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Month: November 2022

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Himmelfarb Library strives to offer study environments that meet the needs of all of our users. Sometimes space is needed to gather a group for study or collaboration. Sometimes a table with space to spread out is best and sometimes a cubicle in deep quiet is necessary for focus and intense study. You can find all these options in Himmelfarb Library.

First Floor = Group Study and Collaboration Zone

Photo of Himmelfarb Library first floor
Himmelfarb First Floor study tables

On the first floor you’ll find mostly open tables and some lounge areas. Because our main service desks are on this floor, the accepted noise level is quiet conversation. There are white boards on wheels for group activities and collaborations. There are also some public computer workstations as well as printers and scanners.

Second Floor = Quiet Study Zone

Photo of Himmelfarb Library second floor
Himmelfarb Second Floor open cubicles

The second floor is the deep quiet zone. Even whispering is discouraged. There are mostly open cubicles for individual study on this floor and some open tables if you need space to spread out. If you are listening to music with headphones, please be mindful that they are set to a level that only you can hear. The second floor also has a number of study rooms for study groups. These rooms should be booked in advance and activities in the study rooms should not disturb others on the second floor; please be mindful of the noise level in study rooms.

Third Floor = Mixed Use Zone

Photo of Himmelfarb Library third floor
Himmelfarb Third Floor open tables and closed cubicles

The third floor has segregated spaces with separate uses. The main zone when you step off the elevator is a quiet study area with a mix of open and closed cubicles and study tables. To the right is the Bloedorn Technology Center and computer classroom space. This area is glassed in and though quiet is encouraged, there are activities occurring there that require conversation including the Body Viz Workstation and anatomical models. You’ll also find the School of Medicine IT help desk in this area. The third floor also has study rooms that can be reserved in advance.

If you find our quiet zones are not being respected and would like our staff to remind users, please reach out to us via IM, email, or phone (202-994-2962) during Monday-Friday business hours, or reach out to the Circulation Desk staff during other hours (in person or phone listed above).

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Image of a person's hand, palms up, one in top of the other. In the top palm are two pills.

Diabetes impacts the lives of approximately 37 million Americans and if left untreated, it can damage a person’s eyes, heart, kidneys or more. Diabetes can cause serious issues for people who have high blood pressure or high cholesterol levels. By encouraging patients to build a team of healthcare professionals, incorporate more exercise into their daily routine and make different nutritional choices, healthcare providers can teach people with diabetes how to effectively manage their blood sugar, or glucose, levels and avoid future health complications. 

It is important to speak to patients about their current level of awareness about diabetes as many people may not be aware of the symptoms or factors that are indicative of a person developing diabetes. The National Institute of Diabetes and Digestive and Kidney Diseases list several symptoms associated with diabetes, though they also stress that “Symptoms of type 2 diabetes often develop slowly–over the course of several years–and can be so mild that you might not even notice them. Many people with type 2 diabetes have no symptoms.” (National Institute of Diabetes and Digestive and Kidney Diseases, n.d., para. 3)  Some symptoms of diabetes include “increased thirst and urination, increased hunger, fatigue, numbness or tingling in the feet or hands, and sores that do not heal.” (National Institute of Diabetes and Digestive and Kidney Diseases, n.d., para. 2) Some factors that may impact whether a person develops diabetes include a family history of diabetes, race, having prediabetes, and being over the age of 35. People who developed gestational diabetes while they were pregnant are also at a higher chance of developing type 2 diabetes later in life. Annual health screenings and blood work can check current blood glucose levels to determine if a person has developed prediabetes or diabetes and health care professionals can also offer advice during these screenings on how patients can manage their blood glucose levels. 

Social media graphic that says 'Diabetes Management. It Takes A Team.'

