Evidence, Bias, and Use…Oh, My! (MLA12 Seattle: Complementary and Alternative Medicine Section)

So at the meeting, librarians present their papers that were accepted to the conference.  These are organized into groups of four sponsored by one of the MLA’s sections.  I’m pleased to say that on Monday I made it to an entire session.  Complementary and Alternative Medicine includes everything from yoga to special diets (veg*nism, gluten-free) to acupuncture to traditional Chinese medicine to etc….  I appreciate CAM because it tends to look at the patient as a whole instead of just the diseased body part.  Plus I was curious as to what the presentations would have to say.  One thing that it is important to know.  Cochrane is a database of systematic reviews.  A systematic review is a study of the studies done.  It then summarizes what we know so far.  Think of it as centralized scientific study information.  The other thing to know is that in Western medicine, a treatment is come up with and then tested before it is used with people.  In CAM, the treatments are already in practice, so traditional randomized control trials (RCTs) used in Western medicine aren’t super-applicable.

“Cochrane Complementary and Alternative Medicine Systematic Reviews: An Analysis of Authors’ Comments on the Quality and Quantity of Evidence and Efficacy Conclusions” by Robin A. Paynter

• CAM limited by RCT-driven evidence-based practice
• 10% of database are CAM topics
• Cochrane has a project to develop a classification scheme of CAM topics.
• 47 out of 53 Cochrane groups have at least one review on a CAM topics
• Treatment ares cover everything from vitamins to yoga
• dietary intervention has 37 studies
• Cochrane expresses concern over poor study designs.
• Difficult to determine active content in plant-based meds
• Significant groupage of comments around insufficient evidence and no effect.
• cross-cultural issues

“Alternative Research Education in a Post-R25 World: Assessing Acupuncture and Oriental medicine (AOM) Student Attitudes Toward Research and the Scientific Method” by Candise Branum

• Acupuncture and Oriental Medicine–AOM
• R25 grants intend to develop research literacy and view research as a bridge between Western medicine and CAM
• Acupuncture Practitioner Research Education Enhancement (APREE)
• AOM student interest in research declined with years in school, a 2006 study found
• Do students recognize the benefits of AOM research? Overwhelming yes.
• Students at schools without dedicated research departments were very unsure about the impact of research.
• Feelings about research slope toward the negative over time.
• Students see the benefits of research but that doesn’t necessarily mean they like it
• A lot of students want to stay alternative and not become complementary
• If they don’t want to be attached, they’re not gonna want to use the bridge of research.

“Complementary and Alternative Medicine’s (CAM’s) Research Agenda and Its Unique Challenges” by Jane D. Saxton

• In 2007: 38.4% of adults used CAM over the previous 12 months.  Also, adults spent $33.9 billion out of pocket on CAM.
• NIH funding to CAM is only 0.5% of the overall budget.
• CAM is individualized not standardized.  (It’s adjusted to fit the patient not one standard applied to all patients).
• Whole Systems Research (WSR) is a term coined in 2002.  It is an approach to studying non-linear, whole systems of care.
• Use of pragmatic RCTs: measure effectiveness, don’t use placebos, patient-centered outcomes (transformational change)
• CAM is the opposite of Western meds.  The treatment is already in use, whereas Western medicine is proposed, tried, then used.
• You don’t need to know the biological mechanism in order to know its effectiveness.
• MeSH terms currently available: complementary therapies, nonlinear dynamics, systems integration
• We need more funding, different approaches, Whole Systems Research!
• Please take a moment to check out the libguide of this presentation.

“Hitchhiker’s Guide to One Corner of the Complementary and Alternative Medicine (CAM) Universe” by  Ron LeFebvre

• Vitalists are more interested in information (they “know” it works).
• Empiricists value EBM but may not be great at finding what they’re looking for.
• Chiropractors don’t like to be associated with medicine.  Use terms like “health care” and “practice” with them.
• A good chiropractic search string: spinal manipulation OR chiropractic OR manual therapy
• New graduates are more likely to be EBP savvy.
• “There’s nothing that makes you more skeptical about research than studying it.”
• There is no widely-used, well-regarded point-of-service tool to serve chiropractic interests specifically.  They do use Dynamed though.
• PEDRO–database for physical therapy/exercise therapy that is also useful to chiropractors

Q and A

• Diet is odd.  Sometimes it is viewed as an alternative medicine, sometimes not.  If it’s a non-western diet, though, it’s considered alternative.
• NIH funded PROMIS is focused on patient-reported outcomes, particularly in treating anxiety/depression.
• N-CAM databse has outcome scales and measures

Statistical Literacy and Techniques in Library Research and Practice (MLA12 Seattle: Research Section)

So at the meeting, librarians present their papers that were accepted to the conference.  These are organized into groups of four sponsored by one of the MLA’s sections.  I was a bit late to the Research Section, since I got caught up at the poster exhibit, but here are my notes for the two presentations I did see that day.

