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Does the medical school library in the United States operate more commonly under the university library or the medical school administration? University-connected medical school libraries were asked to indicate (a) the source of their budgets, whether from the central library or the medical school, and (b) the responsibility for their acquisitions and cataloging. Returns received from sixtyeight of the seventy eligible institutions showed decentralization to be much the most common: 71 percent of the libraries are funded by their medical schools; 79 percent are responsible for their own acquisitions and processing. The factor most often associated with centralization of both budget and operation is public ownership. Decentralization is associated with service to one or two rather than three or more professional schools. Location of the medical school in a different city from the university is highly favorable to autonomy. Other factors associated with these trends are discussed.
With the development and maturation of the technology of displaying peptides on bacteriophage, it has become possible to isolate peptide ligands to various targets. In the phage display strategy, up to 10(9) peptides of different permutations are expressed on the surface of filamentous phage. Thus, peptides capable of binding target molecules in vitro and even target tissues in vivo can be identified. In recent years, a series of libraries that display degenerate peptides of different lengths have been constructed, and specific ligands to cell surface receptors, such as integrins, have been isolated. In the in vivo biopanning, peptides targeting distinct organs or tumors have been rescued after intravenous administration of phage libraries into mice. In one application, the isolated peptide ligands have been used to direct a cytotoxic drug to tumor vasculature in mice. Further applications in radioimaging and radiotherapy are being investigated.
A change in job responsibilities from library manager to hospital administrator provides this year's Doe lecturer the opportunity to reflect on the values of the library profession from a fresh perspective. Librarians play a unique role and remain vital to the health care enterprise but are frequently misunderstood. Their role can be viewed from three angles: service, technology, and a unique sort of professionalism. Librarians must focus their service priorities on the needs of the institution, while remaining true to their own unique professional values. They must be advocates for the appropriate use of technology in support of those service roles. The passion that many librarians bring to their jobs makes librarianship a vocation as much as a profession. The mission and vision developed by the American Society of Health-System Pharmacists in 2001 provides a useful model for defining a personal professional mission and vision.
An experimental offering of the Medical Library Association's continuing education course CE 46, Library Management/Budgeting, was made available to sixteen health sciences librarians via the University of Wisconsin-Education Telephone Network. Features of the hardware of the teleconference network, a few applications relating to medicine and library science, and administrative considerations are examined. The paper also describes how the experimental course was conducted, course participants, design, problems encountered, and evaluation data obtained from participants. A comparison between the teleconferencing mode of delivery and the traditional face-to-face format is stressed. Recommendations call for continued consideration of teleconferencing as a method of delivering continuing education courses and suggest the possibility of MLA providing its own teleconferencing network.
We have developed an in vivo selection system in which phage capable of selective homing to different tissues are recovered from a phage display peptide library following intravenous administration. Using this strategy, we have isolated several organ and tumor-homing peptides. We have shown that each of those peptides binds to different receptors that are selectively expressed on the vasculature of the target tissue. The tumor-homing peptides bind to receptors that are upregulated in tumor angiogenic vasculature. Targeted delivery of doxorubicin to angiogenic vasculature using these peptides in animal models decreased toxicity and increased the therapeutic efficacy of the drug. Vascular targeting may facilitate the development of other treatment strategies that rely on inhibition of angiogenesis and lead to advances in cancer treatment. Our technology is also likely to extend the potential for targeting of drugs, genes, and radionuclides in the context of many diseases.
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Systematic reviews help nurses to manage the overwhelming volume of available information by synthesizing valid data from primary studies and summarizing the results of interventions. One reliable source of systematic reviews of healthcare interventions is the Cochrane Library. This paper briefly describes the Cochrane Collaboration and the Cochrane Library. It also encourages nurse clinicians and nurse administrators to use the Cochrane Library and encourages nurse researchers to contribute to the Cochrane Library by conducting systematic reviews in the field of nursing care effectiveness.
A fifty-year review of the history of health sciences librarianship, as reflected in four editions of the Handbook of Medical Library Practice and its successor, Current Practice in Health Sciences Librarianship, illustrates the significant changes our profession has undergone. Publication in 1943 of the first edition of the Handbook marked an important milestone in the development of the Medical Library Association, as a group of dedicated volunteers documented standard practice and recorded useful data. Administration of health sciences libraries has moved from art to science. Responsibility for the development of collections is now the sole purview of professional librarians. Automation and bibliographic standards have revolutionized the methods for controlling and providing access to information resources. And, the means by which assistance is provided to library users, through the use of computer and telecommunications technology, has changed dramatically.
Budgeting is a responsibility faced by all hospital librarians. Hospital administrators expect the librarian to present a financial plan for the year ahead. The budget must predict expenditures for personnel, library materials, purchased services, and equipment. The current and previous year's financial outlay should be coordinated with the budget year. To present a budget effectively, a librarian must relate financial requirements to goals of the institution of which the library is a part.
