Author Archive for dana

Educational Games from the National Library of Medicine

It is no secret that children love to play games. Games are fun and challenging and if they can incorporate educational concepts all the better! A 2016 report from Project Tomorrow, “From Print to Pixel,” examines trends in digital education. The report indicates an increase in the use of gaming, animations, and other digital content in K-12 education. Some of the findings related to gaming include:

  • The use of gaming by teachers has doubled – from 23% in 2010 to 48% in 2015.
  • 57% of school principals admit that lack of training for teachers is a top barrier to expanding digital learning.
  • Teachers in elementary grades are more likely to use game-based learning.
  • Over 60% of middle school students play games for self-directed learning outside the classroom.

If you are a school media specialist or children’s librarian, you may be looking for health and science games or animations that you can recommend to teachers and students. Well the National Library of Medicine (NLM) does have apps for that (and websites too)! With input from teachers and students, NLM has created several games and interactive sites to teach about chemistry, biology, and environmental health.

Base Chase: In this game, players help DeeNA jump on fast moving platforms to grab bases of DNA to build DNA strands for different animals. Base Chase can be incorporated into biology curriculum and is geared towards high school students. You can download the app for free from iTunes. A video tutorial is included.

Bohr Thru: In the style of the popular Candy Crush game, Bohr Thru players can collect protons, neutrons, and electrons to create the first 18 elements of the periodic table. This is a fun way to increase knowledge of chemical elements and structures. Bohr Thru can be included as part of chemistry curriculum and is geared towards high school students. You can download the app for free from iTunes.

Run4Green: In this Mario-style game, players can collect coins and complete environmentally friendly tasks while learning about important environmental health issues such as, renewable energy, green products, and greenhouse gas reduction. Run4Green is geared towards students in 5-8 grades. You can download the app for free from iTunes.

TOXInvaders: In this fast-paced game, players use a launcher to destroy toxic chemicals falling from the sky. Capturing “good chemicals” earns protective shield points. To move on the next level, players must take a brief quiz about the featured chemicals. TOXInvaders can be implemented into chemistry or environmental health curriculum, and is geared towards middle school students. You can download the app for free from iTunes. A tutorial is included.

ToxMystery: In this interactive learning site, players help Toxie the Cat find chemical hazards hidden throughout the house. Toxie will do a little dance whenever all the hazards are located, and along the way players learn how different substances in the environment affect human and pet health. There are also resource pages for teachers and parents. This site is available in both English and Spanish, and is geared towards ages 7-11 years old. It is freely available online at https://toxmystery.nlm.nih.gov/

Looking to pair these games with other NLM resources?

  • GeneEd: A genetics resource for students and teachers in grades 9-12. Includes lesson plans, animations, virtual and hands-on lab experiments, links to articles, and information on genetics careers. https://geneed.nlm.nih.gov/index.php
  • Environmental Health Student Portal: A resource on environmental health for middle school students and teachers. Includes lesson plans, videos, animations, articles, games, and experiments. The information is focused on air pollution, chemicals, climate change, and water pollution. http://kidsenvirohealth.nlm.nih.gov
  • ToxTown: Provides information on toxic chemicals in everyday locations, and how the environment impacts human health. This interactive site focuses on six specific environments: city, farm, town, US Border Regions, port, and US Southwest. Includes a resource page for teachers. Available in English and Spanish. For all ages.  https://toxtown.nlm.nih.gov/

References:

Project Tomorrow. (2016). From Print to Pixel: The Role of Videos, Games, Animations and Simulations within K-12 education. Retrieved from http://www.tomorrow.org/speakup/SU15AnnualReport.html

Dana Abbey, MLS is the Community Engagement Coordinator for the National Network of Libraries of Medicine, MidContinental Region. She is based at the University of Colorado Health Sciences Library. You can reach her at dana.abbey@ucdenver.edu.

 

Zika Virus: What We Know, What We Don’t Know

The Zika virus has been around for decades, but only recently has gotten the attention of the U.S. with the rapid spread of the virus in the Western Hemisphere. The Zika virus is a mosquito-transmitted infection with mostly mild symptoms like fever, rash, joint pain, and red eyes – many will never even know they were infected. While mosquito seasons vary across the U.S., they often come with warming temperatures around 50 degrees Fahrenheit, and with summer underway, many areas are now addressing ways to prepare for increased exposure to mosquitoes.

Spread of the Zika virus in the United States thus far has been limited to travel-associated cases, 591 as of May 25, 2016. While the majority of transmissions occur through the bite of an infected female Aedes species mosquito (only females bite humans), the virus can be transmitted from mother to fetus, through sexual contact with an infected male, and through blood transfusions. Transmission from mother to fetus is especially troublesome because it can cause microcephaly – babies are born with unusually small heads and brains that have not developed properly, and other birth defects.

Because sexual transmission seems tied to the Zika virus’s presence in infected males’ semen, proper condom use or not having sex are prevention measures. It’s not known if an infected woman can transmit the virus through sexual contact, or if it can be passed through vaginal fluids or salvia. For women trying to get pregnant, it’s now recommended waiting at least 8 weeks before trying to conceive if they or their partner live in or are returning from Zika infected areas.

