HEALTHNET NEWS VOL. XV, NO. 4 WINTER  1999
Lyman Maynard Stowe Library
University of Connecticut Health Center

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TABLE OF CONTENTS

UPDATE
- Healthnet awarded funding to develop consumer health training project
- Coming soon - Connecticut Physician Profiles
- Healthnet turns 15
NETNEWS
- Noise pollution - an important public health concern
- Ordering drugs and medical products online? Here's helpful advice!
- Sleep - perchance to dream
- Spanish language health information
- Medical tests and diagnostics ... and plenty more!
FOR YOUR CONSIDERATION
-Recently published consumer health books:
    *Arthritis Foundation's guide to alternative therapies
    *Raising a child with a neuromuscular disorder
    *Encyclopedia of nutritional supplements
    *KidStress : what it is, how it feels, how to help
    *Guide to top doctors
    *Mayo Clinic on chronic pain



UPDATE


HEALTHNET  AWARDED  FUNDING  TO  DEVELOP  CONSUMER  HEALTH  TRAINING  PROJECT

The National Library of Medicine recently announced funding for 49 electronic health information projects in 34 states.  Healthnet is one of five recipients of this funding in New England.  The project will focus on teaching members of Connecticut’s self-help groups to access reliable, up-to-date, electronic health information to answer questions about a personal medical concern. The project will be developed in cooperation with the Connecticut Self-Help Network in New Haven.  Training will be conducted at the Health Center, the Computer Training Center at the Middletown Library Service Center, public libraries, Self-Help Network offices, and at state health organizations.

Several public libraries and health organizations have already indicated an interest in participating in this project.  Interested librarians will complete 6-8 hours of training and then be asked to train members of self-help groups either in their library or at state health organizations.  Training will consist of the basics of searching MEDLINE using PubMed and guidelines for evaluating and using Internet resources, including MEDLINEplus , Healthfinder, and similar web sites.  This can be a great opportunity for publicizing the resources and services of your library.  If you think you might be interested in participating in this project or if you’d like more information, contact Alberta Richetelle at Healthnet;  860/679-4055; richetelle@nso.uchc.edu.

COMING  SOON  - CONNECTICUT  PHYSICIAN  PROFILES     

A public act passed by the Connecticut legislature in 1999 promises to make important information about physicians accessible to the general public.  Public Act 99-284 – An Act Concerning Managed Care Accountability  - authorizes the establishment of an Office of Managed Care Ombudsman to provide information, referral, and assistance regarding participation in managed health care plans.  Specifically, the office will provide assistance to consumers to understand their rights and responsibilities under managed care plans, offer information to help consumers with managed care plan selection, and assist consumers with the filing of complaints and appeals regarding managed care plan services.  The office will maintain a toll-free telephone number to allow customer access to its services.

Section 33 of PA 99-284 authorizes the Department of Public Health, the state agency responsible for issuing licenses to health care providers, to compile physician profiles for every doctor licensed in Connecticut.  Letters and survey forms have been sent to doctors to submit the requested information.  The profiles will include biographical and current practice information, medical school and year degree granted, postgraduate training, board certifications and specialty areas, medical malpractice history, hospital disciplinary actions in any state, felony convictions in any state, and Connecticut licensure disciplinary actions. Optional information consists of listing of publications in peer reviewed journals, professional awards received, and any activities with professional committees and organizations.

The Department of Public Health will make these physician profiles accessible to the general public via a web site by this summer.  A copy of the survey form and the text of Section 3 of Public Act 99-284 explaining this new mandate  is available on the  Department of Health web site .

 
HEALTHNET  TURNS  15

Healthnet celebrated its 15th birthday on January 3rd.  Healthnet began its existence as an LSCA funded program and continued to operate for three years with grant funds. Services were first offered to the libraries in Waterbury,  Hartford, Bridgeport, New Haven, New London, and New Britain.  In 1986, our services were extended to all public libraries in the state.  Thanks to the hard work of the Connecticut Library Association’s legislative committee and their success in securing state funding, Healthnet was able to continue  to provide valuable services to public libraries after the grant funding ceased in 1987.   Since 1985, we’ve  offered numerous workshops on medical reference tools and techniques, presented programs at CLA’s annual conference, and helped public libraries with research on thousands of consumer health reference questions.

