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Vol. 1, No. 3, January 1999

CHRC Hits 100 Libraries Mark

As of November 1998, one hundred  libraries had contacted the CHRC and asked a total of 192 questions.  We have also had a twenty five per cent increase in  questions since the CHRC training sessions this fall.  As the CHRC service only began in July, 1998, we are pleased to have passed the 100 mark in less than 6 months.  Keep those questions coming!

CHRC Training Sessions

We enjoyed meeting the approximately 200 regional library staff who attended  the six CHRC training sessions held this fall.  Many of you asked about visiting the Treadwell Library.  We would be delighted to show you around and introduce you to our staff  and to the many resources we have here.  To arrange a tour, please call Martha Stone, Coordinator for Reference Services at

"The most unforgettable CHRC question I've ever encountered"  (apologies to Reader's Digest)

"What is the Pound Syndrome?"  To a medical librarian this sounds like one of the easiest questions around, especially when the added information included the fact that this was a disease found in Malaysia.   A quick check of Magalini's Dictionary of Medical Syndromes (Lippincott, 1997), would, I thought, solve this question.  Much to my surprise, nothing was listed.  None of the 10 million citations in the world's biggest medical and biomedical database - Medline - gave me any help. Likewise, there was nothing in the indexes of our textbooks of tropical medicine; in the online archives of the New York Times (http://www.nytimes.com); or even in HISTLINE,  the National Library of Medicine's online History of Medicine database of  articles, books, and book chapters, which covers time immemorial through the present.   Perhaps this was a slang term.  I thought it was time to throw myself at the mercy of the Web.   I used  the metasearch engine, Dogpile (http://www.dogpile.com)  which searches  14 engines simultaneously, as opposed to Metacrawler's nine (http://www.metacrawler.com), and typed the phrase "Pound Syndrome", in quotation marks.  The two references I found had nothing to do with medicine, but everything to do with creative writing.   The expression "pound syndrome" was used in a financial report from Bas-Ex Management, a Swiss company; and it was expanded to "in for a penny, in for a pound syndrome" in an online newsletter, the Karengata Chronicle, from Kenya, where it was used in reference to carrying out plans at any cost.  If any reader wants to shed more light on this seemingly unsolvable problem - please let us know!   Martha Stone, Coordinator for Reference Services.

Massachusetts Models:

In the second article in our series Massachusetts Models, Anne Fladger writes about the Health Information Library at the Beth Israel Deaconess Patient and Family Learning Center.  Anne is a member of BMRLS.


In February 1996, Beth Israel Hospital, now Beth Israel Deaconess Medical Center, launched a multi-disciplinary health education initiative now known as The Beth Israel Deaconess Learning Center.  Established as part of an overall organizational objective to design an improved health care delivery system for the future, the Learning Center helps to empower consumers with both the information and skills they need to maintain health or recover from illness or injury.

The Learning Center includes a consumer health library, a service that teaches patients needed care skills and programming that addresses the health education needs of the community.  By providing services that are responsive to the needs of the medical center, the learning center also helps improve continuity in an environment at continual risk for fragmented, incomplete care.
Goals and objectives of the program include: 
* helping individuals and communities better understand specific illnesses and their treatment, 
* providing the information and support necessary for individuals, families and communities to adopt a healthy lifestyle, 
* helping the medical center achieve its goal of improving the health of the people and communities it serves.

The Health Information Library

The Health Information Library serves patients, family members and the general public.  The library collection contains 1200 items -- books, videos, audio-tapes, newsletters, periodicals, and pamphlets.  Electronic resources include Health Reference Center, PaperChase, Mosby Medical Encyclopedia, Lippincott Nursing Reference, the Mayo Clinic CD-ROM's, and access to the Internet.  New material is added on a regular basis and selection is dependent on reference queries and recommendations from healthcare providers, patients and family members.

The collection is organized using the Library of Congress classification system and the center shares an on-line catalog with the hospital medical library.  The library is open 42 hours a week and borrowing privileges are limited to patients of the medical center.  Pre-paid return mailers are provided for borrowers to return library materials via the mail.  

