# Presentation: 635871

## Janet G Schnall, MS, AHIP
Information Management Librarian
Health Sciences Libraries 
University of Washington, Seattle, WA
schnall@u.washington.edu

**Information Management Librarian**
**Health Sciences Libraries **
**University of Washington, Seattle, WA**
**schnall@u.washington.edu**

**Optimizing the Use of Internet Resources in Public and Community Health  Practice **

## Objectives

- Identify 10 ways to improve public health practice using internet resources
- Describe web resources for evidence-based public health practice
- Identify authoritative consumer materials to support public health education
- Describe different tools to navigate the web to find public health resources

## #1Search a Database 

## Databases

- PubMed*	**http://pubmed.gov*
- CHID Online*	**http://chid.nih.gov*
- TOXNET*	**http://toxnet.nlm.nih.gov*

## PubMed

- Includes MEDLINE (1950’s to present) and PREMEDLINE
- Indexes 4,800 biomedical journals
-  Covers all aspects of biosciences and healthcare
- 75% of citations have abstracts
- Updated DAILY

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## Related Articles

- Related Articles

## Slide 9

## Advantages of PubMed

***Free***
***Links*** to publisher’s sites for full-text journals
- Or, can ***order*** full-text journal articles
***Clinical Queries***/***Systematic***** *****Reviews***** **section limits retrieval to evidence-based citations

## More Advantages of PubMed

- Can easily ***limit*** your search to:
- Age groups
- Human or Animal studies
- Language
- Review articles
- Subsets, such as Core Clinical Journals or CAM
***Clipboard*** allows you to save citations from one search or several searches that you may want to print, save, email, or order
***My NCBI ***allows you to save search strategies in order to generate updates - including automatic e-mail updates

##      http://healthlinks.washington.edu/howto/pubmed/

**Try**

**     ****http://healthlinks.washington.edu/howto/pubmed/**

**Notes:**

Advantage to short clips: 40 seconds to 3 1⁄2 minutes long
	easy to rerecord, update – example, MeSH Browser not MeSH Database change, easy to rerecord.
Worth the time, since reaches more people, on and off site
Usage stats:

## E-Journals

- Check with your library for access to
- 	full-text e-journals
- For UW Affiliates: use the Proxy service to access full-text e-journals from off-campus *http://healthlinks.washington.edu/howto/connect/*

## Open Access Journal Sites

- BioMed Central *	*
*	**http://www.biomedcentral.com/*
- Independent publishing house providing immediate free access to peer-reviewed biomedical research
- Includes *BMC Public Health*
- PubMed Central
*	**http://pubmedcentral.gov/*
- National Library of Medicine's free digital archive of biomedical and life sciences journal literature
*	*

## Order Articles Online for a Fee

- Document Services/University of Washington *https://healthlinks.washington.edu/hsl/docservices/services.html*
- Loansome Doc
*	**https://healthlinks.washington.edu/hsl/docservices/lds-na.html*
- Allows you to order full-text articles after searching *PubMed*

## TOXNEThttp://toxnet.nlm.nih.gov

- Databases in toxicology and environmental health, including:
- TOXLINE: toxicology bibliographic information
- HSDB:	Hazardous Substances Data Bank
- DART:	Developmental and Reproductive Toxicology
- TRI:  	Toxics Release Inventory
- IRIS:	human health risk assessment
- GENE-TOX:	mutagenicity test data
- CCRIS :  carcinogenicity and mutagenicity data
- ITER:	chemical risk information

## #2Search for Evidence

## What is evidence-based public health?

- Evidence-based public health is the conscientious, explicit, judicious use of the current best **evidence** in making  decisions in routine PH practice, and in developing PH policies and programs.
- EBPH practice requires integrating practitioner expertise, accumulated PH and basic science knowledge, and regulatory requirements,  with best **evidence** from systematic research.

- 	Definiton based on: Sackett DL et al. *Evidence based medicine: what it is and what it isn't.**   *
- 	BMJ 1996   Jan 13; 312 (7023): 71-2.

**Notes:**
Evidence-based practice uses the results of scientific studies whenever possible and expert opinion and extensive experience when data are lacking. 

