r.kyser – The Rotation: A Himmelfarb Library Blog

Medical Media: This is Going to Hurt

r.kyserAugust 21, 2024August 21, 2024Leave a comment

Every country’s medical system works slightly differently. While here in the United States we can face frustrations related to insurance, high costs and other issues, that doesn’t mean other medical systems have no issues. For today’s installment of Medical Media, librarian Deborah Wassertzug recommends a television series that takes a look at the system across the pond: the National Health Service of the United Kingdom.

This is Going to Hurt is a limited series television show from the UK, based on a memoir of the same name. Both the memoir, written by former doctor Adam Kay, and the television show, focus on the issues, struggles and experiences of junior doctors working in a National Health Service hospital, specifically their work on the obstetrics and gynecology ward.

For those used to medical television that takes place in the United States, there is a lot of new terminology to get used to. For example, instead of residency, the UK has Doctor Specialty training (1). Despite these changes in terminology, the issues facing doctors will likely be familiar to those aware of the challenges medical professionals face in the United States: burnout, stress, overwork, and funding shortfalls. The show also tackles serious issues related to mental health issues and work-life balance among doctors, a trend also seen in the United States (3). One episode juxtaposes a private maternity hospital with an NHS hospital and raises the question of whether there are safety issues associated with “going private.”

The show isn’t entirely serious: there are lighthearted moments and its genre is likely best described as a black comedy. According to Wassertzug , the show juxtaposes hilarious scenes with serious things people go through in medical settings, to great effect. Due to the involvement of Kay, the show is generally accurate when it comes to the dirtier aspects of medicine, so things do get a little messy.

For those interested, the book and series can be found on Hoopla from public libraries, on consortium loan here at Himmelfarb, and the television series can be found on multiple streaming platforms online.

How Doctor Specialty Training (Residency) Works in the UK. BMJ Careers. Accessed August 21, 2024. https://www.bmj.com/careers/article/how-doctor-specialty-training-residency-works-in-the-uk

Johnson A. CDC Tries Fixing Emerging Crisis: Mental Health Problems Among Doctors, Nurses. Forbes. Accessed August 21, 2024. https://www.forbes.com/sites/ariannajohnson/2023/11/01/cdc-tries-fixing-emerging-crisis-mental-health-problems-among-doctors-nurses/

Doctors’ titles explained - Toolkit for doctors new to the UK - BMA. The British Medical Association is the trade union and professional body for doctors in the UK. June 28, 2024. Accessed August 21, 2024. https://www.bma.org.uk/advice-and-support/international-doctors/life-and-work-in-the-uk/toolkit-for-doctors-new-to-the-uk/doctors-titles-explained

Comic: Mimic in the Machine: Chat-GPT and A.I.

r.kyserAugust 5, 2024August 5, 2024

One of the most frequent questions we get at the library in recent months is in regards to A.I. What is A.I? Is A.I the future? Are we all about to be replaced by robots? In this month's comic strip, we simplify A.I. in order to make sense of what's realistic, what's plausible and what's still science fiction.

Speech Bubble 1:Ever since AI burst onto the scene, I’ve seen a lot of folks misunderstand how it works.
Image: Rebecca, a librarian with light skin and dark curly brown hair in a ponytail speaks in front of a bunch of tech items.

Panel 4:
Narration: In reality, while AI can write or talk, it’s not “thinking” like humans do
Image: The robot displaying a blank expression is next to a thought bubble showing binary code.

Narration: To understand how AI “thinks” we need to understand what this kind of AI is and how it works.
Image: There is a monitor and on it, a pixilated version of Rebecca is shown next to the text “Understand A.I.” Then under that is the text A: Y B: N

Panel 6:
Narration: First, the kind of AI seen in movies is not the same kind in chat-gpt. That is, self-aware AI currently doesn’t exist outside of fiction.
Image: Two books are shown. One of the books has a picture of a robot on it stating “foolish: it is statistically unlikely to be lupus” The title of the book is “Watt.Son M.D”

Panel 7:
Speech Bubble: The AI we see discussed today is known as generative AI. It can produce things like text, images and audio by being trained on large amounts of data (1).
Image: A flow chart is shown. A bunch of file cabinets is first, then an audio icon next to the text or then a picture of a monitor next to the text or and then a smiley face drawing.

Panel 7:
Narrator: I’m going to vastly simplify. Say we want an AI to make images of sheep. First we’d grab a bunch of images of sheep as our training data.
Image: A table is covered with a variety of photos of sheep. The sheep are all different sizes and colors.

Panel 8:
Narration: Over time, as we feed the model more pictures of the sheep, the model starts to identify common shared characteristics between the images.
There is a little white sheep with a black face. Next to it, text states: Aspect: fluffy Feature 2(ear) Feature 2(eye) feature: tail= sheep

Panel 9:
Narration: Now, when this works as intended, after tons of images, our AI can start to produce images of sheep itself based off the training data. This is why it’s called “generative” AI; it is generating new content.
Image: The robot from early has an excited expression on it’s monitor. It points to a fridge where a picture of a sheep is displayed.

Panel 10:
The AI is able to produce these images not because it now “knows” what a sheep is, but by essentially large scale probability. I’m still vastly simplifying, but the AI makes the sheep fluffy not because it knows what wool is, but because 100% of its training data includes wool.
Image: Rebecca stands in front of a television screen. On the screen, the robot looks confused at a black sheep in a field.
Panel 11:
Narration: So if we apply this to words, AI is not so much writing as it is calculating the probability of what word is most likely to follow the word it just typed. Sort of like autocorrect.
Image: The background is a thunderstorm. There is text that reads: it was a dark and stormy _____? A. Night 90% B. Evening 7% C Afternoon 2% D. Day 1%

Panel 12:
Narration: Okay so why bother making this distinction. Why does it matter?
Image: The robot is shown with it’s monitor displaying a buffering message. Above it, a chibi Rebecca says “let me explain.”

