New Informatist Model Based-Services: Spanish Hospital Librarian Experience at Welch Medical Library

Submitted by Maria Luisa Maquedano

Whatever we call them -- medical librarian, clinical librarian, informationist, ISIC or information specialist—the librarians who render their services in hospitals are active agents in the development and application of the new roles demanded by their patrons. However, the different education and training, as well as the budget allocated to the library and the vision of the management team makes the difference in the delivery of services.

The virtual network services of medical libraries, both academic and hospital-based, have been developed effectively throughout the Spanish territory during the last decade, nevertheless the financial and managerial independence of the libraries have discouraged the integration of management and all their material and human resources -- something that would have been extremely desirable in these times of budget cuts.

Each Ministry of Health of the 17 Spanish Regional Administrations has a Virtual Library Portal which includes all its resources and centralized services and provides online access to all the staff public Health Centers. The Ministry of Health of the Comunidad de Madrid also has its own, Biblioteca Virtual Agencia Lain Entralgo, inaugurated in 2004 but with some particular characteristics: the consortial purchase of electronic resources is only partial, the services provided are not centralized and the library management is independent. These factors, among others, have favored the implementation of new computer software in some of the larger hospitals. For example Hospital Universitario 12 de Octubre, Hospital Universitario Puerta de Hierro, and also Hospital Universitario La Paz where I develop my professional activity recently which brought up a new system to centralize their users’ access to resources and services.

In general, all the Health Sciences virtual library portals share a list of links to free and contracted resources, as well as to traditional services: reference, document delivery, bibliographic searching and continuous training. Not all the libraries have provided the new shared services of Web 2.0 tools that allow communication between different types of patrons, and very few have a team of informationists with the capacity to provide their users with all the available information for the development of their daily clinical, teaching and research activities. DeMuro’s editorial recently published in AAP Library Newsletter on non-traditional roles of librarians is highly illustrative.

My interest in this topic began in 1997, when I defended my doctoral thesis "Health Sciences Virtual Library". A lot of water has passed under the bridge since then, but the working hypothesis is still valid: users can access all types of resources via any Internet platform. Today only difference could be the addition of the new variables, sharing and interacting. In the 12 European Congress of Medical Libraries I had the opportunity to hear the presentation “The Welch Embedded Informationist Service Model” given by Blair Anton (Associate Director, Clinical Informationist Services, Welch Medical Library), and I found an interesting example of the implementation of this idea. Therefore, I requested permission for further studies from the Managing Director of my hospital and I wrote to the Director of the Welch Medical Library asking to observe in situ the Informationist team to learn about the variety of their work. My immediate goal is to develop a pilot project “Embedded Informationist-Based Model” in the Internal Medicine Service, whose Head has supported me in carrying out this new line of research for the Hospital Library.

Unfortunately, my stay at the Welch Medical Library is nearing the end, but my program has helped me learn in depth how Welch works, and I’ve had the opportunity to visit the other libraries located in different campuses that make up Johns Hopkins University.

Obviously, the organization of resources and services of a private institution such as the Welch Medical Library cannot be compared to a hospital library of a public Health System because the hospital library´s budget is significantly lower, the scope is more limited and finally, and the audience is more specific. However, I would like to emphasize some of its relevant features, which should be common to all libraries: the specialized education in Health Sciences of the staff, a multidisciplinary team, a good work schedule and overall, a leader of the library with a strong, clear vision of future with the strength to implement that vision.

Hopefully, this visit as an observer will help to promote the participation of Spanish Librarians in some of the international projects led by Library Institutions around the world and also, to foster communication between informationists so that others can enjoy an experience as enriching as mine has been.