While there have been no confirmed blood transfusion-transmission in the U.S., there have been several confirmed cases in Brazil.

Consumer/Patient Education Resources

If you know of a great resource, let me know and I will add it! Please feel free to share or reuse this post.

Dana Abbey, MLS[i]  dana.abbey@ucdenver.edu

[i] Funded in whole or in part with Federal funds from the Department of Health and Human Services, National Institutes of Health, National Library of Medicine, under cooperative agreement number UG4LM012344 with the University of Utah Spencer S. Eccles Health Sciences Library.

 

Health Insurance Literacy

Health insurance is not only one of the costliest products a consumer will purchase, with an average health insurance marketplace price tag of $386 per month for an individual, it is also one of the most complex products to understand. Many people think they have the skills and knowledge to select and utilize their health insurance, but the evidence shows otherwise. Some examples:

  • A 2014 Kaiser Family Foundation report found that 37% of enrollees did not know the amount of their deductible, and 46% thought they were getting a subsidy though it was actually 85%.
  • Three out of 4 people in a 2013 survey by the American Institutes of Research stated confidence in their knowledge of health insurance, but only 20% could calculate the out-of-pocket cost for a visit with an in-network doctor.
  • A 2014 report from the Urban Institute noted that nearly 50% of adults reporting limited literacy and low numeracy skills, with income below 400% of the Federal Poverty Level (FPL), had difficulty locating information to help them support their insurance plan choices.

This lack of literacy can prove detrimental to the consumer if they select a plan that doesn’t provided needed benefits or puts them at financial risk. The concept of “health insurance literacy” is fairly new, and while there is no official definition it has been described as “the degree to which individuals have the knowledge, ability, and confidence to find and evaluate information about health plans, select the best plan for their financial and health circumstances, and use the plan once enrolled.” Another key issue not addressed in this definition is the ability of the consumer to retain insurance coverage over time.

In 2014, the American Institutes of Research reported on their work to develop a measure of health insurance literacy. They created a conceptual model containing four domains: Knowledge, Information Seeking, Document Literacy, and Cognitive Skills. Each domain presents a number of facets that might prove difficult for a consumer to understand, but could also be used as a tool for those developing information for consumers, or those assisting consumers navigate the health insurance landscape.

Resources for those assisting consumers/patients

Resources for consumers/patients

  • Get free help applying, selecting a plan and enrolling in your area at https://localhelp.healthcare.gov/#intro.
  • FairHealth.org. Numerous healthcare decision-support tools to help individuals understand healthcare costs.
  • HealthCare.gov. Resources for selecting or changing a plan, plan categories, determining the total cost of care, and understanding the different kinds of plans.
  • MedlinePlus: Health Insurance. Resources to assist consumers understand and select insurance, includes patient handouts. Many in Spanish.

If you know of a great resource, let me know and I will add it! Please feel free to share or reuse this post.

Dana Abbey, MLS[i] dana.abbey@ucdenver.edu

[i] Funded in whole or in part with Federal funds from the Department of Health and Human Services, National Institutes of Health, National Library of Medicine, under cooperative agreement number UG4LM012344 with the University of Utah Spencer S. Eccles Health Sciences Library.

Veteran’s Health Information Resources

Veterans and their family members need reliable health information resources sensitive and pertinent to their needs. They are unique community members with unique life events and experiences. Many of the skills and coping mechanisms veterans developed during service may prove counterproductive or be misunderstood in civilian life. This, in addition to physical injuries and mental health issues, can make readjustment challenging for the individual, family members, and health providers.

Military Health Issues

Our nation’s nearly 24 million veterans have greater rates of obesity and diabetes, and over one-third suffer from arthritis. Suicide rates among veterans are 7-8 times higher than the general population – 1 nearly every 65 minutes. Military personnel who served in Iraq and Afghanistan survived wounds in numbers far greater than in previous wars – some 48,000 – due to advances in body armor, combat medicine, and improved evacuation procedures. However, the injuries sustained – traumatic brain injury, amputation, blindness, spinal cord injuries, and burns – require sophisticated, comprehensive, and often lifetime care. Mental health issues, like post-traumatic stress syndrome (PTSD), are being reported in high numbers of returning service members. Veterans injured in these two wars were more than twice as likely as those uninjured to have difficulty readjusting to civilian life, and nearly half stated strains in family relationships and frequent outbursts of anger. By the end of 2010, 2.15 million service members had been deployed, and of those returning:

  •  23% suffered from mild traumatic brain injury (TBI)
  •  20% from post-traumatic stress disorder (PTSD)
  •  37% from depression
  •  39% reported problems with alcohol

 

Access to Care

Access to healthcare after deployment can be an additional challenge. Veterans are not automatically eligible for Veterans Affairs (VA) health care. Eligibility is based on veteran status, service-related disabilities, income level, and other factors. Even if an individual is eligible, barriers such as proximity to a VA facility and cost-sharing requirements may affect seeking care in the VA system.