“The Analysis and Translation of Unpublished Health Sciences Data: Extra Innings for the Library Profession” by Wallace McLendon, David Potenziani, and Susan Corbett, AHIP

• The ability to use data to answer questions brings more work to library.
• When people say they want to access data, they really want the information that can be derived from it.
• analytics: reactive vs. proactive
• Libraries hold and curate data. Expand that to analysis.
• Do more to reach administrators in terms of competitive intelligence.
• Don’t define your job too narrowly.

“Hitting a Home Run: Statistician Consults at the AG-VET MED Library Improve Research Design Quality” by Ann Viera

• Medical libraries are partnering with statisticians.
• Librarian-statistician partnership to improve research design.
• The alternatives search was occurring too late in the process to improve animal welfare.  This frustrates the librarian and angers the researcher.
• Access to statistical reports needs to be happening earlier in the research program.
• Consulting on stats improves animal welfare.
• Having the statistician in the library improves the concept of library as space.
• Providing access to the statistician protects faculty from becoming overburderned.
• Do it right or do it over (in research and construction).
• Doing the research before designing the study helps you design the study correctly the first time.

The Slow Hunch (MLA12 Seattle: Plenary 2: McGovern Award Lecture by Steven Berlin Johnson)

After the president’s lecture (and a break) came the John P. McGovern Award lecture.  This was, I have to say, my favorite presentation at MLA12.  Steven Berlin Johnson is the author of popular science books aka science for the layman aka one of my favorite genres!  I was super-excited to get to hear him speak and honestly, his intelligence and wit are even more evident in person.  His books that were referenced in the lecture include: Where Good Ideas Come From: The Natural History of Innovation and The Ghost Map: The Story of London’s Most Terrifying Epidemic–and How It Changed Science, Cities, and the Modern World.  I now present to you my notes from his amazing lecture that I like to call “The Slow Hunch.”

The Eureka Moment Myth

• Truly disruptive ideas do not have a eureka moment.  The eureka moment is a myth.  The best ideas almost always start as a hunch.
• Oftentimes, the external conditions need time to catch up to the idea.
• Darwin had the theory of evolution before he realized it.
• Commonplace Book–collection of quotes that mean something to the owner.  They’d then reread them and out of this their own intellectual sensibility would take shape.

How Coffee Changed the World

• What environments support collaboration and fluidity of ideas?  Liquid networks, such as libraries and coffee houses.
• Almost every key breakthrough in the Enlightenment featured a coffee house.
• It is no accident that as the population went from imbibing a depressant (alcohol) to a stimulant (coffee), the Enlightenment happened.
• There is a lot of diversity of people in a coffee house.

The Evolution of Ideas

• An idea is a network of other ideas brought together in a new configuration.
• exaptation–some feature/trait/aptitude that evolves for a specific purpose but serendipitously turns out to be good for something else when the environment changes (wings for warmth work for flying)
• Exaptation often happens when one industry takes something from another industry, adapts it, and uses it in their own. (Use of wine presses for printing)

The Key to Innovation

• We will be smarter and better as a society if we surround ourselves with those who are different because it provides the opportunity for exaptation.
• The more innovative group has connections to different careers than their own. (Don’t just be friends with librarians)
• Make twitter your diverse coffeehouse.  If you just follow people just like you, you get an echo chamber.  Value diversity because of the openings it allows us.

Information Should Be Open

• Value connecting information over protecting information.
• 311 is a city concierge.  People can call and report problems and also ask for information from it.  Meanwhile, the city is gathering data from the citizens who call.  The city is sharing information but also is taking in information.  This democratizes and diversifies problem-solving.
• Open information architecture rives innovation.
• Chances favors the connector.

