Relevant to Sexual and Reproductive Health & Rights by Quang Thái

Finding Online Information Relevant to Sexual and Reproductive Health & Rights

Martha J Garrett, INFORM IMCH, Women’s and Children’s Health Uppsala University, Sweden May 2009

Finding Online Information Relevant to Sexual and Reproductive Health & Rights An INFORM Sourcebook

Compiled and Written by Dr Martha J Garrett Director, INFORM International Network for Online Resources & Materials International Maternal and Child Health (IMCH) Department of Women’s and Children’s Health Uppsala University, Sweden May 2009

Table of Contents Preliminaries About This Compendium About INFORM

i ii

Introduction About You and Your Access to Information Accessing Information at Uppsala and Elsewhere Developing a Better Strategy Learning Basic Computer Skills

1 4 13 17

Finding and Accessing Different Types of Resources Finding References to the Literature Formulating Search Strings Finding References to Journal Articles Accessing Full Text of Journal Articles Finding References to Books and Grey Literature Accessing Full Text of Books and Grey Literature Finding Bibliographies and Reference Materials Finding Web Sites

22 27 32 38 53 56 62 65

Finding Information on Specific Topics Finding Information on Medicine and Health Finding Information about Public Health Specialities Finding Geographically Based Information

70 79 97

Finding Information for Different Professional Purposes Finding Information for Decision Making (Evidence Based Medicine) Finding Information for Teaching Finding Information for Research and Projects Finding Information for Grant Seeking Finding Information for Writing

102 108 112 120 128

Managing and Using the Resources You Access Managing Searches, References, Text, and Addresses Using EndNote Judging the Validity of Resources Handling Text Ethically Citing Your Sources Correctly

Search Record Sheet

136 140 147 151 154

About This Compendium Support for development of information skills This sourcebook has been written for health professionals working in areas related to sexual and reproductive health and rights. It is meant as a reference for participants in courses on this topic, being held at Uppsala University during the spring term 2009. However, it is also designed to help other end-users who want to access high-quality materials for post-graduate studies, research, teaching, project design and execution, or clinical applications.

Authorship This compendium text has been written by Dr Martha J Garrett, a researcher at IMCH and director of the programme INFORM.

About copying and distributing these materials This compendium and the accompanying teaching materials are copyright free, both in print and digital versions. They may be copied and shared without restriction, as long as they are not sold. However, copies of the compendium should retain the complete form and content of the original. No changes should be made. Suggestions about additional resources to be included in later editions of the compendium should be sent to the author at INFORM. Contact information is given on the following pages.

Copy and share these materials. Information is like loveâ&#x20AC;&#x201D;the more you give, the more you get.

About the choice of resources, topics, sites, and tools The resources in this compendium have been selected using three criteria: they must be cost-free to the end-users (either truly free or available through university subscription or international access programmes), relevant to the health sector, and of academic quality. Most resources are based at major institutions and organizations working in the field of international health. Other sites are included because they have been listed at carefully run gateways. The instructions often refer to Google and Internet Explorer. These choices have been based not on any preference for these tools over the alternatives, but on the fact that they seem to be familiar to most IMCH students. Likewise, it is assumed that the end-users have PCs equipped with Microsoft Office. i

About INFORM What we do INFORM (International Network for Online Resources and Materials) supports development by providing onsite information training in low-income countries. The primary target groups include clinicians, researchers, teachers, policymakers, and community workers in the health sector, as well as librarians and information specialists in this field. INFORM also has experience with information training in other topics, including human rights and international law, mathematics, and physics.

Where we work INFORM is based at Uppsala University in Sweden, with a network of collaborators and collaborating institutions in over 15 countries, all working to ‘bridge the information divide’. Since INFORM began in 2004, it has provided training workshops in Estonia, Latvia, Lithuania, Ukraine, South Africa, Tanzania, Kenya, Zambia, Uganda, Rwanda, Ethiopia, Ghana, Burkina Faso, Afghanistan, Pakistan, Sri Lanka, Vietnam, India, and China. Two regional, multidisciplinary workshops have also been facilitated by INFORM for researchers in Africa. Requests for future training have been received from almost all of the countries in which INFORM workshop have already been held, as well as from Zimbabwe, Mozambique, Somaliland, Sudan, Botswana, Nigeria, Bangladesh, Nepal, Laos, and Cambodia. Within the health sector, INFORM’s major activities involve multi-year national ‘saturation’ training programmes in Tanzania and Vietnam (each reaching a thousand medical doctors), an Africa-wide project delivering information training at malaria research centres, a regional project for medical researchers in East Africa, and a multinational project in Asia regarding information relevant to maternal-and-child survival. INFORM has also developed health information training programmes for the professional staff of organizations such as the Swedish Red Cross and the European office (Brussels) of Doctors Without Borders. In Sweden, INFORM trains visiting researchers and research students from low-income countries about access available to them at their home institutions.

Who our partners and collaborators are INFORM training is always organized in collaboration with a partner institution, which may be a university, hospital, professional organization, government ministry, or nongovernmental organization. Our collaborative approach is symbolized in our logo, which shows two persons joining hands.

Many INFORM workshops have been arranged jointly with the Oxford-based organization INASP (International Network for Availability of Scientific Publications), and the programme collaborates with many other groups and agencies that promote information access in low-income country situations. INFORM also has ties with the international library community, especially the Action for Development through Libraries Programme of IFLA (International Federation of Library Associations and Institutions).

What our training covers INFORM training covers a full range of Web-based information resources available in the country hosting the training, with emphasis on free and pre-paid materials. In countries that are eligible for access to free full-text journal articles through international subsidized access programmes—such as HINARI from the World Health Organization, AGORA from the Food and Agriculture Organization of the United Nations, OARE from the United Nations Environment Programme, or PERI from INASP in the UK—participants learn how to use that access and, if necessary, are given help in registering their institutions. The specific curriculum depends on the workshop focus. Normally many dozens of specific resources are introduced and practiced. Examples of resources that are normally included in workshops for health professionals include the following:  Medline/PubMed, including clinical queries, limit options, and free full-text filter;  GFMER and the National Guideline Clearinghouse for clinical guidelines;  FreeMedicalJournals, Highwire, OpenJ-Gate, DOAJ, and other sites for free-access journal lists;  INASP/PERI, which provides pre-paid access to academic journals in many countries;  HINARI, AGORA, and OARE through which end-users in most low-income countries can access many millions of full-text articles from leading international academic journals;  Cochrane and other EBM sites for systematic reviews:  Essential Health Links and other sites providing managed link sets;  FreeBooks4Doctors, medicalstudent.com, and other sources for free e-books;  Sources for statistics, research and teaching materials, medical images, and more. For each workshop, INFORM produces a printed compendium of about 100 pages covering online resources relevant to the workshop subject. Participants receive this compendium, printouts of the workshop PowerPoint shows and hands-on exercises, and a CD with the corresponding digital files. All INFORM training materials are copyright free so that participants can copy and distribute them to their colleagues and students.

iii

What makes our training different INFORM is not the only information training programme active in low-income countries. However, it is the only programme that provides training that meets all of these criteria:  It is taught onsite at the institutions requesting the training;  It is aimed not only at information specialists, but also at information end-users;  It involves extensive hands-on practice at computers;  It covers the full range of information resources for which the country is eligible; and  It is subject-focused and can be adjusted to cover from one to many topics.

How our work is financed INFORM is non-profit, but all its training costs must be covered. Interested institutions should enquire about funding alternatives. INFORM training has been included in several research and capacity-building programmes funded by development agencies. INFORM has also received contracts from INASP, Sida, the Raoul Wallenberg Institute, International Science Programs, the Multilateral Initiative on Malaria, Doctors Without Borders, the Swedish Red Cross, and the World Bank, as well as grants from the Virtual IT Faculty and the Medical Faculty at Uppsala University, Swedish Programme for Information and Communication Technology in Developing Regions (SPIDER), and the Swedish InDevelop Foundation.

How to reach us Persons wanting more information or wishing to arrange training should contact either Martha Garrett or Anders Wändahl. Dr Martha J Garrett, PhD Director, INFORM c/o International Maternal and Child Health University Hospital, Uppsala University SE-751 85 Uppsala, Sweden Tel: +46-(0)18-611 5986 Mobile: +46 (0)730 500 368 E-mail: martha.garrett@kbh.uu.se Mr Anders Wändahl Trainer, INFORM Librarian, Karolinska Institute Tel: +46-(0)8-524-84059 Email: anders@golonka.se, anders.wandahl@ki.se

About You and Your Access to Information You are a professional working in the field of sexual and reproductive health or a postgraduate student at Uppsala University taking courses on this topic. You may be Swedish, from another European country, or from another region of the world. Your training may be in medicine, midwifery, or nursing, or you may have been trained in some other field relevant to health, such as social work or psychology.

You are a professional or post-graduate student working with some aspect of reproductive health

Regardless of your specific situation, you have probably assumed that, since you are living in a low-income country, your access of online information resource is quite limited. But this may not be true. You may have excellent access. Medical universities, research institutions, government agencies, and local nongovernmental organization in sub-Saharan African countries are eligible for free online access to medical and health journals and other resources through a variety of international programmes.

TIP! You are eligible for many online information resources, which you can find using this sourcebook. The main purpose of this sourcebook is to inform you about these free online information resources and to help you access them. The first step is for you to convince yourself that there are valuable resources out there for you to find. Unfortunately, many resources—both information resources and resources of other kinds—can be overlooked because people just don’t look for them, as the following two true stories illustrate.

The Platform in the Square: A Story about Overlooked Resources A few years ago, a little village in a Latin American country had a serious problem regarding water access. The village was located many kilometres from a large river. However, many decades earlier a flood had opened up a new channel, resulting in a branch that passed near the village before rejoining the river farther downstream. Over time, this branch had become blocked, so that the villagers now spent numerous hours each day fetching water from the river. The situation was not sustainable, and the government was considering moving the village. Digging a well had also been considered, but the idea had been rejected because of the cost.

A woman trained as a hydrologist was sent by the government to have discussions with the village leaders about the problem and possible solutions. Every day she walked to the village headquarters from the house where she was staying. This route took her through the central square, where she often stopped to talk with the villagers, who were sitting and discussing their lack of access to water. One day, as she came into the square, she took a second look at the platform on which some of the local people were sitting. It was a circular structure of concrete, almost two metres across and about half a metre high. “What is this thing?” she asked a villager. “Oh, it’s just a place where we can sit and talk,” answered the man. “How long has it been here?” she queried. “Oh, for ages,” said one of the women. The water expert asked the villagers to take her to the oldest person in the community, a very elderly man. “When you were growing up, was that concrete thing in the middle of the village square?” she asked. “Oh, no,” the old man replied. “When I was young, there was some kind of hole there, and children were not allowed to go near it. Then one day some people came and put that thing on top of it.” The hydrologist took a large group of strong volunteers back to the square, where they lifted aside the concrete platform, which was, in fact, a well cap. And underneath they found a perfectly good well, filled with fresh water. For over a year, the villagers had been sitting on a functional well….sitting and complaining about their lack of access to water.

The Unread Brochure: A Story about Overlooked Resources An INFORM trainer who was going to a lower-income country to facilitate some workshops was asked by colleagues if he could also visit a research group that had reported that they could not access any journals. “They say they have nothing,” his colleagues said. “We have research collaboration with them, and they email us, asking for faxed articles. But we feel uneasy solving the problem this way because we’re not sure about copyrights and also we don’t want them to be dependent on us for literature. Could you please see if you could help?”

When the trainer arrived in the country, he met with librarians at several universities in preparation for the workshops. They discussed what access routes were currently available for academic institutions in the country. The trainer learned that part of the journal access was being arranged via INASP/PERii, and that the libraries had also set up a national library consortium that subscribed to various resources that were provided throughout the country. To make sure that everyone knew about all these resources, the consortium had mailed out a brochure, printed on extremely bright yellow paper that was hard to miss! After the workshops were over, the trainer contacted the research institute and made an appointment to go by and talk with some of the researchers working there. They began the meeting by complaining to the trainer about their lack of access to journals. The trainer didn’t argue with them, but he convinced them to sit down at a computer, guided them to the INASP site, and showed them that their institution was eligible for thousands of academic journals, if they would just register. Although they were pleased to learn of the access, the researchers were very annoyed. “We don’t understand the librarians,” exclaimed the researcher in whose office they were meeting. “It’s good that they help arrange all this access, but why don’t they tell us researchers about it?” Just then, the INFORM trainer looked down on the researcher’s desk and saw, lying on a stack of papers, an extremely bright yellow brochure—the one from the library consortium! He picked it up and handed to the researcher, who began reading it. After a minute the researcher looked up, smiled, and said sheepishly: “Mmmm….maybe we researchers should stop complaining about lack of access and start talking with the librarians and reading the information they send us.”

Accessing Information at Uppsala and Elsewhere This sourcebook has been written for courses on sexual and reproductive health held at Uppsala University during the spring of 2009. Information is therefore provided here about how you, the participants in those courses, can access information while you are enrolled at Uppsala University and also after you complete your studies there.

While in Uppsala, you can (and should!) use the University Library’s resources. The physical University Library is divided among a central library (Carolina Rediviva, the large building at the top of Drottninggatan) and many filial libraries, including the Medical Library. Until recently there was separate library for health and caring sciences, but that has been integrated into the Medical Library. There is, however, a separate branch library on international health at International Maternal and Child Health (IMCH).

Getting into the library’s online system To reach the University’s Library, go online to http://www.uu.se and click on ‘English’ at the top of the page. On the new web page, find ‘Library’ and click on that. The Library’s main web page will now appear.

You can browse around and see what is available. Some materials are open to the public. However, to get into the paid-for resources at the University Library, you still need to be recognized as an authorized user. If you are sitting at a computer that is owned one of the University departments, this recognition will be automatic. If you are not working from a university computer, you will need a username and password in order to access the databases and electronic journals to which the Library has subscribed. (You are assigned a userID and passwords when you are given a student email address. Please talk with your course administrator about how to apply for a student address.) When you click on one of the restricted resources, you will be sent to the University’s central authentication system, CAS, and asked to provide authentication. When you enter your UserID and Password A, and click on the log in button, you will be allowed into the resource.

What the library offers The library’s home page provides information about organization of the library, opening hours, and various services. It also gives a menu listing the resources available via the library. Here are some things to explore:  Electronic books Go to the library site and click on ‘Databases, e-books,….’. On the next screen, select ‘Limit the list by category’ and then select ‘e-book collections’ from the dropdown menu. You will get a list of e-book providers to which the University subscribes. As long as you are at the University, you can enter and use these online book collections. (You may be sent to CAS and told to provide your userID and password. Follow the instructions above.) Note that you often will only be able to read the text, rather than downloading it. The three major sets of available e-books are  NetLibrary, which contains books in the social sciences,  Books@Ovid, which is a collection of medical books, and  AccessMedicine, which is also a medical collection. 5

 Indexes or bibliographic databases Bibliographic databases (also called indexes) are searchable lists of references to journal articles in different areas. Medline/PubMed is a bibliographic database that is free and accessible everywhere. Most databases, however, cost money and can only be accessed through a library that has paid a subscription. You therefore should take the time while you can to look for journal article references in bibliographic databases that are not available to you otherwise. To reach the bibliographic databases, click on ‘databases, ebooks…’ On the next page, find limit the list by category’. Use the drop-down menu and select ‘index’. Click on ‘Submit’. You will get a list of over 200 databases. One you should certainly try is CINAHL, which covers nursing and related fields. If you are interested in the social science aspects of reproductive health, such as behaviours, you should run some searches in Social Sciences Citation Index (a part of the ISI Web of Knowledge/Web of Science), in PsycINFO, and in Sociological Abstracts. When you click on a particular database, you may be sent to CAS and asked to authenticate yourself. If so, use the userID and password as described above. Once you have logged in, you will be sent back to the databases, which will now be open to use.  Electronic journals To reach the e-journals, click on ‘Electronic journals’ on the Uppsala University Library home page. You will be taken to this page. Don’t use it! It is out of date. Instead click on the link beneath the title index and search bars.

This link will take you to the search screen for the updated list of e-journals:

To find a specific journal, click on the letter that is the first letter in the journal title (L for Lancet, etc.) and keep clicking until you reach the specific journal. Alternatively, if you want to find all the journals that have a particular word in the title, type that word into the first search bar and click on ‘Go’. For example, if you type in the word ‘pediatrics’, you get a list of over 30 journals, if you type in ‘paediatrics’, you get about 10 others. If you type in the word ‘child’, you get over 200 journals! If you already have found a reference to a particular article and are looking for the full text, type in the name of the journal. If the University Library subscribes to it, the names of all possible journals will pop up. For example, this is what you will see when you begin to type in Acta Paediatrica.

Click on Go to tell the system that this is the set of journals you are looking for. You will then get the same set, but in red below the search bar.

Now click on the name of the journal in red. You will get a new page, on which the various connections to that journal are listed.

As in this example, one journal may be shown as being available through several routes. Click on the first connection and see if you can get through to the full text. If the journal is paid for by the University Library and is not available to the public, you will be sent to the CAS page to provide the username and password. After you log on, you will be passed on to the publisher or provider of the journal, which in this case is Ebsco host. However, it may happen that you canâ&#x20AC;&#x2122;t reach the full-text articles in the journal via this route, even though you have logged in through the CAS system at Uppsala University. You get a message saying that subscription is required.

If this happens, don’t give up! Back up to the list of connections and try another one. For example, if you try to reach Acta Paediatrica through the InformaWorld connection rather than the Ebsco connection, you do get access to the full-text articles. You can see this on the first page, where there is a small green box indicating access to full-text materials.

If the second connection doesn’t work, try the third, then the fourth. Try ALL the connections! Don’t give up! Sometimes, a connection from the electronic journal list to a publisher takes you to a page that seems to provide only an abstract. Take your time. Look around to see if there is something on the page that says ‘full text’ or ‘htm’ or ‘pdf’ and click on that.  Resources by topic One way to find many resources relevant to your field is to click on ‘databases, e-books, and encylopedias’, find ‘limit by subject’, select your topic using the ‘Select subject below’ drop-down menu, and then click on ‘Submit’. Be sure to go through the subject alternatives carefully. ‘Medical science’ is an obvious choice. But what you need may be under ‘general medical science’, ‘nursing and rehabilitation’, ‘agriculture and food’, ‘social science’, or some other heading

Are You Authenticated? Are You Certain?

Regardless of whether you are trying to access resources via Uppsala University or via some other route—such as your work place—you may miss a huge portion of the resources available to you because you believe, incorrectly, that you are being recognized as an authenticated user. For example, at Uppsala University, end-users who are eligible to use the University Library resources but who access Internet using a wireless connection provided by a university department or who log in to the University’s student network may not be recognized as authenticated users. If this is the case and they try to access full-text articles through the so-called LinkOut system at Medline/PubMed, they will sometimes succeed, which will give them the impression that they are being recognized as an authenticated user. But they may be accessing only those articles that are available as free full text to everyone. When they try to reach other articles, they may be stopped and told that they do not have the right to read the full-text articles—even in cases where the journals are indeed subscribed to by Uppsala University. These end-users will not get a message explaining that they are not being recognized as authenticated users from Uppsala University. The PubMed system cannot give them such a message, since it does not know they are connected with the University! If you are unsure if your Internet connection provides you with authentication, you can check by going online to the University Library, selecting ‘databases’, and then clicking on Science Citation Index. This is a database that is only open to the university community. If you are sent to the CAS page and told to enter your username and password, it means that your connection with Internet is not being recognized as being within the University. If so, you will not be able to reach the full text articles through the LinkOut connection at PubMed. Logging in at CAS and then going to PubMed—either directly or through the list of databases at the University Library—doesn’t fix the problem. Instead, when you find an interesting reference at PubMed, you should make a note of it. Then go to the Uppsala University web page, find the updated journal list, find the journal, and click on it. At that point you will be stopped and sent to CAS, where you can log in. When the log in is complete, you will be allowed access to the full-text article. If you are accessing resources elsewhere, for example at another university, run the same test, using a resource that you know is only available to authenticated users.

Accessing information elsewhere in the world When you leave Uppsala University and go home, you will need to learn new ways to access professional-quality information resources. If you are in a lower-income country and working at a university or other academic institution, at a Ministry office, at a health-care facility, or with a local/national nongovernmental organization, you will still be able to get into many thousands of journals in health and medicine. These will be made available not through institutional subscription, but rather through one or more of the access programmes that have been established since the year 2000 specifically to support health and other critical development sectors in lower- and middle-income countries. Examples of these programmes include HINARI from World Health Organization, AGORA for the UN Food and Agriculture Organization, the Open Africa Initiative from JSTOR, the PERii programme at INASP, the EIFL project, and so forth. Not all access programmes are applicable everywhere. Or, to put it another way, not every country is eligible for every programme. Also, each programme has criteria about what types of institutions and organizations can make use of their information resources. To take an example from just one geographical region, medical personnel working for the Health Ministry in Tanzania, an Ethiopian medical university, a health-related nongovernmental organization in Rwanda, and a research institute in Kenya may have access to different information resources—or, even more likely, access to the same resources but through different routes. If you remain in Sweden, your access will depend greatly on where you are working. Universities and training colleges usually have good access to academic online materials, including e-journals and databases. Health authorities and hospitals have more restricted access. However, the system called EiRA which is the medical information platform for the Swedish County Councils, provides health care personnel will access to about 150 medical and nursing journals and to several databases, including CINAHL and PsycINFO. Contact the library at your own ‘landsting’ or hospital to obtain login information.

The important thing—wherever you are and whatever you are doing professionally—is to investigate what kind of information access is available to you and then to make use of it. This sourcebook provides many details about current access possibilities. Check them out and also go visit the university library wherever you are and talk with the librarians. Keep in mind too that libraries around the world are hooked up to each other through various interlibrary loan arrangements, through which they exchange books and provide photocopies of journal articles to their partner libraries. These arrangements allow users at one location to make use of the resources at many different libraries at a reasonable cost. If a formal interlibrary loan system is not in place, librarians often develop informal exchange systems. Therefore, if you need a journal or book that is not available locally, ask your local librarian if it can be obtained for you. Don’t give up! Never listen to people who say ‘Oh, there’s no reason to go to the library; we don’t have any access to information here.’ ‘Oh, there’s no reason to try and get into that resource, we’re not eligible.’ Remember the story of the well!

Don’t sit on top of the well, complaining about the lack of water!

Developing a Better Strategy Most health professionals use a simple search strategy based on a handful of resources and techniques. What they need is a better strategy that is both efficient (doesn’t require too much time or effort) and effective (results in useful information). This process involves developing a larger and more detailed mental map and cultivating appropriate skills for online searching.

Your current mental map This sourcebook is not meant to teach you everything about information resources in health and medicine. Nor is it intended to make you an IT expert. Instead, its purpose is to help you become better at finding relevant, high-quality information in an efficient and effective manner. Of course, you already have some knowledge about how to find professionally relevant information, including through online Web sites. This knowledge reflects your ‘mental map’ of the information universe, your image of:  What resources exist  Where they are  How you can access them Every time you go online and search for information, you refer to this ‘map’ and select a site to carry out your search. The problem is that your map may be quite limited and only include a handful of sites—including Google.

Why just Googling is not the answer Of all the tools available for finding information online, Google is almost certainly the most popular right now. The basic Google search engine is used all over the world by health professionals looking for online information, and special Google features such as Google Scholar and Google Book Search are also becoming well known in academic circles. Because Google searches result in a huge number of hits, many health professionals are convinced that Googling is the best way to find everything. But it is not. As you will learn as you go through this sourcebook, some of the best, highest-quality information resources cannot be accessed via Google. Furthermore, Google doesn’t screen for quality. When you do a Google search for medical information, some web sites you find will be of doubtful validity and may even include dangerous misinformation. This does not mean that you should stop using Google. But it does mean that you should restrict your Googling to appropriate uses and look elsewhere on the Web for most of your professional information.

The danger of only looking at sites you already know Trying to find everything via Google is just an example of a larger problem—looking in the wrong place. People often miss the resources they need simply because they only look at sites they already know, even though the information is not there. The story below, adapted from a famous Mulla Nasrudin tale, illustrates the problem.

The Lost Keys A woman was walking home in her town one evening, just as it was getting dark. When she came to her own neighbourhood and was almost to her own house, she saw that there was someone under one of the street lamps, moving around and around in the circle of light, and patting the ground. At first she was frightened by this strange behaviour, but then she recognized the person as one of her own neighbours. So she stopped and asked him what he was doing. “I’m looking for my keys,” answered the neighbour. “I dropped them.”

“Oh, that’s really too bad!” the lady said. “It is always so much trouble when keys are lost. I’ll help you look!” So she walked around and around in the circle of light under the street lamp, looking carefully at the ground for the keys, but without any luck. After a few minutes she stopped and turned to her neighbour, who was still on his hands and knees, going around and around over the same ground. “I just don’t see them!” she exclaimed. “Are you sure you dropped them here?” “Oh, no!” the neighbour replied. “I dropped them out there.” And he pointed out into the darkness beyond the circle of light under the street lamp. “But…but…why are you looking here?” the lady asked, bewildered. “Because,” her neighbour explained, “this is where the light is!”

Don’t look in the ‘illuminated’ areas where you feel comfortable. Look where the information is likely to be.

Skills for finding online information A good strategy involves more than just looking in the right place, however. You also need to learn appropriate skills and practice, practice, practice.  Try multiple tools and resources Every time you search online, the best tool or resource for that particular search may be a search engine, a directory, a digital library, a bibliographic database, or an OPAC—all of which are described in this sourcebook. No single tool or resource is always the best one. Think about what you are looking for and start with what you believe to be the most appropriate choice, but also try some others.  Try the advanced search option Many online resources provide an advanced search option. It is almost always a good idea to try this, since it offers you more possibilities in phrasing your search.  Take the time to make careful notes If you can’t download materials directly into your computer, be sure you get the reference so that you can track down the item through some other route. Check the sourcebook chapter on correct citations to see what details should be included. Write the reference carefully and don’t use abbreviations you make up yourself.  Read the instructions or experiment Not all online resources are alike. You can figure out how a system works by experimenting or by reading the instructions. In some cases you can even find a free online tutorial, which will take you step-by-step through the search process.  Scroll, click, scroll, click, click, scroll When you reach a new site, remember that what you need may be at the bottom of the page or on another page. This means you need to move around. Scroll down to the bottom of the page. Click on something and see what it leads to. Scroll, click! Click, scroll! Scroll, click!  Make good use of computerized functions for full text and references You can save most online materials on your computer or on a USB memory stick or other storage device. This allows you to build up a personal collection of full-text articles and other items in digital form. Software also exists that handles identification, collection, and management of references. Check if this software is available at your institution. If it is, take a few hours to learn how to use it, and you will save many, many days of work in the future.  Maintain a folder of favorites or bookmarks Make use of the favorites feature on Internet Explorer (or bookmarks on Mozilla Firefox), so that you don’t have to re-type addresses. First go to a Web site. Click on ‘Favorites’ or ‘Bookmarks’ at the top of the web browser page, and then on ‘Add to Favorites’. Then follow the directions. Once you have a collection, you can even move them between computers.

 Keep a log of your searches It is a good idea to keep a search log, listing where you have been and what kind of searches you have done. Note the date, the resource, the search strings and fields used, and the number of hits. Your log will keep you from missing important resources but also assure that you don’t waste time doing searches you’ve already done. A record sheet for copying is included at the back of this sourcebook.

TIP! Keeping a log will assure that you don’t miss resources and that you don’t carry out the same searcher over and over again! Copy the record sheet at the back of this sourcebook and use the copies for recording your searches.

 Know when to stop When you first begin searching, every search results in relevant new material. After a while, though, you only find items you already know about plus a few others of very marginal relevance. It’s time then to stop, obtain the materials, and read them. Don’t keep on searching just because you may have missed something. There is no way to find everything that has ever been published on a particular topic.

Finding information is like mastering a musical instrument. It takes practice!

Learning Basic Computer Skills Using this sourcebook and CD at a computer The best way to learn from these materials is to use the printed and digital versions simultaneously. The digital version is on a CD. Sit at a computer with the sourcebook open on the table at the chapter you want to use. Turn on the computer, insert the CD, and open the file. Click on ‘Edit’ in the tool bar and then on ‘Go to’, type in the relevant page number, and then click on ‘Go to’. When you reach the desired page, begin reading, clicking on the blue embedded WWW links as you go. Since you will also have the printed copy of the sourcebook open, you will be able to read the instructions about what to look for at the site. Once you have finished at a particular site, go back to the digital file and continue reading the text there until you reach the next embedded link. This may sound hard, but it is actually quite easy.

Mastering other computer skills http://www.itrainonline.org Below are the basics you should know about using a computer. If you don’t know how to do these things, ask a colleague to teach you. You can also go to sites that provide online tutorials, such as ItrainOnline.        

Open a web-browser such as Internet Explorer. Type the web address you want to visit and activate the connection by hitting the return button on the keyboard. Move up and down the screen (scroll) once you reach a site. Move from one Web page to another by clicking on the links. Connect to a Web page by clicking on an embedded link in a Word or pdf document. Add a web page to your favorites/bookmarks file and manage these links. Copy files and web pages to your computer or a USB stick. Set up folders and manage the organisation of documents within them.

Instructions regarding a few other useful computer skills (how to import and insert clip art, how to move favorites/bookmarks from one computer to another, etc.) are provided later in this sourcebook.

Navigating the World Wide Web in different ways http://www.refdesk.com/factbeg.html Learning to use WWW is like getting to know a large city. You may feel confused at first by the number and diversity of sites. Don’t worry—soon you will feel at home.

If you want help, you can go online and use one of the many guides and tutorials about the Internet. One list of these is available at Refdesk. When you turn on a computer and go onto the Web, a particular page (such as the institution’s home page) will be displayed, or the page may even be blank. It doesn’t matter what page you see when you enter the Web. Once you are connected, you can reach a web site in three ways:  Type the address into the address bar at the top of screen on your web browser (e.g., Internet Explorer or Mozilla Firefox) and then press the ‘Return’ button (which looks something like this: ) on the keyboard. The Web addresses are given in this sourcebook in their full correct form, which begin with http://. This signifies hypertext transfer protocol, the format for accessing Web-based materials. You do not need to type in the http:// part of the address in the address bar on your web browser; it will be added automatically.  Click on the address stored in the ‘favorites’ or bookmarks of your WWW browser. You will gradually build up your favorites collection.  Click on a ‘link’ on a Web page or in a document file. As you move around the Web, you will discover that almost every Web page has links taking you to other pages and sites. All you have to do is click on the link, and you are connected. The same process works if you click on the addresses in the CD version of this sourcebook. The links to web sites are shown in blue.

You can reach web sites in three ways: Type an address, use favorites, or click on a link in a Web page or file.

Avoiding common errors in searching and saving A few mistakes cause many of the problems that occur in finding and saving information from WWW. If you can avoid these common errors, you will save yourself a great deal of frustration.

Error #1: Using Google to search for addresses you already have If you already have a Web address in the text of this sourcebook, you can reach the site by inserting the accompanying CD into a computer that is hooked up to Internet, opening the file for the sourcebook, and clicking on the address you want to reach. You don’t have to type any address at all. If you find an interesting address in some other source, you may need to type it into the Web browser (Internet Explorer or Mozilla Firefox) on your computer. But if you have the address, you don’t need to use Google to look it up. Doing so would be a great waste of time. Also, you can end up going to the wrong site. For example, if you Google for ‘Medline’, the top item in the results is MedlinePlus, which is not Medline. The exception is when a site has a very long, complicated address with unusual punctuation, such as http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=nlmcatalog, which is the address of the online catalogue at the National Library of Medicine in the United States. If an address is like this, it can be a good idea to use Google to search for the site and then click on the resulting link. Error #2: Typing addresses incorrectly Web addresses must be typed with care, or you will end up at the wrong place or get a message saying the address was not found. The most common mistakes of this type are:  Spelling words incorrectly  Using the wrong domain suffix (edu, gov, com, org, etc.)  Beginning the address with www even though it is not part of a particular address (www.highwire.stanford.edu, rather than highwire.stanford.edu, for example)  Including parentheses or a final period in an address The final item requires some clarification. Sometimes you will see a web address given in the middle of a sentence and enclosed in parentheses like this: (www.pubmed.org). The parentheses are not part of the web address. If you include them, you will get a message saying the address cannot be found. If a web address is at the end of a sentence, it will be followed by a full stop or period (.) that marks the termination of that sentence. The full stop is not part of the web address. If you include it, you will probably get a message saying that the address cannot be found. Error #3: Typing addresses and search strings in the wrong place Web browsers such as Internet Explorer and Mozilla Firefox have address bars at the top where you can type in an address and then hit the return button in order to reach the site that has that address. Search engines and databases also have search bar, which are the places where you type in a word or phrase indicating what you are looking for. The address bar in a web browser and the search bars in search engines and databases look the same—long blank, rectangular areas. Be sure not to get them mixed up. Type web addresses in the address bar and search terms and phrases in the search bars.

Maddening Medline (#1) A doctoral student working on a malaria vaccine project came to an INFORM workshop, eager to learn about online information. However, when the participants began searching in Medline/PubMed, she sat and sighed unhappily. The INFORM trainer asked if she was having any luck finding references to articles. “No,” she replied. “No matter what I type, I just get links to web pages, not references to articles. It’s maddening!”

“Web pages?” asked the trainer. “Hmmmm. Could I watch?” So he looked over the student’s shoulder while she carried out her search. And he discovered that she was typing her search words in the address bar of the web browser, like this:

What she needed to do instead was to type her search string in the PubMed search bar:

INFORM trainers have often seen this little mistake being made by much more experienced medical professionals and researchers. If you get strange results when you search, check that you are typing the search in the right place.

Error #4: Saving files without any system When you save a document from an online source onto your own computer, be sure it is saved in an appropriate folder and has an appropriate name. If you simply dump all the documents you find onto the desktop, you will soon be overwhelmed with unsorted files. And if you retain the original file name (which is usually an incomprehensible set of letters and numbers such as 23cfhp56hn), you won’t be able to find the articles about specific topics. When you are just starting to collect articles, it is sufficient to have a single folder named ‘Downloaded documents’, into which you place all of your downloaded pdf articles, book chapters, and grey literature such as clinical guidelines. However, as your collection grows, you may find that the folder is so full that you have trouble finding things. In that case, it is a good idea to set up folders within the folder, following a categorization system that makes sense to you. Here are some alternatives to consider:  Folders by type of material (guidelines, research articles, reviews, systematic reviews, training modules, questionnaires, images, etc.)  Folders by geographic focus (materials on your own country, on other countries in your region, on countries elsewhere, on the whole world)  Folders arranged alphabetically by authors name, perhaps A-F, G-M, N-R, S-Z. This system is excellent if you are using a bibliographic software management package such as EndNote, which is described later in this sourcebook.  Folders arranged by sub-topic. For example, if you are working on a project to implement better hospital procedures for handling neonatal asphyxia. One folder may be about neonatal asphyxia itself. But another might be about hospital management. And yet another may be about training health personnel and dealing with their resistance to change.

Finding References to the Literature Regardless of what you do within the health sector, it is important that you make use of the relevant scholarly publications, the so-called literature. A major portion of this sourcebook is devoted to the question of how you can identify and access this literature.

TIP! The literature is the most important source of information for your work.