Rural veterans face additional health care challenges for a variety of reasons, including unequal access to higher quality services, shortages in qualified health professionals, lower incomes, and limited transportation options. On average, rural Veterans travel between 30-90 minutes for primary care, and 60-120 minutes for inpatient care. Forty percent of the nation’s veterans live in rural areas; three-fourths of rural veterans are over the age of 55.

Homelessness

Nearly 1 in 7 homeless adults are veterans, with another 1.5 million at risk of homelessness. PTSD, depression, TBI, substance abuse, low income, unemployment, and difficulty reintegrating into society after long and repeated tours of duty contribute to this surge in homelessness. The Open Doors (http://www.usich.gov/opening_doors/) program, initiated to end homelessness by 2015, reported a 17% reduction in 2012. This program, a collaboration of 19 United States Interagency Council on Homelessness (USICH) member agencies, works to increase stable and affordable housing, provide opportunities for employment and improve access to healthcare.

 

Resources

There are many government sponsored and non-profit organizations serving the needs of veterans and their families. The Veterans Health Resource Guide (http://hslibraryguides.ucdenver.edu/c.php?g=259562) provides a wealth of information for veterans, family members, care givers, and health providers. This guide has information on military health and exposures, clinical care information, insurance and benefits, recommended reading, and policy information. A few of the resources are highlighted below:

Amputee Coalition

http://www.amputee-coalition.org/

The nation’s leading organization on limb loss, offering education, support and advocacy. Provides information on what amputees might experience the first 12 months after limb loss, prosthetics, skin and tissue care, and physical therapy.

 1

Military Families Resource Center

http://www.aacap.org/AACAP/Families_and_Youth/Resource_Centers/Military_Families_Resource_Center/Home.aspx

From the American Academy of Child and Adolescent Psychiatry. This sites focus is the mental health of the veteran, spouse, partner, children and caregivers. Information on how to talk with children about deployment and reintegration, how to deal with media coverage of conflicts, and the needs of returning service members.

 1

Women Veterans Health Care

http://www.womenshealth.va.gov/

Women are the fastest growing group within the Veteran population. The Department of Veterans Affairs has several initiatives to improve services for women veterans. This site proves information on health care services for women including reproductive care, rehabilitation, mental health, and treatment for military sexual trauma.

 2a

MedlinePlus

http://www.nlm.nih.gov/medlineplus/veteransandmilitaryfamilyhealth.html

MedlinePlus has over 900 health topics, including military health. Resources for coping with deployment and separation, illness and injuries, the mental health effects of military service, and family issues.

 4a

 

-Dana Abbey, Colorado/Health Information Literacy Coordinator

-Terri Ottosen, Consumer Health Coordinator, NN/LM Southeastern/Atlantic Region

1 Department of Veteran Affairs. Kemp, RN PhD, Janet, and Robert Bossarte, PhD. “Suicide Data Report, 2012.” (2013): N. pag. Web. 01 Aug. 2013. <http://www.va.gov/opa/docs/Suicide-Data-Report-2012-final.pdf>.
2 Operation Enduring Freedom (OEF) is the name for the war in Afghanistan. Operation Iraqi Freedom (OIF) is the name of the conflict in Iraq that began on March 20, 2003, and ended on December 15, 2011. On September 1, 2010, Operation New Dawn (OND) became the new name of OIF (Secretary of Defense Memorandum, February 17, 2010).
3 “War and Sacrifice in the Post-9/11 Era.” Social and Demographic Trends. Pew Research Center, 05 Oct. 2011. Web. 01 Aug. 2013. <http://www.pewsocialtrends.org/2011/10/05/war-and-sacrifice-in-the-post-911-era/>.
4 Committee on the Assessment of Readjustment Needs Of Military Personnel, Veterans, And Their Families. “Returning Home from Iraq and Afghanistan: Assessment of Readjustment Needs of Veterans, Service Members, and Their Families.” Institute Of Medicine, 2013. Web. 01 Aug. 2013. <http://www.nap.edu/openbook.php?record_id=13499&page=46>.
5 Skupien, PhD, M.S., R.N, Mary Beth. “The Health Needs of Rural Veterans.” FORUM: Translating Research Into Quality Health Care For Veterans. Department Of Veterans Affairs, Oct. 2010. Web. 01 Aug. 2013. <http://www.hsrd.research.va.gov/publications/forum/oct10/default.cfm?ForumMenu=oct10-1>.

Precision Medicine: Finally, it’s all about YOU!

At the January 2015 State of the Union Address, President Obama announced his Precision Medicine Initiative. This initiative would put $215 million dollars toward understanding how to personalize an individual’s medical treatment based on his or her genes, environment and lifestyle. While the concept of precision (also referred to as personalized or individualized) medicine isn’t new – think eyeglasses and blood transfusions – advances in science and technology will allow for the exploration of novel treatments and prevention strategies for complex diseases like coronary artery disease, COPD, and hypertension. One million citizens will be asked to volunteer their health data and numerous public and private entities will be collaborating to explore effective disease prevention and treatment.

