In this assignment, articles from databases are used to answer three patrons' information needs. A discussion of each solution is on this page; patron presentations are linked from the descriptive titles and the "Related links" box on the right.
The general theory was to do an analysis of the information request, then consider databases that might hold appropriate material, then look for the best articles for the patron. There was a lot of iteration in the database/article discovery process, as one did not know the value of a database without running quite a few queries and appraising a lot of articles. When I found a good article I'd sometimes put it in the database section and sometimes in the article section; this page is more note-taking than presentation. You want verbal, you get verbal :)
1. A middle-aged woman has been diagnosed with breast cancer. She is interested in current research about non-surgical treatment options. (client page)
The client is seeking "current research" but the details of what that means are unknown. To a medical specialist, "current research" would be peer-reviewed articles describing medical research projects. While this may be what she seeks, she may also have in mind something written for a lay audience. Lay articles have a variety of depth and breadth. A strategy to consider would be giving her one article at a professional level of detail and informing her that, if this is like what she wants, more can be obtained. The problem is that this might seem to be favoring the one course of action described in the article (if it was in fact about a single treatment option).
Difficulties abound. We do not know what type of cancer was diagnosed. Treatments vary according to cancer type. We do not know if she is post-menopausal, and treatments vary accordingly.
"Non-surgical treatment options" can mean alternative therapies like diet and prayer. This may be what she intends, but without a reference interview one cannot be certain. It would be safest to supply articles of a more substantial nature and refer her to other sources for these types of alternative therapies. If it was not what she intended, she might question your professional ability if you gave her an article about faith based healing.
The librarian must be careful not to make any medical judgements about the patron's condition, and must not give medical advice or make medical recommendations. Since she "has been diagnosed" presumably she is in contact with a medical professional, so refering her to an article along with a recommendation that she discuss it with her doctor would be appropriate.
I asked a good friend of mine, a pediatric surgeon, what "current research" would be in the field of breast cancer. He suggested using a five year filter to be sure not to miss anything important, but to cast a very critical eye on anything older than two and a half years.
Many medical databases are available; there are 161 in the "MEDICINE HEALTH SCIENCES" category of WebLUIS and 22 are in a subcategory "MEDICINE HEALTH SCIENCES--SUGGESTED GENERAL MULTIDISCIPLINARY." Only 71 of the 161 are available to FSU students. Reviewing the database descriptions in WebLUIS yields this list of potential sources:
Alt Health Watch (EBSCO) "This database focuses on the many perspectives of complementary, holistic and integrated approaches to health care and wellness." This may be a source for our "alternative" article or recommendation, if we choose to include one. Results: Sounded promising but it is not available to FSU students.
Books@Ovid supplies full text from reference books. Could be good but not required for assignment. Results: highly clinical and results tend to be chapters from books. Not a good source for this patron.
CINAHL " the Cumulative Index to Nursing & Allied Health Literature" Results: heading is Breast Neoplasms; applicable subheadings are Diet Therapy, Drug Therapy, Radiotherapy, Therapy, and perhaps History and Prevention and Control. This leads to thousands of articles that mignt be relevant, but I cannot understand the content. For instance:
Piccart-Gebhart, M.J. (2004) New Stars in the Sky of Treatment for Early Breast Cancer. New England Journal of Medicine. 350(11):1140-1142.
turns out (by reading this: (Noonan, D. (2003). Breast Cancer's 'New Era'. Newsweek, 142 (16), 67-8 ) that this is about a drug that is used post-operatively, so it is not what our patron wants. I think this database may be too clinical for our use this time.
DynaMed: Dynamic Medical Information System; "a database by medical topic or condition with links to sentinel articles" Results: excessively clinical; choppy presentation, assumes knowledge of current medical literature.
e-Medicine Clinical Knowledge Base "peer-reviewed, disease specific articles" Results: did not work (HTTP Error 500).
Harrison's Online " the most widely used resource in clinical medicine and research" Results: chapters in books, very clinical. http://80-harrisons.accessmedicine.com.proxy.lib.fsu.edu/server-java/Arknoid/amed/harrisons/co_chapters/ch089/ch089_p07.html is treatment page.
