Consumer Connections
ISSN 1535-7821 Vol. 23 No. 3 2007
Articles
Social Networking Sites as a Means of Access to Health InformationTo Interfile, or Not To Interfile: Is That the Question?
Update from the National Library of Medicine, Division of Specialized Information Services
Reviews
The Food-Mood Solution
The Early Intervention Dictionary: A Multidisciplinary Guide to Terminology (3rd ed.)
Teaching Motor Skills to Children with Cerebral Palsy and Similar Movement Disorders: A Guide for Parents and Professionals
Understanding and Managing Your Child's Food Allergies
Publication Information
Articles
Social Networking Sites as a Means of Access to Health Information
Submitted By: Heather Coates, Master's Student, School of Library and Information Science & School of Informatics, Indiana University, Indianapolis, IN.
Social networking sites such as FaceBook, MySpace, Flickr, and LibraryThing have evolved from a popular fad into a lasting, evolving technology embedded in the lives of many Americans. The scope of individuals represented, the topics discussed, and activities taking place at these sites is personally or professionally significant for many of us. Sites that focus more specifically on individuals with health conditions or diseases, such as breast cancer, have been in use prior to use of the term "social networking sites." The focus of health sites is necessarily less on building a large network and more on information and social support, but the underlying structure of general and health specific sites is often the same. The term "social networking" is often confused with the sociological technique of a similar name (social network analysis) that studies the social networks of individuals by focusing upon structural elements known as relationships, rather than individual characteristics (e.g., age, gender, race, profession, etc.). Both concepts have in common the idea of individuals who are loosely bound into networks not quite cohesive enough to be group. To better understand the role of health focused social networking sites, I have drawn upon literature spanning across several disciplines but which focuses on three concepts: social network analysis, social support, and online social networks. Unger and Powell (1980) identify the main function of many social networks as the provision of three types of support: instrumental support (or tangible support), emotional or social support, and referral or information. This article will focus on two of the three: emotional or social support and information access. Furthermore, current evidence indicates that individuals are carrying out the same activities online as conducted in the physical world. Thus, we can apply insights from research on more traditional social networks to our understanding of online social networks.
Social network analysis (SNA) takes a different approach in studying behavior than do traditional social or behavioral science methods. Rather than focusing on the attributes of specific individuals, SNA utilizes theoretical constructs and models to analyze the relationships, or social network structure, between individuals (Wasserman & Faust, 1994). SNA, sometimes also termed structural analysis, is an approach that builds upon theories across multiple disciplines, such as mathematics, sociology, library and information sciences, as well as psychology (McGrath, Krackhardt, & Blythe, 2003; Otte & Rosseau, 2002; Wasserman & Faust, 1994). In other words, SNA provides a framework and methods to study information exchange between people in various social networks. The richness of the data yielded by social network analysis has often been applied to networks existing offline, but less frequently to online social networks, particularly those facilitated by such sites as MySpace and Facebook. The central focus of social network analysis (SNA) is the interaction between the structure of a network, or the ties between individuals, and the members. Thus, there is a plethora of research regarding offline networks using SNA methodologies; there is far less evidence regarding online networks. The relatively small body of evidence that exists does not suggest that ties in online networks are significantly different from those of offline networks.
So why study social networks? The study of traditional or face-to-face social networks has been popular and growing area of study for the past since the mid 1950s; one necessary shortcoming of many of these studies is that they centered on highly specific individual characteristics, groups, or settings. Importantly, some studies have found social networks to be a critical support system. In particular, Stack (1974) determined this was true for low income black families. Often, reports of these studies acknowledge that the specific features and affects of social networks are heavily dependent upon context. Such context is described using a variety of concepts, ranging from gender, race and ethnicity, and education to political affiliation, institutional associations, shared interests, and socioeconomic status (SES). Those focusing primarily on technical aspects of the software supporting online social networks often do not consider the larger social context of either the online or offline environments of the network members. Thus, many current studies of online social networks lack the depth and relevance of research based upon sociological theories.
Despite this, several studies acknowledge the need to interpret results of social network studies within the appropriate social context (Ankem, 2003; Dahan & Sheffer, 2001; Franzen, 2000; Fry & Talja, 2007; Koku, Nazer, & Wellman, 2001; Lakkala, Ilomaki, & Palonen, 2007; Rennecker & Godwin, 2005; Tonn, Zambrano, & Moore, 2001). Tonn and Petrich's insightful article (1998) succinctly framed the idea that "…individuals' actions with respect to technology are best understood as the product of concurrent, intra-personal, relational, and contextual dynamics." However, it is not feasible to measure the full context of an individual's life in a single study. Thus, researchers have designed studies to examine particular aspects of social life, often categorized by the setting – home, work, and community. While these may be valid dimensions of social context, society is organized not only by physical communities, but also by institutions (Ankem, 2003) such as schools, businesses, political groups, and other interest groups. These groups not only have an impact on how time is spent, but on social roles, identities, and situations (Ankem, 2003).