"Quality Assurance" (QA) is a practical tool for library management, a link in the library's relationship with administrative decision makers. Instituting or refining a QA program takes into account formal and informal methods. Described are one library's program and problem-solving model, the role of others in the library's program, types of recordkeeping, and integration of the library program with organizational QA. Positive results include participation in management-level activities and improvement in quality and delivery of services and products. Ten suggestions are made to begin a QA program.
In the summer of 1973 one resource library in each of the six states of the Midwest Health Science Library Network received funding from the National Library of Medicine to hire a coordinator for health science libraries. The development of the role of coordinator is examined and evaluated. The coordinators have proved valuable in the areas of consortium formation, basic unit development, communication facilitation, and program initiation. The function of the coordinators in the extensive planning effort now being undertaken by the network and the future need for the coordinator positions are discussed.
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Ten years of statistics from over 140 U.S. and Canadian medical school libraries are analyzed to determine trends in library collections, staffing, services, and expenditures. In addition, ratios of use patterns and personnel utilization are shown. Costs over the ten-year period are examined in both actual and constant dollar amounts. The trends in costs show continuous rises in absolute and constant dollars both for materials and personnel. The number of serials subscriptions remained fairly constant while the number of monographs added declined slowly. Collection use grew, although traditional external circulation declined. Interlibrary lending and borrowing increased throughout the decade. Reference service workload increased, while the use of external databases decreased. The longitudinal data indicate trends in medical school libraries that may assist administrators and staff to shape future services, staffing patterns, and budget requests.
The concept of "one stop information shopping" is becoming a reality at Columbia Presbyterian Medical Center (CPMC). The goal of our effort is to provide access to university and hospital administrative systems as well as clinical and library applications from a single workstation, which also provides utility functions such as word processing and mail. Since June 1987, CPMC has invested the equivalent of $23 million dollars to install a digital communications network that encompasses 18 buildings at seven geographically separate sites and to develop clinical and library applications that are integrated with the existing hospital and university administrative and research computing facilities. During June 1991, 2425 different individuals used the clinical information system, 425 different individuals used the library applications, and 900 different individuals used the hospital administrative applications via network access. If we were to freeze the system in its current state, amortize the development and network installation costs, and add projected maintenance costs for the clinical and library applications, our integrated information system would cost $2.8 million on an annual basis. This cost is 0.3% of the medical center's annual budget. These expenditures could be justified by very small improvements in time savings for personnel and/or decreased length of hospital stay and/or more efficient use of resources. In addition to the direct benefits which we detail, a major benefit is the ease with which additional computer-based applications can be added incrementally at an extremely modest cost.
The Osler Library's purpose is to build a collection capable of supporting research in the history of medicine. The major acquisition area is material published from 1960 to 1968. Out-of-print material is acquired on microfilm. The Library contains all pre-1850 monographs, transferred from the Medical Library, and all new monographs from 1850 to 1899 are housed there. The catalogs are described, together with special files, including chronological, journal article index, and publishers' lists index.The place of the original Osler collection is discussed, as are methods by which the collections are preserved. The Library hopes to become a deposit center in Eastern Canada for historical medical material.The administration and organization of the Library are described.
The use of continuous quality improvement may keep your film library processes running smoothly, but your staff may still struggle daily with its inadequate design. As the experts who work and live within the design, staff members deserve to play an active role in its improvement. When plans for a construction project that would include a larger film storage area were approved at Tampa General Healthcare, the administrative manager of the film library studied the first generation of blueprints. Encouraged to speak to the designer about her ideas, she presented sketches she had traced over blueprints to relocate the office entrance. Her design suggestions were welcomed. With the film library supervisors now wanting to involve staff members, the administrative manager created a wish list survey asking staff about positive and negative aspects of their work space, and for their suggestions on improving it, if given the chance. They responded with ideas for more soundproofing, better lighting and better storage space. Others recommended better ergonomic design for keyboard height, drawers and even the height of the sliding-glass window in the reception area. These suggestions did not account for the process delays the library experienced, however. Spending time in each of four work areas, the administrative manager found wasted movement, crowding of staff, film and equipment, and inadequate storage. This was the right time for change, she felt, an opportunity that shouldn't slip by. Various plans were created, not only to isolate office workers from noise and traffic, but to include items from the wish list. When it was time for the specifications, staff feedback became critical. The administrative manager consulted with staff members on various shifts and worked with staff ideas and sketches. The time the designer spent visiting the many work areas was critical to finalizing plans. The construction phase came next, after careful planning for carrying out work during the interim, a difficult period. A year later, the administrative manager recommends employee involvement in such projects.