November is American Diabetes Month and this year’s theme is ‘It Takes a Team.’  For many people, living with diabetes can feel overwhelming and may cause them stress, anxiety or depression. But health care professionals can offer guidance and support for patients who must navigate their post-diagnosis reality. The National Institute of Diabetes and Digestive and Kidney Disease has consumer health resources that can be used as instructional tools when speaking to patients about managing their diabetes. The institute’s ‘diabetes ABCs’ breakdown the health tests people should stay aware of. “Knowing your diabetes ABCs will help you manage your blood glucose, blood pressure, and cholesterol…Working toward your ABC goals can help lower your chances of having a heart attack, stroke, or other diabetes problems.” (National Institute of Diabetes and Digestive and Kidney Disease, n.d., para. 4) Additional consumer health resources that may be useful include the American Diabetes Association and their list of local offices which will connect people with other diabetes patients and social or health events. The Centers for Disease Control and Prevention maintains a Diabetes Division which offers more information about the different types of diabetes, statistics on the state of diabetes in the country and nutrition guidance. Health care professionals can also encourage their patients to speak to their friends and family about ways to be supportive. Friends and family can encourage people with diabetes to add more exercise into their routine or choose diabetes friendly foods. 

Living with diabetes can be challenging for patients and requires that they make lifestyle changes to maintain healthy blood glucose levels. Health professionals can share consumer health readings and resources with their patients in an effort to encourage them to make necessary lifestyle changes. By encouraging patients to stay connected to an informed and supportive community, health care professionals give their patients tools to receive the care and space they need to make important, healthy decisions. 

References

National Institute of Diabetes and Digestive and Kidney Diseases. (2022). National Diabetes Month 2022. https://www.niddk.nih.gov/health-information/community-health-outreach/national-diabetes-month.

National Institute of Diabetes and Digestive and Kidney Diseases. (n.d.). Managing Diabetes. https://www.niddk.nih.gov/health-information/diabetes/overview/managing-diabetes.

National Institute of Diabetes and Digestive and Kidney Diseases. (n.d.). Symptoms & Causes of Diabetes. https://www.niddk.nih.gov/health-information/diabetes/overview/symptoms-causes.

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A person measuring their weight on a scale

Photo by SHVETS production from Pexels: https://www.pexels.com/photo/woman-weighing-on-scales-in-studio-6975474/

Warning: This post contains discussion of murder and eating disorders.

At the turn of the 20th century, there was a doctor who literally starved her patients to death. Dr. Linda Hazzard did not have a medical degree, but she was nevertheless licensed by the state of Washington as a practitioner of alternative medicine. Hazzard called herself a fasting specialist, and her methods were rooted in her belief that all health issues were caused by consuming too much food. She treated her patients by making them fast for long periods of time in order to let the digestive system “rest”. They would consume only small portions of vegetable broth, take enemas, and be subjected to violent so-called “massages”. 

That doesn’t sound like a very pleasant course of treatment, so you might be surprised to learn that Hazzard was very popular in her time. She attracted many patients to her Institute of Natural Therapeutics in Olalla, WA, which opened in 1907. Her most famous patients were the British sisters Claire and Dora Williamson, who came to the institute in February 1911. The sisters had a number of minor ailments and were hopeful that Hazzard’s methods held the cure.

For two months, the sisters consumed no more than two cups of broth a day and endured hours-long enemas. When their friend Margaret Conway received a note from one of the sisters that concerned her, she came to visit them. But she was too late – as soon as Margaret arrived, she was told that Claire had just died. Dr. Hazzard, who had performed Claire’s autopsy herself, explained Claire’s death as the result of drugs administered in her youth which had eventually caused cirrhosis of the liver. Margaret, who had been the sisters’ childhood nurse, thought that explanation seemed unlikely. And then she saw Dora – or what was left of her. At this point the nearly skeletal Dora weighed only about 50 pounds (Lovejoy, 2014). Margaret was now convinced that Claire had starved to death and Dora was next in line.

What leads to starvation? Sadly, of course, there are many people in the world who lack basic access to food, and they might succumb to starvation. There are also a number of reasons that people might make the choice to abstain from eating for long periods of time, such as religious practice or as a political statement, but reports of people dying from voluntary starvation in this way have been limited to extreme cases. In developed countries, death by starvation is most often associated with eating disorders such as anorexia nervosa, a psychiatric illness characterized by extreme calorie restriction and disturbed body image. Although we do not know whether the Williamson sisters suffered from anorexia, an examination of the physical effects of anorexia, starvation, and extreme weight loss in general can give us a sense of what happened to the women. 

