national library of medicine · 2019. 7. 25. · s richardso hill )r, (chairman)n dr thoma, s c...

NATIONALLIBRARY ofMEDICINE

FISCALYEAR1978

U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFAREPublic Health ServiceNational Institutes of Health

ISSN: oi(;;i-4r>(X)

NATIONALLIBRARY ofMEDICINEPROGRAMSandSERVICESFISCALYEAR1978

i'.s. DEPARTMENT or HEALTH, EDUCATION, AND WELFAREPublic Hr.-ilth Service\ i i l io i i ; i l Ins t i i i i i cs ot IIr; i

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Z National Library of Medicine.675.M4 Programs and services.U56an -- 1971/72-

-- Betheida, Md.v. lllus., ports.--(DHEW publication no. (NIH) 73-256,

etc.)Continues the Library's Annual report.

Report for 1974/75 called Communication In tlie service ofAmerican health; a bicentennial report from the NationalLibrary of Medicine.

I. National Library of Medicine. Communication In theservice of American health. II. Title III. Title:Communication In the service of American health; abicentennial report from the National Library of MedicineIV. Series

Preface[he purpose of this report is to give an account of the programs and services performed by the

National Library of Medicine last year This preface merely identifies a few highlights which deservesome spec lal mention As always, the labors of the staff are the most precious ingredient contributingto (he progress and accomplishments described in this report I will miss sorely the outstanding con-tributions made by Melvm Day, Deputy Director, who will be leaving NLM early in FY 1979, andDavis McCarn, Associate Director for Planning

Over the past year (he progress made on construction of the new Lister Hill Center Building hasbeen most gratifying The builders are now several months ahead of schedule and, if all goes well, wewill begin to move into the building in the fall of 1979, rather than the spring of 1980 as originallyscheduled

Another bright note this past year was (he appointment of seven new members to the Board ofRegents Alter having to cancel two consecutive meetings because of a lack of members, it is reassur-ing to have once again a Board of Regents made up of leaders in American medicine and medicallibrananship The Library will need the guidance of the Board especially in resolving the many impor-tant issues attendant to the move of the National Medical Audiovisual Center to the new building inBcthesda and the integration of the NMAC with the Lister Hill Center program

Readers of this report will not fail to note that NLM's online services network continues to grow innumber of member institutions, searches performed, and data bases available Among the new onlineservices (his year are SERLINt (biomedical serials), HISTLINE (history of medicine), BIOETHICSLINb,and the Registry of Toxic Effects of Chemical Substances

Also notable this year was a meeting at the National Library of Medicine of eleven hospital medicallibrarians to advise- us on how we at NLM were meeting our commitment to assist hospital librariesIrom that meeting came many valuable suggestionswhich should lead to improved support of theirservice's to health professionals

I invite all members of the health community to let us know how we can better serve their informa-tion needs

Martin M. Cummings, M.D.DirectorNational Library of Medicine

Contentsr POLICY AND DIRECTION 1

Board of Regents 2Lister Hill Center building , 2Financial resources 3Personnel 3

Staffing activities 4Awards and honors 5

Equal employment opportunity 6Exhibits 7

2. LIBRARY SERVICES AND OPERATIONS 9Highlights 10Bibliographic Services Division 11

Indexing 11MEDLARS management 12Online services training 13

History of Medicine Division 13Acquisitions 14Public service 14

Reference Services Division 15Technical Services Division 16Medical Subject Headings 18Mid-Atlantic Regional Medical Library 19

3. COMPUTER AND COMMUNICATIONS SYSTEMS 25

4. SPECIALIZED INFORMATION SERVICES 27Query response 28Publications 28Online retrieval services 29Collaborative activities 31

5. AUDIOVISUAL PROGRAMS 32Research and the application of research 33

Development of audiovjsuals 33Utilizing audiovisual and educational technology 34Planning and evaluating information transfer systems 34

Services 35Audiovisual distribution 35Consultation 36

6. LISTER HILL CENTER 38PHS/CTS program 39Network operation and maintenance project 40Dissemination of information to practitioners 40Information technology 43

7 EXTRAMURAL GRANTS AND CONTRACTS 45Regional Medical Libraries 46Resource project grants 47Resource improvement grants 47Biomedical scientific publications 48Special scientific projects 49Research grants 50Training programs 50

8. INTERNATIONAL ACTIVITIES 52International MEDLARS agreements 53International exchanges and services 54Special Foreign Currency Program 54Regional resources and biomedical information 55Visitors and specialized training 56

APPENDIX 1. Staff bibliography 58APPEN DIX 2. Grant-supported publications 60APPENDIX 3. P.L-480 supported publications 63APPEN DIX 4. NMAC audiovisual materials produced 65

List of TablesTable 1. Financial resources and allocations 3

Table 2. Personnel ceilings 4

Table 3. Online searches 19

Table 4. Offline searches 20

Table 5. Bibliographic services 20

Table 6. History of medicine activities 21

Table 7. Acquisitions statistics 21

Table 8. Growth of "collections 22

Table 9. Cataloging statistics '. ' 22

Table 10. Circulation statistics 23

Table 11. Reference services 23

Table12. Binding statistics 24

Table13. Selected statistics, NMAC 37

Table14. PHS/CTS programs 41

Table 15. Extramural grant and contract programs 51

Table 16. International access to MEDLARS 53

Chapter 1: Policy and Direction

Kent A. Smith, Assistant Directorfor Administration

NLM Board of Regents, May 1978 meeting, left to right: Dr. Thomas C Chalmers, Dr. Cecil G. Sheps, Brig. Gen. Ernest ). Clark(ex officio), Mr. lames F. Williams II, Dr. Faye G. Abdellah (ex officio), Dr. Nicholas E. Davies, Rear Adm. J. William Cox (exoff/do), Dr. Doris H. Merritt, Col. John C. Richards (ex officio), Dr. S. Richardson Hill, Jr., and Dr. Kelly M. West.

NLM Programs and Services

Board of RegentsThe NLM Board of Regents has an important

role in the development of NLM policies andplans On March 20, 1978, the Senate con-firmed the President'snominees for seven posi-tions on the Board, three Board vacancies re-main to be filled The Library had been withoutappointed Regents since August 1977 The newRegents are

Thomas C Chalmers, M DPresident and DeanMount Sinai School of Medicine of the City

University of New York

Nicholas E Davies, M DAttending PhysicianPiedmont Hospital, Atlanta, Georgia

S Richardson Hill, J r , M DPresidentUniversity of Alabama in Birmingham

and SponsoredDons H Merntt, M DDean, Office of Research

ProgramsIndiana— Purdue University

Cecil G Sheps, MDProfessor of Social MedicineUniversity of North Carolina

Kelly M West, M DProfessor of Medicine and of Continuing

EducationUniversity of Oklahoma

James F Williams, IIMedical LibrarianShiffman Medical LibraryWayne State University

Regents are selected from among leaders inthe fundamental sciences, medicine, dentistry,public health, hospital administration, phar-macology, scientific or medical library work, or in

public affairs In addition to the ten appointedmembers there are seven ex officio Regents theSurgeons General of the Public Health Service,the Army, the Navy, and the Air Force,the ChiefMedical Director of the Department ofMedicine and Surgery of the Veterans Ad-ministration, the Assistant Director for Biologi-cal, Behavioral, and Social Science of the Na-tional Science Foundation, and the Librarian ofCongress

The Board met on May 25-26,1978, to reviewNLM programs and grants applications At thattime the Board unanimously elected Dr KellyM West Chairman of the Board of Regents forthe year 1978-1979

One of the first tasks facing the new Boardwill be to reevaluate and redefine the missionsof the Lister Hill National Center for BiomedicalCommunications and the National MedicalAudiovisual Center in anticipation of themerger of these two programs in 1980 For thispurpose, the Chairman appointed the followingBoard members to a special subcommittee DrS Richardson Hill, )r (Chairman), Dr ThomasC Chalmers, and Dr Nicholas E Davies

Lister Hill Center Building

Progress has been rapid on the constructionof the new Lister Hill Center building The con-struction contract was awarded in June 1977 tothe George Hyman Construction CompanyCompletion of the building was originallyscheduled for December 1979, current projec-tions would permit partial occupancy by Sep-tember 1979, three months ahead of schedule

SUA Inc , an interior design firm, has con-ducted a comprehensive space analysis of theN LM programs that will occupy the new build-ing The contractor has defined each program's

Policy and Direction

space needs, identified requirements for officefurnishings, established the interior layout re-quirements for the building, and is currentlyassisting in the design of the public areas.

NLM has begun consideration of art worksfor the Lister Hill Center building. The two majorart works proposed are a mural for the mainlobby conveying the history of biomedical com-munications in abstract form, and a largesculpture to be located on the podium terrace.Artists will be nominated by a panel of expertsfrom the National Endowment for the Arts,with final selection to be made by General Ser-vices Administration's Fine Arts Committee.

Financial ResourcesThe National Library of Medicine's FY 1979

appropriation will provide $41,431,000 and 503positions, an increase of $3,812,000 and 8 posi-tions over the levels available to the Library in

FY 1978. The increase will be used to maintainbasic NLM services, increase support forresearch and development in biomedical com-munications, and upgrade the computers usedto provide online services to the health com-.munity.

PersonnelIn FY 1978, the NLM Personnel Office com-

pleted the second year of the DHEW three-yearclassification review program, auditing 159positions.

The U.S. Civil Service Commission con-ducted a personnel management evaluation atthe National Medical Audiovisual Center(NMAC) in Atlanta in May 1978. The evaluationcovered the personnel management program atNMAC and the problems and issues related tothe pending relocation of NMAC personnel toBethesda in 1980. NLM management has

Table 1Financial Resources and Allocations, Fy 1978

(dollars in thousands)

Amounts available for obligationAppropriation, NLM $36,746

Pay cost supplement 873Earned reimbursements 948Total 38,567

Amounts obligated by Extramural ProgramsAmounts obligated for direct operations

Lister Hill National Center for Biomedical Communications.National Medical Audiovisual CenterOffice of Computer and Communications SystemsLibrary OperationsToxicology Information ProgramReview and approval of grantsProgram direction

Subtotal, direct operations

8,987

3,3523,6513,4768,6422,416

8855,511

27,933

Total obligations, NLM. 36,920


developed an action plan in response to theCommission's evaluation and recommenda-tions.

The Library continues its program to recruitand hire handicapped persons. In FY 1978 a se-cond sign language course was conducted,with 15 employees participating. The NLM EEOCoordinator, Arthur Robinson, has been desig-nated as the NLM Selective/Placement ProgramCoordinator, and has been instrumental in im-proving the work environment and oppor-tunities for handicapped employees.

The Library received 25 new positions in theFY 1978 Congressional appropriations, bringingthe total number of NLM full-time permanentpositions to 495. NLM had 494 employees atthe end of the fiscal year. Primary emphasis hasbeen placed on recruiting specialists in com-puter science and communications engineeringfor the Lister Hill Center, and on hiring staff tomaintain the quality of basic library services

Staffing ActivitiesLionel M. Bernstein, M.D., Ph.D., was ap-

pointed Director of the Lister Hill NationalCenter for Biomedical Communications. He for-

merly served as the Library's Assistant DeputyDirector for Research and Education.

Davis B. McCarn retired from his position asSpecial Assistant for Science Communicationsand Chief, Office of Planning. Prior to that, Mr.McCarn served as Director of the Office ofComputer and Communications Systems and asDeputy Director of the Lister Hill Center.

Myron J. Adams, Jr., M.D., was appointedDirector of the Library's National MedicalAudiovisual Center in Atlanta. Dr. Adams hasbeen associated with NMAC since 1971, havingserved as a Medical Advisor, Chief of theMaterials Development Branch, and DeputyDirector of the Center.

Bruno Vasta, Chierof the Bibliographic Ser-vices Division, Library Operations, accepted aposition as Director, Chemical InformationDivision, Environmental Protection Agency. Mr.Vasta had served in his position since January1977; he previously was Chief of the ToxicologyInformation Services Branch, Specialized Infor-mation Services.

Melvin Spann was appointed to the positionof Chief, Biomedical Files ImplementationBranch, Specialized Information Services. Mr.

Table 2. Personnel Ceilings

FY72 FY73 FY74 FY75 FY76 FY77 FY7812

537

55

Office of the Director :Office of Inquiries and Publications Manage-

mentOffice of AdministrationOffice of Computer and Communications

SystemsExtramural Programs 31Lister Hill National Center for Biomedical

Communications 15Specialized Information Services 17National Medical Audiovisual Center 105Library Operations 192

12

636

5430

11

536

5127

534

5222

10

535

5424

12 14

535

5227

538

5125

1716

103192

2017

100199

2217

101196

2418

101201

241788

212

351888

221

TOTAL 469 466 466 458 472 472 495


Spann, who has been with the Library for twoyears, was associated with chemical informationactivities including the (HEMLINE service, priorto his appointment as Branch Chief

Emilie Wiggins retired from her position asHead of the Cataloging Section, Library Opera-tions, after 30 years of service to the LibraryLillian Kozuma was appointed to fill this posi-tion Ms Kozuma has been with the Librarysince 1972, as a librarian in the Technical Ser-vices Division

Edith D Blair retired from her position ashead of NLM's Reference Section Mrs Blaircame to the Library in 1960 and served as headof the Reference Section since 1971

Sheldon Kotzm was appointed as RegionalMedical Library Coordinator, ExtramuralPrograms, leaving his former position as Head,Loan and Stack Section, Library Operations,where he had served since 1971 DuaneArenales, formerly assistant head of Loan andStack, was appointed to head that operation

Norman Osmski was appointed Chief, Officeof Contracts Management Mr Osmski, whowas formerly a procurement analyst with theDHEW Management and Budget Office,replaced Kenneth Styers Mr Styers was ap-pointed Assistant Director for Administrationand Operations, NMAC, after serving as Chief,OCM since March 1968

Marie Pmho was appointed Chief, Applica-tions Support Branch, Office of Computer andCommunications Systems Ms Pmho has beena computer specialist with OCCS since 1969

Awards and Honors

NLM Director, Martin M Cummmgs, M D,received the 1978 Distinguished Service Awardfrom the American College of Cardiology at itsannual meeting in March Dr Cummings wasalso made an Honorary Fellow of the College,

which represents more than 8,500 cardiovascu-lar scientists in its worldwide membership

On May 18, 1978, at ceremonies in Santiago,Chile, Dr Cummings received honorary mem-bership in the Academy of Medicine of the In-stitute of Chile Chile's Minister of Health pre-sented Dr Cummings with the order of "la Cruzdel Sur," citing the Director's efforts on behalfof Chile's medical libraries which have resultedin improved information services for that coun-try's scientific community

Dr Cummings was also honored by the Mid-Atlantic Chapter of the American Medical Wri-ters Association The Association presented theDirector with a certificate of appreciation citinghis "outstanding contributions to medical com-munications "

Mary E Corning, NLM Assistant Director forInternational Programs, has been elected Chair-man of the Section on Information, Computing,and Communication of the American Associa-tion for the Advancement of Science (AAAS)The Section is devoted to all aspects of com-munications in the disciplines represented bythe association and it is responsible for arrang-ing presentations and programs at the AAASmeetings

Arthur A Wykes, Ph D , a pharmacologistwith the Library's Toxicology InformationProgram, SIS, has been elected a Director of theDrug Information Association The Associationworks to further modern technology in com-munication for the medical, pharmaceutical,and allied fields

NIH Director's Awards

B Earl Henderson, Chief, CommunicationsEngineering Branch, LHC, "For leadership of anationally recognized program to develop andexplore a broad band satellite communicationsnetwork for information transfer in the healthsciences"


David L Kenton, Computer Specialist, OCCS,"For significant effort in providing technicalsupport for the MLIXINE System and for leader-ship in the coordination and installationof MEDiiNt in four countries, thereby expandingthe dissemination of medical information."

NLM Director's Award

Clement P. Fowler, NMAC, for his outstand-ing success in the design, direction, and coor-dination of an exhibit on Health Sciences Com-munications Technology displayed at NLM.

PHS CommendationMedal

Myron J. Adams, )r., M.D., Director, NMAC,"In recognition of unique scientific and ad-ministrative skills and creative leadership andoriginality which have resulted in the develop-ment of multi-media instructional packages thathave improved the learning process for healthprofessionals."

Lionel M. Bernstein, M.D., Ph.D., Director,LHC, "In recognition of his development of aprototype computerized information transfersystem for health care practitioners."

NIH Merit Award

Betsy L. Humphreys, Assistant Head, SerialRecords Section, Technical Services Division,"For providing improved access to biomedicalinformation through the design and implemen-tation of an online serials system to handle25,000 titles."

Grace H. McCarn, Head, MEDLARS Manage-ment Section, LO, "For dedicated and effectivedirection of user support services for the LibraryOnline Retrieval Network."

Melvin L. Spann, Chief, Biomedical Files Im-plementation Branch, SIS,"For vital leadershipand creative application of technical skills infurthering the development of CHEMLINE as amajor national chemical compound informa-tion retrieval service."

EEO Special Achievement

Peggy). Beavers, Librarian, Reference ServicesDivision, "For the positive influence she exertson peers and subordinates asa result of her per-sonal commitment to the NLM EEO program,and for her invaluable contributions to the EEOCommittee."

James). Hartman, Personnel Officer, Office ofAdministration, "In recognition of his sincerededication to the principles of equal employ-ment for all individuals, and for his prowess inmediating sensitive employee-management in-teractions."

Melvin L. Spann, Chief, Biomedical Files Im-plementation Branch, Specialized InformationServices, "For the exceptional leadership andguidance he has provided to the EEOAdvisoryCommittee during his tenure as chairperson.Under his direction, the Committee hasdeveloped strong, well-defined objectives, therealization of which will result in a progressive,responsive EEO program for the Library."

Equal EmploymentOpportunityLibrary AssociateRecruiting

The NLM Library Associate Program is a one-year internship for librarians designed todevelop technical skills and experience necess-ary for effective management support of medi-cal libraries. In an effort to make the NLM Li-brary Associate Program better known to librarystudents, particularly minority students, and toencourage careers in medical librarianship, Li-brary staff conducted visits and interviews at 15library schools which have special medicalbibliography courses or a significant minoritypopulation. Seven Associates were selected forthe program including one minority male (seeChapter 2, "Highlights," for a list of the 1978-79Library Associates).