Maria Luisa Maquedano

Hospital Universitario la Paz

Biblioteca Virtual de Ciencias de la

E-mail: maquedanoml@gmail.com

Ghanaian Scholars Address Global Health Challenges with Library Resources

Submitted by Gurpreet K. Rana

In February 2011, under the auspices of the Ghana-Michigan PARTNER Program Fellowship, University of Michigan welcomed 14 scholars from Kwame Nkrumah University of Science and Technology for a four-month study and research stay. The objective of the fellowship program is to strengthen the interdisciplinary research capacity in Ghana to address global health challenges and include “long-term, comprehensive training of post-doctoral scientists who will become future leaders of interdisciplinary global health research in Ghana”.   (Source: Global REACH, University of Michigan Medical School)

           

 A major component of the PARTNER fellows’ research activities was based upon the successful use of library services and research databases. To provide a foundation in research methods and information skills and to address the scholars’ goals in developing creative solutions for global health, I had the chance to create an integrated instruction program, focusing on literature searching and subject-specific information resources. It was a privilege to provide hands-on computer classroom sessions and lectures, small groups instruction for subject-specific teams, and individual consultations.   The four subject-specific research teams that the scholars were divided into were: Gender and Health; Innovative Technologies in Global Health; Genetic and Epidemiological Study of Breast Cancer; and Occupational and Environmental Health.   I particularly appreciated the scholars’ subject knowledgebase and eagerness to further their information-seeking skills. 

           

The Ghanaian scholars’ arrival was marked by “the” snowstorm of Winter 2011.  These intrepid scholars, most of whom had never seen snow, put any possible culture shock aside to deal with temperature shock! On their first day of instruction at the Taubman Health Sciences Library, most did not remove coats, gloves or scarves.   My statement: “Would you believe me if I told you it gets up to 35 degrees Celsius in the summer?” was met with disbelieving laughter.  (It was 14 degrees F that day).  

One of the fellows exclaimed:  “Don’t say anything funny because if you do, I’ll get tears in my eyes and they will freeze on my face!”  And so began a wonderful relationship with 14 remarkable individuals…..

           

 

Members of the Ghana-Michigan PARTNER Program Fellowship program with instructors and mentors.

My experience with the PARTNER fellows is one I am not soon to forget.  I cannot fully express in a few sentences how the PARTNER fellows, for whom I created instruction sessions, left after actually teaching me.  Their excitement and gratitude in learning information-seeking skills and finding new research materials to investigate made me consider once again how very fortunate we are in our own information environments and the degree of information inequity that scholars in developing countries experience everyday as they conduct vital research.  The PARTNER fellows’ generosity of spirit, openness, and intentions to change “their world” through education is inspiring and provides another reminder of “why we do what we do” as information professionals. 

Gurpreet K. Rana

Taubman Health Sciences Library

University of Michigan 

Email: preet@umich.edu

Report on International Partnership

The Beginning of a Medical Library Partnership with Ukraine

Donna Flake and Diane Darrow of the SEAHEC Medical Library in Wilmington are providing help and consultation to the Danylo Halytskyi Scientific Medical Library of the National Medical University in Lviv, Ukraine.

They traveled to Lviv, Ukraine in June 2009 to work with medical librarians. They visited the two locations of a Medical Library and met with the Deputy Director (Ludmilla Lutsky) along with Medical University officials. Furthermore, they provided training to the medical librarians, doctors, and medical residents.


(Photo: Donna Flake (middle) with Diane Darrow (far right) and the librarians from the Scientific Medical Library, Lviv, Ukraine)

Before the trip they requested and were very generously provided with STAT!Ref and Anatomy TV, as well as EBSCO’s Dynamed for this library for one year period. In addition, three other U.S. medical libraries, plus SEAHEC Medical Library, agreed to supply the Ukrainian medical library with 30 free electronic interlibrary loans. The four U.S. medical libraries are listed as below:
• Hirsh Health Sciences Library at Tufts University in Boston
• Houston Academy of Medicine Texas Medical Center Library in Houston
• Louisiana State University – Health Sciences Center – Shreveport Medical Library in Shreveport, LA
• Fales SEAHEC Medical Library in Wilmington, NC

During Lenny Rhine’s excellent (and free) HINARI training at MLA in Honolulu in May 2009, Donna Flake met Triza Crittle from the University of Nevada at Las Vegas. After each of the HINARI participants provided an overview of his/her work with international medical libraries, Triza told Donna that she wanted to help with their new partnership in Ukraine. Triza contacted Ukrainian Associations based in the U.S. to try to find one that would help to ship current medical books and journals to Lviv, Ukraine. The librarians from SEAHEC Medical Library are excited about Triza’s help with Ukraine.


