Library News

If the COVID-19 pandemic has taught us anything, it’s that we should not underestimate the importance of being able to read, understand, and act on the health information being shared with the Canadian public. With the contrast between the surge of health directives aimed at Canadians and the frequent examples of social behaviour that seem to defy public health orders (Papadakos et al., 2021), one may wonder, how did we get here?

As a health care professional, you are likely familiar with the concept of health literacy: a person’s ability to “access, understand, and utilize information in order to create an informed decision regarding their health” (van Ballegooie & Honag, 2021). In Canada, it’s reported that nine million people have limited literacy skills (Chen et al., 2021), with over half of Canadians reading below a high school level (van Ballegooie & Honag, 2021).

It is important to remember that many factors contribute to a person’s health literacy. Health literacy is not just being able to read and understand written health information. It is affected by a person’s confidence in asking questions, their experience using health resources to stay healthy, and their ability to successfully navigate the health care system. This last point includes a person’s ability to access preventative screening, make decisions about treatments, and self-manage their health at home (Lloyd et al., 2021; Qi et al., 2021; Olisarova et al., 2021).

The global pandemic has brought health literacy to the forefront, highlighting gaps in Canadians’ reading and comprehension levels, as well as in their ability to distinguish between fact and fiction, and in their trust levels in following public health guidance.

Re-examining Canadians’ health literacy matters now more than ever (Abrams et al., 2021; Chowdhury et al., 2021; Papadakos et al., 2021; Qi et al., 2021) as health care professionals continue national efforts to contain the spread of the coronavirus and support thousands of Canadians as they recover from COVID-19 (PHAC, 2021). 

Although addressing the health literacy of Canadians is only one contributor to slowing the spread of the coronavirus, it is a significant one. If Canadians do not have a sufficient understanding of preventative health messaging about COVID-19, the risk of infection and spread of the virus is higher (Abdel-Latif, 2020).

How can health care teams integrate what we know about health literacy into clinical area(s)?

• Engage. In the rush to finalize clinic signage, handouts, or patient pamphlets, don’t forget to include the end user: Nova Scotia Health patients and families. For more on engaging Patient and Family Advisors, check out the Engagement guide: https://library.nshealth.ca/Engagement 
• Review for readability. Nova Scotia Health Library Services’ Patient Education Team is happy to review and make suggestions for any materials (not just pamphlets) that will be used by patients and/or families. Request a plain language review using this form: https://cdha-nshealth-ca.libwizard.com/f/pamphletrequest
• Share credible, easy-to-read, patient-focused resources with your patients and their families:
  • My COVID Recovery NS: Information and resources to help Nova Scotians understand and manage their health after having COVID-19: https://library.nshealth.ca/CovidRecovery
  • Patient Education: A guide to finding easy to understand and trustworthy health information: https://library.nshealth.ca/PatientEducation
• Build your health literacy skillset. Check out these resources for tackling the (mis)infodemic:
  • Abrams, E. M., Singer, A. G., Greenhawt, M., Stukus, D., & Shaker, M. (2021). Ten tips for improving your clinical practice during the COVID-19 pandemic. Current Opinion in Pediatrics, 33(2), 260–267. https://doi.org/10.1097/MOP.0000000000000998
  • Brach, C., Keller, D., Hernandez, L. M., Baur, C., Parker, R., Dreyer, B., Schyve, P., Lemerise, A. J., Schillinger, D. (2012). Ten attributes of health literate health care organizations. NAM Perspectives, 02(6). https://doi.org/10.31478/201206a
  • Kim, Y.-S., Kim, H. A., Kim, M.-S., Kim, H. S., Kwak, M. J., Chun, J., Hwang, J.-I., & Kim, H. (2020). How to improve patient safety literacy? International Journal of Environmental Research and Public Health, 17(19), 7308. https://doi.org/10.3390/ijerph17197308
  • Centers for Disease Control and Prevention - Health Literacy Training (free) https://www.cdc.gov/healthliteracy/gettraining.html

References

Papadakos, J., Reznikov, V., Giannopoulos, E., Giuliani, M., & Papadakos, T. (2021). The literacy demand of cancer & COVID-19 consumer health information. Journal of Consumer Health on the Internet, 25(1), 50–64. https://doi.org/10.1080/15398285.2020.1858258

van Ballegooie, C., & Hoang, P. (2021). Health services: A mixed methods assessment of Canadian cancer patient education materials related to the 2019 novel coronavirus. Cancer Control, 28, 107327482198970. https://doi.org/10.1177/1073274821989709

