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

What Librarians Talk About (MLA12 Seattle: Plenary 3: Janet Doe Lecture by Mark E. Funk, AHIP, FMLA)

The first plenary is given by the MLA president, the second by someone who is not necessarily a librarian but has something interesting to say that will aid us in our profession.  The third plenary, however, is given by a librarian.  Mark E. Funk’s presentation was entitled, “Our Words, Our Story: A Textual Analysis of Articles Published in the Bulletin of the Medical Library Association/Journal of the Medical Library Association from 1961 to 2010.”  Here are my notes.

• An analysis of the words revealed four key areas that librarians talk about: environment, management, technology, and research.
• Although we talk more about building than people, that gap is narrowing.
• We are basically almost not talking about books, but we are increasingly talking about journals.
• Reference is steady.  Searching is increasing.
• Information is the #2 word.
• As our information world becomes more complicated, we are talking more and more about teaching.  “I predict teaching will become ever more important.”
• We are now concerned about what we can do to improve health.
• New groups we’ve reached out to include: clinicians, consumers, and patients.
• We use management words to tell our story.
• We are no longer running our libraries like academic environments; we are running them like businesses.
• We are early adopters and write about it.
• Sometimes new technology becomes so embedded in our lives that we don’t mention it anymore.  For example, you say you talked to someone but don’t mention the telephone.
• Our attention has shifted from automating to digitizing.
• We don’t talk about the internet.  We talk about the web and navigation.
• The word with the sharpest rise and fall is: Gopher
• IMRaDification of our profession.  (IMRaD–Intro, Methodology, Results, Discussion)
• MLA strategic plan encouraged us to do more research, and we responded.
• Hockey Stick terms–little to no use, sharp recent uptake.  May indicate future usage but it could be a drastic rise and fall. Only time will tell.
• EHRs are white hot now. (EHR–Electronic Hospital Record)
• Why do we study history?  It’s very good at explaining change.  Answers the question, how did we get here?
• De-emphasis on physical.  Emphasis on information.  Prefer evidence-based.
• Emphasis on health.  Expanded audience.  Outside the library.   Teaching people.
• Libraries more business-like. Technophiles. More research articles using IMRaD.
• History can hint at the future, but it can’t predict it.
• Our story is being written every day.  We can’t skip chapters to see what happens next.

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.

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.

Friday Fun! (Gym, Thundersnow)

Snow on the ground this morning.

Hello my lovely readers!  I hope you all had nice weeks.  I discovered at my potluck that all of my friends are *amazing* cooks!  We should do this potluck thing more often.

This week I returned to meeting with a trainer.  In January it will be exactly one year since I started focusing on my fitness, and I’m rather determined to meet a few goals before then.  I figured a trainer would help.  He’s also nice and tough on me, which I enjoy.  I am a bit distraught to discover that I’m still having issues holding a plank for a minute. I make it. But just barely.  Needless to say, that’s one of my big goals for the next two months.

We got our first snow of the year last night, and it wasn’t just snow, it was THUNDERSNOW.  That’s what we call it when there’s thunder and lightning with snow instead of rain.  I loooove winter, and I was happy to see snow this morning, although I must admit that I hope this winter isn’t incredibly long like the one in the Little House books.

I got a lot of library loot last night.  I’m thinking of having my own mini read-a-thon at some point next week, especially since I’m no longer working at the restaurant.  I’m picking up my final check today and handing in my uniform.  I’m happy to have my evenings back to myself, though I will miss the extra money, heh. In any case, let me know if you’d be at all into a mini read-a-thon at some point in the next week.

Happy weekends!

Book Review: Farewell by Honore de Balzac

Summary:
Philip, a colonel in the military, lost his love Genevieve in Siberia when retreating from the Russians.  Years later, he randomly stumbles upon her in a country house with her uncle, having lost her mind from her horrible experiences in Siberia with the military after they lost each other.  She is only capable of saying one word.  “Farewell.”