Healthnet has become a national model for consumer health information services and was recently recognized by the National Library of Medicine as a noteworthy national program. The program was featured on  NLM's web site  in recognition of National Medical Librarian’s Month this past October.  In November 1998, I was asked to meet with Dr. Donald  A. B. Lindberg, Director of the National Library of Medicine, and senior management staff  to describe the Healthnet program, specifically how it was developed and  the services offered to public libraries, and to comment on how the National Library of Medicine could help libraries with the provision of consumer health information.
 
 

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                                              NETNEWS

NOISE  POLLUTION -  AN  IMPORTANT  PUBLIC  HEALTH  CONCERN

Leaf blowers, boom boxes, speed boats, rock concerts – what do all of these have in common?  Loud noise that has the real  potential for causing permanent hearing loss.  Noise can be defined as unwanted sound.  It is derived from the Latin word “nausea”.  Not only can repeated exposure to loud sounds damage our hearing, but studies indicate that repeated exposure to any kind of unwanted sound has a negative effect on an individual’s health and well-being.  Noise can raise blood pressure, interfere with restful sleep, increase anxiety and generally reduce our quality of life.

The  Noise Pollution Clearinghouse  offers information on many aspects of noise pollution.  NPC believes “…the air into which noise is emitted and onto which it travels is a “commons”, a public good. It belongs to no one person or group, but to everyone. People, businesses, and organizations, therefore, do not have unlimited rights to broadcast noise as they please, as if the effects of noise were limited only to their private property. On the contrary, they have an obligation to use the commons in ways that are compatible with or do not detract from other users.”  NPC’s mission is to educate the public about the problem of noise pollution and to help communities “take back the commons” from those who are bullying people with their inconsiderate noise pollution.
NPC’s web site  has a  library of resources and tools concerning noise pollution,  links to other groups that have similar collections, a network of  noise activists, and information to assist communities and activists who are working to reduce noise pollution.  They also monitor and report on ongoing local community efforts for stronger noise controls.  Many of the information resources are from the Environmental Protection Agency, the Occupational Safety and Health Administration, newspaper stories, and newsletters from noise pollution advocacy groups.  A law library contains  federal and state laws pertaining to noise as well as texts of U.S. city ordinances regarding noise abatement.

The next time your neighbor operates a leaf blower at 6:00 a.m. or you hear another neighbor rev his car’s engine in the middle of the night,  make a note to visit the Noise Pollution Clearinghouse web site.  Find out what positive steps you can take in your community to curb noise pollution.

ORDERING  DRUGS  AND  MEDICAL  PRODUCTS  ONLINE?  HERE’S  HELPFUL   ADVICE!

The  Food and Drug Administration (FDA) recently launched a  web site  to help patients who buy drugs and medical products on the Internet.  The goal is to educate consumers to select sources that are legitimate rather than those sites maintained by dangerous quacks.

The FDA reports that it is often difficult to tell the difference between legitimate online drugstores and those that sell illegal products.  Besides being illegal, these products are a waste of money and some can be dangerous and deadly.

FDA’s web site offers tips and warnings about buying drugs and medical products and recommends consumers contact the  National Association of Boards of Pharmacies (www.napb.net) to verify whether the web site is a licensed pharmacy.  Information on how to spot  health fraud alerts consumers to some of the practices that sites use to sell products that have not been tested for safety or  efficacy.  Personal testimonies by individuals who have achieved miraculous cures, promises that cures are possible in “just a few days”, and products that promise to cure many different types of diseases or conditions are sure signs of  fraud.

SLEEP – PERCHANCE   TO  DREAM

About 70 million Americans suffer from sleep problems; among them, nearly 60 percent have a chronic disorder. Each year, sleep disorders, sleep deprivation, and sleepiness add an estimated $15.9 billion to the national health care bill. Sleep disorders and disturbances of sleep comprise a broad range of problems, including sleep apnea, narcolepsy, insomnia, parasomnia, jet-lag syndrome, and disturbed biological and circadian rhythms.

