"You're just one of the group when you're embedded": report from a mixed-method investigation of the research-embedded health librarian experience.

OBJECTIVE: Embedded librarianship has received much attention in recent years. A model of embeddedness rarely discussed to date is that of research-embedded health librarians (REHLs). This study explores the characteristics of Canadian REHLs and the situations in which they are employed. METHODS: The authors employed a sequential, mixed-method design. An online survey provided descriptive statistics about REHLs' positions and work experiences. This informed a series of focus group interviews that expanded upon the survey. Through constant comparison, we conducted qualitative descriptive analysis of the interviews. RESULTS: Based on twenty-nine survey responses and four group interviews, we created a portrait of a "typical" REHL and discovered themes relevant to REHL work. REHLs may identify more strongly as researchers than as librarians, with corresponding professional needs and rewards. REHLs value "belonging" to the research team, involvement in full project lifecycles, and in-depth relationships with nonlibrarian colleagues. Despite widely expressed job satisfaction, many REHLs struggle with isolation from library and information science peers and relative lack of job security. CONCLUSIONS: REHLs differ from non-embedded health librarians, as well as from other types of embedded librarians. REHLs' work also differs from just a decade or two ago, prior to widespread Internet access to digital resources. IMPLICATIONS: Given that research-embedded librarianship appears to be a distinct and growing subset of health librarianship, libraries, master's of library and information science programs, and professional associations will need to respond to the support and education needs of REHLs or risk losing them to the health research field.

Surveys of complementary and alternative medicine usage: a scoping study of the paediatric literature.

OBJECTIVE: To conduct a scoping review of paediatric CAM utilisation literature, in order to establish the depth and breadth of the field and identify gaps in knowledge regarding the epidemiology of CAM use. METHODS: A CAM and paediatric search strategy was developed and run in three databases (Medline, Embase, Amed) in June 2006. It was revised and rerun in February 2010. Utilisation studies about paediatric CAM were selected if they had an English or French abstract. Data were extracted into an excel table by one individual. RESULTS: 152 paediatric CAM utilisation studies were identified as of February 2010, 136 were fulltext English. There was variation in how CAM was defined: vitamins were included in 35 studies, excluded in 12 studies and not mentioned in 40; while prayer was included in 64, excluded in 9, and not mentioned in 39. Over half of the studies identified were from North America. The majority of studies were conducted in conventional health settings. The four most commonly studied subpopulations were cancer, asthma, autistic spectrum disorder, and attention deficit hyperactivity disorder. Eighteen percent of studies did not report on the period of assessment used. Twenty-seven percent of studies inquired about adverse events and 32% inquired about costs and insurance coverage. CONCLUSION: There are substantial paediatric utilisation data available but some subpopulations remain poorly researched. The need for transparent utilisation data remains important in order to help prioritize safety and efficacy research.

The PedCAM Network: past, present, and future.

Established in 2004, the Pediatric Complementary and Alternative Medicine Research & Education (PedCAM) Network (www.pedcam.ca) is a multidisciplinary national and international network focused on pediatric research and education with the vision of safe and effective use of complementary and alternative medicine (CAM) use in children and youth and is designed to be a networking and information resource for both researchers and practitioners in the field of pediatric CAM. PedCAM offers a wide variety of resources and opportunities to researchers, clinicians, educators and the general public: educational, and funding opportunities; links to core articles and books; a searchable database of pediatric CAM research articles; biweekly electronic updates for members. Currently, it is engaged in several research projects to strengthen the pediatric CAM knowledge base: (i) a modified Delphi consensus process for establishing a pediatric CAM research agenda; (ii) the identification of validated pediatric outcome measures; and (iii) a synthesis of pediatric CAM utilization studies to identify knowledge gaps. The widespread use of CAM in children, and the resulting need for high quality research and education, suggests that the PedCAM Network will remain relevant and timely in its efforts to connect those working in the field of pediatric CAM in Canada and around the world.

Pediatric integrative medicine: pediatrics' newest subspecialty?

BACKGROUND: Integrative medicine is defined as relationship-centered care that focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, healthcare professionals and disciplines to achieve optimal health and healing, including evidence-based complementary and alternative medicine. Pediatric integrative medicine (PIM) develops and promotes this approach within the field of pediatrics. We conducted a survey to identify and describe PIM programs within academic children's hospitals across North America. Key barriers and opportunities were identified for the growth and development of academic PIM initiatives in the US and Canada. METHODS: Academic PIM programs were identified by email and eligible for inclusion if they had each of educational, clinical, and research activities. Program directors were interviewed by telephone regarding their clinical, research, educational, and operational aspects. RESULTS: Sixteen programs were included. Most (75%) programs provided both inpatient and outpatient services. Seven programs operated with less than 1 FTE clinical personnel. Credentialing of complementary and alternative medicine (CAM) providers varied substantially across the programs and between inpatient and outpatient services. Almost all (94%) programs offered educational opportunities for residents in pediatrics and/or family medicine. One fifth (20%) of the educational programs were mandatory for medical students. Research was conducted in a range of topics, but half of the programs reported lack of research funding and/or time. Thirty-one percent of the programs relied on fee-for-service income. CONCLUSIONS: Pediatric integrative medicine is emerging as a new subspecialty to better help address 21st century patient concerns.

The safety of cruciferous plants in humans: a systematic review.

Some cruciferous plants may serve as preventive treatments for several medical conditions; our objective was to systematically investigate their safety in humans. Four electronic databases were searched, and, of 10,831 references identified, 50 were included. Data were extracted by two independent reviewers, whereafter the association between interventions and adverse events was assessed. Adverse events in 53 subjects were identified through clinical trials; of these, altered drug metabolism was rated as certainly/likely caused by cruciferous plants. Adverse events in 1247 subjects were identified through observational studies, of which none received high causality ratings. Adverse events in 35 subjects were identified through case reports, of which allergies and warfarin resistance were rated as certainly/likely caused by cruciferous plants. We conclude that cruciferous plants are safe in humans, with the exception of allergies. Individuals treated with warfarin should consult their physician. Further investigation of uses of cruciferous plants in preventative medicine is warranted.