## EBP and Guidelines Resources

*PubMed* Clinical Queries/Systematic Reviews
*	**http://www.ncbi.nlm.nih.gov/entrez/query/static/*
*	**clinical.shtml*
*Cochrane Library* (fee): gold standard
- 	*http://www3.interscience.wiley.com/cgi-bin/mrwhome/106568753/HOME*
*National Guideline Clearinghouse*
*	**http://www.guideline.gov/*
*Trip Database   **http://www.tripdatabase.com/*

## PubMed Stategies for Evidence-Based Citations

*PubMed** *Limits
- Randomized Controlled Trial
- Meta-Analysis
- Practice Guideline
- Clinical Trial
*PubMed* Clinical Queries* *and* *Systematic Reviews*         *

## Slide 21

## obesity American Indians

- obesity american indians

## Slide 23

## Cochrane Library

**Cochrane Library**

## http://www.ngc.gov

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## TRIP Database

- http://www.tripdatabase.com

## #3Keep Current with Email Alert Services and Health News

## Information Overload!

- 2 million articles published in biomedical journals each year
- considering everything of potential biomedical importance would require perusing about 6,000 articles per day...
- If you only read  2 articles a day, at the end of year  you would be 60 centuries behind.

- Lundberg GD. Perspective from the editor of JAMA, The Journal of the American Medical Association.
-  *Bull Med Libr Assoc.* 1992 Apr;80(2):110-4.

## What are Email Alert Services?

- Deliver current citations into your email
-  Based on a search strategy you create
- In most cases, abstracts of the articles are provided
- May provide links to *PubMed* and full-text articles

**Notes:**
Why use email alerts?
Keep abreast of new literature in your field
Receive automatic updates 
View tables of contents from your home or office
Some free, some via UW

## PubMed:  MY NCBI

- Your personal space on the NLM computer system for storing search strategies to generate updates
- Free registration required
- NEW!!!: recent *PubMed* citations sent automatically to your email

## My NCBI

- Go to: http://pubmed.gov/
- And click on My NCBI

## Health News

- CNN Health   *http://www.cnn.com/HEALTH/*
- New York Times Health
*	**   **http://www.nytimes.com/pages/health/*
- USA Today Health  *http://www.usatoday.com/news/health/front.htm*
- World  Health News
*	**http://www.worldhealthnews.harvard.edu/*
- Yahoo! News
*	**http://news.yahoo.com/*

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## #4Explore Health Education/Patient Ed Sites

## Best Consumer Health Resource

**MEDLINEplus**** **
***	******http://medlineplus.gov/***
**#1 SOURCE** for quality consumer/patient information
- Includes drug information
- Spanish version
- Predesigned *PubMed* searches
- Interactive tutorials
- News

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**Notes:**
Zithromox –may help in cystic fibrosis pts
azithromycin

## Slide 45

## Do you need...

- Articles or research studies:
- 	Go to *PubMed*
- Information written for consumers/patients:
- 	Start with *MEDLINEplus*

## Additional Patient Ed Resources

- Healthfinder	*http://healthfinder.gov/*
- MEDEM	*http://www.medem.com/*
- NIH Health Information *http://health.nih.gov/*
- ToxTown 	*http://toxtown.nlm.nih.gov/*
- Household Products Database
*	**http://hpd.nlm.nih.gov/*

## Tox Town 		http://toxtown.nlm.nih.gov/

- Tox Town 		http://toxtown.nlm.nih.gov/

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## http://hpd.nlm.nih.gov/ 

- http://hpd.nlm.nih.gov/

## Miracle Gro for Roses 18-24-16 

**Miracle Gro for Roses 18-24-16**

## 					#5
Use Cross-Cultural Healthcare Resources

***Use Cross-Cultural Healthcare Resources***

## Cross-Cultural Healthcare Resources

- EthnoMed
*	**http://ethnomed.org/*
- 	A cross-cultural medicine database containing information about cultural beliefs and medical issues pertinent to healthcare of ethnic groups in Seattle area
- Culture Clues *http://depts.washington.edu/pfes/cultureclues.html*
- 	Tip sheets designed to increase awareness about concepts and preferences of patients from diverse cultures

## http://ethnomed.org/ 

- http://ethnomed.org/

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## Somali Health and Illness

**Somali Health and Illness**

**Notes:**
Somali Asthma Cultural Profile

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## http://depts.washington.edu/pfes/cultureclues.html

## Slide 62

## 					#6
Explore Public Health Websites

***Explore Public Health Websites***

## Key Public Health Websites

- American Public Health Association 	*http://www.apha.org/*
- CDC: Centers for Disease Control and Prevention	*http://www.cdc.gov/*
- EPA: Environmental Protection Agency** ** 		*http://epa.gov/*
- NIH: National Institutes of Health	*http://www.nih.gov/*

## http://www.cdc.gov/ 

- http://www.cdc.gov/

## Slide 66

## More Key Public Health Websites

- Northwest Center for Public Health Practice *http://healthlinks.washington.edu/nwcphp/*
- Partners in Information Access for Public Health Workforce  *http://phpartners.org/*
- Public Health Foundation
*	**http://www.phf.org/links.htm*
- Washington State Department of Health
*	**http://www.doh.wa.gov/*