Chen, A. M. H., Armbruster, A. L., Buckley, B., Campbell, J. A., Dang, D. K., Devraj, R., Drame, I., Edwards, A., Haack, S. L., Ma, Q., Petry, N., Planas, L. G., Sadowski, C. A., Santee, J., Wade, L., & Borja-Hart, N. (2021). Inclusion of health disparities, cultural competence, and health literacy content in US and Canadian pharmacy curriculums. American Journal of Pharmaceutical Education, 85(1), 8200. https://doi.org/10.5688/ajpe8200

Lloyd, J. E., Song, H. J., Dennis, S. M., Dunbar, N., Harris, E., & Harris, M. F. (2018). A paucity of strategies for developing health literate organisations: A systematic review. PLoS ONE, 13(4), e0195018. https://doi.org/10.1371/journal.pone.0195018

Qi, S., Hua, F., Xu, S., Zhou, Z., & Liu, F. (2021). Trends of global health literacy research (1995-2020): Analysis of mapping knowledge domains based on citation data mining. PloS One, 16(8), e0254988. https://doi.org/10.1371/journal.pone.0254988

Olisarova, V., Kaas, J., Staskova, V., Bartlova, S., Papp, K., Nagorska, M., Korucova, R., & Reifsnider, E. (2021). Health literacy and behavioral health factors in adults. Public Health, 190, 75–81. https://doi.org/10.1016/j.puhe.2020.11.011

Canadian Council on Learning. (2008). Health literacy in Canada: A healthy understanding. http://www.en.copian.ca/library/research/ccl/health/health.pdf

Council of Ministers of Education, Canada & the Public Health Agency of Canada. (2017). The health and social dimensions of adult skills in Canada: Findings from the Programme for the International Assessment of Adult Competencies (PIAAC). http://www.piaac.ca/docs/PIAAC2018/PIAAC%202012_Health%20and%20Social%20Dimensions_Canada%20EN.pdf

Abrams, E. M., Singer, A. G., Greenhawt, M., Stukus, D., & Shaker, M. (2021). Ten tips for improving your clinical practice during the COVID-19 pandemic. Current Opinion in Pediatrics, 33(2), 260–267. https://doi.org/10.1097/MOP.0000000000000998

Chowdhury, N., Khalid, A., & Turin, T. C. (2021). Understanding misinformation infodemic during public health emergencies due to large-scale disease outbreaks: A rapid review. Journal of Public Health (Berlin), 1–21. https://doi.org/10.1007/s10389-021-01565-3

Abdel-Latif, M. M. M. (2020). The enigma of health literacy and COVID-19 pandemic. Public Health, 185, 95–96. https://doi.org/10.1016/j.puhe.2020.06.030

Public Health Agency of Canada. (2021, August 20). COVID-19 daily epidemiology update. Canada.ca. https://health-infobase.canada.ca/covid-19/epidemiological-summary-covid-19-cases.html

Kallen Rutledge

Librarian Educator, Patient Education Pamphlets Lead
Nova Scotia Hospital, Central Zone

Did you know? April is Citizen Science month!

What is Citizen science?

Citizen science is a term that is growing in popularity; you are likely familiar with it without even realizing. Every time you’ve filled out a survey on a subject outside of your field, posted your opinion about a research topic or scientific area of interest on social media, or shared a picture you took in nature hoping someone could identify the species you encountered, you were participating in citizen science. In the recently published ebook, The Science of Citizen Science, the authors define citizen science as active engagement in the scientific process by a member of the public (Vohland et al., 2021).

Citizen science and COVID-19

Recently, amateur scientists across the globe, including many Canadians, have joined in the efforts to help track and combat the global pandemic that has been with us now for over a year. By engaging the public in data collection (most often using the Internet, smartphones, and social media), researchers can retrieve more data over a shorter period of time, and from more representative demographics.

Smartphone apps like Zoe, the COVID Symptom Study app, help researchers track the spread of COVID-19. Likewise, many academic journal publishers are enabling researchers to publish their findings faster and more freely, ultimately working towards increasing the global body of knowledge on COVID-19 (Redhead, 2020).

Despite the numerous benefits of this type of public engagement, there are some things to be wary of, including the integrity and security of your personal information. Remember to read the fine print before hitting the ‘I agree’ button. Always make sure the app, website, or organization conducting the research states clearly that they will maintain your anonymity to the best of their ability (Katapally, 2020).

Even with the risks, citizen science has proven that international collaboration is key to fighting back against this deadly virus—just look at how smartphone apps across the world have helped governments and researchers track the spread of COVID-19 (Birkin, Vasileiou, Stagg, 2021)!

Ready to become a citizen scientist?

Here are some of the ways you can participate in citizen science and help the world grow closer to understanding the impact of COVID-19:

Become a FluWatcher 
Before COVID-19, FluWatchers helped scientists from the Public Health Agency of Canada monitor the spread of flu-like illnesses across Canada. Now registered volunteer FluWatchers are also tracking COVID-19 by answering two quick health-related questions each week.

