|   Sue Skoglund, EditorValerie Reid, Webmaster
 For a text-only version of this newsletter, see http://www.mdmlg.org/members/v28no2-text-only.htm 
 Table of ContentsPubMed LinkOut FeatureRemember When...
 Long-Term MDMLG Members
 Highlights of the MHSLA Conference
 When the Hospital
Administration Has to Make Cuts
 Bioterrorism: 
Responding to the New Reality
 November MDMLG Meeting with Special Luncheon
 Announcements
 
 
 E-journals hook up with LinkOut By Bridget Faricy LinkOut is a feature of
      PubMed that is designed to provide users with links to full text sources.
      Although this feature was initially not well publicized, many were happy
      to trip across its functionality. One day the tempting publisher icon at
      the top of a citation was boldly clicked and, believe it or not, the link
      actually worked! As exciting as that was, the
      glow quickly faded as the functionality proved to be a mixed bag. While
      many links worked, many more did not. It became clear that only when an
      institution had already established IP access with a publisher did the
      links really work. Librarians could not recommend that users waste their
      time endlessly clicking and clicking only to find that the journal wasn’t
      one of ours. The question quickly became, what good does a link do if a
      user cannot have a reasonable expectation that the link will take him or
      her to the desired text? NLM now has the answer to
      that question! Libraries can now submit their IP identity and their
      electronic holdings to NCBI using a free software utility from NLM. Once
      that information is in place, a special web address (specific to your
      institution) is created. When PubMed is accessed from that special
      address, only your institution’s publisher icon links are displayed! You can learn all
      about the new LinkOut functionality for libraries and the complete setup
      process at the NLM web site or you can call your RML LinkOut Representative at 1 800 338-7657.   BACK TO THE TOP 
 By Sue Skoglund, reminiscing with Audrey
      Bondar Remember when … … we had SLOBS, then ULOSSOM – printed union lists of
      journal holdings of MDMLG libraries? You had to find the journal title,
      then look down a long list of libraries to see who had the volume/year you
      needed. Do you remember what the acronyms meant?  (Selected List of
      Biomedical Serials and Union List of Selected Serials in Michigan) … we used to call Shiffman Medical Library and ask them
      to check the union list card file they maintained of several (but not all)
      MDMLG libraries’ monograph holdings? Limit of 3 at a time, please.
      Beyond that, we had to call around blindly to see if anyone held a needed
      book. … we used Texas Instruments dumb terminals for Medline
      searches, putting our phones into the acoustical coupling device? These
      babies had a speed of 300 baud and printed on thermal paper that curled up
      like scrolls. Medline would print about 25 lines and then give a
      "continue printing yes/no?" message to which you needed to reply
      "y" every time. … we didn’t even have computers at all? OR fax
      machines OR word processing OR a photocopier located in the library? … broad term Medline searches yielded the GEN TERM
      OVERFLOW error message? … we picked up or delivered STAT interlibrary loans by
      car? … we had sufficient staffing and budgets for our
      libraries? … we could all attend MDMLG meetings four times per
      year, where we would form warm associations with colleagues and swap
      photocopied interloan requests? If you remember any of these, you are a "long-termer."
      You can attest to the fact that technology has certainly changed the way
      we do our jobs. You can also confirm that the relationships formed with
      MDMLG colleagues have remained a constant and valuable asset through
      everything.   BACK TO THE
TOP 
 By Carol Attar In the last issue of the MDMLG News, we
      introduced new members of MDMLG.  This, the second article in our
      series on MDMLG members, focuses on the opposite end of the
      spectrum...our, shall we say, "long-term" members. It is
      surprising how many long-term members there are in MDMLG, including the
      author of this article. It is also evidence of the value we accord to our
      professional organization. If you are one of those who have been a member
      for 20 years or more, but have not been interviewed for this issue, please
      be patient. We may be "saving" you for a future column. In the
      meantime, we can all learn from the experience and advice of these
      colleagues: 
 