Of the many activities happening on social networking sites, the most relevant to health sciences librarians are information access and social support and the resulting impact upon health outcomes. However, a vital part of understanding how such sites are affecting patrons is to explore the context in which they are used. Sometimes, the layers of networks are described as concentric groups, such as in Mertsenmeyer and Fine (2000). They conceive of the family as a nested set of circles representing four systems: 1) the microsystem consisting of the relationships between the child and significant others; 2) the mesosystem consisting of settings in which children and the family spend most of their time; 3) the exosystem consisting of institutions where the children and family are non-participatory; and 4) the macrosystem, which consists of the culture that ultimately affects the first three levels. Schilling, Gilchrist, and Schinke (1984) propose three levels of social supports: the nuclear family, neighbors and friends that are more distant and relatives, and others described by infrequent or superficial contact. The way in these levels are defined is not the key issue for librarians; however, in the interest of providing the best reference services possible, it is important to recognize that understanding patron use of such technologies is embedded within complex and multifaceted social context which likely affects their use of technologies.
Information access within offline social networks has been studied since the mid-1950s. The literature base for online social networks is developing, but remains relatively small in size and scope. Although the terminology often varies depending on the authors' field, information access is a key issue at the heart of understanding the costs and benefits of social networks. Specific populations, such as women with breast cancer, have been studied extensively (Raupach & Hiller, 2002; Sharp, 2000; Fogel, 2004; Fogel, Albert, Schnabel, Ditkoff, and Neugut, 2002), while other populations have been neglected or are relatively more difficult to access. One reason for the focus on individuals who have been diagnosed with breast cancer is the demonstrated high need for information (Raupach & Hiller, 2002) and social support (Sharp, 2000). The potential benefits of studying networks of individuals with acute or chronic health conditions include clear network boundaries (i.e., diagnoses or treatment), the members' need for more information related to the health condition, and the variety of access points at which researchers can contact potential participants. Perhaps the most compelling reason is to assist individuals who are in dire need of aid and support.
Additional findings related to information access patterns in social networks range from general results indicating that social networks are used to locate and access resources beyond the aid provided by the members themselves (Lee, 1969) to specific evidence regarding the needs of parents with developmentally disabled children (Scharer, 2005). More generally, a study by Unger and Powell (1980) on the role of family social networks in mediating stress provided evidence that families utilize different members of the social network for different needs. French and Larrabee's (1999) study of 50 adult clients with hypertension in the South revealed evidence that the low literacy levels have a powerful effect upon perceived benefit of health information as well as health outcomes. Perhaps more important for health sciences librarians is the finding that the measured reading level was two to three grade levels below the reported years of education (French & Larrabee, 1999), which is consistent with previous studies (Jubelirer et al, 1994; Meade & Byrd, 1989; Larson & Schumacher, 1992; Doak et al, 1996). Several studies have suggested that health information materials should be written one to three grade levels below the average level of the target population (French & Larrabee, 1999; Jubelirer et al, 1994; Meade & Byrd, 1989; Estey et al, 1991; Doak & Doak, 1980), while a wide gap in reading levels between patient abilities and health information materials has also been documented (Jubelirer et al, 1994; Meade & Byrd, 1989; Larson & Schumacher, 1992). Given such evidence, it is not surprising that patients perceive little benefit from many of the materials provided to them. Finally, this gap in the readability of educational materials and patient abilities affects expectations regarding health care. French and Larrabee (1999) suggest these discrepancies between client and provider expectations will continue to plague healthcare until clients are able to collaborate with health care providers regarding their own care.
Aiding in social support and coping is another key function of social networks, both online and offline. Social support and coping are individually important processes, but it is when they are combined together that they compose a powerful set of skills (McCubbin, 1979; Shuval, 1981). Schilling et al (1984) state that coping is problem solving when the demands of a specific situation overload adaptive resources, while social support consists of individuals, groups, and institutions who provide various degrees and forms of assistance to help an individual combat stresses. The authors believe that both are "teachable strategies" (Schilling et al, 1984). The study of social support is generally combined with a measure of outcome, whether on physical or mental health, or sometimes both. Such studies can provide the greatest insight into the overall health functioning of individuals, families, and networks.