EEOCommittee

Under the direction of the Chairman, MelvinSpann, the EEO Committee reviewed the NLMAffirmative Action Plan and selected five itemsfrom the plan which were considered to be"top priority action items." The Committeeregards accomplishing these objectives asnecessary to sustain NLM's commitment toequal employment opportunity and affirmativeaction:

t Develop career ladder opportunities inoccupations with limited advancementpotential.

• Administer an effective recruitment andplacement program for minorities,women, and handicapped persons.

• Reestablish the program to employ youthwithin the Summer Aide Program andother components of the SummerEmployment Program.

• Continue special recruitment efforts tosecure minority applicants in the LibraryAssociates Training Program.

• Continue to have a full time EEO Coor-dinator who monitors the NLM EEOProgram and reports to the Director,NLM.

The NLM EEO Committee initiated the EEO(^/PC/ate, a publication to inform NLMemployees of events or items of interest occurringin the EEO community and to provide a forum foremployees to express their ideas and concernsregarding EEO and personnel matters. The EEOUpdate will also respond to employee con-cerns in order to improve communication andaffirmative action efforts at the Library.

Marie Pinho, Chief, Applications SupportBranch, OCCS was selected as the delegate tothe NIH Women's Advisory Committee. AliceLadson, Supervisory Library Technician,Reference Services Division, is the alternatedelegate to the Committee. The delegate repre-sents the Library and advises the NIH Federal

Women's Program Coordinator on issues im-portant to women at NIH.

ExhibitsIn addition to four regular exhibits in the

NLM lobby during FY 1978, one special exhibitwas prepared in collaboration with the NationalEye Institute. The historical development ofneuro-ophthalmology was the subject of an ex-hibit from May 1-12 that featured historicalprints and early works from the History ofMedicine Division. The exhibit coincided withthe Second Congress of the InternationalSociety of Neuro-ophthalmologists, whose 80members viewed the exhibit at a ceremony atNLM on May 2. The exhibit was developed byRonald Fishman, M.D., a Washington, D.C.neuro-ophthalmologist and member of theSociety.

"Medical Bibliography Tool of Science" was the theme ofan NLM exhibit that attracted some 50 visitors from theAAAS Reference librarian Howard Drew (center) helpedshow the visitors around the Library

Earlier in the year, "Health Sciences Com-munication Technology," prepared by staff ofthe National Medical Audiovisual Center, wasfeatured. The exhibit was described in last year'sreport (since it opened in September 1977) andit was on display through December. In January1978 a lobby exhibit titled "Medical Bibliogra-phy: Tool of Science" portrayed the develop-ment of medical bibliography from the in-troduction of printing down to the present


computerized bibliographic services. The ex-hibit reflected the theme of the 1978 annualmeeting of the American Association for theAdvancement of Science whose membersvisited NLM on February 15, viewed the exhibit,and were conducted on tours of the Library.

On May 15 "Medicine on the Early WesternFrontier" was featured in the lobby. This exhibit,prepared by Peter D. Olch, M.D., Deputy Chiefof the History of Medicine Division, proved tobe one of the most popular ever presented. Itwas the subject of several feature articles innewspapers and Dr. Olch was interviewed on

National Public Radio. The exhibit includedpublished and unpublished materials (such asdiaries), prints and photographs of the earlyWest, and artifacts (early surgical instruments,etc.).

The last exhibit in FY 1978, installed in Sep-tember and scheduled to be up until January1979, celebrates the 400th anniversary ofWilliam Harvey's birth in 1578 and the 350thanniversary of the publication of his discoveryof the circulation of the blood. Featured are anumber of portraits and first editions andtranslations of Harvey's publications.

Chapter 2: Library Services andOperations

Joseph Leiter, Ph.D., Associate Director,Library Operations

HISTLINE a new data base on the history of medicine is queried by Senta Lowenstem Laura Young and Dr lames Cassedy ofthe History of Medicine Division


Highlights

New or Revised Publications

• Abridged Index Medicus A com-prehensive review and analysis of contentresulted in changes so that this publication willbetter serve the needs of small hospital librariesThe initial appearance of the revised publica-tion will be lanuary 1979

• Hospital Literature Index, published bythe American Hospital Association (AHA), isnow produced by NLM's MHJLARS system

• NLM Classification, 4th edition (seeTechnical Services Division)

• NLM Audiovisual* Catalog (see Technical Services Division)

• KWOC Index of NLM Serial Titles (seeTechnical Services Division)

• Health Sciences Serials (see TechnicalServices Division)

• Online Services Reference Manual (seeBibliographic Services Division)

• Audiovisual Serials in the HealthSciences, a new quarterly bibliography ofaudiovisual serials intended for continuingeducation in the health sciences,is produced incooperation with and distributed by the Medi-cal Library Association

• Physical Fitness/Sports Medicine is anew recurring bibliography produced incooperation with and distributed by the Presi-dent's Council on Physical Fitness and SportsMedicine

New Online Data Bases

• BiotTHicsLiNE (see Bibliographic ServicesDivision)

• HISILINL (see History of Medicine Divi-sion)

• Health Planning and Administration Thisis a comprehensive file covering literature onthe planning and administration of health caredelivery programs The data base has beengenerated from existing NLM data files, ex-panded coverage of publications not availablein current files, and from publications in the

Hospital Literature Index This file has beenproduced in cooperation with the AmericanHospital Association and the Health ResourcesAdministration and will be publicly available onNovember 1, 1978 Initially containing 95,000citations, the new data base will grow at the rateof about 25,000 records per year

Online Services

• Online searching continued to expand,increasing in FY 1978 to 777,360 searches (up15 percent) An additional 314,162 searches(up 45 percent) were performed offline Of the165 new U S institutions added to the networkthis year, 83 were hospitals and other directhealth care institutions Online training was ex-panded—over 800 users were trained in 29classes

Reference and Circulation Services

• Although interlibrary loan demands ap-peared to be leveling off in FY 1978, demand forreference and reader services continued togrow Part of the drop in loans may be at-tributed to the new copyright law, which be-came effective January 1,1978 Fulfillment ratesand throughput time continued to improve

Technical Processing

• The entire shelf collection of currentserials dating back to 1963 was reviewed itemby item and a complete inventory of missingitems was recorded in an online file We are fill-ing these gaps through purchase and filmingfrom other sources This has produced a signifi-cant improvement in processing and filling cir-culation requests

Card Catalog

• Although computerized catalog files makeit easier to alter bibliographic records inresponse to rule changes and revised catalogingprocedures, maintaining a card catalog is stillonerous and costly The planned adoption of a

10

Library Services and Operations

major revision in the Anglo-American Catalog-ing Rules has created a critical problem for largelibraries. Since a large portion of the NLM cardcatalog is already under complete machine con-trol, a detailed analysis was made of theproblems involved in adopting the new rules todetermine whether closing the card catalog andestablishing machine control over the entirecollection is feasible These studies have beencompleted and a detailed set of specificationsfor converting the entire file to a machinereadable record has been developed. Thethree-year program to implement these plansbegins early in FY 1979 so that conversion willbe complete by the time the revised Anglo-American Cataloging Rules take effect in )anu-ary 1981.

Library Associates

• Seven recent library school graduateswere selected for one year (1978-1979) of train-ing at NLM as Library Associates:Susan ). Barnes, M L.S., University of

WashingtonLarry S. Ellis, M S.L S., Atlanta UniversityBrenda L. Greene, M.S.L S., Pratt InstituteDianne E. McCutcheon, M.S., University of Il-

linois at Urbana-ChampaignPatricia R. Patterson, MS L.S.,Syracuse Univer-

sityBarbara A. Rapp, M.S, University of Illinois at

Urbana-ChampaignPhilip Wexler, M.L.S., Rutgers University

Bibliographic ServicesDivisionIndexing

In FY 1978, 232,563 articles were indexed forIndex Medicus. This includes 229,857 articlesfrom serial l i terature and 2,706 frommonographs. Additionally, 19,265 citationswere processed for special indexes such as In-dex to Dental Literature, International Nurs-ing Index, and thePopu/at/on Sciences: Indexof Biomedical Research. A total of 251,828 arti-

cles was indexed for the MEDLARS data base. Inaddition to these, 1,361 "articles" from 483audiovisual serials and 6,618 articles for theHealth Planning and Administration data basewere processed

Two new indexing stations were set up onein Brazil under the auspices of the PanAmerican Health Organization, the other inSouth Africa. These two join stations in France,Germany, England, and Sweden that also con-tribute indexing to MEDI ARS

The annual indexing orientation was heldSeptember 18, 1978, and was attended by ap-proximately 100 persons including NLM mdex-ers and revisers, U.S. commercial contract in-dexers, and technical resource persons from theregions. The same orientation package of 65pages used at the one-day sessionwas sent to allnon-U.S. MEDLARS centers together with all toolsto be used for 1979 indexing.

During 1978, seminars on indexing consis-tency were conducted for the members of theindexing staff responsible for the revision of arti-cles indexed for Index Medicus and other NLMpublications. These seminars emphasized theimportance of consistency in applying indexingrules. As a result of these seminars, recommen-dations were made for improvements in relatedareas such as in the selection of articles fromchemical journals and other selectively indexedjournals

A concerted effort to control gaps and to im-prove currency in the journals covered in MED-IARS was made during the year. Additionally,more emphasis was placed on the improvementof the overall throughput time from receipt ofthe journal to the time the article is indexed andinput into the data base. As a result, 97 percentof the Index Medicus citations indexed in FY1978 contain 1977 or 1978 imprint dates.

A completely revised MEDLARS indexing train-ing syllabus, consonant with 1979 Medical Sub-ject Headings changes and the latest indexing

11


policy, was prepared The syllabus also contains27 indexing exercises, with answers, for the useof foreign centers conducting their own trainingprograms

MEDLARS Management

The MEDLARS Management Section serves asthe public contact point for the day-to-dayoperation of the NLM Online User NetworkThis Section provides answers to telephone andwritten inquiries about the use and charac-teristics of the various data bases, maintains bill-ing records, processes applications for access tothe data bases, handles the mailing of offlineprints and offsearches, and produces manualsand other descriptive materials

A new data base, BiotrmcsLiNE became avail-able in March 1978 BIOETHICSLINE produced incooperation with the Kennedy Institute Centerfor Bioethics, Georgetown University, providesbibliographic information on questions ofethics and public policy arising in health care orbiomedical research Among the topics coveredare medical confidentiality, euthanasia, geneticintervention, abortion, informed consent,behavior control techniques, human experi-mentation, psychosurgery, recombmant DNAresearch, the definition of death, and the alloca-tion of scarce medical resources HISTLINE (seeHMD report) became operational through NLMonly, and available only to American centers,late in the year

Three new recurring bibliographies were pro-duced The Hospital Literature Index, incooperation with the American HospitalAssociation, the Index of Audiovisual Serials inthe Health Sciences, in cooperation with theMedical Library Association, and Physical Fit-ness/Sports Medicine, produced for the Presi-dent's Council on Physical Fitness and SportsMedicine The MEDLARS Management Sectioncontinued to process various NLM publicationsincluding Index Medicus, Cumulated IndexMedicus, Abridged Index Medicus, the Recur-ring Bibliographies, and Literature Searches

A new edition of the Online ServicesReference Manual was distributed to onlinecenters This manual describes in detail eachdata base and includes chapters on com-munications, software, and searching A Direc-tory of Online Users was prepared for the firsttime The Directory entries are arranged in twosets, one by personal name, the other by loca-tion There are 738 names in the first edition ofthe Directory

The third annual Online Coordinators'Workshop was held at NLM in April At thisworkshop, representatives from each RegionalMedical Library received a briefing on the ac-tivities of the Committee for Extension ofOnline Services to Health Care Facilities andshared views on increasing hospital participa-tion in the online network Information aboutplanning search clinics and about updates andchanges in the NLM data bases was also offered

An important new service that was in-troduced this year is the stored addresscapability A user may now send NLM an ad-dress to be attached to the ID code, so that noaddress information need be typed in at thetime an offline print or offsearch is requested

Administrative and policy changes in FY 1978included the elimination of the $1 00 per filecharge for offsearches, and an increase in thecharge per page of printout from 10 cents to12 cents The period between 11 JO am and1 00 p m daily is now billed as nonprime timerather than prime time In September 1978,NLM began providing Tuesday morning accessto online data bases

Other changes during the past year includedinstituting a time limit and strmgsearch limit foroffsearch processing, which caused theautomatic purging of over 1,700 searches in thefirst year, and the introduction of the LIMITcommand, with which users may control thenumber of citations printed as the result of anoffsearch

12


ON-LINE CENTERS IN THE UNITED STATESNovember 1978

AUSTRALIACANADAENGLANDFRANCE

IRANJAPAN

MEXICOFAHO

SOOTH AFRICASWEDEN

WEST GERMANY

The number of domestic online centers grewto 800 Of these, 282 are hospital or direct pa-tient care facilities In FY 1978 165 institutionswere added to the network, 83 were hospitalsor direct health care institutions

Online Services Training

The online services training program wasmarked by unprecedented growth and diver-sification in FY 1978 821 persons were trainedin 29 courses In addition to classes held in thenewly refurbished training facility in Bethesda,classes were held in Kansas City, Detroit, Atlan-ta, Madison, New York City, Dallas, and LosAngeles.

The Library's Standing Committee for OnlineRetrieval Education (SCORE) developed, tested,

and evaluated the first continuing educationcourse for search analysts, and plans were for-mulated for a second continuing educationcourse.

Based on SCORE recommendations, aprogram for standardized, annual updating ofsearchers was adopted. Technical resource per-sons, selected by each Regional Medical Library,were trained at NLM in a two-day session Theywill conduct one or more update workshopsfor searchers in their respective regions

History of MedicineDivision

In FY 1978 the computerized data base forthe Bibliography of the History of Medicinewas placed online as HISTLINE This new data

13


base currently includes approximately 37,000citations, with the majority of items publishedfrom 1970 through 1977. HISTLINE, in additionto historical references from MEDLINE, isenriched with citations from monographs andjournals not indexed for Index Medicus.HISTLINE became operational late in the year.

Acquisitions

The historical collections were increased bythe addition of 500 books and theses, an esti-mated 15,000 items in the manuscript collec-tion, and approximately 300 prints and photo-graphs. Among the important book acquisitionswere Andrea Cesalpino's Peripateticarumquaestionum libri quinque, Venice, 1571 inwhich the author discussed the "circulation" ofthe blood in ways that mark him as a significantprecursor to Harvey and a second edition ofTimothy Bright's A Treatise of Melancholy(London, John Windet, 1586). The latter work isnot only important in the history of psychiatrybut also in the history of English letters, since it

A recent acquisition of the Prints and Photographs Collec-tion (History of Medicine Division) is (his print of a dentistby the American artist Grace Albee

was used by Shakespeare as an importantsource of ideas when writing Hamlet. Anothersignificant addition to the collection was a copyof Louis Pasteur's rare Theses de physique etde . chimie, presented to the Faculte dessciences in Paris in 1847. The theses werePasteur's first scientific contributions and led tohis work on molecular dissymmetryand thenceto fermentation.

Additions to the manuscript collection in-cluded a microfilm copy of the medically rel-ated items in the papers of Senator Lister Hill.The originals of this material (some 112,300items) are housed in the medical library of theUniversity of Alabama. A unique addition andimportant resource are the files of 18th and19th century American physicians whosenames do not appear in hitherto publisheddirectories. This information was gathered byEmerson Crosby Kelly, surgeon, bibliographer,and historian of medicine (1899-1977) whohad hoped to publish a directory of these earlyphysicians. The library's collection of organiza-tional archives was enriched by the addition ofthe archives of the American Association ofThoracic Surgery. This material, in addition tothe papers of Evarts Graham, John Gibbon, andEmile Holman, provides an important resourcefor the study of the evolution of thoracic surg^ery in the United States.

Public Service

In spite of a substantial reduction in person-nel through much of this fiscal year, service toreaders and distant patrons did not diminish,with 7,560 volumes provided to readers and2,362 books and journal articles forwardedthrough interlibrary loan. Some 1,840 photo-graphs and slides were provided from the printsand photographs collection, including largenumbers of slides ordered by three universitydepartments of the history of medicine forteaching purposes.

Members of the staff have continued to par-ticipate in the affairs and programs of profes-

14


sional societies and to publish the results oftheir research Dr. lames H. Cassedy of theHistory of Medicine Division staff was honoredas the Fielding H. Garrison Lecturer at the an-nual meeting of the American Association forthe History of Medicine "Medicine on the EarlyWestern Frontier," one of the exhibits preparedby the Division, proved to be exceptionallypopular and received newspaper, radio, andtelevision coverage.

Reference ServicesDivision

The annual increase in demand for interlibr-ary loan service, which began shortly after theRegional Medical Library Network came intobeing, now appears to have been reversed forthe first time. The reasonsfor this are not clear atthis time. One may be the passage of a newcopyright law and the establishment ofguidelines containing certain restrictions onlibrary copying. Another reason might be the in-creasing development of local and regionalresources to accommodate local and regionalneeds. Whatever the reasons, interlibrary loanrequests dropped from a high of 280,512 in FY1977 to 261,969 in FY 1978. This fall-off was,however, more than offset by an increase of19,742 in requests for access to the collectionfrom on-site users, so that the total demand onthe collection actually reached an (all-time)high of 425,000. With the advent, in May 1976,of indexing in Index Medicus the proceedingsof congresses, symposia, and certain multi-authored monographs, more requests werereceived for photocopies of articles or chaptersfrom these works.