The  National Center on Sleep Disorder Disorder Research  seeks to improve the health of Americans by encouraging and supporting research in the area of sleep disorders, training and sponsoring the education of sleep disorder specialists, ensuring the transfer of research results to benefit the health of individuals, and  promoting the sharing of information between agencies and organizations concerned with sleep disorders.

The Center’s web site offers information for the public on different sleep disorders such as insomnia, narcolepsy, and restless leg syndrome.  A “Sleep IQ” tests your knowledge about sleep and sleep disorders and there’s also an opportunity to listen  to brief audios on selected topics.  Information for professionals includes assessment and management of insomnia in primary care, assessing sleep apnea risk, and problem sleepiness.

The site also includes special topics on sleep and youth including educating young people about sleep and drowsy driving and the importance of a good night’s sleep.

SPANISH  LANGUAGE  HEALTH  INFORMATION

Graciasdoctor.com  recently made its debut as the first provider of multimedia health care information in Spanish and Portuguese for doctors, patients, and media companies.  Its goal is to offer Latinos around the world a variety of original health-related content that is culturally customized, reliable, and user friendly.  The site’s Board of Advisors includes 8 doctors and 10 journalists.  The lead doctor on the project is Elmer Huerta, a member of the U.S. National Cancer Advisory Board and  the National Board of Directors for the American Cancer Society.  Dr. Huerta also hosts a syndicated radio show which is broadcast in the Americas and a call-in television program on health issues.

All of the information can be viewed in English, Spanish, or Portuguese.  The site is still in development and only a few features are available such as  health stories in the news and commentaries and brief reports on a few medical conditions.  An audio channel and a video channel allow users to listen to or view information on several medical topics.  Currently, all of the audio and video productions are available only in Spanish, although plans are to translate these into English and Portuguese.

MEDICAL  TESTS  AND DIAGNOSTICS . . . AND  PLENTY  MORE!

There are several excellent print resources for consumers on medical tests, namely the Yale University School of Medicine patient’s guide to medical tests (Houghton Mifflin, 1997) and Everything you need to know about medical tests (Springhouse, 1995).  This information, however, is often difficult to locate on the web.  Healthgate ,  a comprehensive health site for consumers and professionals, has a section with descriptions of over 400 medical tests (scroll down the menu on the left side of their main page).

Each test description includes the purpose of the test, where the test is performed, who performs the tests, risks and precautions, patient preparation, how the test is performed and how it feels, approximate cost for the test,  test values, and what the results mean.  Drugs and other factors that may affect the test results and immediate post-test  care are also discussed.   Healthgate states that the information comes from The complete guide to medical tests, but they don’t indicate the author.  The information, however, has the same format as books written by H. Winter Griffith.  Dr. Griffith the author of many consumer oriented medical books.

While you’re at the Healthgate site, you may want to look at what else they have to offer. Included is information on many  diseases and medical conditions, lifestyle issues, current health news, access to MEDLINE, and much more.
 

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FOR YOUR CONSIDERATION

The following books may be of interest to public and health sciences libraries.  They are
not part of the UCHC Library collection.

Arthritis Foundation’s guide to alternative therapies.  Judith Horstman.  Arthritis Foundation, 1999. 285 p.  ISBN 0-912423-234), $24.95.

Arthritis sufferers are among the highest users of alternative  therapies.  People who have rheumatoid arthritis or osteoarthritis often experience daily unrelenting pain that may not be relieved with conventional medicine.  Patients may be eager to try  unconventional remedies in the hope of  achieving some relief.

This attractive, easy to read guide offers descriptions of many so-called alternative and complementary therapies. Chinese medicine, chiropractic, mind-body therapies, yoga, massage, acupuncture, magnet therapy and other therapies are described in separate chapters.  Each chapter includes a description of the therapy and how it is used, scientific evidence about the therapy, expert opinion of whether the therapy is effective, advice on how to find practitioner, and the cost of the therapy.  A list of resources is also included for those who want to learn more. The descriptions are general enough to be helpful to individuals who do not have arthritis but would like to know more about the therapies.