However, evidence for specific populations or networks is sometimes conflicting or inconclusive. For instance, Fogel (2004) found that searching for health information was not associated with psychological coping, while internet use specifically for breast health issues was associated with greater social support as compared to internet use for other purposes and nonuse. On the other hand, a study by Rodgers and Chen (2005) revealed a wide range of psychosocial benefits related to use of an electronic discussion list or bulletin board by using thematic analysis of posts. Such benefits included information exchange, social support, improved affect towards the discussion board, greater optimism towards breast cancer, increased skill or ability to cope with the disease, improved mood, decreased psychological distress, and increased ability to manage stress. The authors reported several interesting findings, but two of the most relevant to social support included the relationship between the total number of posts and information exchange and the relationship between the frequency of posting and improvement in mood (Rodgers & Chen, 2005). Perhaps one reason some social networking sites are increasingly successful is that the telling of stories allows individuals to construct their own identity (Hall, 1996), and to articulate and make sense of their experiences (Hyden, 1997).
Eysenbach, Powell, Englesakis, Rizo, and Stern (2004) conducted a review of the literature for studies on the efficacy of virtual communities as stand alone or adjunct interventions in healthcare. This review yielded only six studies of peer to peer only virtual communities; the rest of the 38 presenting original evidence included some sort of professional moderation or more complex interventions, of which virtual communities were only a portion. Eysenbach et al (2004) found no strong evidence of health benefits in these six studies, although they reported that four studies suggested that greater use of such groups was positively associated with better health outcomes. Similarly, Seeman, Seeman, and Sayles (1985) found instrumental support was positively associated with health at the beginning of the one year study, but that the effect dissipated by the end. However, the study by Seeman et al (1985) did find some interesting effects between participants' sense of general control and preventive care. More specifically, a high sense of general control was positively associated with preventive care, while high consulting was negatively associated with preventive care (Seeman, Seeman, & Sayles, 1985). Kobasa, Maddi, and Puccetti (1982) propose that engagement in a social network enhances an individual's sense of control over their environment, which may explain the effects found in Seeman et al (1985).
So what implications do these results have for the practices of health sciences librarians? Although specific effects of the use of social networks or social networking sites vary widely, there is clear evidence from a variety of populations and settings to indicate the value of technologies enabling social support networks (Bass, McClendon, Brennan, & McCarthy, 1998; Brennan, Moore, & Smyth, 1991; Dunham et al, 1998; Mickelson, 1997). Rodgers and Chen (2005) findings that women who are members of online longer and who have posted more frequently were more likely to shift from information seekers to givers, I would propose that health sciences librarians seek out such individuals and create mentor relationships. While it is always preferable to utilize a trained professional when seeking health information, the fact is that many individuals with serious health concerns do not have the knowledge or time to do so. So let us build relationships with those mentors or gatekeepers at the places at which people are seeking information and support. Secondly, as the question is not whether social networks provide support, but when and under what conditions they are used as a means of support (Unger & Powell, 1980), further research is necessary. Also, longitudinal studies should be undertaken considering that psychological state or well being is dynamic and fluctuates depending on an individual's current circumstances (Bradburn, 1969). Finally, health sciences librarians should attempt to understand the strength of social networking sites through longitudinal research combining qualitative and quantitative methods. A clearer picture of the use of social networking sites given the richness of the context in which they operate could yield significant insight into our patrons. Perhaps some elements of these sites could even be incorporated into library services.
References
Ankem, K. (2003). Influence of information sources on the adoption of uterine fibroid embolization by interventional radiologists. Journal of the Medical Library Association, 91(4), 450-459.
Bass, D. A., McClendon, M. J., Brennan, P. F., McCarthy, C. (1998). The buffering effect of a computer support network on caregiver strain. Journal of Aging and Health, 10, 20-43.
Bradburn, N. M. (1969). The Structure of Psychological Well-Being. Chicago: Aldine.
Brennan, P. F., Moore, S. M., Smyth, K. A. (1991). ComputerLink: Electronic support for the home caregiver. Advances in Nursing Science, 13, 14-27.
Dahan, M., & Sheffer, G. (2001). Ethnic groups and distance shrinking communication technologies. Nationalism & Ethnic Politics, 7(1), 85-107.
DeWalt, D. A., Berkman, N. D., Sheridan, S., Lohr, K. A., & Pignone, M. P. (2004). Literacy and health outcomes. Journal of General Internal Medicine, 19, 1228-1239.
Dunham, P. J., Hurshman, A., Litwin, E., Gusella, J., & Ellsworth, C. (1998). Computer-mediated social support: Single young mothers as a model system. American Journal of Community Psychology, 26, 281-306.