As starvation sets in, nutrient scarcity leads to a decrease in basal metabolism, and the resting metabolic rate (RMR) and heart rate both drop (Olson et al., 2020). Without proper nutrition, the body starts breaking down muscles for protein and fat for energy. People with anorexia often have sarcopenia and loss of skeletal muscle mass (Cost et al., 2020). Starvation can also cause hypoglycemia (Cost et al., 2020; Palmer et al., 2021). This can lead to ketoacidosis and liver failure. Extreme weight loss also affects bone development, sometimes leading to irreversible osteoporosis (Epocrates).

Extreme weight loss can cause an abundance of issues with all of the body’s physiological systems, including the cardiac, reproductive, renal, and gastrointestinal systems (Epocrates). Cardiac issues can range from myocardial atrophy to pericardial effusion and even sudden cardiac death (Cost et al., 2020). On the gastrointestinal level, constipation, diarrhea, and functional bowel disorders are common complaints in people with extreme weight loss (Cost et al., 2020).

Back at the institute, Margaret’s horror only increased once she learned that Hazzard had been appointed executor of Claire’s estate and legal guardian of Dora. Along with John Herbert, the sisters’ uncle, Margaret convinced Hazzard to allow Dora to depart from the institute (only after Herbert paid an extortionate amount of money that Hazzard claimed Dora owed in medical bills). Herbert and another man, Lucian Agassiz, then decided to research Hazzard further. They discovered that Hazzard was connected to the deaths of several other wealthy people – more than a dozen – many of whom had signed over their estates to her. They now believed that Hazzard was less a doctor and more a manipulative serial killer. 

Agassiz initiated a court case against Hazzard. In August 1911, Hazzard was charged with the first-degree murder of Claire, although she continued to claim her innocence. In February 1912, Hazzard was convicted of manslaughter. She served two years in prison and had her medical license revoked. However, in 1920, Hazzard was able to return to Olalla to re-establish her institute, now called the School of Health, where she worked until 1935 when the institute burned down. In the late 1930s, Hazzard fell sick and undertook a fast of her own; she died. 

Do you know of another interesting true crime case with medical connections? Email Rachel Brill at rgbrill@gwu.edu.

References and Further Reading:

Cost J, Krantz MJ, & Mehler PS. (2020). Medical complications of anorexia nervosa. Cleveland Clinic Journal of Medicine, 87(6), 361–366. https://doi.org/10.3949/ccjm.87a.19084 https://proxygw.wrlc.org/login?url=https://www.ccjm.org/content/ccjom/87/6/361.full.pdf 

Epocrates. Anorexia nervosa. Accessed May 19, 2022. https://proxygw.wrlc.org/login?url=https://online.epocrates.com/diseases/440/Anorexia-nervosa  

Lovejoy, B. (2014, October 28). The Doctor Who Starved Her Patients to Death. Smithsonian Magazine. https://www.smithsonianmag.com/history/doctor-who-starved-her-patients-death-180953158/

Olsen, G. (2005). Starvation Heights: A True Story of Murder and Malice in the Woods of the Pacific Northwest. Crown.

Olson B, Marks DL, Grossberg AJ. (2020). Diverging metabolic programmes and behaviours during states of starvation, protein malnutrition, and cachexia. J Cachexia Sarcopenia Muscle, 11(6):1429-1446. doi: 10.1002/jcsm.12630. Epub 2020 Sep 28. PMID: 32985801 https://proxygw.wrlc.org/login?url=https://onlinelibrary.wiley.com/doi/10.1002/jcsm.12630  

Palmer BF, Clegg DJ. (2021). Starvation Ketosis and the Kidney. Am J Nephrol., 52(6):467-478. doi: 10.1159/000517305. Epub 2021 Jul 19. PMID: 34350876. https://proxygw.wrlc.org/login?url=https://www.karger.com/Article/FullText/517305  

Washington State Archives. (n.d.) Linda Burfield Hazzard: Healer or Murderess? https://www.digitalarchives.wa.gov/Collections/TitleInfo/2508 

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Picture of external hard drive.
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This is the fifth article in a series on the changes to the NIH Data Management and Sharing policies that will go into effect for NIH grant applications starting January 2023. For more information, see our previous articles on data management.

