Guided Tour of MedlinePlus Health Information

Black and Latino men in Central Massachusetts are an underserved population suffering significant health disparities. This presentation was part of training provided by the National Network of Libraries of Medicine/New England Region grant, Accessing Health Information for African American, African, and Latino Men: MedlinePlus training for the Barbershop Health Network and the Hector Reyes House, Worcester, MA. Train-the-trainer sessions were presented June 22, June 25, and July 8, 2015 to the staff from both organizations to learn how and where to access reliable consumer health information and, in turn, share these resources with their clients

Supporting Cancer Knowledge Needs Using Online Information

Information is exploding at an exponential rate. Because there is a flood of medical information on the Internet, it can be difficult to wade through the many resources to determine what information is best to use in practice. The intent of this chapter in Cancer Concepts: A Guidebook for the Non-Oncologist is to help the health care provider find reliable online cancer information. To help inform clinical decision making, health science librarians continue to address this rapidly growing body of literature by analyzing resources and identifying the highest quality information available on the Internet. The concept of Evidence-Based Medicine (EBM) is important to understand, as well as the process needed to find literature supporting EBM. Why EBM? EBM is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. Making evidence-based clinical decisions is not about intuition, but finding reliable, up-to-date literature and using it in combination with clinical expertise and patient choice. Once a source for free online quality literature is located, a health care provider can consider the best current evidence to thoroughly answer clinical questions.https://escholarship.umassmed.edu/cancer_concepts/1026/thumbnail.jp

House Librarians as Instructors in a Self-Directed, Capstone-Related 3rd Year Flexible Clinical Experience Program

PURPOSE/PROBLEM STATEMENT In academic year 2010/2011, the University of Massachusetts Medical School introduced a new, longitudinal, integrative curriculum (LiNC). One component of this new curriculum was the introduction of Learning Communities or Houses. . Five Houses were formed to allow inter-class interaction, each that would serve as the medical student\u27s academic and social home. A librarian from the Lamar Soutter Library was attached to each House. Two new components of the LiNC curriculum were a) a longitudinal, cumulative capstone project and b) a 3rd year Flexible Clinical Experience (FCE) program. The first was a natural fit for the House Librarians to interact with students as they conducted foundational research for their Capstone. The second was developed to allow students in their 3rd year an opportunity to choose a pre-designed elective or design their own clinical experience. One type of self-designed FCE is based in the library where students can spend one week conducting research towards their capstone project. METHODS/APPROACH Beginning in academic year 2015/2016, students choosing the library-based FCE are formally required to work with their House Librarian. The librarians now act as the course supervisors. The students share their capstone proposals with their House Librarian and the librarians, in turn, provide comprehensive, library-based research experience, guide students to relevant resources, teach search techniques, and serve as library support for any library or research needs. Following each FCE, the students submit course evaluations. By the spring of 2016, there will be a significant number of evaluations from students that have completed the self-directed FCE with librarian supervision. The authors plan to review the FCE library-based course evaluations for the current year against those from when the House Librarians were not directly involved. RESULTS/LESSONS LEARNED The capstone project can take many different forms, from a traditional research paper to a community outreach project to an artistic expression of medical education. But regardless of format, the capstone must consist of a scientific foundation, guided by evidence and grounded in a fundamental understanding of the literature. By comparing student evaluations responses from before and after formal librarian involvement, we hope to understand the impact librarians have had on capstone preparation, further adapt our methods to improve library integration into this component of the curriculum and explore ways to encourage more students to select the library-based FCE. REFLECTION Because the library-based FCE now requires students to have direct supervision by their House Librarians, our goal is to use information gleaned from the student evaluations to learn how librarian immersion in this component of the curriculum can contribute to the success of both the self-designed FCE and capstone projects

Age, Multiple Chronic Conditions, and COVID-19: A literature review

BACKGROUND: Various patient demographic and clinical characteristics have been associated with poor outcomes for individuals with coronavirus disease 2019 (COVID-19). To describe the importance of age and chronic conditions in predicting COVID-19 related outcomes. METHODS: Search strategies were conducted in PubMed/MEDLINE. Daily alerts were created. RESULTS: A total of 28 studies met our inclusion criteria. Studies varied broadly in sample size (n=21 to more than 17,000,000). Participants mean age ranged from 48 years to 80 years and the proportion of male participants ranged from 44%-82%. The most prevalent underlying conditions in patients with COVID-19 were hypertension (range: 15% - 69%), diabetes (8% - 40%), cardiovascular disease (4% - 61%), chronic pulmonary disease (1% - 33%), and chronic kidney disease (range 1% - 48%). These conditions were each associated with an increased in-hospital case fatality rate ranging from 1% to 56%. Overall, older adults have a substantially higher case fatality rate (CFR) as compared with younger individuals affected by COVID-19 (42% for those \u3c 65 vs 65% \u3e 65 years ). Only one study examined the association of chronic conditions and the risk of dying across different age groups; their findings suggested similar trends of increased risk in those \u3c 65 and those \u3e 65 years as compared to those without these conditions. CONCLUSIONS: There has been a traditional, single condition approach to consideration of how chronic conditions and advancing age relate to COVID-19 outcomes. A more complete picture of the impact of burden of multimorbidity and advancing patient age is needed

Human Lipoxygenase Pathway Gene Variation and Association with Markers of Subclinical Atherosclerosis in the Diabetes Heart Study