(Photo: Donna Flake and Diane Darrow with the
librarians from the Scientific Medical Library, Lviv, Ukraine)

Donna and Diane also have contacted two other medical libraries in Ukraine for cooperation. The two Libraries include
the National Scientific Medical Library of Ukraine in Kiev, Ukraine and Dnepropetrovsk State Medical Academy in Dnepropetrovsk, Ukraine. They also arranged for these databases to be available to these two libraries:
• STAT!Ref
• Anatomy TV (through STAT!Ref)
• Dynamed (through EBSCO)

The medical librarians from Lviv certainly want them to return to Lviv for further cooperation. This partnership with the Medical Library in Lviv is really a “hybrid” partnership. This medical library partnership contains U.S. librarian leaders from NC and Nevada; Interlibrary loan support from Boston, Houston, Shreveport, and Wilmington; and database support from STAT!Ref and EBSCO.

Third visit to Moldova - The NC-Moldova Medical Library Partnership update on activities.

Donna Flake and Diane Darrow lead the NC-Moldova partnership. All the NC Academic Medical Libraries and some of the NC AHEC Libraries participate in the partnership.

Donna and Diane visited the Scientific Medical Library of the State Medical and Pharmaceutical University of Moldova in Chisinau, Moldova for ten days in June 2009. This was their third visit in four years.

They taught HINARI at the library to 23 health professionals including physicians, residents, medical students, medical school faculty members, medical librarians, and representatives from the Ministry of Health. Benefited from Lenny Rhine’s excellent “Train the Trainer” HINARI class at MLA in May 2009, Donna taught a HINARI class in Moldova, which was the first HINARI class of this magnitude taught in Europe. Silvia Ciubrei, Deputy Director of the Scientific Medical Library, advertised the class, registered participants, and created certificates of completion. Other classes were taught during their time in Moldova.
• Dynamed
• STAT!Ref
• Anatomy TV
• Evaluating Medical websites
• Friends of the Library Program
• The Reference Interview
• Marketing the Medical Library
• Integrating the Library’s Electronic Resources into the Electronic Medical Record


(Photo: Donna Flake with librarians and physicians from the Scientific Medical Library, Chisinau, Moldova. Donna taught HINARI to this group.)

While in Moldova they had several meetings with the Medical University’s President and several faculty members. They brainstormed how to improve the medical library and how to expand their partnership. One big accomplishment is that a course will be developed which integrates HINARI and medical database instruction into the curriculum of the Medical University. Prior to their visit, the librarians in Moldova advertised their databases but did not offer classes to the doctors, residents, medical students, and medical faculty members. Also the President of the Medical University has mandated that the medical library develop a marketing plan. This appears to be a direct result of the course they taught on marketing the Medical Library. Other accomplishments of the partnership include sending 20,000 current medical books and journals to this library. These were delivered in three shipments over a four year period. The books and journals were donated by the NC libraries, but the vast majority of the donations came from two medical libraries: the Laupus Health Sciences Library at East Carolina University in Greenville, NC, and the SEAHEC Medical Library in Wilmington, NC. In addition, all the NC medical school libraries and all the AHEC libraries furnish electronic document delivery to the Moldova medical library.

During the visit, Donna Flake was invited to a dinner at the home of the U.S. Ambassador to Moldova. Unfortunately, Diane Darrow had to return to the U.S. before this dinner. In attendance at the Ambassador’s home was also the Minister of Health, the President of the Medical University, and others who had helped our Medical Libraries partnership.

The partnership has been very successful – more successful than they ever anticipated.

Partnership with the Medical Library of Latvia

From 1999-2003 International Cooperation Section had an international medical library partnership with the Medical Library of Latvia in Riga. As this MLA pilot project ended, SEAHEC Medical Library became the permanent sister library to the Medical Library of Latvia. They still are partners and communicate regularly. Latvian Welfare Society, based in Illinois, U.S., is so gracious and generous that they are willing to ships current medical books and journals to the Medical Library of Latvia with free of charge. These donations are from SEAHEC Library in Wilmington, Diane Olson from Loyola Health Sciences Library in Chicago, and several other U.S. libraries. In 2003 when the MLA sister libraries pilot project ended, forty U.S. and Canadian medical libraries were providing free interlibrary loans to the Medical Library of Latvia. Today, thirty of the original forty libraries continue to provide free electronic interlibrary loans.