File storage is an important piece of data management. While conducting your research, you’ll be saving and accessing your data often, so thinking about where and how to store this data before you begin your research is important. However, keep in mind that data storage is different from data preservation. Data storage addresses storage options during the active research process, while data preservation deals with the long-term storage of research data following the completion of a research project (Washington State University Libraries [WSU Libraries], 2022). And remember - backing up your files is an important piece of file storage.

The Rule of Three

When it comes to file storage, the best practice is to follow the “rule of three:” 

  • THREE copies of every file
  • TWO different media types (i.e. types of storage such as local/hard drive and cloud)
  • ONE copy in a different location (Cornell, 2022). 

Another way to think about the rule of three is “here, near, and far.” In this model of the rule of three, you’ll still want to keep at least three copies of your data. Keep one copy “here” - a local copy on your laptop or desktop computer. Keep a second copy “near” - an external copy on a different device (such as an external hard drive or a network drive). And keep a third copy “far” - an external copy in a geographically different location, such as in the cloud (Cornell, 2022). This strategy will ensure that if you lose a copy of a file, you will have it in other locations. However, be sure to save all files in all locations after every change or edit to a document. Having files in multiple locations is only helpful if each copy is updated with the most current version of the document. 

Where Can You Store Files?

There are a variety of different options available when it comes to storing your research data and files. Local hardware, such as your desktop or laptop computer, and external storage devices such as external hard drives can be convenient options. However, this storage strategy can be risky due to the threat of damage, loss, theft, or obsolescence of these devices (Himmelfarb Health Sciences Library [Himmelfarb], 2022). In order to help prevent theft, damage, or loss, it’s best to store external hard drives away from your computer (WSU Libraries, 2022). Network drives are typically very stable and secure since they are controlled by your institution's IT division (WSU Libraries, 2022). However, be aware that many network drives have size restrictions that make it an unrealistic option if you create large amounts of data. 

Remote storage, also known as cloud storage, is an option that stores your files on remotely located servers. This option can often cost money and it’s important to read and understand the terms of service before storing your data on the cloud. Many funders and institutions require any sensitive data to be stored on cloud services whose servers are located in the United States, so be sure to investigate where the servers are before saving your files (Himmelfarb, 2022). GW Box is the university’s enterprise file-sharing service for online cloud storage and collaboration. GW Box is free for all GW students, faculty, and staff. Cloud storage such as Google Drive and Box can be synchronized with your computer, which makes backing up your files easy (WSU Libraries, 2022). If your research required high-performance computing for data analysis, GW High-Performance Computing could be a good solution. Another cloud option is the NIH Science and Technology Research Infrastructure for Discovery, Experimentation, and Sustainability Initiative, also known as NIH STRIDES. More information about NIH STRIDES initiative is available through the NIH Office of Data Science Strategy. 

Storage Formats

For long-term storage, it’s best to use formats that are unencrypted and uncompressed so the files will remain readable in the future. Formats that are open, well-documented, and widely used will help ensure your files will remain accessible and usable in the long term (Himmelfarb, 2022). Preferred file formats include:

  • Text: DOCX, ODT, PDF
  • Databases: XML, SQLite
  • Tabulated data: CSV
  • Images: PNG, JPEG, TIFF
  • Sound: MP3, WAVE
  • Video: MP4

Data Security

Data security is a key concern when it comes to storing your files, especially when data in your files contain potentially sensitive information. It’s important to think carefully about and include data security in your data management plan. Some important considerations include:

  • Who will be responsible for storing and backing up your data? How frequently will this be done?
  • How will you manage access to your data? Consider physical access to hardware. Where will you store computers and external hard drives? Will these be password protected?
  • How will you secure hardware for locally stored data? Will you use firewalls? How will you update antivirus protection? Who will update the software and how often?
  • How will you keep the integrity of your data? Will you use encryption, watermarking, or digital signatures? 