A health information retrieval service, whereby material is mailed to home or delivered to the bedside in an inpatient unit, is available to anyone who calls and requests information.  Resource kits for specific patient populations have been developed, including kits for pregnant women on bed-rest and a pregnancy loss resource kit.  Other resource kits under development include one for caregivers who are caring for a loved one at home.

Professional staff and volunteers help users find materials and use the computers.  Some users need no assistance and make use of the library resources to research their health questions.

Consumer Health Information

We find that our average user is a female between the ages of 40-60.  The top six clinical topics researched are: cancer/cancer treatments, women's health issues, mental health issues, drugs/medications, nutrition, and diabetes.  More specific topics range from a simple request to see a picture of a gallbladder, to more complex questions such as locating clinical trials for treatment of non-Hodgkin's lymphoma.  

From exit questionnaires, given to all users, we learn that  health information is used in a number of ways.  Some people learn more about their illness or health concern; some feel that information received from a healthcare provider is better understood; some go back to their providers and ask further questions; and some people make decisions about treatment options and lifestyle issues.  There is an obvious need for pertinent and reliable health information.  What is also evident is that the information provided by the library does have an impact.  More and more consumers feel compelled to take charge of their health care and the resources in the learning center enable them to do so.

Anne Fladger, Program Coordinator/ Librarian, 	
The Beth Israel Deaconess Learning Center	
Beth Israel Deaconess Medical Center	
330 Brookline Avenue, Boston, MA 02215. 

Learning Center Hours:
Mon., Tues., Wed., Fri.  9am - 5pm
Thurs.                             9am - 7pm

Tel: 617-667-9100 Fax: 617-667-9105

Massachusetts Models aims to introduce CHRC News readers to consumer health information services in Massachusetts and the models of service they follow.  If you would like to submit an article for this series please contact Kate Kelly at 617-726-8600.

CHRC Tip: Non-English Language Internet Resources

One question we have been asked several times is to identify non-English language resources for health information.  Usually, we are asked about a specific topic and resources available in a specific language.  Here are a few of our shortcuts to finding Internet resources.  

A very quick way to find  non-English language resources is via the Hotbot search engine http://www.hotbot.com.  Hotbot allows you to limit your search to certain languages.  In the example below we searched for neurofibromatosis and limited to Portuguese and retrieved three documents.  

Hotbot search for neurofibromatosis limited to Portuguese language.

Limiting to Portuguese, for example, sometime picks up Brazilian medical sites.
Hotbot allows you to limit to Dutch, Finnish, French, German, Italian, Portuguese, Spanish and Swedish.

If you are not sure about either the author or the content of a non English  Internet resource try http://babelfish.altavista.com.  This is a rudimentary translation service which works best if you paste the text into the translation box.  Babelfish translates English to French, German, Portuguese, Spanish and Italian and all of these languages into English.  We stress this is a very rough translation service and some translations are rather odd, but it does give you some idea of the author and content.

You can  find specific non-English language resources on the CHRC web page at:
chresources.html - click on Non-English Language & Health Literacy Resources.  If you have suggestions for additions to this part of our web page, please let us know.  Similarly, if you have questions about non-English language resources, please call us!

Alternative Medicine Resources at CHRC

To help us answer alternative and complementary medicine questions we purchased two databases which focus on these topics.  Sheila Moran, Serials Librarian, reviews these databases below.

Alt-Health Watch

Alt-HealthWatch is a FULL TEXT database produced by  Softline Information, Inc.  CD-ROM costs $1560, online version costs $1795.

Includes seven years of back issues plus cumulative quarterly updates.  Approximately 130 titles (January 1999) including some peer reviewed and professional journals.  There is also coverage of magazines, consumer newsletters, association newsletters conference proceedings, book excerpts, book reviews, case studies and editorials. 