Velta Poznaka, a longtime friend of Donna Flake and tremendously capable Director of the Medical Library of Latvia, expressed that economic problems were mounting for her library, just as it is happening in many libraries worldwide. Velta has had to decrease hours and staff and buy much less. “Fortunately,” she says,” it is a great comfort and support to have a sister library with much assistance from other U.S. medical libraries for interlibrary loans and gifts of current medical books and journals.”

Donna Flake
Robert M. Fales Health Sciences Library
SEAHEC / South East Area Health Education Center
Email: Donna.Flake@seahec.net

Flahiff Returns to Liberia to Teach Nursing Faculty and Students

Thirty years ago I left Liberia after two satisfying years of Peace Corps service teaching math and science in a rural junior high school. This past May I returned for a much shorter stay of three and a half weeks to again share knowledge and learn more about Liberia first hand. This time I traveled with a group sponsored by the Friends of Liberia.



The Friends of Liberia is largely made of "returned" Peace Corps volunteers across the United States. Our group of 27 was divided into 3 teams: health/medical, teacher training and environmental. I was on board as the sole medical librarian with nine other team members including a physician, several nurses, mental health professionals, social workers and a laboratory technologist.

Our team worked at two different upcountry mission hospitals for a week each as guest lecturers in their nursing programs and consultants to the faculty and staff. My goal was to teach basic computer skills and how to find free, relevant reputable health/medical websites.

Both hospitals had Internet connections via satellite; however, electricity is only available for about nine hours each day at both hospitals. Fuel costs for the generators are high, and publicly available electricity is limited to only about ten square blocks in the capital.
Before traveling to Liberia, I collected more than 100 websites (in about 10 categories) and posted them on Delicious for the two hospital sites GantaHospital's Bookmarks and CurranHospital's Bookmarks.

I was hoping to refine them after consulting with faculty and staff at both sites.
Ganta Hospital had 2 computers in a small room that could seat 6 people and no means to show the Web live or through screen shots in a classroom. I presented an hour and half lecture to a nursing class of 30 students and separately to a group of 7 faculty. I focused on the rudiments of searching, Web site evaluation and Web based heath/medical information directories. Most of the students seemed alert and interested and took notes. Two sessions were planned for each class.

A nursing instructor, Professor Andrew Mambu, approached me at the start of the second session of the class for students and proposed that I use his laptop so that students (in groups of five) could view the basics of Web searching. I showed them the Delicious sites and a Web directory, stressing Web evaluation, links and navigation. Many were able to apply what they had learned in lecture and were extremely interested in the website content (disease information). They read as much as they could before their ten minutes was up. The Internet connection was slow but workable.




Curran Hospital had a library (about the size of a reading room) with seven computers. The Internet connection at this site was very similar to what I experience at work. Teaching (similar in content to that at Ganta Hospital) was limited to 2 interested faculty members, a Peace Corps education volunteer on site who showed interest, and the hospital's librarian who had recently completed a 3-month library certificate.

One faculty member was having challenges with using a mouse while the other faculty member seemed adept at navigating a website. I was seated between them and did the best I could strike a balance between their learning levels. The Peace Corps volunteer asked for another meeting. I was happy to oblige, and we went over questions she had about good websites for specific classes the students were taking.
The level and length of training at both sites was limited for several reasons. Teaching schedules by members of our group were not made until on site and were entirely at the discretion of the hospital administration. Faculty, staff and students spend long days at the hospitals so Internet sessions were worked into their existing schedules and the classes conducted by other members of the health/medical team.


A few things probably would have made the experience more relevant for the staff and students. I could have made email contact with hospital administrators ahead of time and gauged expectations and Internet knowledge and experience among the students and staff.

Most staff and many students seemed to own cell phones. Not only could I have "advertised" office hours, but I could have made myself available for consultations by providing my cell phone number. That being said, those who were able to attend the presentations were given basic information on the Internet and, I hope, a good starting point for relevant websites.