Panel 13:
Narration: AI relies on its training data. Let’s consider the sheep example from earlier. In the photos I drew, none of them show a sheep’s legs.
Image: Rebecca sits in front of her tablet with a drawing pen. She gestures to the viewer, exasperated.
Rebecca ‘s Speech Bubble: “Look, I only have so much time to draw these things.”

Panel 14:
Narration: If all the images I feed our hypothetical AI are of sheep from the middle up we might get something like this.
Image: Three pictures of sheep are displayed. None of the sheep have legs and instead are puffballs of wool. One sheep is square shaped.
Narration Con: Our AI can only generate based on its data. So if we feed it no pictures of sheep with legs, we get no pictures of sheep with legs (frankly is also shouldn’t make images of a sheep where the entire body is in the frame either). The backgrounds will be a mashup too, as the AI will consider it as part of the image. This leads to interesting results with a wide range of background types.

Panel 15:
Narration: This is one of the reasons AI images struggle with details like fingers: how many fingers you can see in an image of a person varies widely depending on their pose and the angle of the photograph (2).
Image: Four hands with different skin tones are shown, each with a different gesture. In a little bubble to the left, Rebecca is shown looking tired.
Rebecca Speech Bubble: Drawing hands is hard…

Panel 16:
Narration: The same thing goes for writing: when AI writes out “it was a dark and stormy night” it has no comprehension of any of those words. It’s all based on probability. And this is the misconception that leads to so many problems.
Image: The robot is seated at a chair, typing at a computer. From the computer, text reads “it was a dark and stormy night” and from the robot speech bubble we get more binary.

Panel 17: Narration: For example let’s take AI hallucinations. AI Hallucinations refer to when AI makes things up, essentially lying to the user. Now that we understand how AI works, we can understand how this happens.
Image: The robot is shown its monitor full of a kaleidoscope of colors and two big white eyes. The background behind it is also a mix of colors.
Panel 18: Narration: AI has no comprehension of lies or the truth. It is regurgitating its training data. Which means that if it doesn't have the answer in the training data, or is fed the wrong answer, what you’re going to get is, the wrong answer.

Panel 19: For example, Google AI made headlines when it recommended people use glue to make the cheese stick on their pizza. (3).
Image: A man with dark skin, glasses and a beard stands in front of a pizza and a bottle of glue. He is wearing an apron.
Man’s speech bubble: “A least it said to use non-toxic glue.

Panel 21: That example was pretty harmless, but it can be much worse. AI has told people to eat poisonous mushrooms (4), provided dieting advice on a hotline for eating disorders (5) or displayed racial bias (6).
Image: The grim reaper is shown, wearing a little shef scarf with his sythe. Next to him is a display of mushrooms. Underneath text reads: guest chef death showcases favorite deadly mushrooms.

Panel 22: Generative AI systems also comes up with fake citations to books and papers that don’t exist. Often is mashes up real authors and journals with fake doi numbers
Image: Three journals are shown composed of fragments of other journals on their covers, each stitched together

Panel 23: Narration: And don’t get me started on the ways images can go wrong (8).
Image: Rebecca stands next to a table with school supplies and a rat. The rat is looking up with her with a question mark over its head.
Rebecca’s speech bubble: Just look up AI rat scandal and you’ll understand why I didn’t draw an example.

Panel 24: Image: The rat from the last panel is shown.
Rat speech bubble: So AI is worthless?
Narration: Absolutely not!
Panel 25:
Narration: AI absolutely has uses. While it’s still in early stages, AI has shown promise in helping doctors identify potentially cancerous moles
Image: The robot and a doctor look at a monitor
Doctor: Should I make a biopsy of both?
Robot: 71%
Doctor: Both it is!

Panel 25:
Narration: But it’s not a magical solution to every problem. And when we forget that, our “artificial intelligence” is more artificial than anything intelligent.
Image: The robot’s monitor is shown with the citations for this comic displayed.

Comic written and drawn by: Rebecca Kyser

Citations:

1.Christian B. The Alignment Problem : Machine Learning and Human Values. W.W. Norton & Company; 2021.

2. Lanz D/ JA. AI Kryptonite: Why Artificial Intelligence Can’t Handle Hands. Decrypt. Published April 10, 2023. Accessed August 5, 2024. https://decrypt.co/125865/generative-ai-art-images-hands-fingers-teeth

3. Robison K. Google promised a better search experience — now it’s telling us to put glue on our pizza. The Verge. Published May 23, 2024. Accessed August 5, 2024. https://www.theverge.com/2024/5/23/24162896/google-ai-overview-hallucinations-glue-in-pizza

4. AI-powered mushroom ID apps are frequently wrong - The Washington Post. Accessed August 5, 2024. https://www.washingtonpost.com/technology/2024/03/18/ai-mushroom-id-accuracy/

5. Wells K. An eating disorders chatbot offered dieting advice, raising fears about AI in health. NPR. https://www.npr.org/sections/health-shots/2023/06/08/1180838096/an-eating-disorders-chatbot-offered-dieting-advice-raising-fears-about-ai-in-hea. Published June 9, 2023. Accessed August 5, 2024.

6. Noble SU. Algorithms of Oppression : How Search Engines Reinforce Racism. New York University Press; 2018. doi:10.18574/9781479833641

7. Welborn A. ChatGPT and Fake Citations. Duke University Libraries Blogs. Published March 9, 2023. Accessed August 5, 2024. https://blogs.library.duke.edu/blog/2023/03/09/chatgpt-and-fake-citations/

8. Pearson J. Study Featuring AI-Generated Giant Rat Penis Retracted, Journal Apologizes. Vice. Published February 16, 2024. Accessed August 5, 2024. https://www.vice.com/en/article/4a389b/ai-midjourney-rat-penis-study-retracted-frontiers

9. Lewis. An artificial intelligence tool that can help detect melanoma. MIT News | Massachusetts Institute of Technology. Published April 2, 2021. Accessed August 5, 2024. https://news.mit.edu/2021/artificial-intelligence-tool-can-help-detect-melanoma-0402

Historical Misadventures in Medicine: Jeppson’s Malört

r.kyserJuly 26, 2024July 26, 2024

A picture of the city of chicago, right outside the chicago theater

Welcome to the Halls of Patent Medicine. Back before the regulation of food and drugs in the United States, almost anyone could make a concoction, claim it was medicine and sell it over the counter without a doctor’s prescription (1). This led to predictable results, with all sorts of items being sold for their “medicinal properties.” The history of patent medicine is a treasure trove of outrageous marketing, dubious deals and suspicious substances. So with that in mind, let’s take a look at something from my hometown of Chicago.