Why Now?

Developments in basic science, genomics, proteomics, metabolomics, and advances in technology supporting mHealth, electronic health records, and the storage of big data have created the perfect environment to greatly expand precision medicine. If the past ten years is any indication of rapid change, the sky’s the limit for the next decade:

  • Amount of time to sequence the human genome: 2004-2 years, 2014-2 days
  • Cost of human sequencing: 2004-$22,000,000, 2014-$1,000-$5,000
  • Number of smart phones: 2004-1,000,000, 2014-160,000,000
  • Computing power: 2004-n, 2014-n16

Precision Medicine in Action

The Veteran’s Administration (VA) Office of Research and Development has been working to identify genes linked to post traumatic stress disorder (PTSD), high blood pressure, and heart disease. VA researchers have discovered that individuals with a certain form of the serotonin transporter gene 5-HTT are at a greater risk for PTSD and depression, information which helps individualize use and dosage of selective serotonin reuptake inhibitors (SSRI). They have also found that people with certain forms of angiotensin II receptor type-1 (AGTR1) may have an increased risk for high blood pressure, heart disease, and diabetes. This information can help clinicians develop a personalized preventative care program. Find out more on VA research.

Precision medicine can not only impact an individual, it can address health prevention in an entire community. In 2008, an OB/GYN began mapping children born into poverty in Gainesville, Florida. She was put in contact with a sheriff who was also interested in mapping, but her focus was the community’s incidence of crime. When the two women met, they discovered the maps matched exactly to a one square-mile area and further investigation showed the area also had the highest rate of domestic violence, child abuse and neglect. But why? A ride around the area revealed a lot about the environment and lifestyles of community members. There was poorly maintained housing and a complete lack of access to services like child care, healthy food and medical care – with the closest clinic a 2-hour bus ride away. Find out more about what happened to this community.

Resources for Genetic and Environmental Health

Clinical

Community College and University

  • Environmental Health and Toxicology – portal links health professionals and consumers to many resources to understand the connection between the environment and human health and development.
  • GeneEd Web site – (Grades 9 -12+) Links to vetted genetic Web sites based on high school science curriculum. Includes lesson plans and current events.
  • Genetics Home Reference – Consumer-friendly information about genetic variation and human health.

Consumer and Patient Education

  • Environmental Health and Toxicology – portal links health professionals and consumers to many resources to understand the connection between the environment and human health and development.
  • Genetic Alliance – Nonprofit health advocacy organization committed to transforming health through genetics and promoting an environment of openness.
  • Genetics Home Reference – Consumer-friendly information about genetic variation and human health.
  • NHGRI Talking Glossary – Genetic terms, images and animation. (English/Spanish).
  • Office of Rare Diseases Research – Rare diseases information for patients, families, healthcare providers, researchers, educators and students.

Genetics Professionals

K-12

Public Health

  • Environmental Health and Toxicology – portal links health professionals and consumers to many resources to understand the connection between the environment and human health and development.
  • PHPartners – a collaboration of U.S. government agencies, public health organizations, and health sciences libraries which provides timely, convenient access to selected public health resources on the Internet.
  • Public Health Genomics – information on infectious diseases and noncommunicable diseases with a focus on human and pathogen genomics, genomic tests, family history, public health science, programs and practice, as well as policy and legislation.
  • National Information Center on Health Services Research and Heath Care Technology (NICHSR) – information and tools for the health services research community.

Researcher Tools from NIH

  • GenBank – an annotated collection of all publicly available DNA sequences.
  • Gene – integrates information from a wide range of species. A record may include nomenclature, Reference Sequences (RefSeqs), maps, pathways, variations, phenotypes, and links to genome-, phenotype-, and locus-specific resources worldwide.
  • Genes and Expressions – Tools to help users query and download experiments and curated gene expression profiles.
  • Human Genome Resources – integrated, one-stop, genomic information infrastructure for biomedical researchers from around the world so that they may use these data in their research efforts.
  • International HapMap Tool – partnership of scientists and funding agencies from Canada, China, Japan, Nigeria, the United Kingdom and the United States to develop a public resource that will help researchers find genes associated with human disease and response to pharmaceuticals.
  • NCBI Webinars and Courses – a series of webinars and courses led by NCBI staff who explain and demonstrate the use of various NCBI web resources with particular emphasis on recent changes and improvements.
  • OMIM – comprehensive, authoritative compendium of human genes and genetic phenotypes that is freely available and updated daily.

Other

-Dana Abbey, Colorado/Health Information Literacy Coordinator

Health Insurance Literacy Tools, or “What good is it if I don’t know what I’m doing?!”

Navigating health insurance can be a difficult and confusing process for even the most experienced of us. For someone who has never had insurance before and never needed to navigate the health care system, it can be overwhelming. A patient cannot benefit from having insurance if they do not understand their benefits, or how to access services. This includes people who are unsure of where to go for services, how to make an appointment, or how to prepare for their visit with a health care provider.