        
        
          
            | Ellen O'Donnell, Director of Medical
              Library, St. John Hospital & Medical Center, has been a member
              of MDMLG since 1977. Asked what changes she has seen in the
              organization during that time, Ellen notes a significant reduction
              in both the size of the organization and the attendance at
              meetings. She remembers that, in her early years with MDMLG,
              meetings were often attended by 60 or more people. By contrast,
              she says, today's meetings are considered well attended if 30
              librarians are present. In the 1960's, Ellen explains, grant money
              was made available for the education of medical librarians,
              placing more professionals and larger staffs in the |  |  
            | medical libraries of the
              larger hospitals at that time. By the 70's, however, a cycle of
              budget reduction had already begun. Through the years, she also
              notes, there has been a shift in resource sharing from the local
              level, early on, to the national level with the advent of Docline. |  Asked how she believes our profession has
      changed during that time, Ellen cites a major difference in how she spends
      her day. Where she used to spend most of her time doing reference work
      (especially searches), she is now educating end-users and dealing with the
      headaches of technology. Her patrons today expect instant access to
      electronic journals, creating a host of new issues like licensing and
      archiving of electronic resources. Ellen also notes that she has
      additional responsibility - for the patient TV system - and is operating
      with fewer staff positions than in the past. From the perspective of her 20+ years of
      experience, what would Ellen recommend to her colleagues who are just
      beginning their careers? On the positive side, she says, medical
      librarians enjoy autonomy and the opportunity to be involved in patient
      care. However, she adds, medical librarians in hospitals have fewer
      opportunities for interaction with colleagues than those in academic or
      public libraries. Since career ladders are generally lacking for hospital
      librarians, learning different skills in a variety of positions is
      particularly valuable. "Take opportunities for varied experiences in
      jobs," she says, "and realize that a lot of what you will do is
      managing people and projects, not reference work." 
 
        
        
          
            |  | Daria Drobny joined MDMLG almost 32
              years ago, at about the same time she accepted her position as
              Director of Medical Library at the Rehabilitation Institute of
              Michigan in the Detroit Medical Center. Daria remembers being told
              she would have responsibility for the library's budget, and
              thinking, "I don't even have a check
              book!"  She moved beyond budget management, however, and
              in 1982, with funds she acquired from a Skillman Foundation grant,
              she expanded the Rehabilitation Institute's library into a
              Learning Resources Center, which now encompasses a Patient
              Education Library and Media Center, in |  
            | addition to the Medical
              Library. The Learning Resources Center continues to serve the
              needs of both patients and caregivers, providing information
              resources and Internet and Health Literacy courses upon request.
              It also houses the archives of the Rehabilitation Institute. 
              The Media Center supports all audiovisual services, including
              teleconferencing and outreach to satellite facilities. |  Daria feels that the last five years have
      been the most challenging for her, in dealing with the impact of managed
      care on our libraries, as well as on healthcare in general. She notes
      shrinking FTE's in hospital library departments along with diminished
      budgets for training and conferences. She says that, "What has
      sustained me for so long is working in an environment where you are
      reminded everyday how fortunate you are and how life can change in an
      instant. Witnessing the determination of patients and the dedication of
      the staff still serves as a constant inspiration."  Another
      constant, Daria notes, is the "fervor and dedication" of the
      members of the Metropolitan Detroit Medical Library Group throughout the
      years. Asked about "lessons learned"
      through her years as a medical librarian, Daria cites the importance of
      networking with other people. She says, "It is important to look for
      opportunity to provide additional services, change your services and be
      customer oriented...and look to promote services at every appropriate
      opportunity."  She would also advise those just beginning their
      careers to get involved in making presentations. "Start with poster
      presentations to get your feet wet, and then get involved in speaking
      engagements. Becoming members of hospital committees and working on
      administrative projects are extremely beneficial in promoting your
      skills.  Take risks and accept challenges." 
 
        
        