Review:
I decided to read a Balzac work due to a reference in the musical The Music Man.  The elderly ladies of the town think the librarian is scandalous because she keeps works of Balzac in the library.  Clearly I needed to know what all the fuss was about, so I decided to see for myself.

My first instinct is that this classic work of tragedy shouldn’t actually be that scandlous, which perhaps was the point in The Music Man.  These elderly ladies are *so* ridiculous to object to Balzac.  In any case, however, in retrospect I can see what is so shocking.  The incredible weakness of mind and character demonstrated by both Philip and Genevieve are both irritating and depressing.  I’m not sure what point Balzac was trying to make, but all I could think was that both of them needed to man up.

That’s not to say the book isn’t well-written though.  The translation is lovely, and I’m sure in the original French it is even prettier.  Just imagining Genevieve only being able to say “Adieu” sounds prettier than “Farewell.”  The scenes are vividly described, and the reader is certainly engaged.

Overall, it is a well-told tragedy that suffers a bit from weak characterization.  I recommend it to fans of tragedies and classic French literature.

3.5 out of 5

Source: Audible app for the iPod touch, iPhone, and iPad

Buy It

Friday Fun! (Reflections and Looking Forward)

Hello my lovely readers!  Today is the last day of 2010, and it feels to me like it just flew by, in spite of everything that happened during it.

As far as this blog goes, 2010 was my first full year of blogging.  I really think I’ve solidified what I want my blog to be and look like this year.  My layout and sidebars really reflect who I am, and I think I’ve finally got a solid style going for my reviews as well as weekly schedules.  I hope you guys think so too!  In 2011, I’m hosting my first reading challenge (sign up here!) and now that I’m out of grad school, I expect my non-review posts to be slightly less librarianship focused.  But you never know.

On a personal note, 2010 was the first year I lived entirely in one place since I was 15 years old.  It’s been kind of amazing, and I’m loving having the feeling of having roots somewhere.  As my first full year living in Boston, I’ve been able to fully experience all the thrills of living in such a historic, academic city.  I enjoy every aspect of it–even the ones I complain about.  I love it that I can eat any variety of foods pretty much anytime I want.  I can’t get over the fact that I can get a veggie burger at pretty much every single pub.  I learned how to ride my bike in city traffic and experienced the joy of riding to the park to spend the day on the grass reading while others read, toss a football around, or play volleyball, and cap the day off with a walk to get some bubble tea.  I discovered local independent bookstores and their fabulous used book basements that have killed my tbr pile.  I went to a free Dharma and meditation session for the first time and found out how awesome it is to be quiet in a roomful of people.  I’ve had the bonding experience of struggling with public transit on rainy days and in blizzards.  A recent immigrant who barely spoke English once shared her umbrella with me when waiting for the bus, and it was the highlight of my day.  I tried container gardening for the first time and encountered the community of urban environmentalists.  So many new experiences in so little time.

This year also saw the end of my first real relationship.  It’s been sad and a struggle for me, but I view the entire relationship from beginning to end to now as a wonderful experience, and I wouldn’t undo it for anything in the world.  My only regrets are some of the mistakes I made, but how else can we grow and learn?  Now that I know what a relationship *can* be, I’m working on being ok being alone until the next one comes along.

This year also saw me complete my Masters of Library and Information Science!  The last two weeks have been the first time since I was….what?  Four years old?  That I haven’t been a student.  I’m thoroughly enjoying having time to myself to do more of what I’d like to do.  I’m nervous about the next step of my career–hunting for a higher paying job with the blessings of my current employer–, but I’m also thrilled to see where I end up.  Part of me still can’t believe that I’m a white collar, highly educated, young professional living in a city.  Someone pinch me!

I also hope in 2011 to really get down to business with my writing.  I want to finish at least one novel, hopefully two, and start shopping them around to publishers.  I have faith in my writing, and it’s time to start acting on it.

