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CHRC News
Vol. 3, No. 1, October 2000
CHRC Annual Report
Kate Kelly, CHRC Project Manager,
submitted the CHRC's Annual Report for
FY00 to the Massachusetts Board of Library
Commissioners. In it, she reported the
following statistics:
Treadwell Library received a grand total of
532 queries from 245 libraries. Public
libraries accounted for 77% of queries and
special libraries for 12% of queries. The
remainder came from academic, school and
law libraries, and regional library offices.
The Southeast and Metrowest Regions
together accounted for close to half the
queries, while the rest of the regions
accounted for the remainder.
The most frequently asked queries involved
delivery of health care (representing a wide
range of medical questions about diagnoses
and drugs); neurologic disorders; requests
for recommendations (books, journals,
internet sites), and medical or surgical
procedures.
We are delighted to assist you and look
forward to answering more questions.
Please don't hesitate to be in touch with us.
In the News
Health Reference Interviews
Three excellent web sites discussing
reference interview strategies for public
librarians recently came to light.
Introduction to Health
Reference and Research
http://www.nnlm.nlm.nih.gov/mar/training
/healthreference.html
Prepared by the National Network of
Libraries of Medicine (NNLM) serving the
Mid-Atlantic Region, this up-to-date and
fact-filled site reminds librarians of
important points:
- The reference interview is
absolutely necessary to determine
the level of information needed.
- Consider whether the information
is likely to be available over the
Internet. If unlikely, consider more
traditional channels of research
first.
- Before you pursue the information
you find, evaluate it.
This site also offers sample questions and a
list of general characteristics of consumers
seeking health information.
Reference Interview
http://www.sjvls.lib.ca.us/sjvls/corr/med/CC
MED.HTM
A correspondence course prepared by
California Opportunities for Reference
Excellence (CORE) at San Joaquin Valley
[California] Information Service, this site
gives guidelines for handling medical
questions in public libraries. Even though
the course was prepared before the advent of
the web, the general tenets hold true.
Information is given under general headings:
- Find out what the patron wants.
- Find information the patron can
understand.
- Distinguish between giving
information and giving advice.
The authors of this course remind librarians
to:
- Explain why it's important that the
patron be as specific as possible.
- Be tactful, and use your best
judgement to obtain as much
information as possible without
embarrassing yourself or the
patron.
- Always remind the patron to
consult with his or her health care
provider.
- Find out if the patron is interested
in consumer-level literature, or
material written for the health care
provider or scientist.
- Remember to differentiate
between what you can do -
provide information, and what you
can't do - diagnose or provide
medical advice.
- Use extreme caution with
diagnoses and drugs that sound
alike but which have entirely
different meanings.
- Take care when responding to
medical questions over the
telephone because it is so easy to
mis-hear, misinterpret, or
misunderstand.
Information that will be helpful for you to
obtain could include, but not necessarily be
limited, to the following:
1. Ask the patron for an exact spelling of
the disease or drug, if possible,
including the part of the body
affected, if relevant.
2. What is the age of the person who has
the condition?
3. Is the information for the patron? Is
the patron a health professional?
4. What level is needed? Can the patron
handle technical material?
Special Kinds of Questions -
Medical and Legal
http://www.nlc.state.ne.us/ref/star/chapter9.html
From the Nebraska Library Commission's
Statewide Training For Accurate Reference
Reference Manual (STAR Manual), and
bearing some resemblance to the Reference
Interview above, this site provides sample
caution statements for particular situations
(telephone; providing drug information;
what to do when the patron provides
symptoms and wants a diagnosis to match.)
A checklist for evaluation of medical web
sites is included, as well as a sample
reference intake form and a bibliography.
Rare Diseases and Syndromes
This issue of the CHRC News focuses on a
few selected sources of information for
syndromes and rare diseases. Such written
information (and often, accompanying
illustrations) can be upsetting to the librarian
who retrieves the pages from the fax
machine and to the patron for whom it is
intended, but as all the experts above agree,
such material cannot be "censored." We try
to provide information from more than one
source, if possible, so that if your patron
hasn't indicated a need for consumer level
(or technical level) literature, a variety will
be available.