The demand for reference service was upsubstantially in FY1978 and there was also a risein the useof the Reading Room. For example, inMarch, just under 4,000 persons signed in at theReading Room desk, almost 1,000 of whomwere new registrants

After two decades of unsuccessful attempts,the general revision of the outmoded copyrightlaw of 1909 passed both houses of Congressand was signed into law by President Ford onOctober 19, 1976 It became fully effective onJanuary 1, 1978 Guidelines to the new lawplace the burden of determining copyrightcompliance and maintaining records on the re-questing library, the supplying library requiresrepresentation that the requester is in com-pliance Since NLM is a supplier (we requestperhaps 50 items a year from other libraries),the impact of the new law on our program hasbeen minimal In order to notify librarians of therequirements of the law, two weeks before theeffective date and for over a month after, infor-mation sheets were sent with each photo-copied article on interlibrary loan Although thenumber of rejected requests — those lackingan indication of compliance — was expectedlylarge in January and February, it fell off markedlyin March and April, with the bulk of those notmeeting the requirements coming from foreignlibraries Requests which arrive without thecompliance indication continue to be rejectedand the instruction sheets and an explanatoryletter are sent to the requester

Approval was received during the year fordesignation of NLM as a Selective DepositoryLibrary for government publications in thehealth sciences, and the first shipments werereceived in May. This will substantially reduceselection/acquisition costs and improve theLibrary's collection

Additional compact shelving, which literallydoubles stack capacity, was installed on the Clevel, and by the year's end installation in overhalf the floor had been completed The comple-tion of the new Lister Hill Center building willfree up space for additional shelving and extendthe life of the present building

A new contract for micropreservation filmingof deteriorating journals was awarded in FY1978 The contract calls for filming 1,200,000pages of material in the first year, with renewal

15


options available for an additional two yearsWe were unable to star t up in-housemicropreservation filming of extremely brittlematerial because of the need to dedicate max-imum manpower resources to meet immediateservice needs Attempts will be made to reacti-vate the in-house program, if only at minimumlevels, during the coming year

With the placement of subscriptions to thefiche service of the National Technical Informa-tion Service, the Congressional Information Ser-vice, and the American Statistics Index, ordersfor additional microfiche readers were placed,as well as for a microfiche reader/printer Thefiche collections will be serviced by theReference Section In addition, orders wereplaced for equipment to update quality controlhardware and for fabrication of a new enlarger-reproducer to replace the aging Copyflomachine, which has been processing photo-copies for mterhbrary loans for over 17 years

A few months prior to the beginning of thefiscal year, the Division undertook tosystematically identify gaps in the current jour-nal collection (from 1963 forward) of approx-imately 23,000 titles Every title is being ex-amined not only to determine missing issues,but the bibliographic accuracy of the recordand scope of the journals Approximately 500titles were identified for addition to SERLINE(NLM's automated serials system) as a result ofthis review Approximately 50 percent of thecurrent collection has been reviewed, and over50,000 missing issues were identified and cap-tured as a management record in the gapsmodule of the SERLINI data base This is in addi-tion to gaps identified as a result of "skippedissue claiming," the review of titles during thebinding preparation process, or from mterlibr-ary loans which could not be filled because ofmissing issues Over 4,000 issues have beenreceived from serials dealers and publishers andefforts to maintain the collection in as completea state as possible continue Where location ofmissing items in the original form is unsuc-cessful, arrangementshave been made with the

College of Physicians of Philadelphia and theNew York Academy of Medicine to provide filmcopies of missing issues to complete the NLMcollection This is also expected to be an on-going collection maintenance program

Technical ServicesDivi'sion

The demand for bibliographic support for ac-quisitions, cataloging, reference services, andmterlibrary lending has continued to increaseduring the last year both at NLM and in thefield Continuing budgetary restrictions and in-creased user needs in academic and medicallibraries and information centers have clearlyindicated the need for resource sharing byresearch libraries The Technical Services Divi-sion (TSD) is responding to these needs inseveral areas by improving its machine readabledata bases and through its publication program

During FY 1978, the Technical Services Divi-sion experienced a decline in the production ofordering and acquisitions processing data andin the flow of monographic materials to the TSDCataloging Section This was the result ofserious problems with the Division's minicom-puter-based In Process File (INPROC) Expertswere called in from the Lister Hill Center'sCom-puter Technology Branch to improve IN CROC'Sreliability and, by the end of the year, orderingand acquisitions processing was up substan-tially

A new file maintenance system has beendeveloped and successfully implemented forCAFLINE and AVLINE by NLM's Office of Com-puter and Communications Systems incooperation with TSD staff This new onlinesystem assists in keeping catalogingdata currentby providing extended search capabilities forsets of records requiring modification andvalidation of name, series, and subject entries

The rate of production and revision oforiginal cataloging by TSD staff improved

16


slightly during the year Cataloging backlogs stillexist, however, and are the result of the con-tinuing shortage of catalogers and revisers formaterials in Russian, Northern European, andRomance languages.

The entire (.AiiiNt data base has been madeavailable to the Ohio College Library Center(OCLC) and, through the Canada Institute forScientific and Technical Information (CISTI), tothe Association of Atlantic Universities and theUniversity of Toronto Retrospective CAILINLrecords in MARC format are now available tothe academic community in Canada and willsoon be in the U.S. when OCLC mounts theNLM data. Arrangements for subscription toMARC-compatible CA I I INL data will providethese bibliographic information centers withregular weekly updates of NLM catalogingrecords.

A new sfcKUNL, representing all serial titlescurrently received at NLM, was made availableto the network during November 1977. InMarch 1978 sbRUNE assumed all citation inputand publication functions previously handledby the Journal Authority File (|AF),

As a concurrent effort to the reformatting,editing, and regeneration of machine readableNLM serial files, the serials collection has beenimproved by systematic claiming and serial gap-ping. In addition, a considerable number ofout-of-scope and limited coverage serial titleshave been withdrawn from the collections andserials data base The gapping and withdrawalprograms have been joint efforts of theReference Services Division and the TechnicalServices Division.

The revised 4th edition of the National Li-brary of Medicine Classification was com-pleted and published during 1978 The newedition includes an extensive index, based onMeSH terminology, that provides crossreferences to non-MeSH terms and Library ofCongress subject headings and classificationnumbers Computerized production of the

classification schedules and index will allowfuture machine maintenance and update. Therevised NLM Classification, published by theU S Government Printing Office, is widely usedby medical libraries in the United States and inforeign countries. Japan and Thailand have re-cently requested and been given permission totranslate the 4th edition

In recognition of her excellent work in pre-paring and editing the NLM Classification,Emilie Wiggins, Head of the Cataloging Sectionbefore her retirement in December 1977,received the 1977 National Library of MedicineRegents Award and the 1978 Medical LibraryAssociation Marcia C. Noyes Award.

Several new publications were prepared bythe Serial Records Section in FY 1978, theKWOC Index of NLM Serial Titles and HealthSciences Serials. Both titles are scheduled forpublication during the first half of FY I979. TheKWOC Index of NLM Serial Titles is a revisedand updated edition of the Index originallypublished in 1972. The new edition has alsobeen reformatted and will be produced fromthe NLM Master Serials System using a modifica-tion of the permuted MeSH program.

Health Sciences Serials is the first microficheedition of NLM's SLKLINL and will be producedquarterly by the U.S. Government PrintingOffice. The computer-produced microfichepublication will include bibliographic data andlocator information for all serial titles includedin stRLiNL and will be completely updated eachquarter.

During FY 1978 the Technical Services Divi-sion began the publication of the quarterlyNLM Audiovisual* Catalog. This product of theAVI IN L data base has been expanded to containbibliographic, review, and procurement infor-mation for nonprint and curriculum based self-instructional materials. By the end of the yearthere were over 600 subscriptions to the catalogentered at the Government Printing Office.

17


Inguinal hernia (Mitchell-Banks repair) JVideorecording]/ Videoiurgery -- Don Mills, Ont Souiham BusinessPublicalioni. c!977 I cutetie, 18 mm id , col. , 3/4in Audience level --Medical undergraduate,graduaie, continuing educalion —Specially pediatnci,surgery Rating Recommended Review dale. Apr.1978 Reviewer AAMC Learning method Lecturesupport Credits Barry Shandlmg

I Inguinal Hernia - surgery - videocassettes IShandlmg, Barry II Videosurgery04NLM Wl 960 VC no 5 1977Abatraet:(Critical) This program depicts a modern acceptedapproach to the inguinal hernia in children Therationale and background are presented as well u thetechnical aspects The presentation is internallyconsistent and well done and is recommended Torgeneral and pediatrics surgery students andpractitioners

Price:Sale 30000

Source:Souiham Business Publications Cit No 7800629

( ilalion from the name sec lion of the new quarterly NLM/Auff/owsudK

In a continuing effort to improve thebibliographic control of nonprint materials, TSDstaff participated in Audiovisual Cataloging-in-Publication workshops at the 1977/78 HealthSciences Communicat ions Associat ion(HeSCA) meetings. As a result, an experimentalCataloging-in-Publication program for AV andsupplemental print materials was initiated dur-ing the past year.

Medical SubjectHeadings (MeSH)

In preparing 1979 MeSH, consideration wasgiven to all subject areas based on the changingneeds of the users of NLM bibliographies anddata bases. However, certain areas meritedspecial attention. Terminology concerned withneurologic disorders was thoroughly reviewedwith Dr. Walter Friedlander of the ClinicalNeurology Information Center, with support ofthe National Institute of Neurological and Com-municative Disorders and Stroke (NINCDS).Also with NINCDS support, Dr. Barbara Reinercooperated in a detailed evaluation andamplification of the subject headings con-cerned with communicative disorders. Repre-sentatives of the American Hospital Association

and of the National Health Planning Informa-tion Center (Health Resources Administration)continued to assist our thesaurus expansion inthe health care management area These effortsresulted in many changes in existing headings,in cross references,in hierarchical relationships,and in delineation of the scope of terms. Addi-tionally, 371 new headings, for which therewere no directly corresponding 1978 headings,were introduced in 1979 MeSH.

Several new features of great value were in-troduced into MeSH for 1979. A historical notefor each MeSH heading that has been changedsince 1963 will appear in the Index Medicusedition of MeSH. This is helpful because, incontrast to the citation records contained in thecomputer files, the Index Medicus citation,once printed, is immutable. The user of IndexMedicus must search in one way for articles in-dexed after a MeSH change, and in another wayfor articles indexed before the change. Untilnow, the user who had access to a full set of an-nual MeSH volumes could thread his way backthrough the various subject heading changes.This work has now been done for him by theMeSH Section and will be summarized in thehistorical notes in the current MeSH.

All MeSH drug terms were reviewed and ageneric drug name was substituted for anyproprietary name that was discovered.Numerous names of viruses and other organ-isms were changed to reflect currently acceptednomenclature.

To control the overall size of MeSH, theMeSH Section reviewed all terms that are nowseldom used in indexing or cataloging. Twohundred and seventeen terms representing ob-solete or rarely encountered concepts weredeleted.

Terms originally introduced as minor descrip-tors sometimes become the subject of increas-ing interest and attention in the literature weindex, fifty-nine of these were identified and

18


converted to major descriptors so as to beseparately searchable by the Index Medicususer.

Mid-Atlantic RegionalMedical Library (RML IV)

RML IV serves 500 libraries in health-relatedinstitutions throughout the District of Colum-bia, Maryland, North Carolina, Virginia, andWest Virginia. In FY 1978 a new governancestructure was instituted for the RML, consistingof a 28-member Regional Advisory Council andan 8-member Executive Board elected from theCouncil.

The Council focused on program objectivesand priorities, while the Board concentrated onthe planning process and needs assessment.The Council and Board provide most of theplanning and decision-making for the RML IV

Program, reflecting the increased participationand responsibility being assumed by librarieswithin the Region. New committees were ap-pointed to advise the Board in the areas ofneeds assessment, planning, resource sharing,and communications.

In FY 1978 a technical resource person wasselected from the Region to conduct three NLMonline updates for the 134 online centers in theRegion. A provisional document delivery cost-sharing plan was drafted in accordance withnetwork requirements and principles. NLM inter-library loans filled to Region IV totaled 77, 006 inFY 1978. The Region IV Education Plan, which for-merly emphasized a self-study approach, nowf e a t u r e s bas ic w o r k s h o p t r a i n i n g .Workshops on the bibliographic citation andon hospital library management were given in16 locations to 194 attendees. Six onlineworkshops on search strategy were given for107 experienced online analysts at three loca-tions within the Region.

Table 3. Online Searches

Data base

AVLINEBIOETHICSCANCERLITCANCERPROJCATLINECHEMLINECLINPROTEPILEPSYLINEHISTLINEJOURNAL AUTHORITYMEDLINEMESH VOCABULARYNAME AUTHORITYRTECSSDILINE .:SERLINESTORED SEARCHTDB (TOXICOLOGY DATA BANK)TOXLINE

TOTAL.

July 7975-lune 7976

2,139

4,777891

103,3079,347

20339

486286,250

1,1895,598

39,353

18,356

472,052

TransitionalQuarter'

868—1,469

36822,079

2,7737

280—

13277,963

314832

—6,400———5,454

118,939

FY1977 FY19789,100 10,425— 1,582

15,841 23,0863,863 4,208

125,455 147,13825,482 33,009

596 1,0171,630 2,327— 183

898 511405,653 460,209

2,302 2,30310,464 4,936

471 5,98319,677 19,581— 11,914

45 531,286 1,572

39,432 47,323

662,195 777,360

'luly-Sept 1976

19


Data Base

Table 4. Offline SearchesJuly 7975- TransitionalJune 7976 Quarter? FY 7977 FY1978

AVLINE 6 2 9 20BACK66 15,591 7,546 34,600 38,028BACK69 33,686 10,089 45,185 49,658BACK72 37,749 12,098 59,388 68,423BACK75 — — — 58,625BIOETHICS — — — 1CANCERLINE 330 269 1,257 1,472CANCERPROJ 56 27 286 356CATLINE 78 15 87 101CHEMLINE 3 0 5 17CLINPROT 0 0 6 11EPILEPSYLINE 18 16 31 38HISTLINE — • — — 0JOURNAL AUTHORITY 0 0 0 0MEDLINE 14,169 5,348 26,924 28,846MESH VOCABULARY 5 0 1 0NAME AUTHORITY 0 0 0 0RTECS — — 12 36SDILINE 8,795 5,245 39,454 53,856SERLINE — — — 2TOXICOLOGY DATA BANK (TDB) — — 12 3TOXBACK 2,149 1,239 5,628 6,716TOXLINE 1,354 1,009 5,663 7,953

Total 113,989 42,903 218,548 314,162

'luly-Sept 1976

Table 5. Bibliographic Services

Trans-July 7975- tionalJune 7976 Quarter^

Articles IndexedNLM 38,400 8,600

Other U.S 100,000 24,500Foreign 116,600 32,600

Total 255,000 65,700Recurring bibliographies 28 28journals indexed 2,408 2,410Monographs indexed* 186 159Abstracts entered 103,200 29,100

Indexing of selected monographs began m May I976

FY 7977 FY 1978

39,66384,785

135,532259,980

262,525

225111,467

60,58984,21387,761

232,56328

2,54387

94,174

'My-Sepl 1476

20


Table 6.

AcquisitionsBooksModern manuscriptsPrints and photographs

ProcessingTitles CatalogedModern manuscripts catalogedPictures indexedArticles indexedPages microfilmed

Public ServiceReference questions answeredILL and pay orders filledReader requests filledPictures supplied

History of Medicine Activities

June 1975-July 1976

90482,452

815

3,72144,201

5773,950

160,583

1,7822,1625,7601,995

Table 7. Acquisitions

Serial RecordsNew Titles AddedDiscontinued TitlesCurrent Titles Rec'd

Publications ProcessedSerial PiecesOtherTotal

Obligations for:Publications

Included for Rare Books

FY 1976

722289

18,086

169,72619,582

189,308

$859,572

76,008

Transi-tional

Quarter?

18213,544

119

69516

136519

59,423

408578

1,322430

Statistics1

TransitionalQtr. 19762

28848

18,326

41,6565,225

46,881

$275,997

26,061

FY 1977

50411, Ml

606

3,22561,290

4956,074

1 52,994

1,8032,4565,3861,848

FY 1977

990812

25,831

172,80425,000

197,804

$1,350,683

79,246

FY 1978

48915,805

293

2,78237,527

5264,887

124,158

2,1602,3627,5601,840

luly Sopl rt7h

FY 1978

1,272830

23,711

173,56621,793

195,359

$1,571,836:

81,185

'Does nol include History of Medicine Acquisilions-'luly-Seplember 1476'Includes $S70(X) in quid pro quo arrangements for services Abroad

21


Table 8. Growth of Collections

A. Book MaterialsMonographs:

Before 15001501-16001601-17001701-18001801-1870Americana1871-PresentBrief listed-INPROC

Theses HMDPamphletsBound serial volumes.Total volumes

B. Nonbook MaterialsMicroformsAudiovisualsPicturesManuscripts

Previous Total(Sept. 1977)

5645,4839,594

22,91339,2502,283

352,296113,984

281,311172,0212

545,2021,444,901

60,35635,394

72,235822,308

'Corrected figure 2085 monographs withdrawn by contractor FY 1977-not reported-In collection before luly 1, 1975 Additions now included with monographs'28,720 Microfiche transferred from Documents Collection FY 1977-previously not reported

AddedFY 1978

04164

14560

211,8612,828

1410

38,09653,238

18,4052,755

26315,605

WithdrawnFY 1978

NewTotal

510

6,6197,129

5645,5249,658

23,05839,3102,285

363,64716,812

281,452172,021576,679

1,491,010

78,7618,149

72,498837,913

Table 9. Cataloging Statistics1

FY 1976

Completed Cataloging 15,044

Catalog Cards Filed 118,628

Volumes Shelf-listed 13,326

'Does nol include History of Medicine Cataloging-'luly-Seplember !M7d

TransitionalQtr. 79762

3,051

24,992

3,310

FY 1977

13,507

126,591

12,182

FY 1978

14,186

166,300

14,166

22


Table 10. Cii

Number of requests receivedFor interlibrary loanFor readers

Number of requests filledFor interlibrary loan

PhotocopyOriginal

For readers

Number of requests unfilledInterlibrary loan

RejectedReferredReturned as unavailable

Reader service returned as unavailable . .

rculation Statistics

Transi-July 7975- tionallune 7976 Quarter'

380,475 90,900263,072 64,716117,403 26,184

301,965 74,785205,695 51,743184,704 47,15320,991 4,59096,270 23,042

78,510 16,11557,377 12,97318,127 4,5858,684 2,099

30,566 6,28921,133 3,142

FY 1977

423,801280,512143,289

343,313221,517198,76022,757

121,796

80,48858,99523,0837,946

27,96621,493

FY 7978

425,000261,969163,031

329,119193,804176,15817,646

135,315

95,88168,16528,164

7,44532,55627,716

Table 11. Reference Services

Requests by telephone.GovernmentNongovernment

Requests by mail..GovernmentNongovernment

Readers assisted...Government....Nongovernment

TotalGovernmentNongovernment

Reading room users registered

July 7975-lune 7976

13,2753,5629,713

1,446189

1,257

17,6133,793

13,820

32,3347,544

24,790

28,384

Transi-tional

Quarter' FY 7977 FY 7978

4,0151,2012,814

34243

299

5,8191,0984,721

10,1762,3427,834

15,0434,119

10,924

1,140106

1,034

26,7724,726

22,046

42,9558,951

34,004

16,3174,540

11,777

75333

720

30,7635,811

24,952

47,83310,38437,449

5,725 32,060 33,504

23


Table 12. Binding Statistics

Number of volumes sent to binder.Obligations for binding

July 1975-]une T976

24,997$95,508

Transi-tional

Quar ter 1

6,274$25,000

FY 1977 FY 1978

33,045 33,881$113,104 $157,426

<|uly September 147f>

24

Chapter 3: Computer and Commu-nications Systems

Harry D. Bennett,DirectorOffice of Computer and Communications

Systems

The present IBM 370/1 S8 computers will be replaced early in 1980 Shown in the NLM computerroom are Ernest Freeman (standing, left), Howard Somers, and Richard Wiles of the OCCS staff

25


The Office of Computer and Communica-tions Systems is responsible for providing dataprocessing and data communications supportto all elements of the Library. As such, it has acritically important supporting role for LibraryOperations as well as Specialized InformationServices. The present IBM 370/158 multi-pro-cess computer system is the equipmentworkhorse providing this support.

