convey new research in scientific journals. Health professionals read research in their favourite journals.
Boolean operators - AND, OR and NOT are used to combine search terms to broaden or narrow results. They are used in Medline to refine results and even in Google Scholar.
Caduceus - pronounced ca-doo-see-us, many "medical" organizations use the symbol of a rod entwined by two snakes and topped by a pair of wings. Its origins are in Ancient Greece, and the caduceus symbolizes the practice of medicine itself. (See the caduceus top right.)
“Medical libraries section: a handbook for LIBR 2195 students, 2015” —Page19
CISTI the Canada Institute for Scientific and Technical Information in Ottawa was for many years considered Canada's de-facto "national library of medicine" but is now simply one library dealing with sources in science, technology, engineering and medicine.
Consumer health - we are all consumers when we go to a doctor. In libraries, consumer health is the provision of information for health consumers. In hospitals, consumers are the general public . When you become a patient, you are part of “patient care”.
Complementary and alternative medicine (CAM) - referred to as 'CAM', this area of modern medicine is controversial for some but very popular among patients when conventional Western medicine has no answers. Remedies outside mainstream medicine may include acupuncture, herbal remedies and massage to meditation, yoga and prayer. There are five domains of CAM according to NCCAM.
eHLBC - a BC provincial library consortium of health and post-secondary institutions called the electronic Health Library of BC. Langara College is a participating member. eHLBC provides access to EBSCO CINAHL and other health databases like the psychology database, PsycINFO.
Eponyms - diseases named after a doctor who discovers them (ie. Down's syndrome) are called eponyms. They are very common in medicine and lead to the first articles written by the physician who discovers something. Who Named It? is a free eponym dictionary.
Google - since 1998, physicians and other health professionals search for information on the Internet. In 2004, Google got into academic searching by creating Google Scholar.
NLM - The U.S. National Library of Medicine in Bethesda Maryland is referred to as "NLM" and is the largest medical library in the world. The NLM creates Medline via PubMed and MedlinePlus® for consumers.
MEDLINE via PubMed.gov - is the world's largest medical index and is freely searchable on PubMed, the public interface to MEDLINE.
MeSH - Medical Subject Headings (MeSH) are assigned to articles in MEDLINE. MeSH are helpful when searching medical topics. Articles assigned MeSH terms are designated as either MAJOR or MINOR descriptors, which help to improve your search precision.
Peer-reviewed journals - articles submitted to important medical journals are peer-reviewed by experts before they are published. Almost 90% of the journals indexed in Medline are peer-reviewed.
Residents - After a medical degree (M.D.), physicians do a residency where an area of medicine is studied in detail for four to five years. During this period, these doctors are called residents. Residents are heavy users of libraries and the research literature. They work long hours and deal with many sick patients, usually in hospitals or clinics.
“Medical libraries section: a handbook for LIBR 2195 students, 2015” —Page20
Statistics Canada - produces information about the health of Canadians. For statistics about the health system, try the Canadian Institute for Health Information (CIHI). Another organization producing statistics is the World Health Organization
Assignment #3 CAM website evaluation
Keep your evaluation to 1-2 pages. Value: 5%
In health libraries, the ability to quickly and accurately assess and evaluate the reliability of consumer websites is a core skill. After a while, you start to see a variety of websites and learn to trust a few such as MedlinePlus. With patients, you issue warnings about websites and add: ask your doctor!
Your assignment is to select a consumer or CAM website and write an evaluation of it. I post the instructions for this assignment in Week 12. You are asked to focus on the subject covered, authority (who writes content), coverage and range of topics discussed, whether the site is updated regularly, and whether a solid scientific basis seems to be provided, or whether it’s mostly like an infomercial.
Your job on this assignment is to select a consumer or CAM website, and evaluate it in 1-2 pages using one of the criteria I discuss in class. You will want to be highly critical while pointing out the aspects of the website that are useful, or helpful.
Select one of the websites on the Top Ten Consumer Websites (U.S. Medical Library Association's list) or any of the Top 10 Canadian Health Websites 2014.
These sites are highly recommended; the goal of this assignment is to highlight websites that are among the best consumer websites and to think about why they are the best.
Determine why you believe that these websites are good sources of information, or why you believe they need improvement (ie. functionality, web design, etc.) I encourage critical appraisal!
Evaluation of information is a challenge for all of us working in health libraries. But even if you don't know whether the information you provide to a patron is accurate, point out that it was written by a well-qualified professional (from a nurse, doctor, pharmacist or association) or is taken from an authoritative source (books, journals, PubMed, etc).
Following one of the criteria mentioned (ie. BC Cancer, HON) will provide structure for your evaluation. You can follow one list or two - try to add your own creative elements if and where you feel it is needed.
Please ask for further assistance. I hope this is an enjoyable experience! I look forward to reading your
evaluations. Keep your evaluation to 1-2 pages. "Brevity is the soul of wit" – Shakespeare
You can always ask me for assistance or get feedback before you hand in an assignment.
Send me an e-mail ~Dean