The Centers for Medicare and Medicaid Services oversees the From Coverage 2 Care initiative. This initiative aims to help people with new health care coverage to understand their benefits and connect with primary care and preventative services to improve their health. They offer an 8-step resource guide for patients including sections, “Know Where to go for Care,” with the companion consumer tool “Differences Between Your Provider’s Office and the Emergency Department, ” “Make an Appointment,” and “Next Steps After Your Appointment,” among others. These resources are all available in English and Spanish. They also offer an 11-part series of videos covering the same topics that are available to watch online or download. These are also offered in both English and Spanish. These From Coverage 2 Care resources and additional promotional materials, sample tweets, and badges are available at: https://marketplace.cms.gov/technical-assistance-resources/c2c.html.

Additionally, CMS has supplemental information for special populations, including glossaries in multiple languages, list of substance abuse and mental health services and providers, tools on enrollment for immigrants and refugees, multimedia resources and more. View the list of categories and select by topic here: https://marketplace.cms.gov/outreach-and-education/outreach-and-education.html.

CMS has more than just consumer health tools, they also offer a large collection of technical assistance resources on eligibility, enrollments, tax credits, exemptions, training materials for navigators and much more. Available at: https://marketplace.cms.gov/technical-assistance-resources/technical-assistance-resources.html.

The Internal Revenue Service also offers a guide on the tax provisions of the Affordable Care Act titled, “Health Care Law: What’s New for Individuals and Families.” It includes a list of forms and publications that can be used for preparing a tax return, as well as a glossary of terms, information about qualifying for an exemption and the new premium tax credit. It is available in several languages and can be found at: http://www.irs.gov/pub/irs-pdf/p5187.pdf.

Dana Abbey, MLS
Health Information Literacy Coordinator, National Network of Libraries of Medicine

Health Information Resources for Limited English Proficient Persons

Numerous studies over the past 25 years have demonstrated a strong connection between language and health. Language can affect the accuracy of patient histories, the ability to engage in treatment decision-making, understanding a medical diagnosis or treatment, patient trust level with care providers, underuse of primary and preventative care, and lower use or misuse of medications. Culture also plays a significant role in health, healing and wellness belief systems – impacting how illness, disease, and their causes are perceived by the patient and the care provider.

The story of Mohammad Kochi illustrates how language and culture can impact health outcomes.  Mr. Kochi, a 63-year-old from Afghanistan, is diagnosed with stomach cancer. While he agrees to surgery, he declines chemotherapy due to religious beliefs, language barriers, and family conflict. Mr. Kochi is a Limited English Proficient (LEP) person.

An LEP person is defined as an individual who does not speak English as their primary language and have a limited ability to read, speak, write, or understand English. An LEP person’s national origin is based on ancestry, not citizenship. There are an estimated 25.3 million LEP individuals in the United States – up 81% since 1990.[1]

These persons are protected under Title VI of the Civil Rights Act of 1964, and all organizations receiving Federal financial assistance have a responsibility to take “reasonable” steps to ensure meaningful access to their programs and activities by persons with LEP. Title VI applies to many types of organizations including schools, hospitals, public health clinics, police departments, and social services.

Libraries can play a key role in supporting an organization’s ability to provide meaningful access, especially in the area of health information. The National Library of Medicine (NLM) has developed many no-cost LEP-friendly health information resources for a variety of age and language groups. In addition, there are government agencies and authoritative non-profit organizations creating free health information content to address the linguistic diversity of the communities you serve. (Resources)

Spanish is the predominant language – other than English – spoken in the MidContinental Region (MCR) though you may see communities with strong German, French, Vietnamese, Chinese, Navajo, or Algonquian populations[1]. The following table shows the LEP populations ages 5 and over in the MCR[2]:

pic

Supporting LEP Person’s Access to Health Information

Public Libraries

Public libraries are highly focused on serving their local constituency, and continue to be an excellent conduit for transferring health information to community members with trained staff and technology infrastructure. For many citizens, the public library is the go-place for health information.

INVESTIGATE:

  1. What languages are represented in your community?
  2. What health information resources do you have access to in other languages?
  3. What organizations in your community might you work with to assist a non-English speaker with health information?

SHARE WITH:

  • Local health departments, emergency responders, police and fire departments, clinics, hospitals, schools, churches.

K-12, Colleges, and Universities

Students whose first language is not English require language supports in order to meaningfully participate in school. Schools must also adequately communicate with limited-English-speaking parents about important school-related information in their preferred language.[1]

If you work in a K-12 setting, educators can utilize these resources in the classroom to help introduce, reinforce, and supplement health and science curricula; and school nurses can use them to enhance communication with students and parents. Here are the percentages of school-aged children of immigrants in the MCR[2]:

  • Colorado        24.30%
  • Kansas            28.52%
  • Missouri         29.67%
  • Nebraska        30.29%
  • Utah                29.06%
  • Wyoming        dataset too small for percentage

If you work with colleges or universities offering allied health or health sciences degrees, students would benefit from knowledge of these resources as future healthcare workers.