NLM is working with the General ServicesAdministration on a competitive purchase toreplace the IBM 370 system in early 1980 inorder to provide the capacity necessary to meetthe Library's growing requirements for data pro-cessing services. This replacement, which hasbeen in the planning stages for over two years,will handle the estimated 20-25 percent growthrate until 1985. The system will be installed inthe Data Processing Facility in the new ListerHill Center building presently under construc-tion. This facility has been designed to housethe data processing equipment necessary tosupport NLM through the 1980s.

Considerable emphasis has been placed onimproving the performance of the present 370system so that NLM's data processing require-ments can continue to be met on the existingequipment until the replacement system is in-stalled. In the summer of 1978 four millionbytes of main memory were added to the 370system. This increasewill insure that the presentsystem will continue to meet NLM's needs untilthe new system becomes operational in 1980.

During 1978 OCCS implemented several newonline input systems. MEDNAM (MEDLARS nameauthority processing) provides for the online in-put and maintenance of authority names in sup-port of cataloging. This procedure both im-

proves upon the previous cumbersome batchinput method and accelerates the validationand release of associated catalogitems. MEDVOCis a companion system that provides much thesame facility for input and maintenance ofNLM's vocabulary authority file. MEDCFM is themost recent system and provides greatlyenhanced online maintenance capabilities forthe CATLINE file. MEDCLASS is the name of thesystem which was developed to support the in-put processing of data for the NLM Classifica-tion schedule. Through this system, and thedevelopment of supporting publication soft-ware, NLM was able to produce the first com-puterized classification schedule.

SERLINE, BIOETHICSLINE, and HISTLINE were ad-ded to the growing list of ELHILL retrieval files inFY 1978. Each file required the development ofsubstantial software in order to convert it.toretrieval format. In addition, the ELHILL system —the online retrieval portion of MEDLARS — wasenhanced with a number of new features tofacilitate its use by the biomedical community.These new features, along with the improve-ments made in 1977, were distributed to threeof our foreign partner installations for their useearly this year.

In addition to providing computer training,systems analysis, and software support to allcomponents of the NLM, OCCS continues toutilize off-the-shelf software and tested state-of-the-art advances to optimize and improve exist-ing application systems. Furthermore, the staffprovides assistance to other government andprivate organizations in data base managementsystems technology. In 1978, special data baseswere developed to provide direct support tothe Council on Environmental Quality and theWhite House Conference on Libraries and In-formation Services.

26

Chapter 4: Specialized InformationServices

Henry M. Kissman, Ph.D.,Associate Director,Specialized Information Services

By the end of the fiscal year, construction on the new Lister Hill Center building was well along Visible from this angle are thespecial conference facility (right foreground) and parking structure (left)

27


The Toxicology Information Program (TIP) isthe major activity of NLM's Division ofSpecialized Information Services The objec-tives of this program are ( I ) to create com-puter-based toxicology data banks from thescientific literature and from the files of col-laborating industrial, academic, and govern-mental organizations, and (2) to establish tox-icology information services for (he scientificcommunity.

Actions by the Federal Government in FY1978 to implement the Toxic Substances Con-trol Act of 1976 have caused government agen-cies and industry to increase (heir informationactivities related to toxic substances. This year'sreport shows that greater use than ever is beingmade of NLM's information services in tox-icology and that important new information ac-tivities in the (oxic substances field are beingplanned by (he Toxicology Information Programin collaboration with other agencies.

Query ResponseQuery response service in (he form of

literature searches is provided by (he TlP-spon-sored Toxicology Information ResponseCenter(TIRC) at the Oak Ridge National Laboratory inTennessee.

There has been a 19 percent increase in TIRCservices this year over I977 While (he Centerresponds to search requesls from (he generalbiomedical community as well as from govern-ment agencies, the services provided to the lat-ter group have increased substantially duringthe past year. Thus, in FY 1978, 76 percent ofTIRC services went to Federal agencies asagainst 68 percent in the last fiscal year.

The increase in the overall level of serviceswas accomplished even though the charge ratewas raised from $25 to $30 per hour in order lobring search services closer to full cost recovery.Users are billed for these services through theNational Technical Information Service,Department of Commerce Charges for services

to the Federal agencies are recovered throughmteragency agreements During FY 1978, suchmteragency agreements were negotiated withthe Food and Drug Administration, NationalCenter for foxicological Research, National In-stitute of Environmental Health Sciences, Na-tional Institute of Occupational Safety andHealth, National Cancer Institute, and theChemical Systems Laboratory of the Depart-ment of the Army

PublicationsThe proceedings of the 1976 Symposium on

the Handling of Toxitological Informationhave been published and are now availablefrom the National Technical Information Ser-vice The Symposium was organized by the Tox-icology Information Subcommittee of theDHEW Commiltee to Coordinate Toxicologyand Related Programs to consider develop-

SYMPOSIUM ON THE HANDLINGof

TOXICOLOGICAL INFORMATION

May 27-28, 1976Nllionil Inilituln of Heillh

Dll»W ( omntnn in <

I'uhlishrd I his yr.ii I lie [>m< rcdin^s of I his symfxisium jrc<iv.nl.tblc (mm ihe N,ili< nidi lc( him ,il Intnrnul ion SCTVK c

28

Specialized Information Services

ments over the last decade in the handling oftoxicological information, the present state ofthe information transfer process in this field,and future requirements for toxicological infor-mation. The Symposium was held at the Na-tional Institutes of Health on May 27-28, 1976.

The proceedings contain the 33 papers pre-sented at the Symposium, the transcriptsof thediscussions that followed panel sessions, andrecommendations relating to future informationneeds. The publication also includes a copy ofthe 1966 report of the Panel on Handling Tox-icological Information of the President'sScience Advisory Committee, the documentwhose recommendations led to the establish-ment of NLM's Toxicology Information Programin 1967.

The Toxicology Information Program con-tinues to manage—for the Toxicology Informa-tion Subcommittee—two publications thatdescribe research-in-progress. The first of these,TOX-TIPS (Toxicology Testing-in-Progress),reports new projects in long-term toxicologytesting of chemicals by governmental, in-dustrial, and academic laboratories. The rapidpublication of this information is designed toprevent the unknowing duplication of theseex-pensive tests. TOX-TIPS is published monthlythrough the National Technical InformationService at an annual subscription rate of $25.

The scope and contents of the secondpublication, 7ox/'co/ogy Research ProjectsDirectory, are much larger. It includes descrip-tions of over 12,000 continuing government-supported research projects in toxicology andrelated fields. These descriptions—togetherwith extensive monthly and annual indexes—offer laboratory scientists and administrators theopportunity to learn which organizations sup-port what studies at which institutions. Thepublication is prepared by the SmithsonianScience Information Exchange from its exten-sive data base. In 1978, the 7oxi'co/ogyResearch Projects Directory changed from aquarterly to a monthly publication. Some 300

subscribers receive the Directory from the Na-tional Technical Information Service at thesubscription rate of $100 per year.

The NLM-sponsored Toxicology InformationResponse Center, at the Oak Ridge NationalLaboratory, publishes reviews and annotatedbibliographies in toxicology journals or throughthe National Technical Information Service.During 1978, these bibliographies covered thefollowing topics: vinylidene chloride, healthaspects of chloroform, and polychlorinated andpolybrominated biphenyls. Journal publicationsincluded reviews on mercury poisoning,kepone, mirex, and chloroform.

Online Retrieval ServicesTOXLINE: This bibliographic retrieval service

concerned with toxicological information nowprovides subscribers with online access toalmost 500,000 secondary journal citations andabstracts covering the most recent four years.These records deal primarily with the toxicologyand pharmacology of drugs, pesticides, in-dustrial chemicals, environmental pollutants,and hazardous household chemicals. The TOX-LINE data base is updated monthly. In FY 1978,the entire TOXLINE file was regenerated and in-formation older than 1974 was moved to thebackfile, TOXBACK, raising that file to 400,000records. TOXLINE/TOXBACK contain the followingcomponent files: Toxicity Bibliography,Chemical-Biological Activities (ChemicalAbstracts, sections 1-5, plus sections8, 59, and60), /Abstracts on Health Effects of Environ-mental Pollutants, Pesticides Abstracts, Inter-national Pharmaceutical Abstracts, the HayesFile (a precursor to Pesticides Abstracts),bibliographic files from the EnvironmentalMutagen Information Center, Toxic MaterialsInformation Center, and EnvironmentalTeratology Information Center (all at the OakRidge National Laboratory) and a second,special file of references in teratology.

During the year, more than 47,000 onlinesearches were conducted by TOXLINE users,who also requested more than two million cita-tions, printed offline from TOXLINE and TOXBACK.

29


CHEMLINE: This file presently contains morethan 248,000 chemical records for substancesknown by some 560,000 different names. It in-cludes the 33,000 records on the Toxic Subs-tances Control Act Inventory Candidate List ofthe Environmental Protection Agency.CHEMLINE records contain Chemical AbstractsService (CAS) Registry Numbers, molecular for-mulas, chemical names, synonyms, name frag-ments, ring information, some MeSH terms, anda "locator" data element to aid in identifyingother files with information about a specificsubstance. In 1978 the CHEMLINE file wasestablished at the State University of New York(Albany) to increase its accessibilityon the net-work. Total online usage for CHEMLINE reached apeak of 350 hours per month for a total of morethan 3,450 hours during the year.

A four-month test was conducted in 1978 toevaluate the effectiveness of a set of substruc-ture search screens recently developed by aconsortium of Swiss pharmaceutical manufac-turers in conjunction with Chemical AbstractsService. Representatives from industrial andgovernmental organizations participated in thistest which will lead to enhanced chemicalsearch capabilities in CHEMLINE.

RTEC5: In September 1977 the Toxicology In-formation Program brought a new online dataretrieval file called RTECS into NLM's family ofnetwork services. This file is an online version ofthe National Institute of Occupational Safetyand Health (NIOSH) publication, Registry ofToxic Effects of Chemical Substances. InMarch 1978, the 1976 edition of RTECS wasreplaced by the 1977 version and in September1978 quarterly updating of this file was in-stituted in collaboration with NIOSH.

RTECS provides the online user with acutetoxicity data on some 31,600 substances. Formany substances, the file also contains informa-tion on: threshold limit values, recommendedstandards in air, aquatic toxicity, and eye andskin irritation. All data in RTECS have sourcereferences. NIOSH maintains responsibility forthe content of the file.

Toxicology Data Bank (TDB): The Tox-icology Information Program made substantialprogress in 1978 in the development of the Tox-icology Data Bank (TDB) as an online, interac-tive data retrieval service. The TDB containsevaluated data describing the chemical andbiological properties and the usage of selectedchemical substances which are hazardous andto which populations are exposed. Data ex-tracted from secondary sources such as text-books, handbook, and criteria documents arefurther evaluated by a task group of the NIHToxicology Study Section comprised of phar-macologists, toxicologists and analyticalchemists. Data extraction and data input arecarried out for NLM at the Oak Ridge NationalLaboratory.

In 1978, two online tests by user groups werecarried out on pilot versions of the file. The filestructure was then modified as a result of thesetests. Initial public access by U.S. users of theNLM online services is planned for October1978. At that time, the file will contain some1,100 complete substance records and another1,400 references to records in various stages ofdevelopment.

LADB: The Laboratory Animal Data Bank(LADB) contains descriptive information onanimal strains and provides comparative dataon laboratory animals used as experiment con-trols at research and testing institutions. It is anonline computer system designed for use byscientists; formal training in computer retrievalmethodology is not necessary. Eventually, thesystem will be available through a nationwidetelecommunications network.

Using LADB, a scientist may. (1) select andexamine base-line data for various physiologicand pathologic values; (2) determine the en-vironmental and husbandry conditions for eachanimal group selected; (3) statistically analyzethe retrieved data; and (4) print out the dataasdistributions (such as histograms or data tables)and as complete reports. Data are contributedto LADB voluntarily by industrial, academic,and government laboratories. At present the file

30

Specialized Information Services

contains data from 117 colonies—17,925animals of 22 strains/species on which over201,000 observations were recorded. Formaltesting of LADB has been completed and it isexpected that the file will be ready for publicservice during FY 1979.

The LADB project is sponsored by the DHEWCommittee to Coordinate Toxicology and Rel-ated Programs, the National Center for Tox-icological Research, the National Cancer In-stitute, the National Library of Medicine and theInteragency Regulatory Liaison Group (made upof representatives from the Consumer ProductSafety Commission, Environmental ProtectionAgency, Food and Drug Administration, andOccupational Safety and Health Administra-tion).

Collaborative Activitieswith Other Agencies

NLM's Toxicology Information Program con-tinues to manage the Toxicology InformationSubcommittee of the DHEW Committee toCoordinate Toxicology and Related Programsand several of the projects which this groupsponsors. Included among these are the afore-mentioned Laboratory Animal Data Bank pro-ject and the publications TOX-TIPS and theToxicology Research Projects Directory.

In 1978, the TIP—working in close associa-tion with the Council on Environmental Qualityand the Environmental Protection Agency—began to develop a prototype Chemical DataBase Directory. This online directory file will bean entry point into a proposed multifile infor-mation and data retrieval system— the Chemi-cal Substances Information Network. This net-work, being developed in response to the re-quirements of the Toxic Substances ControlAct, is under the direction of the InteragencyToxic Substances Data Committee (which ismanaged by the Council on EnvironmentalQuality and the Environmental ProtectionAgency and has representation from the Federalagencies concerned with toxic substances, in-cluding NLM).

The Chemical Substances Information Net-work, as planned, will consist of a set of databases containing information related to chemi-cals. Most of these data bases would be linkedthrough communications media, searchableonline, and provide for retrieving coordinatedsets of data. It is planned that the Chemical DataBase Directory, the first step in developing thenetwork, will consist of a descriptive catalogwhich describes the content, structure, loca-tion, and accessibility of network componentdata bases, and a subject catalog which con-tains terms representative of the conceptscovered by these data bases. The Toxicology In-formation Program is developing the detaileddesign of the Chemical Data Base Directory andis planning for a prototype to be operational inFY 1979.

