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The Threat of Pandemics (MLA13 Boston: Plenary 4: Laurie Garrett)

A woman dressed in black standing at a podium in front of a white lighted circle stating One Health.

Laurie Garrett giving her presentation.

The final plenary, and indeed, the final non-CE class or tour event of MLA13 Boston, was on my list of events to blog for the official conference blog.  I summed up the entire presentation.  As stated previously, I can’t reproduce those posts here on my personal blog, so please go over and take a look at that summary before reading my responses to and thoughts on the presentation.

Got it? Good!

Ok, so, what was my reaction to this lecture?  Well, first, honestly I had a bit of a panic.  I felt frightened, unsafe, and like the world is doomed.  At first I thought that was just my anxious-prone self over-reacting to the presentation, but after discussing it with friends and colleagues who were also there, I realized that Garrett seems to have actually sought to pull out this fear in people.

Why?

In a presentation that ends with pleas for us to fight fear and panic, why did she spend so much time investing in frightening us and very little (if any) spent in reassuring us?  Why focus so much on pandemics just a single mistake away, germ warfare close at hand (although, not really since 3D printing of germs isn’t happening yet).  I don’t know.  I don’t know what would make Garrett think making people feel this way is a good thing.  Maybe she’s fallen prey to the idea that the only way to get people to pay attention to your cause is to frighten them.  I know people in various movements who use that tactic.  It’s not one I’m a fan of.  Maybe she didn’t intend to gloom and doom the people present.  But I think she did.  Given that her own speech pointed out the dangers of panic and unwarranted fear, I find it odd that this was her intent.  And yet there you have it.  A room full of frightened librarians.  Think I’m exaggerating?  Check out just a few of the tweets from during her presentation:

Screen shot of a tweet "Nothing like wrapping up a conference with a presentation that will haunt attendee dreams..."One Health? Garrett's doom-scenario suggests we're on course for One Ill-HealthLaurie Garrett is scaring us all to death about pandemics and biosynthesis and germs etc...@Laurie_Garrett is one of the best speakers I've seen in a long time.  Also one of the scariest.YES! RT @mandosally I'm feeling creeped out. Anyone else?I think I'm going to use a 3D printer to make a bubble house and never leave it...Everyone has their own style, and I certainly learned a lot from the presentation and wasn’t bored.  But.  I’m not a fan of nonfiction presentations (aka not horror plays or movies) inciting fear and panic in the audience.  I think it’s counter-productive when talking to a room full of intelligent, educated individuals.  Librarians aren’t 5 year olds who need to be told about icky germs in order to get us to wash our hands.  I’m sure there could have been a way to give this presentation with truths and realities that could be frightening without actually inciting this level of anxiety.  Even just a little positivity and more hope for the future would have been nice.  You don’t want a populace that is exerting all their energy preparing for Armageddon.

I should also mention that I stood up to ask a question of Garrett at the end.  With all the talk of synthetic biology, I wanted to know what her opinion was on GMOs.  I admit, this is not an issue I am yet clear-cut on myself.  I generally prefer organic, but I also understand the value of say rice that has been modified to have more vitamins in it for an at-risk population.  But on the other hand I get the concern of manipulating something at a genetic level and what that might do to our own bodies when we ingest it.  It’s something that just doesn’t have enough long-term studies yet to really show if it’s truly safe or not, and it concerns me that it’s mostly the poor, at-risk populations who are being used as guinea pigs eating it.

In any case, I asked Garrett at the public microphone about her stance on GMO foods and the movement to label them.  Given all of her doom and gloom talk about synthetic viruses, I was shocked at her answer.  She believes that GMO foods are necessary because as more of the world becomes middle class, more of the world is eating meat, and meat eating just cannot be sustained on the land we currently have available, so we must turn to eating synthetic foods.

Um, EXCUSE ME?!?!