          
            | Sandra I. Martin, Assistant Director,
              Shiffman Medical Library at Wayne State University, has major
              responsibility for reference and circulation service, monograph
              acquisitions and library instruction programs. She also provides
              back up, as needed, for the reference desk. Sandra has been a
              member of MDMLG for about 24 years. |  |  As Sandra looks back at her years as a
      medical librarian, she notes a cyclical pattern of activity in our local
      professional organization. Early on, she remembers hearing that the focus
      in MDMLG was on networking with fellow librarians to share skills and
      experiences. Later, MDMLG began tackling major projects. Members hosted
      regional meetings and worked together on large cooperative projects such
      as creating a union catalog to facilitate the sharing of resources.
      Education and professional development of members became a major goal.
      These projects, she observes, served as a training ground for later
      committee work. In those early years, there was a somewhat adversarial
      relationship between MDMLG and MHSLA, and little cooperation between the
      two organizations. Now, however, the responsibility for major projects and
      meetings has shifted to MHSLA and the MLA chapters, and MDMLG, Sandra
      feels, has returned to its earlier emphasis on networking among
      colleagues. Agreeing with Ellen, Sandra attributes much of this change to
      the advent of Docline, which shifted resource sharing away from the local
      level. Technology has resulted in a major change
      in the profession of medical librarianship, as well. Sandra notes that
      librarians used to control all the information resources -- acquiring
      them, organizing them, and using them to find needed information. Now, the
      "end-user" has control over a great deal of that process,
      changing the role of the librarian from gatekeeper to that of
      instructor/facilitator. Sandra's experience in different positions
      during her career has taught her that medical librarians, although they
      face many challenges today, have a very useful set of skills which equip
      them for many new opportunities in today's world. To medical librarians
      beginning their careers, she advises, "Be a
      communicator. There are many different styles of communication, so
      communicate in whatever way you are comfortable -- but get your thought
      and views out!" "Think out of the box. Be flexible.
      You may need to learn new skills or be asked to assume new
      responsibilities. With today's increasing rate of change, you must be
      flexible to adapt. Also, keep on learning."  Sandra recalls a
      longevity study, which cited the "lifelong learner" trait as a
      factor in a long life. Beyond that, Sandra says wryly, " passion for
      learning may also be a factor in the longevity of your career!" 
 
        
        