Chicago’s finest sewer water (2). Pencil Shavings and Heartbreak (3). Soapy Dirty Dishwater (3). All of these descriptors have been applied to Jeppson’s Malört, a hard liquor created in Chicago back in the 1920’s. Known for its distinctive taste, the drink is considered a staple of Chicago. And like some other beverages on the market, Jeppson’s Malört began as a medicine, not as an alcoholic beverage.

Well, at least its inventor claimed it was a medicine (4). During Prohibition, a Swedish immigrant by the name of Carl Jeppson created the beverage (wine). He began selling it to those interested in buying, and given the lack of legally available liquor, the beverage had interested buyers. According to legend, the terrible taste was part of the reason Jeppson was able to sell it; when questioned by the cops, Jeppson told them to try it, and after one shot, they’d agree that nobody would drink something so terrible for fun (4).

But what was Jeppson’s supposed to treat anyway? Stomach worms and parasites, apparently (3). While it likely didn’t have any impact on hypothetical parasites, that wouldn’t cause any problems given lack of regulation of drugs at the time. While the drink came out after the Golden Era of Patent (an era where patent medicines boomed in sales), it would slip through before the passage of the Food Drug and Cosmetic Act, allowing Jeppson to sell his concoction despite his dubious claims (1).

After Prohibition ended, Jeppson sold his formula. Later, it would be popularized in the late 2000’s by a local bartender, and become the iconic drink of Chicagoland. While you can purchase it outside of the city these days, it might be best to hold off unless you want to try the taste of “pencil shavings and heartbreak” for yourself.

1. Smithsonian. Balm of America: Patent Medicine Collection. Smithsonian Institution. Accessed July 25, 2024. https://www.si.edu/spotlight/balm-of-america-patent-medicine-collection/history

2. Schnitzler N. Check Out This Documentary On Malört, The Spirit That’s Proud To Be Undrinkable. Food Republic. Published April 21, 2015. Accessed July 25, 2024. https://www.foodrepublic.com/2015/04/21/check-oDow C. Jeppson’s Malört - A Brief Education. Real Food Traveler. Published November 12, 2019. Accessed July 25, 2024. https://www.realfoodtraveler.com/jeppsons-malort-a-brief-educationut-this-documentary-on-malort-the-spirit-thats-proud-to-be-undrinkable/

3. Dow C. Jeppson’s Malört - A Brief Education. Real Food Traveler. Published November 12, 2019. Accessed July 25, 2024. https://www.realfoodtraveler.com/jeppsons-malort-a-brief-education/

4 John W. Chicago’s Malört Liqueur Is Both Off-Putting and Excellent. Food & Wine. Accessed July 25, 2024. https://www.foodandwine.com/travel/history-of-malort-chicago-novelty-liquor

Medical Media: House MD

r.kyserJuly 22, 2024July 23, 2024

The world of medicine has always drawn fascination from outsiders. Maybe this is why so many television shows, books and movies revolve around doctors, nurses, and other medical settings. As part of a new series on the blog, we here at Himmelfarb are going to dive into personal favorite pieces of media centered around medicine. While some of these titles may be familiar, hopefully there will be one or two among the bunch for one to enjoy as a treat after big exams.

To start off the series, we’ll begin with my recommendation:

House MD (2004-2012)

I’ve always loved a good mystery. As a teenager, I poured over classic Sherlock Holmes stories, fascinated by the solutions that I could never see coming. So it shouldn’t be a surprise that when I happened to catch an episode of House MD that I was instantly hooked.

House MD is a mystery show packaged inside a medical show. Based on the character Sherlock Holmes (there’s a reason House’s best friend is named “Wilson”) and a real life doctor (1), the show centers on the aforementioned Doctor House, who is an expert at solving difficult medical mysteries. House is often cynical, unfriendly, and rude, but he’s engaging to watch despite his personality flaws. Each episode, House and his team aim to solve a medical mystery centered around a patient of the week. Like his namesake, House is unconventional and while his habit of breaking and entering is inadvisable in the real world, it does make for exciting television. The side characters of the show, such as Wilson, Cuddy, House’s team and later a cast of interns, provide plenty of other perspectives to follow that contrast with House’s own cynical worldview. When the show is at its best, the mystery of the week is compelling and ties into something going on in House’s own life.

While parts of the show have aged poorly in the years since it’s premiered, the base formula of a flawed protagonist and a mystery only he can solve still holds up. It’s absolutely worth a watch if one wants to take a dive into one of the most popular shows of the 2000s. Just don’t take House’s bedside manner as a learning example.

1.Gonzalez S. There’s A Doctor Behind ‘House’: Internist Lisa Sanders. YaleNews. Published October 30, 2009. Accessed July 22, 2024. https://news.yale.edu/2009/10/30/theres-doctor-behind-house-internist-lisa-sanders
2. House M.D. Heel & Toe Films, Shore Z Productions, Bad Hat Harry Productions; 2004.

Comic: Plagiarism

r.kyserJuly 12, 2024July 29, 2024

What is plagiarism anyway? In today's blog post, here's a comic about what plagiarism is, and how to avoid it.

Narration: Sometimes I think people view plagiarism like an unseen horror movie monster: they know it's bad and should be avoided, but aren’t clear on the specifics.
Image: There is a red question mark centered in the center of the page. Around it, is text that states as follows:”Plagiarism is: stealing? Not using quotes? Bad. It’s Def Bad!”