So the lady who just spent over an hour and a half talking about how dangerous synthetic biology could turn out to be turns right around and says that meat eating isn’t sustainable to feed the entire globe (which it isn’t, see this article in the American Journal of Clinical Nutrition) turns right around and says that well we have to eat GMOs to feed everyone because people won’t just give up meat.  Right, ok, if someone is so concerned about the possible bad consequences of synthetic biology don’t you think she might possibly take this opportunity to espouse a vegetarian, vegan, or even just more plant-based diet to combat the global food crisis instead of relying exclusively on GMOs?  Apparently not.  Apparently it’s really great to fear-monger about pandemics and international relations but when it comes to what we eat, the basis of much of our health, that’s too controversial.

Well, at least it was an interesting final couple of hours of MLA13, although I can’t say I really feel that it was very useful to librarians or working to promote true global health.

National Library of Medicine Update (MLA13 Boston)

Photo of a slide showing user expectations, ILL librarian expectations, and an ideal future.

Slide from presentation showing What users want out of ILL. What ILL librarians think are issues with ILL currently. What a perfect world future of ILL would look like.

This year I got to go to the annual presentation by the National Library of Medicine (NLM) at MLA.  NLM is an important medical library resource, as it provides many free, trustworthy health, medicine, and science research resources to the public.  The NLM Update provides information on any important changes by NLM in the last year, as well as just any information/resources they would like to highlight.

  • clinicaltrials.gov
    • have data available of national origin of studies
    • you can build your own specialized view if you’d like to
    • a unique source of summary results for many trials
    • NN/LMx training for librarians coming soon
  • standardization makes information more usable
  • SNOMED Clinical Terms (SNOMED CT)
  • Genetic Testing Registry
    • 3,005 tests registered by 290 labs in 37 countries
    • useful inks for EHRs (Electronic Health Records)
    • international standard for location of genetic variations
  • PubMed Health
    • more digitized guidelines
    • specifically focused on flu site
    • working on global microbial identifier for food-borne pathogens
  • FY 2013 budget
    • lost 5.5% annum ($19.2 million less)
    • people are the most important NLM resource.  Call them “brain-ware.”
  • Index Cat
    • XML data available for 3.7million citations
    • index journals we trust cover-to-cover to keep up
  • NLM exhibits
    • Native Voices: Native Peoples’ Concepts of Health and Illness” is current exhibit.
    • There is an app of the interviews portion of the exhibit available on iTunes
    • The NLM traveling exhibition program has been booked by 457 institution in 48 states.
    • The Harry Potter exhibit grew out of last-minute attempt to make science interesting to middle schoolers.
    • Traveling exhibits consist of 6 banners that can be rolled into mailing tubes for quick shipment.
    • You must do local programming to borrow an exhibit
  • NLM Associate Fellowship Program
  • MedPrint
    • a program to get libraries to commit to keep print runs of journals
    • check page to see what’s been saved already
  • Environmental Health and Toxicology
  • Disaster Information Management Research Center
  • Inter-Library Loan (ILL)
    • requests down almost 50% in last 10 years in Docline
    • investigating this
    • conference call with focus groups representing:
      • hospitals
      • large academic libraries
      • special libraries
    • not planning to take Docline away
    • national survey in March 2013
      • 60% hospitals
      • agreed journals are electronic now
      • disagreement on if licenses are easy to understand
  • MedlinePlus
    • 15 years old in English, 10 years old in Spanish
    • multiple language link –> follows US medical practices, also available in English translation
    • US is 37% of users
    • very active twitter account
    • mobile site
      • going through usability study
      • More Spanish speaking males use than females.  More English speaking females use than males.
      • most of us want the full site not the mobile site
  • MedlinePlus Connect
    • allows EHR to send a code and get back patient-specific health information
  • 5 day posting of jobs is a requirement of the government to speed up hirings.  It is not a sign that they already know who to hire.

After the NLM Update, I attended the poster sessions.  This is not something one tends to take notes at, so I don’t have very much to say about them, except that I am proud of my medical librarian friend who had a poster in the session. Go Katie!

Up next, the final plenary session! Phew!