INVESTIGATE:

  1. What languages are represented in your school district, college, or university?
  2. What health information resources do you have in other languages?
  3. Who in your institution or community would benefit from these resources?
  4. Do you have access to trained interpreters? If so, what languages?

SHARE WITH:

  • Teachers, faculty, school nurses, students, parents, administrators.

Medical Care and Public Health

Communication problems are the most common cause of serious adverse events with LEP patients and clients. They are at higher risk for longer hospital stays, readmission, misdiagnosis, and inappropriate treatment.

INVESTIGATE:

  1. What languages are represented in communities served by the medical care or public health staff?
  2. What health information resources do you have in other languages?
  3. Who in your institution or community would benefit from these resources?
  4. Do you have access to trained interpreters? If so, what languages?

SHARE WITH:

  • Clinical staff, compliance staff, volunteers, case workers, patient navigators.


[1] U.S. Department of Education, Office for Civil Rights. Title VI Enforcement Highlights, July 2012, p. 13. Accessed July 18, 2014. http://www2.ed.gov/documents/press-releases/title-vi-enforcement.pdf.

[2] Urban Institute, Children of Immigrants Data Tool, 2011. Accessed July 21, 2014. http://datatools.urban.org/features/childrenOfImmigrants/chart/coi.html


[1] See the Resources section for multi-language and language identification tools.

[2] Authors’ tabulations from the US Census Bureau’s 2010 American Community Survey (Table B16001. Language Spoken at Home by Ability to Speak English for the Population 5 Years and Over). Accessed July 18, 2014. http://www.census.gov/hhes/socdemo/language/data/census/table1.txt.


[1]Migration Policy Institute, Limited English Proficient Population of the United States. Accessed July 18, 2014. http://www.migrationpolicy.org/article/limited-english-proficient-population-united-states/.

School Librarians: Engaging Teachers and Students with the History of Medicine

“When school librarians collaborate with classroom teachers to enrich curriculum content, they help create more authentic learning experiences.”

—Dr. C. Beth Fitzsimmons, National Commission on Libraries and Information Science Chairperson (2004-2008)

Douglas County High School (DCHS) in Castle Rock, Colorado recently served as host to the National Library of Medicine’s (NLM) Every Necessary Care and Attention: George Washington and Medicine exhibit. The only high school west of the Mississippi to receive the 6-week exhibit, Peggy Cummings, the school’s Library Media Specialist, had to make a strong case to NLM to bring the exhibit to her site.

Cummings, who has been with DCHS for eleven years, was no stranger to planning exhibits and programming. She worked closely with the school’s social studies teaching staff to bring the Gilder Lehrman Looking at Lincoln: Political Cartoons from the Civil War Era exhibit to the library, and she has hosts an annual two-day event” Remembering Our Veteran’s” –in conjunction with the Douglas County public library archival staff. Cummings interest in hosting the George Washington exhibit was peaked with a listserv posting announcement, noting that resources like this can serve as a bridge between the classroom and the library. “There were so many facets to George Washington that were not as well-known as they should be. And this would provide a way to work with different academic departments. “

Figure 1 Peggy Cummings, Library Media Specialist

Figure 1 Peggy Cummings, Library Media Specialist

The exhibit explores the health and safety issues Washington faced in his personal, political, and military life. Medical practices during George Washington’s life (1732-1799) relied heavily on home remedies, herbal treatments, and hypothesis. Washington and his wife Martha had their share of illness; George survived anthrax, pneumonia, and skin cancer, and had continual issues with malaria. Martha contracted measles and suffered from gall bladder disease.  Washington oversaw the medical care of his family, plantation staff, slaves, and troops at a time when medicine was just beginning to embrace evidence-based or scientific practice.

Figure 2 Six-panel exhibit with Washington cut-out for selfies and groupies.

Figure 2 Six-panel exhibit with Washington cut-out for selfies and groupies.

Cummings saw great potential to include just about everyone in the school, and had two years to make it happen – the earliest the exhibit could be booked as it traveled across the country to various sites. She didn’t waste a minute, working to get support from administration, faculty and staff; hunting down supplementary materials – including a George Washington cutout; and, planning the budget. Engaging faculty was a continual effort – from talking about the exhibit at meetings, to sparking interest with frequent, short e-reminders. Cummings put together resources for the teachers to tie the exhibit into their class curriculum, for example comparing the modern day Ebola epidemic to Smallpox. She also involved the district’s school nurses – providing space for their monthly meeting and hosting an exhibit reception catered by the DCHS culinary students.

Figure 3 One of many interactive history learning stations.

Figure 3 One of many interactive history learning stations.