Health and Wellness Resource Center and Alternative Health Module "Topics in health and medicine, medications, and wellness. " Results: This is a good resource with reference materal and journals both; easy to use navigation; accessible material.
Health Reference Center - Academic provides a wide variety of health resources Results: nothing that hadn't been seen before.
Health Source: Nursing/Academic Edition "provides nearly 520 scholarly full text journals focusing on many medical disciplines." Results: The results were too clinical, comprised mostly of studies from MEDLINE.
Journals@Ovid "An extensive collection of medical and nursing journals from a variety of publishers" Results: high quality medical research. This would be a good database for detailed medical research.
Good review of a book: Lang, N. P. (2004). The Breast: Comprehensive Management of Benign and Malignant Disorders, vols 1 & 2.JAMA. 291(23):2874-2875, June 16, 2004.
Good overview if patron has metastatic cancer: Ali, S.M.; Harvey, H.A. Lipton, A. (2003) Metastatic breast cancer: overview of treatment.Clinical Orthopaedics & Related Research, 1(415S), S132-S137
MD Consult Core Collection "access to over 30 renowned medical texts, articles from more than 40 clinical journals, practice guidelines, drug information, 2,500 patient education handouts, CME, and daily medical updates customized to your specialty." Results: This is an excellent site for our patron to visit, incorporating journals with books, clinical handouts, news, and other sources of current information.
MDX Health Digest Contains citations with abstracts of health articles, written in language suitable for the general public. Results: lots of lay articles from a wide variety of popular sources, but very little on non-surgical treatments.
Medline (PubMed) U.S. National Library of Medicine. Results: very good
Medline Plus: Free access to consumer health information including drug information, medical encyclopedia, news, and health care directories. Results: excellent resource. Many links to other government agencies and definitive sources. No periodicals, unfortunately.
ProQuest Medical Library: "All full-text articles from over 100 medical journals." Results: not available at FSU.
Some broad general databases also should be searched:
ScienceDirect -- Elsevier Science Journals Results: lots of articles (4,555 on breast cancer treatment) Mostly high quality clinical studies; no surveys or overviews apparent in first few hundred results.
Wiley InterScience Results: lots of articles, clinical studies, nothing helpful that I could find at the right level.
LexisNexis Academic Lots of good articles, accessible to lay person but referencing academic papers. Cyroablation link came from here; LexisNexis had a news article promoting the maker of the device used in the procedure, but there was enough information to find the article in Ovid:.
Sabel, M.S., Kaufman, C.S., Whitworth, P., Chang, H., Stocks, L.H., Simmons, R. & Schultz, M. (2004). Cryoablation of early-stage breast cancer: work-in-progress report of a multi-institutional trial. Annnals of Surgical Oncology, 11(5), 542-549. This article can be found in the database "Journals@Ovid" by searching for its title.
This is an ethical dilemna, because it seems that standard medical response is surgery, and she is asking for non-surgical solutions. It's also a challenge because there are many different forms of cancer and we don't know what she's got. It's also a challenge because there are so many articles!
1. Underwood, A. (2004). Fresh Weapons For an Old Battle. Newsweek, 143(19), 64. mentions a non-surgical experimental procedure called ablation.
2. A " Patient Handout" on breast cance from Elsevier's MDConsult is an excellent overview of the subject and describes non-surgical approaches, including hormone therapy, chemotherapy, and radiation treatment, although it does say that surgery is generally part of the treatment.
(How to find it
Go to databases / MD Consult Core Collection / create login / login / Advanced Search / search within Patient Handouts / breast cancer / choose “Cancer, Breast: Comprehensive Version” from Patients Handouts Search Results. The descriptions of non-surgical treatment alternatives starts about ¾ of the way down the page.
Rationale: This is an authoritative and comprehensive article designed as a “Patient Handout” from a database product designed for doctors. It has everything: written for patients, coming from medical source, alternatives to surgery. The only hassle is getting registered and finding it; I provided instructions on how to do this. My login: richackerman/qwe49poi )
Parker-Pope, T. (2002, January 18). Experimental treatment excises breast cancer without using surgery. Wall Street Journal. (from health and wellness resource center) (never actually read this; too old)Harmer, V. (2000). Adjuvant treatment for breast cancer patients. Nursing Times 96(49), 34-36. Too old.
