National Network of Libraries of Medicine

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Dragonfly

Winter 1999 -- Volume 30, Number 1

The newsletter of the National Network of Libraries of Medicine, Pacific Northwest Region.

In the current issue:

Tribal Connections Awards for Web-based Health Resources

PRESS RELEASE

The University of Washington has announced awards to 16 American Indian and Alaska Native communities in the Pacific Northwest as part of the Tribal Connections Project.

With funding from the National Library of Medicine, the Regional Medical Library at the University of Washington is connecting 16 American Indian and Alaska Native communities to the Internet. The aim is to improve access to social and health resources, emphasizing HIV/AIDS information.

The Tribal Connections Project will:

Work with American Indian/Alaska Native community leaders in health care, social services, and computer systems.
Fund installation of network wiring, buy computer hardware, and pay connection charges.
Provide training and user support to tribal agencies such as health departments, schools, tribal colleges, clinics, environmental agencies, and social service departments.
Help communities create their own Web sites in order to provide health information to the entire community and to share with others.

An Advisory Panel with broad representation, including American Indian/Alaska Native health professionals and experts in information and communication technologies for American Indian communities, provides guidance and oversight of the project.

Project Staff:

Roy Sahali, Project Manager
Chholing Taha, American Indian Resources Librarian
Linda Milgrom, Project Librarian
Michael Boer, Regional Medical Library Systems Coordinator
Nancy Press, Regional Medical Library Acting Associate Director
Sherrilynne Fuller, Ph.D., Regional Medical Library Director and Principal Investigator
Fred Wood, Ph.D., Project Officer at the National Library of Medicine

Successful Applicant Communities:

Alaska

Arctic Slope Native Association, Barrow
Norton Sound Health Corporation, Nome
South East Alaska Regional Health Consortium, Juneau
Toksook Bay (Yup'ik Eskimo), Toksook Bay

Idaho

Nez Perce Tribe, Lapwai

Montana

Fort Belknap Indian Reservation, Harlem
Fort Peck Tribes, Poplar

Oregon

Confederated Tribes of the Umatilla Indian Reservation, Pendleton

Washington

Lower Elwha Klallam Tribe, Port Angeles
Lummi Indian Nation, Bellingham
Nisqually Indian Tribe, Olympia
Samish Indian Nation, Anacortes
Sauk-Suiattle Indian Tribe, Darrington
Spokane Tribe of Indians, Wellpinit
Stillaguamish Tribe of Indians, Arlington
Suquamish Indian Reservation, Suquamish

Dragonfly, Winter 1999 -- Vol. 30, Number 1 (posted on PNRNews January 29, 1999)

Lawrence Livermore Fellowship Position for Tribal Connections

The Tribal Connections Project has received an extra boost from the Native American Program at the Lawrence Livermore National Laboratory. The Lab has funded a special student position to help Roy Sahali, our Tribal Connections Project Manager, maximize the impact of our project in the various communities. The money for this position was granted to the Division of Biomedical Informatics, within the Department of Medical Education, with Sherrilynne Fuller as P.I. A senior UW student, Del Chafe, has been hired to work with the 16 American Indian and Alaska Native communities that are receiving funding, equipment, and training from the RML. The Tribal Connections awards are targeted toward specific health care agencies and organizations within the tribes. Del Chafe's job will be to explore options for connecting even more agencies within each tribe to the Internet.

Dragonfly, Winter 1999 -- Vol. 30, Number 1 (posted on PNRNews February 1, 1999)

The Environment of Local Public Health: What Does Population-based Focus Really Mean?

So you want to work with your local public health department? Maybe they've contacted you for copies of articles. Or you see good reasons to establish a mutually beneficial relationship with them. As with reaching out to serve and collaborate with any group, it pays to know something about who they are and what they do.

What do you know about your local public health department? Who are their "customers?" Who funds them? To whom do they report? Typically, a local health department is part of county government, although in urban areas it may be a combined county-city entity, and in more rural areas several counties may form a single health district. This has implications for how an agency is organized and whom it reports to. All good things to know.