What makes a book a book? What makes a journal a journal? When you search for literature, you are looking for three types of publications: journal articles, books, and grey literature. You can distinguish these from each by looking in the publication (often on the back of the title page) for a special number.  A journal has an International Standard Serial Number (ISSN).  A book has an International Standard Book Number (ISBN). Publications that have neither an ISSN nor an ISBN are ‘grey literature’. In certain fields, such as molecular biology, the grey literature is not very important. In others, such as community-based rehabilitation, it is extremely important.

TIP! A journal has an ISSN. A book has an ISBN. A piece of grey literature has neither.

Alternative ways to find the literature There is no single way to find literature. The four most common techniques are:    

Unstructured manual searching Snowballing Using published bibliographies Searching in digital resources, usually online

Unstructured manual searching involves going to a library, wandering around, and browsing through the printed journals and books. This is a wonderful way to spend an afternoon, but it is neither an effective nor efficient way to find information.

Snowballing means building up a collection from a single initial publication, typically a recent journal article or book. At the end of the text is a list entitled ‘References’. This contains information about the journal articles, books, and other publications that the authors have cited in the text. To snowball, you go through these references, select those that seem relevant, and then find the actual publications. Next you check the references at the end of these items, select the most important, and so forth. Snowballing is like a game, and it’s a fast way to build up a collection. Snowballing has drawbacks, however. One is that you can end up with a biased subsection of the literature. Another is that snowballing only goes back in time. If you do a search in 2010, most of the references will be from 2008 and earlier. The term ‘bibliographies’ is sometimes used for the reference lists at the end of publications. But bibliographies can also be publications by themselves. Some bibliographies are published as books and contain thousands of references. More limited bibliographies are available in literature review articles on specific topics. The final technique, searching in digital resources, is the primary means of finding literature today. The digital resources include both databases and library catalogues, which are normally used online. This sourcebook will guide you through the process.

The importance of bibliographic references All the techniques described above, except for unstructured manual searching, begin with a search for references. Once you have references, you can find the full-text of the item in digital or paper form. In some cases, when you click on an online reference, a file of the full text pops up, and you can download a copy onto your own computer. In other cases, you need to go looking for the full text elsewhere, and this sourcebook will help you do this. Often you will be able to track down the material by yourself. But, if that doesn’t work, you can ask help from a librarian. Finding references is thus essential to finding literature. And references are extremely valuable, since they point to the full-text materials. You should never refer to references as being ‘only’ references, as if they were not important.

References point to the literature and are never ‘only’ references. 23

But what exactly are bibliographic references? Bibliographic references—often just called references—are short descriptions of books, articles, and other literature, giving information about who created the work and when and where it was published. The reference provides all the details you need to track down a copy of the material. If an item is a journal article, the reference will include:  Author’s name  Title of the article  Name of the journal  Date of publication  Volume number and possibly issue number  Page numbers If an item is a book, the reference includes:  Author’s name  Book’s title  Place of publication  Publisher  Year of publication References to grey literature vary widely, depending on the nature of the item. They often look like book references, since they include the name of the author, the publisher, and the place and date of publication. But they may also include other details if more information is necessary to identify and retrieve the item. References to the same item may look different because of the reference style (for example, Harvard or Vancouver), which determines the order of the information and how it is formatted. Thus a reference to a book, a journal article, and a piece of grey literature can be formatted in these or other ways. (The references are not real.) Journal article: Gorse, Anne L. 2008. ICT in health promotion. Medical Informatics, vol. 19, no. 2, pp. 317-338. Gorse AL. ICT in health promotion. Med Inform. 2008;19(2):317-38. Book: Andersson, Michael H. 2009. Health Informatics. New York: Praeger. Andersson MH. Health Informatics. New York: Praeger; 2009. Grey literature (conference paper, in this example): Piper, Sam. 2006. In: Lamb, Kim, editor. MEDDATA 06 Proceedings of the 15th Congress on Medical Data; 2006 August 6-10; Rome, Italy. New York: International Society for Medical Data; 2006, p. 1561-1565. Piper S. In: Lamb K, ed. MEDDATA 06. Proc 15th Congr Med Data; Rome, 6-10 Aug 2006. NY: Inter Soc Med Data; 1561-5.

The distinction between references and citations If you use a bibliographic database such as Medline/PubMed or CINAHL, you are looking for references. You use the references to track down the full-text articles. When you find the full text of an article and read it, you will see that the authors have mentioned other pieces of literature, which were the background for their work. When they describe what they have learned from the literature, they give the reference in abbreviated form, either as a number or author and date. They then give the full references at the end of the article, in a list that is normally labelled ‘References’. The process of referring to the literature is called ‘citation’. We say that the authors have ‘cited’ a certain article or book. The citation is given in the text of an article, and the reference list is a list of the works that have been cited in that article.

The relationship between primary and secondary resources When you look for literature, you ultimately want to find primary resources—materials such as journal articles, books, and grey literature, which contain information relevant to your work. However, as you’ve learned on the preceding pages, the best way to find the primary resources is to look for the bibliographic references describing them. The resources that contain these references are called secondary resources and include reference lists at the end of publications, bibliographies, literature review articles, bibliographic databases, and library catalogues. These secondary resources differ in the types of references they contain.  Bibliographic databases normally contain references only to journal articles.  Catalogues usually contain references primarily to books and grey literature.  Reference lists, bibliographies, and literature review articles usually contain references to all types of publications Bibliographic databases may be labelled as indexes, citation indexes, or abstract databases and are usually created by a commercial company or a special library. Today there are thousands of bibliographic databases, each covering a specific sector. In other words, bibliographic databases are usually topic focused. An example of a bibliographic database is Medline, often called Medline/PubMed, which is maintained by the National Library of Medicine in the US but made available free to the whole world. Medline is one of the most important resources you have for finding the literature relevant to medicine and health. Catalogues today are primarily in the form of online public-access catalogues (OPACs) contain references to the ‘holdings’ (the owned materials) of a library or group of libraries. In other words, catalogues are geographically focused. The references in an OPAC describe the books and grey literature owned by the library, as well as the journals subscribed to by a library, but references to individual journal articles are normally not included.

TIP! Look in bibliographic databases for references to journal articles. Look in catalogues for references to books and grey literature. Look in bibliographies, reference lists, and review articles for all sorts of references.

Secondary resources

Primary resources These are the materials you want to find. Articles in journals. True journals have ISSN numbers. Books. True books have ISBN numbers. Grey literature, which lack ISSN and ISBN numbers. Policy statements, practice guidelines, newsletters, agency reports, and conference proceedings often fall into this category.

This is where you should begin your searches. These resources will give you references to journal articles, books, and grey literature. Examples: Bibliographic databases like Medline Catalogues/OPACs Bibliographies Literature reviews Publisher databases

Tertiary resources These resources point to databases, catalogues, etc. Examples: Directories of databases Bibliographies of bibliographies Indexes of catalogues

Reference materials These are materials where you go to ‘look something up’. They give overviews on a subject. They often overlap with seconday and tertiary resources and often include bibliographies.

In-house literature These are materials that are published by the same institution/agency which has written them. They are normally primary resources. They may be true books or journals, but more often they are grey literature.

Examples: Encyclopaedia Directories Dictionaries Yearbooks Handbooks Study guides Reviews Statistical databases

Many information resources ‘published’ at WWW sites of organisations fall into this category.

Formulating Search Strings Once you access a resource in which you want to carry out a search (Google or another search engine, Medline/PubMed or another bibliographic database, an OPAC, etc.) you should take great care in formulating your search strings—the words or phrases that you will type into the search bar. Here are some details to consider.  Boolean logic Most databases accept search strings with AND, OR, or NOT. These are Boolean operators, which limit or expand your searches. The process by which the system decides which items to include is called Boolean logic. In each resource you use, you will need to check if it ‘supports’ Boolean logic (if you can do a search with the Boolean operators), what Boolean combinations are possible, and what Boolean operators are ‘assumed’ if you don’t type in any yourself.

George Boole, the creator of Boolean logic Boolean logic is named after the man who conceived it, George Boole. Boole was born in English in 1815. He was a school teacher and self-taught mathematician who eventually became a professor of mathematics. Unfortunately, he died at the age of 49, cutting short a promising career.

Boole published numerous scholarly articles, primarily on topics related to algebra, probability, and logic. His work was widely recognized as brilliant, and he was made a Fellow of the Royal Society, as well as receiving honorary degrees from Oxford and other universities. One of Boole’s most important accomplishments involved laying the foundation for the algebra of logic, which is today called Boolean logic. This logic is important in several braches of science, including computer technology and circuitry, and it is also the basis for digital search systems in library science. Sources: http://www.kerryr.net/pioneers/boole.htm http://www-groups.dcs.st-and.ac.uk/~history/Biographies/Boole.html

Doing Your Boolean Searches Correctly Boolean operators can be tricky! It helps to phrase what you are trying to find using double word sets, namely EITHER/OR, BOTH/AND, BUT/NOT. “I want to find all the references to articles that are about EITHER pregnancy OR childbirth”. The correct search phrase is pregnancy OR childbirth. “I want to find all the references to articles that are about BOTH pregnancy AND micronutrients.” The correct search phrase is pregnancy AND childbirth. “I want to find all the references to articles that are about pregnancy BUT NOT about childbirth.” The correct search phrase is pregnancy NOT childbirth. The pictures below illustrate Boolean searches. The large circle represents the references to pregnancy. The smaller circle represents the references to childbirth. Some references are, of course, to both topics. The red areas indicate the results of different searches.

pregnancy OR childbirth

pregnancy AND childbirth

AND

pregnancy NOT childbirth

NOT

Many databases have ‘built’in’ Boolean logic. If you don’t use a Boolean operator, the system makes an assumption about what you mean. In Medline/PubMed, the assumed operator is AND. If you type a search phrase consisting of just search terms without operators, AND will be added automatically between the terms. However, if you do a search in some other databases, the assumed Boolean operator will be OR. This difference in the assumed operator makes a huge difference in the results of the search.

TIP! If you type in a list of search terms without operators, the system may add them automatically. In Medline, the system assumes AND. Some other databases assume OR.  Spelling Some systems, such as Medline/PubMed, have built-in information about British and American spellings, so that you can do a search for one form and find references for either form. Other systems aren’t so ‘smart’, so you must do separate searches for labour and labor, gynaecology and gynecology, anaemia and anemia, etc.  Open and closed forms and punctuation Always look at your search terms and ask yourself if they could take another form. For example, pre-eclampsia can be written preeclampsia, without a hyphen, and breastfeeding may be written as breast feeding. The combination of HIV and AIDS is frequently shown as HIV/AIDS, but it may be expressed as HIV-AIDS. These differences in word form and punctuation can affect the results of your search.  Phrases You also may need punctuation if you want to search for a phrase. For example, if you search for reproductive health (without any punctuation) in Medline/PubMed, the system will respond as if you had typed reproductive AND health. You will get references to articles in which both terms are found in the title, abstract, key words, or MeSH terms. Some of these will not be about reproductive health. If you want only references on that topic, enter the phrase with double quotation marks: “reproductive health”. (Other punctuation may be needed in other databases. Check the instructions.)  Punctuation in complex search strings If your search phrase is complex, you may also need to add punctuation around groupings. In Medline, this is done using parentheses ( ). They are not the same as brackets [ ]. For example, if you want to do a search that is about either pregnancy or childbirth and that is about either complications or risks, the search string would be: (pregnancy OR childbirth) AND (complications OR risks) The system will carry out the instructions within each set of parentheses first—searching for references to articles about either pregnancy or about childbirth and searching for references to articles about either complications or risks—and will then combine the results to find the references that are found in both sets.

 Truncation Truncation means using an * or other symbol to indicate unspecified parts of words. child* for child, children, child’s, children’s, childhood, childlike, etc., reproduct* for reproduction, reproductive, reproductable, etc. Most databases only allow truncation at the end of a word. The symbol used to indicate the missing letters varies greatly. Look for ‘Search tips’.  Spacing Be sure to leave normal spaces between words, including around Boolean operators. This may seem obvious, but it isn’t. Searchers sometimes assume that the search system can recognize words even when they are strung together without normal spaces in between, as the following story illustrates.

Maddening Medline (#2) A researcher attending an INFORM workshop complained that he was never able to find anything in Medline/PubMed. “Medline just doesn’t work!” he exclaimed. “No matter what I look for, I get nothing! I always have zero hits. It’s maddening!”

The trainer asked the researcher what he was studying, and he said he was working on malaria in pregnancy. The trainer suggested that he carry out a Medline search on this topic while she watched over his shoulder. So he did so, and what he typed was: malariaduringpregnancy The result was zero hits and the message: The following term was not found: malariaduringpregnancy. “Well, try it with normal spacing around the words,” the trainer suggested. So the researcher typed in malaria during pregnancy And he got about 2,500 references.

 Alternative search strings (the words typed into the search field) Eventually you will get a feel for what search strings you must use to extract the information you need. In general, search functions just match the words in your search phrase with words in the title, abstract, key words, etc. Thus, in phrasing your string:  Avoid terms such as references, research, output, impact, effect, problems, etc.  Don’t always include a country or region in the search string—good research can be done anywhere, and you can benefit from seeing what has been done elsewhere.  Be careful with terms such as ‘community-based’. The authors may have used other constructions, such as ‘in the community’.  Consider whether a concept may be expressed in an alternative way. For example, ‘increases in survival’ may be called ‘decreases in mortality’.  Limiting functions If your search results in a large number of ‘hits’, you may be able to reduce the list by limiting to particular years, one language, etc. Such limiting functions are available on most catalogues, databases, and search engines. Medline/PubMed has an extremely useful set of limits. To see what is available, click on the ‘Limits’ tab on the search page. But be careful about over-using the limits function. There are so many options that you may get carried away.

Maddening Medline (#3) A participant at an INFORM workshop complained to the trainer that there were no references in Medline to her topic, which was evidence based nursing. “Hmmm,” said the trainer. “That sounds strange. What did you use as your search string?” “I just wrote evidence based nursing,” answered the participant. “And I get nothing! It’s maddening!”

“Let’s take a look,” said the trainer. She sat down next to the participant and looked at the screen. The participant had entered a simple search string, but she had also gone to the limits page and restricted the search to references for articles published in the past two years, in English, with links to full text, about human adolescent females, and based on randomized controlled trials. The trainer asked the participant a few questions about what information she really needed and then removed the limits regarding date, full text links, and the randomized controlled trials. The resulting hit list included hundreds of references.

Finding References to Journal Articles To keep up on new developments, health professionals want to read journal articles. Articles don’t provide the overview that books do, but they are excellent sources for information about research. Also, it may take years for a book to move from manuscript to product, whereas articles are published much more quickly.

Topical (subject-based) bibliographic databases http://www.pubmed.org (Medline/PubMed) http://agricola.nal.usda.gov (Agricola) http://www.eric.ed.gov (ERIC) An electronic collection of bibliographic references for journal articles is called a database, although that term may also be used for other kinds of data collections. The term ‘index’ is also encountered, and bibliographic references are sometimes called ‘citations’. Most bibliographic databases cover one topic. Medline indexes journals in medicine and related topics; CINAHL gives references to articles in nursing and allied health professions; Social Sciences Citation Index covers politics, economics, and sociology; PsycINFO lists references in psychology, and so forth. There are thousands of databases, each providing references in a limited area. Databases often include bibliographic information about articles published only in certain journals. If a database has a set journal list, you will not find information in it about articles in other journals. Some databases cover just a few hundred selected journals. Medline has a broader scope but still only indexes certain journals.

TIP! Bibliographic databases are usually limited to one topic and index only pre-selected journals Many bibliographic databases are available online. A few are free, the most important example within the health sector being Medline, which can be accessed at the PubMed interface at the National Library of Medicine in the United States. Other free online databases include Agricola, which provides references to literature in agriculture and nutrition and ERIC, which supplies references to publications about education. Most other topic-focused bibliographic databases require subscription and are very expensive, in some cases costing tens of thousands (even hundreds of thousands!) of US dollars per year. Uppsala University has hundreds of online databases, which you can use online while you are in any course at the university. (See the beginning of this sourcebook for instructions.) The database CINAHL is currently included among the many resources that are available free of charge to HINARI countries, and other databases are sometime provided free or at low cost through other information access programmes. CINAHL is also available to most health personnel in Sweden through the EiRA system. (Again, see the beginning of this sourcebook.)

Google Scholar http://scholar.google.com Google has an academic search engine called Google Scholar, with which you can search through many free databases, including Medline/PubMed and publisher databases. This approach can save you a great deal of time. The list of ‘hits’ includes links to full-text articles in the cases where they are available free-of-charge. In some cases, there may even be links to the user’s home institution library. For example, if you do a search in Google Scholar from a computer that is logged in to the University system, the results will include many SFX link notations such as “try it @ Uppsala UB”, meaning that the full text may be available at the Uppsala University Bibilotek (Library). To find out, you just click on the “try it”. You will be sent to the Library’s website and, usually, asked to log on using your username and password. Follow the instructions given at the beginning of this sourcebook. But Google Scholar is not magic. It cannot get you into the academic bibliographic databases that require a subscription. Nor does it provide automatic access to full text of articles in journals that require subscriptions. And if you do the searches at a computer that is outside a university system, links to the university library will not be provided. Furthermore, Google Scholar is not the best choice for references to medical articles, since it doesn’t have as many options as Medline/PubMed. You can’t, for example, limit your searches to a particular age group, or to review articles, or to randomized clinical trials. It is therefore usually best to use Medline/PubMed to look for references to articles in any area of medicine and to use Google Scholar if you don’t have access to specialized bibliographic databases on other topics of interest.

Google Scholar is great, but it’s not magic.

Publisher databases http://www.interscience.wiley.com (Wiley Interscience, including Blackwell) http://www.springerlink.com (SpringerLink) http://sciencedirect.com (Elsevier ScienceDirect) http://www.biomedcentral.com (BioMed Central) Another way to find references to journal articles is to go to the publishers sites, where they have set up free databases about their own publications (typically both journals and books). Examples of major publishers providing this service are given above.

Searching publisher databases is less efficient than searching in a topical bibliographic database covering a whole field, such as Medline. However, doing an online search in publisher databases is much more efficient than going through the tables of contents of journals, one by one, and it may be a reasonable approach if you are looking for references in a field for which you have no topical bibliographic database available.

Making Good Use of Publishers’ Services Most publishers provide special services for online users, free of charge. To use these services, you must register. The process may be called ‘subscription to services’, but the registration is free, however, as are the services. If services do cost money, you will be required to give credit card information.  An eTOC is an electronic table of contents for a journal issue. Many journal publishers provide a free service in which they email out the table of contents of each newly published journal issue. Usually all you need to do is sign up by sending them your email address. Look on the home page of the journal for eTOC or TOC.  E-mail notifications may also be automatically mailed e-TOCs. However, in other cases, they may be updates on searches that the end-user has carried out previously in the publisher’s database.  RSS (Really Simple Syndication/Rich Site Summary) is another system for keeping up to date. An RSS feed is a link that automatically sends out updates, for example, the table of contents of new journal issues. Instead of being sent to individual email addresses, the information is made available online, and users reach it when they want to by clicking on a link labeled with the journal name. Registering or subscribing to an RSS feed is simple and free. You just look for the RSS icon , click on ‘subscribe’, and indicate where you want the link to be placed. The icon may be marked XML, which is the language in which RSS is written.

Medline/PubMed http://www.pubmed.org Medline/PubMed is the single most valuable free resource for finding references in medical journals. Medline is a bibliographic database and contains references to research articles that have been published in selected journals. At the moment, the total number of references is about 18 million. The easiest way to use Medline is through the PubMed interface at the address above. PubMed is not the database, but is the system through which you carry out searches in Medline and also reach the full-text articles if they are available. It is important to understand that neither Medline nor PubMed contains the full-text articles. The articles are at the journal and publisher web sites, and a system called LinkOut connects Medline/PubMed with these web sites.

 Doing a simple search in Medline/PubMed When you reach the search page for Medline/PubMed, you will see that there is a search bar into which you can write your search string. After you do this, you should click on ‘Go’. The system will find the references that match your search string, and you will get a list of the ‘hits’. To read a summary of a paper, you click on the title of the article. This will take you to another page, where you will find the abstract. On the abstract page you may also see, in the upper right-hand corner, one or more ‘buttons’ that lead via the LinkOut system to the publisher, the journal, or an archive. In some cases, the full-text article is free, and you can reach it easily, read it, and download it. You just click on the button and up comes the full text. If the article is in a journal subscribed to by Uppsala University, you should also be able to access it via PubMed’s LinkOut—as long as you are working at a computer owned by the University and connected via a fast (rather than wireless) connection. Otherwise you are likely to have trouble. See page 10.

TIP! To reach the full text of most articles indexed in Medline/PubMed, you may need to go through the University Library e-journals list If you are from a lower-income country, you will be able to access most full-text articles via HINARI, following the instructions given later in this sourcebook.  Using limits in Medline/PubMed If your search results in thousands of hits (references), you can limit the search to reduce the number. You do this by adding another search term or using the limits provided by PubMed. To see what limits are available, click on the ‘Limits’ tab on the search page. When the new page comes up, scroll through the choices. You can limit to languages you known and to articles published during a certain period, such as the past 10 years. You can also select specific types of articles, such as clinical trials, or limit your search to research about a particular age group or just males or females. If you are working on a topic that is relevant both to humans and animals, you may want to restrict your searches to research articles about humans, and you can do this on the limits page also. Another alternative is to limit the search to references in which the title includes your search term or phrase. To do this, go to the Limits page, scroll all the way to the bottom, and find the box labeled ‘Tag Terms’. Click on the drop-down menu and then scroll down and select ‘Title’. Then click on ‘Go’. All the references you get will have your search term(s) in the title of the article.

TIP! When you use limits, begin with just one or two, such as language and dates. Gradually add more if the number of hits remains large.

 Using MeSH The NLM provides a search vocabulary called MeSH (Medical Subject Headings), which makes it possible to search for all the articles in Medline about a specific topic even if the subject is called different things in different articles. If you have trouble finding references in Medline, it may help to check your search terms in MeSH. The link to the MeSH database is in the left-hand bar at Medline/PubMed. When you click, you will come to the MeSH home page, which provides three excellent online tutorials about MeSH. You can also carry out simple searches for MeSH terms on the same home page, using the search bar at the top of the screen. Or, alternatively, you can click on the link to the database itself. This link is shown in red and underlined. The page you reach will be labeled ‘Medical Subject Headings’. Find the heading MeSH Browser and click on ‘Online searching’. This will take you to the MeSH database browser, where you can do more advanced searches and can also explore the subject heading categories by clicking on the button labeled ‘Navigate from tree top’. To navigate through the tree, click on the + before the category of interest in order to reveal the subcategories, then click on the most relevant of these, and so forth, until you find the MeSH term you are seeking.  Using clinical queries If your particular interest is a clinical one, you should take advantage of the clinical queries function at PubMed. This can be found in the left-hand column of the main search page. Click on the link, and at the clinical queries page, type in the disease or condition and indicate what you are interested in (e.g., diagnosis, etc.) and whether you want a narrow or broad search (narrow is usually better). When the results come up, you can click on the ‘Details’ tab to see how the system has interpreted your query. In most cases, the query consists of many Boolean strings, MeSH terms, and special filters. This is not the kind of search that most end-users can construct on their own!  Why Medline ‘doesn’t work’ Users sometimes complain that Medline doesn’t work. One reason is that they look in Medline for something that isn’t there, such as information about conference proceedings, obituaries, references to books and grey literature, calls for proposals, and so forth. Medline only contains references to journal articles. The second common reason is inappropriately detailed search strings. This point has already been made earlier but deserves repeating. The Medline search system looks for references that contain all the significant words in the search string—in the title, the abstract, or the MeSH ‘labels’ added to the reference when it is entered in the database. Search strings that include extraneous terms therefore often don’t work. If you type ‘programme’ in your search string, you won’t find references in which the activity referred to as a ‘project’. If you are looking for references to articles about research on asphyxia, you should not include the words ‘references’, ‘articles’, and ‘research’ in your search. Just type the word asphyxia. The Medline/Pubmed system ‘understands’ that you are looking for references to articles about research on this topic.

Maddening Medline (#4) A ministry official was concerned about how badly the referral system for pregnant women was working in his country, so he began a study. He began his literature search at Medline, but he couldn’t find anything, and he almost gave up.

Then he went to a course abroad that included INFORM training, and he talked with the trainer. “There’s absolutely nothing in Medline about referrals during pregnancy. It’s maddening!” “Could I watch while you search?” asked the trainer. The ministry official agreed, sat down at a computer, went online to Medline/PubMed, and typed: references to research about problems with the referral system for women with pregnancy complications in Nepal Sure enough, the result was 0 hits. The trainer then explained that, if a search string is a long list of terms without any Boolean operators, Medline will assume that there are ANDs between significant terms. So the search string was being interpreted as: references AND research AND problems AND referral AND system AND women AND pregnancy AND complications AND Nepal This meant that all these search terms had to be present in the title, abstract, or among the associated Mesh terms. The trainer explained this and suggested that the ministry official eliminate the non-essential terms and try something simple, such as: referral* AND pregnan* The ministry official tried this simple search and got good results. “Ah, hah!” he said. “Now I understand! I thought you were just supposed to type in what you are interested in finding, and the system would provide a list of references that might be relevant.”

Accessing Full Text of Journal Articles Electronic journals and links to full-text articles An increasing number of journals can be read online. Some are truly ‘e-journals’. They are produced only in electronic form—no paper version even exists. Many other journals are still distributed in printed form but can also be read online. Arrangements for access to e-journals vary with regard to cost, scope of access, and timeliness of access. Some e-journals can be accessed free of charge by everyone, whereas others must be paid for by an institution such as a university library, an international programme arranging access, or by an individual subscriber. What everyone loves is direct access to the full text. You find a reference in an online bibliographic database, click on the reference, and are taken right to the full–text article, which you are allowed to read and download free-of-charge without any hassle. When this happens, it is wonderful, but it only occurs if specific conditions are met.  The journal in which the article was published must be an e-journal available online. Remember, there are journals that are still only published in printed form.  There must be a link between the place where you found the reference and the web site of the journal.  The article must be free to everyone, or it must be ‘free’ to you either through an institutional subscription (such as subscription by the Uppsala University library) or an access programme such as HINARI or INASP/PERii.  An authentication system must be in place that automatically recognizes you as being eligible to access the full text. If these conditions are not met, it won’t be possible to get full-text articles free of charge just by linking out from the references in a database such as Medline/PubMed. But you can probably still obtain them in some other way. While you are in a course at Uppsala University, you may be able to get them by going through the updated list of e-journals subscribed to by the University Library, as was described at the beginning of this sourcebook. When you are home, you will almost certainly be able to access full text through other routes. This chapter provides details about some possibilities.

There is almost always a route from the reference to the full-text article, but it may not be direct. 38

Different types of ‘free’ journals Publishing any journal costs money. There is no such thing as a completely free journal, since someone must pay for the production costs. However, for most people, ‘free’ simply means that they don’t need to pay personally for something out of their own pocket. A growing number of journals are free in this sense. One reason is that many programmes have been established since 2000 to help bridge the information gap between different world regions by providing free access to journal articles. The situation is complicated, however, since ‘free’ is used to refer to so many different access systems. In most lower-income countries, for example, health professionals can access many thousands of journals without paying for them personally, but these ‘free’ journals are not coming from a single source and are not free in the same way. 

    

  

Some online journals are available through free access that applies to everyone in the world. These journals are often referred to as open access. In fact, open access only applies to free-access journal articles provided under a license that allows unrestricted derivative use. ‘Free-access’ is used in this sourcebook for the general category that includes both open access and other free access materials. Some journals are not really free access, but they provide limited access to selected articles, or to special issues, or to each issue for a short time after it is put online. Some journals make all articles available free of charge after an embargo period, often 6-12 months after publication. Some articles are available free in digital archives. Certain journals are provided free by the publisher through national provision programmes for everyone in certain countries. Yet other ‘free’ journals are available through donor-supported access paid for by bilateral aid agencies and arranged by the International Network for Availability of Scientific Publications (INASP) through its programme called PERii (Programme for Enhancement of Research Information). Some scientific journals are available free to end-users in most lower-income countries through HINARI and other United Nations-based access programmes. End-users can access some journals thanks to subscriptions paid for by universities, libraries, learning resource centres, national educational agencies, and consortia. Various document-delivery services provide printed or emailed copies of journal articles free of charge in lower-income countries.

These different access routes into cost-free journals and articles are described in detail on the following pages. Make sure that you learn about all of them. The access route you ignore may lead to that essential article you are looking for.

‘Free’ can mean many different things. The important thing is that you don’t have to pay for the articles yourself.

Free access: journal articles available free to everyone Many journals, including hundreds of peer-reviewed journals in health, now make their articles available free of charge to every one. This access can take various forms.  Some publishers make all their journals available to everyone at no charge, thanks to alternative financing systems.  Some journals are referred to as being free but are actually not available free of charge until some time after their publication. This embargo period may be as short as several months or as long as 3 years.  Other publishers provide certain materials at no cost and may refer to these as free access. Examples are journal issues available free for one week after going online, selected free special issues, and selected free articles.  Some journals give authors the option of paying the publisher so that their articles are available as open access. If the author pays, then everyone can read the article free of charge. In addition, free-access articles can be obtained through a variety of routes. The sites listed below include examples of all of these, which include:  Individual free-access publishers  Gateways and directories listing free-access journals  Archives of free-access articles  Directory of archives of free-access articles  Online databases allowing searches for free-access articles  Sites providing pre-set searches to free-access articles on specific topics

 Open J-Gate http://www.openj-gate.org Open J-Gate is the largest portal into English-language journal literature, with many thousands of free-access journals in all fields. You can carry out a search (use advanced search) to access articles in all these journals. When you find a relevant reference, click on ‘full-text link’ and then on ‘pdf’ or another choice. If nothing happens, look near the top of the screen for a message that pop-ups have been blocked. Click on the message and follow the directions to allow temporary pop-ups. Another way to use Open J-Gate is to click on ‘Browse by Journal’ at the home page. An alphabetical list of the journals will come up. To sort out those that have ‘reproductive’ or another word in the title, use the drop-down menu at ‘Find title’ so that it reads ‘Find title containing’ and then type in the search term.  Directory of Open Access Journals (DOAJ) http://www.doaj.org DOAJ is another gateway in free-access journals in all academic disciplines. It provides annotated lists of free-access journals in each field, complete with links to the journal site. A fair number of the journals are in languages other than English.  HighWire Press http://highwire.stanford.edu http://highwire.stanford.edu/lists/freeart.dtl Highwire Press provides access to over 1 million free, full-text articles from over 900 journals. Most articles are about biomedicine or health. To find the free articles, begin by clicking on ‘more search options’ above and to the right of the main search bar. On the advanced search page, type in your search term, indicating if you want to find articles with that term in the text or title and if you want to search by exact phrase. When the results come up, scroll down the list. The free-access articles are clearly marked with icons saying ‘This article is free’ or something similar. Highwire also maintains a list of over 250 journals in medical fields that provide at least some free full-text articles. Clear information about the embargo period is provided, as well as a link to each journal. The address is the second one given above.  Essential Health Links http://www.healthnet.org/essential-links/index.html Essential Health Links includes a list of sites through which journals can be obtained. Scroll in the menu and find ‘Full-Text E-Journals’, which includes both sites providing free-access journals and those for programmes such as HINARI. You can also find free articles on specific medical topics. Scroll to ‘Specific health resources’ and select a topic. On the topic page, scroll down to the page contents list and then click on ‘PubMed—Free Fulltext Articles’.  Free Medical Journals http://www.freemedicaljournals.com FreeMedicalJournals, one component of the Flying Publisher group, lists about 430 free medical journals, which are categorized by language and topic. The first page of the site currently gives the impact factor of a large number of important free-access journals, including ones available after an embargo period.

 Geneva Foundation for Medical Education and Research http://www.gfmer.ch/Medical_journals/Free_medical.php http://www.gfmer.ch/Guidelines/Obstetrics_gynecology_guidelines.php The Geneva Foundation for Medical Education and Research provides an excellent list of free online journals. Go to the first address above. Click on any specialty and you’ll get a list of relevant free journals, with links. GFMER also provides pre-set searches on a wide range of topics in maternal and child health. Go to the second address given above and click on a topic of interest. When the page comes up, click on ‘PubMed Free Full Text’ at the top of the page, and the search will be done automatically.  BioMed Central http://www.biomedcentral.com BioMed Central is an example of a publisher using a new approach to financing. Costs are covered by authors’ page charges and through donations from partner institutions, so that free online full text is available to everyone. To get a list of all the free-access journals published by BioMed Central, click on ‘Subject Areas’.  Public Library of Science http://www.plos.org Another example of a free-access publisher is PLoS, which publishes journals in science, medicine, biology, genetics, pathogens, and neglected tropical diseases.

Free access is like an open door to the world’s academic literature.  PubMed Central http://www.pubmedcentral.nih.gov PubMed Central (PMC) at the National Library of Medicine maintains an archive of free full-text articles and a list of free-access journals. The PMC archive is linked to PubMed. The abstract of any research article published in 1966 or later and stored in PubMed Central will also come up in a PubMed search. Therefore searches for free fulltext research articles should normally begin with PubMed, rather than PMC. You can search for articles in the PMC archives or use a list of the journals from which articles are archived in PMC. To reach the list, click on ‘Journal List’ at the top of the page. The table that comes up lists the journal alphabetically, gives information about the first and latest issues included in the PMC archive, and indicates the timing of the free access (immediate or after a particular embargo period). You then have the option of searching in a specific journal (click on ‘search’) or browsing through the archives issues (click on journal title). When you find an article that looks interesting, just click on ‘full text’ or on ‘pdf’ to get the free full-text article. Note that you will be accessing the article in PMC itself, not linking to the publisher. 42

 Open DOAR http://www.opendoar.org PubMed Central is not the only open-access repository. There are over a thousand of these archives, some specializing in materials within a specific discipline, others storing research produced in a particular institution or country. The DOAR (Directory of Open Access Repositories) web site lists these repositories and allows searches both for the archives themselves and for their contents.  Medline/PubMed http://www.pubmed.org When you do a search at Medline/PubMed, it is possible to sort out all the free full-text articles, that is, the free access articles. Type your search term or string and then click on the tab labelled ‘Limits’ and select ‘Links to free full text’. The results will include both free-access articles archived in PubMed Central and freeaccess articles that can be accessed at publisher sites. The results will not include most articles for which you are eligible via access programmes such as PERii and HINARI or through subscriptions paid for by your institution (or Uppsala University while you are in Uppsala), a national agency, or a consortium. This is because, even if you personally do not have to pay for these articles, they are not true free access.

TIP! Don’t think of journals subscribed to by a library or paid for by HINARI as ‘free’. Doing so can lead to confusion about the free full-text limits at Medline. Once you have gotten the list of hits, click on the authors of an individual reference if it seems interesting. This will take you to the abstract page. On the abstract page you will find ‘buttons’ marking links to PubMed Central and/or to the publisher’s site. Click on the button to reach PMC or the publisher and access the free full-text article.

Access via national provision Some publishers have a policy of providing certain journals free, but only to end-users in low-income countries. Here are some examples of these programmes. Oxford Journals Developing Counties Offer http://www.oxfordjournals.org/access_purchase/developing_countries_journals.html Oxford Journals has a special programme through which developing countries can receive about 160 of Oxford publications either free of charge or at reduced rates. To obtain more information about the programme, go the address given above. 