Teachers embraced Cummings enthusiasm and many took on the challenge to integrate the rich history of the exhibit into their curriculum, and together developed “Essential Questions” for various academic areas:

  1. Art: How can you summarize historical events into a contemporary design looking piece?
  2. Family and Consumer Sciences: What Colonial foods are still available today and how can we incorporate these into a contemporary baked good menu?
  3. Language Arts: Does poetry influence culture of culture influence poetry? What is close reading of non-fiction text and how can I use this technique for all of my class readings?
  4. Music: How can I adapt Colonial piano music into a score for a string sextet?
  5. SNN Basic, Mild, Moderate (Special needs students): How can I incorporate a piece of information in the display into my research and final report?
  6. Social Studies: How did Americans influence the French Revolution, and the French influence the American Revolution?  What primary source resources did the Founding Fathers use and how were these incorporated into the Declaration of Independence, Bill of Rights, and the U.S. Constitution?
  7. World Languages: How did Spain’s colonization of the new world differ between North and South America at the time of the American Revolution? What influence did the French and Indian War have on Washington, and later, what role did the French play in the Revolutionary War?
Figure 4 Students. Library staff and volunteers researched colonial towns and  created signage to mimic the streets Washington might have walked.

Figure 4 Students. Library staff and volunteers researched colonial towns and created signage to mimic the streets Washington might have walked.

Peggy’s Tips for Exhibit Success:

  • Have the backing of who’s in charge.
  • Have authority, there are a lot of nitty-gritty decisions you need to make.
  • Plan ahead.
  • Publicize ahead.
  • Learn as you go.
  • Ask for help and cooperation.
  • Pace yourself, you will be working a lot of extra hours.
  • Smile and enjoy.

Peggy’s Supplemental Exhibit Resources:

National Library of Medicine’s Exhibition Program:

Explore the exhibitions and educational resources about the social and cultural history of medicine. There are a number of traveling exhibits and a wealth of online materials, including lesson plans and online activities, that can be used to support K-12 health and science curriculums.

The Knee Bone’s Connected to the ….. Toxicology Resources from the National Library of Medicine You Just Might Need!

The Knee Bone’s Connected to the ….. Toxicology Resources from the National Library of Medicine You Just Might Need!

November 14, 2014

Have you ever had a customer or student inquire about environmental resources, what may be toxic in our geographic environment or even a home environment? Or what about lead in the soil? Or which careers may have hazardous exposures? These are just a few of the Sorry, there are no polls available at the moment.questions you may receive since our lives are filled with chemical exposures.

How can you learn more? Well, the National Library of Medicine provides a host of free resources for just these purposes, through its Environmental Health and Toxicology Portal (http://sis.nlm.nih.gov/enviro.html). Take a look at just a few of the resources mentioned here.

LactMed: http://lactmed.nlm.nih.gov A database of more than 900 drugs and other chemicals to which breastfeeding mothers may be exposed. For example, a young mother may wish to know if she can take aspirin while breastfeeding. By simply doing a search on aspirin, she can find that it is “best avoided during breastfeeding.”

TOXMAP: http://toxmap.nlm.nih.gov/toxmap/ A Geographic Information System that uses maps of the United States to help users visually explore Toxic Release Inventory, (TRI) on more than 650 toxic chemicals. Is your community noted on this map? Also available is information on the Superfund program, part of a Federal government effort to clean up land in the U.S. that has been contaminated by hazardous waste.

Haz-Map: http://hazmap.nlm.nih.gov An occupational toxicology database that links job tasks to occupational diseases and their symptoms. Want to know more, for example, about risks to hairdressers or child care workers? More than you want to know!

Household Products Database : http://householdproducts.nlm.nih.gov/ Human health effects information on more than 12,000 brand-name consumer products from landscape and yard to personal care to pesticides to pet care. Find the chemical make-up (maybe you have an allergy!), check for manufacturers, learn about first aid and how to dispose of the product safely. For a real challenge, find what ingredient is in acne scrub and toilet bowl cleaner!

Tox Town: http://toxtown.nlm.nih.gov An interactive guide to commonly encountered toxic substances and environmental health risks. Tox Town is highly interactive, with graphics, animation, and sound to add interest to learning about connections between chemicals, the environment, and the public’s health. For example, in the Farm location, click on the cat and hear the cat meow. Then explore information on pets. Recommended for high school and college students, educators, and the concerned public.

Wireless Information System for Emergency Responders (WISER®): http://wiser.nlm.nih.gov Provides a wide range of information on hazardous substances, including substance identification support, physical characteristics, human health information, and containment and suppression advice. How about recommending this to the emergency responders in your city? It’s easily downloadable to a mobile device.

Disaster Information Management Research Center (DIMRC): http://disaster.nlm.nih.gov/ Health information resources and informatics research related to disasters of natural, accidental, or deliberate design. Learn what you should have on hand in your home for emergency preparedness. And if this isn’t enough, try this for lots more databases! Enviro-Health Links: http://sis.nlm.nih.gov/enviro.html

For more information contact: Dana Abbey, MLS Health Information Literacy Coordinator National Network of Libraries of Medicine, MidContinental Region Dana.abbey@ucdenver.edu.