The Rise of Evidence-Based Health Sciences Librarianship (MLA13 Boston: Janet Doe Lecture by Joanne Gard Marshall, AHIP, FMLA)

The third plenary is given by a librarian who is respected in the field, but who is not the current MLA president.  Last year, we had a fascinating lecture by Mark Funk in which he showed us his extensive research documenting what librarians talk about in our published literature.  This year, Joanne Gard Marshall presented “Linking Research to Practice: The Rise of Evidence-Based Health Sciences Librarianship,” which while an interesting title mostly came across as a list of names of people she considered important.  She also spent 5 to 10 minutes summing up Mark Funk’s previous speech.  I think my tweet from during this plenary sums up my feelings pretty well:

Screenshot of a tweet reading #mlanet13 ehhhh summing up previous yr's doe lectures isn't very impressive as a doe lecture itself As with any lecture, though, I was still able to glean some useful or interesting information from it.  I’ve listed them out below.

  • David Sackett founded Evidence-Based Medicine (EBM), and his textbook Evidence-Based Medicine: How to Practice and Teach EBM, 2e is considered crucial in the field.
  • Sackett defines EBM as, “The conscientious, explicit, judicious use of current best evidence in making decisions about the care of individual patients.”
  • Evidence-Based Practice (EBP) is influenced by three factors:
    • Best research
    • Clinical expertise
    • Patient values and preferences
  • The old indexing (in PubMed etc…) didn’t used to include type or level of evidence in the terminology.
  • Evidence-Based Librarianship (EBL) is advocated for by McKibbon and Eldredge.  You may see a free PMC article summing that up here.
  • Steps of EBL:
    • formulate answerable question
    • search for evidence
    • critically appraise evidence
  • The research section of MLA has a free journal, Hypothesis, that is recommended.
  • MLA has a research imperative that you may read here.
  • “Randomized Control Trials, contrary to popular belief, are not the only way to control variables.”
  • Booth and Brice are named as big names in EBL.  Their book is Evidence-Based Practice for Information Professionals: A Handbook.
  • There is a journal on EBL called Evidence Based Library and Information Practice.  It is free, but you must register to comment or receive email notifications of new issues.
  • Recommends the book Diffusion of Innovations by Everett M. Rodgers to help with where we are going in EBL.  Take the model presented and adapt it and truly make it work for us.
  • Research must be balanced and paired with professional knowledge.

While the information I garnered is good, for a one hour lecture, it’s not very much. I left off the lists of names of previous Janet Doe lecturers, for instance.  I believe that if Marshall had focused much more in on the topic of EBL and its connection to EBM, which is an interesting topic, that it would have been a much better lecture.  Instead this received only a portion of the time so that we could be subjected to the names of previous Janet Doe lecturers and of course lists of people to thank. I am pleased to have found two new open access journals to read for my profession, but I do wish the lecture had gone further.

Up next is section programming.

 

The Power of Communication to Influence Health (MLA13 Boston: Plenary 2: McGovern Award Lecture by Dr. Richard Besser)

A tanned, white man standing in front of a blue background with a white moon-shape that says "One Health" on it behind him.

Dr. Richard Besser speaking at MLA13 One Health

After the first plenary and a short break came the second plenary, the McGovern Lecture.  I was surprised to see on twitter (the hashtag for the conference was #mlanet13 if anyone is interested) that many librarians didn’t see the value of having a plenary lecture by a non-librarian talking about non-library things.  I responded to this criticism in one of my official MLA13 blog posts The Value of the Non-Librarian Perspective: Thoughts on Plenary 2.  Please do take a moment to check that out.

And now back to the plenary.  Dr. Richard Besser is the medical correspondent for ABC, but more interestingly to me, he also was the acting director of the CDC during the H1N1 epidemic.  Epidemics ultimately were a theme of the conference, which makes sense since the overarching theme was One Health.  One health meaning the global health of all living creatures and how we are all interconnected.  Below are my notes from Dr. Besser’s lecture.

Introduction

  • Describes himself as an accidental journalist
  • If you change your life, then the terrorists win.
  • The reason Israelis are so well-prepared is because they face it every day.