Outbreaks Near Me
This website was created to help the public securely and anonymously check in to help researchers track symptoms of COVID-19 across North America.

CoronaReport 
The COVID-19 pandemic has affected more than just our physical health. Citizens can use this app to help track the impact of the coronavirus on their social, mental, and behavioural health, too.

Cochrane Crowd
Help Cochrane’s collaborative team of volunteers categorize and summarize health care research in support of evidence-based medicine.

For more information, visit our COVID-19 Research guide and stay up to date: https://library.nshealth.ca/COVID19Research.

References

Birkin, L.J, Vasileiou, E, Stagg, H.R., (2021). Citizen science in the time of COVID-19. Thorax. doi: 10.1136/thoraxjnl-2020-216673

Katapally T. R. (2020). A Global Digital Citizen Science Policy to Tackle Pandemics Like COVID-19. J Med Internet Res, 22(5), e19357. https://doi.org/10.2196/19357

Redhead, C. (2020, April 27). Scholarly publishers are working together to maximize efficiency during COVID-19 pandemic. Open Access Scholarly Publishing Association. https://oaspa.org/scholarly-publishers-working-together-during-covid-19-pandemic/

Vohland, K., Land-zandstra, A., Ceccaroni, L., Lemmens, R., Perelló, J., Ponti, M., Samson, R., ... Wagenknecht, K. (2021). The Science of Citizen Science. Springer International Publishing. https://doi.org/10.1007/978-3-030-58278-4

Kallen Rutledge

Librarian Educator
Nova Scotia Hospital, Central Zone

Over the course of the COVID-19 pandemic, there has been a lot of discussion and debate about preprints. The onset of COVID-19 created an urgent need for rapid and widespread dissemination of scientific research. Sharing research in the form of preprints facilitates this by allowing researchers to release their completed manuscripts immediately and publicly. In this way, preprints have undoubtedly had a huge impact on the way that scientific research is both shared and critiqued. This blog post will revisit preprints: what they are, where to find them, and considerations for consuming preprint content.

What preprints are and where to find them

Preprints are completed manuscripts that have been made available prior to formal peer review or publishing in a scholarly journal. They are primarily posted to preprint servers, sometimes referred to as preprint archives or preprint repositories. Preprint servers are public websites that can be accessed by anyone for free, as opposed to many scholarly journals which are subscription-based and only available for a fee.

Preprint servers allow readers to make public comments, serving as an informal way for authors to gather feedback before their article is published. Some of the major preprint servers include:

• bioRxiv: The Preprint Server for Biology
• medRxiv: The Preprint Server for Health Sciences
• Research Square
• OSF Preprints: Center for Open Science
• SSRN (Social Science Research Network)

PubMed also includes preprints that report on research funded by the National Institutes of Health.

Exercise caution with preprint content

Remember that preprints have not been formally peer reviewed. For example, medRxiv cautions:

Preprints are preliminary reports of work that have not been certified by peer review. They should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information. (medRxiv)

Advantages of preprint sharing

Although consumers must be cautious with preprints, there are also many advantages to sharing research in this form, for both authors and readers:

• Research results can be shared immediately, as opposed to waiting for an article to be formally published in a scholarly journal.
• Preprints posted to public servers are accessible by anyone for free, which can result in more views and citations.
• Preprints are increasingly being integrated into the formal publication process of scholarly journals, meaning that some publishers allow research to be posted publicly as a preprint while it undergoes formal peer review.
• Preprint servers facilitate informal peer review by allowing subject experts and other researchers to give feedback via public comments.

Preprints are an important source of emerging scientific research, particularly for COVID-19-related topics. For more information about preprints and how to search for them, reach out to us at AskLibrary@nshealth.ca or book an online consultation with a Library Services team member.

Kristy Hancock

Librarian Educator

Are you involved in patient care? Do you find it challenging to keep up to date with the latest clinical information related to COVID-19? You can use point-of-care tools at the bedside to check the best available evidence about diseases and conditions, including COVID-19.

A point-of-care tool is a digital reference resource designed to help with clinical decision making. Evidence within a point-of-care tool is appraised and synthesized from various sources, and updated frequently to ensure currency, reliability and accuracy. These tools can be used on desktop computers or mobile devices, with some available for use offline.

Through Library Services, Nova Scotia Health staff, physicians and learners have access to several point-of-care tools. This post outlines how to use BMJ Best Practice and Isabel to find clinical information related to COVID-19.

BMJ Best Practice

BMJ Best Practice is an evidence-based generalist point-of-care tool uniquely structured around the patient consultation, with advice on symptom evaluation, test ordering and treatment approach. BMJ Best Practice includes 1,000+ evidence-based condition and symptom topics across 32 clinical specialties. 