A chapter on nature’s remedies includes descriptions of  herbs and nutritional supplements with an emphasis on their purported benefits for people with arthritis. Each brief description offers cautions on side effects, interactions with standard medications, and other warnings. Recommended readings and web sites and references for each chapter are included in an appendix.

A helpful guide for those who want to learn more about the possible benefits and risks of alternative therapies.

Raising a child with a neuromuscular disorder:  a guide for parents, grandparents, friends, and professionals.  Charlotte E. Thompson, M.D.  Oxford University Press, 1999. 275 p. (ISBN 0-19-512843-5). $25.00

After the initial shock, and after trying to absorb myriad medical details from the pediatrician, a reading of this informative and practical book may be the next logical step for a parent whose child has been diagnosed with a neuromuscular disorder.  These disorders include muscular dystrophy, inflammatory myopathy, spinal muscular atrophy, or mitochondrial disorder.

Director of the Center for Handicapped Children and Teenagers in San Francisco and a professor of pediatrics at the University of California at San Diego, Dr. Thompson recommends parents use her book as a source to refer to as questions arise. She suggests that they read one chapter at a time and “just try to get through one day at a time.”

In addition to describing the history, initial and future symptoms, diagnosis, genetics, and treatment of many neuromuscular disorders, Dr. Thompson advises parents how to be effective advocates for their child and how to continue to give needed attention to other family members and to themselves.  She also discusses adaptive equipment, general medical care, grooming, navigating the educational and medical care systems, and socializing with other children. The appendix includes a glossary, suggestions for additional reading, an age-appropriate chores chart for children, and a resource guide to helpful agencies  (though no Internet addresses or websites are included).

Recommended for public libraries as an easy-to-read, helpful, and encouraging resource for parents.   (JK)

Encyclopedia of nutritional supplements.  Michael T. Murray.  Prima Health, 1996.  564 p.  (ISBN 0-7615-0410-9), $19.95.
 
More people are turning to so called “natural therapies” to help prevent disease, to augment standard medical treatments, and, unfortunately in many instances, to replace treatments that may be prescribed by licensed health care providers. This compendium is designed to help the reader make informed decisions about  the use of one of these natural therapies,  nutritional supplements.  Murray, a licensed naturopathic doctor and author of  several books on natural medicine, cautions that the supplements included in this book are not to be used in place of proper medical care from a licensed practitioner.  He includes not only M.D.’s in this category, but naturopathic doctors,  doctors of osteopathy, chiropractors, and “other natural health care specialists”.

This compendium includes profiles of vitamins, minerals, essential fatty acids, accessory nutrients such as flavonoids, and glucosamine, and glandular products.  Each profile gives the food sources for the supplement, deficiency signs and symptoms, recommended dietary allowances for specific age groups, the beneficial effects of the supplement, available forms (capsules, liquid, etc.) and the principal uses for the supplement.  Safety issues and possible interactions with other supplements or medications are also discussed.

An encyclopedic quick reference guide for specific health conditions comprises the second half of the book.  Here Dr. Murray offers recommendations for specific supplements that may be helpful in treating a variety of conditions such as bladder infections, hives, hypertension, irritable bowel syndrome and other common problems.  References for each chapter are included in a separate section at the end of the book.

Much of this information is included in Murray’s Encyclopedia of Natural Medicine, but in a briefer form.  This comprehensive guide may be useful for those interested in more in depth information on nutritional supplements and their use in treating or preventiing illness and disease.

KidStress. What it is, how it feels, how to help.  Georgia Witkin, Ph.D. Viking, 1999. 212 p. (ISBN 0-670-87392-2)

Television personality (WNBC’s Live at Five) and popular magazine author Dr. Georgia Witkin has written a easy-to-read overview of the many stresses children face today.  A psychotherapist, Dr. Witkin is also a professor of psychiatry and director of the Stress Program at the Mt. Sinai School of Medicine in New York City.