Search using subject headings or keywords in the text of articles or in titles.  I found it  best to search by keywords due to the limited number of subject headings . The system does have Boolean operator capability.
A search  on the term osteoarthritis retrieved 148  hits. Combining otsteoarthritis with glucosamine sulfate retrieved 24 hits which is substantial given the limited coverage.  Most of these citations appeared relevant.

View this database as a  complement to mainstream medical databases.  It is very easy to use and is an excellent tool for the consumer who is looking for information not available in more conservative databases.  The ability to limit to peer reviewed journals  is helpful as the authority of the information in  some titles could be considered questionable. 

AMED (Allied and Alternative Medicine)

AMED (Allied and Alternative Medicine) is
a Silverplatter product  compiled and maintained by the Health Care Information Service of the British Library.  It is a bibliographic database with abstracts and keywords but no full text. The CD-ROM costs  $950.  The online version costs $1425.

Covers  from 1985 onwards and is updated quarterly. Data is taken from about 500 journals identified from the 50,000 received by the British Library Document Supply Centre.  This is supplemented by a monthly search of MEDLINE for relevant allied and alternative medicine material.  In addition to journal articles, substantial letters, editorials and other contributions are selected.

AMED allows searching by subject heading  and keywords, but  you also can search from related terms in a citation called a lateral search and also from the thesaurus or the index.  This database has Boolean operator capability and subject headings are based on MESH.

Searching for osteoarthritis retrieved  319 hits, considerably more than Alt-Health Watch.  However, combining osteoarthritis with glucosamine sulfate yielded only 1 hit which was disappointing and might reflect a more conservative publication coverage.   However, the higher retrieval for osteoarthritis  represents the larger coverage of materials in this database compared to Alt-Health Watch.

This database clearly has more authoritative sources than Alt-Health Watch and more comprehensive coverage . However, AMED does not offer full text retrieval and given consumers' insatiable appetite  for full text, this could be a drawback.  The good news is that it has rich access points and covers many more resources than Alt- Health Watch and it, too, is very easy to use.

Other new, alternative medicine resources available at the CHRC include the following books:

Complete German Commission E Monographs: therapeutic guide to herbal medicine.  1998.  ISBN 0-9655555-0-X
This is the translation of the German Commission E study of the safety and efficacy of over 300 herb and herb combinations.  "It represents the most accurate information available in the world of the safety and efficacy of herbs and phyto medicinals" - Varro Tyler ( Purdue University, author of The Honest Herbal).

PDR for Herbal Medicine. 1998.
ISBN 1-56363-292-6.
Details the prescribing information for over 600 botanicals with over 500 full color photographs.  Organized in A-Z format with scientific and common English names, indications, therapeutic categories, side effects and more.

Cassileth, Barrie. The Alternative Medicine Handbook: complete reference guide to alternative and complimentary therapies.  1998.  ISBN 0-393-04566-8.

Fugh-Berman, Adriane.  Alternative Medicine, What Works: a comprehensive, easy to read review of the scientific evidence, pro and con. 1997.   ISBN 0683-30407-0

Schulz, Volker; Hansel, Rudolf; Tyler, Varro.  Rational Phytotherapy: a physicians' guide to herbal medicine. 1997. ISBN 3-540-62648-4.
A practice oriented introduction to phytotherapy.  Offers a quick insight into dosage, from of application and effects of the most important herbal remedies.

Gotkin, Janet and Page, Kate. ed's. HealthInform's Resource Guide to Alternative Health: an annual directory of information sources on alternative and complimentary therapies.  ISSN 1090-6649.
Basic information on 56 alternative therapies compiled by two librarians.

These are just some of our more recent additions.  Check our online catalog, MAGIC, for full details:
http://www.mgh.harvard.edu./library/library.htm and click on MAGIC.


CHRC Contact Information

Tel: 1-877-MEDI-REF (1-877-633-4733)
 or    617-726-8600

Fax: 617-726-6784

or treadwellqanda@partners.org

Consumer Health Reference Center
Treadwell Library 
Bartlett Hall Extension 1 
Massachusetts General Hospital 
Boston, MA 02114.