Panel 2:
Narration: This is Understandable: What does stealing an idea even look like?
Image: A man with pale skin wearing a black and white striped shirt, a black domino mask, and a black hat, is running away. He is dressed to look like an classic bank robber. He is holding under his arm an empty thought bubble.
Robber Speech Bubble: “You’ll never catch me copyright lawyers!”
Panel 3:
Narration: Webster’s defines “Plagiarize” as “to steal and pass off (the ideas or works of another) as one’s own” “without crediting the source”
Image: A larger man with brown skin, short hair and a tank top points up at the narration bar.
Man’s Speech Bubble: Oh hey! A citation!

Narration: Sounds simple enough. Credit others for their work.
Image: A man with dark brown skin and dreads, wearing a long sleeved shirt, gestures to a fat woman with curly gray hair, a long sleeved shirt, a skirt and some jewelry. She looks confused, scratching the back of her head.
Gesturing Man speech bubble: Behold! My source!
Confused women speech bubble: This seems excessive…

Panel 5:
Narration: But like many things in life, the devil is in the details.
Image: A horned demon, which looks like a mix of a goat, and a dragon with three eyes, clawed hands, sharp teeth and a pointed tail spreads their arms in delight. They hold a red pitchfork and wear a white suit with a yellow tie. Behind them is fire.

Panel 6:
Narration: It can be shockingly easy to plagiarize unintentionally.
Image: A woman with light brown skin and brown/blonde hair in a ponytail gestures to a pile of empty thought bubbles. She wears a green blouse and blue jeans and looks defensive and confused. Standing across from her is an older bald man with dark brown skin, simple glasses, and a mustache. He is wearing a suit with a yellow tie and belt. His hands are on his hips.
Woman’s Speech bubble: I don’t know where these uncited sources came from!
Older man’s Speech bubble: That’s what they all say!

Panel 7:
Image: A picture of Rebecca, a librarian, with pale skin, dark brown curly hair, and glasses speaks to the viewer.
Speech Bubble: I think the best way to explain what is and isn’t plagiarism is to provide examples.

Panel 1:
Narration: So let’s start with some common examples of plagiarism:
Image: Rebecca chases after a humanoid cat, who is dressed as a cat burglar. The cat is gray, wearing a little black hat, with light gray fur that darkens like a cat burglar mask over their eyes. The cat is holding a speech bubble where the text is obscured by their arm, and the end of the speech bubble looks ripped. One of Rebecca’s speech bubbles includes only the tail, implying the cat stole her original speech bubble and is running off with it. The cat is labeled as “The Copycat Plagiarist”
Rebecca speech bubble: My speech bubble!
Cat speech bubble: Mine now!

Panel 2:
Image: Rebecca is in the background, clearly irate, her hands stretched out. Her speech bubble is once again missing with only the tail remaining. In the foreground, the cat is speaking to the viewer. He holds a hammer, and his own speech bubble features two wooden boards that connect the tail and the bubble itself.
Narration: Most folks know that copying someone’s words directly is plagiarism.
Cat Speech Bubble: For example, copying and pasting text directly from Wikipedia.
Panel 3:
Narration: But it’s also plagiarism to take someone’s words and just change a few words or change the order (2).
Image: Rebecca and the cat are facing each other. Rebecca looks irate and the cat is looking up, innocently. Their respective speech bubbles have highlighted text showing where the cat is taking text from Rebecca.
Rebecca’s Speech Bubble 1: If it’s someone else’s idea or thoughts, it still needs a citation.”
Cat’s Speech bubble 2: “It still needs a citation if it’s someone else’s concept or outlook.”

Panel 4:
Narration: The best way to avoid both these issues is a proper citation. But what does a proper citation look like?
Image: A man with brown skin, short brown hair, a blue tank top, and 5 o'clock shadow, shrugs in the middle of the panel, surrounded by question marks.

Panel 5:
Narration: First, when using information from a source, you should cite it. These often are in the reference section.
Image: A piece of paper that says “References” at the top of the page is shown, with a warm glow behind it, showing its importance.
Panel 6:
Narration: But the reference section isn’t the only step: when we paraphrase, quote, refer to or use ideas from a specific piece of work, we need to show readers which reference we’re using. That’s where in-text citations come in.
Images: In the background, the cat looks bored, staring into the distance. In front of him, Rebecca holds out her hand to cut him off and yells.
Cat speech bubble: “Lame”
Rebecca Speech Bubble: “Quiet You!”

Panel 7:
Narration: (There are a variety of citation styles but they all have the same purpose. Fields tend to have a citation style they prefer.)
Image: A fashion runway is shown, with a red curtain in the background and stereo speakers. On the runway, the letters MLA are shown wearing clothing like a crown, jeans, shoes and a scarf.

Panel 8:
Narration: In-text citations help us match a piece of information to its source.
Image: A woman with light brown skin, and red hair, wears a detective outfit including a deerstalker. Behind her is a whiteboard with red string connecting various post-it notes, centered around the text “it’s connected”

Panel 9:
Narration: Think of in-text citations like a map that can guide a reader to the original source. It allows folks to retrace the author’s steps.
Image: A picture of a map is shown, with four land masses, a boat, and a giant octopus tentacle. There is a dotted line that connects a subscript 1 to a big red X.

Panel 10:
Image: Rebecca speaks to the audience.
Rebecca Speech Bubble: So how do we use in-text citations? Whenever talking about or using a specific source, add an in-text citation

Panel 11:
Narration: When using a direct quote, also include quotation marks so readers know what is another person’s work and what isn’t (2).
Image: A split panel is shown. On the left, is the cat, speaking to the audience, with the label of “wrong” next to him. On the right, Rebecca is shown speaking to the audience, with the label of “right” next to her.
Cat speech bubble: “They said it is critical to use proper citations.”
Rebecca speech bubble: “They said “It is critical to use proper citations (15).”

Panel 1:
Narration: In-text citations also should be used for images, especially graphs or charts.
Image 1: Three different kinds of graphs are shown: a pie chart, a line graph and a bar graph. There is also a picture of a skull with text under it that states “diagrams too!”