 BMJ http://journals.bmj.com/subscriptions/countries.shtml The British Medical Journal has a policy of providing its journals free of charge to readers in lower-income countries. Click on the link above to obtain more information.

 Proceedings of the NAS http://www.pnas.org/cgi/content/full/99/9/5751 http://www.nap.edu/info/faq_dc_pdf.html The Proceedings of the National Academy of Sciences in the US and reports from the NAS are available free to eligible developing countries. More information is available at the first address given above. Registration is not necessary, but users do need to sign in. Details about how to do so are given at the FAQ page at the second address.  HighWire’s list of journals free to developing economies http://highwire.stanford.edu/lists/devecon.dtl HighWire Press at Stanford University provides a list of about 100 scientific and medical journals that are made available by the publishers free to persons in low-income countries. One of the items on the list is the very important general journal, Science. No registration is necessary, since the server at Stanford automatically determines the location of the user through the IP number. This means that institutions without stable IP (Internet protocol) numbers will not be able to access the full text of these journals.

TIP! Journals can be of very high quality and yet be available via free access. Judge them by their worth, not by how they are financed.

Donor-subsidized access through INASP/PERii http://www.inasp.info Donor agencies are helping to improve research in selected lower-income countries by financing access to journals in collaboration with PERii (Programme for the Enhancement of Research Information), a component of a British charity called INASP (International Network for the Availability of Scientific Publications). A central institution or national team handles PERii coordination for each country. The resources accessible via PERii vary tremendously among countries, ranging from a small number of journals to many thousands, depending on funding available from donors and/or through national library consortia. To use the resources, an institution must first register with INASP and then with each resource provider. The technical means of accessing PERii resources also varies. In some cases, access is through links to the PERii publishers on an institution’s library web page, and the end-users are recognized by the IP (Internet Protocol) numbers of their computers. In other cases, end-users must have a list of web address for the PERii publishers and a separate username and/or password for each. If this is the case, necessary information should be provided to students and staff by the institutional library. For more information about PERii in a particular country, go to INASP’s web site and use the country finder. Select the country (for example, Tanzania) from the drop-down menu and then click on ‘Go to Country’. You will get a list of the resources for which Tanzanian institutions are eligible and contact information for the group coordinating PERii in Tanzania.

The Ignored Bulletin Board An INFORM training team was visiting a university in a low-income country, where they were meeting with leaders of the medical faculty to plan onsite INFORM workshops about information access. One of the INFORM trainers and the Dean of Medicine were walking down a hallway in the Medical School, looking at the facilities, and talking about what topics would be covered in the training. “Of course the workshop will cover the various routes into full-text journal articles,” the trainer said. “We will describe various ways to find free-access articles and introduce the access programmes such as HINARI and INASP/PERii.”

“Not INASP!” the dean exclaimed. He stopped walking, leaned back against a bulletin board, and said in a frustrated voice, “I’ve heard about that organisation, and my colleagues elsewhere say that the PERii programme is really great. But they aren’t doing anything in our country. It really disappoints me that they aren’t helping us to access online resource. So there’s no reason to mention them in the workshop.” “Uhmm, Sir,” said the trainer. “I think you should look at the bulletin board you’re leaning on.” The Dean took a step forward, turned around, and began to laugh. He had been leaning on a poster, put up by the Medical School Library, explaining that the university community had access to thousands of online journals through the PERii programme and giving instructions about how teachers, researchers, and students could obtain the necessary passwords to access the materials. The poster was a bit dusty and had obviously been there was some time—at least a year. “I think I have some things to learn,” the Dean said. And when the INFORM workshop ran the next month, he didn’t just send his staff. He was a full-time and enthusiastic participant himself.

To make use of PERii, your institution must first register with the country coordinator. Once an institution is approved, it must also register with each publisher and provider listed for the country. This involves filling out and submitting forms with a list of the institution’s IP (Internet Protocol) numbers. The registration is normally handled by the librarian or, if there is no librarian, by the director of the institution. You can check the status of your institution’s registrations. For example, if you are at a Tanzanian institution, start at the Tanzanian country page, select the resource (e.g., Nature Publishing) and on the resource page find the link to INASP’s registration database. You will get a list of all countries that receive Nature Publishing journals via PERii. Click on ‘Tanzania’ to see a list of Tanzanian institutions approved to receive resources via PERii. If your institution is not listed, it means that you are not yet part of PERii. Contact your librarian and request that this be done. If your institution is listed, click on its name. You will either get a message saying your institution is already registered for the resource (Nature Publishing) or a message explaining what needs to be done so that your institution can receive the resource. Again, if you find a PERii resource for which your institution has not registered, contact your librarian.

TIP! Many institutions make only partial use of their PERii resources because they register with PERii but not with the individual publishers and providers.

Access through UN programmes: HINARI, AGORA, OARE http://www.who.int/hinari (HINARI) http://www.aginternetwork.org/en (AGORA) http://www.oaresciences.org/en (OARE) Three major international access programmes—HINARI, AGORA, and OARE—are based at United Nations agencies. HINARI is an extremely valuable access programme for medical and health professionals in low-income countries. The resources it provides are wonderful. AGORA and OARE also provide resources useful in the health sector— AGORA on nutrition and OARE on environmental topics. To reach full-text materials via HINARI (or the other two programmes), you must be at a registered institution or organization. Individual access is not allowed, and institutions and organizations in the higher-income countries are excluded from the programmes. To see if your institution has registered, go to the HINARI home page, click on ‘Register’, then on ‘Registered Universities and Professional Schools’. If your institution is not listed, contact your library staff and request that they register. Only one registration is required for each institution. The HINARI site gives the impression that only educational institutions are eligible. However, Ministry of Health offices, hospitals, and health care centres can register. So also can NOGs as long as they are local, that is, restricted to the country. Regional and international NGOs and consulting agencies working on contract within the health sector are excluded and cannot participate in the programme. 46

Ease of Access Varies Under Different Arrangements There are many access routes through which end-users can reach resources made available via programmes such as PERii and HINARI or paid for by their own institutional libraries, national agencies, or library consortia. These different access arrangements are important because they affect how easily end-users reach full text.

How easily you can reach full-text articles depends on the access arrangements at your own institution.  At some institutions, the library prepares a document listing the web addresses, usernames, and passwords for the various resources and distributes this list to the teachers and students. End-users can sit at any computer (including at home), go online to a publisher, type in the username and password, and access full text.  At some institutions, authentication is handled via IP addresses. The library submits the institution’s IP addresses to the publishers, and any end-user sitting an institutional computer can go directly to a publisher and access the full text.  In some cases, the library has a web page with links to the resources, and the log-in information is invisibly embedded in the links. The end-users typically have a single username and password that allow them to reach that e-resources page or to activate any specific link on the page. When the users reach the publisher’s site, they are recognized as coming from an eligible institution and given full-text access. Be sure to talk with your institutional librarian to learn exactly how you can get into access programmes such as HINARI and PERii, as well as through other sources such as library consortia. Note that the HINARI list of registered universities and professional schools does not list the government offices and NGOs that are registered. You can find out the status of your organization or institution by checking with your colleagues or, if you can’t find anyone who knows, use the HINARI email address (hinari@who.int) to contact the HINARI office. Alternatively, just go ahead and send in a registration. If you have learned about HINARI through an INFORM workshop, through lectures by an INFORM trainer in a course in Sweden or elsewhere, or through this INFORM sourcebook, the HINARI office has asked that you mention in your registration that you have learned about HINARI from INFORM. 47

Once your institution or organization is registered, you will be able to access the fantastic resources provided through the programme. The specific way you access those resources will depend on your institution. Access is handled quite differently at different institutions. Talk with a librarian to find out what the local system is. If you know that your institution is registered with HINARI but you cannot gain access or get information about access, contact the HINARI office at the email address hinari@who.int and inform them of the situation. When you get your HINARI username and password, write them here. Note that, if your ID or password includes zero, you must use the numeral, not the capital version of the letter ‘o’. 0 (the numeral) is not the same as O (the letter). Our HINARI user ID is ______________________________ Our HINARI password is ____________________________ After you reach the HINARI web page and log in using the user ID and password, you should be sent automatically to the resource page that lists the scholarly journals and other materials provided by the programme. If not, click on ‘Full text journals…’ from the column to the left on the HINARI home page. On the resource page, you will find a list of the journals being provided by HINARI. The set is changing constantly but often includes close to 6,000 journals. Note that, after each journal listed, there is a range of dates. These are the volumes and issues of the journal available through HINARI. The range of years varies immensely. Not all the journals listed on the resource page are available in every country. Every year the publishers participating in HINARI decide which countries will receive their journals. If a publisher is going to terminate access to its journals in a particular country, the HINARI office notifies the registered institutions in that country. The good news is that the resource page at HINARI has been revised to provide countryspecific information. This means that—theoretically—you can see which journals you can access as full text and which you cannot. To see what is available to you in a particular field, click on ‘Find journals by subject category’, and then select a particular topic. You will get a list of all the HINARI journals that cover that topic. They will be divided into those journals which you in your country can access in full text via HINARI, and those to which you do not have full-text access. You will get the same information if you look for journals by title or language. If you click on ‘Find journals by publisher’, you will get a list of all the publishers participating in HINARI, divided into those for which you do and do not have full access. Unfortunately, testing of this system in one country (Vietnam) at an INFORM workshop in early 2009 revealed serious flaws. The filter resulted in a message saying that Elsevier journals were available (although they were not) and that Springer journals were not available (although they were). It’s a good idea, therefore, to go ahead and click on the link to any journal you want to access and see what happens.

Using Medline/PubMed and HINARI together Perhaps the most useful feature of HINARI is that it allows you to do searches in Medline/PubMed for full-text articles in journals that are participating in the HINARI programme. There are many millions such articles. If you do searches in Medline/PubMed correctly, you can access these articles free of charge. However, you must do this carefully, or you will be blocked when you try to open the full text. Begin by logging in and going to the resource page. Click on ‘Search HINARI articles through PubMed (Medline)’. When you reach Medline/PubMed, carry out your search. Do not go to the limits page and click on ‘Links to free full text’. If you do so, you will lose the articles in the HINARI set that are not free access—several million articles. Your results will be arranged in three sets, marked with three tabs. The ‘All’ set will be a list of references to all articles matching your search. The ‘Free Full Text’ set will include references to articles available via free access. The third, ‘HINARI’, will give you the references to articles in journals provided via HINARI. When you click on a reference in the HINARI list and go to the abstract page, there will be a button labelled HINARI at the top of the page, over the abstract. If you click on this HINARI button, you will be linked to the publisher’s site, where you should be able to read and download the full-text article, free of charge, as long as the publisher is providing access to end-users in your country. Note that there will also be a button that provides a direct link to the publisher or provider. If you click on this button, the publisher may not recognize you as a loggedon HNARI user, and you will not reach the full text paid for by HINARI. If you find yourself blocked, be sure to go back to the HINARI site, find the journal in the journal list, and go to it directly. Very often, if you are blocked when you try to go via the publisher link at Medline/PubMed, you can get through via this other route! To recap, you can use Medline to reach a full-text article provided by HINARI if:  The journal in which the article is published is on the list for your country.  Your institution is registered with HINARI.  You have logged in to HINARI.  You have accessed Medline/PubMed from the HINARI site.  You have not gone to the Limits page and clicked on ‘Links to free full text’.  After doing your search, you have clicked on the HINARI tab to get the references to articles in journals provided via HINARI.  You have clicked on the HINARI button to reach the publisher’s site. If you follow the instructions for accessing full text via Medline and are still blocked from the full text, do try an alternative route. Note down the reference, back up to HINARI, make sure you are still logged in, find the journal in the journal list, click on the direct link to the journal site, and then find the issue and article you are seeking. Remember that Medline/PubMed cannot find references to journals not indexed by Medline. Thus some journals made available through HINARI in the social sciences will not be indexed in Medline, so the articles in them cannot be retrieved this way. However, you can access the full-text articles in these journals by logging in at the HINARI site, selecting journals by topic, and then going directly to the journal site.

Hopeless HINARI Two INFORM trainers arrived in a country to facilitate a series of workshops for physicians. When they arrived at one of the training sites, they were met by a group of young doctors who were very good with computers but very sceptical about online access, especially about HINARI. “We’ve tried it, and it just doesn’t work,” said the most outspoken of the doctors. “Well, HINARI did have some technical problems,” replied one trainer, “but those have mostly been worked out. So the system functions quite well now.” “No, it doesn’t!” insisted the participants. “We’ve all tried and tried, and we can’t get into full-text articles. The system is hopeless!” “OK,” said the other trainer. “You show us what you’re doing, and let’s see if we can figure out what the problems are and how they can be solved.” So the whole group sat together and went online, using a projector so that everyone could see what was happening. The exercise revealed that:  Some doctors were using HINARI without a username or password, assuming they were not needed since their country was eligible and their institution was registered.  Some were using an out-of-date username or password.  Some were logging on at HINARI, linking up to Medline, doing searches, but then not clicking on the button marked HINARI, arguing “We’re already inside HINARI, why should we click on the HINARI button again?”  Some were reaching publisher pages that presented abstracts but not full text and they didn’t understand that they needed to click on ‘pdf’ to get the full-text articles. Once these and several other misunderstandings were cleared up, the doctors were able to access the full text of all the journal articles provided via HINARI. “You were absolutely right!” one of the young doctors exclaimed. “HINARI does work! Wow!”

National library consortia and eIFL http://www.eifl.net Access may also be provided through library consortia. You can find out if your country has such a consortium checking at eIFL (Electronic Information for Libraries), an international network supporting library consortia. Go the site, click on ‘member countries’ and then on the country you are interested in.

Programmes providing full text in other formats In some cases, the most useful information is information that is delivered in print form, on CDs, or by telecommunication systems such as e-mail and mobile phones. A variety of organisations offer such services. In some cases the service is free; in others there is a cost, but it is low compared to the normal price.  One Source at the INFO Project http://www.infoforhealth.org/onesource.shtml For printed materials, a good source is One Source, part of the INFO Project at Johns Hopkins University in the United States. This composite database covers most aspects of health in lower-income countries. Many items in the database are not available via Medline/PubMed because they are not from journals. Examples are commission statements, materials from UN agencies, communication materials, and so forth. Some items can be accessed free online. If so, a link is given, often in the form of a DOI icon. Other items can be ordered as attachments to emails or as printed copies by post—free to health professionals in developing countries. There is a limit of 75 items per week. When you find an item you want, click on ‘Add to cart’. When you’ve finished your selections, click on the cart symbol in the upper right-hand corner. You will be asked to register. Go ahead and do this—it is safe and free. Be sure to note down your password so that you don’t forget it! After you are registered, indicate that you want to go back to the last page you were looking at. This will be the page with your ‘basket’ of items you are ordering. Check that the list is correct and then place the order. You will then be asked for more information, including a regular mailing address in your home country. Fill in all the required fields. At the bottom, indicate that you want to have the materials sent by email or by regular mail. (Note that the programme will not send items to you at a Swedish address!) In the comments field, state that you have learned about One Source through INFORM.  The Global Development Network Document Delivery Service http://www.gdnet.org/middle.php?oid=26 The GDN has a document delivery arrangement via the British Library of Development Studies (BLDS). Researchers at member institutions can request freecopies of articles, book chapters, and grey literature from the BLDS collection, which covers all aspects of development. Scanned materials are sent by email or regular post. Registration and requests for materials must be done by librarians or administrators institutions, not by individual researchers.

 AED-Satellife Center for Health Information and Technology http://www.healthnet.org Satellife makes medical information resources available to all health professionals in low-income countries. It does this through a global network called HealthNet, which links healthcare workers around the world by way of e-mail. The network, which is aimed primarily at persons working in areas without good Internet connections, currently includes over 10,000 members. Satellife also hosts online discussion groups and provides a managed link set of information resources, Essential Health Links.  eGranary (Internet in a Box) http://www.widernet.org/digitallibrary eGranary is not a free resource, but it still deserves mention here because it provides a unique service. It is a digital library designed to be used where Internet connectivity is lacking or very limited and contains millions of web pages. It requires a plug-and-play server that works with any local area network. More information and forms to submit to obtain cost quotes are available at the web site.  TALC http://www.talcuk.org The organisation TALC (Teaching Aids at Low Cost) produces a range of CD-ROMS related to health in lower-income countries. These are available either at low cost or free of charge. The free CD-ROMS are estimated by TALC staff to contain the equivalent of 12,000 pages of information, including journal articles.

Printed journals and print copies of individual articles If you can’t get into a journal online, check if it is available in print form at a library. You can do this by going to the library and looking through the section where the journals are kept or asking help from a librarian. Remember too that libraries around the world are connected via interlibrary loan arrangements, through which they provide copies of journal articles to their partner libraries. These systems allow users at one location to use the resources at many different libraries at a reasonable cost. Even in countries where interlibrary loan systems are not formally in place, librarians may have informal systems for exchanging materials needed by end-users. It never hurts to ask!

Accessing and downloading special issues and article series http://www.who.int/child_adolescent_health/documents/lancet_child_survival/en/index. html (Lancet series on child survival via WHO) http://www.who.int/reproductive-health/donateresearch.htm To reach special article series, you may need to go to the publisher and register. However, if the series deals with a public health subject, the articles may be hosted elsewhere. Two examples are the famous series published by the journal Lancet about child survival and reproductive health, both of which can be accessed and downloaded at WHO via the links given above. Special issues are similar to article series in that they deal with a single topic. But all the articles are published together in the same issue of a journal rather than being spread out over time. Be aware of the difference! Using HINARI, for example, you can search for and download articles in a series, but you may not download an entire issue of any journal. 52

Finding References to Books and Grey Literature As explained in the chapter about finding literature references, the best place to find references to books is in library catalogues or OPACs. These pages will tell you more about OPACs and how to find them. Alternative ways of finding book references— including through booksellers and publishers and through Google Book Search—will also be covered.

Why you should look outside of your own country Why isn’t this enough to look in library catalogues of the country where you are? Why bother to look for book catalogues at libraries outside of that country? After all, what these catalogues list are the books owned by those foreign libraries, not by libraries in your own country. Nevertheless, it is well worth the time to look in OPACs elsewhere, for a variety of reasons.  If you find a book that you would like to read but is not available locally, your own library may be able to purchase a copy for you or obtain one through interlibrary loan or document delivery arrangements.  If you have funds for personal book purchases, you can use the OPACs to see what books are being selected by outstanding medical libraries around the world.  And, perhaps best of all, you will soon discover that a huge number of the books listed in major medical OPACs are free, online e-books that you can access with a single click. You will find details about getting into full-text e-books in the next chapter. But first you should learn to find OPACs and search in them for book references.

Different kinds of OPACs http://www.library.uq.edu.au/natlibs/ (Gateway to catalogues at national libraries) http://www.bl.uk/ (British Library) http://www.copac.ac.uk (COPAC in the UK) http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=nlmcatalog (NLM catalogue) http://www.who.int/publications/en/ (WHO publications page) As explained earlier, an OPAC (online public-access catalogue) contains bibliographic information about publications owned by a library. These materials are referred to as the library’s ‘holdings’. The holdings catalogued in the OPAC include books, of course, but also journals subscribed to by the library and the grey literature owned by the library. Usually an OPAC does not include information about the contents of journal issues or about individual journal articles.

As you will discover, libraries use different software as the basis for their catalogues, so the search screens for different OPACs can look different. Nevertheless, most of them have similar features and are rather easy to use. The majority of OPACs provide information about the holdings of normal single libraries, such as those of universities. Some, however, are catalogues for national libraries, which often have large holdings and special collections. An index of national libraries is available via the library at the University of Queensland in Australia. One example of a famous national library is the British Library. Other OPACs are union catalogues covering more than one libraryâ&#x20AC;&#x201D;for example, all the libraries in a multi-university system, a consortium, or a country. An example of a major union catalogue is COPAC. It provides free access to the merged online catalogues of 24 university libraries in the UK and Ireland, as well as the British Library and the national libraries of both Scotland and Wales. Yet other libraries have topic-focused catalogues. Within medicine, an important OPAC is the catalogue at the National Library of Medicine in the United States. (This is not Medline.) Another key OPAC in the health sector is the catalogue for the library of the World Health Organization in Geneva. To reach this library, go to the WHO publications page and click on the link to the WHO library database. This catalogue is not as extensive as the one at the NLM, but it is more focused on public health and other health topics of interest to professionals in lower-income countries.

Through your computer and WWW, you can reach library sites and OPACs around the world.

Finding other OPACs http://www.libdex.com (Libdex) http://www.google.com/dirhp (Google directory) http://www.lib.uiowa.edu/hardin/hslibs.html (Medical/Health Sciences Libraries)

If you know the address for an OPAC, all you have to do is open your WWW browser, type the address, and click on ‘Go’. But how do you find addresses for OPACs in the first place? There are many possible routes, including these three. To find OPACs anywhere in the world, you can look in LibDex, which is an index of 18,000 libraries around the world. It is possible to look through a list of libraries in each country. Another possibility is to go to the Google Directory. Click on ‘Education’, then find universities. Go to a specific university and then find the library and the OPAC. Or click on the ‘Regional’ section, select a region and country from the menu, then education, then universities, and then find the libraries. Finally, to find medical and health science libraries, try the link set on this topic provided by the library at the University of Iowa. The libraries in the list are primarily in the United States, but some medical libraries elsewhere are included.

Finding book information through booksellers and publishers http://www.amazon.co.uk (Amazon) http://books.google.com (Google Book Search) Another place to look for bibliographic information about books is at the web sites of publishers and booksellers. The largest bookseller on WWW is Amazon, but there are many other choices. When you find information about books at booksellers’ sites, you can often get more details than you can from an OPAC, including the table of contents. A good way to get book details from a large number of publishers at once is to search by way of Google Book Search. Click on ‘Advanced search’, then type in the word(s) or phrase describing the subject you are after. You will get information about books for sale, the table of contents of each, and links to online book sellers.

Accessing Full Text of Books and Grey Literature For many years, full-text e-books were rare in comparison to e-journals. Today, an amazing number are available. Some of the most important ones are reference literature (encyclopaedia, handbooks, encylopedia, etc.) and textbooks. They may not be as pleasant to read as the print versions, but they are lighter.

E-books are much lighter.

Sources for free e-books in general http://www.questia.com/Index.jsp (Questia) http://www.netlibrary.com/ (NetLibrary) http://www.ebooks.com/ (eBooks) http://www.google.com/Top/Computers/E-Books/ (Google Directory) http://www.dmoz.org/Computers/E-Books/ (Open Directory) There are numerous commercial e-book sites. Three of these are Questia, NetLibrary, and eBooks. All these sites provide a mixture of online e-books. Some of the books are available only by subscription and others are free. For other general e-book sources, check the sections about e-books in the Google and Open Directories.

Sources for free e-books in medicine and health The Web is full of free electronic books in medicine. Literally thousands of these ebooks are online, covering every speciality. The best places to find these are not the general e-book sites, however. Instead, you should go to gateways, OPACs, and the web sites of major health organisations. Here is a selection of possibilities. ď&#x201A;ˇ The Uppsala University collections (only while you are in Uppsala) As long as you at an Uppsala University course, you can access the e-books subscribed to by the Uppsala University Library. Go to the University Library site, click on ebooks, and scroll through to see what is available. The major collections relevant to reproductive health will be NetLibrary, Books@Ovid, and AccessMedicine.

 Essential Health Links http://www.healthnet.org/essential-links/index.html (Essential Health Links) Essential Health Links is probably the best place to get an overview of sites providing free medical e-books. Scroll down in the list and look for ‘Full text e-books’, then click on the links and go exploring.  FreeBooks4Doctors http://www.freebooks4doctors.com A major site for medical e-books is FreeBooks4Doctors, which has over 600 books available free of charge. Just one example is the classic Guide to Effective Care in Pregnancy and Childbirth (Oxford University Press). Major recent additions at this site include the comprehensive HIV Medicine 2007 and Tuberculosis 2007. You can also find links to the Merck Manual, HIV Medicine, the Atlas of Human Malaria, Sars Reference, Microbial Threats to Health: Emergence, Detection, and Response, and many other books of relevance to public health.

 National Library of Medicine Bookshelf http://www.ncbi.nih.gov/entrez/query.fcgi?db=Books (Bookshelf at NLM) The US National Library of Medicine maintains a database of online books called Bookshelf. You can scroll through the list, select a book, open and read it, and usually download it free, chapter by chapter. You can also search through the entire collection for passages on the topics you are interested in. The books cover a full range of topics, from basic sciences to public health. Here are a few examples of the 90 books currently on the Bookshelf: Antiretroviral Resistance in Clinical Practice Bioinformatics in Tropical Disease Research Disease Control Priorities in Developing Countries Global Burden of Disease and Risk Factors Guide to Peripheral and Cerebrovascular Intervention Immunology and Evolution of Infectious Disease The Intolerable Burden of Malaria: I, II, and II Medical Microbiology Neuroscience Priorities in Health Retroviruses Surgical Treatment

 National Library of Medicine Catalogue http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=nlmcatalog Another rich resource for e-books is the NLM catalogue. When you do searches in the catalogue, you will see that many references are for free, online materials. Some of these are clearly labelled as ‘electronic resource’. Others are labelled as a book or other type of document, but, when you click on the title and go to the full reference page, you will find a link that takes you to the full text. You can limit your search to e-books and other online e-resources by clicking on the limits tab and then on ‘Links to Full Text’.  International Development Research Center http://www.idrc.ca/ IDRC is a major player in international development. The Center has published several important books about health, which are available online. Go to the homepage, click on ‘Publications’, then ‘IDRC Books’, and then ‘All our books’. The books are shown on three pages, which can be scrolled through quickly. Click on a title to get information about how to download it. Two titles to look for are Fixing Health Systems and Health: An Ecosystem Approach.  National Academies Press http://www.nap.edu http://cart.nap.edu/cart/pdfaccess.cgi?action=dcsignin The National Academies Press has published more than 4,000 e-books that can be read online without charge. Of these, about half are available in pdf form, and about 600 can be downloaded free by users. Start on the home page and select a topic of interest. The Press is interdisciplinary, so you will find a choice of many subjects, including food and nutrition, health and medicine, biology and the life sciences, math, chemistry, and physics, and much more. If you select ‘Health and Medicine’, you will go to a new page, where a list of books will be provided. Note that these are only a few selected titles of recent publications are shown on this page. To browse through the rest of the books about health and medicine, click on the list of sub-topics to the left. There are currently about 30 books on women’s health, about 100 on public health, and so on. If a book looks interesting, click on the title to see more details. You will then be given various options, including reading the book online, purchasing a print copy, or downloading all or part of it in pdf form, either free or for a charge. To get the free pdf, find the blue button labelled ‘Sign in’ (to download free pdfs). You will be taken to another page where you can register and then click on ‘Get pdfs’. Don’t be afraid to do so—registration is free.  Medical Approaches http://www.medicalapproaches.org/ A medical book written by junior doctors for other junior doctors is available through the Medical Approaches web site. It can be downloaded free in formats for both regular computers and ‘handheld’ ones.

 MedicalStudent http://www.medicalstudent.com/#MedicalTextbooks (Medical Student) The Medical Student web site at provides access to hundreds of online textbooks in most medical specialities. Not only students, but also teachers, researchers, and clinicians are sure to find useful texts here. Books available through links from this site include a large number of human atlases, including radiologic and histologic ones, e-textbooks on most medical specialties, handbooks with clinical guidelines, and much, much more. Check it out.

 World Health Organization http://www.who.int Remember that WHO is an important medical publisher and the provider of possibly the greatest number of free e-books relevant to international health. Go to the WHO web site and click on ‘Publications’. From this page you can access many of the major WHO publications, such as The World Health Reports and The International Classification of Diseases. The publication page also has a link to the WHO library catalogue. When you do a search in the catalogue and the results come up, look down the right hand side to see the notations indicating that publications are available via a full-text link. These will include books, journal articles, and grey literature, all downloadable and free of charge. You can even limit your search to the 18,000 books and other documents that are available as free e-resources by using the advanced search option and selecting ‘online’ under ‘location.’ You can limit your search to books by selecting ‘monographs’ under ‘type’. A blank search for monographs that are available online currently yields about 5,800 hits. In addition, check the publications listed in the web pages for specific health topics. Start by clicking on ‘Health topics’ from the menu on the home page. Select a topic of interest and go to that page. Look there for ‘publications’ and ‘technical information’, as well as links to specific sub-topics. Also be sure to look through the programmes. Start on the WHO home page and click on ‘Programmes and projects’, then a programme, and keep clicking until you reach the publications.

Free books in print form http://libweb.lib.buffalo.edu/dokuwiki/hslwiki/doku.php?id=book_donations#donation_i nformation (Book donation list, State University of New York at Buffalo) http://www.sabre.org/index.php (Sabre Foundation) Numerous programmes collect books—including new books directly from publishing companies—and donate them to universities and hospitals in lower-income countries.

A list of such programmes is given at the first address above. If you need printed books and have limited funding, it would be worth your time to go through the list. Note that most programmes send books only to institutions, not to individuals. An example of one organization providing books is the Sabre Foundation, which calls its work ‘humanitarian aid for them mind’.

Sources for free grey literature Some of the most important publications in the health sector are not journal articles or true books. Instead, they are grey literature. These include policy statements, working papers, committee reports, agency guidelines, news articles and press releases, official ministry documents, and much, much more.  One Source at the Info Project http://www.infoforhealth.org/onesource.shtml An excellent source for free grey literature in health is One Source, introduced earlier in this sourcebook. To recap, this is a service within the Info Project at Johns Hopkins University. It provides access to a wide range of documents, including a great deal of grey literature. The full text can be reached online via the web sites, or free copies can be ordered as emails or as printed copies. Everything is free to health professionals in developing countries. You can order up to 75 items per week.  World Health Organization http://www.who.int WHO is also a very important source for grey literature. The description above, of how to find free e-books at WHO, also applies for online grey literature. You can find the materials through the WHO library database, by using the advanced search and selecting ‘document’ as type and ‘online’ as location. A blank search with these limits currently yields over 10,000 items. Another way to find grey literature at WHO is to look through the pages on different health topics and the various WHO programmes and projects. Again, the instructions given above for finding e-books at WHO apply also for grey literature.

BOOK The latest in information technology, which seems certain to revolutionise the information field, is the new Bio-Optic Organised Knowledge device, also known as a ‘BOOK’. The BOOK is a technological wonder. It has no wires, no electric circuits, no batteries, nothing to be connected or switched on. It is so simple, even a child can operate it. Compact and portable, it can be used anywhere, yet it is powerful enough to hold as much information as a CD-ROM disc.

A reader using a bio-optic organised knowledge device, also known as a book.

A BOOK is constructed of sequentially numbered sheets, each capable of holding thousands of bits of information. OPT (Opaque Paper Technology) allows manufacturers to use both sides of the sheets, doubling the information density. The pages are locked together, thus keeping the sheets in their correct sequence. A BOOK may be taken up at any time and used merely by opening it. Passwords are not needed. Each sheet is scanned optically by the user, registering the information directly into the brain. A flick of the finger takes the user to the next sheet. BOOK never crashes or requires rebooting. The Browse feature allows the operator to move forward or backward to any sheet. Many BOOKs also come with an Index feature, which pinpoints the location of any selected information for instant retrieval. An optional Bookmark accessory allows the operator to open BOOK to the exact place left in a previous session, even if the BOOK has been closed. Bookmarks fit universal design standards; thus, one Bookmark can be used in many different BOOKs, and numerous Bookmarks can be used in a single BOOK. Users can also make personal notes next to BOOK text entries with an optional programming tool called ‘Portable Erasable Nib Cryptic Intercommunication Language Styluses’ or ‘PENCILS’. Portable, durable and affordable, the BOOK is being hailed as the precursor of a huge entertainment wave. The appeal of the BOOK seems so certain that thousands of content-creators have committed to the platform, and investors are reportedly flocking to the new phenomenon. Look for a flood of new titles soon. (Just for fun! Adapted from various WWW sources. Originator unknown.)

Finding Bibliographies and Reference Materials Bibliographies Bibliographies list published materials on selected topics. Today, now that WWW simplifies the work of searching, they are often overlooked. This is unfortunate, since a high-quality bibliography is extremely valuable. If you find one, it can save you weeks of searching. Most helpful are bibliographies that are annotated (with notes describing and evaluating each item). Perhaps one reason that bibliographies and study guides are often missed is that they are often called something else—literature guides, literature reviews, or resource guides. Another complication is that they exist in so many forms:  Books (found by looking in catalogues).  Journal review articles (found by looking in bibliographic databases).  Online resources (found by doing Web searches).  Bibliographies in book form http://www.nlm.nih.gov (NLM) To get a feel for the available bibliographies in book form, go to a major OPAC and do a search for bibliographies. One good place to try is at NLM. Start at the NLM home page and follow the links to the NLM catalogue. Type ‘bibliography’ as the search term and limit the field to ‘title’. If you find a book here or in another catalogue that looks extremely valuable for your work, you may be able to find a copy in a library in your own country or arrange for it to be borrowed from a library abroad.  Bibliographies in journal article form http://www.pubmed.org To find bibliographies in article form, go first to the relevant bibliographic database. For medical topics, start with Medline/PubMed. Click on the ‘Limits’ tab and scroll down to ‘Type of Article’. Click on ‘bibliography’ and then on ‘Go’. You will get close to 14,000 hits. To find bibliographies on a specific topic, type a search term or phrase into the search bar and click on ‘Go’ again.  Bibliographies as online resources http://www.google.com http://www.who.int An increasing number of bibliographies are available ‘loose’ at Web sites. This means that they probably have not gone through the peer review and editing processes associated with the publication of books and journal articles. However, if a bibliography is put online by a reputable organisation, you will probably find it useful. One way to find bibliographies is to use Google’s advanced search. For example, type ‘reproductive health bibliography’ (without quotation marks) in the search bar labelled ‘this exact working or phrase’. For bibliographies at WHO, go to the WHO web site and type the search (e.g., midwifery bibliography) into the search bar in the top corner. The open courseware materials at sites such as GFMER and Johns Hopkins University—which are described in the sourcebook chapter on resources for teaching— usually include reading lists and/or bibliographies. 62

Reference literature/resources Sometimes what you need is not in a ‘regular’ book or an article but another type of resource, such as a handbook or encyclopaedia. This is the ‘reference literature’—a very confusing name, since this is not the main place to find references. Reference literature is where you go to look up information. Many reference resources are useful for academic and professional purposes. Examples include encylopedia, dictionaries, almanacs, directories, atlases, yearbooks, and handbooks. These may include facts, statistics, contact information, glossaries, maps, calendars, and bibliographies.