Her book expands on the results of a 1997 online Prodigy survey of children and their parents about the stress children feel, what causes it, and how children exhibit it. After responses were compared, the results showed a misunderstanding by many parents about what causes stress in their children

The main portion of the text is an explanation of childhood stress: its triggers and its physical and behavioral manifestations. Children’s responses about the specific types of stress they experience and suggestions for guiding children in coping with their symptoms follows. The author’s practical suggestions focus on current situations –adjusting to stepparents and stepsiblings, living in single parent homes, starting school, dealing with bullies, birth of a sibling, etc.

In a conclusion that will be comforting to many parents, she says that individual children’s reactions to difficult situations may be a reflection of their innate personalities rather than their parents’ missteps. The parent’s role is to help children learn to deal effectively with the stress these situations evoke. Breezy, readable, and helpful, this book may be useful for a library’s parenting section.   (JK)

Guide to top doctors. Center for the Study of Services, 1999.  $19.95 320 p. (ISBN 1-888124-060-7)

In an effort to make informed decisions regarding their medical care, consumers often search for  information about the qualifications of doctors.  They also want to know who “the best” doctor is in a given medical speciality.  This type of information is difficult, and often impossible, to obtain.  A reliable print or online source that evaluates physicians or lists their credentials can be helpful. The best doctors in America, Northeast Region, 1996-97 is one such resource  but currently out-of-print and becoming dated.

Utilizing the peer recommendation method of the publishers of the Best Doctors, the nonprofit consumer organization Center for the Study of Services of Washington, D.C. compiled a list of more than 15,000 specialists and primary care physicians. The physicians are based in fifty U.S. metropolitan areas, including the Fairfield and New Haven county areas of Connecticut. The listings are organized by state, and include very brief information about each doctor: address, medical school and year of graduation, fields of board certification if applicable, and number of times that physician was recommended by other doctors when the book was compiled.

Brief articles at the beginning of the book give useful advice about selecting a doctor, obtaining the best care from your doctor, and when to switch doctors. The appendix includes an explanation of certification specialties and a state-by-state listing of the appropriate agency to contact when registering a complaint about a physician.

Two year online access to the same information is available at the organization’s website for $19.95, also the cost of the book. The organization’s website at www.guidetotopdoctors.org includes a list of state web sites that report disciplinary and investigative actions taken against physicians and the status of their state licensing. An especially helpful feature is an online compilation of the doctors’ lists of many health insurance plans, with hyperlinks.  (JK)

Mayo Clinic on chronic pain.  David W. Swanson, M.D., editor. Mayo Foundation for Medical Education and Research, 1999.  178 p. (ISBN 1-893005-02-X), $14.95.

This practical, brief, easy-to-read guide to coping with ongoing chronic pain is the newest in a series of consumer health books published by the well-known Mayo Clinic of Rochester, Minnesota. Beginning with an explanation of the origins of pain in the human body, it discusses causes of persistent pain, the cycles of pain sufferers experience and cycles of family responses, and medications used to alleviate it. The advice is based on the experiences of practitioners at the Mayo Clinic’s Comprehensive Pain Rehabilitation Center.

The authors advocate behavior and lifestyle changes as well as medication for coping with chronic pain. The recommendations include establishing personal goals, participating in an exercise program, and adjusting one’s daily routine. There is a daily chart that can be used as a personal planner. The book includes a chapter on complementary and alternative medicine that briefly explains types of alternative medicine used for pain control and states whether or not there is scientific proof for their effectiveness.  One chapter gives advice on selecting a reputable pain center or pain clinic. There is a chapter with directions and pictures about specific exercises and others with suggestions on how to cope with the stress pain sufferers experience and communicating effectively with friends and family. The book includes advice on expressing sexuality and stress-relieving exercises.

The book includes an index and a list of organizations to contact for additional information and support. The organizations’ website addresses are included.  (JK)

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Healthnet News is written by Alberta L. Richetelle with the assistance of Judith Kronick. If you have questions about anything in the newsletter or about Healthnet services for Connecticut public libraries, please call 860/679-4055; e-mail address: richetelle@nso.uchc.edu.

© 1999 University of Connecticut Health Center. All rights reserved.