Don’t worry; this blog won’t suffer.  It’s so closely tied to my favorite hobby of reading that I have a hard time imagining ever not blogging again.  I’m looking forward to 2011.  I’m eager.  I will strive for my goals and take everything life throws at me.  Anytime I start to struggle or feel down, I just remember how shocked and proud 14 year old me would be of 24 year old me, and I smile.  I can’t wait to see what 2011 brings.  Everything is a learning experience, and I truly feel that I am beating down more and more demons as I get older.  Bring it on, 2011.  I’m ready, and I’m not afraid.

 

Friday Fun! (Long Weekend, Job Hunt)

Hello my lovely readers! As ya’ll know, last weekend was a 3 day weekend for moi.  I am pleased to report that I managed to hit up some Memorial Day weekend sales with my gal pals.  The rest of the weekend was mostly devoted to being lazy, as it should be.  I also had my first veggie burgers of the season.  I know you can eat them year-round, but for some reason I prefer them when it’s warm out.

Since I’m acquiring my MLIS in January 2011, at my yearly review a couple of weeks ago I talked to my boss about my position.  It was newly created when I was hired, so whether they wanted to keep it paraprofessional or make it professional was unclear.  Well folks, they want to keep it paraprofessional.  I’m welcome to stay, but also have their blessings to start looking for a professional position, which I’ve been doing.  So I’m looking for my first professional job.  You guys know how job hunting is; I don’t need to go into that.  It has, however, been taking up a bit of time.  If any of you guys happen to hear of anything or can put a good word in for me, I’d appreciate it.

This weekend I’m looking forward to trying out a longer bike ride again to see if I’m getting any better.  This undoubtedly will be combined with picnicking and reading.  Happy weekends!

Librarianship Is a Service Career

Librarianship is a service job.  I think a lot of librarians tend to forget that.  Oh sure, the general public can be annoying.  Anybody who has ever worked with them is fully aware that the more people you interact with in one day, the more likely you are to come across someone who is conniving or making insane demands.  The fact of the matter is though, most of the people who come to you for help aren’t that type of person.  They’re generally good people who will respond to the tone you’re setting.  That tone should be I’m here to help you in a non-judgmental manner not I’m suspicious of you and am going out of my way to make your life more difficult.  Unfortunately, a lot of people’s experiences with librarians are falling into the latter camp.

Part of this is because people get stuck in their ways.  “Well, the old manager never let patrons use the fax machine, so I’m not going to let patrons use the fax machine,” instead of allowing for extenuating circumstances or setting up a pilot program to allow use of the fax machine and see how it goes.

Part of it is because it can be hard to stay cheery when working with the public.  Maybe the previous person you interacted with was screaming at you for no reason.  Maybe something upsetting is going on in your personal life.  The fact of the matter is, though, that this next patron coming up to you didn’t do either of those things to you, so you should give her the best service you possibly can and not rain on her parade.

Finally, part of what I’m seeing is quite frankly librarians not wanting to actually have to work at work.  A librarian on twitter today said he would like to design his own summer reading program theme, and another librarian responded why would he bother?  It’s so much more work to make your own theme than to use the pre-packaged one.  Similarly, I’ve seen librarians visibly groaning at needing to go acquire an item from the stacks for a patron or hoping for no in-depth reference questions.  Excuse me, but helping people is our jobs.

Our job isn’t to sit behind a desk all day hoping no one will need us.  Our job isn’t to pick the easiest summer reading program.  Our job isn’t to refuse to offer a service that patrons want because we think it’s silly.  Our job is to make the library a welcoming place where patrons know there’s someone who will do his or her darnedest to make their day easier and more fun.

There’s been all this hullabaloo in the past week over whether or not librarians are “professionals.”  It’s time librarians stopped worrying about terms and started actually working at providing the excellent service our patrons need.