Librarians as a Benefit to Public Health

Clinical guidelines and protocols define the quality of patient care for people suffering from a range of conditions all over the world. It is therefore essential to make sure the underlying literature reviews and analyses are as complete as possible. That way, we can ensure that research and clinical decision making is funded on the best possible available evidence. In evidence-based medicine, comprehensively conducted systematic reviews and meta-analyses are considered to provide the highest form of evidence support for clinical practice. The only limitations to this type of research are time and expertise. To conduct a really good systematic review on a medical topic, a large team of researchers can often take 18 months or more and review tens of thousands of scientific articles gathering evidence of practical clinical experience and scientific findings from different parts of the world. The relevant scientific literature is found through scrutinising a range of electronic databases of data published in journals, conference proceedings, books, protocols, guidelines, and case studies. Consequently, the planning phase is very important as review articles have to follow a strict standardized and pre-defined research methodology. Careful planning will also determine how many people are needed to conduct the review, how much time it will take, and where the end-result should be published. Librarians are highly trained in the skills of scientific literature-based research by systematic construction of complex search strategies designed to maximise the quality of the resulting review article.

National Medical Library Director, Linda Östlundh talks to us today about how the changing role of professional librarians means they are increasingly becoming integrated research partners. Linda originally comes from rural Western Sweden where she earned a bachelor’s degree and a master’s in library and information sciences. Her career as an academic  librarian has taken her to Agder University on the Southern tip of Norway, a nuclear research institution and to several institutions in the Middle East. Linda has spent over 20 years training and supporting research organisations including spells at the world-famous Alexandria library in Egypt, Weill Cornell University, the University of Boraås – Sweden, and for the last 4 years she has been in the United Arab Emirates, where she is currently Director of the National Medical Library at UAEU.

According to Ms. Östlundh, the optimum multidisciplinary team required to perform such painstaking reviews and analyses include clinical specialists, scientific researchers, and library and information professionals. Indeed, the Institute of Medicines Standards for Systematic Reviews and the Cochrane Handbook for Systemic Reviews and Interventions now recommend incorporating professional medical librarians in the team to design and perform the searches. The resulting improved search precision, documentation transparency, and reproducibility means that increasingly librarians are being asked to co-author systematic reviews with the research teams. Ms. Östlundh, who has presented at conferences in Europe and the Middle East on this topic points out the “additional benefit of bringing in the professional librarian is their knowledge of the publication cycle, how long it takes certain publications to review and publish, their ability to select the best journal to maximise visibility and readership, expertise in bibliometric analysis and in research productivity tools that can streamline the research process.” At UAEU, Ms. Östlundh has been involved in over 60 systematic reviews of which 12 have now been published, including one in a Scopus top 1% journal, while the others are at various stages of the writing, peer review, and publication process.

Ms. Östlundh developed expertise in the field of bibliotherapy during her master’s degree and wrote her thesis on the topic. Bibliotherapy is a creative therapeutic technique used by therapists, psychiatrists, librarians, teachers and other health professionals with people in a variety of clinical scenarios or as support for various types of emotional distress or difficult life situations. “It can help very ill or disoriented people, those with communication difficulties, and people with problems created by isolation,” said Ms. Östlundh. “With bibliotherapy, people can use fiction stories to relate to others through character association and deflect direct references to their own situation, they can use non-fiction to compare with other people’s situations, popular scientific literature to understand certain conditions, and fiction and poetry for escapism and distraction.”

With the current and ongoing Coronavirus pandemic, large sections of the population have been and expect to continue to experience movement restrictions. Some elderly and vulnerable people have endured quarantine or have been confined in ‘lockdown’ which places practical and emotional challenges on them and their families as they await the long-anticipated vaccine. Meanwhile, front-line health professionals who are exposed to a high risk of infection and a stressful work environment which has been shown to increased stress, suicidal thoughts, and depression. They can also benefit from certain forms of bibliotherapy that help them manage the stress connected with their work during the pandemic. Ms. Östlundh teamed up with UAEU psychiatrists, Prof. Emmanuel Stip and Dr. Karim Abdul Aziz to write about the benefits of bibliotherapy to those affected by COVID-induced isolation and emotional distress. In an aptly titled article, ‘Bibliotherapy: Reading OVID during COVID’ the authors reviewed the history of bibliotherapy and found that the therapeutic benefit of reading was first identified by the ancient Greeks including Aristotle and Diodorus Siculus. More recently, the philosopher Friedrich Nietzsche and the neurologist Sigmund Freud referred to Aristotle's idea of catharsis when describing how literature can have a therapeutic effect on negative emotions. The paper includes a list of 22 suggested titles designed to help people reduce stress, improve sleep quality, and stimulate emotional intelligence

Clinical evidence developed with the weight of knowledge found in carefully selected recent scientific publications improve clinical guidelines for healthcare professionals that affect all of us. Deeper, thorough reviews of existing scholarly literature, even sometimes including ancient texts can provide the contemporary clinician with clinical solutions to modern challenges. And reading carefully selected books can help vulnerable people through the stress of COVID lockdown. The central theme to all of these public health improvement stories is the integration of professional librarians into scientific research teams, and Ms. Östlundh is a fine example to follow.