After I had all this information realized that none of these articles were any good, but at least I had an idea of decent databases. I scanned several hundred more abstracts looking for decent articles. Finally found a few and put them on the client page.
2. A nine-year-old is writing a report for school on the cars that don't cause so much pollution. (client page)
The literal request "cars that don't cause so much pollution" has a myriad of answers because we don't know what the baseline is. The Federal government passed a series of air quality control laws over the past few decades, and all cars on the road "don't cause so much pollution" compared to the vehicles of 1960. California has stricter air quality laws than the rest of the nation, and cars sold there "don't cause so much pollution" compared to cars outside the state. New types of automotive power sources are being sold or developed. The hybrids sold by Toyota and Honda generate less pollution than today's internal combustion engines. The electric car was tried but failed to find marketplace success. Propane powered vehicles have been built; they generate less pollution. Diesels are an alternative. The fuel cell is prohibitively expensive today, but a hydrogen based transportation energy system is the ultimate in lower pollution and has gotten high level attention. The "Hydrogen Fuel Initiative" has a $1.7 billlion R&D budget for a five year program.
Finding age-appropriate material is the largest challenge in this information request. A nine year old is probably in third grade, so material classified for grades 2 - 4 would be appropriate. Simpler material may work if it can be found. The student can read up several grade levels with help, so up to about grade 6 or grade 7 would be acceptable. With help, an informative article from Motor Trend or Car and Driver might work. Another source of overviews would be general news magazines like Time or U.S.News and World Report.
InfoTrac Kids Edition "Designed for grades K-6" (http://www.gale.com/itkids.htm)
InfoTrac Junior Edition Junior high and middle schools
InfoTrac Student Edition High school
InfoTrac General Reference Center Gold best run of Weekly Reader :)
InfoTrac Custom (Professional Collection)
These five have many age appropriate publications like Weekly Reader, Time for Kids, New Moon, Junior Scholastic, Kids Discover, Odyssey.
Primary Search (EBSCO) and SIRS Discoverer would be good but we don't have access to them.
A couple of other databases could be useful, although they are not going to have very much that a nine year old could understand, and the user interfaces to use them will be a large obstacle:
ABI/INFORM Global: general purpose database for Time Magazine etc.
Lexis/Nexis Academic: good for newspaper features about hybrids
2005 Cars: fueling the future. (2004). Consumer Reports, 69(10 ), 15. Retrieved from LexisNexis. Discusses background, hybrids, diesels, renewables, fuel cells. She will need help to read this, but it explains all the alternatives clearly.
Miller, J. (2004) Fill'er up ... and charge it--the new hybrid auto. Odyssey 13(4), 19. Retrieved from InfoTrac OneFile. This is an article about hybrids that is easy to read. It explains the basic concepts and has an interview with a Mom and her two sons. This would be great.
Hybrids are hot! (Environmental News). (2002). Junior Scholastic 104 (16), 11 (From General Reference Gold) . This is an older article but it is written at a good level and talks about the basic issues.
Good but not the BEST...
Grose, T.K. (2003). Clean machines. ASEE Prism, 13(1), 34-38 [from WilsonWeb, Education Full Text , hard article but good one, talks about fuel cells, maybe the next step after hybrids]
Tsang, E. (2004). Yellow bikes and flying cars. New Moon, 11(July-August). An article that s/he can read alone, retrieved from InfoTrac for Kids. This is fun but it is pretty small and only part of the article deals with car pollution.
Ebersole, R. (2001, September 28). Give up the gas guzzler; gasoline-electric hybrid vehicle. Current Science, Sept 28, 2001. Not so current :)
This article is for 7-10 graders so it is a little challenging but it has some fun information for you. With some help:
Tucker, L. (2003). Fuel for debate: gas guzzlers are an environmental hazard. Can car engineers clean up their act? Science World, 59 (13), 10-14
Also recommend the website: How does a hybrid car work? http://www.howstuffworks.com/question262.htm
Lots of good articles in Science, Fortune, Economist, etc but these are not written for 9 year olds.