Health Information Resources for Limited English Proficient Persons

Numerous studies over the past 25 years have demonstrated a strong connection between language and health. Language can affect the accuracy of patient histories, the ability to engage in treatment decision-making, understanding a medical diagnosis or treatment, patient trust level with care providers, underuse of primary and preventative care, and lower use or misuse of medications. Culture also plays a significant role in health, healing and wellness belief systems – impacting how illness, disease, and their causes are perceived by the patient and the care provider.

The story of Mohammad Kochi illustrates how language and culture can impact health outcomes.  Mr. Kochi, a 63-year-old from Afghanistan, is diagnosed with stomach cancer. While he agrees to surgery, he declines chemotherapy due to religious beliefs, language barriers, and family conflict. Mr. Kochi is a Limited English Proficient (LEP) person.

An LEP person is defined as an individual who does not speak English as their primary language and have a limited ability to read, speak, write, or understand English. An LEP person’s national origin is based on ancestry, not citizenship. There are an estimated 25.3 million LEP individuals in the United States – up 81% since 1990.[1]

These persons are protected under Title VI of the Civil Rights Act of 1964, and all organizations receiving Federal financial assistance have a responsibility to take “reasonable” steps to ensure meaningful access to their programs and activities by persons with LEP. Title VI applies to many types of organizations including schools, hospitals, public health clinics, police departments, and social services.

Libraries can play a key role in supporting an organization’s ability to provide meaningful access, especially in the area of health information. The National Library of Medicine (NLM) has developed many no-cost LEP-friendly health information resources for a variety of age and language groups. In addition, there are government agencies and authoritative non-profit organizations creating free health information content to address the linguistic diversity of the communities you serve. (Resources)

Spanish is the predominant language – other than English – spoken in the MidContinental Region (MCR), though you may see communities with strong German, French, Vietnamese, Chinese, Navajo, or Algonquian populations[2]. The following table shows the LEP populations ages 5 and over in the MCR[3]:

Supporting LEP Person’s Access to Health Information

Public Libraries

Public libraries are highly focused on serving their local constituency, and continue to be an excellent conduit for transferring health information to community members with trained staff and technology infrastructure. For many citizens, the public library is the go-place for health information.

INVESTIGATE:

  1. What languages are represented in your community?
  2. What health information resources do you have access to in other languages?
  3. What organizations in your community might you work with to assist a non-English speaker with health information?

SHARE WITH:

  • Local health departments, emergency responders, police and fire departments, clinics, hospitals, schools, churches.

K-12, Colleges, and Universities

Students whose first language is not English require language supports in order to meaningfully participate in school. Schools must also adequately communicate with limited-English-speaking parents about important school-related information in their preferred language.[4]

If you work in a K-12 setting, educators can utilize these resources in the classroom to help introduce, reinforce, and supplement health and science curricula; and school nurses can use them to enhance communication with students and parents. Here are the percentages of school-aged children of immigrants in the MCR[5]:

Colorado        24.30%

Kansas            28.52%

Missouri         29.67%

Nebraska        30.29%

Utah                29.06%

Wyoming        dataset too small for percentage

If you work with colleges or universities offering allied health or health sciences degrees, students would benefit from knowledge of these resources as future healthcare workers.

INVESTIGATE:

  1. What languages are represented in your school district, college, or university?
  2. What health information resources do you have in other languages?
  3. Who in your institution or community would benefit from these resources?
  4. Do you have access to trained interpreters? If so, what languages?

SHARE WITH:

  • Teachers, faculty, school nurses, students, parents, administrators.

Medical Care and Public Health

Communication problems are the most common cause of serious adverse events with LEP patients and clients. They are at higher risk for longer hospital stays, readmission, misdiagnosis, and inappropriate treatment.

INVESTIGATE:

  1. What languages are represented in communities served by the medical care or public health staff?
  2. What health information resources do you have in other languages?
  3. Who in your institution or community would benefit from these resources?
  4. Do you have access to trained interpreters? If so, what languages?

SHARE WITH:

Clinical staff, compliance staff, volunteers, case workers, patient navigators.


[1]Migration Policy Institute, Limited English Proficient Population of the United States. Accessed July 18, 2014. http://www.migrationpolicy.org/article/limited-english-proficient-population-united-states/.

[2] See the Resources section for multi-language and language identification tools.

[3] Authors’ tabulations from the US Census Bureau’s 2010 American Community Survey (Table B16001. Language Spoken at Home by Ability to Speak English for the Population 5 Years and Over). Accessed July 18, 2014. http://www.census.gov/hhes/socdemo/language/data/census/table1.txt.

[4] U.S. Department of Education, Office for Civil Rights. Title VI Enforcement Highlights, July 2012, p. 13. Accessed July 18, 2014. http://www2.ed.gov/documents/press-releases/title-vi-enforcement.pdf.

[5] Urban Institute, Children of Immigrants Data Tool, 2011. Accessed July 21, 2014. http://datatools.urban.org/features/childrenOfImmigrants/chart/coi.html