Q and A

• Remind people that surprise and serendipity is happening with the new information tools.  It doesn’t just happen when browsing physical stacks.
• Core ideas are ideas that were simultaneously and independently discovered within the course of two to three years.  This happens because of the adjacent possible.  The adjacent possible is possible moves you can make at that moment in time.  The possibilities are limited.  You couldn’t invent computer programming before computers.  Thus when something in the world changes, the adjacent possible changes, leading to core ideas.
• Create a culture of amateur inventors and innovators (lay experts).
• Release early, release often.
• There is a non-linear relationship between population size and innovation (10x population size = 17x innovation).  The thing to remember in modern times, though, is that the internet is big-city-like.

Anger Can Be Power (MLA12 Seattle: Plenary 1: President’s Address by Jerry Perry, AHIP)

Right after the new member’s breakfast was the first plenary session.  The president’s address.  I realized as soon as I saw him onstage that I had actually chatted with him at the new member’s breakfast.  He was so friendly and personable!  But he’s also intelligent and a game-changer.  I’m glad I got the chance to both meet him and listen to his speeches.  (Yes, speeches. The other was at the awards luncheon).  Perhaps what impressed me the most, though, was that Perry’s speech addressed a topic that was already on my radar.  Enough of my intro, though, here are my notes from the address.

• Embrace a love of reinvention.
• Create a legend around yourself.
• Don’t look back. Something might be gaining on you.
• Love what you do.
• We need to get angry at the hand-wringing that is going on within the profession.  We are in fact doing that great American thing of reinventing and staying current.  We know we are changing and staying current, so it is more than ok to have righteous indignation at “the end is nigh” talk.
• Anger can be power, and you know you can use it.

How could I not love an MLA president who tells us it’s ok to have righteous anger?

Friday Fun! (Get Your Geek On)

Hello my lovely readers!

I have super-exciting news!  This weekend I’m attending my first ever work conference, specifically the Medical Library Association’s 2012 conference in Seattle.  This is going to be so many firsts for me!  My first business traveling, first stay at a 5 star hotel, first time outside of the airport in Seattle (or on the west coast period), and first time where I will be completely surrounded by other medical librarians. In other words, no one will be saying, “I’ve never heard of a medical librarian” or asking, “So what do you do all day?” I alas doubt I’ll have much time to see very much of Seattle, although I fully intend to hit up at least one, maybe two, of their famous veg-friendly restaurants.  I also will be flying a grand total of approximately twelve hours, so definitely expect to see an upswing in reviews around here when I get back.   Thank goodness I invested in that kindle last year!

And yes I am sitting here getting excited about tons of things people outside of my field have never even heard of being discussed at the poster sessions and plenary sessions and sunrise meetings.  I mean, I did pick a career I *enjoy*, people.

Also, the hotel has a rocking gym I plan on utilizing, not to mention a bathtub which is always a luxury for me, the lady whose apartment only has a shower stall.  Plus the awesome host librarians organized a sunrise yoga session. Yes.

So it’s a big, exciting weekend with lots of air time (yes, it takes 6 hours to fly nonstop from Boston to Seattle), so I will be getting lots of reading done.

I hope you all have lovely weekends and cross your fingers for me that I won’t get lost in my smart-phoneless state!

Friday Fun! (New Job! *Confetti*)

Hello my lovely readers!

I am so incredibly happy to get to give you all a big update in the life of moi this week.  Tuesday morning after the long weekend, I got a phone call offering me my first professional librarian job!!! Although I’ve been doing the work of a librarian for quite some time now, this position actually requires an MLIS and is in the exact same area of librarianship as my interests.  I don’t like to name exactly where I work on this blog, because this blog represents just me and not my workplace.  Suffice to say, then, that I will be working in educational librarianship in a library that supports one of the medical schools in the Boston area.  The library is the ideal mix of medicine and academia, and I’m so stoked to start work there in mid-March.

This of course means that my life over the next couple of weeks and at least through March is going to be crazy (crazy in a good way).  I’ll have a new schedule, new commute, new health insurance, new paycheck schedule, new….well everything!  It’s all wonderfully exciting and still kind of hard to believe after over a year of job hunting.

Of course this means that other things, like my writing and this blog, are going to have to be pushed to the back burner for a bit until I adjust to all the newness.  One thing I know about me is that I can sometimes push myself too hard, and I don’t want to do that this time around.  So, I’m going to push the release of Waiting For Daybreak back to May or June.  You can also probably expect a few less posts a week here, although I will be doing my best to write up everything for all books finished that week over the weekend and schedule them ahead of time for the next week (Wow, did that sentence make sense?)  There will also be slower responses to comments.  These are all good things, though, because this just means this blog has returned to being my hobby instead of what I’m doing to keep my sanity while job hunting, lol.