What does a local health department do? Some think that public health is about minimal medical care to poor people. That used to be truer than it is now in an era of managed care and an expanding domain of what constitutes public health concerns. Many health departments do provide some patient care (e.g., immunizations, STD clinics, prenatal screening, and nutrition counseling). But local public health has become much more than that. It is a mix of services designed to meet the needs of communities in preventing the spread of disease, protecting people from unsafe drinking water, air, and hazardous waste, and ensuring that people have the information and resources needed to live healthy lives. These are known as population-based services.

Who are the health professionals on staff? You may find every type represented, and then some. You may find physicians and nurses who also care for patients at the hospital or clinic. There are public health nurses who work in a variety of roles with child care centers and school districts, mental health and drug and alcohol treatment programs, and law enforcement agencies. There are environmental health specialists who inspect drinking water for bacterial or chemical contamination; who work with solid waste programs to insure safe disposal; who inspect restaurants and train food workers to prevent foodborne illness. In larger jurisdictions there will be epidemiologists and others trained in tracking infectious disease outbreaks. There are those who monitor the health status of a community. There are social workers and data analysts. The list is a long one and it depends on local needs and programs.

In a nutshell: Local public health is very broad. To those used to the clinical care environment it is also somewhat messy. Public health is the application of health science in a community context. It's science, but it's also politics. It follows that the information needs are very broad and overlap with subject areas that we don't usually think of as being health-related.

Clearly, MEDLINE isn't always the answer in this uncertain territory. Like their clinical counterparts, though, most public health workers will find PubMed to be an enormously useful tool and a great boon to their practice. But not all will. Environmental health is a good example of an information challenge encountered in public health. Much of it, of course, is directly concerned with human health (e.g., vector-borne pathogens and toxicology). But it also gets into other areas such as surface and ground water use, sewer and septic system inspection and permitting, sanitation codes and practices, -- you get the idea.

The point is not to be discouraging. A librarian trained in working with health professional information needs has a tremendous amount to offer public health workers. Just be aware that many needs, and the resources to meet them, go beyond those that most of us are familiar with. No need to be daunted by that. As a librarian, you have information retrieval and evaluation skills that are of great value to this audience. Show them PubMed and other NLM resources, but also demonstrate how to do a smart and effective Web search. Show how to efficiently separate useful items from the other stuff and their time will have been well spent.

Other than providing brief and basic introductions to PubMed, what can you offer? Copies of articles and Loansome Doc service are sure to be popular. The public health nurses may be your most enthusiastic customers, but they probably aren't used to obtaining articles (or paying for them). This could be a good opportunity to let staff know what services you offer. Many of them won't know what's available.

Other thoughts on the local public health environment:

Public health practice is much more data-based than knowledge-based. This is part of the nature of the enterprise. When tracking an outbreak of E. coli O157, you are more concerned about numbers of victims, where they are, and how they were exposed, than you are about research on the organism and its effects on its host. (If you were treating a victim, though, -- a clinical rather than a population focus -- the opposite would be true.)
But the practice of public health is developing as a discipline. Its own body of knowledge -- one that is distinct from medicine or, say, public administration -- is growing. Similar to other fields in this process, public health practice will become more knowledge-based as the knowledge base about it grows.

A related factor is the pressure for accountability. The focus on program evaluation and outcomes is encouraging a look at best practices in designing community interventions, for example. Increasingly, local public health is an information service: It gathers, compiles, analyzes, synthesizes, interprets, and disseminates population-based information about the health of the community.
Local health departments are strongly oriented toward the state health department. Although independent entities, the locals look to the state for leadership, coordination, and funding. It's a good idea to spend some time combing through the state department's Web site to get an idea of what resources and data are there. This will be a limited view because it's only what is publicly available. Much of the traffic between the local and state levels is sensitive data, increasingly available to authorized users over a secure intranet. Nevertheless, the state health department's Web site will give you a glimpse of what's happening and some of that will be reflected at the local level too.
At the top of the public health hierarchy is CDC. CDC sets much of the public health agenda that other levels of the hierarchy then carry out. Learn its Web site (warning: it's not always easy to get around) and you've taken a step toward anticipating what questions you may be asked by your local public health workers. You will look good if you know where immunization guidelines can be found: you might try Travelers Health, and the Prevention Guidelines Database, but don't forget to use the Search tool to find other important documents. Know how to retrieve a recent issue of the Morbidity and Mortality Weekly Report (MMWR): in PDF format from the MMWR pages and in HTML from the MMWR dataset in the CDC WONDER search system.