It can sometimes seem difficult and even
intimidating to try and find information
about rare diseases and syndromes. Once
investigation begins, it's often startling to
find how much information is available.
Even though it may be written more for the
health care provider or scientist than the
consumer, there are often non-profit
organizations and support groups to help
individuals and their families. A rare or
"orphan" disease affects fewer than 200,000
people in the United States. There are more
than 6,000 rare disorders that, taken
together, affect approximately 25 million
Americans. One in every 10 individuals in
this country has received a diagnosis of a
rare disease.
NORD
http://www.rarediseases.org/
One of the most important sources of
information about rare diseases is the
National Organization for Rare Disorders,
Inc. NORD is a federation of more than 140
not-for-profit voluntary health organizations
serving people with rare disorders and
disabilities. Thousands of affected
individuals and their families, as well as
support groups, health care and human
service professionals, and advocates for
people with rare disorders and disabilities,
rely on NORD's assistance and leadership.
NORD is dedicated to helping people with
rare diseases and assisting the organizations
that serve them. Since its inception in 1983,
NORD has served as the primary non-
governmental clearinghouse for information
on rare disorders. NORD also provides
referrals to additional sources of assistance
and ongoing support.
Treadwell librarians are more than happy to
search NORD for you and print out the
complete reports, which would otherwise
cost $7.50 each. Abstracts are available
free. NORD is easily searched by typing the
name of the disease you?re looking for into
the search box on the home page.
For instance, try searching for Landau
Kleffner Syndrome, a rare neurological
disorder of childhood. There is no need to
use hyphens or apostrophes, and it's a good
idea to omit the word "syndrome" or
"disease". NORD allows for truncation:
enter the first few characters of the word you
are looking for, followed by an asterisk.
Synonyms as well as Related Disorders are
listed, along with a brief abstract, and links
to web sites of support organizations
Genetic & Rare Disorders
http://www.mgh.harvard.edu/library/chrcind
ex.html
An excellent beginning place is the link to
Genetic & Rare Disorders, under Diseases,
Disorders, & General Health Information
on the Consumer Health Reference Center
site. The Massachusetts Department of
Public Health's Genetics Program at
http://www.acadia.net/nergg/state_programs.
html#MA is one of many programs with a
variety of services available to the public,
including consumer information and referral,
health care provider education, congenital
anomaly surveillance, technical assistance in
genetics education materials and projects,
grant preparation and implementation,
liaison to newborn screening, genetics
education and outreach to underserved
populations, and family-centered consumer
information and referral.
DIRLINE: Directory of
Information Resources Online
http://dirline.nlm.nih.gov/
The Directory of Information Resources
Online (DIRLINE) is the National Library
of Medicine's online database containing
location and descriptive information about a
wide variety of information resources
including organizations, research resources,
projects, and databases concerned with
health and biomedicine. This information
may not be readily available in bibliographic
databases. There are 14,000 records
including genetic and rare diseases. Each
record contains information on publications,
holdings, and services. DIRLINE is easy to
search. For instance, type aneurysm and
you'll find full contact information for the
Brain Aneurysm Foundation, Inc., located in
Boston.
OMIM - Online Mendelian
Inheritance in Man Database
http://www.ncbi.nlm.nih.gov/Omim/
OMIM is a catalog of human genes and
genetic disorders developed for the web by
the National Center for Biotechnology
Information (NCBI). Much of OMIM is
highly technical and meant for the scientist
and researcher. It can be useful as a "last
resort" for the lay person. Click on ?Search
the OMIM Database? and type the name of
the disease. As with NORD, you can allow
for truncation with an asterisk. For instance,
type scoliosis. Fifty diseases are listed,
ranked in relevancy order. The text includes
scientific and historic information. The links
to Medline citations may be the most useful
part of OMIM for the general user.