          
            |  | Sharon Phillips is an example of
              someone whose skills and flexibility have taken her into one of
              those "new opportunities."  After spending many
              years as a hospital librarian, Sharon became the Director of Media
              Services at Wayne State, and now has moved to a position at WSU so
              new that she does not yet have a title. She explains that this
              move is part of a reorganization and strategic planning effort
              within the WSU library system, so her job duties will be evolving
              over the next few months. Her probable title will be Director of
              Training and |  
            | Development. In this
              position, she will be responsible for planning and coordinating
              training and development for librarians and support staff across
              the Wayne State campus. She also will be involved in developing
              faculty skills in using technology for instruction and research. |  Sharon has been a member of MDMLG since
      1977, and through the years, she notes that the membership has become
      smaller. "That is not surprising," she adds, "since there
      are fewer hospitals now!" She compares the change in our organization
      to the changes in healthcare - notably constraints in both time and money
      - that prevent MDMLG members from the degree of participation in the
      organization that was possible in prior years. Also, Sharon sees a
      reduction in support from members' institutions. This creates a challenge
      for MDMLG to find smarter ways to manage finances. A great example of
      this, she says, is moving the directory and newsletter to the web, saving
      both time and money for the organization and its members. Sharon has also observed a change in
      MDMLG's role in recent years, as MHSLA has taken on more responsibility.
      She links this to a change in demographics, resulting in more librarians
      in out state hospitals, where once they were concentrated in the
      metro-Detroit area.  As to changes in our profession over 20+ years,
      Sharon, too, points to the changes in technology. She remembers the time
      when searches were done on terminals connected to remote computers.
      Libraries had to pay, by the citation, for their printouts, and search
      strategies were always carefully prepared in advance, so you could get on
      and off quickly. She says, "We thought that when, later, we got our
      own Medline on CD's, we had gotten rid of modem and connection problems
      forever! Now, however, we have come full circle and are again paying for
      use times and again subject to being bumped offline...   The
      Internet has changed all libraries and we need to reexamine the role of
      libraries and librarians. We have become more facilitators, and less
      mediators in the search for information." She feels, however, that
      medical librarians have a stronger grasp of this situation than librarians
      in other types of libraries. To colleagues, Sharon echoes the need for
      flexibility. She acknowledges that hospital jobs are less predictable than
      in the past, but she believes that hospitals provide a good environment
      for medical librarians to develop a broad range of skills and experiences
      that are transferable. She would like to see medical librarians play a
      stronger role in developing the Internet as an effective information
      resource, citing the current difficulty in retrieving good, specific
      information using Internet interfaces. She is concerned that information
      technology development is taking place in medicine without involvement of
      medical librarians. "We need," she says, "to
      do a better job of promoting our unique  skills to assess the quality
      of information and match information with user needs."   Finally, Sharon says to those beginning
      their career, "Pursue as many opportunities for learning as possible.
      Choose the work because you love it, and success will follow!"   BACK TO THE TOP 
 By Marilyn Kostrzewski The Michigan Health Sciences Libraries Association held
      its 28th annual conference on October 10-12, hosted by the
      Mid-Michigan Health Sciences Libraries Group, at the beautiful Soaring
      Eagle Resort. The conference, entitled Soaring to New Heights: Weaving
      Tradition and Technology, provided opportunities to investigate the
      electronic, physical and multicultural challenges of healthcare
      information needs. Three distinct continuing education classes were offered
      on Wednesday. The full day course dealing with the management and
      licensing of electronic resources was taught by Laurie Thompson, Director
      of the Health Sciences Library, SUNY Upstate Medical University in
      Syracuse, New York. In the morning, she guided the class through multiple
      facets of digital licensing, including explanations of terminology,
      contract process and how the Copyright laws apply to this type of
      licensing. The afternoon was spent analyzing an actual contract, assessing
      needs, negotiating strategies and tips on working with your company’s
      legal department. It provided a very relevant and systematic guide for
      tackling the challenges of electronic resource management. Stephanie Weldon from the GMR, taught the "Consumer
      Health Information Course", a useful class for librarians developing
      strategic plans for their consumer health libraries. Covered topics
      included needs assessment, mission statements, funding, disclaimer
      statements, marketing, library volunteers, collection development, and
      benchmarking. As is so often true when librarians get together, the shared
      insights and experiences of attendees contributed to the success of this
      class. The lively course entitled "Using the Basic Tool of
      the Information Age - Your Brain", taught by Dr. Barbara Herrin of
      Dominican University’s Graduate School of Library and Information
      Science, was both informative and entertaining. Attendees learned how
      their individual personalities, as determined by the Myers-Briggs tool,
      influence how they solve problems and work with others. Barbara used a
      variety of visual aids and role-playing techniques to illustrate concepts
      and stimulate discussion. Ask Diane O’Keefe how this class augmented her
      enjoyment of the conference. Thursday launched the transcultural aspect of the
      conference, with the keynote speakers, husband and wife team Duncan
      Sings-Alone (Dr. C.W. Duncan, PhD and Dr. Priscilla Cogan, PhD),
      presenting a very enlightening and engaging presentation of storytelling
      and personal anecdotes. They contrasted Western and Native American
      medicine’s role in the healing process of mind, body and spirit. A variety of vendors were present, on Thursday, to present
      product demonstrations and answer questions. Breakfast and breaks were
      supported in part by a few of them. The business meeting was conducted by President, Doris
      Blauet. State librarian Christie Pearson Brandau addressed the audience
      concerning the NetLibrary, the state library cooperative ventures, her
      cabinet position role in Governor Engler’s Department of History, Arts
      and Libraries and stated how impressed she was by our group’s
      camaraderie. Mike Simmons, Sparrow Hospital, incoming president accepted
      the gavel for the upcoming year. He provided the group with a very
      inspiring slide presentation. Judy Barnes, Ingham Medical Center, was
      introduced as the incoming secretary. The following scholarship winners
      were introduced: Pat Vinson from Wayne State, Barbara Few from U of M, and
      Jill Werdel Spretzer, University of Detroit Mercy, a new MHSLA member. The
      MHSLA poster session was enjoyed on Thursday with 6 presentations. At the conclusion of the program, Joanie Emahiser,
      Beaumont-Royal Oak and Doreen Bradley, Taubman Medical Library, Ann Arbor
      invited the assembly to the 29th Conference to be held in Ann
      Arbor, October 16 - 18, 2002, hosted by MDMLG region. Following lunch, the Barbara Coe Johnson and Jeanne
      Brennan Memorial Speaker, Felita Wilson, from Wayne State University,
      highlighted the consequences of inadequate patient literacy levels in
      relation to the types of health information available, and discussed
      current research being done in this arena. Later in the afternoon, Duncan Sings-Alone presented an
      enlightening interactive program on Reiki Healing. Participants
      experienced how the energy flow within themselves, channeled in the proper
      way, can provide relaxation and comfort for themselves and others. The special event featured the Saginaw Chippewa Indian
      Tribe providing entertainment following a delicious meal prepared by the
      resort chefs. Singers, dancers and musicians, of all ages, outfitted in a
      variety of native costumes, provided entertainment and insight into the
      Native American culture and customs. Concurrent sessions were the order of the day on Friday.
      Our own Alexia Estabrook, Providence Hospital, presented two sessions
      concerning the MHSLA electronic journal club. She explained the Web
      Crossings software, topic choices, responsibility of the convener, and
      receiving MLA credit that can be used to apply for or renew AHIP
      memberships. Jeanne Drews, Michigan State University, presented a very
      practical course on preparing for a library disaster. At the conclusion we
      all had the materials to create a complete disaster plan. The Multicultural Challenges of Healthcare was the
      topic of the program presented by Rose Alcodray-Kalifa, RN, Oakwood
      Healthcare Systems. Her session addressed the impact of cultural and
      ethnic traditions and beliefs on the delivery of healthcare services.
      Concepts of cultural competency were explained. Stephanie John, Saginaw Cooperative Hospitals, presented
      an authoritative program on Using Personal Digital Assistants. She
      discussed how information professionals are supporting PDAs in their
      resource centers. A demonstration of a variety of devices and their uses
      complemented the program. I found this conference to be very instructional and
      invigorating. It presented aspects and items affecting the delivery of
      healthcare information that are not traditionally considered. Entertaining
      presenters, enthusiastic participants, attractive facilities, and
      delicious cuisine provided a very enjoyable and educational event.   BACK TO THE TOP 
 By Christine Miller When a hospital administration has to make
      cutbacks, the medical library and positions in the library are always in a
      precarious position. The medical library itself does not provide direct
      patient care nor does it generate income, which makes the medical library appear
      quite expendable. As a solo librarian in a
      community hospital medical library, my job was recently in jeopardy, as
      was the status of the medical library itself. The entire (tiny) library
      budget was going to be cut. The new administration was not
      aware of the many services offered by the medical library. In addition to
      providing reference, research and article ordering for all employees in
      the hospital, I order all publications for the entire hospital. I also
      provide reference help to patients, their families and the community -
      when they can find my little library! We do not have a community health
      library. Fortunately for me, and for the hospital, a large number of
      physicians objected to the cutback plan. My library may be somewhat unique in that
      it is situated immediately adjacent to the Doctors Lounge, and near the
      doctor's dictation area, which is attached to the Medical Records
      department. As a solo librarian, my work is quite visible to the doctors.
      In no particular order, I think that some of the following points may have
      been somewhat instrumental in influencing physician support: 
        