Janice Flahiff
Mulford Library
University of Toledo/Health Science Campus
Email: Janice.Flahiff@utoledo.edu

As Old As Tomorrow

Modern Buddhist monastics and healing arts practitioners of Tibet are increasingly engaging in a syncretism of sorts with interdisciplinary, foreign medical and scientific scholars and institutions- not unlike that which took place almost 1,400 years ago in central and upper Asia. By official invite of Tibetan King Songtsen Gampo (Chi: Qizonglongzan), physicians from China, India, Nepal, and Persia (Tagzig, Tajikistan) convened on the "Roof of the World" in a 7th century CE Pan-Asian symposia ('The Old Medical School') which produced the first collation of their collective medical knowledge translated into the Old Tibetan language: mijigpei-tsoncha (Fearless Weapon).

The 8th century CE Tibetan King Trisong Detsen hosted an international medical conference at the Sam-Ye Gompa (Tib: བསམ་ཡས, Samye Monastery) where he gathered together native Tibetan masters of secular and non-secular sciences, lotsawa (discipled translators), along with scholars and skilled practitioners of the medical systems of China, Dol-po, Greece, Guge, India, Kashmir, Mi-nyag, Mongolia, Nepal, Persia (Sogdiana), and East Turkistan. Post-conference proceedings resulted in a translated synthesization of the differing foreign medical traditions of Indian Ayurveda and Siddha, Græco/trans-Arabic/Persian Unani Tibbia, traditional Chinese medicine (TCM), native curative therapies of Iron Age elders of the Qingzang Plateau, mi chos family folk medicine, and indigenous, pre-Buddhist root culture of Bönpo healers of the Himalayas.

[At its genesis, systematization of traditional Tibetan medicine (TTM) was informed and influenced by earlier Bön belief systems, including those observed by Yungdrung, hermits, ascetics, and shamanic invokers existing outside of the monastic construct. Born from this mystifying matrix were medical and veterinary teachings (gSo rig mdo dgu 'bum bzhi, among others) attributed to founder Tönpa Shenrab Miwo, said to be transmissions transcribed in the Zhang Zhung sMar-yig script and transliterated into Tibetan. Scholarly disputation remains unresolved regarding recension and reconstruction of the earliest Bön tantric texts (otherwise known as the Four Volumes of the Healing Sciences) and the protohistory and epistemiology of Bön medicine vis-à-vis evolution of TTM as understood and acknowledged by mainstream Buddhists. Certain botanic medicaments denoted in Tibetan Materia Medica do bear archaic BCE names of Bön origin].

The amalgamated conference compilation of 156 chapters presented to King Detsen reconciled the foreign medical methodologies with Vairotsana's translated Four Medical Tantras said to be originally transmitted by Shakyamuni Buddha (Siddhartha Gautama). Known as Gyud-Shi (Tib: rGyud-bZhi ,Chi: Sibu Yi Dian) – redacted by Tibetan royal court physician Yuthok Yonten Gonpo the Elder, supplemented later in the 12th century CE with revisions and the Yuthok Nyingthig Root Text and Commentary composition of Gongpo the Younger and his disciple Sumton Yeshe zung – these formed the classic, fundamental medical treatise of the Tibetan healing sciences system (gso ba rgba) upon which Gonpo the Elder's 'New Medical School' (Tanadug Institute) was founded in 762 CE.

Forward-thinking bhikkhuni, bhikkus, lamas, and geshes of this era are similarly engaged in scientific and medical knowledge exchange efforts with pre-meds, other undergrads, and faculty teams in fully- formalized East/West collaborations such as those between the Library of Tibetan Works and Archives (LTWA) and Emory University.

Envisioned as a bridge of discourse between the "inner and outer sciences" by Emory College's Dean Robert Paul and the 14th Dalai Lama (Tenzin Gyatso), the Emory-Tibet Partnership (ETP) has yielded significant contributions to interdisciplinary scholarly communications, not the least of which is the Library of Tibetan Works and Archives' Emory-Tibet Science Initiative (ETSI). Administered via the College's Program in Science and Society and by the Emory NeuroScience and Behavioral Biology Program, ETSI oversees curriculum development, training materials creation, and instructional model design in the implementation of comprehensive, standardized, sustainable coursework for monastics. Coalescing scientists, science educators, philosophers, physicians, scholars, and Buddhist practitioners from cross-disciplinary fields of biology, religion, physics, neuroscience, behavioral biology, psychiatry, and philosophy, ETSI's pedagogical approach is grounded in principles of problem-based, collaborative, experiential learning, with opportunities for discourse and discovery anchored by field work. The Science Curriculum for Tibetan Monastics introduce advanced-level concepts of cosmology, life sciences, and neuro/cognitive sciences, augmented by mathematics.