Include bibliographies and reference resources in your literature searches  Google and Open Directory reference sections http://www.google.com/Top/Reference/ http://www.dmoz.org/Reference/ General reference resources—such as calendars, dictionaries, directories, thesauri, atlases and other geographical materials, and biographies of famous people—are becoming quite easy to access online, free of charge. You can find them easily by going into the reference sections of the Google Directory or the Open Directory.  Columbia and Wikipedia encylopedia http://www.questia.com/library/encyclopedia/ http://www.bartleby.com/reference/ http://en.wikipedia.org/wiki/Main_Page For more specific information, you will probably need an encylopedia. One encylopedia that is available free online is the Columbia Encylopedia, which can be reached through both Questia and Bartleby. An alternative is Wikipedia, an online encylopedia written by volunteer contributors, rather than by topic experts selected by an editor. The plus side of Wikipedia is that it is huge and has articles covering just about everything. The negative side is that you cannot see who has written the article and what credentials that person has. It’s a fine place to start in finding information, but use it with caution, and don’t include references to Wikipedia articles in academic papers. If you find an interesting Wikipedia article that seems to be solid, it will have a list of references at the bottom, which will lead you to the original sources, including books, journal articles, and grey literature. Track these down and read them yourself. 63

 Medical dictionary and encylopedia at NLM http://www.nlm.nih.gov/medlineplus/mplusdictionary.html http://www.nlm.nih.gov/medlineplus/encyclopedia.html If you want definitions or encylopedic articles on medical topics, you should consider going to an authoritative source such as the National Library of Medicine. The place to look at the NLM is MedlinePlus. This is not Medline, but a related site providing information resources both for professionals and the public.  Reference literature via HINARI http://www.who.int/hinari If your institution is registered for HINARI, you should go to the programme’s site, log in, and make use of the reference works provided there online. Examples include the Cochrane Library, Clinical Evidence, the British National Formulary, the e-Resources Management Handbook, and many other valuable resources. The full text of all these resources may not be available in your country due to restrictions by certain publishers. However, you should definitely check to see which you can get into.  Reference literature in the form of journal articles http://www.pubmed.org Not all reference literature is in the form of heavy books. Some journal articles function as reference literature because they provide an overview of a field. These are usually called review articles or tutorials. They often include good bibliographies, as well as factual information, a summary of current knowledge, points of debate, new research issues, etc. To limit your search at Medline/PubMed, type in the topic of interest in the search bar, then click on ‘Limits’. Under ‘Publication type’ select ‘Review’ and then click on ’Go’.  Reference literature through subscription http://www.europaworld.com/pub/about (Europa Publishing) http://www.accessmedicine.com/textbooks.aspx (McGraw-Hill Access Medicine) http://www.oxfordreference.com (Oxford Reference) Some of the best reference literature is produced by special publishers specializing in reference literature. These works are expensive, regardless of whether they are in print form or in online format. However, a library near you may have arranged for access to some of these resources. Be sure to ask! There are many commercial publishers of this type. Just three examples are given here.  Europa produces reference literature focusing on different world regions.  McGraw-Hill offers the medical reference package call Access Medicine, which includes 60 comprehensive textbooks covering all aspects of medicine, including clinical specialities. This is one of the e-book packages available at Uppsala University.  Oxford Reference, a division of Oxford University Press, publishes encyclopaedia, dictionaries, maps, and resources guides on all academic topics. The online reference books available on health and medicine include, for example, Dictionary of Food and Nutrition, A-Z of Medical Drugs, Oxford Companion to Medicine, Dictionary of Public Health, and much more.

Finding Web Sites Five approaches to finding things on the Web Eventually you will build up a collection of WWW addresses relevant to your work. Some of these you will obtain from sources such as this sourcebook, and others you will hear about from colleagues. You will also want to find some yourself. There are five basic tools you can use to dos so—search engines, menus, gateways, pathfinders, and digital libraries. Sometimes the distinction between these categories is hazy.

There are many tools available to help you find the best Web sites.

Search engines http://www.google.com (Google search engine) http://yahoo.com (Yahoo search engine) http://searchenginewatch.com/2156221 (Article about major search engines) http://www.hon.ch/MedHunt/ (MedHunt medical search engine) http://www.scirus.com/ (Scirus science search engine) You probably already use a search engine, such as Google or Yahoo. Search engines are extremely easy to use. You type a word or phrase into a blank bar and click on ‘search’. The search engine then finds the Web sites that match the description and gives you the list. When you click on a link in the list, you are hooked up to the site. Google is not the only search engine. There are many others. Searches done with different search engines do not give the same results. If you are interested in learning about search engines, go to the article listed above at Search Engine Watch about major search engines and directories.

You might want to try some specialized search engines. One example is MedHunt, which is maintained by Health on the Net (HON). This search engine looks through medical sites, rather than all the sites on the Web, and you can even restrict the search to sites adhering to the HON code. Another specialized search engine is Scirus. It claims to be the most comprehensive science-specific search engine and scientific research tool on the web. When you do a search with Scirus, it looks through over 480 million science-specific web pages.

Menus (directories) http://www.google.com/dirhp (Google Directory) http://dmoz.org (Open Directory Project/Directory Mozilla) http://vlib.org (WWW Virtual Library) http://bubl.ac.uk (BUBL Link, catalogue of Internet resources) Another option is to look through some menus, which are lists of choices. No WWW menu covers everything on the Web. The Google directory covers many topics, including medicine and related fields. Click first on ‘Health’, then on ‘Medicine’, and keep going until you find web pages with the information you are seeking. You can also try starting with at ‘Regional’ and then move through the menu to the country of interest and then, for example, for ‘Health’.

An alternative directory for the whole web is the Open Directory Project, which is also known as DMOZ (Directory Mozilla), due to its association with an open source browser initiative called the Mozilla project.

In addition, you should check out the general Web directories organised by academic groups. One of these is the WWW Virtual Library, in which responsibility for the subdirectories on specific topics is shared by universities around the world. Another is the BUBL directory, which is maintained by librarians in the UK. Both the WWW Virtual Library and the BUBL directory have become unfashionable with the advent of Google, and some of the entries are out-of-date. Nevertheless, you can find excellent, high-quality resources in both, so they are worth a visit.

Link sets and gateways http://www.healthnet.org/essential-links/index.html (Essential Health Links) http://www.mic.ki.se/Diseases/index.html (Biomedical links at Karolinska Institutet) http://lib.itg.be/biblinks.htm (Selected web links at ITM Library, Antwerp) The problem with most search engines and directories is that they are not quality controlled. There are exceptions, of course, such as the specialized search engines and academic directories mentioned above. But when you use a commercial search engine or directory such as Google, you should be aware that no one is checking the validity of the information provided at the sites. If you want more guidance from professionals in your field, an alternative is to find a gateway, that is, a managed set of links. The people running the gateway have found and evaluated Web sites on a specific topic, and those sites meeting certain standards have been included. Short descriptions are often provided, as well as the links. Gateways may cover a region, a specific topic, a certain type of resource, and so on. One important gateway in medicine and health is Essential Health Links at Health Net, which has already been mentioned several times. The site specializes in high-quality, materials relevant to low-income countries. Unfortunately, a growing number of the links are out-of-date, but the site is still worth visiting. The Biomedical Links at Karolinska Institutet Library in Sweden is also a very useful medical gateway. Scroll through the list to find the topic you are interested in, click, and you will get a long list of web resources in that area. Be sure also to look to the left on the Diseases and Disorders page. There you will find links to other parts of the gateway which provide links to medical images and clinical case studies. The library of the Tropical Medicine Institute in Antwerp, Belgium, maintains a long, comprehensive set of links relevant to international health, including links to sites on specific biomedical topics (tropical medicine, parasitic diseases, medical entomology, microbiology, infectious diseases, etc.) and to general resources, such as organisations, e-journals, online libraries, and so forth. When you use gateways, you often find more gateways. In other words, some of the sites you reach via the gateways also provide link sets. Likewise, when you go through menus, you almost always see items labeled ‘Web directories’. These are usually managed link sets or gateways. You can also find gateways on a specific topic by using the advanced search at Google. Type in both the topic you are interested in and something such as ‘Web resources’ or ‘WWW resources’ or ‘gateway’ or ‘links’ or ‘directories’.

Pathfinders and subject guides Pathfinders and subject guides are the third type of tool you can use to find materials on the Web. These are written documents, available online or in print form, that give guidance about how to locate and access different kinds of information resources. They are normally focused on a single sector or topic, such as agriculture, engineering, nursing, etc. The sourcebooks produced by INFORM are examples of pathfinders.

 Subject guides from university libraries http://www.healthlibrary.emory.edu/ http://www.mcgill.ca/library-assistance/subject/ http://www.lib.monash.edu.au/subjects/ Three library web sites offering subject guides are listed above. At Emory, click on subject guides from the menu. The addresses for McGill and Monash link directly to the subject guide web pages. However, these are just three examples among literally thousands. Most university libraries in the high-income countries and a growing number in lower-income countries provide guides to information resources on selected subjects. These guides may be labelled as ‘subject guides’ or ‘study guides’ or ‘pathfinders’. You can find subject guides by going first to a library web site and looking around on the library home page. (The earlier chapter of this sourcebook about finding references to books provides information about how to locate libraries.) Medical and health libraries are, of course, a logical place to look first. When you find a pathfinder at a university library, remember that some of the resources listed in it may be available only to people studying or teaching at that particular university. But a typical pathfinder also includes links to many online resources that are free to everyone.  Subject guides from other sources http://www.intute.ac.uk/subjectbooklets.html#hls (INTUTE subject guides) http://pdf.usaid.gov/pdf_docs/PNADM001.pdf (USAID guide on HIV resources) Pathfinders and subject guides can also be found outside of university libraries. One excellent set has been produced by INTUTE to help end-users find Web resources on selected topics. The topics covered include healthcare and medicine, pregnancy and childbirth, biological sciences, social research, education, and more. Some pathfinders are produced by national or international agencies, nongovernmental organisations, or academic consortia. One example, listed above, is the USAID guide to online resources regarding HIV.

Digital libraries http://infomine.ucr.edu (INFOMINE) http://www.intute.ac.uk (INTUTE) http://hso.info (Health Sciences Online) Both gateways and pathfinders will give you recommendations about valuable resources on the Web, and addresses for reaching them. You can access the materials in either case by clicking on the link or typing in the web address to reach the site where the resources are available. Digital libraries (also called virtual libraries or e-resource archives) are similar to gateways and pathfinders since they are based on expert evaluations of materials and contain links to selected materials.

However, these libraries offer the added convenience of search capabilities. In other words, you can search through the collection of recommended links to find those on particular topics.

One example of a digital library is INFOMINE from the University of California. This digital library covers an enormous number of Web resources relevant to university study and research. Among the items are databases, e-journals and e-books, OPACs, directories of researchers, and much more. Begin by clicking on ‘Biological, Agricultural, & Medical Sciences’ and then type in a search.

INTUTE at is another digital library providing access to the best WWW resources for research and teaching. The service is run by an academic network in the United Kingdom. The library currently includes over 118,000 records with links. Coverage is multidisciplinary, with health and life sciences being one of the four main categories. INTUTE provides many different search possibilities. You can work your way down within each of the main categories, or you can do a search at the home page. To give just one example, if you use the second approach and search for ‘midwifery’, you will get a list of 344 items. Many of these are likely to be familiar to midwives who use WWW, but some may be unknown gems.

HSO, which was launched late in 2008, is a collaborative effort of WHO, the World Bank, the World Medical Association, CDC, and other organizations concerned with health and medicine. The site has links to over 50,000 health information resources, including guidelines, courses, books, training modules, and other materials for clinical work, teaching, and research. To use the system, search within the HSO links, rather than with ‘All’. If you get no response when you visit the site via Internet Explorer, try going there with Mozilla Firefox.

Finding Information on Medicine and Health The importance of two mega-resources for medical information This sourcebook describes hundreds of web sites where information can be obtained about health and medicine. However, most of these sites are focused on single specific topics, such as health in humanitarian assistance, or human parasitology, or child nutrition, or malaria. Also, many of the sites only offer a single type of resource, such as e-books or clinical recommendations.

However, two web sites are mega-resources for medical and health information in English. These are the World Health Organization and the Department of Health and Human Services in the United States. Together these two sites provide a wealth of highquality, free, online materials, including bibliographic databases, full-text e-books, archived full-text journal articles and links to other full-text journal articles, reference works, videos and medical images, tutorial and training modules, statistical databases, clinical guidelines, and advice on research. Users who have been trying to find professional medical information only via Google will also benefit by visiting a few other sites specializing in such information. These sites are described in greater detail elsewhere in this sourcebook, but they are mentioned here again to emphasize their value as sources of high-quality information.

World Health Organization http://www.who.int The World Health Organization has responsibility for promoting public health around the world and produces a huge amount of information relevant to health in lower-income countries. If you are serious about finding good health information online, you should try to spend at least several hours investigating the WHO site and learning what is available in your particular field of interest.

 HINARI http://www.who.int/hinari As described earlier, WHO hosts HINARI, through which persons at eligible institutions can access and download full-text articles from thousands of journals, free of charge. HINARI also provides access to other resources that normally require subscription, such as major reference works.  Information about health by country and region http://www.who.int/about/structure/en/index.html http://www.who.int/about/regions/wpro/en/index.html http://www.wpro.who.int/ http://www.who.int/countries/vnm/en/ Visitors to the WHO site can access country information both by clicking on ‘About WHO’, which leads to information about the regional offices and then the specific countries within each WHO region, or by clicking on ‘Countries’. A selection of links to pages about WHO regions are given here.

 Information on specific health topics http://www.who.int/topics/en/ (Health topics menu) http://www.who.int/topics/avian_influenza/en/ http://www.who.int/topics/breastfeeding/en/ http://www.who.int/topics/cancer/en/ http://www.who.int/topics/child_health/en/ http://www.who.int/topics/environmental_health/en/ http://www.who.int/topics/family_planning/en/ http://www.who.int/topics/health_systems/en/ http://www.who.int/topics/hiv_aids/en/ http://www.who.int/topics/infectious_diseases/en/ http://www.who.int/topics/malaria/en/ http://www.who.int/topics/nutrition/en/ http://www.who.int/topics/pharmaceutical_products/en/ http://www.who.int/topics/reproductive_health/en/ http://www.who.int/topics/traditional_medicine/en/ http://www.who.int/topics/tropical_diseases/en/ WHO produces and provides a wealth of information materials on hundreds of health topics of international importance. These resources can be found by starting at the ‘Health topics’ menu at the first address given here. The other addresses are direct links to selected health topic pages, provided here to encourage exploration. It is impossible to know what will be available on any given topic. Explore thoroughly, clicking on every link and scrolling all the way to the bottom of every page. Note too that there are additional links in the menu to the left on many pages.

Be sure to check out everything under ‘Technical information’ and ‘Publications’ on each topic page. In most cases, you will need to click on a link labelled ‘More about’ and a link labelled ‘More publications’ in order to reach all the materials—which may include policy statements, e-books, e-journals, clinical guidelines, videos and images, tutorials, teaching modules, and health communication materials.  Publications http://www.who.int/publications/en/ (Publications page) http://www.who.int/whr/en/index.html (Current World Health Report) http://www.who.int/whr/previous/en/index.html (Archive of World Health Reports) http://www.who.int/classifications/icd/en/index.html (ICD) http://www.who.int/medicines/publications/pharmacopoeia/overview/en/index.html (International Pharmacopoeia) WHO is a major medical publisher and provides most of its publications online, free. These can be accessed through various routes, some of which have been described earlier in this sourcebook. The first address given above is to the Publications page itself. From this page it is possible to access free, online, downloadable versions of major WHO publications, including World Health Reports, International Classification of Diseases, and International Pharmacopoeia. Direct links to these three publications are given above. A link on the Publications page leads to the WHO library database (catalogue). As described earlier, about 18,000 free, full-text online publications can be accessed by doing searches in this catalogue and limiting the location of materials to online. Finally, remember that many publications can be found most easily by looking on the appropriate topic or programme page. In other words, to find publications about malaria, go to ‘Health topics’ and select ‘malaria’ or go to ‘Programmes and projects’ and select the Global Malaria Programme, the Roll Bank Malaria Partnership, and the Special Programme for Research and Training on Tropical Diseases (TDR).

TIP! WHO is much more than HINARI. The WHO web site provides a wealth of information on medicine and health.

 Statistical information http://www.who.int/research/en/ (Data and Statistics page) http://www.who.int/whosis/en/index.html (WHOSIS) http://www.who.int/infobase/report.aspx (Global InfoBase Online) http://www.who.int/globalatlas/ (Global Health Atlas) http://www.who.int/healthinfo/statistics/regions/en/index.html (Regional databases) http://www.wpro.who.int/information_sources/databases/ (WPRO statistics)

Member states collect and report health information to WHO annually, and these data are incorporated into several different WHO databases that are available free online. They can all be reached through the main page on ‘Data and statistics’; the first address given above is a direct link to this page. The three major statistical databases maintained by WHO provide different types of information. The WHO Statistical Information System (WHOSIS) is the place to look for country-based statistics on 70 core indicators, including mortality, morbidity, risk factors, service coverage, and health systems. The WHO Global InfoBase Online focuses on chronic diseases, as well as the risk factors associated with these diseases. The Global Health Atlas gives statistics on infectious diseases. These databases are constructed differently, so it takes a while to master all three. Take your time and follow the instructions on the page. The hardest to use is probably the Global Health Atlas, but its construction is similar to the software SPSS, so health professionals familiar with that software will feel right at home. Links to regional databases are also provided from the ‘Data and statistics’ page. Finally, at the bottom of the Data and statistics’ page, you can find links to yet other databases on specific diseases and health topics, including HIV, TB, diabetes, immunization, maternal and neonatal care, national health accounts, health workforce, burden of disease, causes of death, life expectancy, mortality, alcohol, nutrition, and more. If you work in any of these fields, don’t miss these statistical resources.  Programmes and projects http://www.who.int/making_pregnancy_safer/en/ (Making Pregnancy Safer) http://www.who.int/neglected_diseases/en/ (Neglected Tropical Diseases) http://www.who.int/immunization/en/ (Immunization) http://www.who.int/imci-mce/ (Integrated Management of Childhood Illness) http://www.who.int/hiv/en/ (HIV/AIDS) http://www.who.int/diseasecontrol_emergencies/en/ (Disease Control in Emergencies) WHO’s work is organised into programmes and projects, many of which are carried out in collaboration with other international agencies. These programmes and projects have their own pages at the WHO web site. It is worthwhile to visit those relevant to your professional interests, since they often provide materials other than those on the ‘Health topics’ pages. Direct links to a few selected programmes are provided here.

The Department of Health and Human Services, United States http://www.hhs.gov/ The other mega-resource for health information is the Department of Health and Human Services, probably the largest national health agency in the world. Although many DHHR activities and institutions are focused on the health of the American public, others are international in scope and also draw on international expertise. The department encompasses a dozen agencies, of which three are of special interest to health professionals in lower-income countries. These are the National Institutes of Health, the Centers for Disease Control & Prevention, and the Agency for Healthcare Research & Quality, all of which are described below.

ď&#x201A;ˇ National Institutes of Health http://www.nih.gov/icd/index.html (NIH portal page) One of the organisational divisions of the DHHR is the National Institutes of Health (NIH), which comprises 27 different institutes and centres. These can all be accessed via links at the address given above. The 27 institutes and centres carry out programmes on various diseases or handle special services within the NIH. They are listed below. If you are working in an area addressed by one of these institutions, you should take the time to visit the NIH portal, find the link to the relevant web site, and see what kind of free, online information is being offered there for health professionals.

National Cancer Institute (NCI) National Eye Institute (NEI) National Heart, Lung, and Blood Institute (NHLBI) National Human Genome Research Institute (NHGRI) National Institute on Aging (NIA) National Institute on Alcohol Abuse and Alcoholism (NIAAA) National Institute of Allergy and Infectious Diseases (NIAID) National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) National Institute of Biomedical Imaging and Bioengineering (NIBIB) National Institute of Child Health and Human Development (NICHD) National Institute on Deafness and Other Communication Disorders (NIDCD) National Institute of Dental and Craniofacial Research (NIDCR) National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) National Institute on Drug Abuse (NIDA) National Institute of Environmental Health Sciences (NIEHS) National Institute of General Medical Sciences (NIGMS) National Institute of Mental Health (NIMH) National Institute of Neurological Disorders and Stroke (NINDS) National Institute of Nursing Research (NINR) National Library of Medicine (NLM) Center for Information Technology (CIT) Center for Scientific Review (CSR) John E. Fogarty International Center for Advanced Study in the Health Sciences National Center for Complementary and Alternative Medicine (NCCAM) National Center on Minority Health and Health Disparities (NCMHD) National Center for Research Resources (NCRR) NIH Clinical Center (CC)

ď&#x201A;ˇ The National Library of Medicine http://www.nlm.nih.gov (NLM home page) http://www.pubmed.org (Medline/PubMed) http://www.ncbi.nlm.nih.gov/sites/entrez?db=nlmcatalog (NLM catalogue) http://www.ncbi.nlm.nih.gov/sites/entrez?db=books (Bookshelf) http://www.nlm.nih.gov/mesh/meshhome.html (MeSH) http://www.nlm.nih.gov/databases/ (List of NLM databases) http://medlineplus.gov/ (MedlinePlus) http://www.nlm.nih.gov/medlineplus/tutorial.html (Medical tutorials) http://www.nlm.nih.gov/medlineplus/surgeryvideos.html (Surgery videos) http://www.nlm.nih.gov/medlineplus/druginformation.html (Drug information) http://www.nlm.nih.gov/medlineplus/encyclopedia.html (Medical encyclopedia) http://www.nlm.nih.gov/medlineplus/mplusdictionary.html (Medical dictionary) http://www.nlm.nih.gov/medlineplus/healthtopics.html (Health topics) One of the NIH institutes is the National Library of Medicine, the largest medical library in the world. The NLM produces the Medline database of references to articles in medical journals and provides the PubMed interface for searching in that database. The NLM catalogue allows searches for books, journals, audiovisual materials, and grey literature owned by the library. A growing number of the items listed in the catalogue are available as free online full-text materials. To assist users of Medline, PubMed, and other NLM resources, the library also maintains MESH (Medical Subject Headings), a controlled vocabulary thesaurus. MESH consists of hierarchically arranged sets of terms. The system makes it possible to find references that may use different words for the same concepts. But this is just the beginning. The NLM offers dozens of databases. One of these is Bookshelf, through which users can read and/or download almost 100 major books on everything from biochemistry to public health priorities in low-income countries. Another useful NLM feature is MedlinePlus, which provides medical and health information for both patients and health practitioners. Among the materials accessible via MedlinePlus are 165 slideshow tutorials, hundreds of surgical videos, a medications database, a medical encyclopaedia, a medical dictionary, and expert opinion on 750 different health topics, most of which are of international relevance. TIP! Medline is great. But donâ&#x20AC;&#x2122;t miss the other professional information resources at the NLM.

 Fogarty International Center (FIC) http://www.fic.nih.gov/ (FIC home page) http://www.fic.nih.gov/programs/research_grants/index.htm (FIC research grants) http://www.fic.nih.gov/programs/training_grants/index.htm (FIC training grants) http://www.fic.nih.gov/funding/index.htm (Funding programmes summary) http://www.fic.nih.gov/funding/directory_fellowships.htm (Directory home page) http://www.fic.nih.gov/funding/globaldir06.html (Whole directory online) The Fogarty International Center is another NIH body that will be of interest to health professionals outside the United States who want to obtain research support or training fellowships in health. The site includes information about the Center’s own research grants and training grants plus a useful funding summary page with contact information and deadlines for all granting programmes. In addition, the FIC maintains an online directory of grant and fellowships available in global health from about 100 foundations and funding agencies around the world. On the directory home page you can look for grants aimed at a specific group (pre-doctoral, post-doctoral, health professionals, institutions). Alternatively, you can access the whole directory and scroll through the annotated listings.

 Centers for Disease Control and Prevention (CDC) http://www.cdc.gov (CDC home page) http://www.cdc.gov/malaria/ (Malaria page) http://www.cdc.gov/flu/avian/ (Avian flu page) http://www.cdc.gov/ncidod/sars/ (SARS page) http://www.cdc.gov/ncidod/EID/index.htm (Emerging Infectious Diseases journal) http://www.dpd.cdc.gov/dpdx/ (DPDx) The Centers for Disease Control and Prevention are also under DHHR but are separate from NIH. CDC is primarily known for its work on emerging infectious diseases but is actually involved with many others aspects of health. The CDC website refers to itself as being an ‘online source for credible health information’. This suggests that CDC’s role overlaps with that of NLM. However, most materials available at CDC are different from those at the NLM, so it is worth exploring.

At the CDC home page, information is made available by topic (diseases and conditions, emergency preparedness, environmental health, etc.) and by user group (researchers, public health professionals, healthcare providers, etc.) Try both routes. A click on ‘Diseases and conditions’ leads to a page that is somewhat misleading, since it only lists the diseases about which information is most often requested. To obtain the whole list of disease topics, go through the alphabetical listing. As you will discover, the topics that are covered are international in scope, so you can find information here about diseases such as malaria, avian flu, and SARS. Note also that CDC provides a free online journal entitled Emerging Infectious Diseases. DPDx is the CDC division dealing with diagnostic parasitology. DPDx is very hard to find, but a direct link is provided above. If you are involved in any aspect of learning, teaching, research, or clinical work regarding parasitology, this will be an extremely valuable resource for you. The site provides detailed life cycle diagrams, bench aids, microscopic photos, and more. The coverage is comprehensive and international.

 The Agency for Healthcare Research & Quality http://www.ahrq.gov (AHRQ home page) The AHRQ is not as well known internationally as NIH and CDC, but it has much to offer health professionals seeking online information about the value of interventions and technologies in health care. The agency works with research institutions, including medical universities, to evaluate different tools and methods for prevention, diagnosis, and treatment, and it also compiles evaluations from other sources. To access information at the AHRQ, go to the home page and begin by looking under ‘Clinical Information’. The menu has links to pages providing resources about evidence-based practice, outcomes and effectiveness, effective health care, technology assessments, and clinical practice guidelines. There is also a link to the National Guideline Clearinghouse, which has its own database of clinical guidelines that allows users to browse or search through guidelines and to compare different guidelines on the same topic. In addition, it is worthwhile checking what is available under the headings ‘Research Findings’ and ‘Quality and Patient Safety’.

And a few other especially valuable sites http://www.healthnet.org/essential-links/index.html (Essential Health Links) http://www.intute.ac.uk/healthandlifesciences/ (INTUTE section on health sciences) http://www.intute.ac.uk/supportdocs/healthcare.pdf (Guide to WWW health resources) http://www.emedicine.com (eMedicine) http://www.flyingpublisher.com/ (Amedeo)

Besides the two mega-resourcesâ&#x20AC;&#x201D;WHO and DHHSâ&#x20AC;&#x201D;literally thousands of Web sites providing access to online materials about health and medicine. Hundreds of these have already been introduced or are listed in later chapters of this sourcebook. Several deserve special mention here because they are especially rich sources.

An outstanding medical gateway is Essential Health Links at AED/Satellife, home of HealthNet. The gateway provides links to web sites with medical information resources that are free, high-quality, and relevant to developing country situations.

Perhaps the most useful digital library on health and medicine is the INTUTE section on health and life sciences. INTUTE also provides a pathfinder about finding online information about medicine and health.

For comprehensive clinical information that is evidence-based and constantly updated, the best place to go is probably eMedicine, which provides expert, refereed guidance on over 6500 diseases and conditions.

Flying Publisher maintains numerous many sites to clinicians and researchers in the health sciences, including Amedeo, FreeBooks4Doctors, FreeMedicalJournals, and GoldenLinks4Doctors.

Finding Information about Public Health Specialities Health professionals who have read the preceding chapters of this sourcebook and visited the sites listed in those chapters will already have a very good idea of where and how to find professional-quality information—not only journal articles and books, but also other types of materials provided through trustworthy gateways and digital libraries and on the major medical web sites. Regardless of your particular training and role and your topical interests, you will be able to find excellent materials by searching through these resources.

TIP! Remember to use the various routes into full-text articles and books, the five tools for finding web sites, and the mega-resources for medical information.

The purpose of this chapter is to point out some especially valuable ‘gems’ for some selected topics that are of particular public health interest in all lower-income countries. These include the main focus of the Child Health programme (reproductive and maternal health, child health, nutrition, infectious diseases), as well as other public health areas, including environmental health, essential drugs, gender-based violence and other gender aspects of health, public health in conflict and emergency situations, disabilities and rehabilitation, and social aspects of health.

Reproductive and maternal health, including pregnancy and delivery  World Health Organization http://www.who.int/reproductive-health/ (WHO reproductive health page) http://www.who.int/topics/maternal_health/en/ (WHO maternal health page) http://www.who.int/rhl/en/ (WHO Reproductive Health Library) http://www.who.int/rhl/access/en/index.html (RHL access information) http://www.who.int/making_pregnancy_safer/en/ (WHO Making Pregnancy Safer) http://www.who.int/making_pregnancy_safer/documents/ (MPS publications) WHO is one of the richest information sources regarding reproductive and maternal health. The addresses given above are good starting points for exploring. On the reproductive health page, don’t just look at the highlights. Most of the useful material is listed in the menu to the left under the heading ‘Health topics’ (which gives links to pages about specific subjects within reproductive health, such as adolescent sexuality, family planning, unsafe abortion, maternal and perinatal health, etc.) and the heading ‘Cross-cutting issues’ (which leads to pages about emergency situations, gender and human rights, mapping best practice, linkages between sexual health and HIV, etc.). The same instructions apply to the page on maternal health. Keep clicking! 79

Please note that the Reproductive Health Library (RHL) is not the same as the WHO reproductive health page. Nor is it the same as the Reproductive Health Gateway, which is described later. The RHL is described as an electronic review journal focused on reproductive and sexual health. This description is misleading. The Library is a collection of the most important documents that health professionals in developing countries need to improve reproductive health in those countries. Among the materials included in the RHL are full text of published articles from other journals, full text of Cochrane systematic reviews on relevant reproductive health topics, expert commentaries on those reviews, practical advice on implementing the findings of the reviews, effectiveness summaries on all interventions evaluated in the RHL, and a set of training videos on manual and surgical procedures. RHL is available free to eligible countries, both online and in the form of free CDs. For details about access, click on the given address.

WHO is one of the best sources for information about reproductive health, including maternal and child health

WHO has a department of Making Pregnancy Safer (MPS). From the home page address given above, click on ‘Do you want to know more?’ to reach links to information about the department, its mission, the priority countries, MPS work at the regional level, and IMPAC (Integrated Management of Pregnancy and Childbirth). Also on the MPS home page, click on ‘All publications’ to get a menu of over 50 valuable items. The menu includes a list by topic (continuum of care, emergency/crisis situations, managing complications, midwifery, monitoring and evaluation, policy and programme management, etc.), a list by type (clinical guidelines, field manuals, reports, monitoring guidelines, training manuals, etc.) and a complete list by title. Among the materials one can find here are practical guides on basic newborn resuscitation, care in normal birth, and kangaroo mother care, guides for doctors and midwives about managing complications in pregnancy and childbirth and managing newborn problems, midwifery training modules on managing eclampsia, incomplete abortion, postpartum haemorrhage, prolonged and obstructed labour, and much, much more.

 The INFO Project and the Reproductive Health Gateway http://www.infoforhealth.org/index.php http://www.infoforhealth.org/RHGateway/index.shtml The INFO Project at the Bloomberg School of Public Health at Johns Hopkins University is another major resource on family planning and reproductive health information. This site is a goldmine. It has everything—online training courses, searchable databases, photos and other images, communication materials for health promotion, links to relevant websites, and free books, journals, and articles. On the home page, click on the tabs at the top (products and services, databases, e-learning, networks and communities, knowledge management, browse topics, and search One Source) in order to get some overall orientation. Note that One Source incorporates six databases, including POPLINE; so if you search here, you don’t also need to search in POPLINE for grey literature. After you are oriented, scroll all the way down the home page and look through both the ‘hot topic collections’ and the ‘featured links’ list. The final item among the featured links is the Reproductive Health Gateway; the direct link is given above. This gateway allows you to do searches simultaneously in 140 different web sites with information about reproductive and sexual health. To see where you are searching and to get a list of live links, click on ‘list of sites’ to the right of the search bar.  INTUTE http://www.intute.ac.uk/ http://www.intute.ac.uk/healthandlifesciences/booklets/ INTUTE has hundreds of items related to reproductive and sexual health, as well as to pregnancy and childbirth. You can either carry out a search on the home page or browse through the section ‘Health and Life Sciences’. If you do the latter, be sure to look both in ‘Medicine’ and in ‘Nursing, Midwifery and Allied Health’. Note too that one of the INTUTE subject guides to internet resources is on the topic of pregnancy and childbirth.  Emedicine http://emedicine.medscape.com/ Emedicine provides constantly updated reviews on thousands of medical topics, including obstetrics and gynecology. If you click on that topic, you will get a menu that includes labour and delivery, complications during pregnancy, and obstetrical complications. If you are looking for information about pediatric conditions and diseases, you must go in by clicking first on pediatrics and then scrolling through the different categories. The review articles that make up Emedicine are available free-of-charge. If you want to be able to search within the database, you will need to register with Medscape. Registration is free.  Geneva Foundation for Medical Education and Research http://www.gfmer.ch/Guidelines/Obstetrics_gynecology_guidelines.php GFMER provides international collections of clinical guidelines and other practice recommendations on all aspects of gynaecology, obstetrics, and reproductive health, examples being family planning, sexually transmitted diseases, pregnancy, maternal infections, labour, delivery, neonatology, and postpartum care.

 Other sources on reproductive health http://www.reproline.jhu.edu/index.htm (ReproLine at Johns Hopkins University) http://www.reproductiverights.org/worldwide.html (Center for Reproductive Rights) http://www.engenderhealth.org/ (Engender Health) http://www.path.org/reproductive-health.php (PATH) http://www.rho.org/index.php (Pathfinder International) http://www.guttmacher.org/ (Alan Guttmacher Institute) http://www.ippf.org/en/ (International Planned Parenthood Federation)

Neonatal, infant, and child health Be sure to check out the reproductive health resources given above, since many of them have materials concerning neonatal care and even child health. In addition, however, you should take advantage of the following special resources focused specifically on child health and survival.  World Health Organization http://www.who.int/topics/child_health/en/ At WHO, one place to begin is the health topic page on child health. Be sure to click on all the links under both ‘Technical Information’ and ‘Publications’. The many resources found by following these links include information about Integrated Management of Child Illness, measurement of child mortality, the WHO programme on ‘Newborns, Infants, and Children’, the free, downloadable pocket book of hospital care for children, and much more.  UNICEF http://www.unicef.org (UNICEF) http://www.unicef.org/devpro/index.html (DevPro Resource Centre) http://www.childinfo.org/ (ChildInfo at UNICEF) UNICEF, the UN body responsible for the wellbeing of children, is another major resource. Click on ‘Publications’ to gain access to free, downloadable reports such as The State of the World’s Children 2008: Child Survival and Children and AIDS. Note that the main publications page only shows a few recent items. To get to a full list of documents, or to select documents by subject or region, use the menu in the upper lefthand corner. Among the topics are health, immunization, HIV/AIDS, and nutrition, as well as non-medical subjects such as children’s rights, education, and gender concerns. Two parts of the UNICEF site are rather difficult to find but have especially valuable information for public health professionals. One is the DevPro Resource Centre, which provides links to data and statistics, research resources, and materials by thematic areas. The other is ChildInfo, which supplies statistical information on child health and survival, child nutrition, newborn care, the millennium development goals, and many other aspects of both maternal and child health. This is also where you can find results from UNICEF Multiple Indicator Cluster Surveys (MICS). MICS that are available online typically include survey archives, data sets, and the final reports, sometimes in multiple languages.