I do hope you guys will keep following along, because I’m still the same me, just a far far happier one now.

Announcement: 2012 Reading Project!

I decided I won’t make you guys wait as long as I originally said to find out what my 2012 project is going to be.  I made the reading list, the button, and created the page, so why not announce it now and get participation commitments going?

So!  The Opinions of a Wolf hosted 2012 reading project is…..*drum-roll*

Woo! *Applause*

The gist of it is, I am concerned and downright fed up with the state of health in America.  Congress just declared pizza a vegetable! It is time we took the power over our own health out of the hands of the government, society, the FDA, hospitals, and put it back where it belongs.  With us!  To this end, using my librarian and book blogger skills, I carefully selected 12 nonfiction titles to read addressing a variety of topics from how your diet can prevent and reverse heart disease to how the food industry manipulates science to how to avoid processed foods.  It’s a great list that I’m really excited to explore!!

The third Saturday of every month will be dedicated to a discussion (hosted by me) of the book of the month.  In addition, I will do my best to also review one healthy cookbook or fitness book each month, and I invite you to do so as well!

You’ve got a month to get yourself signed up, spread the word, and gather the first couple of books on the list.  You don’t have to have a blog to participate, but it would be awesome if you at least had a LibraryThing or GoodReads account to help create the buzz this information needs.

Just head on over to the dedicated Diet for a New America Reading Project 2012 page and leave a comment noting your intent to participate and a link to either your blog post announcing your participation or to your account on LibraryThing or GoodReads.

I’m super-excited for this project and hope you all are too!!

Book Review: His Father’s Son by Bentley Little

Summary:
Steven’s life in California is so typical it borders on boring.  He writes for AlumniMedia.  He’s engaged to a librarian named Sherry.  He goes out for happy hour every Friday night with his three buddies.  Then one day his mother calls him and informs him his father tried to kill her.  His father has had strokes and dementia, but in a moment of absolute clarity in the VA hospital, his father whispers to Steven, “I killed her.”  Thus begins Steven’s tailspin into a world of darkness and ever-changing morality.

Review:
I believe this book succeeds in serving its purpose–it’s a page-turner with chills.  If someone asked me for a simple thriller for the beach, I’d have no qualms handing this over.  I cannot rid myself of the vibe though that the idea of this book could have led to a thriller of excellent quality instead of beach read quality, and that is a bit disappointing.

The set-up is excellent.  Here we have an ordinary guy with some issues with his parents, but he still tries to live up to his family obligations.  Then his father has an episode that makes mortality something Steve is no longer able to ignore.  Steve then starts this quest that could easily be read as a metaphor for adults dealing with the increased fragility of their parents.  However, about two-thirds of the way through, the plot takes an unexpected twist that then essentially nose-dives off a cliff into a scenario that is jarring and rather insulting to the reader.  The book is not at all about what it at first appeared to be, and honestly, the original concept was much more intriguing than the final answer.  The resolution is cliche, whereas the original set-up was not.

Other than the plot, Little sets scenes fairly well.  It is easy to envision both the simpler scenes as well as the more complex scenes of violence.  His writing style is not particularly memorable though.  I didn’t once feel the need to write down a quote or dog-ear a page.

One of the more interesting elements of the book is that Steven is a writer, and his short stories pepper the book to give you an idea of his mental state at the time.  I honestly enjoyed the short stories more than the actual book itself.  I could easily see myself reading a collection of Little short stories in the future.

Overall, this is an enjoyable, if forgettable, thriller ideally suited to summer beach reading.  I recommend it to fans of thrillers looking for an easy read.

3.5 out of 5 stars

Source: PaperBackSwap

Buy It

Randomness: Tumblr!

You guys!  I totally have a tumblr now that will contain complete epic randomness that thus far is mostly book quotes and kitties.  You should def check it out!  Particularly if you like my blog, which, um, if you’re reading this, you probably do.

Hey Ya’ll!!

I just wanted to write up a quick post to tell you that

I AM GOING TO BE ON VACATION FOR A WEEK!!!!!

Until Wednesday to be exact.  Granted, it’s a staycation, but it’s my first holiday from work since when I graduated from undergrad.  I know, I know.  Anyway, if I feel so inclined I might post before then, but don’t count on it. I am, after all, planning on being out and about taking my lovely city of Boston by storm.  Also possibly sleeping periodically.  Maybe.

Eh, who am I kidding, I rarely sleep!!  But there will definitely be sake involved.

<3