Panel 2:
Image: Rebecca and the Cat are standing behind a wall. The cat is leaning on the wall looking frustrated, one arm raised up. To his right, Rebecca responds to him.
Cat speech bubble: So I have to cite everything!? Who am I supposed to cite for basic stuff like “water is wet and I don’t like it!”
Rebecca speech bubble: No, of course not. For two reasons!
Panel 3:
Narration: The first part “water is wet” is what we would consider common knowledge (4). Common knowledge includes facts that most people would know without looking them up.
Image: In the narration, there is a little pop out bubble of Rebecca’s face to denote she is narrating. In the image, the cat, no longer humanoid, looks disgruntled as it sits under a rain cloud.

Panel 4:
Narration: So a fact like “diseases can be caused by germs” doesn’t need a citation to ward off the ghost of Louis Pasteur.
Image: A person with dark skin and long hair sits at a desk, looking at a computer. An exclamation mark is above their head. Above them, the ghost of Louis Pasteur floats, with his arms crossed.
Ghost speech bubble: “Excuse me?!”
Panel 5:
Narration: The second reason is “I don’t like it” is your personal opinion you don’t need to cite yourself.*
Image: Rebecca is shown trying to shove a closet door shut.
Rebecca Speech Bubble: “However if you’re using something you previously published, that’s another story (and another comic).”

Panel 6:
Image: The cat with his arms outstretched, yells at the audience.
Cat speech Bubble 1: How am I supposed to remember all this?

Panel 7:
Narration: By asking for help!There are guides for multiple citation styles in the library and online. Your librarian can also help with citation questions.
Image: Rebecca speaks to the audience, gesturing to the list of floating words. The floating words are “zotero” “refworks” and “endnote”
Rebecca Speech Bubble: “There are even programs made specifically to help manage citations.”

Works Cited:

“Definition of PLAGIARIZE.” Merriam-Webster. Published June 20, 2024. Accessed June 26, 2024. https://www.merriam-webster.com/dictionary/plagiarize
Harvard College Writing Program, “What Constitutes Plagiarism?” Harvard University. Accessed June 7, 2024. https://usingsources.fas.harvard.edu/what-constitutes-plagiarism-0
University of Washington Health Sciences “Library AMA Style Guide: In-Text Citations.” University of Washington Health Science Library, University of Washington. Published March 1, 2024. Accessed June 26, 2024. https://guides.lib.uw.edu/hsl/ama/intext
Purdue University, “Common Knowledge & Attribution - Purdue OWL®.” Purdue University. Accessed June 26, 2024. https://owl.purdue.edu/owl/avoiding_plagiarism/common-knowledge_attribution.html

Crash Diets, Magical Seeds, and Devious Dentists: TikTok and Health Misinformation

r.kyserJuly 8, 2024July 8, 2024

When people ask if I use TikTok, I respond with an unconventional reply: only for research purposes. While the wording I use is intended to be humorous, I’m actually telling the truth. I downloaded TikTok in grad school to study misinformation on social media during the height of the Covid-19 pandemic, and to this day, I use it to see what misinformation is spreading online.

Before I get into specifics, let me be clear that TikTok is not the only source of misinformation on the internet or even the worst. It’s hard to gauge how much misinformation spreads from platform to platform, and it’s my personal belief that every social media site has its own misinformation problem that expresses itself in different ways. The problems I see on TikTok can be seen everywhere from X to Meta. But given TikTok’s popularity, it seems best to focus on that platform.

Back to TikTok. To give readers a taste of what I’m talking about, here is a smallsampling of the type of videos I got on TikTok just last week:

Claims that eating a type of seed leads to living over 100 years old and never getting cancer
Claims that using a type of veggie powder in your drink can improve your heart health, a powder the video creator also sells
The claim that teeth can heal themselves and that dentists are lying to you to gain money
Promotion of a crash diet that claims to cure all diseases

Needless to say, these health claims are false. If there were a type of seed we could eat that would lead to perfect health, we’d all know about it. But I bring up this type of content not to debunk it, but to ask an important question: why do people believe in these kinds of claims? Most of this content is easily disproved, and some of it has been debunked for decades – take the claim one does not need glasses, for example (Klee, 2023).

The answer to that question is multifaceted. Since the study of misinformation became more popular, journalists and scientists alike have theorized why some health claims, no matter how ridiculous, still manage to go viral. History has also offered some insights; given the long history of quackery, there are plenty of examples to pull from.

Here are some reasons why these ideas continue to be popular:

Lack of Health Literacy: Health literacy is something that one has to learn. When you lack health literacy, you can be more susceptible to believing outlandish health claims.
Cost of Health Care: Health care is expensive, especially if you lack insurance. When you can’t afford recommended treatments, fringe medical ideas can be more appealing if they don’t break the bank.
They Confirm Our Biases: Claims that back up biases we already have can be particularly enticing. If I love fresh strawberries and see a post claiming fresh strawberries help treat an illness, I’m more likely to buy into the idea.
Negative Experiences with Healthcare: When you have negative encounters with healthcare, alternatives become more appealing, especially when they validate feelings that were previously dismissed (Boyle, 2022)
Feeling Anxious/Lacking Control: It’s scary to feel out of control of your own health. Many scams promise that their products offer control over your body, which can be very tempting (Nan, 2022).

One thing I want to draw attention to is what isn’t included on this list: lack of intelligence. While health literacy does help one spot misinformation, it does not provide immunity: some of the biggest spreaders of Covid-19 misinformation are medical professionals (Bond, 2021). No amount of factual knowledge makes us immune to fear, bias, and other emotions that drive the uptake of health misinformation.

So how do we avoid misinformation? Remaining skeptical is always a good place to start, as well as being aware of one's own biases. As for combating misinformation on a wider scale, teaching health literacy, assisting individuals with high healthcare costs, and improving patient experiences are all ways to start.

In the meantime, let us all take the health information we hear online with a grain of salt we can only see if we keep wearing our glasses.

Bond, Shannon. “Just 12 People Are Behind Most Vaccine Hoaxes On Social Media, Research Shows.” NPR, 14 May 2021. NPR, https://www.npr.org/2021/05/13/996570855/disinformation-dozen-test-facebooks-twitters-ability-to-curb-vaccine-hoaxes.