TIP! At UNICEF, don’t miss the DevPro Resource Centre and ChildInfo.  CORE http://www.coregroup.org/ CORE is an international consortium focused on child health and nutrition. Its work is divided into six initiatives—one of which is the Child Survival and Health Network Program—and into eight working groups, including ones on IMCI, safe motherhood, malaria, HIV/AIDS, and other aspects of maternal and child health. Each working group page provides access to tools and links to relevant web sites.  US Coalition for Child Survival http://www.child-survival.org/index.php http://www.child-survival.org/downloads/publications/csbibliography.pdf At the coalition’s home page, click on ‘Resources’ in the top bar, then on ‘Download Center’ to get a list of free pdf documents, including ones on diarrheal diseases, malaria, measles, and breastfeeding, as well as an annotated bibliography on child survival.  Geneva Foundation for Medical Education and Research http://www.gfmer.ch/Guidelines/Obstetrics_gynecology_guidelines.php The GFMER clinical guidelines collection includes a large section on neonatal health. Among the many topics covered are handling newborns, Kangaroo care, neonatal feeding, hypoclycemia, jaundice, resuscitation, respiratory tract diseases, and much more. Also be sure to check under the heading ‘maternal and neonatal infections’.  Sources for infant feeding information http://www.who.int/nutrition/topics/infantfeeding/en/index.html (WHO infant feeding) http://www.waba.org.my/ (World Alliance for Breastfeeding Action) http://www.ibfan.org/site2005/Pages/index2.php?iui=1 (IBFAN) http://www.coregroup.org/working_groups/nutrition.cfm (CORE) http://www.linkagesproject.org/ (Linkages) The WHO infant feeding page links to resources such as the Global Strategy for Infant and Young Child Feeding and the International Code of Breast-milk Substitutes, as well as information about exclusive breastfeeding and complementary feeding.

WHO and many nongovernmental groups provide information about breastfeeding

WABA is the international umbrella organisation for groups promoting breastfeeding through research, policy formulation, and action. The WABA site is a major gateway into information resources on breastfeeding and other aspects of infant feeding. Be sure to click on ‘Resources’. International Baby Food Action Network (IBFAN) provides a huge collection of resources about the Nestlé Boycott and other actions to prevent the unethical marketing of breast-milk substitutes. The CORE working group on child nutrition has produced and collected a useful set of tools and resources on the subject. One of these, for example, is the technical reference materials produced by the Global Health Bureau at USAID to support the preparation of grants proposals within the areas of child survival and health. Another is a pathfinder called the ‘Nutrition Resource Guide’, a short but very useful annotated list of online resources on nutrition, including breastfeeding and child nutrition. The working group page also provides links to numerous other sites on child nutrition. Linkages is a worldwide programme aimed at improving feeding of infants and young children. The site provides access to training modules, technical reports, monitoring and evaluation devices, protocols, and much more. Click on ‘Tools’ and ‘Publications’ to find these information resources. Another feature of the Linkages site is its list of external links, which are divided into categories (breastfeeding sites, child survival sites, food and nutrition sites, maternal and neonatal health, etc.) and include short descriptions of each site. It is easy to miss this useful list. Click on ‘Links’ near the top of the page, above the main tabs.

Nutrition Finding information about nutrition is a challenge because the subject has roots not only in health, but also in biochemistry, agriculture, and behavioural sciences. The sites listed here are restricted to those covering nutrition in general, since infant and child nutrition resources have been covered above.  United Nations agencies http://www.who.int/topics/nutrition/en/ (WHO nutrition page) http://www.fao.org (Food and Agriculture Organization) http://www.infoforhealth.org/onesource.shtml (AGORA) WHO is a major source of information on nutrition, as it is on all public health topics. Begin with the nutrition page. Be sure to click on all the links under ‘Technical Information’, ‘Publications’, and ‘Statistics’. For a different perspective, another United Nations agency—the Food and Agriculture Organization—is a good place to look. Nutritional information can be found by looking through the topics and by browsing through the publications. Note that, as at WHO, many publications that are sold by FAO are also available as free downloads. Finally, end-users seeking nutritional information should remember that the FAO hosts AGORA, which is a sister programme to HINARI. The journals offered overlap somewhat with those provided via HINARI, but many are not included in HINARI. A few of the many subject categories are agriculture, biology, and food science and nutrition. Access to AGORA is, like access to HINARI, requires registration and a

username and password. Access arrangements must be handled by libraries. If your institution is not registered, and you need better access to nutrition journals, ask your librarian to send in the registration.  Literature sources http://www.pubmed.org (Medline/PubMed) http://www.ncbi.nlm.nih.gov/sites/entrez?db=nlmcatalog (NLM catalogue) http://www.who.int/publications/en/ (WHO publications page) http://agricola.nal.usda.gov/ In looking for nutritional information, don’t forget the major resources covered earlier in this sourcebook. Medline/Pubmed includes over 400,000 references matching a search for ‘nutrition’. The catalogue at NLM includes over 600 items about nutrition that can be accessed online in full text, and the WHO library (reachable via the publications page) provides over 750 such links.

Papaya, bananas, pineapple….fruit salad!

Another major source for literature references is Agricola at the National Agricultural Library (NAL) in the United States. Agricola is both a catalogue of books and other holdings at the NAL and a bibliographic database of references for journal articles, book chapters, and grey literature.  Other resources on nutrition http://www.nal.usda.gov/fnic/ (Food and Nutrition Information Center) http://www.cdc.gov/nccdphp/dnpa/nutrition/health_professionals/index.htm (Nutrition Resources for Health Pros) http://www.arborcom.com/ (Arbor Nutrition Guide) http://www.micronutrient.org/ (Micronutrient Inititative) The Food and Nutrition Information Center (FNIC) is part of the National Agriculture Library in the United States. It is similar in function to Medline Plus at the National Library of Medicine and provides information both for the general public and for professionals. Be sure to look not only through the major items on the home page, but also through the listings in the menu to the left labelled ‘Browse by Subject’. This is the route into professional information about nutrition, diet, food composition, food additives and supplements, as well as research tools, links to organisations, and more. The CDC page entitled ‘Nutrition Resources for Health Pros’ may also be helpful. Both the FNIC and the CDC page are very much oriented toward nutrition in the United States, but some of the resources are generic or have international relevance. 85

The Arbor Nutrition Guide is an independent gateway and digital library in Australia, providing links to organisations and resources on food, clinical nutrition, applied nutrition, and food science. The Micronutrient Initiative is an NGO supporting and promoting food fortification and supplementation programmes. It provides a links sets, as well as publications and other resources online.

Major infectious diseases The prevention and treatment of infectious diseases continues to be a major public health priority of most lower-income and tropical countries, including for health professionals working primarily with child health. Information about all of these diseases can be obtained from WHO. The health topics pages are usually better places to begin than the programme pages, but the TDR programme page is an important exception. In addition, many official and nongovernmental organisations and networks focus on individual diseases, such as malaria, TB, or HIV/AIDS. A sample of some sites to investigate is given below. (Many others can be found by going through medical gateways such as Essential Health Links and Biomedical Links or by searching in a digital library such as INTUTE.) At each site, be sure to explore thoroughly. The most valuable professional resources are not necessarily on the first page. For example, at the CDC viral hepatitis page, some of the best material is in the resource center for health professionals, and the link is in the bottom left-hand corner of the page.  Tropical diseases http://www.who.int/tdr/ (WHO TDR—infectious tropical diseases) http://www.who.int/neglected_diseases/en/ (WHO NTD—neglected tropical diseases) TDR is WHO’s special programme for research and training on tropical diseases and a major source of both information and financial support for work and study. NTD deals with neglected diseases in the tropics, including Buruli ulcer, Chagas disease, dengue haemorrhagic fever, dracunculiasis, fascioliasis, trypanosomiasis, leishmaniasis, leprosy, lymphatic filariasis, neglected zoonoses, onchocerciasis, schistosomiasis, soiltransmitted heminthiasis, trachoma, and yaws. WHO also has separate programme pages for each of these diseases, which can be reached through links at NTD, as well as pages listed under ‘Health topics’.  HIV/AIDS http://www.who.int/topics/hiv_infections/en/ (WHO HIV/AIDS page) http://www.who.int/hiv/topics/vct/en/index.html (WHO HIV testing and counselling) http://www.who.int/hiv/topics/en/index.html (WHO index of HIV topics with links) http://www.who.int/hiv/topics/mtct/en/index.html (WHO mother-to-child transmission) http://sis.nlm.nih.gov/hiv.html (HIV/AIDS information from NLM) WHO has dozens of pages with information and links to resources about HIV/AIDS. The index of HIV topics leads to other pages regarding AIDS medicines, antiretroviral therapy, essential prevention and care, HIV drug resistance, HIV surveillance and monitoring, paediatric HIV, and much more. The NLM site is a comprehensive gateway to information resources about HIV/AIDS prevention, treatment, and research.

 Tuberculosis http://www.who.int/topics/tuberculosis/en/ (WHO TB page) http://www.who.int/hiv/topics/tb/en/index.html (WHO TB and HIV) http://www.cdc.gov/tb/links.htm (CDC TB links)  Hepatitis http://www.who.int/topics/hepatitis/en/ (WHO hepatitis page) http://www.cdc.gov/hepatitis/index.htm (CDC viral hepatitis page)  Measles http://www.who.int/topics/measles/en/ (WHO measles page) http://www.cdc.gov/ncidod/Diseases/submenus/sub_measles.htm (CDC measles page)  Malaria http://www.who.int/topics/malaria/en/ (WHO malaria page) http://www.who.int/malaria/treatmentguidelines.html (WHO treatment guidelines) http://www.mimalaria.org/ (Multilateral Initiative on Malaria/MIM) http://www.nlm.nih.gov/mimcom/mimcomhomepage.html (MIM malaria resources) http://www.dpd.cdc.gov/dpdx/HTML/Para_Health.htm (DPDx parasite index) http://www.dpd.cdc.gov/dpdx/HTML/Malaria.htm (Comparison of malaria species) http://www.dpd.cdc.gov/dpdx/html/imagelibrary/malaria_il.htm (Malaria images) http://www.amanet-trust.org/ (AMANET) http://www.impact-malaria.com (Impact Malaria) http://www.malaria-world.com/ (Malaria World) http://www.rollbackmalaria.org/ (Roll Back Malaria) http://www.malaria.org/ (Malaria Foundation) http://www.scidev.net/en/health/malaria/ (SciDev resources about malaria)

Environmental health Environmental health is one of the most challenging aspects of public health in lowerincome countries. As the population of these countries have grown—often very rapidly—increasing demands have been put on the natural systems, resulting in deforestation, depletion of water resources, and erosion of land. Simultaneous development of industry and chemical-based agriculture have resulted in high levels of pollutants in the air and water. These factors contribute to global environmental problems—climate change, ozone depletion, land degradation, freshwater scarcity, ecosystem disruption—which endanger the well being of the whole planet. They also have serious implications, both short-term and long-term, for the health of the people, and children may be especially susceptible. 87

 WHO http://www.who.int/phe/health_topics/outdoorair_aqg/en/index.html (PHE) http://www.who.int/phe/publications/en/index.html (PHE publications) http://www.who.int/topics/environmental_health/en/ http://www.who.int/topics/water/en/ http://www.who.int/globalchange/en/index.html http://www.who.int/globalchange/ecosystems/en/ http://www.who.int/globalchange/climate/publications/en/index.html http://www.who.int/heli/en/index.html WHO has a major programme on public health and environment (PHE), which addresses issues such as UV radiation, air pollution, and water quality. PHE produces numerous publications on these and other environmental subjects. You can also access WHO information resources on environment by selecting ‘Health topics’ on the WHO home page and then clicking on the subject in which you are interested. There are numerous options, including environmental health in general, water, sanitation, air pollution, and so forth. For a global perspective, try the ‘Global Change’ pages at WHO, which provide information resources on worldwide environmental trends and also links to other sites, such as that of the Intergovernmental Panel on Climate Change. HELI; the Health and Environment Linkages Initiative, is another rich source. This programme is a joint effort of EHO and UNEP. The web site provides tools for collecting and analysing scientific data, as well as others for economic and impact assessment. The HELI home page also gives a list of priority risk areas, including vector-borne diseases, urban environments, water, toxic substances, and more. Clicking on any of these areas will take you to a web page that provides a directory of web resources on the topic, with links leading to a huge amount of information. United Nations Environment Programme http://www.unep.org/ UNEP is the major agency within the United Nations for environmental issues. On the home page, you can chose to watch multimedia presentations, link up with the news centre, investigate UNEP activities around the world, and post questions to experts. Near the bottom of the page is a drop-down menu for different thematic areas, including health and environment. To find professional information, the best choice is probably to select ‘Resources for…scientists’. On the page that comes up, select UNEP Scientific Centers and then keep clicking until you reach the unit you are interested in. This may take quite a few steps, but don’t give up.

Essential drugs and other pharmaceutical products Pharmaceutical products are a major weapon in the fight against disease and are consequently of interest not only to pharmacists, but also to clinicians. Excellent research-based information is available through the Web about essential drugs and other pharmaceutical products. Health professionals who can find this information effectively and efficiently can use it to save lives and reduce suffering.

 World Health Organization http://www.who.int/medicines http://www.who.int/topics/pharmaceutical_products/en/ http://www.who.int/topics/essential_medicines/en/ http://www.who.int/medicines/publications/essentialmedicines/en/ http://www.who.int/topics/drug_resistance/en/ Protecting drug quality, guaranteeing supplies of essential drugs, and preventing development of drug resistant micro-organisms are public health issues in every country, and WHO is very much involved in leading and coordinating these efforts. The materials available on the pages listed above are copious. As always, be sure to go through the pages carefully, especially the sections labelled ‘Technical Information’ and ‘Publications’. Most of the resources are somewhere else, reachable by clicking on ‘More about…..’ or ‘More publications’. Key pharmaceutical publications available from WHO include WHO Model Formulary, WHO Essential Medicine Library, WHO Model List of Essential Medicine, and International Pharmacopoeia.  Other official sources http://www.ncbi.nlm.nih.gov/sites/entrez?db=books (NLM Bookshelf) http://www.nlm.nih.gov/medlineplus/druginformation.html (NLM drug information) http://www.nlm.nih.gov/medlineplus/antibiotics.html (MedlinePlus antibiotics page) http://www.cdc.gov/drugresistance/ (CDC drug resistance page) http://www.guideline.gov (National Guidelines Clearinghouse) http://www.nelm.nhs.uk/ (National Electronic Library of Medicines) The NLM Bookshelf includes a book entitled Drug Class Reviews, which provides systematic reviews of the effectiveness of different classes of drugs. A drug information database, with basic information aimed largely at consumers, is provided as part of NLM’s MedlinePlus. MedlinePlus also has a page on antibiotics, including on drug resistance. More information about drug resistance can be obtained from the relevant CDC page. For evaluations of various drugs, you can go to the National Guideline Clearinghouse, find ‘Browse’ and click on ‘Treatment/Intervention’ and then ‘Chemicals and Drugs’. The UK National Electronic Library of Medicines has numerous useful links organised both alphabetically and by category. Some of these, for example, go to pharmacy reference materials at other sites.  Professional and commercial sites http://emedicine.medscape.com/ http://www.bnf.org/ http://www.rphworld.com http:/www.rxlist.com http://www.pharmacy.org/ http://www.emedicine.com http://www.fip.org Emedicine provides lists of drugs that can be used to treat various diseases and conditions. The articles in the pediatrics section gives recommended dosages for children if such information is available.

The British National Formulary (BNF) is an excellent online pharmaceutical reference for healthcare professionals. Although it is primarily designed for users in the UK, free access is also provided to lower-income countries. Registration is required but is free. You must have an IP number that shows you are in a lower-income country. RPhWorld at is a major gateway for pharmacists, providing a wide range of resources relevant to clinical practice. RXList, the Internet Drug Index, gives information about prescription drugs, including patient information materials. Pharmacy.org is the pharmacy gateway for the WWW Virtual Library. The International Pharmaceutical Federation provides statements and guidelines about various aspects of clinical pharmacy, and much more.

The Life-Saving Value of Pharmaceutical Information A doctor from a lower-income country was spending a year as a guest lecturer at a European university. One day she knocked on the door of an INFORM trainer at the university and pleaded for help. She explained that a colleague at home was seriously ill and was only expected to live a few more weeks. Could the trainer go online and see if new treatments were available that could save him? The doctor’s colleague had a chronic illness that, in itself, was not deadly since it could be controlled with medication. However, he had recently developed a second condition. “In our country,” the doctor explained, “having one or the other condition is not so serious. But if someone develops both, it can be a very serious matter, since the medications we know about for one are contraindicated for the other. If the conditions become severe, as they have for this man, there is nothing that can be done.” The trainer went online and within minutes found and printed out a list of medications that could be used in treating patients suffering from both conditions simultaneously.

The doctor read through the list, then stared at the trainer and then exclaimed: “My country is poor, and our people suffer and die because we are poor. We don’t have enough health facilities, or personnel, or medications. But, in this case, we’ve had the medications for 10 years. The people who died in my country during that time because they had these two diseases didn’t die because we are a poor country. They died because we in the health sector don’t know how to find this information.” Then she ran and faxed the list of medications to the hospital where her colleague was dying, and his life was saved.

Gender-based violence and other gender issues The health status of people, their risk of contracting certain diseases, and the access they have to health services is determined in part by their gender, by whether they are male or female. One role of public health is to address and deal with these possible genderbased inequalities within health. A specific aspect of gender and health is gender-based violence (GBV), primarily in the form of violence against women. This violence has implications for the abused women and their children, including those not yet born. GBV is a major public health problem all over the world, and many international agencies and nongovernmental organisations have campaigns to increase awareness of the problem and provide information about how it can be prevented. The following sites are good beginning points for collecting information resources about gender issues in health and, specifically, about genderbased violence. Most of the sites provide free downloadable reports, books, brochures, and communication materials.  World Health Organization http://www.who.int/topics/gender/en/ http://www.who.int/gender/violence/en/ http://www.who.int/gender/violence/who_multicountry_study/en/index.html  UNIFEM (United Nations Development Fund for Women) http://www.unifem.org/gender_issues/ http://www.unifem.org/campaigns/vaw/resources.php  Amnesty International http://www.amnesty.org/en/campaigns/stop-violence-against-women http://www.amnesty.org/en/library/info/ACT77/001/2004  Geneva Foundation for Medical Education and Research http://www.gfmer.ch/Guidelines/Obstetrics_gynecology_guidelines.php GFMER provides links to guidelines regarding preventing and treating violence against women and domestic violence. Click on ‘violence’ or the subcategories.  End Violence Against Women http://www.infoforhealth.org/endvaw/ The End Violence Against Women site, part of the INFO Project at Johns Hopkins University, provides a comprehensive collection of information and resources relevant to the international struggle to end gender-based violence. Special focus is placed on resources that deal with the effects of violence on women's reproductive health.  UN Family Population Fund (UNFPA) http://www.unfpa.org/publications/detail.cfm?ID=69&filterListType=3  Reproductive Health Response in Conflict http://www.rhrc.org/resources/index.cfm?sector=gbv  ELDIS http://www.eldis.org/go/topics/resource-guides/health-systems/gender 91

 Gender and Health Equity Network http://www2.ids.ac.uk/ghen/index.html

Public health in conflict and emergency situations Unfortunately, every country must be prepared for humanitarian crises, both natural ones and man-made ones such as wars and many environmental disasters. As part of the preparation, the medical community should be ready to take responsibility for public health during the emergency. Here are some useful addresses to get you started in finding information about humanitarian assistance. Many of these sites provide not only their own information, but also links to other sites providing other information.

 Relief Web http://www.reliefweb.int/ This site, which is maintained by the United Nations Office for Coordination of Humanitarian Affairs, is a major gateway providing links with individual agencies and organisations, news updates, archives of research papers, and much more. To find country-based information on humanitarian crises, just click on the regional links in the middle column and then select the country of interest. The page will be full of links to press releases and reports from various organisations and agencies regarding wars, disasters, and humanitarian crises in that country.  Voluntary Organisations in Cooperation in Emergencies http://www.ngovoice.org/ VOICE is a network of about 90 European nongovernmental organisations working with humanitarian assistance, and the site serves as a gateway to those NGOs.  One World Net http://www.oneworld.net  UN Office for Coordination of Humanitarian Affairs (OCHA) http://ochaonline.un.org/  UN Office of the High Commissioner for Human Rights (OHCHR) http://www.ohchr.org/EN/Pages/WelcomePage.aspx  Humanitarian Aid Office of the European Commission (ECHO) http://ec.europa.eu/echo/index_en.htm

 UN Refugee Agency http://www.unhcr.ch  Aid Workers Network http://www.aidworkers.net  The Sphere Project http://www.sphereproject.org  Overseas Development Institute http://www.odi.org.uk  Humanitarian Practice Network http://www.odihpn.org  Integrated Regional Information Networks (IRIN at OCHA) http://www.irinnews.org  Active Learning Network for Accountability and Performance http://www.alnap.org  United Nations Environmental Programme (UNEP) http://www.unep.org  US Committee for Refugees http://www.refugees.org/  Internal Displacement Monitoring Centre http://www.internal-displacement.org/  Reproductive Health Response in Conflict Consortium http://www.rhrc.org/resources/index.cfm?sector=gbv  ELDIS http://www.eldis.org/go/topics/resource-guides/conflict-and-security

Disabilities and rehabilitation In lower-income countries, where financial resources and skilled human resources are limited, the care and rehabilitation of persons (including children) who have been born with disabilities or have developed them due to disease or have been injured in accidents or disasters may be considered a low-priority for health services. Luckily, a growing number of countries are finding ways to help people with disabilities to lead full and healthy lives, including through the provision of rehabilitation services. Numerous online information resources are available to support health professionals working in this area; a selection is given below.

 Global-HELP http://www.global.help.org Global-HELP publishes e-books on cerebral palsy, clubfoot, spina bifida, orthopaedics, plastic surgery, wounds, and rehabilitation. Click on ‘Publications by title’ to get a full list. All the books can be downloaded free as pdf.  Source http://www.asksource.info/ Source is an international information support centre that works within the field of health and disability. Its primary function is collecting and disseminating information. They maintain a major international database of resources about disabilities.  World Health Organization http://www.who.int/nmh/en/ (NMH) http://www.who.int/violence_injury_prevention/en/index.html (VIP) http://www.who.int/disabilities/en/index.html (DAR) http://www.who.int/violence_injury_prevention/en/index.htm http://www.who.int/nmh/a5817/en/ http://www.who.int/disabilities/en/ http://www.who.int/topics/rehabilitation/en/ At WHO, issues related to rehabilitation and prevention of injuries are handled by the Department for Noncommunicable Diseases and Mental Health (NMH), especially the departmental unit VIP (Violence and Injury Prevention and Disability). Links on the VIP home page lead to specialized pages on a variety of topics, including injury-related disability and rehabilitation. The Disabilities and Rehabilitation Team (DAR) also has a web site, with information resources about medical care and rehabilitation, communitybased rehabilitation, assistive devices, and capacity building. In addition, there are several other relevant WHO pages, examples of which are given above.  International Society for Prosthetics and Orthotics http://www.ispo.ws/  The Open Rehabilitation Journal http://www.bentham.org/open/torehj/  Center for International Rehabilitation Research Information and Exchange http://cirrie.buffalo.edu/search/index.php

Social aspects of health Health has many aspects besides the purely biomedical ones. It is also affected by geography, community, housing, social context, policies, economics, cultural attitudes to age and gender, traditions, and family relationships.  Medline/PubMed http://www.pubmed.org In searching for information resources about the non-medical aspects of health, don’t forget Medline. The database now covers almost 5,000 journals, and these include an increasing number of journals focused on social aspects of health.

Social factors have important impacts on health.  Uppsala University Library http://www.uu.se While you are at Uppsala University, you can also look for articles about social issues in the databases subscribed to by the University Library. Good choices are Social Science Citation Index and Sociological Abstracts. You can also go online to the e-journals specializing on social topics. Check pages 4-14 of this sourcebook for instructions.  Free journal sites http://www.freemedicaljournals.com (FreeMedicalJournals) http://www.gfmer.ch/Medical_journals/Free_medical.php (GFMER) http://www.doaj.org (Directory of Open Access Journals) The first two sites listed above are gateways into free medical journals and have been introduced in earlier sections. At FreeMedicalJournals, click on the lists for family practice, psychology, addiction, and rehabilitation. At GFMER’s journal list, click on public health, psychology, substance abuse, family and rural medicine. The third address given above is for the Directory of Open Access Journals, which provides links to free journals from a full range of academic topics. The collection includes links to 54 journals in anthropology, 106 in psychology, 74 in sociology, 25 in gender studies, and 178 in the social sciences.  Guidelines at GFMER http://www.gfmer.ch Guidelines on many social aspects of health can also be found at GFMER. Click on the database for obstetrics and gynecology guidelines and then on violence, child abuse, and sexual abuse.  Grey literature at the INFO Project at Johns Hopkins http://www.infoforhealth.org/onesource.shtml The One Source database at the INFO Project covers much more than reproductive health. This is a good place to do searches for topics such as health seeking behaviour, behaviour change, violence against women, and interpersonal communication.

 Free database on child abuse and neglect http://www.nisc.com/frame/freeaccess-f.htm. A free database on child abuse and neglect is available from the National Information Services Corporation (NISC) in the United States through its search service, which is called BiblioLine. Using the database requires one-time registration, which is available at the address given above.  United Nations sources http://documents.un.org/ http://www.unhcr.ch/cgi-bin/texis/vtx/rsd http://unbisnet.un.org/ http://untreaty.un.org/ If you are working in an area of interest to the UN (child rights, human rights, refugees, etc.), you may need access to UN documents. Some of the places to look are listed above.  INTUTE http://www.intute.ac.uk The best general gateway for links to resources within the social sciences is probably INTUTE. You should definitely try this resource if you are looking for information about social aspects of health. Notice that the linkages even include resources about research methods in the social sciences, including the Research Methods Knowledge Base.

Finding Geographically Based Information Sometimes what you need is information about a particular country or region, such as national health policies, descriptions of health care systems, and statistics on diseases. The pages that follow give some examples of resources providing this kind of information.

General information by countries and regions There are many gateways providing links to Web sites on specific regions and the countries in those regions. You can use them to find different kinds of information—not just on health, but also on history, politics, economics, and society—and can access maps, photographs, news, and much more.  Library of Congress gateway and portals http://international.loc.gov/intldl/intldlhome.html (Global Gateway, LOC) The Library of Congress in the United States has a Global Gateway that covers all world regions and countries. Be sure to click both on ‘Portals to the World’ and on ‘Research Guides and Databases’, since these provide different resources.  NationsOnLine http://www.nationsonline.org/oneworld Yet another super-gateway is NationsOnLine. Click on ‘Africa’, then on the country you are interested in. When you get to the country page, be sure to scroll all the way to the bottom to see all the links that are provided.  Regional gateways http://www.healthnet.org/essential-links/ (Essential Health Links) http://www-sul.stanford.edu/depts/ssrg/africa/guide.html http://www.africa.upenn.edu/Home_Page/WWW_Links.html http://www.africa.upenn.edu//Home_Page/Country.html http://www.columbia.edu/cu/lweb/indiv/africa/cuvl/index.html http://www.columbia.edu/cu/lweb/indiv/africa/cuvl/health.html http://coombs.anu.edu.au/WWWVL-AsianStudies.html (Australia National University) http://digicoll.library.wisc.edu/PAIR/ (University of Wisconsin) http://www.library.ucla.edu/libraries/eastasian/e_asia.htm (University of California) http://www.columbia.edu/cu/lweb/indiv/southasia/cuvl/ (Columbia University) http://lib.nmsu.edu/subject/bord/ (New Mexico State University) http://www1.lanic.utexas.edu/ (University of Texas at Austin)

One way to find regional gateways is to go to the Essential Health Links gateway, which is listed first above. The remaining addresses are to various gateways to regional information for Africa, Asia, and Latin America. Many of the best gateways of this sort are based at universities having strong regional study programmes. All of these are organized so that you can browse by topics, including health, or by country. Don’t make the mistake of only looking at information about your own region of the world. There are sure to be health professionals in other parts of the world who are facing the same problems and challenges as you are.  World Wide Web Virtual Library http://vlib.org/Regional (Regional Studies links at VLIB) The WWW Virtual Library includes a section on regional studies. Each section is maintained by a different university specializing in that part of the world. Some of the link sets are quite old and out-of-date, but sometimes you find great links that you have missed elsewhere.  International development gateways http://www.reliefweb.int (Relief Web) http://www.elids.org (Eldis) http://www.developmentgateway.org (Development Gateway) Other good bets are gateways dealing with international development. At Relief Web, for example, you can find information by looking for ‘See all countries….’ and clicking on one of the regions listed. Then select the country of interest. When you get the country page, you will find information about various sectors, including health. Be sure to look also under ‘Background Information’, and click on ‘AlertNet Country Profile’. When you get to the AlertNet page for the country, click on ‘show’ next to the various sectors in order to reach statistical information, official reports, and much more. Other possible sources include Eldis and the Development Gateway.  Other gateways via Google http://www.google.com/dirhp You can find other regional and country gateways on your own via the Google Directory. To find information about regions, click on ‘Regional’, then on the region (Asia, for example) and then on ‘Guides and Directories’. To find information about a specific country, click on ‘Regional’, the region of interest, then the country, and finally on ‘Guides and Directories’.  Demographic and social statistics and resources http://unstats.un.org/unsd/demographic/products/indwm/wwpub.htm (UN Statistics) http://mdgs.un.org/unsd/mdg/default.aspx (UN Millennium Indicators) http://www.childinfo.org/ (UNICEF statistics on children and women) http://popindex.princeton.edu (Population Index) These sites are especially focused on statistical information related to development issues, particularly on population and social indicators.

Health information by countries and regions As noted above, the general gateways into world regions often have special sections on health. If you are looking for regionally-based health information, you should check these out. In addition, however, you should not miss the resources listed below.  World Health Organization http://www.who.int/research/en/ (WHO data and statistics page) http://www.who.int/countries/en/ (WHO country page) http://www.searo.who.int/ (SEARO home page) http://www.wpro.who.int/ (WPRO home page) For health information by country, WHO is a good starting point. For statistical information, start with ‘Data and statistics’. The resources here have been described earlier, in the chapter on finding information about medicine and health. For other geographically-based information, go to the WHO country page and select from the list. The country pages give information about the national WHO office, basic demographic statistics, disease outbreaks, mortality and burden of disease, risk factors, health service coverage, and health systems. Another source is the regional WHO offices, all of which can be reached through the WHO site by clicking on ‘About WHO’ and then on ‘People and offices’. Direct links are provided here to two such offices—SEARO (South-East Asian Region) and WPRO (Western Pacific Region). WPRO provides an impressive array of health information by country and region. Click on ‘Countries and areas’ to reach the page that provides the country health information profiles (CHIPS), which are available not only for the countries within the Western Pacific Region, but also for those within the South-East Asian Region. Click on the name of the country to go to a country page that provides a ‘country context’ document. Links to the left on each country page lead to detailed information on health systems, health situation and trends, and other topics.  Other general resources for regional health information http://www.measuredhs.com/ (DHS—demographic and health surveys) http://www.globalhealth.gov/ (Global Health at US Health and Human Services) http://www.whc.ki.se/index.php (World Health Chart) DHS is one of the best known and trusted sources of independent statistical information on health and other social indicators. Global Health at Health and Human Services is primarily oriented toward aspects of international health that have a potential impact on health in the US. However, the site does provide some useful information and links on international health by region and by topic. The World Health Chart, which has been developed by WHO and various Swedish institutions, shows changes in international health over time, including relative health status of different world regions.

Yearbooks by subscription on regions and countries Some of the best information resources about countries and regions are books. Examples are the yearbooks produced by special reference publishers and sold both in print form and as online e-books. Regardless of the format, these yearbooks are expensive, so they are not something you are likely to purchase individually. However, you should check if they or similar reference works about countries and regions are available in the reference room of a local university library. An example of these references is the Europa World series, which includes the World Year Book and nine regional surveys covering the whole earth. A typical regional publication includes the following:  General chapters by experts on the region, covering geography, politics, history, economy, environment, health, and other sectors.  Country chapters providing detailed national information on the same topics.  A regional directory and national directories, giving names and full contact information for international and national organisations and institutions in all major sectors (education, government, trade and industry, politics, research, etc.)  Regional and national calendars  Select bibliography of books, journals, and articles on the region and countries

Regional and national journals online http://www.inasp.info http://www.ajol.info http://www.bangljol.info http://www.nepjo.info http://www.sljol.info http://www.philjol.info http://www.vjol.info Journals published in Africa and in several Asian countries are now available online thanks to various programmes aimed at increasing awareness and use of these publications. All the materials included at the sites are free to view, although full-text articles cannot always be accessed online. These activities have been promoted by the British organisation INASP. Links to the various databases can be found at the INASP web site at the first address given above. Click on ‘Project Finder’ and select a project from the drop-down menu. Then click on ‘Go to project’. At the moment, the listing includes African Journals Online, Bangladesh Journals Online, Nepal Journals Online, Sri Lanka Journals Online, Philippines Journals Online, and Vietnam Journals Online.

Maps and news  Maps http://www.google.com/dirhp (Google directory) http://maps.google.com/maps?hl=en&tab=dl (Google map function) http://go.hrw.com/atlas/norm_htm/world.htm (Holt Rinehart Winston maps http://encarta.msn.com/encnet/features/mapcenter/map.aspx (Encarta maps) http://www.embassyworld.com/maps/maps.html (Embassy World maps) http://geography.about.com/library/maps/blindex.htm (About.com maps)

100

If you are after maps of a country, you can find sources via the Google Directory, by clicking on ‘Reference’, then ‘Maps’, and then ‘Regional’. Google also has its own Map function; the direct link is provided above. A selection of other map sites are given here. Remember that many general of geographical information also have maps.  Newspapers and other news media http://www.google.com/dirhp http://www.abyznewslinks.com/ To get into news sources such as newspapers via the Google Directory, click on ‘News’ and then ‘By Region’. Alternatively, try ‘News’, then ‘Newspapers’, and then ‘Regional’. ABYZ News Links is a wonderful gateway for newspapers and other news media around the world. Click on the relevant region to get started.

Language tools http://www.google.com (Google) http://www.google.com/language_tools?hl=EN (Google language tools) Sometimes language is a barrier to using information from another region of the world. A growing number of online tools are helping to reduce this problem. One of the best sites is the Google language tools page, where you can paste or type in text and have it translated free from one language to another. The page also has a feature that translates whole web pages. And the service is completely free. Fantastic!

Thanks to online translators and other language tools, you can read and understand online materials in other languages.

101

Finding Information for Decision-Making You are probably aware that the international community is putting increased emphasis on the importance of applying research evidence to decision making in health and medicine. Doctors, midwives, nurses, and other health personnel are urged to apply relevant evidence in making decisions about clinical care, and international agencies, ministries of health, and professional organisations use relevant evidence to create guidelines for policy formulation and decision-making in health services and health care. The phrase ‘evidence-based’ is perhaps the most commonly used description for decision-making based on research evidence—evidence-based medicine, evidence-based nursing, evidence-based midwifery, and so forth—and EBM (evidence-based medicine) has become the accepted general term for the entire enterprise. EBM is the practice of medicine based on integration of clinical experience with evidence from research. It is aimed at providing the best care for patients with the available resources, by assuring that methods used for preventing, diagnosing, and treating diseases are ones that research has shown are effective. In some parts of the world, EBM has been erroneously perceived as being a system that promotes only sophisticated, costly, and high-tech procedures. This misconception has resulted in claims that EBM is not relevant for lower-income countries. This makes no sense. EBM is about making most rational use of available resources (medications, equipment, human resources, etc.) to provide the best care. It is relevant to every health system in the world. The expression ‘EBM literature’ is also a source of confusion. When people say they are looking for EBM literature, they can mean any of these things:  Tutorials, books, and other resources that will teach them about what EBM is and how they can practice it.  Specific journal articles and other research publications to support clinical decisions about individual patients.  Review articles, meta-analyses, systematic reviews, consensus statements, clinical guidelines, recommendations, and other resources based on the original research literature. The amount of EBM material reachable via WWW is overwhelming. If you do a Google search for evidence based medicine, you get over 9 million hits. The following pages will help you get an overview of this immense body of resources.