Public health professionals, like all practitioners, need one-stop-shopping. This is never truer than for information resources that are notoriously scattered. Two Web sites that attempt to answer some of that need are the Northwest Center for Public Health Practice and the Washington INPHO sites:

http://healthlinks.washington.edu/nwcphp/ and http://healthlinks.washington.edu/inpho/

These sites attempt to organize relevant and authoritative resources. From the NWCPHP page, note in particular the Tools and Calendar features (buttons on the control panel). From the INPHO page, follow the links for Diseases, Injuries & Disabilities => Infectious Diseases => Disease Specific Resources. These specific disease pages are examples of a practitioner's "information toolkit." They are categorized templates for the kinds of information a public health professional might need. They are pre-packaged and ready to serve.

The focus of both sites is Washington State but much is applicable beyond state borders. Feel free to refer to these resources if they would be useful in your setting. I welcome any comments or suggestions on how to improve them: Neil Rambo, nrambo@u.washington.ed, 206-616-3472.

Dragonfly, Winter 1999 -- Vol. 30, Number 1 (posted on PNRNews March 10, 1999)

1999 Local Outreach Awards Available

"It's a brand new world for many of them. When you show them the resources they can get, things they didn't know were out there, they are really excited. And they are really grateful. It re-energizes you and makes you remember why you went into the profession."

A previous Outreach Award recipient, a librarian, was talking about her experience with the health professionals she "reached out to" through her funding. This year the NN/LM PNR is refocusing and expanding its outreach efforts by making funding for Local Outreach Awards available not just for Network Member Libraries but also for those organizations that we consider our Outreach Partners. Outreach Partner organizations are non-profit healthcare organizations or associations whose outreach goals are closely aligned to those of the NN/LM PNR. They should represent health professionals in our target population of unaffiliated health professionals described in the next paragraph. It is also advantageous to have a working relationship with the NN/LM PNR. Examples of our Outreach Partners are the Northwest Regional Primary Care Association and similar organizations representing primary care practitioners, AHECs in the states of our region, and health departments in the region, both county and state.

Any proposal, which targets health professionals who lack adequate access to health care information and who are not affiliated with an institution that has a medical library, will be considered, but those that address the NN/LM PNR's specific target populations will receive priority. We focus our outreach efforts on healthcare professionals located in rural or under-served areas, those serving primarily minority populations -- in either inner city or rural areas, or public health workers. NN/LM member libraries and Outreach Partner organizations are invited to submit project proposals that will complement and extend the NN/LM outreach mission.

To find out more, go to http://www.nnlm.nlm.nih.gov/pnr/rfq/1999/

If you're still hesitating, wondering what you would do, then think about:

providing information access training, including Internet, Internet Grateful Med, MEDLINEPlus or PubMed, to a state association for nurse practitioners, physician assistants, pharmacists, or other health professionals that are not normally served by medical libraries.
doing an exhibit and hands-on training at an annual meeting of environmental health officers, public health nurses, or other public health workers.
training primary care clinic workers, such as those in migrant worker clinics or urban clinics, to use the Internet and then assisting them in developing a home page.
extending library service, including PubMed training and Loansome Doc services, to a nearby clinic, long-term care facility, or community agency.

Summaries of past outreach proposals that we've funded are at:

http://www.nnlm.nlm.nih.gov/pnr/rfq/1999/grantsummaries.html

Applications are due April 30, 1999, and awards will be made within one month. The number of awards will depend on the projects chosen and their budgets. We are planning to fund two or three proposals, each up to a maximum of $5,000. The period of performance for any proposal should begin after July 1st 1999 and should not go beyond July 31, 2000. Also, since these are purchase orders funds will not be disbursed until invoices are presented for expenses incurred.

If you have questions please contact Nancy Press, Acting Associate Director (pressno@u.washington.edu) or Maryanne Blake, Outreach Coordinator, (blakema@u.washington.edu).