Boyle, Patrick. “Why Do People Believe Medical Misinformation?” AAMC, 3 Nov. 2022, https://www.aamc.org/news/why-do-people-believe-medical-misinformation.

Klee, Miles. “‘You Do Not Need Glasses’: A Wellness Coach’s Bogus Claim -- And Its 100-Year History.” Rolling Stone, 18 Sept. 2023, https://www.rollingstone.com/culture/culture-features/wellness-coaches-wearing-glasses-false-claims-1234822624/.

Nan, Xiaoli, et al. “Why Do People Believe Health Misinformation and Who Is at Risk? A Systematic Review of Individual Differences in Susceptibility to Health Misinformation.” Social Science & Medicine, vol. 314, Dec. 2022, p. 115398. ScienceDirect, https://doi.org/10.1016/j.socscimed.2022.115398.

Robson, David. “Why Smart People Are More Likely to Believe Fake News.” The Guardian, 1 Apr. 2019. The Guardian, https://www.theguardian.com/books/2019/apr/01/why-smart-people-are-more-likely-to-believe-fake-news.

Robson, David. “Why Smart People Believe Coronavirus Myths.” BBC, 6 Apr. 2020, https://www.bbc.com/future/article/20200406-why-smart-people-believe-coronavirus-myths.

Pride in the Collection

r.kyserJune 12, 2024July 29, 2024

A piece of wrinkled shaded with the colors of the rainbow

Every person is different, and that diversity makes human beings so fascinating. In order to serve diverse populations, it’s important for us here at Himmelfarb Library to have a wide variety of materials for students to learn from. One of these populations is the LGBTQ+community.

To help students locate material related to diverse populations, we have a Diversity and Disparities in Health Care collection. This collection covers a wide range of unrepresented groups, including queer people. Given the wide variety of content we offer, it would be impossible to cover everything in one blog post (which is a good thing). Instead, here are a few books from our collection to give readers a glimpse of what the library has to offer.

Global LGBTQ Health: Research, Policy, Practice, and Pathways.

By: Hwahng, Sel J. editor.; Kaufman, Michelle R. editor.

This book takes a look at the intersection of global and LBGTQ+health. Aiming to take a larger look at LGBTQ+health across the world, this text offers insight into issues on both a regional and global scale.

The case against conversion "therapy": evidence, ethics, and alternatives

Haldeman, Douglas C., editor.

While many states have now banned the practice known as “conversion therapy” there are still places where it is used, often on LGBTQ+ youth. This text takes a look at the motivations behind the practice, the decades of evidence showing it to be actively harmful, and why LGBTQ+identities are not something to be “cured” but embraced.

Trans medicine: The emergence and practice of treating gender

Shuster, Stef M., author.

This text covers both the history and contemporary practice of Trans medicine. Medicine for transgender people is often misunderstood due to both a lack of knowledge and misinformation. In this book, readers can not only learn that Trans medicine is not new, but is backed by decades of science.

Bodies and barriers: Queer activists on health

Shanker, Adrian, editor.; Levine, Rachel Leland, 1957- writer of foreword.; Kendell, Kate, writer of afterword.

Health disparities can exist for a variety of reasons. In this text, multiple queer activists explain some of the factors that lead to such disparities, what negative outcomes result, and ideas on how to fix them.

The script - queer futures

Wortham, J., film producer.; Fryer, Brit, film director.; Schamus, Noah, film director.; Multitude Films, production company.; Good Docs (Firm), distributor

Our last resource for this post is a film. Using recreations of personal interviews, this film takes a look at how transgender and nonbinary people interact with the medical system, and how practitioners and patients interact with one another.

References:

Haldeman DC, ed. The Case against Conversion “Therapy”: Evidence, Ethics, and Alternatives. American Psychological Association; 2022.

Hwahng SJ, Kaufman MR, eds. Global LGBTQ Health: Research, Policy, Practice, and Pathways. First edition. Springer; 2024. doi:10.1007/978-3-031-36204-0

Shuster SM. Trans Medicine: The Emergence and Practice of Treating Gender. New York University Press; 2021.

Shanker A, ed. Bodies and Barriers: Queer Activists on Health. PM Press; 2020.

Wortham J, Fryer B, Schamus N. The Script - Queer Futures. [Distributed by] GOOD DOCS; 2023.

Comic: Predatory Publishing

r.kyserMay 29, 2024July 25, 2024

Sometimes researching can be more complicated than it appears. Below, we take a look at predatory publishing, what it is, and how to avoid it.

A title card that says predatory publishing

Narration: A label next in the bottom left corner denotes the speaker as “Rebecca, Librarian, Amature Cartoonist.” — Pp Page 1

Rebecca in the boat, looks down concerned at the sea, where multiple shark fins can be seen poking through the waves. The speech bubble states “But there metaphorical waters can prove treacherous. And unlike real sharks, these threats to scientific knowledge provide little benefit to the scholarly ecosystem”

Narration: “Introducing Predatory Publishing” is at the top of the page. At the bottom, there is a label for the shark, which states “Ponzi, the Shark”
Image: A shark wearing a top hat and bow tie waves a fin, looking smug.

Panel 4 Narration: “But what are predatory publishers?”
Image: Rebecca looking stern, looks forward with a parrot on her shoulder. “Predatory publishers are journals that only exist to make money.”

panel 5
Image: A white man with blonde hair and old fashion clothes, holding onto ship wreckage like Jack in Titanic, looks at a mermaid with brown skin, black hair and a purple tail. In the background there is other evidence of a ship wreck. The man says “What do you mean “make money?” to which the mermaid replies “You didn’t know?” — Pp Page 1

Image: Now under the sea, the mermaid from earlier gestures to a treasure chest full of gold. Other sea life float in the background. She says “Scientific publishing is a huge business. One publisher, had a profit margin of almost 40% in 2023 (1). In contrast, Apple’s was 44% (2). — Pp Page 1

Panel 1 Narration: To best understand how publishers make so much money, one must learn how the publishing process works.
Image: The parrot from earlier says “Polly want an explanation!”