TIP BMJ Best Practice is most useful when you have a specific disease or condition, such as COVID-19, that you want to learn more about.

To access the desktop version, visit Library Services’ Databases A-Z page and click on ‘BMJ Best Practice’ from the list. Information about downloading and installing the mobile app can be found here.

Finding COVID-19 evidence in BMJ Best Practice (desktop version)

1. In the search bar at the top of the homepage, type in ‘COVID’. From the predictive text that appears, click on ‘COVID-2019’.
2. You will be directed to the Coronavirus disease 2019 (COVID-19) page. You can use the menu at the top of the page to navigate through sections such as Overview, Diagnosis and Management.
3. To view a customized treatment regime for COVID-19 based on a patient’s comorbidities, click on ‘Treatment algorithm’ from the top menu.

4. Select the applicable comorbidities from the list and click on ‘Show treatment algorithm’.

5. You can then navigate through the step-by-step treatment recommendations.

Isabel

Isabel is a web-based diagnosis checklist system. Enter the patient’s age, gender, and signs and symptoms, and Isabel instantly returns a list of possible diagnoses.

TIP Isabel is most useful when there is no clear diagnosis for a set of symptoms.

To access both the desktop and mobile versions, visit Library Services’ Databases A-Z page and click on ‘Isabel’ from the list.

Entering a patient’s clinical features in Isabel (desktop version)

1. In the Clinical features box on the left-hand side of the homepage, select the patient’s age, gender at birth and travel history.
2. Enter the patient’s abnormal clinical features (symptoms) by typing and clicking on the appropriate choices from the predictive text that appears. For example, sore throat, headache and runny nose.
3. Click on ‘Get Checklist’.
4. Potential diagnoses based on the clinical features entered will appear as a list in the Checklist box. For example, Coronavirus. Click on the + to the left of ‘Coronavirus’ to expand the section.
5. Click on ‘COVID-19’ for information about the topic.

6. From the menu on the left, you can navigate through various resources, including BMJ Best Practice, for evidence related to COVID-19.

For more support with COVID-19 evidence or point-of-care tools, reach out to us at AskLibrary@nshealth.ca or book a consultation with a Library Services staff member.

Kristy Hancock

Librarian Educator

As the amount of COVID-19 evidence grows, it is important to be able to zero in on a specific type of evidence. With the abundance of editorials and commentaries on COVID-19, it may be helpful for clinicians and researchers to focus on finding articles that report specifically on COVID-19 therapeutic interventions. These and other article types are currently available through various resources, including curated COVID-19 collections that contain primary study reports and evidence syntheses. However, databases like Embase® offer benefits such as advanced searching features and unique content from a wide variety of scholarly journals.

This post will walk you through searching in Embase® (Elsevier) for COVID-19-related randomized controlled trials (RCTs), which are typically regarded as the ideal study design for therapeutic interventions.

About Embase®

Embase® is a biomedical database with emphasis on European pharmaceutical and psychiatric literature. The database contains article citations and abstracts, with links to article full text where available. Note that Embase® contains research that has been accepted for publication in scholarly journals; it does not contain pre-/post-prints or unpublished clinical trial data related to COVID-19.

Pre-developed COVID-19 search strings

To save you both time and effort, pre-developed COVID-19 search strings are ready for you to copy and paste into various databases, including Embase®. The following resources include COVID-19 search strings developed specifically for Embase®:

• Medical Library Association (MLA): COVID-19 Literature Searches
• Canadian Agency for Drugs and Technologies in Health (CADTH): CADTH COVID-19 Search Strings
  Note: You will need to copy and paste the search one line at a time.
• Nova Scotia Health Library Services: COVID-19 Search Strategies

Searching Embase® for COVID-19 RCTs

1. Copy a pre-developed COVID-19 search string for Embase® from one of the above resources.
2. Select Embase® from Library Services’ Databases A-Z page.
3. On the Embase® homepage, paste the pre-developed COVID-19 search string into the top search bar.

4. Click on the Show…results button on the right-hand side.
5. From the Results Filters on the left, click on the Study types drop-down menu.
6. Select randomized controlled trial (not randomized controlled trial topic).

7. Click on the Apply button at the top of the Results Filters panel.
8. Before browsing the search results, you may want to select Show all abstracts (A) or change the Sort by order (B) from the top of the results list, depending on your preferences.

9. To view the full text of an article, click on View Full Text.

10. If full text is not available, click on Check for full text at NSHA, then Request document via Local Document Delivery System to request a copy of the article.

For more COVID-19 resources, see our COVID-19 Research guide.

Questions? Email AskLibrary@nshealth.ca or book a consultation with a library staff member.

Kristy Hancock

Librarian Educator