(Himmelfarb, 2022)

What’s Your Backup Plan?

Creating a backup plan for your files will prevent the loss of data in the event of losing files or data from disasters such as fire or flood, theft, unauthorized use, or hardware/software malfunctions (Himmelfarb, 2022). Following the rule of three described above provides a great level of protection through multiple copies in a variety of locations. Knowing how to recover data from your backups before you need to in an emergency is also highly recommended (Cornell, 2022). Having two backups of your data, one locally on a device other than your main workstation, and another remotely is a great way to backup your data. 

Having a regular backup routine is also important. A full backup, backing up each file every time you do a backup, allows you to retrieve all of your data if you need to do so. However, this method takes a lot of time and resources. Another option is to do incremental backups. During incremental backups, you only need to back up files that have been edited or changed since your last backup (Himmelfarb, 2022). 

To Learn More:

To learn more about storage options, take a look at the Storage Options page of our NIH Data Management and Sharing Plan Research Guide.

References:

Cornell University. (June 2022). Data storage and backup. Research data management service group: Comprehensive data management planning & services. https://data.research.cornell.edu/content/data-storage-and-backup

Himmelfarb Health Sciences Library. (November 14, 2022).  Storage options. NIH data management & sharing plan (DMSP) Research Guide. https://guides.himmelfarb.gwu.edu/NIHDMSPolicy/storage-options

Washington State University Libraries. (January 10, 2022). Data storage & backup. Research data management. https://libguides.libraries.wsu.edu/rdmlibguide/datastorage

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Graphic listing holiday hours. Same hours are listed in blog post.

Himmelfarb Library will be closed during the Thanksgiving Holiday. Our hours this week are as follows:

DateDayHours
November 23, 2022WednesdayClosing at 8:00pm
November 24, 2022ThursdayClosed
November 25, 2022FridayClosed
November 26, 2022Saturday9:00am - 8:00pm
November 27, 2022SundayOpening at 9:00am

We will resume normal 24/7 hours after re-opening on Sunday, November 27, 2022.

Even though our building is closed, our electronic resources (including our databases, e-books, and e-journals) are still available during this time. 

Have a Happy Thanksgiving!

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With Halloween candy behind us, it is time to think of what to put on the table for the upcoming Thanksgiving season. Even if you are not one who celebrates, what better way to wrap up the fall season than with some bountiful food? No matter your preferences or dietary needs, there is an abundance of options to choose from to add flavor to your meal.

Watching carbohydrates? Not a problem. This Cauliflower casserole with mixed seed crust is low in calories, carbs, and is a vegetarian dish! Maybe you are after a bit of color, something to stand out against the earthy starchy tones? What better way to impress than with this Beet & Goat Cheese salad? Another vegetarian option that is both gluten and soy free, this salad is an excellent source of potassium, and beets can even help lower blood pressure! 

Maybe classic is more your flavor. Also free of nuts and soy, Eatingwell’s homemade cranberry sauce includes just a bit of orange peel which compliments the tart flavor of the cranberry. If you are seeking an appetizer to pair with some crackers or veggies, a Pear-Pecan Cheese Ball just may hit the spot. 

For the main course, how exciting would it be to try Ina Garten’s Herb-Roasted Turkey Breast? If Thanksgiving traditions are new to you, Food Network offers a How to Carve a Turkey video that offers beginner-friendly tips. Tired of traditional turkey? Why not try some Turkey Spring Rolls? Or, if your dietary preferences are sans-meat, Vegan Wild-Rice Butternut Squash offers a burst of flavor with wild rice, sage, and cherries! 