31

Chapter 5: Audiovisual Programs

Myron J. Adams, Jr., M.D., DirectorNational Medical Audiovisual Center

Students at the National Medical Audiovisual Center participate in a three-day workshop on ' Designing Learning Spaces

32

Audiovisual Programs

The National Medical Audiovisual Center(NMAC) is responsible for planning and ad-ministering a national program to improve thequality and utilization of learning materials inthe health professional community The Centerconducts an intramural program and supportsextramural activities to apply audiovisual andeducational technology to complement NLM'sefforts to aid in the dissemination of informa-tion important to the progress of medicine andto the public health

Currently located in Atlanta, Georgia, NMACwill move to the new Lister Hill Center,scheduled for completion in 1980 Efforts arenow underway to integrate NMAC with theLister Hill National Center for Biomedical Com-munications (LHNCBC) to form one Librarycomponent responsible for research anddevelopment in the dissemination of informa-tion

In the report that follows, NMAC's programsare divided under two mam headings Researchand the Application of Research, and ServicesUnder the first heading are activities dealingwith the development of audiovisuals, theutilization of technology, and planning informa-tion transfer systems Under Services aredescribed NMAC's distribution and consulta-tion activities

Research and theApplication of Research

Development of Audiovisuals

During FY 1978, the National MedicalAudiovisual Center continued its support of ex-tramural development of audiovisuals, includ-ing the two series "Leaders in AmericanMedicine" and "Leaders in American Nursing,"and the development of high-quality pro-totypes for audiovisual teaching materials

Efforts to provide standards and guidelinesfor all aspects of audiovisual development andevaluation were emphasized in FY 1978 Oneapproach seeks to develop guidelines for select-ing appropriate segments from the total cur-riculum—determining what factors influencetheir selection and how to achieve widespreadacceptance and application of this information

A complementary effort is aimed at how toselect and validate professional content inaudiovisual instructional materials Accuracy,currency, and adaptability to audiovisual for-mats are primary considerations Guidelines forthe design of instructional formats, as they relateto audiovisual development and use,are alsobeing studied Matching content, stated objec-tives, and test materials, and the appropriateselection of media, are essential ingredients inthis effort

NMAC's sponsorship of extramural develop-ment of audiovisual materials has uncoveredspecific production shortcomings withinschools of the health professions This has ledNMAC to formulate and promote a com-prehensive set of standards for technological re-quirements of all audiovisual productions Alsoprompted by these experiences is a project todevise guidelines for revising partially obsoleteaudiovisual materials—those in which certaindata are no longer valid but which are, other-wise, highly valuable and perhaps irreplaceable

The evaluation of audiovisual leachingmaterials is being addressed by three majorresearch and development efforts Their objec-tives are (1) to devise techniques for obtainingstudent test data from a national program offield testing of completed audiovisual projects,(2) to obtain useful data for assessing the effec-tiveness of audiovisual teaching materials whilethey are in early stages of development (so thatrevisions can be made without major invest-ment), and (3) to obtain subjective reactions toaudiovisual instruction for use in predicting stu-dent performance as a result of each instruc-tion

33


In FY 1978, through a combination of con-tractual, collaborative, and in-house efforts,NMAC has developed 80 products 3 motionpictures, 30 videotapes, 39 slide/tape units, 5filmstrips, 2 journal articles, and 1 exhibit

Utilizing Audiovisual andEducational Technology

Many health professions faculty have had lit-tle preparation for their teaching respon-sibilities, and they express interest in acquiringmore information and skills in educationalmethodology To assist them, NMAC's Educa-tional Training and Consultation Programdevelops innovative teaching approaches,evaluates their effectiveness, and provides train-ing in audiovisual and instructional technologyto health professions faculty

This is done largely through a program ofworkshops and seminars that demonstrate avariety of training methodologies for healthprofessional educators When evaluated andfound effective, these workshops are sharedwith NMAC's regional centers In these centers,evaluation is continued to determine howeffective the training is in improving the qualityof teaching in schools of the health professions

Faculty training at NMAC and its nineregional centers has increased steadily duringrecent years In FY 1976, 500 received training,in FY1977,659 received training, and in thisfis-cal year, 889 received training The total num-ber of workshops and seminars held at NMACand its centers also increased in the last yearfrom 26 to 40

The primary goal of the NMAC regional train-ing center program is to develop a network ofregional centers, staffed by experienced faculty,that can (1) use NMAC-packaged faculty train-ing materials effectively, (2) make training morewidespread through the multiplier effect, and(3) provide a laboratory setting in which tostudy the process of faculty training

Three new regional training centers were ad-ded to the network this year, bringing the totalto nine The three new centers are located atthe University of Florida's I Hilhs Miller HealthCenter, the University of Texas Health ScienceCenter at San Antonio, and the University ofCalifornia at San Francisco The number ofregional-based workshops has risen from fourin 1975-1976 to a scheduled 38 in 1978-1979Attendance at these workshops has been fromall of the major health professions

Topics covered during workshops and semi-nars include test construction, instructionaltechnology and innovations in teaching,development, and evaluation of audiovisual in-structional materials, simulation, television pro-duction, learning space, basic graphic art for thehealth science teacher, effective use of media,basic photography, and how to teach and useinterpersonal skills

NMAC is planning to develop new andmodify existing workshops for a new consti-tuency—directors of continuing educationprograms in schools of the health professions,hospitals, etc

Planning and Evaluating InformationTransfer Systems

NMAC is involved in developing prototypeinformation transfer systems, including evaluat-ing their effectiveness and disseminating infor-mation about them to the health sciences com-munity The Center has worked with a numberof professional groups in an attempt to developcomponent parts of information transfersystems One of these projects comparesvarious techniques for defining content in agiven area Four approaches, ranging fromanalyzing lecture notes to simulated jobanalysis, are being compared

In FY 1978, NMAC completed a survey of theutilization of instructional technology inschools of the health professions A final

34


NMAC crew on location records a scene for the videotape "Removal of Animal Brains for Rabies Testing "

repor t *—descr ib ing the purpose andmethodology of the project, a detailed analysisand interpretation of the data, and conclusionsand recommendations—was sent to theschools that participated in the survey and toother interested organizations and individuals.

In May 1978, NMAC invited consultants inmedical education and instructional develop-ment programs to discuss with a special studygroup how to develop models for evaluatingsuch programs. Also during this year, a contractwas given to the Ohio Regional Medical

""Instructional Technology in the Health Sciences, Final Report1977, available on request from Ihe National Medical AudiovisualCenter 1600 Clifton Road, N E , Atlanta Georgia i0333

Audiovisual Consortium (ORMAC) to evaluateits impact on participating schools.

ServicesAudiovisual Distribution

The NMAC free-loan collection consists of898 16mm motion picture titles and 277 3/4-inch videotape titles. During FY 1978, theCenter received and processed 54,176requestsand shipped 49,482 films and videotapes. Thenumber of requests increased by 15 percent thisyear. Several factors contributed to this in-crease—the distribution of a revised catalog(July 1977), individual announcements of allnew titles added, and the increasing popularityof the 3/4-inch videotape format.

35


Original edited master videotapes were in-ventoried and 3/4-inch duplicate masters wereprepared to protect this valuable collection. Alloriginal 16mm preprint material has been in-ventoried, placed in new containers, and filedin the automatic storage and retrieval system.

Center staff member Carole Morton chec ks an audiovisualinstructional unit for deh/ery to the National AudiovisualCenter

Twenty-eight self- instructional teachingpackages, 16 motion picture titles, and 37videotape titles were placed in the SalesProgram of the National Audiovisual Center,General Services Administration. These new ti-tles are in the fields of dentistry, nursing,anatomy, pediatrics, forensic medicine, andhistory of medicine. During this year, 3,008teaching packages, 228 motion pictures, and119 videotapes were sold. Also, 2,737 duplicateaudiotapes were produced. Most of these wereused in NMAC's loan and sales programs.

From the 1,125 programs in the historical col-lection, 126 selected titles have been transfer-red to videotape; an abstract for each is being

written. The Center is developing a method todetermine which titles of the collection havelasting historical value.

Consultation

On request, this program assists healtheducational institutions by collecting data andproviding recommendations regarding thedevelopment, implementation, and manage-ment of instructional resources or biomedicalcommunication programs.

Several on-site consultations and one in-depth survey were conducted during FY 1978.The survey, at the New Jersey College ofMedicine and Dentistry, was to evaluate thebiomedical communication operations in theschools of medicine and dentistry and to pro-vide recommendations on how the tworesources could be organized to maximize theirefficiency in responding to the needs of facultyin both schools.The on-site consultations wereprovided to the American Psychiatric Associa-tion, the Chicago Dental Society, and theUniversity of Texas Medical Branch inGalveston.

One hundred twenty-nine consultationswere provided to administrators, faculty, andstaff from schools of the health sciences, univer-sities, and hospitals, and representatives ofGhana, West Germany, Iran, New Zealand, Hol-land, Cuba, Chile, Israel, and Canada. Subjectscovered included continuing education;evaluation of audiovisual teaching programs;organization, staffing, operation, and budgetingfor a biomedical communications program;facilities planning; and the design and develop-ment of learning materials.

36


Table 13. Selected Statistics, NMAC(FY 1978)

FY1978

Audiovisuals requested 54,176Audiovisuals shipped 49,482Titles added (film and videotape) 95Audiotape duplication 2,737Titles to NAC for sale 81Teaching packages sold through NAC 3,008On-site consultations 5NMAC-based consultations r. 129Monographs distributed 1,887NMAC-based workshops (362 attendees) 16Regional workshops (527 attendees) 24Audiovisual units completed 80

37

Chapter 6: Lister Hill National Cen-ter for Biomedical Communications

Lionel M. Bernstein, M.D., Director

Representative Dan Rostenkowski (D III ) address a hospital group in Cleveland via satellite from the Lister Hill Center s CTSstudio facility joining in the live, two way discussion on March 16 were (left to right) Alexander McMahon, President of theAmerican Hospital Association, Dr Robert B Hunter, Chairman of the Board of the American Medical Association, andThomas H Sherlock President of Blue Cross of Maryland Operating the camera is Liz R Somogyi

38

Lister Hill Center

This annual report is written, for the first time,in the actual shadow of the new Lister HillCenter building. During the period of thisreport the Center acquired a new Director anda new branch, the Health Professions Applica-tions Branch. A subcommittee of the Board ofRegents, chaired by Dr. S. Richardson Hill, anda group of outside consultants reviewed theprograms of both the Lister Hill National Centerand the National Medical Audiovisual Center.

The PHS/CTS satellite program demonstratedthe power and flexibility of a satellite.-basedbroadband biomedical communications systemin its first full year of operation. Computer -con-ferencing is being used to bring the opinions ofexperts to bear on validating and updating theHepatitis Data Base. A new Advanced TerminalSystem promises to combine the best features ofseveral previously incompatible com-puter/terminal systems. Investigations were-started on the potential of a powerful newdevice, the optical video-disc, for high densitystorage and retrieval of both digital data andaudiovisual materials.

PHS/CTS ProgramThe Public Health Service/Communications

Technology Satellite Program is an outgrowth ofearlier Lister Hill Center satellite-basedprograms. In 1971, the first such program, viaATS-1* satellite, introduced interference-freevoice communications to approximately twodozen locations in various parts of Alaska. In1974, the launch of ATS-6 gave the Lister HillCenter the opportunity to introduce video asacommunications medium for biomedical ex-perimenters in Alaska and the Pacific North-west.

The launch of the Communications Tech-nology Satellite (CTS)in 1976 provided the firstopportunity to experiment with a truly nationalbroadband interactive communications net-

*ATS Applications Technology Satellite

work for health education programs, and dis-semination of NIH research results providingfull-duplex color video and audio capability.CTS also represents a step forward in tech-nology since it operates at the relatively availa-ble super high frequencies and possesses an ex-ceptionally powerful transmitter.

The National Library of Medicine hasdesigned and installed a network of six smallearth terminals. This network functions both asa demonstration laboratory for the PHS healthagencies and as a technology test laboratory forthe Lister Hill Center. In light of this multipur-pose function, objectives for the PHS/CTSprogram are developed in three areas: ademonstration project, a network operationand maintenance support activity, and a tech-nology project.

The experiment, which has reached as high as70 hours per month and has averaged 44 hoursof broadcast over the past 18 months, originallywas to have been concluded in December1978. In response to appeals from the healthcommunity, the National Library of Medicinehas agreed to continue its involvement in main-taining the network and providing technicalsupport to the participating health agenciesthrough )une 1979.

The PHS/CTS program has three aims; to

• Promote the dissemination of informa-tion among members of the health com-munity.

• Promote increased access to continuingeducation programs for health profes-sionals.

• Promote the sharing of faculty and cur-riculum as a form of resource sharingamong health educational institutions.

Wilbur Cohen, then Secretary, Department ofHealth, Education, and Welfare, established theLister Hill National Center for Biomedical Com-munications in a memorandum dated Septem-ber 18,1968. This memorandum stated, in part,

39


that: Substantive materials and information tobe transmitted (over the Biomedical Com-munications Network) will remain the respon-siblity of the program missions involved." Todate, more than 13 projects have been con-ducted using the PHS/CTS network. A list ofsome of these projects and the PHSagenciessponsoring them is given in Table 14.

Network Operation andMaintenance Project

The Lister Hill Center has assumed the rolesof network coordinator and technical supportgroup for the PHS/CTS program. The PHS/CTSnetwork consists of six earth terminals locatedin Bethesda, Maryland; Lexington, Kentucky;Denver, Colorado; Bozeman, Montana; Seattle,Washington; and Fairbanks, Alaska. These sixstations provide interactive video and audiocommunications for the health programs thatare being demonstrated.

A treadmill test, taped at the National Institute on Aging'sGerontology Research Center in Baltimore, was used by in-stitute Director Dr Robert N Butler during a CTS telecastto the University of Colorado Medical Center on February16

The Center's responsibilities in assumingthisrole are to coordinate the scheduling for thePHS experiments, operate and maintain the sixearth terminals, provide technical coordination

for the PHS programs, and operate the newNLM telecast facility.

The PHS/CTS network also served as alaboratory for conducting experiments to im-prove the cost-effectiveness and practicality ofbroadband communications. Two experiments,"spectrum optimization" and "spectrum shar-ing," explored the extent to which bandwidthcan be saved, thereby reducing communica-tions costs. It was found to be possible to fre-quency-multiplex two video signals into eitherCTS channel. "Broad area coverage" experi-ments explored the quality of reception underthe marginal carrier-to-noise ratio signalsreceived at the peripheries of the satellitefootprints.

A practical problem, inherent in any interac-tive communications system that uses a satelliteas a relay point, is an annoying "echo" in theaudio channels. The echo can be controlledmanually, but the need for extra personnel addsto system costs. Measurements of audio chan-nel impairments led to recommending the in-clusion of a voice-gate amplifier to provide amore robust threshold to the echo suppressionmechanism so that speech chopping and otherannoyances were substantially reduced.

Dissemination of Informa-tion to Practitioners

The overall objective of the Health Profes-sions Applications Branch's information transferprogram is to develop an easily and immediatelyaccessible information system that will providepractitioners with information needed to dealwith their day-to-day patient problems. Healthpractitioners encounter great difficulties in re-maining current because there is little time tosearch out the everexpanding amounts of newbiomedical information becoming available.Research and development initially will bedirected toward construction of a small numberof comprehensive knowledge banks by analysis,

40

Lister Hill Center

Project

Nursing Child AssessmentSatellite Training

Dietitians Workshop

Continuing Dental Education

Table 14. PHS/CTS Programs

Implementing Agency

University of Washington,School of Nursing

Drug Abuse P reven t i onTeleconference

Drug Treatment

MEDLINE Training Seminar

Health Teleconference Semi-nar

Admissions and MinorityRecruitment

Independent Learning andFaculty Sharing

Health Consultation

Legislative Process

Research Dissemination

Teleconference

Supporting Health Agency

Division of Nursing, HealthResources Administration

American Dietetic Association National Library of Medicine

Consortium composed ofHealth Systems Research Divi-sion, University of Florida, andfour Schools of Dentistry atUniversities of Colorado, Ken-t u c k y , M a r y l a n d a n dWashington

Participating Youth Groups

Drug Treatment Center

National Library of Medicine

National Health Associations

Consortium of four Univer-sities Washington, Alaska,Montana, and Idaho (WAMI)

WAMI

WAMI

WAMI

University of Colorado

• Monsour Foundation• Society of Neuroscience• HeSCA• Institute of Pediatrics

Division of Dentistry, HealthResources Administration

National Institute on DrugAbuse, Alcohol, Drug Abuseand Mental Health Administra-tion

National Institute on DrugAbuse; Alcohol, Drug Abuseand Mental Health Administra-tion



Division of Medicine, HealthResources Administration

Division of Medicine (HRA)

Division of Medicine, HRA

Division of Medicine, HRA

National Institutes of Health


41


synthesis and translation of clinically relevantinformation available in books and journals intocompact, manageable computerized forms

A prototype computerized informationtransfer system using the diseases "viralhepatitis" asthe initial test model has been con-structed As a comprehensive bank of informa-tion, this system (1) contains substantiveanswers to questions posed by practitioners(rather than bibliographic citations), (2) pro-vides answers that are current and are the con-sensus of a group of ten experts, (3) is im-mediately responsive to inquiries (reliable,ready computer access and response), and (4)provides data supporting the answers as well ascitations to primary publications for moredetailed study if desired Knowledge pertainingto aspects of viral hepatitis important to thepractitioner has been synthesized using the in-formation contained in several outstanding syn-theses on the subject previously published byhepatitis experts Relevant information has beenselected, placed in a highly organized hierarchi-cal arrangement to permit easy retrieval, and en-coded into a minicomputer The contents ofthe Hepatitis Data Base will be maintained cur-rent by review of selected literature by experts

The first draft of the Hepatitis Data Base(HDB) was completed in September 1977Since then, the HDB has gone through suc-cessive refinements The first completely up-dated consensus document will be publishedin 1979 as a supplement to The Annals of In-ternal Medicine with an invitation to readers toidentify errors of omission or commission in thedata base and to propose alternatives

The consensus process is facilitated by theuse of computer conferencing Linking betweenthe experts and the research staff of NLM ismainly by means of Electronic Information Ex-change (EIE), an experimental computer con-ferencing network under developmental studyby the National Science Foundation and main-tained at the New Jersey Institute of Tech-nology Mail and telephone are used to supple-

ment communication as necessary Computerconferencing provides a medium of com-munication that is virtually independent of thecustomary constraints of space and time Use ofcomputer-managed conferences eliminates theneed to gather at a common table or to gatherby separate telephones at a common time Par-ticipation is asynchronous Each participantuses a terminal at the time and place of hischoosing and automatically receives all com-munications and reactions initiated by otherparticipants since his last session at the terminalHe or she can then enter comments and newcommunications into the system for distribu-tion to others This enables participants to be invirtually constant touch with one another to.ex-change ideas and findings on a daily or weeklybasis and allow the validation (and updating)func t ions to occur readi ly amongstgeographically dispersed busy individuals

Highly interactive data base delivery is sup-ported by a Data General Eclipse C/330minicomputer, using the MUMPS/MIIS operat-ing system and the Hewlett-Packard 2648Avideographics display terminal Data base main-tenance includes the capabilities to update text,table, figure and bibliographic data sets Astand-alone microprocessor/floppy disc versionof the delivery system has been developedwhich permits local display and retrieval of in-formation without the need for costly com-munications facilities or large centralized datacenter supporting activities

During the coming year initial testing andevaluation of the Hepatitis Data Base andderivative products will be conducted at the in-stitutions of the collaborating experts Resultingdata will provide necessary feedback to guidethe ongoing development and refinement ofthis prototype information transfer systemEmphasis will be placed upon assessing thecost-effectiveness of the methodologies used toconstruct, validate, and update the data basecontents, and to begin to assess the utility of thismode of information transfer for medicaleducation and medical decision making underactual practicecircumstances

42

Lister Hill Center

Information TechnologyThe Computer Technology Branch (CTB) is

reporting on three current projects of generalinterest: the Integrated Library System (ILS); theAdvanced Terminal System (ATS); and theVideodisc Project, which it shares with theCommunications Engineering Branch.