          I love my job, and it probably shows.
          I put the physician’s research
          requests at the top of the priority list.
          I interact with all library
          patrons in a professional manner, everyday.
          I try to help everyone to be
          comfortable with computers and not to feel "challenged" by
          technology.  (The doctors seem to be impressed with my computer
          ability, knowledge of medical terminology, and my ability to do
          quality medical information research.)
          Working with an incredibly small
          budget, I manage to purchase core reference materials and highly
          recommended texts. Perhaps it boils down to doing a
      professional job, enjoying it, and having a great staff of doctors who
      know that "Information is your best medicine. " (Michael E.
      DeBakey MD – as quoted on the MEDLINEplus.gov Health Information pencil
      holder on my desk!)   BACK TO THE TOP 
 By Elena V. Koustova In the aftermath of the tragic events of
      the past September all of us share in grief and anger, as we struggle to
      understand the causes of the recent past and worry about the future. As
      librarians, we face a daunting yet urgent task of finding effective ways
      of helping our country and the communities we serve to deal with the
      present and potential threats. This article will address some of the
      issues concerning one of such threats: bioterrorism. The first of these issues that begs notice
      is the necessity of differentiating between "biological
      terrorism" and "biological warfare (weapons)". These terms
      are sometimes used interchangeably in publications geared towards the
      general public as well as some professional writings. However, they are
      not one and the same thing. Their differences are important for the
      understanding of our current situation and planning response to any future
      events involving biological threats. Biological warfare defined as employment in
      war (i.e., in the context of a military confrontation) of microorganisms
      to injure or destroy people, animals, or crops [1] is probably almost as
      ancient as war itself [2, 5]. The use of biological weapons was outlawed
      by the 1925 Geneva Protocol, but the concerns over the possibility
      remained. In 1972 these concerns were addressed by the 1972 Biological
      Weapons Convention which outlawed development, production, and stockpiling
      of biological weapons including the ones based on naturally occurring
      toxins [3]. In the period between 1945 and,
      approximately, 1979, the threat of biological warfare was viewed almost
      exclusively in the context of hostile actions between states as evidenced
      by this quote from a 1946 US government study: "…only a nation with
      sizable resources in specially-trained scientific personnel and industrial
      facilities can produce the means to wage open, large-scale biological
      warfare. In order to utilize successfully the biological warfare
      potentialities of any nation, a favorable national policy and the support
      of high governmental agencies are prerequisites" [4]. This view of state-supported programs as
      the only potential source of development and use of biological weapons was
      about to be challenged by two important developments: proliferation of
      terrorism, particularly terrorism of religious extremists, and rapid
      advances in molecular genetics and biotechnology. The first of those
      trends was about to supply motives and the second one the means for
      bioterrorism - the use, or threatened use, of biological agents to promote
      or spread fear or intimidation upon an individual, a specific group, or
      the population as a whole for religious, political, ideological,
      financial, or personal purposes. In 1984 the Rajneesh group in The Dalles,
      Oregon, contaminated food with salmonella in an attempt to disrupt and
      influence the outcome of local elections. This event is considered to be
      the first known instance of intentional use of a biological agent with
      terrorist purposes on US territory. More than 700 people became seriously
      ill; luckily, the terrorists' choice of pathogen did not intend to cause
      deaths and none occurred [3]. Despite this ominous event, during the next
      ten years the potential use of biological weapons continued to be viewed
      almost exclusively in connection with state-supported programs [5]. The turning point in the perception of
      bioterrorism as a real threat came in 1995 after the members of a Japanese
      religious cult "Aum Shinrikyo" released Sarin in the Tokyo
      subway, killing thirteen and injuring several hundred people. The
      subsequent investigation revealed multiple prior attempts by this group to
      produce and disperse biological agents (Clostridium botulinum and
      anthrax). These findings and the resulting surge of public interest in
      bioterrorism [6] prompted several research projects attempting to provide
      global overview of any events concerning the actual use or attempts to use
      biological agents, attempts to purchase materials, hoaxes, threats,
      consideration or discussion of use, etc. [3, 7]. The studies produced
      several interesting conclusions, which were proved to be true by recent
      events: 
        