EBM gateways http://www.healthnet.org/essential-links/index.html (Essential Health Links) http://www.urmc.rochester.edu/hslt/miner/digital_library/evidence_based_resources.cfm (Nesbit Guide to Evidence Based Resources, Miner Library) http://www.welch.jhu.edu/internet/ebr.html (Evidence Based Medicine web links, Welch Library)

102

Essential Health Links includes a section on EBM, with links to databases, journals, search engines, centres, and other EBM resources. Even more comprehensive are some of the EBM link sets maintained by medical libraries. Addresses for two outstanding EBM gateways at medical libraries are given here.

Major EBM centres http://www.cebm.net/ (Centre for Evidence-Based Medicine, Oxford) www.shef.ac.uk/~scharr/ir/netting/ (Netting the Evidence) www.york.ac.uk/inst/crd/ (Centre for Reviews and Dissemination) http://hiru.mcmaster.ca/hiru/HIRU_McMaster_HKR.aspx (The McMaster Health Knowledge Refinery; click on sub-topic from menu) http://www.cebm.utoronto.ca/ (Centre of Evidence-Based Medicine, Toronto) http://www.cche.net (Centre for Health Evidence) http://www.ebmny.org/ (Evidence-Based Medicine Resource Center, New York) Links to selected EBM centres are listed above. It should be emphasized that the list given here is not comprehensive. Readers wanting to find more EBM centres are advised to make use of the EBM gateways. The centres differ in what they have to offer. Examples of what you can find are links to other EBM centres and organisations, online EBM articles, EBM conference and course information, practice guidelines and recommendations, journals with focus on EBM, information about methodological filters for finding EBM research papers, tools for evaluating research, glossaries of EBM terminology, review databases, tutorials, teaching materials, EBM search engines, and more.

Weighing the evidence has become important in all health sector activities.

Resources for learning and teaching EBM  EBM bibliography http://www.ebmny.org/ebmbib.html Bibliographies are a useful tool for getting a ‘feel’ for the literature in any field. A bibliography about EBM is available online from the Evidence-based Medicine Resource Center maintained by the New York Academy of Medicine Library and the New York Chapter of the American College of Physicians.

103

 Journal articles series http://www.bmj.com/collections/read.dtl (How to Read a Paper series) http://www.cche.net/usersguides/main.asp (Centre for Health Evidence tutorials) Perhaps the most famous set of articles on EBM is the series by Trisha Greenhalgh, first published in the British Medical Journal, on ‘How to Read a Paper’. The whole set is available online, free, from BMJ. Also noteworthy is the series of articles published in the Journal of the American Medical Association (JAMA). The Centre for Health Evidence provides the basic text free online as ‘Users’ Guides to Evidence-Based Practice’.  Library based tutorials http://www.hsl.unc.edu/services/tutorials/ebm/welcome.htm http://www.uic.edu/depts/lib/lhsp/resources/ebm.shtml http://www.library.usyd.edu.au/subjects/medicine/tutorials/ebmtut/index.html http://www.lib.mcg.edu/guides/ebmguide.php A growing number of medical and health libraries are producing their own guides to EBM. Examples can be found at the library sites shown above.  Books and other resources http://www.usersguides.org/textbooks.asp (AMA User Guides) http://www.cebm.utoronto.ca (Centre for Evidence-Based Medicine) The full versions of the guides published as article in JAMA are sold by the AMA as a book under the title Users’ Guides to the Medical Literature: A Manual for EvidenceBased Clinical Practice. The Centre for Evidence-Based Medicine in Toronto, Canada, has also produced a book on EBM entitled Evidence Based medicine: How to practice and teach EBM, which can be purchased from their web site. In addition, the CEBM provides online syllabi for EBM teaching units, based on materials from the book, including critical appraisal worksheets, teaching tips, and a PowerPoint presentation on teaching EBM in developing countries.

EBM literature  The original journal articles http://www.pubmed.org If you make use of one of the EBM tutorials listed above, you will learn about using original research to guide decision-making in clinical situations. In most cases this means going online into Medline/PubMed to find references to relevant articles. (If you are doing clinical work in nursing, midwifery, or another health specialty, you might find the references in another bibliographic database, such as CINAHL.) The tutorials will help you learn how to word your searches to find the articles providing evidence on the clinical question you are trying to answer. In Medline/PubMed, you can also take advantage of several special features to identify the most useful research reports. One possibility is to click on ‘Limits’ and then narrow the search under ‘Type of article’ to clinical trials or randomized controlled trials. Another possibility is to click on ‘Clinical queries’ from the menu to the left on the Medline/PubMed home page, and then to select a search by clinical study category (diagnosis, therapy, etc.).

104

 Meta-analyses and reviews http://www.pubmed.org Using Medline and other bibliographic databases, it is also possible to find articles that do not report original research but either re-analyse or review published research. Metaanalysis articles are ones in which data from original studies, which may not have involved large sample sizes, are compiled and subjected to new analysis. Review articles usually summarize what has been published about a particular topic during a certain period. Good reviews also draw conclusions, identify methodological issues, and point to areas requiring more research. Both meta-analyses and reviews can be found in Medline using ‘Type of article’ choices on the Limits page.

Health professionals in many countries have free or pre-paid access to Cochrane reviews, BMJ’s Clinical Evidence, and many EBM journals.  EBM journals Journals specializing in EBM and related topics continue to grow in number. These journals review articles in selected journals and report findings that are considered by the reviewers to be scientifically sound and of significant clinical interest. Examples of EBM journals includes Bandolier, Bailliere's Best Practice & Research journals, ACP Journal Club: Evidence Based Medicine for Better Patient Care, Clinical Evidence, Evidence-Based Nursing, Evidence-Based Mental Health, Evidence-Based Cardiovascular Medicine, Evidence-Based Healthcare and Public Health,, EvidenceBased Obstetrics and Gynecology, and Evidence-Based Practice. Note that many of these journals are available via HINARI.  Systematic reviews http://www.pubmed.org http://www3.interscience.wiley.com/cgi-bin/mrwhome/106568753/HOME (Cochrane Library) http://www.who.int/hinari (Cochrane Reviews via HINARI) http://www.clinicalevidence.com (BMJ Clinical Evidence) http://www.who.int/hinari (BMJ Clinical Evidence) Systematic reviews are different from normal review articles. Systematic reviews are normally carried out by a committee of experts who review journal articles (and other resources such as clinical trials databases) to determine what the research indicates about the validity or effectiveness of preventive, diagnostic, or treatment methods.

105

One way to search for systemic reviews is via Medline/PubMed. Go to the PubMed site, click on ‘clinical queries’, scroll down on the new page to ‘Find Systematic Reviews’, type in your search term or phrase, and click on ‘Go’. Systematic reviews are a well-known part of the EBM literature primarily because of the systematic reviews produced through the Cochrane Collaboration. The Cochrane Collaboration is named in honour of Professor Archibald Cochrane, a British medical researcher who made important contributions to epidemiology and to the promotion of evidence-based medicine. The Collaboration arranges systematic reviews of health care interventions and publishes the results in the Cochrane Library as the Cochrane Database of Systematic Reviews. If your institution has a stable IP number, you can just go directly to the Cochrane web site and click to see if you can reach the full-text reviews. Alternatively, if your institution is registered with HINARI, you can go to the HINARI home page, log in, and then, on the resource page, look through the items listed as ‘Reference Sources’ and select ‘Cochrane Library’. Regardless of how you get there, when you reach the Cochrane Library site, look near the top of the page and find ‘Browse Cochrane Reviews’. Then select either ‘By Topic’ or ‘By Review Group’. Both the list by topic and the list by review group include both protocols and reviews. The protocols are descriptions of reviews that the group will be carrying out. Naturally, they do not include any conclusions. The reviews, which are listed after the protocols, explain how each system review was carried out, list the sources were examined, and draw conclusions. The review group members may state that the evidence indicates that a particular technique for diagnosis, prevention, or treatment is effective or ineffective, or they may state that the evidence is insufficient to draw any conclusion. The summaries of all the reviews are available free to everyone. The full text is free to institutions in many lower-income countries and is subscribed to by many Swedish universities. In addition, the Cochrane Library is included in the resources provided to Swedish health care personnel via EiRA. (See page 7 for details.) The Cochrane Library includes much more than the database of systematic reviews. Browse around the page and see what’s available. There is a database of reviews carried out by other organisations, a register of controlled clinical trails, a register on method studies, and a database on economic evaluations. BMJ has also gathered and evaluated information about clinical interventions and made it available at a site called ‘Clinical Evidence’. Access is supposed to be free of cost in low-income countries. One access route is direct, the other via HINARI. The systematic reviews at Clinical Evidence are different from those at Cochrane, since they often present recommendations on handling certain clinical problems, rather than focusing on the effectiveness of single measures. One set of systematic reviews available at Clinical Evidence deals with managing HIV/AIDS in resource-poor settings. Among the topics covered are managing TB in people with HIV, treatment and prevention of invasive fungal diseases, antiretroviral treatment regimens, prevention of mother-to-child transmission of HIV, and many more.

106

 Consensus and best-practice statements, clinical guidelines, recommendations http://www.ahrq.gov (AHRQ) http://www.guideline.gov (National Guideline Clearinghouse) http://www.nice.org.uk/ (NICE) http://www.emedicine.com (e-Medicine) Evidence from the research literature is sometimes translated into consensus statements and best-practice statements, clinical guidelines, recommendations, and policies issued by international agencies, health ministries and departments, professionals organisations, NGOs, and other entities. A large collection of guidelines and evaluations of impact is available through the Agency for Healthcare Research and Quality, which includes the National Guideline Clearinghouse, both of which have been mentioned earlier. AHRQ itself carries out its own evaluations of interventions and technologies, often in collaboration with medical universities and other research institutes. The Clearinghouse provides a database in which guidelines can be searched and also compared. In the UK, the National Institute for Health and Clinical Excellence (NICE) draws on a large evidence base to provide guidance to medical professionals about how to promote good health and prevent and treat illness. E-medicine calls itself the ‘continually updated clinical reference’. It provides up-todate, peer-reviewed articles summarizing the state-of-the-art for specific conditions and evaluating diagnostic and treatment options for each. This is an amazing resource. It currently offers reviews on over 6500 topics. To access the reviews, select a major heading—medicine, surgery, or pediatrics—and then a specialty. When you reach the speciality page, you will get a list of articles, organised for easy browsing.  Guidelines and recommendations in reproductive health http://www.gfmer.ch/Guidelines/Obstetrics_gynecology_guidelines.php (The GFMER guideline collection on obstetrics, gynaecology, and neonatal health) http://www.gfmer.ch/TMCAM/TMCAM_guidelines.php (The GFMER guideline collection on traditional, complementary, and alternative medicine) http://www.who.int/rhl/en/ (WHO Reproductive Health Library) The Geneva Foundation for Medical Education and Research provides detailed lists of guidelines from many international sources on most aspects of reproductive, maternal, and neonatal health. It also has an excellent gateway for guidelines and recommendations regarding traditional and alternative medicine. The WHO Reproductive Health Library includes Cochrane reviews and other evidencebased evaluation within the area of reproductive health and perinatology. The Library includes many full-text Cochrane reviews within the area of reproductive health and perinatology, together with independent expert commentaries, a complete list of evaluated interventions classified by the degree of their effectiveness, a set of training videos on many and surgical procedures, and other valuable materials. The Library can be ordered as a free CD and can be accessed online. Be sure to click on all the menu items and to scroll all the way to the bottom of each page to avoid missing important resources. For example, the links to the RHL videos are at the bottom of the RHL home page. Among these are videos on management of the third stage of labour, on vacuum extraction, and on Caesarean section.

107

Finding Information for Teaching Teachers in the health sector need information resources that will both save them time and improve the quality of their teaching. There is no reason to re-invent the wheel— that is, to create something that already exists and is available online, copyright free, and free. Examples of such resources include whole curricula, PowerPoint presentations, online tutorials, teaching modules, and visual materials.

In teaching, there’s no reason to re-invent the wheel.

Degree programme curricula http://www.nyu.edu/mph/academics/ http://www.hsph.harvard.edu/academics/master-of-public-health-program/program/ Institutions that are planning to establish new degree-granting programmes do not need to ‘re-invent the wheel’. Detailed information about such programmes at other institutions is available online, free of charge. Typical descriptions include the admissions requirements, the programme schedule, the courses offered, and possible concentrations. Two examples of Master of Public Health programmes are given here.

Courseware, modules, tutorials Similarly, materials are available that can be used in teaching specific courses in all areas of medicine and health. These materials include course plans, lecture notes, PowerPoint presentations, and much more. A few routes into these valuable resources are detailed below.  Open courseware http://www.ocwconsortium.org http://ocw.jhsph.edu/ The easiest course resources to use are Open Courseware, which are clearly marked as being provided under an open license, which means that they can be used and adapted freely. The Open Courseware movement is growing rapidly, and many universities are participating. The faculty at these universities contribute a wide range of materials, typically including a summary of each course, the schedule, the reading list, lecture notes, and presentations, often in the form of PowerPoints.

108

To find courseware, go to the OCW home page and click on ‘Use’ to get a list of links to participating institutions. For course materials on public health, the best Open Courseware site is probably Johns Hopkins University’s Bloomberg School of Public Health. A direct link is given above. Topics include maternal and child health, population science, global health, public health, infectious diseases, and much more. Within each topic you will find a series of lectures, complete with PowerPoint slides and recommended readings.  The Supercourse http://www.pitt.edu/~super1/ The Supercourse is another place to find lecture presentations on health topics. The 3500 lectures are grouped by topic into epidemiology, diseases, and public health. Some presentations are in html format, to watch online. Others can be downloaded and saved as PowerPoint pdfs. Be aware that the quality of the lectures varies a great deal. If you use materials from this site, scrutinize them carefully.  Learning modules from BMJ http://learning.bmj.com/learning/channels/international/subscribe.html#Devel BMJ offers online learning modules for professionals. These modules normally cost money but are free to users in low-income countries. To obtain more information, scroll to the bottom of the page. The learning modules can be used by teachers to update their knowledge and to get ideas about how to teach a particular topic. Teachers can also consider having their own students sign up for the online modules.  MedlinePlus tutorials http://www.nlm.nih.gov/medlineplus/tutorial.html Through MedlinePlus, the National Library of Medicine offers over 165 online tutorials about diseases and conditions, tests and diagnostic procedures, and surgical and other treatments. The tutorials are aimed at patients, but they can also be used as instructional material at the introductory level of professional training.  Teaching modules from WHO http://www.who.int http://www.who.int/making_pregnancy_safer/documents/midwifery_training/en/ http://www.who.int/reproductive-health/stis/training.htm http://uic.edu/sph/glakes/who_modules/ http://who.arvkit.net/sw/en/index.jsp WHO has teaching materials available on most topics. These can be found by looking through health topics, as well as programmes and projects. Alternatively, click on ‘search’ in the upper right-hand corner of the WHO home page. On the next page, click on ‘Advanced search’. Type the topic of interest in the top search space and ‘training modules’. Other searches, such as for ‘teaching materials’ or ‘toolkit’, are also worthwhile. Direct links to selected online WHO training modules are provided above.  Course files from GFMER http://www.gfmer.ch Click on ‘English’, then on ‘Education’ in the top bar. On the new page, scroll down until you see courses (primarily in reproductive health) and look for the course files. Click on one, then scroll down until you get the titles of the lectures. Click to get the slides. The readings and other links are provided to the right of each lecture title.

109

Visual materials  Medical images http://www.healthnet.org/essential-links/index.html (Essential Health Links) http://www.mic.ki.se/Medimages.html (Images section of KI Biomedical links) http://www.vts.intute.ac.uk/tutorial/imagesearching/ (INTUTE tutorial) http://phil.cdc.gov/phil/home.asp (Public Health Image Library, CDC) http://www.infoforhealth.org/index.php (INFO Project, Johns Hopkins) http://www.bioscience.heacademy.ac.uk/imagebank (ImageBank) http://www.biologyimagelibrary.com/ (BioMed Central image library http://www.dpd.cdc.gov/dpdx/HTML/Image_Library.htm DPDx image library) For many teachers in the health sector, finding suitable images is one of the most frustrating aspects of preparing lectures. Sites providing images can be found via Google, but the images found through this route are often for sale or are not of professional quality. A better approach is to look at professional sites. These can be found by looking in major medical gateways, such as Essential Health Links and the KI Biomedical Links. The advantage of the KI site is that it is possible to browse for images on specific topics. INTUTE provides a useful tutorial to image searching. The tutorial includes a tour of major image sites, as well as advice about quality and legal implications. For public health images, a good source is the Public Health Image Library maintained by CDC. Another is the INFO Project at Johns Hopkins University. An excellent image bank in the biosciences is ImageBank. This is the place to go when you are looking for photos of organisms, for example. The BioMed Central image library is also a good source. One of the best places for photos of parasites is the DPDx image library.  Videos http://www.nlm.nih.gov/medlineplus/surgeryvideos.html (NLM surgical videos) http://www.who.int/rhl/videos/en/index.html (WHO reproductive health videos) http://www.who.int/surgery/publications/training_videos/en/ (WHO surgery videos) The MedlinePlus section of the National Library of Medicine provides free access to hundreds of videos on various surgical procedures. The videos cannot be downloaded but can be viewed online. Other videos are available through WHO, examples being the videos that are part of the WHO Reproductive Health Library and those on surgical procedures. All these can be found using the search function at the WHO home page.  Clip art and animations Microsoft provides a collection of clip art with its word processing and office software. Using this collection is very easy. When you are working in Word and want to insert a picture in the document, go to the toll bar at the top of the page and click on ‘Insert’ and then on ‘Picture’. A small menu will appear to the right, with the top option being ‘Clip Art’. When you click on ‘Clip Art’, a search space will appear to the right of the document. You may either search for a clip using the search bar or click on the link marked ‘Organize clips’ in the bottom side corner to reach the Clip Organizer. Once at the Clip Organizer you can browse through the available clips.

110

Either way, when you find what you want, right click with the mouse and click on ‘Insert’, and the clip art will be inserted into the Word text. You can then format it, including making it a different size if you wish. Exactly the same technique can be used to insert a piece of clip art in a PowerPoint slide. Note that, if you insert an animation into a PowerPoint slide, it will seem static. When you run the show, however, it will ‘come to life’. The clips that are provided with your software are limited. If you want something that is not in the collection, you can go to the Micrsoft Clips Online site and see if the image you want is available. The link to Clips Online also comes up automatically when you select ‘Insert’, ‘Picture’ and ‘Clip Art’. When you reach the site, you first should carry out a search for images matching a particular search term. After the results come up, you can then choose to limit them just to clip art or just photographs or just animations. Scroll through the results, clicking on the square in front of the images you want. When you are done, click on download and follow the instructions. The images will be added to your clip organizer under ‘Downloaded Clips’. You can move each clip to an appropriate sub-folder, and you can set up new sub-folders as necessary.  Screen prints Sometimes the best way to teach about something is to save a picture of a specific Web page and insert it into a Word document or a PowerPoint slide. You can also add circles, arrows, and other devices to the picture to emphasize points you want to make. Begin by opening the Paint program on your computer. You reach this by clicking on Start, Programe, Accessories, and then Paint. Reduce the window but do not close it. Now open Internet Explorer or another web browser program. Go to the site where you want to ‘take a picture’. When the screen you want to save is visible, press the Print Screen button. This will be in different locations on different keyboards. If you have a keyboard in which the Prnt Scrn is shown in blue, you will need to hold down the Fn button in blue at the same time. Note that you will not see anything happen when you press the button. Now click on the reduced Paint window. When it comes up, click on ‘Edit’ and then ‘Paste’, and the Web screen you have selected will be pasted in. It is possible to move the image around by moving the mouse while holding down the left mouse button. At this point, you can add circles, arrows, and text using regular Paint feature. When you are finished, save a copy. Do this in the same way you would save a Word document, but save the file in My Pictures and set up a folder marked Screen Prints. . When you want to use one of the screen dumps in a PowerPoint presentation, click on ‘Insert’, ‘Picture’, ‘From File’, then select the screen print you want, and then click on ‘Insert’.

111

Finding Information for Research and Projects If at some time in your career you become involved with research activities, you will certainly benefit from information resources that support the research process. Such information resources may also be relevant to your professional work in general, either now or in the future. The sites described in this chapter will help you in finding documents providing guidance about:  Research designs and methods  Questionnaires and other instruments  Research protocols  Registration of clinical trials  Research and publication ethics  Scientific writing and research reporting  Funding and grant proposals

Research designs and methods  Medline/PubMed http://www.pubmed.org One of the best places to learn about research designs and methods is in published journal articles, which you can find through the routes described earlier in this sourcebook, including via Medline/PubMed. Authors must describe how they carried out their research, including the designs they used (for example, a case-control study or a longitudinal study) and the specific methods they used for collecting and analysing the data (interviews, surveys, content analysis, specific statistical tests, etc.). Therefore, if you read the literature about research in your particular area of interest, you will find a great deal of information about the research designs and methods that are being used by other researchers working on the same topic. You should also look for review papers on your topic, since these often discuss issues regarding designs and methods. You can find the review papers by going to ‘Limits’ at Medline/PubMed and selecting reviews under ‘Type of Publications’. Finally, if you are interested in learning more about a certain design or method, try searching for articles about that design or method. If, for example, you have heard about grounded theory and think this might be a technique applicable to your research, you can go into Medline/PubMed and search for the phrase “grounded theory”.

112

 BUBL http://www.bubl.ac.uk/index.html The BUBL directory is old-fashioned and somewhat out-of-date. Nevertheless, it includes links to numerous valuable academic resources about research. Go to the address given above, click on ‘Subject menus’ and then on ‘Research’. In the new menu, explore the general resources, those on research methods, and—if you are doing quantitative work—those on statistical methods.  INTUTE http://www.intute.ac.uk The INTUTE digital library is full of resources about research design and methods. You can find these by browsing or by using the search function. Begin by going to the INTUTE home page and carrying out a series of searches, for research design, research designs, research method, research methods, and so forth. You will find hundreds of resources, some of which are sure to be relevant for your own research. If you wish, you can restrict your search so that only items in the health and life sciences division of the digital library are retrieved. Remember, however, that many research methods used in the health and medical sciences come from mathematics or the social sciences.  Research Methods Knowledge Base http://www.socialresearchmethods.net/kb/contents.php If you are looking for a single site that gives an authoritative introduction to research designs and methods, this is it. To enter the textbook, click on ‘Table of Contents’ in the menu to the left and then move through the text by clicking on the links to the various sections. Just about everything you might want to learn about research is covered here: philosophy and ethics of research, sampling, measurement, design, analysis, and design, plus chapters on about a hundred specific topics within research. This is a fabulous resource—not just for research, but also for teaching about research. If you want to use it in teaching, you can do so free of charge, but you need to contact the author. Details are given at the Knowledge Base web site.  BMJ publications on research http://www.bmj.com/collections/statsbk/index.dtl (Statistics at Square One) http://www.bmj.com/collections/epidem/epid.dtl (Epidemiology for the Uninitiated) http://www.bmj.com/collections/read.dtl (How to Read a Paper) BMJ has published three books about research design and data analysis in health and medicine, all three being based on series of BMJ articles. They are Statistics at Square One, Epidemiology for the Uninitiated, and How to Read a Paper. The content of the first two is self-evident. The third work, How to Read a Paper, is a guide to understanding articles based on different types of medical research—clinical trials, qualitative studies, and so forth. It is also an excellent introduction for researchers considering these various approaches for their own research projects.  CCHE Users’ Guide to Qualitative Research in Health Care http://www.cche.net/usersguides/qualitative.asp The Centre for Health Care Evidence in Canada provides an online guide to qualitative research on this topic. Like the How to Read a Paper series, the main purpose of this document is to help readers interpret research articles. However, researchers planning qualitative research on health care will find it useful in designing their own studies.

113

 International Development Research Centre (IDRC) http://www.idrc.ca/ To find research books at IDRC, go to the homepage. Click on ‘Publications’, then ‘IDRC Books’, and then ‘All our books’. The books are shown on three pages, which can be scrolled through quickly. Click on a title to get more information about the contents and to order the book (for money) or download it (for free). Three examples of IDRC books providing guidance on research are given below. Note that the book on qualitative research for tobacco control described designs and methods that are relevant to qualitative research on any health topic. Qualitative Research for Tobacco Control: A How-to Introductory Manual for Researchers and Development Practitioners. Designing and Conducting Health Systems Research Projects Volume 1. Proposal Development and Fieldwork. Designing and Conducting Health Systems Research Projects Volume 2. Data Analyses and Report Writing.  The World Bank http://www.worldbank.org The World Bank is another source for research guides. Go to the home page, click on ‘Publications’, and then on ‘Documents and Reports’. You can browse by topic or carry out a search. Alternatively, click on ‘Data and Research’, then ‘Research’, then ‘Research Programs’, and a topic of interest. Once you reach a topic page, look for ‘Publications’, and ‘Survey and Analysis Tools’. The results are impressive. For example, the Living Standards Measurement Study alone provides nine online books and guides to research design.  Health Research System Analysis http://www.tropika.net/svc/specials/hrsa-toolkit/pages/background The Health Research System Analysis (HRSA) initiative is a major collaborative programme to promote benchmarking and system analysis. The initiative is headed by WHO and involves many international organisations concerned with research, including the Alliance for Health Policy and Systems Research, the Council on Health Research for Development, the Global Development Network, the Global Forum for Health Research, and more. The HRSA has developed a research toolkit that can be accessed through TopIKA Net. It is not obvious how to reach the various parts of the toolkit. Read each section, and wherever there is a place to click, click.  Canadian Health Research Foundation http://www.chsrf.ca/home_e.php The CHRF has a very user-friendly website that focuses on bridging the gap between research and management. For this reason, the materials provided at the site cover a wider range than just research. Be sure to click both on ‘Resources’ and on ‘Tools’.  Ethiopian Science and Technology Commission http://www.estc.gov.et/Health%20Research%20Methods%20Module.pdf The Health Department of the Ethiopian Science and Technology Commission, in collaboration with the Ethiopian Public Health Association and Regional State Health Bureaus, has produced a training module on health research methods, which is available online as a free full-text document online.

114

 Search for Common Ground (SCG) http://www.sfcg.org/programmes/ilr/proj.pdf If you are doing projects rather than research, you will want to read about acceptable project models. Logical framework and results framework approach are two models commonly required by potential funders. A free online guide to online resources about these and other models is available from SCG. The materials listed have been produced by a variety of funders and organisations and include such works as these: Guide for Designing Results-Oriented Projects Project Cycle Management Manual Logic Model Development Guide The Logframe Handbook TIPS: Building a Results Framework Participatory Rural Appraisal

TIP! In looking for research guidance, check the professional sources first, including the two mega-resources. If you don’t find what you need, then try Google.

 Google and Open Directory/DMOZ http://www.google.com/Top/Science/Social_Sciences/Methodology/ http://www.dmoz.org/Science/Social_Sciences/Methodology/ If the resources listed in this section don’t give you what you need, try using search engines or looking in a general menu such as the Google Directory or the Open Directory/DMOZ. Direct links to the sections about research methods are given here.

Questionnaires and other instruments  Finding existing questionnaires and instruments http://www.who.int (WHO) http://www.emro.who.int/cah/surveys.htm (Child and Adolescent Health survey forms) http://www.biomedcentral.com/1472-6963/7/72/additional/ (Article with questionnaire) http://www.pubmed.org (Medline/PubMed) http://www.who.int/hinari (Access to CINAHL) http://www.lib.uiowa.edu/Hardin/hapi.html (Hardin Library list of instruments) http://aramis.stanford.edu/HAQ.html (Health Assessment Questionnaire) http://surveynet.essex.ac.uk (Survey Resources Network) Designing and testing a questionnaire can be difficult and time-consuming. Using questionnaires that have already been validated and employed in previous studies may be a better idea. The problem, of course, is obtaining free copies of such questionnaires. One of the best sources for free questionnaires on health topics is WHO. Go to the home page and carry out a search in the search bar in the upper right-hand corner. Try several different terms and phrases, such as questionnaire, questionnaires, survey, survey

115

instruments, etc. You might also try using the advanced search to look for questionnaires on specific topics. The regional offices of WHO are also a potential source. For example, various versions of a survey instrument with questions about treatment of children at outpatient clinics are available free online via the EMRO office. Scroll down at the address given above and find the links marked ‘forms’.

You can find questionnaires online, as well as advice about developing your own. If a questionnaire has been designed by a researcher or research group and used as the basis for a published piece of research, you may be able to obtain a copy free of charge by contacting the authors. Contact information is always provided in the article and today normally includes an email. When you write, explain who you are, what you are studying, and ask for a copy of the instrument and permission to use it in your research. In some cases, you can find the questionnaire, in its entirety, included in a published paper. Sometimes it is not in the main paper but is nevertheless available online. The BioMed Central address above provides an example—an article in which the questionnaire is available as an additional file. You can look for articles about research based on questionnaires and other instruments at Medline/PubMed by typing in the appropriate search (questionnaire, research instrument, interview instrument, survey instrument, or the name of a specific instrument). A search for questionnaire yields almost 280,000 hits. One for research instrument yields over 27,000 references, including 1500 review articles. A search for quality of life AND research instrument yields over 3000 references, including about 300 reviews. Research instruments should be valid, and some research is aimed specifically at validation. You can find articles reporting such research via Medline/PubMed. Type in the search term (questionnaire, for example), then click on ‘Limits’, and on the Limits page click on ‘Validation studies’ at the bottom of the ‘Type of Article’ drop-down menu. This particular search yields about 6700 references. Searching for instruments is also possible in the database CINAHL, which is accessible to researchers in HINARI countries. On the search page, select advanced search. On the new page, find ‘Publication Type’ and use the drop-down menu to select ‘research instrument’ or ‘questionnaire/scale’. A search for research instrument yields 106 references; one for questionnaire/scale yields over 15,000 hits. These can be focused by adding a specific search term or phrase, such as coping or pain or quality of life. A list of over 100 questionnaires and other research instruments that were already described in the CINAHL database in 2004 is available at the Hardin Library page given above. In many cases, the article indexed in the database provides the full text of the instrument.

116

University sites are another possibility. Full text of the Health Assessment Questionnaire can be downloaded from the Stanford University address given above. And the Survey Resources Network provides access to dozens of questionnaires, as well as lists of survey questions for research in the social sciences and related areas such as health. Unfortunately, some questionnaires must be paid for. This is the case if the instrument has been produced and published by a company or organisation, which holds the copyright and only allows use of sold copies. If you manage to obtain a ‘pirate’ copy of a copyrighted questionnaire and use it in your research, you can eventually run into trouble when you try to publish the work.  Designing your own questionnaires http://www.worldbank.org/ (World Bank) http://student.bmj.com/back_issues/0601/education/187.html (Student guide) http://www.bmj.com/cgi/content/full/328/7451/1312?ecoll (Hands-on guide, 1) http://www.bmj.com/cgi/content/full/328/7452/1372?ecoll (Hands-on guide, 2) If you want to develop your own questionnaire, advice is available from many sources, including the general sites on research design and methods given earlier in this chapter. The World Bank has published hundreds of documents about designing questionnaires and survey instruments, including ones specifically for work in developing countries. To find these, go to the World Bank home page, click on ‘Publications’ and ‘Documents and Reports’, and then carry out a search for questionnaires. Other guidance about developing questionnaires is provided in articles published by BMJ. The links are given above. The first is meant as an introduction for students and covers the wording of individual questions, formats of responses, arranging questions, the administration, piloting, and evaluation of questionnaires. The other resource is the Hands-on Guide to Questionnaire Research by Petra Boynton and Trisha Greenhalgh. The guide consists of two papers, one on selecting, designing, and developing questionnaires and one on administering, analysing, and reporting questionnaires.

Research protocols http://www.who.int/rpc/research_ethics/guidelines/en/index.html http://www.uclh.nhs.uk/Researchers/Information+for+investigators/Protocol+writing+g uide.htm (University College London Hospital guides to protocol writing) It is a mistake to imagine that the process of writing about a research study begins after the research has been done. In fact, researchers must describe their planned studies in writing well before they are begun. The descriptions, which are called research protocols, are needed for various purposes. They must be included when the research is submitted for ethical clearance, for funding, and for approval by research councils and academic institutions. For this reason, guidelines for preparation of research protocols can be found at many Web sites regarding research. An example, given above, is the web page on guidelines and resources with the WHO programme for Research Policy and Cooperation.

117

The University College London Hospital in the UK has produced two guides specifically about preparing protocols for clinical trials and observational studies. The guide on clinical trials provides information about what needs to be included in the protocol, including a description of the study design, subject selection and recruitment, sample size calculation, trial interventions, randomization, measures to avoid bias, data collection, and statistical analysis. Links and references are also provided, leading to more detailed information and guidance on specific aspects of the protocol.

TIP! Writing about a research study should begin well before the study itself, with the production of a research protocol.

Registration of clinical trials http://icmje.org/clin_trialup.htm In 2004, the members of the International Committee of Medical Journal Editors issued a statement promoting registration of all clinical trials. The statement said that a paper reporting on a clinical trial would only be considered for publication if the trial had been registered before the first patient was enrolled. Since then the ICMJE has issued several updates on trial registration. The address given above leads to the most recent update. Links to earlier updates and the original statement on clinical trial registration can be found in the menu under ICMJE Editorials.

TIP! If you are planning a clinical trial and want to publish the results, be sure the trial is registered before you enroll the first patient.

Research and publication ethics http://www.publicationsethics.org (Committee on Publication Ethics) http://www.wame.org (World Association of Medical Editors) http://www.blackwellpublishing.com/Publicationethics/ (Blackwell guidelines) http://www.icmje.org/sponsor.htm (ICMJE Sponsorship, Authorship, Accountability) http://www.who.int/rpc/research_ethics/guidelines/en/index.html (WHO RPC) http://www.who.int/ethics/research/en/ (WHO Ethics and Health) http://www.sherpa.ac.uk (SHERPA, including Romeo and Juliet)

118

Research involves many ethical considerations, both in the research itself and in the publication of the research results. The Committee on Publication Ethics (COPE) has an interesting web site covering many aspects of this subject. Although COPE materials are primarily aimed at journal publishers and editors, some items will be of interest to researchers. Just one example is a document on how to handle authorship disputes. To reach this guide, look at the menu to the left on the COPE home page, and find ‘Resources’ and then ‘Guidelines’. The World Association of Medical Editors site is similarly focused on providing guidance for editors, but the material here provides an excellent introduction for researchers wanting to learn about research ethics. The WAME Publication Ethics Policies for Medical Journals can be found by clicking on ‘resources’. The policies and recommendations cover many topics of relevance to researchers, including study design, authorship issues, conflicts of interest, peer review, editorial decisions, originality and prior publication, and plagiarism and allegations of possible misconduct. Blackwell Publishing provides best practice guidelines on publication ethics, which are available online at Blackwell own site. This document, like those described above, is intended primarily for editors, but most topics are also of concern to researchers. A few examples include transparency, research misconduct, protecting rights of research participants/subject, redundant publication, and protecting intellectual property The International Committee of Medical Journal Editors has also produced a statement regarding sponsorship, authorship, and accountability, which covers many of the same topics. It can be accessed at the ICMJE web address given above. Certain WHO programmes are good places to look for advice and guidance about research ethics. For example, at the page for RPC (Research Policy and Cooperation), you will find information about seeking informed consent. Many other resources on ethical standards and procedures for research involving human beings are provided under the WHO Programme on Ethics and Health. The guidelines include both WHO’s own and ones developed by other bodies, such as the Council for International Organizations of Medical Sciences and the World Medical Association. When researchers successfully complete and publish research, they must deal with yet another set of ethical issues regarding copyright, intellectual property rights, and dissemination of the research results. Once a paper is published, is the publisher the only source for copies of the paper? Can individual readers only access the paper through institutional or personal subscription or through access programmes such as HINARI? Or are there other ways in which the information can be disseminated? Can the authors post a copy of the paper on their own home pages or deposit a copy in an open-access archive? Are they obligated to do so? A site called SHERPA in the United Kingdom will help researchers answer these questions. One of the resources available at SHERPA is ROMEO, a database regarding publishers’ policies on copyright and self-archiving. Another resource is the database JULIET, which provides similar policy information about the archiving policies and requirements of research funders.