Aims. Genes of the 5-lipoxygenase pathway are compelling candidates for atherosclerosis. We hypothesize that polymorphisms in ALOX12, ALOX15, ALOX5, and ALOX5AP genes are associated with subclinical atherosclerosis in multiple vascular beds. Methods. Families with two or more siblings with type 2 diabetes and their nondiabetic siblings were studied as part of the Diabetes Heart Study (DHS). European American diabetic (n = 828) and nondiabetic (n = 170) siblings were genotyped for SNPs in the ALOX12, ALOX15, ALOX5, and ALOX5AP genes. Subclinical measures of atherosclerosis (IMT, coronary (CorCP), carotid (CarCP) and aortic (AorCP) calcified plaque) were obtained. Results. Associations were observed between ALOX12 with CorCP, ALOX5 with CorCP, AorCP, and IMT, and ALOX5AP with CorCP and CarCP, independent of known epidemiologic risk factors. Further, lipoxygenase pathway SNPs that were associated with measures of atherosclerosis were associated with markers of inflammation (CRP, ICAM-1) and calcification (MGP). Conclusions. Polymorphisms within ALOX12, ALOX5, and ALOX5AP are genetically associated with subclinical atherosclerosis and with biomarkers of disease in families with type 2 diabetes. These results suggest that variants in lipoxygenase pathway genes may have pleiotropic effects on multiple components that determine risk of cardiovascular disease

Climate Services Can Support African Farmers' Context-Specific Adaptation Needs at Scale

We consider the question of what is needed for climate services to support sub-Saharan African farmers' adaptation needs at the scale of the climate challenge. Consistent with an earlier assessment that mutually reinforcing supply-side and demand-side capacity constraints impede the development of effective climate services in Africa, our discussion of strategies for scaling up practices that meet farmers' needs, and opportunities to address long-standing obstacles, is organized around: (a) meeting farmers' climate information needs; (b) supporting access, understanding and use; and (c) co-production of services. A widespread gap between available information and farmers' needs is associated with entrenched seasonal forecast convention and obstacles to using observational data. Scalable innovations for producing more locally relevant historical and forecast climate information for farm decision-making are beginning to be adopted. Structured participatory communication processes help farmers relate complex climate information to their experience, and integrate it into their management decisions. Promising efforts to deliver rural climate services strategically combine communication channels that include participatory processes embedded in existing agricultural advisory systems, and innovations in interactive broadcast media. Efforts to engage farmers in co-production of climate services improve delivery to farmers and dialogue among stakeholders, but often with little impact on the usability of available information. We discuss challenges and options for capturing farmers' evolving demands, and aggregating and incorporating this information into iterative improvements to climate services at a national scale. We find evidence that key weaknesses in the supply and the demand sides of climate services continue to reinforce each other to impede progress toward meeting farmers' needs at scale across Africa. Six recommendations target these weaknesses: (1) change the way seasonal forecasts are produced and presented regionally and nationally, (2) use merged gridded data as a foundation for national climate information products, (3) remove barriers to using historical data as a public good, (4) mobilize those who work on the demand side of climate services as an effective community of practice, (5) collectively assess and improve tools and processes for communicating climate information with rural communities, and (6) build iterative co-production processes into national climate service frameworks

Assessment for learning : a model for the development of a child’s self competence in the early years of education

In recent years policy documents, curricula and other educational initiatives have promoted a pedagogy founded on the concept of independent learning. This is broadly defined as ‘having the belief in yourself to think through learning activities, problems or challenges, make decisions about your learning and act upon those decisions (Blandford and Knowles, 2009:336). The central role of Assessment for Learning (AfL) in this process is often overlooked in practice. By considering the findings from a small scale research study this article addresses the central role of the teacher /practitioner in developing effective AfL in the early years classroom (3-5 years)

Women bargaining with patriarchy in coastal Kenya:contradictions, creative agency and food provisioning

Gender analysts have long recognised that challenging existing patriarchal structures involves risks for women, who may lose both long-term support and protection from kin. However, understanding the specific ways in which they ‘bargain with patriarchy’ in particular contexts is relatively poorly understood. We focus on a Mijikenda fishing community in coastal Kenya to explore contradictions in gendered power relations and how women deploy these to reinterpret gendered practices without directly challenging local patriarchal structures. We argue that a more complex understanding of women’s creative agency can reveal both the value to women of culturally-specific gendered roles and responsibilities and the importance of subtle changes that they are able to negotiate in these. With reference to food provisioning, the analysis contributes to more nuanced understandings of gendered household food security and women’s creative approaches to maintaining long-term security in their lives

The \u27Healthy Parks-Healthy People\u27 Movement in Canada: Progress, Challenges, and an Emerging Knowledge and Action Agenda

In this article, we outline progress and challenges in establishing effective health promotion tied to visitor experiences provided by protected and conserved areas in Canada. Despite an expanding global evidence base, case studies focused on aspects of health and well-being within Canada’s protected and conserved areas remain limited. Data pertaining to motivations, barriers and experiences of visitors are often not collected by governing agencies and, if collected, are not made generally available or reported on. There is an obvious, large gap in research and action focused on the needs and rights of groups facing systemic barriers related to a variety of issues including, but not limited to, access, nature experiences, and needs with respect to health and well-being outcomes. Activation of programmes at the site level continue to grow, and Park Prescription programmes, as well as changes to the Accessible Canada Act, represent significant, positive examples of recent cross-sector policy integration. Evaluations of outcomes associated with HPHP programmes have not yet occurred but will be important to adapting interventions and informing cross-sector capacity building. We conclude by providing an overview of gaps in evidence and practice that, if addressed, can lead to more effective human health promotion vis-à-vis nature contact in protected and conserved areas in Canada