Stanley Jablonski?s Online
Multiple Congenital Anomaly /
Mental Retardation (MCA/MR)
Syndromes?
http://www.nlm.nih.gov/mesh/jablonski/syn
drome_title.html
This 700-entry database describes congenital
abnormalities associated with mental
retardation. Special attention is given to the
type of information which, because of space
limitations of the printed form, is often
completely omitted in the existing reference
sources. Searching can be carried out in a
variety of ways: in all fields of the
document; by OMIM number; by a major
characteristic of the syndrome, or by
?Personalia? (the scientist or physician who
made the original discovery). For instance,
choose Personalia and type Angelman. His
first name and nationality are listed, along
with a summary of the syndrome which
bears his name, a genetic disorder with many
neurologic components. Click on the name
of the syndrome to find complete
information, including links to Medline
subject headings; links to the entry in the
OMIM database; major features of the
syndrome, historical references, and a
Medline bibliography.
Office of Rare Diseases (ORD)
http://rarediseases.info.nih.gov/ord/
The ORD's web site covers 6000 rare
diseases, including current research,
publications from scientific and medical
journals, completed research, ongoing
studies, and patient support groups. ORD,
which is a branch of the National Institutes
of Health (NIH), also provides links to
many clinical trial databases to find
information on current or planned rare
disease studies. The Patient Travel and
Lodging section includes direct links to
organizations supplying special airfare
flights to research and treatment sites, as
well as links to hotels, motels and other
lodging near medical centers.
Print Resources
We often use print sources to supplement
web-based information. Sometimes, books
are our primary source of information.
Birth defects encyclopedia : the
comprehensive, systematic, illustrated
reference source for the diagnosis,
delineation, etiology, biodynamics,
occurrence, prevention, and treatment of
human anomalies of clinical relevance /
Mary Louise Buyse, editor-in-chief.
Cambridge, Mass.: Blackwell Scientific
Publications, 1990. This extraordinarily
comprehensive book runs to almost 2000
pages with 2000 articles and 1700 black-
and-white photographs, and is arranged in
alphabetic order, with numerous see
references as well as complete information
about the disease, treatment and prevention,
if applicable, bibliographic references, and
OMIM number, if available. In addition to
familiar diseases, such as sickle cell anemia
and fetal alcohol syndrome, it also includes
benign diseases, such as ACHOO
Syndrome (Autosomal Dominant
Compelling Helioophthalmic Outburst
Syndrome.) It should be noted there is no
indication of the availability of a newer
edition.
Another frequently-used reference book,
The encyclopedia of genetic disorders and
birth defects / James Wynbrandt and
Mark D. Ludman. New York: Facts on
File, 2000, contains over 1000 entries.
Definitions range in length from a paragraph
to three pages, with numerous see
references. Terms associated with the field
of genetics, such as recombinant DNA, are
also defined. Appendices include congenital
malformation statistics, birth defect
statistics, selected web resources, and an
extensive bibliography.
Dictionary of medical syndromes / edited
by Sergio I. Magalini and Sabina C.
Magalini / Philadelphia: Lippincott-Raven,
1997, is another source to which we
frequently refer for brief information. The
thorough index includes see references. An
important feature of this book is the
inclusion of "classic citations," references to
the original articles that described the
syndrome.
Often, information about a specific
syndrome will be included in a textbook on
a broader topic. For instance, Shadow
syndromes / John J. Ratey and Catherine
Johnson. New York: Pantheon Books, 1997
includes chapters on masked depression,
hypomanic personality, intermittent rage
disorder, attention deficit disorder, and
autism. Syndromes related to neuro-
muscular disease, such as acid maltase
deficiency or carnitine deficiency syndrome,
can be found in such textbooks as Myology
: basic and clinical / editors, Andrew G.
Engel, Clara Franzini-Armstrong. New
York: McGraw-Hill, 1994.
Trying to find information about genetic and
rare diseases can be both frustrating and
rewarding. Please don't hesitate to contact
us for assistance.
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CHRC Contact Information
Tel: 1-877-MEDI-REF (1-877-633-4733)
or 617-726-8600
Fax: 617-726-6784
E-mail:
treadwellqanda@partners.org
or treadwellqanda@partners.org
Consumer Health Reference Center
Treadwell Library
Bartlett Hall Extension 1
Massachusetts General Hospital
Boston, MA 02114.
http://www.mgh.harvard.edu/library/chrcindex.html
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