          "Since 1985, the number of
          terrorist incidents involving the threatened or actual use of
          chemical, biological, radiological, or nuclear materials has risen
          sharply…"
          "… two types of targets have
          increased in frequency: the general civilian population (with the
          apparent intent of inflicting indiscriminate casualties) and a
          symbolic building or organization."
          "… the technical barriers to
          mass-casualty terrorism are eroding." [7]. The implications of these statements become
      even more poignant if one recollects the ruling paradigm of the previous
      decades: only states [nations] are capable of using and producing
      biological weapons on a large scale. Consequently, the U.S. bio-defense
      programs designed by the latter half of the 1990's were predominantly
      intended to protect the armed forces against biological warfare [9] and
      did not address the fact that terrorists attacking civilian population had
      become a threat of equal importance. The growing probability of such attacks
      prompted the federal government and some non-government organizations to
      conduct a review of the existing US programs of dealing with biological
      assaults. Examples of such reviews can be found in the reports on
      bioterrorism published by the United States General Accounting Office
      (http://www.gao.gov/)  and the Chemical
      and Biological Weapons Nonproliferation Project      of the Henry L. Stimson Center. According to the GAO reports, the major
      flaws in the plans of response to bioterrorism are: 
        
          Lack of coordination between various
          agencies responsible for federal terrorism research, preparedness, and
          response programs (see the "Organizational chart for terrorism
          response", http://www.cns.miis.edu/research/cbw/domestic.htm#wmdchart)
          Insufficient state and local planning
          and a lack of hospital participation in training on terrorism and
          emergency response planning
          Need of better management of federal
          medical stockpiles that can be used to treat civilian and military
          victims in the event of a biological attack The Stimson Center Report "Ataxia: The
      Chemical and Biological Terrorism Threat and the US Response"      further detailed the "pitfalls in front-line readiness" to
      Biological attacks: 
        