119

Finding Information for Grant Seeking

Funding and grant proposals Many people working in the health sector of low-income countries eventually seek funding to support health delivery, clinical improvements, research projects, development of new educational programmes, or some other aspect of their work. Looking for grants is a complicated matter. Finding relevant information first can make the process easier and increase the chances that a grant proposal will be funded. One problem is that there are so many different types of funders, which have different purposes and different required procedures for grant seekers. This chapter therefore begins with an overview of the various categories of funders. Other parts of the chapter provide guidance about funding strategies and preparation of letters of inquiry and grant proposals, as well as tips about where to find relevant online resources.

The first rule of funding: You seldom get funding unless you ask for it.

A typology of funders and foundations Funders can be classified according to where they get their funding, how and where they give grants, and how involved they are in the work they support. The following categories are neither exclusive nor exhaustive. In other words, an individual funder may fit into more than one ‘box’, and there are more categories than are listed here. The European Foundation Centre has a typology table of foundations in Europe that includes 15 different types, many of them not even included here.  United Nations agencies The United Nations is large and complex, with many agencies and programmes. Examples include the World Health Organization (WHO), UNICEF, International Labor Organization (ILO), United Nations Population Fund (UNFPA), and the United Nations Development Fund for Women (UNIFEM). These bodies are often called ‘multilateral’, since they receive money from many countries. In turn, they often make their own grants, usually to the governments of low-income countries and sometimes to nongovernmental organisations.

120

 Development banks These international banks are best known for their loans to governments and their involvement in economic policies. The International Development Banks include the World Bank Group, the Asian Development Bank, the African Development Bank, and regional development banks. Although these banks work primarily with governments, they also disperse grants to NGOs.  ODAs (Official Development Agencies) The primary ODAs (official development assistance agencies or just official development agencies) are institutions such as Sida in Sweden, DFID in the United Kingdom, and USAID in the US. These ODAs channel part of their countries’ international development budgets to the governments of poorer countries, as well as to organisations working on international issues. Such support is called ‘bilateral’ aid, and the countries giving the funding are often referred to as ‘bilateral donors’. Donor countries typically select certain ‘partner’ countries to receive bilateral aid. It should be noted that the ODAs frequently change their funding priorities in response to political pressure, feedback from recipient countries, and evaluations of the effectiveness of current funding schemes. A few ODAs are multilateral, such as the OECD’s Development Assistance Committee. The European Union is another multilateral funding source. The EU grant system is so complicated that writing proposals (and handling reports if a grant is received) requires special training, and even European universities now have special offices to handle EU proposal and grants.  Corporate giving programmes Many companies spend a portion of their profits on programmes to benefit the communities or countries where they have a presence. Corporate foundations exist in many varieties; some focus on a single community, and others have a global scope.  Private foundations Private foundations are grounded on the personal wealth of an individual or family, with grants being made according to the founder’s original interests and those of the current board of trustees. These organisations are a huge source of funding, especially in the US, where the tax system encourages creation of foundations. At the moment there are about 80,000 private foundations in the US.  Public foundations Public foundations receive their funding from a variety of sources, not just the wealth of a single family. They often rely heavily on fund-raising campaigns to collect money, which they then distribute to selected good causes. Community foundations, a subset of public foundations, limit their grants to a specific geographic site, either a single town or city or a somewhat wider region.  Operating foundations Some private foundations are classified as ‘operating’ or ‘operational’. Such foundations use their funds to carry out activities themselves, rather than giving grants to other organisations.

121

You can find many funding resources online.  International foundations A few foundations are based in one country but channel all or most of their funding to international causes; these are commonly referred to as international foundations. Examples are the Bernard van Leer Foundation in the Netherlands, the Soros Network of Foundations based in the United States, the Aga Khan Foundation in Switzerland, and so forth.  International NGOs and charities Some organisations have a legal basis in one country—often a developed one—but collect money all over the world and spend it on programmes in the developing regions. These are often referred to as being international NGOs or charities. Examples are CARE and Save the Children.  Charities and trusts In the UK, as well as some Commonwealth countries, the term ‘foundation’ has no legal meaning. Instead, private or corporate funds can be placed into charitable trusts to be used for philanthropic purposes. Associations and nongovernmental organisations that collect money and use them for their own activities are referred to as charitable organisations or just charities.  501(c)3s In the United States, nonprofit organisations and institutions can apply to the Internal Revenue Service (IRS) for tax-exempt status. There are many types of entities that qualify, such as churches, universities, nongovernmental organisations, and foundation, and different types are characterized according to the applicable section of the IRS code internal revenues. Many foundations that give away money are 501(c)3s, but so also are the organisations to which they give the money.

Restrictions on grant seekers All funders set limits on their grant-giving, the most obvious being restrictions to specific programme topics and to specific countries. However, there are always other types of restrictions, and these come in a bewildering array.

122

There is no way to predict what policies a funding agency or foundation board have in place, and it can take a long time to sort through all the details about what a specific funder will and will not fund. Thus a funder may allow or limit grants to:  Organisations (none to individuals)  Individuals  Non-profit organisations  Organisations registered for tax exemption (e.g., 501(c)3s in the US)  Grass-roots organisations  Organisations already receiving support from the donor  Organisations not receiving support from governments  Pre-selected organisations (so that no unsolicited proposals are accepted) Geographic limitations may be set, so that grants are only given:  To organisations based in a specific country  To organisations not based in a specific country  For projects in specific country or countries (even specific localities) Every funder gives grants for specific purposes and not for others. The following are examples of purposes that may (or may not) be funded:  Travel and conferences  Networking  Planning  Publications and information dissemination  Scholarships  Research, or a specific type such as clinical research  General and operating expenses  Delivery of services  Buildings and other capital improvement  Purchase of equipment  Matching funds Purpose is not the same as ‘programme’ or ‘interest’. Two funders may have similar programmes, for example, on environmental quality, but give grants for quite different purposes, one just for research and the other for operating expenses and matching funds. In addition, grants (and therefore grant proposals) are normally limited:  By amount, to a certain range  By duration, often to 1-2 years, sometimes with renewal possible Some funders, especially private foundations, allow grant seekers to submit proposals or letters of inquiry at any time, and these are handled on a rolling basis. However, other funders have submission deadlines, typically a couple times a year. Sometimes a funder or a programme within a funding agency will only accept proposals when they are submitted in response to calls for proposals or requests for proposals. Look for these announcements on the funders’ web sites.

123

Developing a grant-seeking strategy When you reach the WWW site of a potential funder, look around the site to learn more about its philosophy and programmes. Look for the annual report, instructions for grant seekers, and a list of recent grants. If you meet the funderâ&#x20AC;&#x2122;s criteria for grant-seekers, you should print out the essential information or save it on a memory disk. Save the printed pages in a binder and put the downloaded file in a separate folder on your memory stick. Then, when you have collected current material about all or most of the likely funders, sit down and read through the whole stack, reading the information very carefully. Weed out those funders that are not in fact relevant. Donâ&#x20AC;&#x2122;t waste your own time or theirs by applying to a funding agency or foundation that is inappropriate or for which you are not a qualified applicant.

Take the time to develop a grant-seeking strategy

Make a chart of the remaining funders, showing their specific interests, their restrictions, the kinds of support they provide (travel money, funding for conferences or publications, support for equipment and/or supplies, salaries), the size range of their grants, the deadlines for their applications, etc. Then map out a grant-seeking strategy, specifying which funders will be approached, when they will be approached, what kind of support they will be asked for, the amount that will be requested, and the period the grant will cover. Finally, prepare the letters of inquiry (for funders requesting an LOI as an initial approach) and the proposals for those not requiring LOIs.

Online sources of information for grant-seekers ď&#x201A;ˇ World Health Organization http://www.who.int http://www.who.int/alliancehpsr/callsforproposals/Alliance%20HPSR_Joint_Call_WellcomeTrust.pdf http://www.who.int/tdr/grants/forms/call-reentry-inst-strength-long.pdf WHO is one potential source for research funding, but announcements about funding opportunities are scattered at the site, since they are posted by different programmes and projects. One way to look is by going to the web pages for the programmes and projects most relevant to your own work.

124

Another possibility is to use the WHO search function. Click first on ‘search’ in the upper right-hand corner of the WHO home page. On the next page that comes up, click on ‘Advanced search’. On the advanced search page, type your own topic in the first search space and ‘funding opportunities’ in the space for an exact phrase. You should re-do the search using other phrases and terms, including ‘call for proposals’, ‘request for proposals’, ‘request for LOIs’, ‘request for letters of interest’, LOIs, RFPs, etc. Links to two web pages with recent WHO calls for proposals are given above.  National Institutes of Health, DHHS http://grants.nih.gov/grants/oer.htm (National Institutes of Health grants page) http://www.fic.nih.gov/programs/research_grants/index.htm (FIC research grants) http://www.fic.nih.gov/programs/training_grants/index.htm (FIC training grants) http://www.fic.nih.gov/funding/index.htm (FIC funding programmes summary) http://www.fic.nih.gov/funding/directory_fellowships.htm (Directory home page) http://www.fic.nih.gov/funding/globaldir06.html (Whole directory online) The NIH is a major funder of health research, including internationally. The easiest way to find out what is available is to go to the address above, which gives information about grants and other funding opportunities from all NIH entities. This site is full of resources; take the time to follow the links and see what is available on each page. The Fogarty International Center deserves special mention here, because of its focus on global health issues. As noted earlier, the FIC provides not only information about its own grant, but also an online directory of funding sources around the world.  Pathfinders and gateways to international funders http://www.lib.msu.edu/harris23/grants/privint.htm (Michigan State University) http://www.fundsnetservices.com/searchresult.php?sbcat_id=30 (FundsNet) http://www.proposalwriter.com (Deborah Kluge) Some resources that are a hybrid between gateways and pathfinders provide excellent guidance on where to find funding. One excellent resource, maintained by the Michigan State University Library, is entitled ‘International and Foreign Grant Makers’. The web page lists about 120 funders and provides notes and links for all. Yet another gateway to international funders is available via Fundsnet. Note that the address above only leads to the initial page out of six. Keep clicking.  World Bank http://siteresources.worldbank.org/INTSMALLGRANTS/641999551116493187648/20551423/GuidetoResources2003.pdf The World Bank’s has an online guide about funding resources for nongovernmental organisations and civil society organisations. The guide covers not only funding opportunities within the Bank itself, but also other funders around the world. The document is in pdf format, but there are embedded links to all the sites listed.  AIDA database of official donor agencies http://aida.developmentgateway.org/index.do The AIDA database is a service of the Development Gateway, which is jointly maintained by OECD, the World Bank, and UNDP. The AIDA database provides information on the grants given by UN agencies, multilateral funders such as the development banks, and the major official donor agencies of the high-income countries.

125

There is funding out there. Go look.  Foundation Center http://foundationcenter.org. http://foundationcenter.org/pnd/specialissues/item.jhtml?id=3000057 The Foundation Center in New York is the largest organisation provides services to both funders and grant seekers. The Center maintains an online directory of funders. Use of the directory requires a subscription. One for about $25 per month covers the largest 10,000 foundations in the United States and half a million grants given by these foundations. There is also another database, costing about $10 a month, that is specifically designed to help find foundations giving grants to individuals. The Center offers a more limited gateway to international funders, free of charge, at the second address given above. The page is actually a special issue of an online journal, Philanthropy News Digest, on the topic of international philanthropy.  PNNOnline http://www.pnnonline.org http://www.pnnonline.org/search.php?query=&topic=19 (PNN WorldWide) http://www.pnnonline.org/article.php?sid=4620 (PNN article on top Euopean funders) PNNOnline: Nonprofit News and Information Resources publishes extremely useful online articles about the interests and granting patterns of specific funders. Although most of the site has to do with funders and funding in the United States, there is a section called PNN WorldWide, which provides international funding news. The archives are also useful, since you can search for news stories about funders in which you are interested. One of the archive articles is a report on Europe’s top 40 foundations; the link is given above.  European Foundation Center http://www.efc.be http://www.efc.be/membership/currentmembership.htm (EFC member profiles) http://www.efc.be/projects/thematic/ (EFC thematic interest groups) http://www.efc.be/projects/knowledge/ForGrantseekers.htm The European Foundation Center is primarily oriented toward providing services for its members. However, the EFC does maintain an online database on profiles on EFC member foundations, and this can be accessed free of charge. The foundations are not all in Europe; a fair number are based in other parts of the world. It is possible to see what EFC member foundations are interested in specific topics, such as health, by looking through the thematic interest groups. Yet other useful resources can be accessed through the EFC page specifically for grant-seekers.

126

 Funders in the United Kingdom http://www.acf.org.uk http://www.trustfunding.org.uk The Association of Charitable Foundations and Trustfunding Org UK are both major routes into information about funders in the UK. The two sites are frustrating, since access to the information about specific donors requires the purchase of printed guides or subscriptions to online databases, which are very expensive.  Funders in the Asian and Pacific regions http://www.asiapacificphilanthropy.org/ (Asia Pacific Philanthropy Consortium) http://www.jfc.or.jp/eibun/e_index.html (Japan Foundation Center) http://philanthrophy.org.au (Australian foundations) http://www.anz.com.au (Australian trustee programme) http://www.perpetual.com.au (Australian trustree programme) Some sites serve as gateways to the foundations, charities, and other funders in a whole region. An example of a regional gateway is the Asia Pacific Philanthropy Consortium. Be sure to click on ‘Philanthropy Resources’ and then on ‘Information by Society’. The resulting menu leads to information about philanthropy patterns and specific foundations and funders in various Asian countries. More detailed information about funders in Japan can be obtained at the Japan Foundation Center. For Australia, important addresses are to a gateway for foundations and to two major trustee programmes, which manage many hundreds of individual trusts and foundations.  Two major sources for international health funding http://www.gatesfoundation.org/Pages/home.aspx http://www.gatesfoundation.org/topics/Pages/topics-overview.aspx http://www.gatesfoundation.org/grantseeker/Pages/overview.aspx http://www.theglobalfund.org/EN/ http://www.theglobalfund.org/en/applicantsimplementers/?lang=en Two funding sources are well known internationally as major supporters of research and activities promoting health. One is the Bill and Melinda Gates Foundation, and the other is the Global Fund. You can explore the Gates sites by starting with the home page and clicking on the links. Be sure to look through the list of topics being funded and the instructions given to grant-seekers. At the Global Fund site, the most important page is the one for applicants and implementers.  Google http://www.google.com http://www.google.com/dirhp http://www.dmoz.org One way to find funders and foundations is via search engines such as Google. If you know the name of a foundation, just search for that. If not, try doing searches for foundations, funders, or philanthropy. In the Google Directory or DMOZ Open Directory, look under ‘Society’ and then ‘Philanthropy’.

127

Finding Information for Writing For many people, writing is the most difficult part of their professional work, especially if the writing has to be done in English and English is not their mother tongue. But in many cases, writing is unavoidable. You must write proposals to get funding, and you must write up and publish the research you have carried out or the knowledge you have gained will be lost. Your work may also require other types of writing, such as technical reports and reports to funders. The following pages give some tips about professional writing and point to some online sources that can provide more assistance.

Writing may be difficult, but it is essential.

Things to decide before you start writing Before you begin writing anything, think about your target audience. It may be the scientific community, policy makers, the general public, a funder who financed your research, or an agency that has hired you to carry out a project. Sometimes you can select your target audience, and other times you must accept one that is determined by the circumstances. Consider your purpose. Ask yourself what you are trying to do with this piece of scientific writing. Request (e.g., funding or permission)? Report? Describe? Evaluate? Recommend? Convince? Interest? Stimulate debate? Determine what categories of information you need to convey. A request to a medical ethics committee must include detailed ethical considerations, but these would be inappropriate in a scientific paper. A report to a funder or contracting agency should incorporate a budget, but this would have no place in an article aimed at the public. Decide how you want the piece to be organised, that is, what sections it will have and how they will be ordered. Research proposals, scientific papers, reports to agencies and funders, and popular articles require different types of organisation.

128

Consider also the type of language you should use, so that you can use it throughout the piece. Some aspects of language that you should think about are these:  Person. The usual choice is between first person (I and we) and third person (he, she, they).  Voice. In active voice, the subject of the sentence is the agent carrying out the action. (We made this discovery.) In passive voice, the subject of the sentence is the object on which the action was performed. (This discovery was made.)  Tense. Depending on the piece of writing, it may be appropriate to use past tense (we did this, this was done), present perfect tense (we have done this, this has been done), present tense (we now know that…., it is now known that….), and future tense (we will continue this work, this work will be continued). Most pieces of scientific writing require more than one tense, e.g., present sense for generalizations and to describe on-going work, past tense to describe completed work, future work to describe plans, etc.)  Tone. If you are writing a professional article, the tone should be formal. But if you are writing an informal piece—for example, for a magazine—a less formal tone would be appropriate.

Formatting In some cases, you will be given specific guidelines for formatting a document. For example, if you submit an article to a journal for publication, you will need to format it in the style required by the journal publisher. The instructions will probably tell you what typeface you must use, what size the fonts must be, how wide the margins must be, and so forth. If you have no instructions to follow, you will need to decide about the formatting yourself. Remember that the overall appearance of the final document can be improved by sticking to one basic typeface. Select one that is pleasant and easy to read. Times New Roman, which looks like this, is a good choice. Avoid typefaces that look like typewriting (such as Courier) and ones that are overly stylized or elaborate (such as Playbill or Desdemona or Braggadocio). To clarify divisions and add emphasis, use different sizes (8 pt., 10 pt., 12 pt., etc.) and different ‘alphabets’ (roman, italic, or boldface, in capitals and lowercase) of the same typeface. For example, put the title and sub-titles in a larger point size than the text and emphasize the main headings by using bold face. However, never have more than four varieties on a page, normally no more than three. (For example: title in bold, roman, caps and lower case, 16 pt.; sub-headings in bold, italics, caps and lower case, 12 pt.; individual items in roman, caps and lower case, 12 pt.) The document will also look better if you use bullets on lists (rather than little dashes) and avoid underlining (which makes the text look ‘busy’). Be sure to leave sufficient space between major sections, to be consistent with the formatting, to number the pages, and to include a date.

129

Writing letters of inquiry (LOIs) and proposals When you are writing in order to find funding, prepare one LOI or proposal at a time, keeping in mind the programme interests and grant limitations of a single funder. Determine what categories of information you need to convey. Check the instructions for grant-seekers to see what this particular funder wants to know. Stick to this list if at all possible. The organisation of the LOI or proposal—the order in which you present the information—may also depend on the guidelines of the particular funder. If the funder does not provide guidelines, you will have to determine yourself what to include and how to organise it. In general, LOIs and proposals should include these sections:  A statement of what you want to do  Background about other research/programmes on the problem  The research/programme design and methods  The material or target population  A timetable  Personnel and their credentials (often in the form of resumes)  The budget If the proposal is for a research activity, you will also need to include details about the study design, sampling method, and techniques for collecting and analysing data. Many proposals require attached materials. These often include resumes, which are discussed below. If you are applying on behalf of an NGO, you will need to attach documents regarding the organisation’s legal status. If you are seeking funding for medical research, you will need to attach a clearance from a medical research ethics committee. If you are planning a development project, you may need to attach a logframe analysis. Proposals should be written in simple, clear, straightforward language. In general, this means that they should be written in first person and active voice, and much of the material will be in future tense (this is what we are going to do, this is how we will do it, this is how much money we will need, etc.). Avoid jargon and special terms, unless you must use technical terms to describe the work. Remember that the programme officer who will read your proposal will have knowledge of the general area but may not know a great deal about your specific topic.

Preparing resumes for proposals A resume or curriculum vitae (‘c.v.’) is a description of your background and experience. Even the best of proposals can be rejected if the applicant is not presented well in the resume. So do spend sufficient time preparing this important document.

130

The items you will probably want to include in your resume are these:  Your full name.  Full professional address, including university, department, postal code, street address or other necessary details, city, country.  Other contact information, such as telephone number at work, fax number at work, email address, mobile telephone number, etc.  Citizenship and country of residence, if other than that of citizenship.  Educational background. What universities you have attended, what degrees you have earned, and when. If you have earned a general university degree that does not indicate your areas of study, you should specific these areas. Normally you would not list the courses taken within a degree programme. However, if you have also taken some courses that did not lead to a degree, these can be listed.  Professional experience. Where you have worked, what positions you held, and the time period for each.  A list of personal references. Persons who have agreed to write a letter of recommendation for you if contacted by a potential donor.  Publications. Books you have edited or written, journal issues you have edited, articles you have written and had published in journals, and abstracts included in conference proceedings.  Related experience. Membership in professional associations, attendance and/or presentation of papers or posters at meetings, serving on university and professional committees, giving guest lectures, taking study trips, advising students, teaching courses, organising conferences, writing reports, doing evaluations, consulting, etc.  Skills. Languages skills, writing and editing skills, computer literacy, types of computers you have worked with, ability to use various computer software, familiarity with Internet and WWW, ability to run certain kinds of analysis or operate certain kinds of equipment, etc.  Honours and distinctions. Scholarships, fellowships, awards, election to membership or office, prizes, etc. Restrict this list to professional honours.

Preparing a professional resume is part of the grant seeking process. Depending on the specific situation, you may or may not want to include a photograph of yourself and information about your gender, your date of birth, your marital status, and the number of children you have. You also should think carefully about mentioning outside interests such as hobbies. The addition of personal information may make your resume more interesting, but it can also give the impression that you are not a serious professional. You must judge the situation yourself.

131

There are many acceptable approaches to organizing a resume. In deciding which to take, consider the activity for which you are seeking funding, any guidelines provided by the funder to whom it will be sent, how much you have to say about yourself, and what ‘works’ for you when you write. One possibility is to write the resume in a narrative form, that is, as a story about your life. A narrative resume can be written either in first person (I did this…) or third person (he or she did that…). But it is more common for resumes to be in outline form. Regardless of whether you use a narrative or outline form, straight chronological description is not very interesting. Do you really want to begin with your early education? Reverse chronological order will probably highlight more interesting items. Another possibility is to arrange items by category, with the one most relevant to the proposal being given first. For example, if you’ve worked in teaching and research and are now seeking financial support for development of an educational programme, you will want to organise your resume to emphasize your pedagogic experience. If you are communicating across cultures and/or languages, think about these points:  Give all the information in the language used by the funding agency.  If you come from a culture where names are not structured as in English (personal name first, family name last), indicate which name is which.  Avoid abbreviations that will not be understood outside your own country.  Academic terms should be translated carefully. Check a dictionary. If still in doubt, give the term in the original language and explain it as well as you can.  The meaning of academic credits, points, and degrees in your particular academic system should be explained as necessary.  Publication titles should be given first in the original language and then in English in brackets.  Addresses should include the country. Telephone and fax numbers should include the country and regional codes.  Information about geographic location, such as for universities, should be sufficiently detailed to be clear but should not insult the reader’s intelligence. Do not identify London University as being in London, England, United Kingdom.

Writing scientific papers All scientific journals have guidelines for the preparation of articles. Authors must prepare manuscripts accordingly. Papers that don’t follow the standard pattern are usually returned without even being reviewed. Therefore, before you start writing, you should decide what journal you will submit your article to and follow the guidelines for that journal. These can be found in the journal itself, often on the inside cover, and are usually entitled ‘Instructions for Authors’. A common arrangement for a scientific paper is title, authors’ names, authors’ professional affiliations, abstract, introduction, materials and methods, results, discussion, and references. There may also be a section for acknowledgements and a list of keywords. If the research you are reporting does not fit this standard arrangement for some reason, you should discuss with the editor the possibility of using a different order.

132

A problem with the standard organisation is that it does not make clear where you should state the purpose of the work or the basic design. One possibility is to state the purpose at the beginning of the introduction and the design at the beginning of the materials and methods. There are several points to consider regarding language.  Journal articles by a single author are often written in passive voice in order to avoid the use of ‘I’, which some editors consider inappropriate. The use of ‘we’ is more generally accepted. Sentences in passive voice must be rewritten to active voice if they are ambiguous about, for example, whether they are describing earlier research or the new work being reported.  A combination of past and present tense is usually needed. Work that is completed should be in past tense, but generalizations should be in the present tense.  Remember that sensationalist language, loaded terms, strongly emotional adjectives, and exclamation points do not belong in scientific articles. Be aware that there are rules regarding tables, figures, and other illustrations. Again, your first source of information should be the ‘Instructions to Authors’ of your intended journals. Your references should be handled as carefully as the main text. It is hard to get a good article published if the references are not dealt with in a professional way. Follow the guidelines of the journal and be consistent. Some more tips about references are given later in this sourcebook.

Online guidance about writing Online guidance about writing comes in various forms, including advice about writing LOIs and grant proposals, general guides to writing scholarly papers, instructions to authors submitting manuscripts to specific journals, uniform requirements for manuscripts and reports, and reporting guidelines for certain types of research.

 Author Aid http://www.authoraid.info/ Author Aid is a comprehensive resource for researchers and other academic professionals in developing countries. The site provides help on writing in general, writing scientific papers, publishing papers, handling citations, avoiding plagiarism, dealing with other ethical issues related to writing and publication, preparing grants proposals, and much, much more. When you get to the Author Aid site, be sure to click on ‘Resource Library’ to reach a list of PowerPoint presentations on different aspects of writing and publishing.

133

 Guides to writing proposals http://www.authoraid.info/ (Author Aid) http://www.who.int/tdr/grants/forms/call-reentry-inst-strength-long.doc (TDR guidelines) http://foundationcenter.org/getstarted/learnabout/proposalwriting.html (Foundation Center courses and materials on proposal writing) http://www.proposalwriter.com (Deborah Kluge) For help about writing grant proposals, the best place to start may be Author Aid. However, look also at the websites of funding agencies and foundations. Most of these offer guidelines for grant seekers at their web sites. To give one example, the Special Programme for Research & Training in Tropical Diseases (TDR) provides guidelines for applicants in its call for proposals, with details about what should be included. Although the Foundation Center in New York sells courses in proposal writing, some of the online courses are offered at no charge. Go to the address given above and scroll down until you find the free resources. Deborab Kluge’s excellent web site also provides guidance on proposal writing, as well as other free and useful resources.  University guides to writing http://abacus.bates.edu/~ganderso/biology/resources/writing/HTWtoc.html http://www.gs.howard.edu/sbe/text/sci_paper_guidelines.doc Many universities and university libraries in English-speaking countries have produced their own guides to writing scholarly papers, including in the sciences and medicine. These can be found online at university web sites around the world. Just two examples are given above.  Links to writing guidelines via INTUTE http://www.intute.ac.uk/ INTUTE has over 1500 items related to writing. Although some of these might not be so relevant to you, some of them are sure to be. There are links to online courses, tutorials, and guidelines regarding writing in general, writing scientific papers, writing in particular subjects, and more.  Instructions to authors gateway http://mulford.meduohio.edu/instr/ (Instructions to Authors Gateway) As already mentioned, an obvious place to get guidance about writing a scientific paper is in the ‘Instructions to authors’ of the journal in which you would like to publish. You can usually find these instructions easily at the online site of the journal. Another way to find them is through the gateway entitled ‘Instructions to Authors in the Health Sciences’ maintained by the Mulford Health Science Library of the University of Toledo in the United States.  Uniform requirements http://www.icmje.org/index.html (ICMJE Uniform Requirements) http://www.glisc.info/ (GLISC guidelines on technical reports) Certain standards are expected for reports, regardless of whether they are being submitted for publication in journals or will be published as technical reports or other grey literature. The International Committee of Medical Journal Editors (ICMJE) has prepared a set of guidelines entitled ‘Uniform Requirements for Manuscripts Submitted to Biomedical Journals’. Most medical journals require that potential authors comply with these guidelines, which deal with various ethical issues in research, as well as editing and writing of research reports.

134

A similar set of guidelines regarding grey literature has been produced by the Grey Literature International Steering Committee (GLISC) under the title ‘Guidelines for the Production of Scientific and Technical Reports’.  Reporting guidelines (RGs) http://www.equator-network.org http://www.consort-statement.org/ Finally, researchers should check to see if a reporting guideline (RG) exists for their type of study. Such guidelines have been developed in efforts to improve the quality of medical research publications by encouraging accurate reporting and transparency. Perhaps the most famous RG is the CONSORT statement (Consolidated Standards of Reporting Trials), which was developed to improve reports on randomized controlled trials (RCTs), so that readers could understand and assess the reports more easily. The recommendations are in the form of a checklist and flow diagram. CONSORT is no longer the only reporting guideline, however. RGs have been developed and published online for experimental studies, observational studies, diagnostic accuracy studies, qualitative research, economic evaluations, and many other types of research. Most of the RGs are known by their acronyms, examples being QUORUM, STARD, STROBE, and MOOSE. These and other RGs can be accessed through the EQUATOR network website, which serves as a gateway and resource centre on good research reporting in health and medicine.

TIP! Take advantage of the good writing guidance available on the Web.

135

Managing Searches, References, Texts, and Addresses As the preceding chapters make clear, the amount of information available online is enormous. Just doing searches for that information will require a great deal of time. To avoid wasting time, it’s important that you manage your searches, your references, and your collection of web addresses.

Keeping track of your searches It s a good idea to keep a record of the searches you have done. This record should include information about the following:  What resource you have searched in (WWW via Google or another search engine, Medline/PubMed directly, Medline/PubMed via HINARI, a publisher database, the NLM library catalogue, the WHO library catalogue, and so forth)  The date  What search strings and limits you have used  What results you have obtained (number of hits) A search record sheet is provided at the very end of this sourcebook. You can create your own search log by printing it out and copying it in multiple copies. As you use the sheets, file them in order in a ring binder, sorted first by resource and then by date. One purpose of maintaining such a log is to avoid duplication. You almost certainly have limited time to do searches for information. When you sit down to carry out a search, you will be able to refer to your log and check whether you have looked in a particular resource, when you last searched there, and what search strings and limits you have already tested. The log also has another purpose. Maintaining search records will help you learn about appropriate search strings. You will soon discover that some search strings are effective in one resource but don’t work well in another resource, and some don’t work anywhere.

Managing references http://en.wikipedia.org/wiki/Comparison_of_reference_management_software http://www.soton.ac.uk/library/infoskills/bibliographic/index.html http://www.adelaide.edu.au/library/guide/gen/bibsoft/ http://www.adelaide.edu.au/library/guide/gen/bibsoft/tutorials/endnote/ http://www.ulrls.lon.ac.uk/tutorial/Reference/bibsoftware1.asp http://www.endnote.com/ Keeping track of the references you find is another matter. When you just have 10 references, you don’t need much of a system. You can just write them down, ideally in a Word document.

136

If you are doing information searches for a major research project, however, you will have a much larger number of references. You may initially collect thousands of references, out of which you identify several hundred as being of greatest relevance. These are the items that you will want to acquire in full-text form, read, and use in designing your own research and in writing the background to your research papers. Keeping track of hundreds of references can be a very intimidating task. The good news is that bibliographic software management software—also called reference management software—has been developed to handle the work. This computer software helps you to collect the references from databases, catalogues, and other sources, keeps the references stored in ‘libraries’ on your computer, and then put the references in the correct form when you write a paper. Examples of bibliographic software management software include Reference Manager, EndNote, ProCite, Bibus, and RefWorks, but there are many more. Some are free; others cost up to several hundred US dollars for a license. In academic settings, bibliographic software is often purchased by an institution on a license that allows installation on multiple computers. In some cases, universities buy a site license so that teachers, researchers, and students can all download the software for their own use. Go online if you have funds to purchase bibliographic management software and want guidance in selecting the package that if appropriate for your purposes, or if you already have a particular software and want to learn more about how to use it. General information can be found online at sources such as the Wikipedia. More guidance and tutorials on specific software are available at numerous university library sites, and the software producers also provide online instruction and help. Examples of addresses are given above. If you need more, just Google. Since EndNote is widely used around the world, basic instructions for using this particular bibliographic software management software are given in the next chapter.

Maintaining a full-text collection If you are able to locate and download many full-text resources (and you will), how are you going to keep those organised? It is a real waste of time to find a reference, search for the full text, download it, and then lose it. You will need to have a system. If you use bibliographic software management software, that software will almost certainly allow you to make notes about each reference in your collection. You can use this feature to write down whether you have acquired the full text, where the digital form is stored on your computer, and where you are keeping the paper form. In storing the digital files on your computer, consider what will make it easiest for you to find a specific paper. You may want to set up a folder labelled ‘Downloaded articles and grey literature’, another labelled ‘Downloaded e-books’, and yet another labelled ‘Saved web pages’. These can then be further divided to simplify the process of finding specific materials. The most logical system is to file alphabetically by author. The corresponding articles in paper form should be kept in order in labelled ring binders or other holders.

137

Managing Web addresses It is also important to keep track of good Web addresses you have found so that you don’t have to go look for them again. Two simple tools are the ‘favorites’ feature associated with Internet Explorer and the ‘bookmarks’ function of Mozilla Firefox. Both allow you to maintain lists of the sites you use often. Once you have found a site and added it to the favorites or bookmakrs list, you can reach the site without typing the address.

Favorites and bookmarks help you find your place on WWW.

To use favorites in Internet Explorer, do the following:  Open Internet Explorer.  Type in an address, such as http://www.who.int, and go to that site.  Once you reach the site, click on ‘Favorites’ at the top of the screen.  In the drop-down menu, click on ‘Add to Favorites’.  A small window will pop up, labelled ‘Add a Favorite’.  Check first to see if the proposed name for the site is acceptable. If not, type a different name.  Once the name is as you want it, look at the next line. If you just want the web address added to your favorites list, click on ‘Add’.  If you want to put the web address in a folder within the favorites list, click on ‘New folder’. In the new box that pops up, type in the name of the folder (for example, you might label the folder ‘International agencies’ if you want it to contain web addresses for WHO, UNICEF, etc.). Then click on ‘Create’.  You will be taken back to the ‘Add a Favorite’ box. It will now show that you are ready to add the WHO web site to your folder called ‘International agencies’ within your favorites list. Click on ‘Add’ and you’re done. The next time to want to reach WHO, just click on ‘Favorites’, scroll down in the dropdown menu until you see the folder ‘International agencies’, click on that and then on the WHO name, and you will be linked automatically to the WHO site. You can add as many folders as you want to your list. If you feel they are getting difficult to handle, click on ‘Favorites’ and then on ‘Organize favorites’. You will get a box that allows you to move, delete, and rename any link, as well as to add more folders.