Lastly for dessert, who needs apple pie, when you can make an Apple Crisp? This sweet & crunchy treat also goes well with vanilla ice cream! You can warm up with a nice Hot Cider with Apple Brandy & Spices, and subtract the alcohol if you prefer. 

We wish you all a safe, healthy and joyous end of November filled with savory meals and incredible shopping deals! 

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Himmelfarb Library just launched a Research Guide on the NIH’s Data Management and Sharing Plan (DMSP) requirements that come into effect in the new year. If you are applying for a research grant or renewing an existing grant through NIH on or after January 23, 2023 that will generate scientific data, you will need to comply with the new requirements and include a plan in your grant application.

Screenshot of Himmelfarb Library's NIH Data Management and Sharing Plan (DMSP) Research Guide
Screenshot of Himmelfarb Library's NIH Data Management and Sharing Plan (DMSP) Research Guide

The new research guide will help step you through the process of developing a plan, from general information to get you started, to storing, sharing and budgeting options. If you’re unsure if you need to comply, it defines what scientific data is and what activity codes are subject to the policy. The guide also includes freely available tools and sample DMSPs from a variety of sources.

Understanding and applying FAIR principles are key to a successful DMSP. FAIR stands for Findable, Accessible, Interoperable and Reusable. The Getting Started page breaks down the FAIR principles and how to apply them to your data practices.

The guide includes videos from a variety of sources, including a two webinar series from the NIH that provide an overview and more in depth look at the policy. You’ll find other videos on the Getting Started page on commonly used tools including the DMPTool site, NLM Common Data Elements Repository, and LabArchive.

Storage options available to you at GW are covered as well as options for sharing archived data through general and specialized repositories. Guidance on estimating costs and building them into your grant round out the guide.

Through the fall we’ve published a series of blog posts on data management and sharing, including data management resources, best practices for writing a data management plan and file naming conventions. All of these articles are linked on the guide’s homepage. We are planning additional blog posts in the coming months, so stay tuned to this space and check the Research Guide for updates and new materials.

Questions about DMSPs that you can’t find answers to in our research guide? You can reach out directly to Sara Hoover, Metadata and Scholarly Publishing Librarian, at shoover@gwu.edu for more information and guidance.

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Celebrate National Nurse Practitioner Week. Supporting GW Nurse Practitioner Studies. Top E-Books at Himmelfarb.

November 13-19, 2022 is National Nurse Practitioner Week! Himmelfarb Library is proud to support our nurse practitioner (NP) students and faculty by providing a glance at our top NP e-books!

  • Aesthetic Procedures: Nurse Practitioner’s Guide to Cosmetic Dermatology: This textbook offers guidance to both experienced and novice aesthetic NPs. It reviews skin structure and anatomy, facial structure aging, the effects of aging and environmental exposures, pharmacology of aesthetic medications, benefits of treatments, and more. This is a one-stop resource for in-depth learning about cosmetic dermatology!
  • Adult-Gerontology Nurse Practitioner Certification Intensive Review: This is a must-have resource if you are studying for the adult-gerontology primary care NP certification exam (AGNP exam). This concise, well-organized text includes updated information, review questions at the end of each chapter, full-color images, and four practice tests with hundreds of practice questions and rationales (800 questions in total). Get test-ready with targeted “need-to-know” details about diseases and classic presentations you’ll see in patients across the lifespan.
  • Family Nurse Practitioner Certification Intensive Review: This text synthesizes the complex knowledge you’ll need to pass the ANCC and AANPCB certification exams. New test-format questions that include photos of skin and eye conditions and EKGs are included alongside drag-and-drop and multiple-choice questions. Non-clinical topics that are part of the exam are also covered including research, ethics, legal issues, advanced practice law, health practices of various cultures, and reimbursement guidelines. More than 700 practice questions are included to help you prepare!
  • Nurse Practitioner’s Business and Legal Guide: This book explains and analyzes legal issues for relevant nurse practitioners. This edition includes documentation requirements for avoiding malpractice, new case studies on risk management, current state laws, regulatory developments and prosecutions of NPs, and case analyses and lessons from these cases. Additional topics covered include medical bio-ethics terminology, malpractice cases, emerging health policy issues, opioid and controlled drugs prescribing guidelines, clinical performance measures, and much more!
  • Guidelines for Nurse Practitioners in Ambulatory Obstetric Settings: This clinical reference is a comprehensive source for current, evidence-based guidelines for NPs. This text covers clinical topics and practice standards relevant to preconception, prenatal, and postpartum nursing care. Each topic is broken down by definition, etiology, history, physical exam, lab exam, differential diagnosis, treatment, complications, consultation/referral, and follow-up. 
  • The Doctor of Nursing Practice Project: A Framework for Success: This book provides a road map for DNP students to complete their DNP project effectively and efficiently. This text outlines how the project has been used to prepare clinical scholars for practice. This edition includes a newly added chapter on health policy that highlights DNP core competencies used in advocating for healthcare policy change. 