          Disease surveillance system is not
          prepared for early detection of a covert bioterrorist attack
          Lack of awareness of the symptoms and
          epidemiological patterns of biowarfare diseases by the majority of
          primary care and emergency department physicians, which would compound
          the difficulty of telling a covert biological attack from a natural
          outbreak and organizing a response in a timely manner
          The current cost-cutting practices of
          just-in-time stocking of supplies by hospitals would be
          counter-productive in case of a mass disease outbreak caused by an act
          of terrorism
          Mass psychogenic effects of a
          biological attack would further complicate the work of hospitals; the
          staff is likely to be affected as well Numerous changes addressing these and other
      shortcomings of the US disaster response plans occurred since the
      publication of the reports cited above, including the National
      Pharmaceutical Stockpile Program (http://www.bt.cdc.gov/stockpile) 
      and the establishment of the CDC Bioterrorism Preparedness and Response 
      Program.  However, the ability of primary and emergency care physicians to
      recognize and report the onset of a biological attack remains crucial for
      the success of all the renewed plans and programs. It also continues to
      remain unsatisfactory [13]. How are we as medical librarians responding
      to this situation? Building specialized collections of
      web-based materials on bioterrorism seems to be the unanimous first
      response of the library community. Webliographies and bibliographies on
      bioterrorism were created almost overnight by MEL,
      MLA (http://www.mlanet.org/resources/caring/resources.html),
      NLM,
      on the sites of various other libraries and organizations.  Some of the benefits of this approach
      include: 
        
          Assembling materials compiled by
          different agencies in one collection helps to remedy the insufficient
          coordination of effort between agencies noted in the GAO reports
          Such collection is "instant",
          easily (or "self") updated, remotely accessible by patrons The main drawbacks of such solution are the
      inevitable duplication of efforts and its total dependence on the
      communication technology. While we can tolerate the former, the latter
      becomes dangerous in the event of any disruption of communication systems.
      This issue has been raised on MEDLIB-L by Jeannine Gluck (http://listserv.acsu.buffalo.edu/cgi-bin/wa?A2=ind0109c&L=medlib-l&F=&S=&P=12846) 
      who suggested a possible solution: keeping printouts of reputable
      resources on diagnosis and treatment of illnesses caused by biological
      agents most likely to be used. This approach solves the problem of
      dependence on communications but creates some challenges of its own:
      keeping the printout collection sufficiently updated and deciding which
      agents have higher priority.  Nevertheless, creating a collection of
      printed materials at least on the Category A agents appears to be an
      excellent idea. Adding printouts of local information such as state/county
      bioterrorism preparedness and response plans
      [11] and contact information for local emergency management programs 
      might be another way to enhance such a collection. Some of the other possible approaches to
      the situation might be: 
        
          Tailoring routine bibliographic
          instruction to cover more of the terminology and resources specific to
          bioterrorism and infectious diseases
          Developing partnerships with local
          first response organizations as well as public libraries in order to
          educate the public on issues related to potential biological attacks Active professional communication is still
      another way to contribute to thwarting the threat of bioterrorism. The
      discussion and recommendations on MEDLIB-L (http://listserv.acsu.buffalo.edu/cgi-bin/wa?A0=medlib-l&D=0) 
      that followed the initial terrorist attacks and their aftermath have
      already provided a wealth of resources and ideas. Let us hope that our
      professional community will continue to be a source of strength and wisdom
      to all of us in those difficult times. REFERENCES 
        
          Biological warfare: Infoplease.comhttp://www.infoplease.com/ce6/history/A0807621.html
        R. E. Hurlbert. Chapter XV,
        Addendum: Biological weapons. In: Malignant Biology.  Microbiology
        101 Internet Text, 1997.
        