The Integrated Library System is an attemptto design and develop a minicomputer-basedintegrated library system with all major libraryfunctions operating on one bibliographic file.The circulation and online catalog referencesubsystems are being developed first, as a col-laborative effort between the National Libraryof Medicine and the Army Library, Pentagon.The Army Library contributes developmentalfunds and provides library personnel to workwith the Computer Technology Branch (andLibrary Operations, NLM) on the requirementsand functional design, while CTB designs anddevelops the ILS.

The system is designed to run on a wide rangeof equipment configurations, from $20,000 fora small system serving one or two users to$250,000 for a large centralized system serving64 users. The ability to do this without anyredesign would be a unique capability. Fewsoftware systems exist today that can span sucha range of user populations without major revi-sion.

The Advanced Terminal System is a "three-in-one" terminal system that can do things thatformerly required three different, and mutuallyincompatible systems. (1) It works, not onlywith the University of Illinois PLATO system(which has always required its own plasma dis-play terminals) but with any other CAI (com-puter assisted instruction) terminal that uses thestandard ASCII (American Standard Code forInformation Interchange) coding system; (2) Itbrings the versatility of the PLATO system'sgenerated graphic displays (requiring a largecomputer) to other much smaller CAI systems;(3) It does not have to be connected to a major

computer, but has enough internal computingpower to stand alone. A combination of twomicroprocessor units and two arithmetic pro-cess units, the products of high performancesolid state technology, give the Advanced Ter-minal System the power of a minicomputer—acomputer that can generate graphics in additionto using standard CAI courseware. This internalcomputer is powerful enough to characterizethree dimensional structures and to performother complex mathematical functions. Onepre-production system has been delivered, withanother on order. The later model will use a"fixed disc" which can store very much largeramounts of data.

Videodisc projects. Most, if not all, of theimprovements in information technology havetaken place by exploiting fortuitous advancesinancillary technologies—taking a devicemanufactured for one purpose and using it foranother. Library microfilming, for example,came from the major business market formicrofilming checks and industrial records. The35mm film was first developed for cinematogra-phy. Another product for the entertainment in-dustry, the optical videodisc, offers far-reach-ing potential. The videodisc was developed toprovide "paper-back" versions of videoprograms for mass sales. Like the LPrecords theyclosely resemble, videodiscs can be turned outinexpensively in vast quantities once the expen-

Videodisc machine in the Lister Hill Center's LearningResource Laboratory

43


sive master disc is made. Videodisc technologyoffers great potential for high density storage,rapid random access, full video bandwidth,long life expectancy, and low reproductioncosts. The Library contracted for two prototypeindustrial versions (the industrial models offerrandom access to any track, ascontrasted to thehome entertainment models) of opticalvideodisc systems from MCA (formerly theMusic Corporation of America). One player isbeing used to develop a low cost unit for themass storage of digital data. The other is beingused to explore the application of this tech-nology to the storage, delivery and distributionof audiovisuals.

The digital data videodisc project has as itsobjectives the development of an intelligentminicomputer-based controller for industrial

videodisc players, and the encoding/decodingof digital information for storage and retrieval.Potential applications include the distributeddelivery of large bibliographic data bases, andextension of the distributed information deliv-ery systems to include text, randomly accessiblecolor images, and audiovisual sequences for in-tegration with computer-based educationalsystems.

The audiovisual videodisc project will extendthe intelligent controller described above todevelop a prototype system which will be usedto demonstrate and evaluatecost effective massstorage of all forms of library audiovisuals, suchas those referenced by AVLINI This includessuch techniques as variable speed playback, in-cluding speech compression, and high-resolu-tion storage.

44

Chapter 7: Extramural Grantsand Contracts

Ernest M. Allen, Sc.D., Associate Directorfor Extramural Programs

Meeting of the Regional Medical Advisory Board for Region II (New York and New Jersey)

45


The Medical Library Assistance Act of 1965,as amended, authorizes the National Library ofMedicine to conduct a program of grants andcontracts to develop better and more accessiblehealth information services. The most recent ex-tension of the Act covers the period through1981.

The NLM Office of Extramural Programs con-tinued in 19.78 to support activities related to amore effective biomedical information net-work, particularly through the Regional MedicalLibrary Program. Resource Project Grants andResource Improvement Grants that related tothis purpose received high priority. PublicationGrants and Special Scientific Projects awardedwill facilitate the dissemination and sharing ofinformation related to medicine and otherhealth-related disciplines. Research Grantsfollowed the traditional pattern of supportingprojects expected to benefit biomedical com-munications; however, a formal review of theResearch Grants Program initiated in 1977 wasconcluded in 1978 with several importantrecommendations for changes in the program.

The International Programs Division ad-ministers the Publication Grants Programauthorized by the Medical Library AssistanceAct as well as publications support under theSpecial Foreign Currency Funds, P.L 480. TheDivision of Biomedical Information Support ad-ministers the other programs.

Regional Medical LibraryProgram

The Regional Medical Library (RML) programis a keystone activity in that it facilitates thetransfer of many NLM direct-service programsto the library and health-science communities,and that it seeks to coordinate and integrate theinformation services of the nation's health in-stitutions. This national, cost-sharing activityserves as a model for information networkdesign, and it is widely recognized for its effec-tiveness and efficiency.

First authorized in 1965 by the Medical Li-brary Assistance Act, the RML program, throughthe efforts of the health science library com-munity, has provided the impetus for develop-ment of a decentralized service network, whichutilizes the established resources of participat-ing institutions. Decentralized organization, ascompared to a monolithic system, assures con-tinued strengthening of local resources, a rapidresponse to requests for needed materials, andthe ready availability of biomedical informationto the nation's health workers.

There are eleven Regional Medical Libraries,including the National Library of Medicine. TheNLM, which serves as the RML for the Mid-Atlantic Region, also acts as a national backupfor the entire program. All RMLs maintainprograms for the delivery of biomedicalliterature, and each provides an array of otherservices based on the characteristics and needsof its region.

The regional document-delivery program wasimplemented to supplement the interlibrary ex-change which existed prior to the establishmentof the RML network. Until recently, the cost-sharing aspects of this program were looselydefined and informally applied. During the lastfew years, however, it has become evident, be-cause of increasing volume and costs, that a ra-tional and explicit basis for determining fiscalresponsibilities of the Federal and non-Federalsectors had to be established. In FY1978, it wasagreed with the RMLs that materials availablelocally are a local fiscal responsibility and thatNLM would be responsible for materials notreadily available locally.

The plans recognized that although the docu-ment-delivery service has always been a veryimportant part of the RML program and will re-main so, there are many other RML functionswhich require increased attention. Amongthese are the complex problem of equalizing ac-cess to audiovisual material, educationalprograms for library personnel who need totake better advantage of the RML network, and

46

Grants for Library Assistance

increased cooperation with other library and in-formation organizations and networks.

The Regional Medical Library Directors meettwice a year, and each RML also sponsorsperiodic meetings of its advisors to review andevaluate current activities and consider futuredirections. In an effort to promote a greater in-terchange among regions, it was decided in FY1978 that one of the two annual meetings will,henceforth, be held at a Regional Medical Li-brary.

RML obligations have averaged over threemillion dollars per year since FY 1976. Approx-imately 50 percent of these funds go for thedocument-delivery program, 25 percent for theadministration of RML operations, and 25 per-cent for indirects costs and other RML activities.

Medical Library ResourceProject Grants

The goal of this program is to improve accessto health information by strengthening healthsciences libraries and by fostering coordinationand cooperation at state and local levels. Pro-ject Grants enable health institutions to im-prove their library facilities; to implement newprograms or to augment existing ones; and todevelop cooperative arrangements with otherinstitutions. As a result of these grants, institu-tions should be able to function more effec-tively in the Regional Medical Library Network.During FY 1978, 16 new Resource Projectswere initiated, totaling $820,872.

Also during FY 1978, Resource Project Grantfunds supported the development of statewidenetworks in Hawaii, Idaho, Maine, Nebraska,Oregon, and South Dakota. These statewidemedical-library services complement theRegional Medical Library Network. Grant fundssupport, for up to three years, a coordinator andstaff to encourage the establishment of libraryservices in health-related institutions and tofoster cooperation among existing libraries serv-

ing health personnel. The Project Grants fundthe major start-up costs for these services, withthe understanding that non-NLM funds will beobtained to continue them.

The audiovisual facility otthe Philadelphia College of I'li.i -mac y and Soencc teceived an NLM RCSOUKC Pio|eu < >tctnlPictured are Diane Wolf, Sherry Montgomery, and Dr Dan-iel A Hussar of the College

In NLM's continuing effort to encouragecooperation among health science libraries, tenconsortia received Project Grant funds in FY1978 for establishing consortium services,developing audiov isual resources, andcooperative cataloging. As one example, a Pro-ject Grant was awarded to Mount AuburnHospital in Cambridge, Massachusetts, to makeprofessional health-sciencesliterature easily ac-cessible to community-based health practi-tioners who lack hospital affiliation. Six publiclibraries are participating with the hospital libr-ary.

Medical Library ResourceImprovement Grants

The purpose of the Medical LibraryResourceImprovement Grant Program is to assist thedevelopment of basic collections. Support isavailable to consortia and to single institutionsthat do not find it practicable to join a consor-

47

•NLM Programs and Services

tium. At a January 1978 meeting of communityhospital librarians at NLM, several recommenda-tions were made to improve this program, andthe modifications needed were approved bythe NLM Board of Regents in May. Thesechanges will: allow single institutions and con-sortia to compete for grants on an equal basis;eliminate the $4,000 ceiling for consortiumplanning, organization, and implementation;and make the support available for purchase ofbooks and journals the same for single institu-tions as for each consortium member.

In FY 1978 Resource Improvement grantswere awarded to three consortia to enable theirmembers to assess information needs and plana cooperative acquisitions program, and sixconsortia received funds for their individualmembers to purchase materials. Three ResourceImprovement grants were awarded to single in-stitutions.

Biomedical ScientificPublication Grants

Grants for biomedical scientific publicationsfacilitate the dissemination of information bysupporting studies which are beneficial to U.S.scientists, educators, and health practitioners.The international publications program,authorized under Public Law 480 and utilizing

special U.S. - owned foreign currencies in Po-land, Israel, Tunisia, Yugoslavia, India, Pakistan,and Egypt, is described in Chapter 8, Interna-tional Activities.

The scope of the domestic Publication GrantProgram includes the preparation and publica-tion of critical reviews and monographs inhealth fields; publications in library and infor-mation science and in biomedical communica-tion; pilot or temporary support for periodicalpublications; studies in the history of medicine;translations of current foreign biomedicalmonographs; publication of symposia proceed-ings; and secondary literature tools in the healthsciences, such as atlases, catalogs, andbibliographies.

During FY1978, 47 Publication Grants, total-ing $1,071,416 were funded. Of these, 27 werenew awards, including a monograph on thesocial context of medical research, a directoryof health science libraries, and a history ofdiabetes. Some priority is given to the award ofsmall grants for projects which are underwayand scheduled for early publication. Thispriority is reflected in the average amount of allPublication Grants awarded in FY 1978 —slightly over $23,000.

The program encourages the support of pro-jects which may contribute to the improvement

nine \e» \ \nik! \1oiUv: \« ,

Two recent publications resulting from the NLM Publication Grant Program

48


of health care delivery in the U S — a primaryconcern of American medicine today Amongthe new Publication Grants activated in rY1978 were a critical review on consensualvalidity in health care, pilot funds to develop a"Human Experimentation Committee Newslet-ter," and an analysis of public policy in relationto swine flu liability

Among the studies published in FY 1978which had received earlier support under thePublication Grant Program was a review of (herole of physicians today Stewart G Wolf andBeatrice B Berle, eds, Limits of Medicine TheDoctor's lob in the Coming Era (New YorkPlenum Press, 1978) FY 1978also saw thepublication of a monograph by PhilipHershkovitz entitled, Living New WorldMonkeys (Platyrrhmi), Volume I (Chicago, Il-linois The University of Chicago Press, 1977)This book, a monumental treatise on NewWorld nonhuman primates in the suborderPlatyrrhmi, is addressed to systematists, pn-matologists, behavionsts, and investigators whouse nonhuman primates as experimentalanimals in biomedical research The Library'scontinuing interest m the history of medicine isreflected in Dr Lester S King's The Philosophyof Medicine, The Early Eighteenth Century(Cambridge, Massachusetts Harvard UniversityPress, 1978) Dr King's book is an analysis ofmedical theory of the eighteenth century,traced through the influence of doctrines ofprevious eras as far bac k as the fifth century B C(For a complete listing of books, periodicals,and journal articles received in FY 1978 result-ing from NLM Publication Grants, see Appendix2)

Special Scientific ProjectsThe Special Scientific Project Grant Program

supports the preparation of authoritativetreatises on major health topics The NLMBoard of Regents and other advisors haverecommended that the Library provide grantsupport for treatises which will help bridge in-tellectual domains in the health field, bring

together in a balanced way a growing anddiffuse literature, and synthesizeor organize thegenerally agreed-upon slate of knowledge in aparlic ular field The books that result from grantsupport should be cogent, perceptive analyses,written for the attention of a broad professionalor multiprofessional audience

Preparing such treatises makes great demandsupon scholarship, calls for the ability to organ-ize material appropriately yet concisely, and re-quires the skill to write gracefully and per-suasively Eminently qualified scientists orhealth practitioners who have these abilities arerelatively few and they frequently have manyconflicting demands upon their time Conse-quently, an objective of grant support is to helpsuch persons prepare these treatises by enab-ling them to devote more time to the projectthan would otherwise be possible

Special Scientific Project Grants may be forone or more years Usually the period of grantsupport coincides with the completion of themanuscript and its delivery to a publisher Atleast one additional year is usually required forthe publisher to complete the editing and thebook production

During the last several years descriptiveprogram materials have been developed anddisseminated, and members of the scientificcommunity have been helpful in publicizingthe availability of the program and participatingin the review process Consequently, there hasbeen an increase in the number of recent ap-plications for support The Board of Regentsreviewed eight applications for Special Scien-tific Project Grants in FY 1978 and approved six

Four books, which had received grant sup-port in previous years, appeared in print thisyear They are

• | Robert Andrews, M D, D Sc , TheRadiobiology of Human CancerRadiotherapy, Second Ed i t i onBaltimore, Maryland, University ParkPress

49


• Roy Hertz, M D , Ph D , Chonocar-cinoma and Related CestationalTrophoblastic Tumors in Women NewYork, N Y Raven Press

• Kelly M West, M D, Epidemiology ofDiabetes and Its Vascular Lesions NewYork, N Y , Elsevier North-Holland

• Hyman ) Zimmerman, M D , Hepatotox-icity The Adverse Effects of Drugs andOther Chemicals on the Liver NewYork, N Y , Appleton-Century-Crofts

Research GrantsThe recommendations of a task force to im-

prove the quality of NLM-sponsored researchprojects and for setting future goals and direc-tions of the Research Grants Program were pre-sented to the NLM Board of Regents in May1978 The Board requested that the ExtramuralPrograms staff develop specific plans to imple-ment the recommendations Accordingly, newprograms to support career development forresearch in the medical information sciencesand in computer-based medicine are being pro-posed The plans recognize that thephenomenal increase in knowledge abouthealth and medicine requires vigorous researchinvestigations into the principles and processesof the information sciences that are unique toor characteristic of the field of medicine and ofhealth-care services These plans will be con-sidered by the Board of Regents at future meet-ings

Several new research grants awarded in 1978represent examples of the research that NLMwishes to promote A research project at theMassachusetts Institute of Technology willdemonstrate how simultaneous informationsearches of multiple online bibliographic databases can be simplified so that the requestercan personally perform the search In essence, aspecial computer program will automaticallytranslate commands and requests from a userinto language required by a particularbibliographic retrieval system, thereby sur-

mounting many of the obstacles which preventthe inexperienced user from directly accessingmultiple data bases

At Beth Israel Hospital, in Boston, an onlinebibliographic retrieval system tailored to theneeds of hospital library clientele will bedeveloped and tested The data base to be usedwill be a subset of MLDLINL that contains onlycitations available in the hospital library Thesearch procedures will be simplified so thatthey are virtually self-explanatory for an inex-perienced user

Another approach to information processingis the linguistic study being conducted at NewYork University This project will extend certaincomputer techniques, which have beendeveloped to process and format the languageof medical records, to the medical literature aswell The use of computers in linguistic analysisof medical records and literature could greatlyincrease the data available for biomedicalresearch and clinical decision-making Applica-tions of computer technology, such asthe threeexamples cited, will result in major changes inthe health-care system and create new systemsfor information handling

Training GrantsThe NLM's Training Grants Program in Health

Science and Computer Technology was begunin 1972 One of the objectives of the program isto promote a more effective integration of com-puter technology into all phases of clinicalmedicine—teaching, practice, and research

In FY 1978, $1,360,383 was expended in sup-port of this program Approximately one half ofthe training funds covered direct trainee ex-penses (stipends, tuition, etc ) and the otherhalf reimbursed the grantee institutions forsome of the added expenses generated as aresult of the training grant These grants supporttraining activities in 10 institutions throughoutthe United States the University of California,

50


San Francisco; the University of Alabama; DukeUniversity; the Ohio State University; theUniversity of Minnesota; Case Western ReserveUniversity; the University of Missouri-Colum-bia; Mt. Sinai School of Medicine; Georgia In-stitute of Technology; and the University of Il-linois.

In FY1978, 71 individuals received training inthe 10 programs. Forty-one were predoctoralstudents and 30 were postdoctorals.Of the pre-doctoral, 16 were seeking a masters degree and23 a doctoral degree. Of the postdoctoraltrainees, 20 were physicians.

During 1978 a study was undertaken todetermine the current career activities of thoseindividuals who had previously received sup-port from the Training Grants Program. The data

are being collected and will be analyzed andreported in the coming year. The results willdetermine whether the original objectives havebeen met and whether they are still valid orneed modification.

In addition to the grants for training, a con-tract was awarded to the Council on LibraryResources to sponsor and support managementinterns at selected major health science li-braries. The objective of the joint NLM/CLRprogram is to assist in developing managers forthe nation's academic health sciences libraries.Three management interns were selected in FY1978 from among 34 applicants. They will eachspend the 1978-79 academic year at a host li-brary, working closely with the director and topadministrative staff.