Eysenbach, G., Powell, J., Englesakis, M., Rizo, C., & Stern, A. (2004). Health related virtual communities and electronic support groups: Systematic review of the effects of online peer to peer interactions. British Medical Journal, 328(1166).
Fogel, J. (2004). Internet breast health information use and coping among women with breast cancer. Cyberpsychology & Behavior, 7(1), 59-63.
Fogel, J., Albert, S. M., Schnabel, F., Ditkoff, B. A., & Neugut, A. I. (2002). Internet use and social support in women with breast cancer. Health Psychology, 21(4), 398-404.
Franzen, A. (2000). Does the internet make us lonely? European Sociological Review, 16(4), 427-438.
French, K. S.,& Larrabee, J. H. (1999). Relationships among educational material readability, client literacy, perceived beneficence, and perceived quality. Journal of Nursing Care Quality, 13(6), 68-82.
Fry, J., & Talja, S. (2007). The intellectual and social organization of academic fields and shaping of digital resources. Journal of Information Science, 33, 115-133.
Hall, S. (1996). Representation: Cultural representation and signifying practices. London: Open University Press.
Hyden, L C. (1998). Illness and narrative. Sociology of Health and Illness, 9(1), 48-69.
Kobasa, S. C., Maddi, S. R., Puccetti, M. C. (1982). Personality and exercise as buffers in the stress-illness relationship. Journal of Behavioral Medicine, 5(4), 391-404.
Koku, E., Nazer, N., & Wellman, B. (2001). Netting scholars: Online and offline. American Behavioral Scientist, 44(10), 1752-1774.
Lakkala, M., Ilomaki, L., & Palonen, T. (2007). Implementing virtual collaborative inquiry practises in a middle-school context. Behaviour & Information Technology, 26(1), 37-53.
McCubbin, H. I. (1979). Integrating Coping Behavior in Family Stress Theory. Journal of Marriage and the Family, 41(2), 237-244.
McGrath, C., Krackhardt, D., & Blythe, J. (2003). Visualizing complexity in networks: Seeing both the forest and the trees. Connections, 25(1), 37-47.
Mertsenmeyer, C., & Fine, M. (2000). ParentLink: A model of integration and support for parents. Family Relations, 49(3), 257-265.
Otte, E., & Rosseau, R. (2002). Social network analysis: A powerful strategy also for the information sciences. Journal of Information Science, 28(6), 441-453.
Raupach, J. C. A., & Hiller, J. E. (2002). Information and support for women following the primary treatment of breast cancer. Health Expectations, 5(4), 289-301.
Rennecker, J., & Godwin, L. (2005). Delays and interruptions: A self-perpetuating paradox of communication technology use. Information & Organization, 15, 247-266.
Rodgers, S., & Chen, Q. (2005). Internet community group participation: Psychosocial benefits for women with breast cancer. Journal of Computer-Mediated Communications, 10(4), article 5.
Scharer, K. (2005). An internet discussion board for parents of mentally ill young children. Journal of Child and Adolescent Psychiatric Nursing, 18(1), 17-25.
Schilling, R. F., Gilchrist, L. D., & Schinke, S. P. (1984). Coping and social support in families of developmentally disabled children. Family Relations, 33(1), 47-54.
Shuval, J. T. (1981). The contribution of psychological and social phenomena to an understanding of the aetiology of disease and illness. Social Science and Medicine: Part A, Medical Sociology, 15(3), 337-342.
Seeman, M., Seeman, T., & Sayles, M. (1985). Social networks and health status: A longitudinal analysis. Social Psychology Quarterly, 48(3), 237-248.
Tonn, B., Zambrano, P., & Moore, S. (2001). Community networks or networked communities. Social Science Computer Review, 19, 201-21
Unger, D. G., & Powell, D. R. (1980). Supporting families under stress: The role of social networks. Family Relations, 29(4), 566-574.
Wasserman, S., & Faust, K. (1994). Social Network Analysis: Methods and Applications. Cambridge: Cambridge University Press.
To Interfile, or Not To Interfile: Is That the Question?
Submitted By: Nancy Seeger, M.Ed., MLIS, Family Resource Center Health Librarian, Rainbow Babies & Children's Hospital, Cleveland, Ohio.
Searching the archives of most library-related online forums reveals a number of threads concerning the pros and cons of interfiling children, teen and adult materials in public library collections. This is often an issue in special libraries serving health consumers, especially those located in a pediatric setting, and it was an issue I faced when I began a new position in a family resource center housed on the first floor of a pediatric hospital.