3. A free-lance writer is working on an article about memory and aging. He is wondering how much "senior moments" are culturally induced phenomena. The magazine he is writing for is read by a diverse population of retired professionals. (client page)
The patron is a writer, and presumably understands material at an advanced level, although not necessarily at a clinical medical level. The target audience for his article reads at a high level. Background material on causes of memory loss in the aging population would be appropriate. The point of view that the researcher wants is more pyschological or sociological than medical, so the social science directories may be better sources of information - we need to look in both medical and psychology/sociology sources.
I explored a number of databases.
ISI Web of Knowledge - not very good
AARP Ageline - abstracts, not very useful
Social Sciences Full Text - lots of good material
WilsonWeb Social Sciences Full Text - excellent
HIghwire Press - contains Levy article
APAPsycNet - abstracts contain information about nine of Levy's articles and full text for seven. Not many articles but they are good.
A PA PsychArticles – this database contains many journals of interest, including “Psychology and aging” which may have articles of interest on the topic. Needs more exploration.
Levy, B. (2003). Mind matters: cognitive and physical effects of aging self-stereotypes . The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 58B(4), 203-P211. Becca Levy, a professor at Yale University, has conducted lots of research on the aging process. This discusses how stereotypes of aging effect the aged and deals specifically with research on cultural influences on memory in the elderly. See, for instance, Levy, B. (1996). Improving memory in old age by implicit self-stereotyping. Journal of Personality and Social Psychology, 71,1092-1107. From the abstract: "This research highlights the potential for memory improvement in old individuals when the negative stereotypes of aging that dominate the American culture are shifted to more positive stereotypes."
Bonnesen, J.L. & Burgess, E. O. (2004). Senior moments: the acceptability of an ageist phrase. Journal of Aging Studies, 18(2), 123-142. This is an excellent article on “senior moments” from ScienceDirect Elsevier Science Journals
Volz, J. (2000). Successful aging: the second 50. Monitor on Psychology, 31(1). This article is a good overview of research areas of interest, discussing recent research into memory loss, aging, and the social behavior. The article suggests that the memory loss previously thought of as inevitable with encroaching age is, in fact, a function of ones life choices, exercise, and social dynamics. This would be a good message to convey to the writer's audience.The article suggests many other sources of information. A representatitve quote: “John Cavanaugh, PhD, a researcher on aging issues at the University of North Carolina at Wilmington, believes the answer lies buried in memory, and filed under "Beliefs." With memory, it does appear that people's belief systems are important," says Cavanaugh. "There are hints that the kinds of things people tell themselves [about their ability to remember] matter."
Stevens, F.C., Kaplan, C.D., Ponds, R.W., Diederiks, J.P., and Jolles, J. (1999). How ageing and social factors affect memory. Age and Ageing, 28(4), 379-384. This article argues that social activities reinforce and strengthen memories in older population. It's in Oxford Journals Online.
Nelson, Aaron (Ed.). Albert, Marilyn S. (Ed.). Gilbert, Susan. Allison, Kathleen Cahill (Ed.). Harvard Medical School Improving memory: understanding and preventing age-related memory loss. [Book] Harvard Health Publications, Boston, MA. 2004. (48p.) This recent publication offers a comprehensive overview of the interaction between age and memory.
Sliwinski, Martin J.. Hofer, Scott M.. Hall, Charles. Buschke, Herman. Lipton, Richard B. (2003). Modeling memory decline in older adults: the importance of preclinical dementia, attrition, and chronological age. Psychology and Aging, 18(4), 658-671. This article provides a scientific treatment of current theories of memory loss and aging.
Extra credit: Science of Aging Knowledge Environment (SAGE KE) at http://80-sageke.sciencemag.org.proxy.lib.fsu.edu/ Is it web or database?
I discovered lots of interesting databases during this project. I can see that with practice one can get very good at this type of research. The breast cancer research was difficult due to the enormous amount of hightly specialized literature that was almost all about surgical treatment or followup; articles on non-surgical approaches were, like the proverbial needles, hard to find.