This summer, in a new ETSI collaboration, Emory faculty and students undertook an intensive Tibetan Mind/Body Sciences program in Dharamsala, India (residence of the Dalai Lama and location of LTWA). While devotees were lectured in math, philosophy, cosmology, biology, physics, and neuroscience, University students simultaneously explored Buddhist contemplative ethos of mind/body medicine, subtle anatomy, and science of the spirit. Several pre-meds were introduced to aspects of ethnobotany and medical anthropology while collecting botanical samples during their Himalayan field trips – just as the ancients sought out pharmaceuticals and adapted uses and laws of the Materia Medica (Menze-rigpa) based upon regional resources provided by the landscape of the Land of Snow.

(Photo: © Ajay Pillarisetti. Courtesy of Emory-Tibet Partnership, Emory)

LTWA and ETSI expanded the Sager Science for Monks Program (which included introductory biophysics, math, computer workshops) and now offers the Sager Science Leadership for Tibetan Monastics (SSLTM) program. This June past, LTWA organized the 1st Science Exhibition by Monastics, presenting interactive projects of ETSI and SSLTM participants. Students from Drepung Monastery presented distinctions and correlations between Buddhist texts (San: Abhidharma-kosha, Tib: chos mngon pa mdzod) which expound on sense power and perception of manifested phenomena in relation to sound source, vibrations, waves, and the mechanism of hearing. Fellow truth-seekers from the same Drepung Monastery discerned dialectical challenges to prevailing "big bang" and quantum fluctuation theory within the cosmologic precepts as taught in the Kala-chakra (དུས་ཀྱི་འཁོར་ལོ, time-wheel, time-cycles) texts - yet discovered agreement with lesser-established modern scientific theories of multiple universes and space particles within the same tantric texts. The Zhang-Zhung group from Menri Monastery demonstrated scientific properties and nature of light in accordance with Dzogchen teachings and tantric texts within the Bön tradition. Inspired by Mendeleev's periodic table of chemical elements reduced to quantum particles, exhibitors from Saakya Dhongag Choeling Monastery generated a comparative Buddhist table of elements of subtle consciousness as constituent factors in the experienced world in keeping with the Abhidharmasamuchaya (Compendium of Higher Knowledge).


(Photo: ©Theresia Hofer. Courtesy of Wellcome Trust Images Collection.
Tibetan doctor with an old copy of a Gyu Shi ("Four Tantras") and a book on compounding medicines, which was composed by the previous generations of his medical family lineage and takes into account the locally available materia medica, Tibet Autonomous Region, China, 2003.
Released under Creative Commons Attribution-Non-Commercial No-Derivatives version 2.0 licence, England & Wales.)


Further contributing to cross-continental medical and scientific knowledge transfer, L TWA maintains world-wide manuscript exchange projects such as with the Gorky Scientific Library in Leningrad. It disseminates information on doctors and medical practitioners, medical history, and medicinal plants in its annual Tibetan Medicine publication. Under Directorship of LTWA's Geshe Lhakdor, its Research and Translation Department conducts intensive 3-months-long translation training sessions year-round (its current cycle ends this October). Its Seminar on Science Terminology (ཚན་རིག་གི་ཐ་སྙད་ཕབ་སྒྱུར་ཚོགས་འདུ) has generated a science textbook (produced by Emory University professors and Buddhist translators who hold degrees in life sciences, engineering and philosophy) in the Tibetan and English languages and a contemporary science glossary introducing into contemporary Tibetan lexicon concepts such as electromagnetism, climate change, cloning. LTWA produces Science Journal, a bi-annual Tibetan/English publication of translations of in-depth articles on neuro-biology, foundations of science, solar system, and meterology. Published quarterly, its Science Newsletter presents short articles, stories, and facts about science and science-related subjects. Section features include news, cosmology, physics, biology, scientists' biographies, and articles along the science/Buddhism paradigm. ETSI and ETP organized the 1st International Conference on Science Translation into Tibetan (ICSTT) at Emory this past March, expecting to further extend discourse while developing translational techniques in this developing field.