In addition to these high-use titles, Himmelfarb also has a Nurse Practitioners Guide that links to core research databases such as CINAHL Complete, ClinicalKey for Nursing, PubMed, and Scopus to help you research and find full-text resources. This research guide can also help our NP students and faculty identify resources relevant to physical examination, diagnosis, drug information, professional organizations, and evidence-based practice. The textbooks tab provides links to all required textbooks and includes links to additional recommended textbooks. 

Accessing these e-books from anywhere is easy! Check out our Off-Campus Access Guide for tips and instructions on how to access these books from off-campus. And remember - our reference staff is always available to help answer your questions about research or access to our resources!

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As viruses like flu, RSV, and COVID-19surge this November, it is critical that we also make every effort to take care of our lungs. November is Lung Cancer Awareness month and there are preventable factors that can contribute to the cause of this type of carcinoma. 

Smoking is the most prolific and well known contributing factor that endangers even those who don’t smoke. If you are in an area that frequently contains cigarette smoke, leaving the area, or distancing yourself from it can greatly reduce your chances of contacting any type of harmful chemicals which may lead to cancer. Air pollution, exposure to asbestos, or diesel exhaust may also lead to this deadly type of cancer. 

While the list of specific causes may be vast, it is important to educate yourself further on the condition so that you can communicate and adopt healthy habits to help reduce risks. There can also be genetic risk factors.

If you find yourself interested in spreading the word about Lung Cancer Awareness Month, the American Lung Association has stories on survival and experiences with lung cancer, several ways to speak out through social media and also their initiative: the Lung Force walk. 

If you would like to explore more on what Himmelfarb has to offer on lung cancer, we have several resources available, here are a few examples from our catalog: 

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Photo by EVG Kowalievska

The United States has a history of assisting vulnerable populations with community needs, often with varying degrees of success. The Indian Health Service (IHS), part of the Department of Health and Human Services, is one such government organization that provides healthcare for millions of Indigenous people and since its inception, the service has positively impacted federally recognized Native nations despite budgetary constraints. The Service employs physicians, nurses, dentists and other healthcare professionals to meet the healthcare needs of Indigenous populations and the organization sponsors professional opportunities for Indigenous students at both the undergraduate and graduate levels who express an interest in entering the healthcare field.

The Indian Health Service was created in 1955 and was born out of a long history of the United States government providing assistance to Indigenous nations. “The provision of health services to members of federally-recognized tribes grew out of the special government-to-government relationship between the federal government and Indian tribes. This relationship, established in 1787, is based on Article 1, Section 8 of the Constitution, and has been given form and substance by numerous treaties, laws, Supreme Court decisions, and Executive Orders.”(Warne & Frizzell, 2014, p. S263) The federal government would send military physicians to Indigenous communities in an effort to address the spread of diseases such as smallpox. Unfortunately the government spent far less money on the healthcare of Indigenous people in comparison to members of the military. In 1880, the Commissioner of Indian Affairs, Thomas J. Morgan requested more funding to cover expenses and he “calculated the disparity in resources, finding that the Army spent $21.91 per soldier and the Navy $48.10 per sailor, while the government only appropriated $1.25 per Indian patient.” (Trahant, 2018, p. 118)