Table 15. Extramural Grant and Contract Programs

(in thousands)

ResearchResource ProjectsResource ImprovementTraining**Special ScientificProjectsRegional Medical

Libraries**Publications'*OtherTotal

luly 7975-lune 7976

( 14)* $1,147( 27) 663( 10) 26( 11)

( 2)

( 8)( 40)

1,056

59

2,721606

Transi-tional

Quarter'

3) $ 2062) 264) 112) 333

( 1)

( 2)( 4)

13

63062

FY 7977 FY 1978

(112) $6,278 (18) $1,281

( 15) $1,165 ( 13) $1,111( 46) 1,696 ( 39) 1,848( 20) 77 ( 1 3 ) 165( 10) 1,207 ( 11) 1,459

( 3) 109 ( 7) 248

( 9) 3,086 ( 9) 3,020( 42) 738 ( 47) 1,071( 4) 276(149)$8,354 (139)$8,922

! relit in nuinlxf ul pi(>|i><ls

51

Chapter 8: International Activities

Mary E. Corning, Assistant Director forInternational Programs

52

International Activities

The NLM is a national resource with interna-tional impact. Its international activities include:bilateral quid-pro-quo MEDLARS agreements;exchange of biomedical literature; collaborationwith national and international organizations intheir establishment of regional services; infor-mation services to the developing countriesthrough an NLM/Agency for InternationalDevelopment (AID) agreement; special foreigncurrency program for the support of publica-tions; participation in international organiza-tions; providing technical consultation; andreceiving non-U.S. colleagues for specializedtraining.

International MEDLARSAgreements

NLM has eleven international MEDLARSpartners: Australia, Canada, France, Germany,Iran, )apan, Mexico, South Africa, Sweden,United Kingdom, and the Pan American HealthOrganization (PAHO). The Fifth Meeting of theInternational MEDLARS Policy Advisory Groupwas held October 27-28, 1977. Policy officialsand Directors of the foreign MEDLARS Centersattended. This meeting provided an oppor-tunity for joint review of policies, experiences,and future plans of NLM and the Centers.

At the meeting, Miss Corning reviewed thebackground of our international cooperationand discussed current issues. Issue papers werepresented on Document Delivery by Sir HarryHookway and Dr. Philip Holmes of the UnitedKingdom; Data Base Building by Dr. Henry Kiss-

man, NLM Associate Director for SpecializedInformation Services; and Networking by Dr. S.Abrahamsson and Dr. Goran Fal ken berg ofStockholm, Sweden.

Of particular interest were the regional ac-tivities of the Pan American Health Organiza-tion's Regional Library of Medicine (BIREME)and the Pahlavi Library of Medicine in Iranwhich was designated in 1978 as the WHORegional Library for the Eastern Mediterranean.One principal concern of the Policy Group washow to provide services to the developingcountries now that WHO has terminated itsMEDLINE activities.Most of the Centers are facedwith limitations on personnel, and extensivefree services to the developing countries couldbe undertaken only if sponsored and funded bythe appropriate technical assistance or develop-ment agency within the providing countries.

The quid-pro-quo bilateral agreement whichis the basis for international MEDLARS collabora-tion continues as an effective mechanism forcooperation. Together, these bilateral arrange-ments constitute essentially an internationalnetwork in which the value of biomedical infor-mation is recognized as vital to the advance-ment of medical research, education, and theimprovement of health. Table 16 summarizesthe modes of access to the N LM data bases. Tendata bases — MEDLINE, TOXLINE, CHEMLINE,CATLINE, SERLINE, AVLINE, CANCERLIT, CANCERPROI,

CLINPROT, RTECS — are available to the foreignCenters, but not all Centers have chosen tosearch all data bases.

Table 16. International Access to MEDLARS

Tapes

Germany*japan

Tapes/Software

Sweden*United Kingdom*Australia*PAHO

Online NLM

FranceCanadaIranMexicoSouth Africa

'Supplemental online access to NLM computer

53


International Exchanges andServices

The NLM continues its international publica-tions exchange program with 810 institutions in87 countries where an equitable exchangebalance can be achieved. This program is in ad-dition to NLM's regular acquisitions programand often provides both NLM and the par-ticipating country with material not easily ob-tained otherwise.

In FY 1978 the Assistant Director for Interna-tional Programs was invited to visit Cuba by theMinister of Public Health to observe Cuba'shealth information activities. As a result of thisvisit, a cooperative program was established inthe exchange of publications between the Na-tional Information Center for Medical Sciencesof the Ministry of Health in Cuba and NLM. TheLibrary also accepted for special training Pom-peya Garcia, Director of the National MedicalLibrary of Cuba and Daisy del Valle, Director,Department of Information Development of theNational Information Center for MedicalScience.

Mary E Corning (center) and visitors from Cuba Daisy delValle (left) and Pompeya Garcia

The NLM provides interlibrary loans ofpublished and audiovisual materials interna-tionally for a fee. Exceptions have been madefor countries with which the United States

Agency for International Development has ahealth program. Under an agreement betweenAID and NLM, the Library has provided duringthe,past year approximately 22,000 interlibraryloans, 12 reference replies, 497 MEDLINEsearches, 52 subscriptions to Index Medicusand 48 subscriptions to Abridged IndexMedicus. Approximately 25 percent of thesewere for technical support of PAHO's RegionalLibrary of Medicine in Sao Paulo, Brazil; 36 per-cent to Turkey; 10 percent to India; 9 percent toIndonesia; and 7 percent to Korea. This agree-ment terminates at the end of FY 1978. Futureinternational interlibrary loan of documentsand loan of audiovisual material will be on a feefor services basis only.

Special Foreign CurrencyProgram

The Library's Special Foreign CurrencyProgram, authorized by Public Law 83-480,made 20 new awards in FY1978 for a total of 88active projects for $1,680,423 (equivalent).Under the NLM P.L. 480 program, appropria-tions of U.S.-owned, local foreign currenciesare utilized for scientific writing projects incooperating countries, including Poland,Tunisia, India, Pakistan, Egypt, and Yugoslavia.The collaborative NLM program is also con-tinued in Israel through a bloc award from theU.S.-lsrael Binational Science Foundation.

Included among the projects in the sevencooperating countries are the preparation ofcritical reviews and monographs analyzingbiomedical research and practice; translationsof foreign monographs in the health sciences;studies in the history of medicine; the publica-tion of major international symposia and con-ference proceedings; and the preparation andpublication of authoritative bibliographies,guides, and other literature tools in thebiomedical sciences. The program makes itpossible for the Library to procure and dissemi-nate published information which is importantto the progress of the biomedical sciences and

54


the public health, using foreign scientific per-sonnel and resources.

Critical reviews and biomedical monographscontinue to be the most frequent type of pro-ject undertaken in the program, constituting 66percent of the funding. Fifty-five percent of allprojects active in FY 1978 were undertaken intwo countries— Poland and Israel. During FY1978 Dr. Saul jarcho, Consultant to the NLMBoard of Regents, accompanied by Dr. JeanneBrand, Chief of NLM's International ProgramsDivision, carried out a program review of theLibrary's publication activities in Egypt. Amongother projects currently being developed in thatcountry is a series of studies in the history ofArabic medicine.

Examples of new projects activated in FY1978 include a critical review on surgery of thespleen; a translation of a Russian study of emo-tional stress and arterial hypertension, and acatalogue of manuscripts on medicine andpharmacy in the National Library of Cairo andthe Municipal Library of Alexandria, Egypt.

Recent publications resulting from the N LM Special ForeignCurrency Program (P L 480)

Among the books published in FY 1978under this program was Early Therapeutic,Social and Vocational Problems in theRehabilitation of Persons with Spinal CordInjuries (New York: Plenum Press, 1977),

edited by Professor Marian Weiss, Director ofthe internationally recognized RehabilitationClinic at Konstancin, Poland. Another signifi-cant study, funded in the NLM program inIsrael, reviews current development in familymedical practice— Jack H. Medalie, ed., FamilyMedicine — Principles and Applications(Baltimore: The Williams and Wilkins Co.,1978). (For a complete listing of books andjournal articles resulting from the NLM P.L. 480program received in FY 1978, see Appendix 3).

Regional Resources andBiomedical Information

The PAHO Regional Library of Medicine(BIREME) continues as a model activity in serv-ing as a regional biomedical and health informa-tion resource. Its extensive activities include ex-change of materials, reference services, in-terlibrary loans, computer-based informationservices from the MEDLARS data base, anddeveloping a library network.

About 16 percent of BIREME's annual budgetis provided by PAHO's regular budget, 7 per-cent from WHO, and 77 percent from externalsources including federal, state, and localgovernments of Brazil and from philanthropicagencies. The staff of the Library has increasedfrom 23 in 1969 to 71 in 1978. The most signifi-cant aspect of this increase is the addition ofphysicians and especially trained professionalpersonnel. Since 1969, BIREME has performed288,000 loan services; prepared 8,255 specialbibliographies; obtained and donated 309,000journal issues to other Latin American librariesto strengthen their collections; and has pro-vided specialized training to 324 Latin librarians.

Dr. Cummings, Director of NLM and Chair-man of the Scientific Advisory Committee forBIREME, attended the Tenth Meeting of theCommittee in Sao Paulo, Brazil. The Committeereviewed both policy considerations and theoperational status of BIREME.

55


The Pahlavi Library of Medicine, establishedin Tehran, Iran, in 1975, has recruited andtrained additional staff. It has also initiated anaudiovisual program to assist the health com-munity and has increased its specialized staff. InJanuary 1978 the World Health Organization(WHO) designated the Pahlavi Library ofMedicine as a WHO Regional Center for provid-ing biomedical information services to theWHO Eastern Mediterranean region.

Cooperation is being initiated between theWorld Health Organization's Advisory Commit-tee on Medical Research and the National Li-brary of Medicine. The National Library ofMedicine will produce a specialized recurringbibliography in those tropical diseases selectedby WHO for primary emphasis. The PahlaviLibrary of Medicine will print it and the WHOwill distribute approximately 10,000 copies.This model activity, when tested, may serve asabasis for developing further specialized infor-mation services and products significant fordeveloping countries.

Visitors and SpecializedTraining

NLM receives about 1,000 international visi-tors annually. During FY 1978 these individualsrepresented 49 countries and many interestssuch as medical research and education, healthcare, information and library science, ad-ministration and development of biomedicaland health information programs, and con-struction of new library buildings.

Formal delegations from japan includedrepresentatives of the Ministry of Health andWelfare, the Diet Library, and computer and in-formation organizations. Groups of Librarianscame from Brazil, Spain, Germany and Colom-bia. Delegations from Italy were from the Minis-try of Health and the National Federation ofMedicine which included the Chief of theCabinet of the Ministry of Health, members ofthe Italian Parliament, and physicians.Australian visitors have included Senator David-

son; Mr. K.W. Edmondson, Secretary of the Na-tional Health and Medical Research Council;Mr. ). G. Burt, the Assistant Director General,Department of Health; Dr. G.N. Lance, theChief Research Scientist, CommonwealthScientific and Industrial Research Organization;and, from the National Library of Australia, Mr.Bryan Yates, the Deputy Director, Mr. A. Ellis,the Assistant Director General for Networks andCoordination, and Mr. T. Barley, the Chief ofComputer systems. N LM also assists other agen-cies in receiving and preparing programs for in-formation specialists from other countries.

In connection with NLM's bilateral MEDLARSagreements, NLM has received a number of in-dividuals for specialized programs. They in-clude: George Milligan of the Institute for Medi-cal Literature, South African Medical ResearchCouncil, for training in indexing medicalliterature and searching the various NLM databases; Fahimeh Shafaie of the Pahlavi Library ofMedicine in Iran for training in audiovisual; Dr.Cesar Macias of the National Center for Infor-mation and Documentation in Health of theMinistry of Health, Mexico, for advanced train-ing as a search analyst; and Caterina Vollono ofthe Istituto Superiore di Sanita in Rome, Italy,for training in searching the various NLM databases.

The NLM does not have nor does it fund aformal program for trainees from abroad. Itdoes, however, try to respond to special re-quests from other governments or institutionswhere a person's experience qualifies him forspecialized training which can be applied uponhis return home. Some of those in suchprograms were: Pompeya Garcia, Director ofthe National Medical Library in Cuba; Daisy delValle, Director of the Department of Informa-tion Development of the National InformationCenter for Medical Sciences, Ministry of PublicHealth, Cuba; Dr. med. Oystein Wendelbo,Deputy Librarian, University Library of Bergen,Norway; and Dr. Reinhard Bradler from theGerman State Library, Berlin, East Germany.

56


In June, Miss Corning served as a consultantto the Subcommittee on Health Manpower andMedical Education of the U.S.-Egyptian Work-ing Group on Health during the latter's meet-ings in Egypt. She discussed with Egyptianofficials their interests, needs, and desires inbiomedical and health information. The Assis-tant Director also reviewed, with the World

Health Organization Regional Office in Alex-andria, the Egyptian medical library scene,WHO's designation of the Pahlavi Library ofMedicine in Iran as a WHO Regional Library,WHO's plans for developing a medical librarynetwork in the region, and WHO's plannedhealth information system.

57

Appendix 1: Staff BibliographyThe following works were published by National Library of Medicine staff in FY 1978

Bachrach, C A and Charen, T Selection of MEDLINE contents, the development of its thesaurus,and the indexing process Medical Informatics 3 (3), 237-254, 1978

Beckelhimer, M A, Cox, ) W, Hutchms, ) W, and Kenton, D L The MEDLINE hardware and soft-ware Medical Informatics 3 (3), 197-209, 1978

Brand, J L Evolutionary years of American neurology, 1865-1875 Proceedings of the 25th Interna-tional Congress for the History of Medicine Quebec, 1977, Vol 2, pp 507-521

Bndgman, C F An audiovisual learning resource at the' National Library of Medicine BiosciencesCommunications 4 (2), 134-41, 1978

Brooke, M L , Lasco, R A , and Lawrence, A D Teaching higher level mental processes with motionmedia Improving Human Performance Quarterly 7 (1 ) , 197-203, 1978

Chapman, G I and Ford, W H LHC-Pilot Systems Guide A Lister Hill Technical Report (No TR7802) Springfield, Va, National Technical Information Service, May 1978, 44 p

and LHC-PILOT User Guide A Lister Hill Technical Report (No TR-7801) Springfield,Va, National Technical Information Service, May 1978, 77 p

Cosmides, C ) (Ed ) Symposium on the Handling of Toxicological Information, May 27-28,1976,National Institutesof Health Report No PB-283164 Springfield, Va , National Technical Infor-mation Service, 1978, 228 pp

The Toxicology Information Program Ibid, pp 21-28Cummmgs, M M Scholarship and sarcoidosis Mount Sinai journal of Medicine 44 (6), 704-705,

1977Day, MS Les activites d'IST aus Etats-Unis In Pohtiques et Systemes d'Information Scientifique

La Revue de L'Association des Universites Partiellement ou Entierement de Langue Fran-caise Bibliotheque Nationale du Quebec, June 1978, pp 88-99

_____ On-line systems and national policy In Kent, A and Calvin, T | (Eds) The On-line Revolu-tion in Libraries New York, Marcel Dekker, Inc, 1978, pp 85-94

Survey of health bibliographical information systems In Shires, DF and Wolf, H (Eds)MEDINFO 77 Second World Conference on Medical Informatics Toronto, Aug 8-12,7977 New York, North Holland, 1977, pp 297-300

Doszkocs, T E An associative interactive dictionary (aid) for online bibliographic searching In Bren-ner, EH (Comp ) The Information Proceedings of the ASIS Annual Meeting White Plains,New York, Knowledge Industry Publications, Inc 1978, Vol 15, pp 105-109

___ An associative interactive dictionary for online bibliographic searching In Moneta, J (Ed) In-formation Technology New York, North-Holland Publishing Company, 1978, pp 489-492

Flint, C Legal and ethical aspects of proprietary rights to federally funded media programs journal ofBiocommunications 4 (3), 9-17, 1977

Ford, W H Interactive graphics system under MUMPS (Massachusetts General Hospital Utility Multi-Programming System) In Zapolm, 1977 St Louis, Mo , MUMPS Users Group, 1978, pp 28-40

Eisenberg, L ) , Standing, R A , Tidball, C S, and Leiter, | MEDLEARN A computer-assisted instruction(CAI) program for MEDLARS Bu//etm of the Medical Library Association 66 (1), 6-13,1978

Erdman, B The role of communications for providers and consumers of health services, educationand research information, In Day, SB, Cuddihy, R V and Fudenberg, HH (Eds) TheAmerican Biomedical Network Health Care Systems in America Present and Future SouthOrange, N ), Scripta Medica and Techmca, 1977, pp 91-102

Goldstein, C M and Ford, W H Lister Hill Center plasma terminal system and implications for medi-cal networks In New Directions in Educational Computing, Proceedings, 1978 ADCIS Con-ference, Dallas, Texas Akron, Oh, Association for the Development of Computer-Based In-structional Systems, University of Akron, 1978, pp 48-60

Henderson, B E High and mighty teleconferencing a state-of-the-art report Biomedical Com-munications 6 56-8, 1978

and Breeden, TD Visual teleconferencing experiments via a 14/12 GHz satellite system

58

American Institute for Aeronautics and Astronautics 7th Communications Satellite SystemsConference, April 28, 1978, pp 1-7

Kassebaum, L , and Leiter, | Training andcontinuing education for on-line searching Medical Infor-matics 3 (3), 165-175, 1978

Kenton, C and Scott, Y B MEDLINE searching and retrieval Medical Informatics 3 (3), 225-235,1978

Kissman, H M Projects of the Toxicology Information Subcommittee of the DHEW Committee toCoordinate Toxicology and Related Programs In Cosmides, G J (Ed) Symposium on theHandling of Toxicological Information, May 27-28, 1976 Report No PB-283 164 Springfield,Va, National Technical Information Service, 1978, pp 54-57

Lyon-Hartmann, B and Goldstein, C M Recommended data elements for the descriptive catalogingof computer-based educational materials in the health sciences Library Resources and Techni-cal Services 22 191-5, 1978