Although free-standing consumer health libraries and those housed in hospitals and other medical institutions are generally defined as special libraries, they face many of the same issues as public libraries. Most special libraries handle a homogeneous population and specific subject matter. Medical libraries typically serve physicians and other medical professionals. Corporate libraries manage collections focus on one corporation's interests, and serve its employees. Consumer health libraries are special libraries that serve the general public. While collections in such libraries focus on health issues, subjects can cover everything from medical reference to personal stories, and the user population is the same as can be found in the public library. When making decisions about the use of space and effective shelving options, it is crucial to consider these unique characteristics of the consumer health library, and explore what works in public libraries.
The current trend in public libraries leans toward providing spaces and shelving for teens and children that are separate from the adult collections. Librarians advocating for separate collections often support the rationale that young people have different needs and use materials differently than adults. Children are more likely to explore library materials that are contained in an area designed just for them. Low shelves with appealing covers facing out are more enticing, and give young children a sense of control over the material. When children's books are interfiled among adult titles, the children themselves are unlikely to find them. Even if they are looking for books on a specific topic, they may not be able to locate or access them on adult-sized shelves. If a children's area in a consumer health library is also equipped with hands-on anatomy models, kid-friendly computer workstations loaded with age appropriate health-related applications, and colorful displays, children are more likely to interact with the available information and materials.
Young adults can also benefit from library spaces that consider their special needs and characteristics. This may be especially true in consumer health libraries. Teens looking for health related material may be more comfortable browsing in an area designed only for them, especially if they are searching for sensitive subject matter, and want more privacy. They may be looking for information on sexually-transmitted disease, eating disorders, gay/lesbian topics or mental health concerns. Having an area designated specifically for teen health issues can feel more welcoming and accepting to young adults in difficult situations. A 15 year old pregnant teen comes to the library with very different concerns and questions than those of a 36 year old woman expecting her first child. With separate collections children, teens and adults can more easily find relevant materials without wading through titles that are too childish, too basic, too complicated or directed towards the needs of a different age group. Library users – especially teen users - typically gravitate towards materials that are easily accessible, and are more likely to stop browsing if their first attempts to locate information fail to find relevant materials. If the majority of the items on the shelf under a specific topic are age-appropriate, they are likely to feel successful early in their searching,and gain confidence that they can find what they need.
One of the goals for our library is to encourage teens to become more involved in their own medical care through increased teen use of the library. With that objective in mind, my first thought was to develop and maintain a special collection of teen health materials, and shelve them in a special area designed specifically for young adults. As I had recently come from a public library that had successfully created a well-received and functional teen area for young adults, I knew how well it could work. I had also decided to use the Planetree Classification System to catalog our resource collection, and when I learned that the Planetree model advocated a separate Kids Corner for juvenile health materials, it seemed to be clearly the right choice. Then I stepped back and looked at the space in which I had to create these separate collections, and the choice became a bit more complicated. When describing our Family Resource Center, one might say that it is lovely, cozy and welcoming, but when looking for ways to organize our various collections, the first adjective that comes to mind is small. First and foremost, it is a small library space, and while it is one of the many characteristics that I love about the resource center, its small size creates an enormous shelving challenge.
I posed the question of interfiling to the CAPHIS Listserv to find out what others in similar situations were doing. I received a large number of responses, and found that most of them came from libraries choosing to interfile children, teen and adult health-related books. I thought that limited space would play a significant role in deciding to interfile, and space and size clearly do have an impact on shelving decisions. There is no doubt that interfiling uses less shelf space, and trying to organize separate collections in a small library often creates cramped and uncomfortable spaces. However, I found that most librarians choosing to interfile did so primarily because of several other benefits they had discovered.
Many librarians found that it can be very helpful to library users to have all the materials on a single subject kept together. This is especially useful for parents of pediatric patients who may want to find information suitable for themselves, their hospitalized child and the patient's siblings or friends as well. Interfiling allows parents to browse all of the materials available without searching in multiple sections.
Another recurring rationale was that interfiling offers a respectful and non-intrusive way to accommodate varying literacy levels. With subject specific books presented in various reading levels shelved side by side, patrons can choose material with a reading level that best suits their needs. Many adults patrons benefit from simplified diagrams and graphics that often accompany books designed for younger readers, and young adults who are already familiar with the basics on a particular topic might be encouraged to explore more in-depth material shelved for adults. With interfiling, there is no need to risk offending or embarrassing adults with limited reading abilities by directing them to the children's section. Instead they can be led to the subject shelf required, and then browse the different materials on their own to find what works best for them.