Starting at the CDC and Advice on Being the New Person

  • Recommends the leadership book Good to Great
  • 1st ask your new boss what they think of their organization and ask them if they think it needs: big change, small change, or stabilization

How to Respond to a Pandemic

  • If you can spread out a pandemic so hospitals aren’t flooded, you’ll save lives.
  • You use different words to get different responses.
  • With a new emerging infection, you only get one shot to get ahead of it.
  • Be transparent with the public.
  • Base actions on fact.
  • Apply rapid learning –> guide will change based on new knowledge
  • If you lose the trust of the public, you’ve failed.
  • Three key aspects of communication:
    • Be first
    • Be right
    • Be credible
  • Homeland Security is in charge during a declared national emergency
  • Dr. Besser was featured on The Daily Show during the H1N1 epidemic
  • When he met with the cabinet, Obama said, “I want our responses based on science.”  An excellent support of evidence-based medicine.
  • Don’t use jargon with a non-science expert.  (For that matter, don’t use your specialty’s jargon with someone who is not also a specialist).  Just because someone is intelligent doesn’t mean they know the jargon.
  • Translate science into clear, spoken English.
  • Flu can spread for 12 days after infection.
  • How do you tell a good study from a bad one?  Which are reportable?

Q and A

  • Once someone is obese, it’s very very hard to lose that weight. Prevention is much easier.
  • So many diseases emerge from eating meat.
  • up-to-date is “an aggregator site” be sure to check primary sources
  • “A lot of people practice based on what they learned in residency.”
  • Check out his weekly twitter chat which he has complete control over at handle @abcdrbchat on Tuesdays at 1pm EST.

Check out Dr. Besser’s biography at ABC news, his twitter, and his book Tell Me the Truth, Doctor: Easy-to-Understand Answers to Your Most Confusing and Critical Health Questions.

Up next will be the third plenary, the Janet Doe lecture by Joanne Gard Marshall.

Medical Library Association (MLA)13 Boston, Intro and Plenary 1

An assortment of library-themed buttons.

Library-themed buttons acquired from the vendor booths during opening night.

Hello all!

Most of my readers know that, in addition to being a book blogger and indie author, I also have a day job as a librarian for the academic library that serves a Boston-area medical school and and teaching hospital.  Since this is my day job, I’m a member of the Medial Library Association (MLA) and every year we have a conference that my institution graciously sends me to.  Last year it was in Seattle.  This year it was in my home city of Boston.  Last year I blogged quite a bit of the conference information here both to share it and to help me remember what I learned.  You can see the series of posts starting with this one in May of 2012.  This year since I had a year of conferencing under my belt, I applied to be an official conference blogger, and I got the position. Yay!  I was assigned to write 2 to 3 posts about the plenary sessions.  So this year I will still be posting some information from the conference here on my own blog, but I will also be linking out to the official conference blog, as I am not supposed to reproduce my posts for that blog on my own personal blog.  I also will be providing additional commentary on those plenaries on my own blog, though, so they will also be discussed here.

The first event I went to was the grand opening of the exhibit halls on Saturday night after I got off of work.  I only was there for around 45 minutes, due to my work schedule, so I didn’t get to see even half of the exhibits.  Ah well!  It was still a fun start to the conference.

The next morning was when the ball really got rolling with the first plenary session.  The first plenary introduces the theme of the conference and features the address by the current MLA president.  You can see my summary of it on the official blog here.

While  was excite about the international aspect of MLA this year (the meeting was held in conjunction with the International Conference on Medical Librarianship (ICML), the International Conference of Animal Health Information Specialists (ICAHIS), and the International Clinical Librarian Conference (ICLC) ), I was disappointed by the lack of content in the presidential address.  I’m not a big fan of “think positive” as a general message to begin with, but it also felt that Blumenthal really didn’t offer much practical advice from her extensive real world library experience to the rest of us.  I missed the enthusiasm of 2011/12 president Jerry Perry’s speech.

Stay tuned for notes from the 2nd plenary by Dr. Richard Besser, medical correspondent for ABC and one-time acting director of the CDC.