Panel 2
Narration: “Traditional publishing looks something like this. Scientists submit to journals who publish it to the world (ideally). And money flows like this: scientists submit to journals for free (or a small fee) and publishers pay to publish the work to the world, who pay higher costs in return for access. Publishers get work for free that is edited for free and then charge individuals, libraries, ect for access.
Image: A flow chart of a beaker, a journal and the Earth is shown demonstrating the relationship described in the narration.

Narration: This can lead to science being behind a paywall, especially for scientists, schools and others who can’t afford to pay.
Image: Rebecca and Polly the parrot stand on opposite sides of a poster with a picture of a journal on it. The poster says “$$$$ science.” Rebecca, talking to Polly, says “I can’t afford this.” Polly, who is resting on a bird perch, says “Polly can’t even afford a cracker…”

Panel 1
Narration: SO a new model was born: open access. It looks like the traditional model but money flows like this (authors pay to journals to publish their work and journals pay to publish to the world). The idea is the author pays a fee to ensure wider access.
Image: A flow chart of a beaker, a journal and the Earth is shown demonstrating the relationship described in the narration.
Panel 2:
Narration: Ideally, the rest works the same. Scientists submit their best works, it’s peer reviewed and if it passes muster, it’s published like traditional publishing.
Image: We see the Earth in space with an Astronaut floating in the foreground. The astronaut says “I even get access out here!” There is also a UFO floating over the Earth as a gag.

Narration: Except…what if instead of being discerning about what you publish, you just accept everything? After all, the more articles you accept, the more money you make in fees. — Pp 2

Narration: This is the business model of predatory publishers: accept anything and make a profit from the fees. Some tactics of predatory publishers include:
Image: A wanted poster of Ponzi the shark is affixed to a brick wall. On the poster, Ponzi looks alarmed. The text of the poster says “wanted: fraud.”

Narration: Pretending to be respected journals by spoofing the name of a more reputable publication.
Image: A bald Black scientist wearing glasses looks concerned at Ponzi, who looks the same except for a drawn on fake mustache. Both of them stand next to posters. The scientist’s poster says “submit to Nature.” Ponzi’s poster states “submit to Natures.”

Panel 1

Narration: Or they’ll ue the name of a defunct journal that has a better reputation.
Image: Ponzi the shark is seen floating underwater over a human skeleton. There are two labels affixed to each. The skeleton is labeled as “human sciences.” Ponzi is labeled as “human sciences 2.0”
Panel 2:
Narration: They might offer services like peer review with no intention of doing it, or claim rapid turn around times.
Image: A white and yellow tropical fish stares at a piece of paper on a fish hook. The paper says “pls review in 24 hours.” Question marks are shown over the fish’s head.

Narration: The reason this is a huge issue is partially one of quality. Predatory publishers flood scientific literature with B.S that can be dangerous. — Pp 2

Narration: The other issue impacts scientists: those tricked into publishing in these journals can see a hit to their reputations.
Image: A line up of three figures is shown with a text box underneath. The first two figures are literal clowns in full makeup while the third is a scientist with brown skin and brown hair looking horrified in their direction. The text underneath the three states” This issue: Balloon animals found to boost happiness page 8. The speed of trick flowers page 32. New cells found in clinical trials page 41.

Panel 1:
Image: The shipwrecked sailor holding onto wood planks from page 1 floats in the ocean. He asks “So what do we do about this? Give up on open access?”
Panel 2:
Image: Rebecca is seen balancing on the mast of the ship with the sail behind her. He says “of course not! Open science is important. We just need to be careful.”

Narration: Look for red flags. Things like:
Image: A red flag is seen in the sky. On the red flag there is a yellow circle which showcases Ponzi the shark.

Panel 1
Narration: Editors who have frank credentials, lack expertise that matches the journal or don’t exist at all.
Image: A volleyball with a face painted on it in red (much like Wilson in Castaway) rests on a beach. Below it, a text box states: “Editor in Chief: Wilson V. Ball”
Panel 2:
Narration: Having a weird street address for a business or no about page.
Image: An underwater cave is shown, There is a wooden sign in front of the cave that says “home of Natures.”

Panel 1

Narration: You’re naked to submit work entirely unsolicited.
Image: An anglerfish with a letter in the place of its light antenna, floats in the deep sea. With sharp teeth it says “You got mail.”
Panel 2:
Narration: Promising rapid publication.
Image: A stopwatch on a chain is shown with the intervals of 15, 30 and 45 on it. The top interval says “publish.”

Panel 1 Narration: Unsure about a publisher? You can ask a librarian or try using Cabells, a director of publishing opportunities. It identifies predatory publishers. We offer access to Cabells through Himmelfarb.
Image: The interface of Cabells is shown where journals are marked as predatory.

Panel 2

Narration: Good luck!
Image: Rebecca is seen in the bird's nest, giving a salute to the audience. The ocean and sun can be seen behind her,

Sources:

Yup K. How Scientific Publishers’ Extreme Fees Put Profit Over Progress. Published online May 31, 2023. Accessed May 6, 2024. https://www.thenation.com/article/society/neuroimage-elsevier-editorial-board-journal-profit/
Miglani J. Apple Sales And Profits Analysis For FY 2023 — Top 10 Insights. Forrester. Published November 21, 2023. Accessed May 6, 2024. https://www.forrester.com/blogs/apple-sales-and-profits-analysis-for-fy-2023-top-10-insights/
Bueter R. Research Guides: Predatory Publishing: Home. Himmelfarb Health Science Library. Accessed May 29, 2024. https://guides.himmelfarb.gwu.edu/PredatoryPublishing/Home

Inclusive Medicine for LBGT Adults

r.kyserMay 20, 2024July 29, 2024

Going to the doctor can be an anxiety-inducing experience. Regardless of how comfortable one is with their medical provider, the prospect of test results bearing bad news can make a routine visit understandably nerve-wracking.

But what if one’s apprehension regarding medical care was due to other reasons? What if going to the doctor meant being called the wrong name and pronouns for the entire visit? What if your visit led to being grilled about your life and hobbies as if they’re to blame for whatever ails you? What if you had to change how you looked or dressed to get treatment?