        M. Leitenberg. Biological Weapons in the
        Twentieth Century: A Review and Analysis*
        Biological Warfare, Activities and
        Capabilities of Foreign Nations, A Military Intelligence Service Special
        Study, War Department, Washington, DC, March 31, 1946, p. 18,
        Declassified.
        Medical Management of Biological
        Casualties. U.S. Army Medical Research Institute of Infectious Diseases,
        1998.
        D.E.Kaplan. Terrorism's next wave, Nerve
        gas and germs are the new weapons of choice. U.S. News Online, November
        17, 1997.  
        J. B. Tucker. Historical Trends Related
        to Bioterrorism: An Empirical Analysis. Emerging Infectious Diseases.
        5(4):498-504, 1999 Jul-Aug.  http://www.cdc.gov/ncidod/eid/vol5no4/tucker.htm 
        T.J. Torok, et al. A large community
        outbreak of salmonellosis caused by intentional contamination of
        restaurant salad bars. JAMA 1997;278:389-95.
        B.Rosenberg. A way to prevent
        bioterrorism. San Francisco Chronicle, 18 September 2001, A17.  http://www.sfgate.com/cgi-bin/article.cgi?f=/chronicle/archive/2001/09/18/ED180411.DTL 
        J.R. Baker Jr., G.S. Omenn. Practical
        plan can deter bioterrorism. Detroit News, 10 October 2001.
      
        A.E. Smithson, L.A. Levy. Ataxia: The
        Chemical and Biological Terrorism Threat and the US Response. Henry L.
        Stimson Center, Washington, D.C. October 2000.
        A.Goldstein. Anti-Terror Campaign Turns
        to Doctors :Physicians Scramble to Learn About Bio-Weapons; Some Urge
        Mandated Training. Washington Post , October 14, 2001; Page A12.http://www.stimson.org/pub.cfm?ID=12
   BACK TO THE TOP 
 By Sue Skoglund The next MDMLG meeting will be held at Genesys Regional
      Medical Center in their new Athletic Sports Center on Thursday, November
      15, 2001. Denise Forro, head of interlibrary loan services for Michigan
      State University, will discuss ARIEL – how to do it, problems and
      concerns. In keeping with the Sports Center location, there will be
      a "Take Me Out to the Ballgame" light luncheon (hot dogs,
      nachos, etc.) provided before the meeting. Jill VanBuskirk will present an
      overview of the upcoming MLA survey on benchmarking with tips on how to
      complete the survey form during this brown bag luncheon without the brown
      bag. The luncheon begins at 12:00 noon. The business meeting
      will begin at 1:00 p.m., followed by a break and the program. Further
      information, along with a map, can be found on the MDMLG
      Meetings web page.   BACK TO THE TOP 
    
         Misa Mi is looking for two people to join her Public
      Relations Committee. E-mail her at mmi@dmc.org 
      or call her at Children’s Hospital 313/745-0252 if you are interested. Jill VanBuskirk wants to encourage MDMLG members to
      participate in the upcoming MLA survey on benchmarking. Jill is the
      Benchmarking Chapter Educator for MC/MLA. More information should be
      available on the MDMLG and MLA web sites later in November. The survey
      itself should be coming out by the end of the year. The location of the February 21st MDMLG meeting
      has been changed. It will be at the Ford Community and Performing Arts
      Center in Dearborn. Mark you calendar for June 10-11, 2002. The Professional
      Development Committee is working on a National Library of Medicine
      workshop similar to the ones held in Ann Arbor (Pubmed, Toxnet). The date
      and place are set: June 10-11, 2002 at Shiffman Medical Library. 
      More details to come. Providence Hospital Helen L. DeRoy Medical Library has
      hired a new LTA, Donell Decenzo. Don was a teacher in Detroit for 30 years
      and had been a volunteer in the library for the past 4 years. His
      developing interest in libraries led him to take LTA courses at Oakland
      Community College. Don is also a new member of MDMLG. Congratulations to Gina Hug on the birth of her son.
      Alexander Paul Hug was born September 18th, weighing five pounds, one
      ounce.                       BACK TO THE TOP 
 Communications Committee 2001-2002 Carol Attar…………………..  carolattar@home.com Gay Byrnes………………….  Gaybyrnes@yahoo.com
 Bridget Faricy……………….   bfaricy@beaumont.edu
 Helen Koustova……………..   hkousto1@sladen.hfhs.org
 Maureen LeLacheur…………   mlelach1@sladen.hfhs.org
 Valerie Reid, Webmaster……   vreid1@sladen.hfhs.org
 Sue Skoglund, Chair…………   rohlibrary@hotmail.com
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