In an effort to make browsing interfiled materials more user-friendly and effective for patrons, many librarians use labeling techniques to classify age-appropriate materials that are shelved together. Some strategies include a brightly colored spine label indicating a child's book, or extending the call number (i.e. using Planetree, add a .5 to the call number for children's books, and a .6 for teen titles) to create clear, yet invisible, divisions between materials for different ages grouped by subject on the same shelf.
In the end, I finally chose a slightly hybrid approach to shelving for our Family Resource Center. Visitors to our library will find recreational books divided into separate age-appropriate collections, grouped by topic, and shelved in alphabetical order by author. Donated mass market paperbacks for teens and adults are uncataloged, and have their own rack. Entertainment movies are divided by format (VHS tapes and DVDs have separate shelves), and grouped by genre (drama, comedy, family, animated & kids) shelved within the designated genre in alphabetical order by title. Each genre has its own brightly colored spine label to make re-shelving easier. Our health resource collection remains separate from the recreational reading materials, and I have decided to interfile all the health resource books, videos and DVDs for children, teens and adults. I am currently cataloging the collection, and will use the Planetree System with extended call numbers to designate materials for younger readers and teens.
However, still coveting the idea that young people appreciate their own space populated with books based on their needs, and hoping to encourage more teens to access the library's health resources, I would like to set aside a corner area for displays of health-related material specifically geared toward teens. The plan includes changing the displays frequently, keeping the themes current and teen-focused, and sprinkling each display with selected young adult recreational reading choices, magazines and new DVDs to attract attention. I am also working on creating topical resource lists for teens that will provide books titles, video/DVD selections, article links & Web sites related to subject specific teen health issues.
Every library has its own way of shelving materials, and what works at one library may not be practical at another. Considerations such as space, user population, collection size and type of parent institution can create differences in the advantages and disadvantages that surface when choosing between maintaining separate age-grouped collections and interfiling. Perhaps the question is not which shelving strategy to choose, but how to take the best qualities of each and integrate them into a system that works for your library setting. Learning about the methods that others have tried can expand your options, and help you develop a shelving plan that will work best for your consumer health library.
Update from the National Library of Medicine, Division of Specialized Information Services
Submitted By: Colette Hochstein, D.M.D., MLS (Colette@nlm.nih.gov), Division of Specialized Information Services, NLM.
The Division of Specialized Information Services (SIS, http://sis.nlm.nih.gov/) at the National Library of Medicine (NLM) creates information resources and services in toxicology, environmental health, chemistry, and HIV/AIDS. Another component of SIS, the Office of Outreach and Special Populations, seeks to improve access to quality and accurate health information by underserved and special populations. Many SIS products help to address the toxicology and environmental health information needs of the general public.
TOXMAP http://toxmap.nlm.nih.gov
A new version of TOXMAP (http://toxmap.nlm.nih.gov) was released August 7. This version includes:
More search options: Users can now search TOXMAP by Chemical Abstracts Service/Registry Number (CAS/RN), Toxics Release Inventory (TRI) facility name/ID, release medium, release year ranges, release amount, Superfund (NPL) site name/ID, and Hazard Ranking System (HRS) score.
Geographic regions: Users can create their own geographic region, or select a pre-defined region from a menu. Setting a geographic region limits search results to those inside the specified region. Regions can be saved for future access.
Regional TRI summary tables: Users can view summary (aggregate) TRI release amounts for their geographic region.
Updated and expanded glossary and FAQs.
TOXMAP (http://toxmap.nlm.nih.gov) is a Geographic Information System (GIS) from the Division of Specialized Information Services (http://sis.nlm.nih.gov) of the U.S. National Library of Medicine (NLM) (http://www.nlm.nih.gov) that uses maps of the United States to help users visually explore data from the U.S. Environmental Protection Agency (EPA)'s Toxics Release Inventory and Superfund Program.
New Look for Tox Town
Tox Town now has a new look http://toxtown.nlm.nih.gov/ that includes a new home page, a new header and footer on each page, and a new layout for the text version pages and the Spanish version pages.
Toxie the Cat Can Now Speak Spanish/ Toxie the Cat Ahora Habla Español
Toxie, the ToxMystery (http://toxmystery.nlm.nih.gov) guide cat, has returned to school and can now speak Spanish. By selecting the "Español" or "English" tab on the upper right of the homepage, gamers can move between Spanish and English as they explore the site's "house of hazards."
ToxMystery is an e-learning game that uses animation, sound effects and positive reinforcement to help 7-11 year olds learn about possible chemical hazards around the home. ToxMystery en español's "Para los padres" (For Parents) page gives parents more detailed information about potential household hazards. The "Para maestros" (Teachers) page has lesson plans and downloadable classroom activity pages in Spanish. ToxMystery can be used in science and health classes.