Sadly, these experiences are not uncommon for adults who identify as LBGT. According to a new survey out of the Kaiser Family Foundation (KFF), one third of adults who identify as LBGT have experienced discrimination when they are treated by a health care provider. Negative experiences included but were not limited to:

A provider assuming something about them without asking (1).
A provider implying or suggesting they were to blame for a health problem (1).
A provider ignoring or rejecting a request or question (1).

These negative experiences make patients less likely to seek care and can impact their health as a result. Even when LBGT adults continue to seek care despite these negative experiences, discrimination can lead to increased levels of anxiety or distress, which in turn can contribute to mental health conditions like depression or anxiety. Given that 46% of LBGT adults report being unable to receive mental health services when they needed them in the last three years, this only worsens existing issues (1).

LBGT patients are people, just like anyone else. Thankfully, there are things practitioners can do to provide a more welcoming attitude to LBGT patients.

Don’t assume one’s legal name and gender markers are what they use. Ask patients what they wish to be called by and what pronouns they want you to use.
Don’t make assumptions: Never assume something about a patient just because they are LBGT.
Have material in your office or medical facility that identifies your practice as a safe space. This can include patient materials about health concerns that disproportionately impact LBGT individuals, having a private policy on display, and showcasing rainbow stickers or signs that state the area is a safe space (4).
Ensure your intake forms are inclusive. There are examples online one can use as templates like those available from Queering Medicine (3).
Explicitly use inclusive language and images both in the office and on all social media.

As pride month approaches, let’s work to ensure medicine is welcoming to all our patients, regardless of who they are.

1.Survey: LGBT Adults Are Twice as Likely as Others to Say They’ve Been Treated Unfairly or with Disrespect by a Doctor or Other Health Care Provider. KFF. Published April 2, 2024. Accessed May 20, 2024. https://www.kff.org/racial-equity-and-health-policy/press-release/survey-lgbt-adults-are-twice-as-likely-as-others-to-say-theyve-been-treated-unfairly-or-with-disrespect-by-a-doctor-or-other-health-care-provider/

2. Queering Medicine - Intake Form Guidance for Providers. Queering Medicine. Published July 8, 2021. Accessed May 20, 2024. https://www.queeringmedicine.com/resources/intake-form-guidance-for-providers

3. Daniel H, Butkus R. Lesbian, Gay, Bisexual, and Transgender Health Disparities: Executive Summary of a Policy Position Paper From the American College of Physicians. Ann Intern Med. 2015;163(2):135-137. doi:10.7326/M14-2482

4. Bourns A, Kucharski E, Peterkin A, Risdon C, eds. Caring for LGBTQ2S People : A Clinical Guide. Second edition. University of Toronto Press; 2022.

Mental Health Awareness Month

r.kyserMay 10, 2024May 10, 2024

An image from NAMI (the national alliance on mental illness) that says "small steps can lead to big progress in mental health"

When we talk about illnesses, one of the many things that might first come to mind is symptoms. A friend complains about a sore throat, a fever and white patches on the tonsils? We might advise them to go see a doctor about a strep test. A child complains of a headache and starts sporting a rash made of tiny red dots? It wouldn’t be outrageous to consider chicken pox the culprit. Of course, disease presentation can vary and many illnesses share symptoms, but at the end of the day, many illnesses provide a visible clue that something is wrong.

Mental illness is far less visible to the naked eye. There is no rash that accompanies depression, nor is there a wheezing cough that comes with anxiety. The symptoms of mental illness, as the name implies, are often found in thought patterns and behaviors of those who have them. And while these thought patterns and behaviors can be observed, it often far more than a passing glance to properly diagnose someone. The average delay in treatment after a person starts showing symptoms of a mental illness is 11 years (1).

Just because the symptoms of mental illness might not be as clear as other illnesses, they are just as debilitating.

While mental illness may be hard to spot, that doesn’t mean it isn’t common. While one in five adults in the United States experience mental illness, only half of them receive treatment (1). The statistics for children are even more dire: nearly 70% don’t receive treatment (2).

Treatment in itself is often difficult to access, with long wait lists to see a provider and spotty insurance coverage among other issues.

To help raise awareness about mental illness, May is Mental Health Awareness Month. The National Alliance on Mental Illness (NAMI) is celebrating with the campaign “Take the Moment” which aims to highlight programs NAMI provides for patients and their loved ones dealing with mental illness, as well as working to erase stigma around mental health. Here at GW, our Resiliency and Well-Being Center has its own list of topics it will be discussing both this month and the month of June.

Mindfulness and Stress Management (May 8-21)
Healthy Eating (May 22 - June 4)
Restorative Sleep (June 5-18)
Physical Activity: Improving Movement and Exercise (June 19 - July 2)

The center will also be offering classes about practicing mindfulness both online and in person.

Here are some ways you can decrease stigma around mental illness:

Language really matters. Terms like “bipolar” and “OCD” can be thrown around as slang for being “moody” or “neat” respectively, despite being terms for serious mental conditions. Don’t perpetuate stigma and stereotypes about these conditions: use different words rather than conditions to describe what you mean.
Reach out to others: It’s okay to need help. If you haven’t been feeling well, you can find help. The school’s Resiliency and Well-Being Center provides resources to support those who are coping. There are also plenty of national resources one can use: NAMI offers a variety of resources in-house and also curates outside resources for those who either need help or want to help someone else.
Know mental health is for everyone: stigma about mental health implies that those who have mental illness are simply “not trying hard enough” or “seeking attention.” This couldn’t be further from the truth: mental health conditions are caused by a variety of factors including genetics and environment.

1. Mental Health Awareness Month. NAMI. Accessed May 6, 2024. https://www.nami.org/get-involved/awareness-events/mental-health-awareness-month/

2. House TW. A Proclamation on National Mental Health Awareness Month, 2024. The White House. Published April 30, 2024. Accessed May 6, 2024. https://www.whitehouse.gov/briefing-room/presidential-actions/2024/04/30/a-proclamation-on-national-mental-health-awareness-month-2024/

Author: r.kyser