138

If you use Mozilla Firefox as your web browser, you can also save and organise web addresses using the feature called ‘Bookmarks’. The steps are almost identical to those for ‘Favorites’.

Exporting favorites and bookmarks If you work at more than one computer, you also need to know how to export your favorites and bookmarks, so you can move them from one computer to another using a USB memory stick. To do this with favorites, follow these steps:  Click on the Internet Explorer icon. Click on ‘File’. Click on ‘Import and Export’.  You will now have a new screen for the Import/Export Wizard. Click on ‘Next’.  Click on ‘Export favorites’ and then on ‘Next’.  In the next screen, click either on ‘Favorites’ or on the specific folder you want to copy, and then click on ‘next’.  In the next screen, click on ‘Browse’ and then on the up arrow to reach ‘My computer’.  Double click on ‘My computer’ and then double click on the desired drive (e.g., often E for USB memory sticks).  You will now have a screen that says ‘Removable disk E’ at the top. In the bar at the bottom, check the name that the favorites folder will have and change it if you want. Then click on ‘Save’.  The system will now send you back to the Wizard. Click on ‘Next’. Click on ‘Finish’. Click on ‘OK’.  When you open your flash disk, you will find the favorites in the form of an Internet Explorer icon. Click on that icon to reach the links. If you are using bookmarks in Mozilla Firefox, follow these steps:  Click on the icon for Mozilla Firefox’. Click on ‘Bookmarks’. Click on ‘Organize bookmarks’. Click on ‘Import and backup’ and then on ‘Export html’.  Select where you want the bookmarks to be copied and give them the name you want. Click on ‘Save’. Note that it is easier to copy bookmarks with Mozilla than to copy favorites with Explorer. On the other hand, it does not seem possible with Mozilla to select a specific folder of favorites for copying.

139

Using EndNote EndNote is one of the many computer programs now available that handle bibliographic references. Although bibliographic management software is expensive, it also saves enormous amounts of time, and an increasing number of universities and ministries in low-income countries are purchasing them. These instructions are therefore included both for the reproductive health course participants who already have EndNote and for those who obtain it in the future. These instructions refer primarily to EndNote 9. If you have another version of the software, the details may vary somewhat. For example, the X1 version has a ‘search online’ feature rather than one labeled ‘connect’. Nevertheless, the basics are the same.

Set up the new library for the references you are going to save It is best to set up a new library for yourself within EndNote before you do searches. To do this, click on the EndNote icon. A screen should come up that gives you the option ‘Create a new EndNote library’. Click on the circle to select this, then on OK. The system will now give you the chance to determine where the new library will be. It does not have to be inside EndNote. You will need to decide on the name for your library. In the space after ‘File name:’ where it says ‘Untitled’, type the name for your new library (for example, Kangaroo mother care or eclampsia). Then click on ‘Save’. A new screen will now pop up. This is your new library. Note that it is labeled with the name you gave it, followed by ‘enl’ (EndNote Library). Now close the library by clicking on the X box in the right hand corner.

Importing references from a catalogue or database The next step is to connect to a catalogue or a database such as Medline/PubMed and do a search for relevant literature. To do this, stay within the open EndNote program and click on ‘Tools’ and then on ‘Connect’. Select the bibiliographic resource you want. Note that many library catalogues (OPACs) are available. One of these is Libris, but it is listed as ‘Swedish National Library’. Another valuable source is PubMed (Medline). Note—use PubMed, not one of the connections to Medline. When you click on name of the resource, the program will make a connection and you will get a search screen labeled with the name of the resource, e.g., ‘PubMed MEDLINE at PubMed (NLM)’ or ‘Libris at Swedish Union Catalog’. Once you reach the database or library catalogue in which you want to find references, type in the search terms and limits that are appropriate for your topic, indicating the appropriate Booelean operators. You can add fields if you want to add terms or limit in more ways. Look for ‘’add fields’. 140

When you are satisfied, click on ‘search’. If the number of reference is huge, click on cancel and go back and add more terms or limits. Once you get down to a reasonable number, click on OK to confirm remote search. The program will now start finding the references. You will see the little fairy lights dancing around the red EndNote logo. When the references have been transferred, you still have to copy them into your new library. To do this, click on ‘Copy all references to’ and then on ‘choose library’, then on the EndNote icon that has the correct name on it, and then on ‘open’. The program will copy the references into the library very quickly. Once it’s done, close the library by clicking on the X in the upper right hand corner of the library screen. You will now be back at the screen with the originally transferred references. Close this also by clicking on the X in the upper right hand corner. You will get an inquiry screen asking if the program should discard the references retrieved from the catalogue or database. Click on OK, and you’re done.

Exporting references to EndNote from a bibliographic database You can also add references by starting at a bibliographic database, carrying out a search, selecting those references you want to save, and exporting them to the appropriate library. In summary, you do this by going first to the database you want to export from. Most databases are very expensive, so that they are rare at libraries in low-income countries. But check! Also, if you have HINARI, you can get into the database CINAHL and into a special version of the Web of Knowledge. Details about using the Web of Knowledge database is provided below. However, the general approach is the same for all other databases. You carry out your search and select the references you want to save in your EndNote Library. You ‘tell’ the system that you want to export these to EndNote, and the references are then sent to your computer. In some cases you may need to add an import filter. This is simple—you just pick from a list, indicating where you got the references. Web of Knowledge via HINARI Note that the interface pages for the Web of Knowledge change quite often, so the instructions given here may not apply. But if you look around the screens patiently, you should be able to find your way. Log on first at HINARI and then select Web of Knowledge from the list of databases in the column to the right.

141

Type in your search. You can use Boolean operators (AND, OR). Click on the ‘Search’ button. If you get too many ‘hits’, go back and add other terms. When you have your hit list, go through it and mark those references on a specific page that look interesting and relevant for your work. Click on the box in front of each individual reference. When you have selected the references on a page, save them by clicking on ‘Add to marked list’. Then move to the next page and continue selecting your references and saving them in the marked list. When you have completed your selection, click on the ‘marked list’ button near the top of the screen. Select what fields you want to include in the output. You probably will want to check ‘abstract’, as well as author, title, and source. The click on the button labelled ‘Export to reference software’. On the next page, click on ‘Export’. Wait for the system. After a few seconds, a window will come up showing the contents of your own computer. Often it is open to the part of the computer where you have your EndNote libraries. If this doesn’t happen, you will need to browse until you find them. Then click once on the library in which you want to store the references; the name will turn blue. Then click on ‘Open’. An EndNote Library screen of the selected library will now open up, but it probably will show just the newly transferred references. For example, if you already had 100 references in the library and you have now downloaded 25 from ISI, the screen will only show 25 references, and at the bottom of the screen you will see ‘Showing 25 of 125 references’. To see the whole library, with all the references, close the screen and open the library again. Blackwell Synergy You can also download references into EndNote from publishers’ databases. An example of such a database is at Blackwell Synergy. You can reach this by clicking on ‘B’ under ‘Databases, e-books,..’ at the Uppsala University Library or just by Googling for Blackwell. At the Blackwell Synergy homepage, click on advanced search and use the title search bar. Type in the words for your search. Click on the ‘Search’ button (below the search bars). When you get the hit list, check the references that look interesting to you. Or click on ‘Select all’, near the top of the list. Then click on ‘Export citations’. On the new page, scroll down to the bottom and choose what you want to export (reference or reference and abstract). Click on EndNote and on ‘direct export’. Click on ‘Download References’. When a small screen pops up, click on ‘open’. A new screen will come up with your own computer files. Find the EndNote library you want to save the references in. Click on it once to highlight, then on ‘open’. Then follow the instructions given earlier for the other databases.

142

Adding references to your library manually The references for some of the materials you find will have to be added manually to your EndNote library. To add a reference, click on the EndNote icon, then open your own EndNote library. In the new screen, click on ‘References’ and then on ‘New reference’. Select the reference type at the top of the screen. This will assure that the required fields are provided. For example, if you select ‘Journal article’, the fields will the name of the journal, as well as the volume, issue, and page numbers. If you select ‘Book’, the fields will include the city of publication and the name of the publisher. There are always more fields provided than you actually need to fill out. Check the instructions for the Vancouver style on the final pages of the course guide to determine what you need for the particular item you are recording. EndNote beginners often have trouble in handling authors’ names. Check a reference that has been downloaded to see how these should be entered. The correct form is last name, comma, first names(s) or initials. If there are multiple authors, each name has to be entered on a separate line within the author field. When you have filled in the required information, just close the screen by clicking on the X in the upper right-hand window, and the reference will be added to your library.

Moving through the references in your library After you have saved the references, you will want to go through them, checking each one and selecting those you feel are most relevant. Then you can begin finding the full text articles or the printed books. There are two ways to move through the references. One is to open the library, double click on the first reference, check it out, then close the screen by clicking on the X in the upper right hand window. Then double click on the second reference, and so forth. This is not the easy way! A better approach is to begin by opening the first reference. When you are ready to move on to the next reference, do not close the reference window. Instead, click on the icon in the reference screen that shows a stack of papers with an arrow pointed to the right. This will take you to the next reference. You can scroll through the references, forth forward and back, without closing the window and going back to the list.

Editing individual references in your library There may be instance in which you need to edit a reference you have downloaded. For example, when you download references from Medline/PubMed, the URL (web address) is automatically included in the reference. This is useful, since you will need to give the URL as part of the reference for any e-journal article you cite in your paper. However, when you download references to journal articles from other bibliographic databases, the URL may not be included. In such cases, if you track down the full text

143

and realize that you will be using it in writing you paper, it is a good idea to add the web address to the EndNote reference. To do this, open your library and double click on the reference. A new screen will open up, showing the details of the reference. Type in the URL in the field given and then close the screen. The changes will be saved automatically.

Managing the references in your library There are several ways in which you can manage your library. First, if you find references that you know are not going to be useful, you can discard them. Open the library, click on the reference to highlight it, then click on ‘References’ at the top of the screen, and then on ‘Delete References’. If you want to delete multiple references, you can highlight all of them at the same time. Click first on one you want to discard, then click on another while holding down the Control (Ctrl) button, then yet another while holding down the Control button. When you have highlighted all that you want to discard, click on ‘References’ and then on ‘Delete References’. You should also clean up your library by getting rid of the duplicates, which you are sure to have if you have downloaded references from several databases. To do this, go to ‘References’ and then on ‘find duplicates’. A new screen will pop up, showing just the references that have been entered more than once. All of the ‘extra copies’ will be highlighted. To discard these (while keeping one copy), go back to ‘References’ and click on ‘Delete References’. The system will check that you are sure about discarding the duplicates. When you verify that you do want to get rid of these, they will disappear, and you will be left with just one copy of each. To get back to the whole library, close the screen and reopen the library, which will now be free of duplicates.

Finding things in your library Most users have had the frustrating experience of trying to remember, unsuccessfully, which article contained certain information. With EndNote, you have a tool for quickly searching through your references to find the one you are seeking. Let’s say you are studying micronutrients and pregnancy. You have collected up hundreds of references in your EndNote library, gone through them, selected several dozen papers and gotten the full text of these. After reading the papers, you are now sitting down to write, and you reach a point where you want to refer to the impact of helminthes on miconutritient status, and you know you have read about this in a couple of the papers, but you can’t remember which ones. Go into your EndNote library. Click on ‘References’, then on ‘Search References’. In the screen that comes up, type the term you are after (helminthes) and decide whether you want to look just in any field or in just the title or the abstract or whatever. Then click on search, and you will get a list of the relevant articles. You can then scan the abstracts to find the specific ones you are seeking.

144

To make this process even more effective, you can add keywords to each individual EndNote library entry. Just scroll down the page until you reach Keywords, click, and begin typing in the keywords you associate with the article or book. Press return and start a new line for each keyword.

Printing out the whole library You may want at some point to print out your whole library, that is, the list of all the references you have collected. To do this, open the library and check that the reference style is set for ‘Vancouver’. Then go to the tool bar at the top of the library screen, and click on the printer icon.

Citing as you write With EndNote, it is very simple to insert references from your library and build a reference list for your paper. When you are ready to write, begin by opening your EndNote library. At the top of the screen, select the reference style. Most EndNote versions offer many hundreds of styles, including Vancouver. Once you have set the style, don’t close the screen but minimize it by clicking on the little box in the upper right-hand corner with the _. Now open Word and begin writing. When you write something that refers to information or ideas that you have gotten from your reading, insert a reference to that source. To do this, click on the EndNote bar at the bottom of the screen and click once on the relevant reference to highlight it. Then go back to the Word screen and click on ‘Tools’ in the tool bar at the top of the Word screen. Then select EndNote and then ‘Insert selected citation(s)’. If you have selected Vancouver style, the program will insert the reference as a number (1) and also give the reference just below where you are writing. This reference is the beginning of your reference list. Continue writing, inserting references as you go along. If you need to refer to more than one publication, you can select multiple references from your EndNote library by clicking first on one and then on the others while holding down the Control button. If you refer to a work that you have cited earlier in the paper, the EndNote program will automatically use the original number assigned to that publication. And, as you put in your citations, the reference list will grow automatically. When your paper is finished, all you have to do is type References above the list and it’s done!

Editing your reference list You may find that the EndNote version you have does not handle certain references according to the latest Vancouver instructions. If this is the case, you will need to edit your reference list.

145

Probably the biggest problem will be that the program does not automatically include the URL for e-journal articles. If you have been careful about recording these in the EndNote library, it won’t take you long to fix this error. Go into the library, find the reference, find the URL address, copy it, and then paste it into the reference list. Copying a Web address can seem impossible if you try to highlight it from the front. Instead, put the mouse cursor at the end of the address and draw it backwards to the front, then click on the copy icon.

Changing to a different style Once you have assembled a library and written a paper using EndNote, it is extremely simple to switch to another style. For researchers submitting papers to journals, this feature is very important, since individual journals differ in the style they require their authors to use. If you have been using an existing library to write a paper using Vancouver style, and you are now going to write another paper on the same topic but need to use the Harvard (name and date) system, just open the library and change the style at the top of the screen. But what do you do if you have written a paper using Vancouver, and your adviser suddenly decides that the Harvard style is better? Just changing the preferred style in the library will have no impact on the style in your paper. But EndNote can fix this for you. Open the Word file and go to ‘Tools’ in the tool bar. Click on EndNote, and then on ‘Format Bibliography’. When the new screen comes up, select the new style you want the paper to be in. Then click on OK. The program will automatically change both the citations in the text and the bibliography (reference list) to the new style.

146

Judging the Validity of Resources Going to the literature for authoritative information Knowledge systems are often authoritarian. People are taught to accept information as true because it is provided by someone of high status. But if you want to become a good information user, you must learn to be intellectually critical. This means judging for yourself the quality and worth of all the information you find. However, it is more likely that the information you find will be basically valid if you begin with authoritative sources. Authoritative is not the same as authoritarian. An authoritative source is one characterized by experience, knowledge, and honesty. It is a source you can basically trust, that you know will usually give you high-quality, valid information. Thus, to find books, you should look first in a university library catalogue. If a book is there, someone—usually a librarian or teacher—has judged it as being valuable. When you search for articles, you should look in international refereed journals or databases indexing such journals. Articles published in these professional journals have been approved by other researchers. Therefore you can generally trust these publications more than you can articles published in popular magazines. Again, this doesn’t mean that everything printed in a library book or professional journal is good quality or valid. It is certainly possible to find academic literature that contains data errors, omissions, misinterpretations, false theories, biases, and lies. The best policy is to approach every piece of information with an open but critical mind. Below are some points to consider in critical reading of scientific papers, scholarly books, and grey literature.

Critiquing a piece of literature  Publisher. In general, publication by a reputable academic or commercial press is an indication that a book is of good quality. However, even reputable presses sometimes publish poor books, and some relatively unknown publishers have high standards. The most trustworthy journals are refereed and international in scope.  Authors. As you work in a field, you may begin recognizing experienced and respected researchers. If you don’t recognize the authors of a piece, ask yourself these questions: What are their credentials? What degrees do they hold? Where do they work? Are there questions in your mind about the objectivity of the work? Regardless of the authors’ credentials, keep an open mind. Experts aren’t always right, and even newcomers to a field can do excellent work and make important contributions.

147

 Organisation and format. How have the authors structured the material? Does the organisational structure make sense, considering the nature of the work done? Is the material in each section appropriate for that section? For example, does the ‘results’ section contain only results? Does the title accurately describe the work? Will it be easy for researchers to find when they search bibliographic databases? Are keywords identified? Is an abstract included?  Language. Is the language suitable for a scientific publication? Is it clear and straightforward? Is it free from errors in spelling and grammar? Are technical terms defined? Have the authors avoided overly technical, elaborate, or emotional language?  Topic, question, purpose. Have the authors made clear what they studied, what they were trying to learn, and why they carried out the work? If they were testing a hypothesis, have they stated that hypothesis clearly?  Background. Have the authors clarified the theories, concepts, and assumptions behind the work? Have they given sufficient information about related earlier work by themselves and other researchers?  Study design. Do the authors give a clear description of the study design? Do they define the study population? Do they state how the samples were selected? If the work was experimental, it is clear how individuals were assigned to the experimental and comparison groups? Do the authors describe the techniques and instruments they have used? Is it clear what kind of information was collected, what variables were measured, and what kind of analysis was done?  Consistency, logic, and overall quality. Are there inconsistencies? Is the purpose or the design defined differently at various points? Does the work make sense? Is the design suitable to the question asked? Have appropriate methods been used? Are they valid and reliable? Was the analytical approach appropriate and valid? Are results clearly presented? Do the numbers ‘add up’? Are conclusions supported by results? Does the study design allow drawing of the conclusions? Are assertions of causality well grounded? Did the design require a control group, and if so, was one included? Was the sample large enough to allow generalization to the population?  References. How many references are given? Are they limited in some way—for example, to just books, to only one or two journals, or to materials published by just one government agency? Are fairly recent publications included? If you do a quick search of a few bibliographic databases (catalogues, indexes, etc.), do you find numerous relevant references not cited by the authors?  Funding. Who paid for the study? Does this funding reassure you about the quality of the work or does it raise questions in your mind about the objectivity of the work?  Clearances. Was the work approved by relevant research ethics committees? Was permission obtained from relevant authorities?

148

Evaluating information from WWW Unfortunately, judging the validity of information resources becomes more of a challenge when you are looking for information ‘loose’ on the Web, that is, outside of the published literature. To judge online information resource, first go through the check list given above for critiquing pieces of literature. Then consider the following additional points.  Producer/sponsor. Who is responsible for the site? Is it an official agency, a nongovernmental group, etc.? What do you know about them? See if an external sponsor is paying for the site. If you decide that a site is of doubtful trustworthiness because of its sponsor, don’t waste your time reading the documents there. Remember too that information made available by a generally trusted institution is not necessarily true. An example is official statistical information, which may be based on poor data or adjusted for political reasons.  Inclusion in academic gateways. Persons and organisations who set up gateways usually know a great deal about the ‘players’ in a particular field and their trustworthiness. They try to include high-quality sites and exclude poor ones. So a good way to find good sites is to use a good gateway. Gateways are often run by librarians in collaboration with researchers and clinicians. Many of the sites listed in this sourcebook are gateways.  Open information about identity. Look for Web material that is signed, with identified authors. You can then ask the same questions about these persons that you would about the authors of printed material. Beware of materials that have anonymous authors, unless the responsible organisation is clearly identified. Watch out also for charlatans posing as scientific experts. Because of the lack of a peer review system, you are more likely to come across these on the Web than in the scientific literature.  Language. The quality of the writing is often a good measure of overall quality. Is the language suitable for a serious topic? Is it clear and straightforward? Is it free from errors in spelling and grammar? Are technical terms defined?  References to information sources. Information presented as ‘facts’ on Web sites should be substantiated. In other words, the producer should clarify the sources of information, give bibliographic references for printed material, identify persons making policy statements, and so forth.  Internal and external consistency. Check sites for internal consistency and logical soundness. Do statements made in one section agree with those made elsewhere at the site? Do things add up? Are you sure that the statements of ‘fact’ are true? Are the authors possibly engaging in unsound argumentation, such as drawing false conclusions from true statements? Comparing information on several Web sites about the same topic is also a good exercise. Look for points on which sites disagree and see if you can figure out the underlying reasons.

149

Watch out for hoaxes and frauds!

Spotting medical hoaxes and frauds http://www.quackwatch.org (Quackwatch) http://www.hhs.gov/nvpo/tips.htm (Dept. of Health and Human Services) http://www.nlm.nih.gov/medlineplus/webeval/webeval.html (MedlinePlus) http://www.vts.intute.ac.uk/detective (INTUTE) WWW is full of fake research and false information. This is especially true in areas such as medicine. After a while, you should be able to spot doubtful web sites. They claim to be run by experts but provide no details about these experts’ credentials. They often take a stand against academia, government, the research community, and anything else they label as ‘the establishment’. They make wild accusations and may even try to get you to donate money to their cause. The need to evaluate information for validity is especially true in the case of medical information on the Web, since false medical information can have serious, even life-ordeath consequences. And, unfortunately, such information is extremely common online. If you want an overview of the problem, you can visit Quackwatch. Medical organisations around the world are trying to counteract false medical claims by providing clear, well-written guidelines for evaluating online medical information. An example is ‘Ten Tips for Evaluating Immunization Information on the Internet’ from the United States Department of Health and Human Services, which was written to counteract dangerous misinformation about vaccinations. The National Library of Medicine in the United States also provides a brief online tutorial to help users learn to evaluate web sites. A more general introduction to evaluation web-based materials is available at the INTUTE site. It is aimed primarily at university students and presents evaluation of web materials as a form of detective work, but the points it makes are serious ones.

150

Handling Text Ethically The importance of referring to earlier work All academic research and writing is based in part on earlier publications. Every writer or researcher ‘stands on the shoulders’ of the persons who have worked in the same field. Therefore, before you carry out a piece of research, it is essential that you go through the literature and become familiar with the relevant publications. Doing a literature review not only will help you understand the topic itself, but also will give you some ideas about research questions of your own and about possible research designs and methods. Later, when you have completed your research and are preparing a manuscript for publication, you will then draw on the facts, hypotheses, and other points you have obtained from the literature. You will describe earlier relevant work as part of the background section of your article, and in the discussion you will compare your own findings with the earlier published results. Doing this does not decrease the value of your own work. In fact, the opposite is true, because it demonstrates your familiarity with your own research field. If you do not discuss the earlier work to which yours is related, you may have trouble getting your article published in a good journal, since reviewers will remark that you do not seem to know the relevant literature.

Attribution—giving credit where it is due It is unethical to claim something as your own work if it has actually been done by someone else. This is why, if you use information or ideas from a source, you must give credit to the author. This process of giving credit is called attribution. When you refer to the work of others, you should state the source clearly, regardless of whether it is an article, a book, of some other resource. References should be given both in the text, where the material is used, and at the end of the paper in a list entitled ‘References’. (Details are provided in the final chapter of this sourcebook.) Citations must be made to all aspects of original work, including research results, new research methods, ideas, and even language. Writing is part of the research process, so original passages must be attributed to their creators.

Handling of text passages Failure to attribute materials to the sources is a serious matter and can lead to charges of intellectual dishonesty and plagiarism. Plagiarism usually refers specifically to unethical copying of words and language—usually from printed texts, but also from sources such as speeches and web pages. So plagiarism is the theft of another person’s written work. But what constitutes theft?

151

The clearest cases are those in which a writer copies long verbatim (word for word) passages from another person’s work and fails to attribute the passage to the original author by giving a reference. This clearly constitutes plagiarism. But, in many instances, the situation is not so clear. As a result, many guidelines have been developed on proper scholarly writing. These guidelines often lay out three alternative, acceptable ways of handling cited text, namely:  Quotation. This involves: a) copying a passage verbatim, b) setting it in quotation marks, c) citing the source at the point of quotation, and d) including the source in the reference list for the piece.  Paraphrasing. This involves: a) rewriting a passage completely in one’s own words, b) citing the source at the point where the paraphrase is given, and c) including the source in the reference list.  Summarizing. This involves: a) summarizing the text in one’s own words, b) citing the source at the point where the summary is given, and c) including the source in the reference list. Note that all passages taken from another source must be given a reference, regardless of whether they are quoted, paraphrased, or summarized. If the ideas or data or passage of text are your own, but you have used them before in another publication, you must also give a reference. This is important to clarify that they are not being published for the first time in the current article. There is a limit to how much material you can quote or paraphrase. But where exactly is the line? Quoting or paraphrasing one sentence is acceptable. Quoting or paraphrasing several pages is not. The limit lies somewhere between the two, and judgment about acceptability has to be made in each individual case.

Paraphrasing and patchwriting It seems to be universally agreed that, as stated above, true paraphrasing involves completely rewriting the cited passage in one’s own words. Guides to scholarly writing agree that minor alterations simply do not ‘count’ and that such paraphrasing is unacceptable. Changing a few words, adding or deleting a word or two, or switching the order of phrases is not sufficient for the sentence to be considered one’s own. Paraphrasing is often found in conjunction with patchwriting. Patchwriting (sometimes called mosaic writing) is the type of plagiarism that authors are most liable to commit if they are uncomfortable with the language in which they are writing. These authors create an article by selecting a large amount of text—often copied from online resources—paraphrasing the selected passages, and then tying the bits together with a few sentences of original text. Patchwriting is fast and easy and requires negligible efforts compared to that which went into the original sources. It is both poor writing style and intellectually dishonest. For this reason, patchwriting is not acceptable even if the passages are thoroughly paraphrased and even if proper attribution is given for every sentence in every paraphrased passage.

152

It is easy to avoid unacceptable paraphrasing and patchwriting. Collect your background literature and study it thoroughly until you really know the material. Then sit down without those resources available. If you work at the computer where the text files of the background articles are stored, do not open those files while you are writing. If necessary, turn off your computer and write on paper with a pencil.

Write completely from your own head, summarizing what you have learned from the literature. Then, when you are done with the draft, you can go back, add the references, and check the details for accuracy. You can also add quotations if that is appropriate.

Placement and repetition of references Many authors automatically put all their references at the end of a paragraph. But this is not a good practice. References should not always be placed at the end of a paragraph or even at the end of a sentence. They should be placed immediately after the information to which they apply. Giving the citation at the precise relevant point becomes even more important when a paragraph consists of several sentences and includes references to several different sources. If the references are given in a lump at the end of the paragraph, it is often unclear which information has come from which source. Thus an article containing multiple passages of either quoted or paraphrased materials should contain clear references to each individual point taken from the original source. The result is a text filled with citations, either names and dates or citation numbers, depending on the reference style being followed. Authors are better off being overly careful in this regard, rather than risking charges of plagiarism.

Common knowledge Writers are not expected to give citations for facts that their readers will already know. However, the writer must be very certain that the facts are commonly known. Furthermore, â&#x20AC;&#x2DC;common knowledgeâ&#x20AC;&#x2122; cannot be used as justification for lifting a passage from another authorâ&#x20AC;&#x2122;s work and not giving a citation. If the information is so widely known, then it should be possible to describe it without stealing the specific language of another writer.

153

Citing Your Sources Correctly

The basics of references Readers should be able to track down your sources on the basis of the bibliographic information you provide. The specific information that is required for the reference depends on the type of resource.  Book references give the author’s name, the book title, the publisher, and place and date of publication. Place is normally a city, sometimes with state and/or country included, and the date is given as a year. It is not appropriate to give ISBN number.  References for journal articles should include the author’s name, the title of the article, the name of the journal, and the volume, issue, and page numbers. It is not appropriate is give ISSN number or place of publication.  There are also standard forms for other printed materials, such as edited books, reports from institutions, newsletters, book chapters, dissertations, and so on. See the next unit for more details on these.  Giving correction references for electronic resources (such as articles found at a web site) can be very difficult, since the exact address changes if the document is moved within the site. That is why you should not only give the usual information about the article, but also the web address and the date on which you accessed the material. Many organisations that put material on the web are now giving specific information about how documents should be cited, and this helps a lot.

Different bibliographic styles Different disciplines have various ‘styles’ for handling references, both in the text and in reference lists. There are numerous systems for handling bibliographic references, including Harvard, Vancouver, MLA, Chicago, APA, CBE, and many others. Reference styles differ both in how the individual references look in the reference list and in how the references are cited in the text. For example, in the Harvard system the citation in the text is in the form of the author’s name and the date of the publication (Smith 2005), and the cited works are listed alphabetically in the reference list. In the Vancouver system, the citation is just a number (1), and the cited works are listed in the same order in which they appear in the text (1, 2, 3, ….) Researchers should be aware that, if they submit a paper for publication in an international journal, that journal will almost certainly have its own required bibliographic style. The instructions below are based on the Vancouver system, which is the one used by most medical journals.

154

Citations should point clearly to your sources of information.

Handling references in the text      

In the text, when information is given that has been taken from a particular source, the source is cited. Note that a citation is needed for any quoted, paraphrased, or summarized information. The citation or reference is given as a number, which is normally shown in superscript. The first publication cited is referred to as 1, the second publication cited is referred to as 2, and so forth. If multiple publications are cited, they are listed as 1,2,3 or as 1-3. A publication that has already been cited and is then cited again in the paper retains the same number.

Here is an example: …… The government has made a commitment to decreasing maternal mortality1 but success in the rural areas has been greatly impeded, especially in the southern part of the country,2 where armed conflict is interfering with efforts to strengthen public health programmes. The situation may change dramatically if a cease fire can be established.1,3 However, maternal deaths are unlikely to decrease unless the relevant programmes within the Ministry of Health are fully funded.1,4-7

Handling references in the reference list In the Vancouver system, the references that are cited in the text are listed in the same order, by number, in the reference list. Each reference is made up of parts providing different information about, for example, authorship and date of publication. The various parts of the reference are separated by periods (full stops), and the whole reference also ends in a period. The specific information you need to include in the reference depends on the sort of resource it refers to: a book, a journal article, a chapter in an edited book, a conference paper, a web site, etc.

155

The Vancouver system is designed to save space and avoid unnecessary formatting. Please note the following:  Names are given in this form: last name followed by initials, without any punctuation: (Smith AC)  Names of multiple authors are given without an ‘and’ between the final two: (Smith AC, Longmire D, Fellowes RS)  The journal name is given in official abbreviated form (don’t make these up yourself: N Engl J Med is correct, not NEJM  The information about volume, issue, pages, and dates are given in compact form, with minimal spaces: 2001 Jan 12;236(1):172-8.  Page intervals include only the numerals needed: 172-8, 234-45, 199-203.  Journal articles that are read from online sources require a special type of reference that includes the web site and the date cited, that is, the date the reference was added to you own paper.

Examples of references in Vancouver format Standard journal article Halpern SD, Ubel PA, Caplan AL. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002 Jul 25;347(4):284-7. Article in journal that carries continuous pagination throughout a volume Halpern SD, Ubel PA, Caplan AL. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7. Article with more than six authors Rose ME, Huerbin MB, Melick J, Marion DW, Palmer AM, Schiding JK, et al. Regulation of interstitial excitatory amino acid concentrations after cortical contusion injury. Brain Res. 2002;935(1-2):40-6. Article with organisation as author Diabetes Prevention Program Research Group. Hypertension, insulin, and proinsulin in participants with impaired glucose tolerance. Hypertension. 2002;40(5):679-86. Article with no author given 21st century heart solution may have a sting in the tail. BMJ. 2002;325(7357):184. Article published electronically ahead of the print version Yu WM, Hawley TS, Hawley RG, Qu CK. Immortalization of yolk sac-derived precursor cells. Blood. 2002 Nov 15;100(10):3828-31. Epub 2002 Jul 5. Journal article on the Internet, not available in print form Abood S. Quality improvement initiative in nursing homes. Am J Nurs [serial on the Internet]. 2002 Jun [cited 2002 Aug 12];102(6):[about 3 p.]. Available from: http://www.nursingworld.org/AJN/2002/june/Wawatch.htm Book with personal author(s) Murray PR, Rosenthal KS, Kobayashi GS, Pfaller MA. Medical microbiology. 4th ed. St. Louis: Mosby; 2002.

156

Book with editor(s), compiler(s) as author Gilstrap LC 3rd, Cunningham FG, VanDorsten JP, editors. Operative obstetrics. 2nd ed. New York: McGraw-Hill; 2002. Book with both author(s) and editor(s) Breedlove GK, Schorfheide AM. Adolescent pregnancy. 2nd ed. Wieczorek RR, editor. White Plains (NY): March of Dimes Education Services; 2001. Chapter in a book Meltzer PS. Chromosome alterations in human tumors. In: Vogelstein B, Kinzler KW, editors. The genetic basis of cancer. New York: McGraw-Hill; 2002. p. 93-113. Conference proceedings Harnden P, Jones WG, editors. Germ cell tumours V. Proceedings of the 5th Germ Cell Tumour Conference; 2001 Sep 13-15; Leeds, UK. New York: Springer; 2002. Conference paper Christensen S, Oppacher F. An analysis of Koza's computational statistic. In: Foster JA, Lutton E, Miller J, Ryan C, Tettamanzi AG, editors. Genetic programming. EuroGP 2002: Proceedings of the 5th European Conference on Genetic Programming; 2002 Apr 3-5; Kinsdale, Ireland. Berlin: Springer; 2002. p. 182-91. Scientific or technical report issued by a funding/sponsoring agency Yen GG (Oklahoma State University, School of Electrical and Computer Engineering, Stillwater, OK). Health monitoring on vibration signatures. Final report. Arlington (VA): Air Force Office of Scientific Research (US), Air Force Research Laboratory; 2002 Feb. Report No.: AFRLSRBLTR020123. Contract No.: F496209810049. Dissertation Borkowski MM. Infant sleep and feeding: a telephone survey of Hispanic Americans [dissertation]. Mount Pleasant (MI): Central Michigan University; 2002.

More advice from online sources http://www.nlm.nih.gov/bsd/uniform_requirements.html (Uniform Requirements) http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=citmed.TOC&depth=2 (Bookshelf) http://apps.carleton.edu/campus/library/find/guides/general/?guide_id=133205 http://www.smith.edu/libraries/research/stylemanuals.htm http://www.library.carleton.edu/reference/researching/eciting.html http://www.bath.ac.uk/library/webpubs/references.html The International Committee of Medical Journal Editors produces a guide for authors entitled â&#x20AC;&#x2DC;Uniform Requirements for Manuscripts Submitted to Biomedical Journalsâ&#x20AC;&#x2122;, which deals with all aspect of manuscript preparation and submission. One component is the Vancouver Guidelines, which specifies how references to different types of materials should be given. The guidelines are in the public domain and are available online, including at the NLM. Perhaps even more useful is the online book Citing Medicine: The NLM Style Guide, which can be reached via Bookshelf at the address given above.

157

If you are interested in learning more about handling references and about reference styles, there are numerous WWW pages you can consult. Many of these have been created by university librarians to give guidance to students. A few examples of some sites to try are listed above.

And keep practicing Handling citations correctly is like playing a sport or playing an instrumentâ&#x20AC;Śit requires practice. Every time you write an article or report, take the time to do the citations correctly according to the bibliographic style you are using. Each time, it will be a bit easier.

Keep practicingâ&#x20AC;Ś.it gets easier.

158

Search Record Name _________________________________________________________________ Resource: _____________________________________________________________ Date ____________________

Search String

Limits

# of Hits