McCarn, D B MEDLINE users, usage and economics Medical Informatics 3 (3), 177-183 1978MEDLARS/MEDLINE In Ralston, A and Meek, CL (Eds) Encyclopedia of Computer

Science New York, Mason/Charter Publishers, 1976, pp 880-881McCarn, G H The on-line user network Organization and working procedures Medical Infor-

matics 3 (3), 211-223, 1978Mehnert, R B National Library of Medicine The Bowker Annual of Library and Book Trade Infor-

mation New York, R R Bowker Co , 1978, pp 72-76Schoolman, H M and Bernstein, L M Computer use in diagnosis, prognosis and therapy Computers

are used to stimulate the reasoning of expert clinicians Science 200 826-931, 1978Schultheisz, R ) , Walker, D F , and Kannan, K L Design and implementation of an on-line chemical

dictionary (CHEMLINE) journal of the American Society for Information Science 29 (4),173-179, 1978

Simon, R C and Doszkocs, T E Implementation of a user interface for a complex numeric/textualdatabase In Brenner, E H (Comp) The Information Age in Perspective Proceed ings of theASIS Annual Meeting White Plains, New York, Knowledge Industry Publications, Inc 1978,Vol 15, pp 309-313

Spann, M L, Chu, K C, Wipke, W T, and Ouchi, C Use of computerized methods to predictmetabolic pathways and metabolites lournal of Environmental Pathology and Toxicology 2123-131, 1978

Sparks, SM Letting the computer do the work American lournal of Nursing 78 (4), 645-657,1978____ On-line information systems HPEER (Health Professions Educators Exchange of Research)

Newsletter 7 (3), 3-7, 1978and Mitchell, G E The National Medical Audiovisual Center lournal of Nursing Education

17 (1), 29-34, 1978Stermck, B R MEDLINE data communications Medical Informatics 3 (3), 185-195, 1978Suthasmekul,S Telephone biotelemetry lournalof Clinical Engineering 3 137-44, April-June 1978____ and Thoma, G R Adaptive delta modulation coding for telephone biotelemetry of ECG Pro-

ceedings of the 73th Annual Meeting, Association for the Advancement of Medical Instru-mentation, March 29-Apnl 1, 1978 Arlington, Va , Assoc for the AMI, 1978, p 258

Tonkery, D and Mcllvane, M E Bibliographic control of nonprmt educational material lournal ofBiocommumcations 5 (2), 28-30, 1978

Vasta, B M and Kissman, H M Meeting the needs for toxicology information In Proceedings of aSymposium on Implementation of the Toxic Substances Control Act Washington, DC,American Chemical Society, 1978, pp 13-17

Waserman, M ) Relieving parental anxiety John Warren's 1792 letter to the father of a burned childNew England lournal of Medicine 299 135-6, 1978

< and Clausen, C Index to lournal of the History of Medicine, Vols 1-30, 1946-1975 1978,131 pp

59

Appendix 2: Grant-Supported PublicationsAlexander, John T. Charles de Mertens, An Account of the Plague Which Raged at Moscow, 7777.

London, 1799. Introduction and annotated bibliography, pp. i-v, I-6. Newtonville, Mass.:Oriental Research Partners. 1977. 39 pp.

Allen, Virginia E. " 'When We Settle Down, We Grow Pale and Die': Health in Western Indian Territo-ry," The lournal of the Oklahoma State Medical Association, Vol. 70, No. 6, June 1977, pp.227-232.

Binford, Chapman, and Connor, Daniel H. (eds.). Pathology of Tropical and Extraordinary Diseases.Vol. 1. Washington, D.C.: Armed Forces Institute of Pathology. 1976. 339 pp.

Chaff, Sandra L, Haimback, Ruth, Fenichel, Carol, and Woodside, Nina B. (comp., ed.) Women inMedicine. Metuchen, N.).: The Scarecrow Press, Inc. 1977. 1124 pp.

Chernin, Eli "Patrick Manson (1844-1922) and the Transmission of Filariasis," The American lournalof Tropical Medicine and Hygiene, Vol 26, No 5, September, 1977, pp 1065-1070

Davis, ).C., and Hunt, T.K.(eds.). Hyperbaric Oxygen Therapy. Bethesda,Maryland: Undersea Medi-cal Society, Inc. 1977. 348 pp.

DeFelice, Louis ]. "Fluctuation Analysis in Neurobiology," International Review of Neurobiology,Vol. 20, 1977. pp. 169-208.

Forbes, Thomas R. "A Mortality Record for Coldbath Fields Prison, London, 1795-1829," Bulletin ofthe New York Academy of Medicine, Vol. 53, No. 7, Sept. 1977, pp. 666-670.

"Coroners' Inquests in the County of Middlesex, England, 1819-42,"lournal of the History ofMedicine and Allied Sciences, Vol. 32, No. 4, Oct. 1977, pp. 375-595.

Downer's Quest. Transact ions of the American Philosophical Society Held at Philadelphia forPromoting Useful Knowledge, Philadelphia, Pa.: The American Philosophical Society, Vol. 68,Part 1, 1978. 52 pp.

Frieden, Nancy M. "The Russian Cholera Epidemic, 1892-93, and Medical Professionalization," jour-nal of Social History, Vol. 10, No. 4, Summer 1977. pp. 538-559.

Graham, O.H., and Hourrigan, ).L. 1977. "Eradication programs for the arthropod parasites oflivestock," lournal of Medical Entomology, 13 (6): 1977. 629-658.

Haber, Carole. "The Old Folks at Home: The Development of Institutionalized Care for the Aged inNineteenth-Century Philadelphia," The Pennsylvania Magazine of History and Biography,Vol. 101, No. 2, April 1977, pp. 240-257.

Hallenbeck, )ohn M., and Greenbaum, Leon )., )r. (eds.). Arterial Air Embolism and Acute Stroke.(The 13th Undersea Medical Society Workshop) Bethesda, Maryland Undersea MedicalSociety, Inc. 1977. 193 pp.

Harbach, R.E., and Knight, K.L. "Comparative and Functional Morphology of the Mandibles of SomeFourth Stage Mosquito Larvae (Diptera: Culicidae)," Zoomorphologie, Vol. 87, 1977, pp.217-236.

60

. ./'A Mosquito Taxonomic Glossary, XIV., The Larval Body (except Chaetotaxy)," MosquitoSystematic!. Vol. 10, No. 1, 1978. pp. 53-105.

"A Mosquito Taxonomic Glossary. XV. The Egg," Mosquito Systematic!, Vol. 10, No. 2,1978.pp. 249-299.

Hershkovitz, Philip. Living New World Monkeys (Platyrrhini). Vol. 1. Chicago: The University ofChicago Press. 1977 1,117 pp.

Howard, R.P. "Oklahoma Medicine in the First Year of the 46th State — 1908," Bulletin of theOklahoma County Medical Society, Vol. 49, May, 1977, p. 17.

Howard, R.P. "Chiropractic Licensing Was Defeated in Our Legislature in 1908," Bulletin of theOklahoma County Medical Society, Vol. 49, No. 8, Oct. 1977, p. 5.

"Guthrie and Logan County Medical Societies Since 1889," Bulletin of the Oklahoma Coun-ty Medical Society, Vol. 50, No. 3, March 1978, p. 33.

larcho, Saul. "Christopher Packe (1686-1749): Physician -Cartographer of Kent," Journal of the Histo-ry of Medicine and Allied Sciences, Vol. 33, No. 1, )an. 1978. pp. 47-52.

Kamp, Martin. Index to Computerized Teaching in the Health Sciences. San Francisco: Universityof California. Oct. 1975. 183 pp.

King, Lester. The Philosophy of Medicine; The Early Eighteenth Century. Cambridge, Mass.: Har-vard University Press, 1978. 291 pp.

Knight, Kenneth L., and Harbach, Ralph E. "Maxillae of Fourth Stage Mosquito Larvae (Diptera:Culicidae)," Mosquito Systematics, Vol. 9, No. 4, 1977. pp. 455-477.

Lomax, Elizabeth. "The Laura Spelman Rockefeller Memorial: Some of Its Contributions to EarlyResearch in Child Development," journal of the History of the Behavioral Sciences, Vol. 13,1977. pp. 283-293.

"Hereditary or Acquired Disease? Early Nineteenth Century Debates on the Cause of InfantileScrofula and Tuberculosis," journal of the History of Medicine and Allied Sciences, Vol. 32,No. 4, October 1977. pp. 356-374.

Lyle, Katherine Ch'iu, and Segal, Sheldon, J. (eds.). International Family Planning Programs,7966-7975; A Bibliography. University, Alabama: The University of Alabama Press. 1977. 207PP

Niebyl, Peter H. "The English Bloodletting Revolution, or Modern Medicine Before 1850," Bulletin ofthe History of Medicine, Vol. 51, 1977, pp. 464-483.

O'Neill, Ynez Viole. "The Funfbilderserie— A Bridge to the Unknown," Bulletin of the History ofMedicine, Vol. 51, 1977, pp. 538-549.

Rather, L.). "Langenbeck on the Mechanism of Tumor Metastasis and the Transmission of Cancer fromMan to Animal," Clio Medica, Vol. 10, No. 3, 1975. pp. 213-225.

61

Rosenberg, Charles E "The Therapeutic Revolution Medicine, Meaning, and Social Change in Nine-teenth-Century America," Perspectives m^Biology and Medicine, Summer 1977 pp 485-506.

"And Heal the Sick Hospital and Patient in 19th Century America," /ourna/ of Social History,Vol 10, No 4, 1977, pp 429-447

Sauer, | R "Acanne salivary glands-physiological relationships "I. Med fnt,Vol 14,No 1,1977 pp1-9

Savitt, Todd L "Slave Life Insurance in Virginia and North Carolina," The journal of Southern Histo-ry, Vol 43, No 4, November 1977, pp 583-600

Scott, Alwyn C Neurophysics New York, New York John Wiley & Sons 1977 340 pp

Sussman, George D "The End of the Wet-Nursing Business in France, 1874-1914 "Journal of FamilyHistory, Vol 2, No 3, Fall 1977, pp 237-258

"Enlightened Health Reform, Professional Medicine and Traditional Society The CantonalPhysicians of the Bas-Rhm, 1810-1870," Bulletin of the History of Medicine, Vol 51,1977, pp565-584

Vercammen-Grandjean, P H , and Langslon, R The Chigger Mites of the World Vol III Leptotrom-bidium complex Section A Leptotrombidium s str 612 pp Section B Trombiculmdus,'Hy-potrombidium & Encotrombidium, plus heterogertera 1061 pp Section C Iconography 298pp San Francisco, California George Williams Hopper Foundation of the University of Califor-nia, 1975

Wolf, Stewart G, and Berle, Beatrice Bishop (eds ) Limits of Medicine, The Doctor's lob in theComing Era. New York Plenum Press, 1978 155 pp

62

Appendix 3: PL-480 Supported PublicationsEdery, H , Ishay, J , Gitter, S, and Joshua, H "Venoms of Vespidae " In Handbook of Experimental

Pharmocology. New Series, Vol 48, pp 691-771

Eisenberg, Shlomo "Lipoprotem Metabolism and Hyperlipemia," /Atherosc/erosis Rev;ews, Vol 1,1976. pp 23-60

Globerson, A. "In Vitro Approach to Development of Immune Reactivity," Current Topics inMicrobiology and Immunology, Vol. 75, 1976, pp 1-43

Kochetkova, Veromka I Paleoneurology. With an Introductory Commentary and Editorial Contribu-tions by Harry ) Jerison New York' John Wiley & Sons, 1978, 340 pp

Kostyuk, P.G Structure and Function of the Descending Systems of the Spinal Cord Trans fromRussian. Jerusalem, Israel. Israel Program for Scientific Translations. 1977 220 pp

Mayer, Michael, and Rosen, Fred "Interaction of Glucocorticoidsand Androgens with Skeletal Mus-cle," Metabolism, Vol 26, No. 8, August 1977. pp 937-62

Medalie, Jack H. Family Medicine — Principles and Applications. Baltimore, Md The Williams &Wilkms Company 1978. 372 pp

Mittman, Charles, and Bruderman, Israel. "Lung Cancer To Operate or Not?" American Review ofRespiratory Disease, Vol. 116, 1977 pp 477-496

Nesmeyanova, Tat'yana N Experimental Studies in Regeneration of Spinal Neurons, with an in-troduction and editorial contributions by Donald Scott, Jr Trans from Russian by the AmerindPublishing Company New Delhi, India VH Winston Sons, Washington, D C 1977 267 pp

Piotrowski, Jerzy K Exposure Tests for Organic Compounds in Industrial Toxicology Cincinnati,Ohio U S Department of Health, Education, and Welfare, Public Health Service, Center for Dis-ease Control, National Institute for Occupational Safety and Health September 1977 138 pp

Shibolet, Shlomo, Lancaster, Malcolm C, and Danon, Y "Heat Stroke A Review," Av/af;on, Space,and Environmental Medicine, Vol 47, No. 3, March 1976 pp 280-301

Sidorova, V.F The Postnatal Growth and Restoration of Internal Organs in Vertebrates. Trans bythe Agence Tumsienne de Public-Relations, Tunis, Tunisia and printed by Amerind PublishingCo., New Delhi, India Dist. by PSG Publishing Co., Inc Littleton, Mass 1978 202 pp

Spira, Dan T , and Greenblatt, Charles L "International Symposium on Immunology and Im-munopathology of Malaria I" Israel Journal of Medical Sciences, Vol 14, No 5, May 1978pp. 503-616

Weiss, David W (ed.) "Immunological Parameters of Host-Tumor Relationships," Israel lournal ofMedical Sciences, Vol 14, No. 1, January 1978 200 pp

Weiss, Marian, et a/. Early Therapeutic, Social and Vocational Problems in the Rehabilitation ofPersons with Spinal Cord /n/ur/es. New York Plenum Press, 1977 378 pp

63

Wojtczak-Jacoszowa, Jadwiga. Physiological and Psychological Aspects of Night and Shift Work.Cincinnati, Ohio: U.S. Dept. of Health, Education, and Welfare, Public Health Service, Centerfor Disease Control, National Institute for Occupational Safety and Health, December, 1977. 88

PP

Zuckerman, Avivah. "Parasitological Review: Current Status of the Immunology of Blood and TissueProtozoa. 1. Leishmania." Experimental Parasitology, Vol. 38, 7975, pp. 370-400.

64

Appendix 4: NMAC Audiovisual Materials Produced

Motion PicturesMedical Emergencies in the Dental OfficeStaging the Advanced Cardiac Life Support Providers' CourseEffective Teaching

VideotapesDistinguished Leaders in Nursing series

Mabel Keaton StaupersLucile P. Leone

Functional Anatomy of the HypothalamusAcromegaly, Concepts in Diagnosis and TreatmentBuild Your Own Copy Stand (for less than $100.00)Health Science Consortium Dental Units

Diagnosis and Treatment Planning in EndodonticsPart 1: Clinical Pulp Testing

Oral Surgery Clinic RoutinePart 1: Sterilizing Oral Surgery InstrumentsPart 2: Patient Positioning and Preparation of the Instrument Tray for Clinical Oral SurgeryPart 3: Hand Scrub and Basic Protocol for Clinical Oral SurgeryPart 4: Establishing an Uninterrupted Intra-Oral Field

Cavitron Ultrasonic Dental Unit SeriesPart 2: Techniques of Operation

Clinical Procedures for Dental AssistantsPart 1: The Anesthetic Syringe

Root Canal Therapy on an Extracted Lower MolarPart 1: Access and Length DeterminationPart 2: InstrumentationPart 3: Obturation

Sharpening Penodontal InstrumentsPeriodontal PacksStandard Clinical Oral Surgery Instrument PackPatient-Operator Positioning in Dental HygieneThe Reshaping, Characterization and Glazing of Anterior Ceramo-Metal RestorationsDam Kids: Techniques of Rubber Dam Use With ChildrenMeasurement of Blood Pressure in Dental Practice

Removal of Animal Brains for Rabies TestingHealth Hazard AppraisalHandling the Tools of Your TradeSymposium— Exercise 1Symposium — Exercise 2Designing Medical Organizations (Underlying Concepts)Designing Medical Organizations (To Matrix or Not)Type-B Viral Hepatitis

65

Slide/TapesCross Anatomy Series

Male External Gen italiaFemale Pelvic VisceraPeritoneum and Endopelvic Fascia of the Female PelvisThe Perineum Part IThe Perineum. Part IIFemale External GenitaliaThe Thoracic Wall Part IThe Thoracic Wall Part IIThe Thoracic Wall Part IIIThe Thoracic Wall Part IVThe Breast

Human Physiology SeriesRenal Function IRenal Function IIThe Physiology of Cell Membranes and Biological TransportThe Regulation and Control of Peripheral CirculationThe Anatomy and Physiology of the Arterial SystemAcid-Base Balance- General PrinciplesMechanisms of Hemostasis and Fibrmolysis

Early Diagnosis of PregnancySpontaneous AbortionThe Menstrual HistoryEctopic PregnancyThe Complete Gynecologic HistoryThe Obstetrical HistoryEvaluation of a Child with a Hear Murmur Series

Evaluation of the MurmurThe Basis of the Pediatric Cardiovascular ExaminationDifferential Diagnosis

Evaluation of Cyanosis in the NewbornPlanning for Pediatric ScreeningFundamentals of MalariaHealth Science Consortium Dental Units

Normal PenodontiumPart 1 GmgivaPart 2 Penodontal Ligament, Cementum and Alveolar Bone

Diagnosis and Treatment Planning in EndodonticsPart 2 Pupal PathosisPart 3 Penapical Pathosis

Cavitron Ultrasonic Dental Unit SeriesPart 1 Introduction

Signs and Symptoms of GingivitisSigns and Symptoms of PenodontitisLaterally Positioned FlapG mgivectomy/G mgivoplasty

66

PrintFundamentals of MalariaThe Female Reproductive System

FilmstripsCaplura Y Preparation IV Animates De LaboratonoEl Diagnoslico l)e La luherc ulosisManifulacion De Animalcs Do I aboratonoLa Participacion De La CommunidadSaniamento En LI Matadcro

(•7

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