Come play with Toxie and see if you can find the hazards in English and en español!
WISER 3.0 for Palm OS Now Available
WISER 3.0 for Palm OS can be downloaded at http://wiser.nlm.nih.gov
This release takes the first steps in catching up with recent improvements made for the Windows and Pocket PC platforms, and includes: radioisotope substance list (see the All vs. Chemical vs. Radiological option on the Known Substances list); protective distance substance data that now incorporates the ERG's initial isolation and protective distance ("green section") data; and "Help Identify" enhancements (in addition to properties and symptoms, users can also narrow the results list by substance categories and NFPA 704 placards).
WISER plans additional capabilities in future releases, including Windows Mobile Smartphone support, additional substance category support (including more categories), additional tools/reference materials for radiologicals and chemicals, and biological mode (biological substance list and related tools and reference materials).
Keeping the Artist Safe: Hazards of Arts and Crafts Materials
Artists, craftspeople, and hobbyists are often exposed to potentially hazardous substances. You can learn more about these hazards and how to safeguard against unnecessary exposures at "Keeping the Artist Safe: Hazards of Arts and Crafts Materials" http://sis.nlm.nih.gov/enviro/arthazards.html
NLM also offers other Enviro-Health Links (http://sis.nlm.nih.gov/enviro/envirohealthlinks.html) on topics such as:
Children's Environmental Health
http://phpartners.org/cehir/sampler.html
Indoor Air Pollution
http://sis.nlm.nih.gov/enviro/indoorairpollution.html
Outdoor Air Pollution
http://sis.nlm.nih.gov/enviro/outdoorairpollution.html
Arsenic
http://sis.nlm.nih.gov/enviro/arsenicandhumanhealth.html
Lead
http://sis.nlm.nih.gov/enviro/lead.html
Book Reviews
Challem, Jack. The Food-Mood Solution. Wiley, 2007. 273 p. index. ISBN: 978-0-471-75610-1 $24.95
Jack Challem, author of The Food-Mood Solution, has been writing on nutrition topics for 30 years, publishes The Nutrition Reporter™ newsletter, and writes for many magazines. Other books he's written include: Syndrome X: The Complete Nutritional Program to Prevent and Reverse Insulin Resistance and Feeding the Genes Right.
According to Challem, bad moods are caused by poor food choices resulting in imbalanced neurotransmitters and an inadequately nourished brain. Stress also robs the body of essential nutrients and compounds the issue. High carbohydrate and fast foods raise the glucose and insulin levels significantly leading to poor concentration, fatigue and variable moods; protein foods, fiber, and non-starchy vegetables better stabilize blood sugar and therefore create better moods.
While the book contains recipes that reflect his suggested eating habits, much of the book is focused on the use of supplements to combat mood problems. While he notes that individuals taking medications such as Prozac, Zoloft, etc. shouldn't stop taking them without working with their doctor to "transition between drugs to nutritional treatments", (p.60) he doesn't include any warnings as to the negative consequences that could result from taking both, or, that these substances are unregulated and may have inconsistent potency.
While the author has an easy writing style and the content is accessible to many, important warnings are missing. For that reason, this book is not recommended for purchase. A better book would be Managing Your Mind and Mood Through Food by Judith J. Wurtman, PhD who is a research scientist at MIT and is in private practice.
Reviewed By: Allison Howard, Shimberg Health Sciences Library, University of South Florida, Tampa, FL.
Coleman, Jeanine G. The Early Intervention Dictionary: A Multidisciplinary Guide to Terminology (3rd ed.)Bethesda, MD: Woodbine House, 2006. 457 p. ISBN-13: 978-1-890627-63-8.
The Early Intervention Dictionary is now in its third edition, a testimony not only to its general usefulness but to the crying need for definitional assistance in consumer health. Early intervention programs, and by extension readers of early intervention dictionaries, are focused on the "zero to three" population. This wide-ranging glossary covers the specialized vocabularies of this domain, including audiology, child development, early childhood education (including special education), pediatrics, social work and hearing and visual impairments; new in this edition are Autism Spectrum Disorders, mental illness and neurological issues, and sensory integration dysfunction. Acronyms, abbreviations, initialisms, prefixes and suffixes are defined as well as words and phrases, and the coverage of topics is generally appropriate and excellent. The visual format of the book is clear and the writing suitably concise.
As in the previous editions, some accuracy has been sacrificed in the interests of simplifying technical information for a general audience. For example, the International Classification of Diseases is defined as a manual for "diagnosing medical disorders" when the ICD is actually a classification system used principally for representation of disorders for administrative purposes, i.e., billing. This is more than a subtle distinction for the anxious parent who is truly in search of a diagnosis, as opposed to a code.