(Provided here is a list of LTWA desiderata in an appeal for donated titles for its Foreign Language Reference (in- and out-of-print), University Dissertations/Theses, and Journals collections. http://www.ltwa.net/Support_edited.html. Many medical and sciences works are denoted).

Driven by forces internal and external to Tibet (political exigencies," biomedicalization", medical tourism, epidemiological vicissitudes, insurance approval for complementary/alternative therapeutics, and health market globalization), momentum is rapidly accelerating in the worldwide adoption and adaptation of TTM. TTM formulae have been manufactured for years in Switzerland (covered by health insurance), Denmark, Lithuania, and Latvia. Evidence-based clinical studies, formalized coursework, controlled experiments in cancer, hepatitis, diabetes mellitus, cardiovascular function, hypertension and other afflictions have been conducted by universities, medical schools, and hospitals of Harvard, Yale, Stanford, Virginia, Texas, Miami, Toronto, Austria, Scotland, Italy, China, Russia, Japan, and elsewhere. As of this month, India's Medicine Central Council has accorded legal status to the TTM system. China has issued an international call for paper presentations at its March 2010 TTM conference. "Biomedicization" and modernization of TTM is not welcomed by all, won't be a cure-all, nor necessarily will it be cohesive or even comprehensive, and vigilance should be maintained with a view towards mutual benefit. But as ailing, aging populations face the frontiers of tomorrow, we'll all be drawing from the waters of very ancient wells. Ostensibly, the way forward is back.

LaVerne Poussaint
Plutonic Research & Knowledge Teams Intl (PRAKTI)
Email: laverne.poussaint@deepmed.net

Advice and such for sources for African health care professionals/students

Written by Flahiff, Janice [Janice.Flahiff@UTOLEDO.EDU]

Hello all,

Upcoming travel plans seem to be firming up for a 3 week stay in Liberia (this May!) focusing on service projects.
I will be traveling with the Friends of Liberia, spending a week each at 2 hospitals up country with
the Health/Medical contingent. My colleagues are mostly health care professionals (nurses and
a psychologist).

Neither hospital is connected with the HINARI program, and it is not feasible to introduce HINARI at this time.
However, both hospitals do have Internet connections (when there is sufficient electricity!).

I am in the process of collecting free relevant Web sites. One of the coordinators of our group
is in contact with the hospital directors at both sites. She said both hospital directors see this
project of gathering Web sites along with a short workshop on finding good health information
on the Internet to be of value to them. The coordinator (a nurse) and I have agreed that de.lic.ious
is the way to go.(We are both familiar with it). The Web site or sites will be something to leave them with,
and it opens the way for future collaboration, albeit long distance.

The site is at http://delicious.com/GantaHospital (and will be modified for the Zorzor hospital)
Presently have 60 bookmarks, aiming for about 100.

The Ganta Hospital focus will be nursing students and their instructors. There is a great need for the basics (how to monitor blood pressure,
identity heart and bowel sounds, develop DDx, judicious use of antibiotics, post surgery infection prevention.

The Zorzor Hospital focus will be midwifery (students and their instructors).

Sound and video sites are OK, but I need to augment with text/minimal images because bandwidth and electricity
are not optimal at times.

So far I have started "harvesting" from at least some of the following (and a big thank you to HINARI for including many of these in one
of their modules)
*Source Bibliographic Database: International Health and Disabilityh (http://asksource.info/res_library.htm
*INTUTE at http://www.inute.ac.uk/healthandlifesicences/omnilost.html
*Karolinska pages on Diseases, Nursing, etc [this is great!]
*CDC pages
*considering National Guideline Clearinghouse
*NN/NLM nursing resource page
*Martindale's Health Science Guide (great resource for nursing related videos)
*Scirus.com (found some fairly decent blood pressure monitoring guides for students)
*Medical student.com (starting to go through this)
*TRIP database (thinking about this)
*PubMedCentral (for the instructors)
*mining WWW for free African-centered journals

At this point, I wonder if I am reinventing the wheel.
If any of you have the time and advice in sources to mine for the de.lic.ious site, it would be greatly appreciated.

I am very appreciative of the newsletter. That is how I found out about HINARI.

Thank you in advance for "listening"