In 1911 President William Howard Taft urged Congress to raise the salary of healthcare workers employed in the Indian Service. But the history of underfunding Indigenous healthcare continued. When the Bureau of Indian Affairs opened a health division in 1921, the system suffered from poor funding, unsanitary facilities and inadequate supplies which placed a strain on the quality of care provided. In 1955, Congress transferred the health programs away from the Bureau of Indian Affair to the newly formed Indian Health Service. They also raised the service’s budget from $10 million to $17.7 million a year. Finally in 1976, “Congress proposed a sweeping new authorization for Indian health programs. The Indian Health Care Improvement Act…called on Congress to appropriate at least $1.6 billion in new funding for Indian health, spending resources on improving staffing, facilities, access to care for urban Indian populations, and, for the first time, opened up Medicare and Medicaid revenue.” (Trahant, 2018, p. 119)

The Indian Health Service’s headquarters is located in Rockville, Maryland and has twelve service areas located across the country. The current head of the service is Roselyn Tso, an enrolled member of the Navajo Nation. Tso began working for the Service in the 1980s and has worked in many different capacities, including serving as the director of the Indian Health Service Navajo Area in 2019. The Indian Health Service provides access to hospitals, health centers, dental clinics and behavioral health facilities to Indigenous communities in the twelve service areas. The organization also offers healthcare education so people can improve their quality of health outside of regularly scheduled appointments. The Indian Health Service is one of the few federal organizations that prioritizes Indigenous applicants during the job search process and they also host funding opportunities for students interested in a career in healthcare. Scholarships are available for undergraduate, graduate and preparatory school students. The Indian Health Service also offers an extern program where participants earn valuable, hands-on skills while working in IHS facilities. 

While the organization continues to suffer from poor funding in comparison to other federal organizations, the Indian Health Service has improved the overall health of their patients. For example, the infant mortality rate for Indigenous communities has drastically decreased since 1955 and “The Centers for Disease Control and Prevention reported that, in the United States from 2004 to 2008, 84 percent of American Indians and Alaska Natives have a ‘usual place for health care.’” (Trahant, 2018, p. 120) Besides the lack of adequate funding, another criticism of the Indian Health Service is the organizations’ lack of focus on Indigenous people who live in urban areas.  Over the years, the IHS has sought  to provide resources to patients in urban areas,  and to meet the needs of over 2 million Indigenous patients.

The Indian Health Service was born out of the numerous treaties, legally binding agreements and promises made between the US federal government and the governments of Indigenous nations such as the 1832 treaty between the War Department and the Winnebago Tribe in Wisconsin in which the federal government promised two physicians in exchange for land (Trahant, 2018). The healthcare and administrative workers in the IHS search for creative solutions to meet the pressing healthcare needs of their patients. And by offering scholarships and externships, the organization aims to tackle the healthcare industry’s lack of Indigenous workers. The Indian Health Service’s mission is “To raise the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest level” and by fulfilling this mission, the IHS provides an example for other healthcare organizations committed to addressing health disparities in other vulnerable and underserved communities.

References:

Indian Health Service. (n.d.). Indian Health Service: The Federal Health Program for American Indians and Alaska Natives. https://www.ihs.gov/

Marcinko, T. (2016, November 13). More Native American Doctors Needed to Reduce Health Disparities in Their Communities. AAMCNEWS. https://www.aamc.org/news-insights/more-native-american-doctors-needed-reduce-health-disparities-their-communities. 

Warne, D. & Frizzell, L.B. (2014). American Indian Health Policy: Historical trends and contemporary issues. American Journal of Public Health, 104(3), S263-S267. https://doi.org/10.2105/AJPH.2013.301682

Trahant, M.N. (2018). The story of Indian health is complicated by history, shortages, & bouts of excellence. Daedalus, 147(2), 116-123. https://doi.org/10.1162/DAED_a_00495

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