More troubling is the absence of citations and attribution of source material for the definitions; these are resources that might further empower the researching consumer to seek additional information outside the covers of the book. For example, appendices listing immunization schedules are not attributed to any organization, let alone a source. The entries for terms themselves are left un-sourced, which forces the reader to place a great deal of trust in the author. For example, the entry for Thimerosal states: "…believed by some people to produce mercury poisoning and to trigger symptoms of autism spectrum disorder in young children." Without more information, the reader has no idea who these people are and if she should believe them. Conversely, the entry for Facilitated Communication states explicitly "Research indicates…that children do not improve their communication skills". Without some hint as to what that research is, the reader cannot put this statement in context.
For this reason, this reviewer recommends this title as a valuable adjunct and gateway to other literature, and not as the stand-alone reference book that many consumers–particularly worried parents and family members of zero-to-three children–will probably see.
Reviewed By: Catherine Arnott Smith, University of Wisconsin-Madison, School of Library and Information Studies, Madison, WI.
Martin, Sieglinde. Teaching Motor Skills to Children with Cerebral Palsy and Similar Movement Disorders: A Guide for Parents and Professionals. Woodbine House, 2006. 237 p. index. ISBN 10: 1-890627-72-0. ISBN 13: 978-1-890627-72-0. $19.95.
Cerebral palsy is a neurological disorder that affects a child's coordination and ability to move. A child who has cerebral palsy often has difficulty in the various stages of motor development, including lifting his or her head, rolling over, sitting, crawling and walking. This book provides valuable information as to how both parents and professionals can assist children with cerebral palsy or other developmental delays as they go through these stages of development.
Martin, an experienced physical therapist, explains cerebral palsy and discusses motor development, both in typical children and in children with cerebral palsy. She addresses the aspects of this disorder that make it more difficult for these children to move and provides an overview of physical therapy goals and treatment techniques. Many of the chapters in this book present exercises parents can do with their children to maintain flexibility or to develop specific motor skills. These chapters contain numerous helpful photographs that illustrate the exercises, with suggestions of how to incorporate the use of toys to interest the children. Most chapters end with a "Frequently Asked Questions" section that provides practical answers to questions that parents may have when they try to implement the suggested activities with their children. An additional chapter on other types of interventions for this population completes the book.
While this book contains much practical information, some of the discussions of why children with cerebral palsy move as they do or the theoretical background for some of the exercise may be too technical for some readers. However, the lack of information on this topic makes this book a valuable addition to most pediatric consumer health collections.
Reviewed By: Deborah Magnan, Samuel and Sandra Hekemian Medical Library, Hackensack University Medical Center, Hackensack, NJ.
Sicherer, Scott H. Understanding and Managing Your Child's Food Allergies. Johns Hopkins University Press, 2006. 312 p. index. ISBN 10: 0-8018-8492-6; ISBN 13: 978-0-8018-8492-4. $18.95.
Multiple studies have documented the large increase in allergies and allergy related diseases such as asthma, atopic dermatitis, and allergic rhinitis over the last twenty years. An increase in food allergies and adverse reactions to food in children has also been seen, and parents of children with these allergies will find this book to be a useful and informative guide. Scott Sicherer, M.D., the author, is a researcher at the Jaffe Food Allergy Institute at Mount Sinai and an associate professor of pediatrics at the Mount Sinai School of Medicine, and he uses case scenarios that are loosely based on his patients to effectively illustrate many of the concepts he presents in his book.
The book includes sections that carefully discuss the role of the immune system in food allergies and adverse reactions to food, the diagnostic process that occurs when an allergy is suspected, and the treatment of allergic reactions, both with medication and modification of a child's diet. Information about how to avoid foods that trigger allergies is provided and chapters in this section incorporate helpful advice for eating at restaurants and in social situations, and detailed suggestions for dealing with food allergies at school and camp. Other sections address allergies at different stages in life, information on coping with the impact of food allergies on all members of the child's family, and current research being conducted in this area. A list of resources as well as references to the professional literature are included. This book is highly recommended for all consumer health collections.
Reviewed By: Deborah Magnan, Samuel and Sandra Hekemian Medical Library, Hackensack University Medical Center, Hackensack, NJ.
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Consumer Connections (ISSN 1535-7821) is the newsletter of the Consumer and Patient Information Section of the Medical Library Association. It is published on the CAPHIS website quarterly. Notification of publication is sent via the CAPHIS listserv. CAPHIS is the largest section of the Medical Library Association.
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