## http://healthlinks.washington.edu/nwcphp/ 

**http://healthlinks.washington.edu/nwcphp****/**

## http://phpartners.org/ 

- http://phpartners.org/

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## http://phpartners.org/hp/ 

- http://phpartners.org/hp/

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## 					#7
Find Statistical Resources

***Find Statistical Resources***

## Useful Statistical Websites

- American FactFinder 	http://factfinder.census.gov/home/saff/main.ht	ml?_lang=en
- FastStats A to Z	http://www.cdc.gov/nchs/fastats/
- Fedstats	http://www.fedstats.gov/
- National Center for Health Statistics	http://www.cdc.gov/nchs/
- State Health Facts Online		http://www.statehealthfacts.kff.org/
- Statistical Abstract of the United States	http://www.census.gov/statab/www/

## FastStats

- http://www.cdc.gov/nchs/fastats/

## FedStats

- http://www.fedstats.gov/

## Slide 79

## http://www.statehealthfacts.kff.org/ 

- http://www.statehealthfacts.kff.org/

## Public Health Data

- CDC Wonder				*http://wonder.cdc.gov/*
- Washington State Health Data*	**http://www.doh.wa.gov/Data/data.htm*

## 					#8
Navigate the Web Beyond Google

***Navigate the Web Beyond Google***

## Navigation Difficulties

- Size of the Web
- Lack of control or review
- Lack of quality standards

**Notes:**
The web contains over 4.3 billion pages of  information.
Combined coverage of eleven majorsearch engines is 42% of the Web.
No individual search  engine coversmore than 16% of the Web.
Overlap between individual searchengines is low.

## View cached page to resurrect dead pages
Includes similar pages feature
Search for images
Includes pdf and other file types
Search within results

- Includes *similar pages* feature
- Search for *images*
- Includes *pdf* and other file types
*Search within results*

- Google Special Features *http://www.google.com/*

## Slide 85

## Google Advanced Search Features

- File Format, *i.e.* pdf
- Date, *i.e.* pages updated in last 3 months
- Occurrences, *i.e.* terms appear in title
- Domain, *i.e.* .gov, .edu
- Links, *i.e.* pages that link to the page

## Slide 87

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## Meta-Search Engines

- Allow you to send searches to more than one search engine at a time

## Meta -Search Engines

**Vivisimo**

**DogPile**

*http://www.vivisimo.com/*

*http://www.dogpile.com/*

## Vivisimohttp://www.vivisimo.com/

- All the speed and functionality of *Google*, with clustering added
- Clustered results in left margin
- Why use clustering?
- Learn at a glance types of information  available
- Uncover results that are otherwise buried

## Slide 92

## 					#9
Evaluate Web Resources

***Evaluate Web Resources***

## Evaluation Strategies

- Evaluate using  **Criteria for Evaluating Web Resources**
- Determine the type of site by analyzing **Web Site Addresses**
- A User's Guide to Finding and Evaluating Health Information on the Web***http://www.mlanet.org/resources/userguide.html***

## Criteria for Evaluating Web Resources

- Authority
- Accuracy
- Objectivity
- Currency
- Coverage
- Design

## Analyze the Website Address:URL (Uniform Resource Locator)

- edu
- org
- com
- gov

**http****://****www.cdc.gov****/****nip****/****child.htm**

**sub directory**

**name of host computer**

**how information **
**is transmitted**

**filename**

## #10Contact Your Ultimate Search Engine... a librarian!

**Notes:**
Combined experience:

University of Washington Health Sciences Libraries
Library Liaisons to the UW Department of Pediatrics:
Janet Schnall: 38 yrs
Leilani St. Anna: 20 yrs

Children’s Hospital Librarians:
Susan Klawansky: 15 yrs
Kathleen McCrory: 17 yrs

Total: 90 years experience

Librarians are integral proactive members of interprofessional teams.
Help find info, teach how to use information resources, how to manage info. 
After looking for 10-15 minutes, call us.

## Final Thoughts:  Key 5 Resources

- PubMed, including Clinical Queries and My NCBI
- MEDLINEplus
- EthnoMed
- Partners in Information Access for Public Health Workforce
- Advanced Google

## For more information...

- If you are affiliated with the UW,  contact the *nursing library liaison*:
- 		Janet G. Schnall, MS,AHIP
- 		206.543.7474
- 		schnall@u.washington.edu
- Or, contact the National Network of Libraries of Medicine (NN/LM) for exhibits, workshops, classes, and project collaborations
- 	NN/LM		800.338.7657
- 	Linda Milgrom	206.221.3200
- 	lmilgrom@u.washington.edu

## Optimizing the Use of Internet Resources in Public and Community Health  Practice

*PowerPoint presentation located: **http://healthlinks.washington.edu/hsl/liaisons/schnall/*