Dragonfly, Winter 1999 -- Vol. 30, Number 1 (posted on PNRNews March 12, 1999)

Web Access to CATLINE, SERLINE, AVLINE

NLM is preparing to provide public access to its new Integrated Library System, "NLM Locatorplus," in mid-April 1999. Locatorplus, which replaces CATLINE, SERLINE, AVLINE, and Locator will be available from the NLM Home page at http://www.nlm.nih.gov/.

A web tutorial on how to use Locatorplus will soon be announced in the electronic NLM Technical Bulletin. In addition, Reference and Customer service staff have prepared a number of FAQs regarding Locatorplus that will be available at http://www.nlm.nih.gov/services/faq.html as of mid-April 1999.

Some wonderful new features will be available via Locatorplus:

One can view current receipts of serials and monographs (effective with 1999 receipts).
Books, audiovisuals and journals can be searched together or separately.
Searches can be limited to the history of medicine collection or reference collections.
Hotlinks to online journals will be available from many records.
One can search on such field specific areas as indexing status or conference name.
Direct access to other resources will be available through Locatorplus including NLM databases, MEDLINEplus, Images from the History of Medicine, TOXNET, HSTAT, and other medical library catalogs.

NLM is excited to be able to provide, in one integrated product, so much information directly to customers. There are more parts to total NLM system reinvention efforts and more work to be done, but the ILS/OPAC functions are sound and ready to be shared.

Because reinvention is not complete, DOCLINE will continue to point to the old SERLINE, CATLINE and AVLINE databases until Fall 1999 when a brand new DOCLINE arrives. This is not a problem for borrowing journals, because serial titles will be added to both Locatorplus and SERLINE, but is a problem for ordering monographs and audiovisuals. Since CATLINE and AVLINE are no longer being updated, new records for monographs and audiovisuals will appear only in Locatorplus. These records will contain NLM UIs which will not be recognized by DOCLINE. ILL requests for these new items will require the user to type the bibliographic information and call number into DOCLINE in order to initiate the loan.

Questions, comments and suggestions regarding this launch can be sent to: custserv@nlm.nih.gov

Dragonfly, Winter 1999 -- Vol. 30, Number 1 (posted on PNRNews March 2, 1999)

Will OCLC/WLN merger affect SERHOLD (or vice versa)?

We have had several questions from SERHOLD participants about the effect of the OCLC/WLN merger. Two main points:

We don't know.
Whatever it is, we want to continue our concept of maximum benefit for minimum effort (you fill out just one form for both SERHOLD and your other system).

All of the Pacific Northwest states are potentially affected.

Washington SERHOLD libraries have taken advantage of a conversion program (thanks to Susan Klawansky's grant writing), so that SERHOLD holdings get transfered by the RML to WLN. We will continue to send the Washington SERHOLD data to WLN for the forseeable future. New conversion programs could be a good solution to our problem of updating multiple databases easily.

Oregon SERHOLD libraries fill out one multipurpose form that is used both by our office and by OCLC. This form might even be a prototype to be used in other parts of the region!

Many of you in Alaska, Idaho, and Montana also participate in OCLC or WLN and might be able to take advantage of greater cooperation.

Another piece of the pie: NLM is converting *all* of the SERHOLD data to MARC format, which will make it much more interchangeable with other databases.

So, we only see cooperation growing, not declining. We would welcome any opportunities you see in your own states for working with other types of libraries, your state library, or your database company. Just let us know!

Dragonfly, Winter 1999 -- Vol. 30, Number 1 (posted on PNRNews January 28, 1999)

Time to Check Your SERHOLD data

You may update your SERHOLD data at any time during the year for DOCLINE to look at, but we only refresh our SERHOLD products once or twice during the year. We'll soon be requesting our spring SERHOLD data refreshment from NLM from which we make state union lists.

Since SERHOLD and DOCLINE are moving to the Web this year--exact date unknown, we don't know when we might be able to get our fall update.

So, now's the time! Please check your SERHOLD data to make sure that they are accurate! The more accurate your data, the better DOCLINE will work for everyone. Please get your changes in before the end of March.

You can get the latest version of your SERHOLD holdings list (as of September 2, 1998) from the NN/LM server: http://www.nnlm.nlm.nih.gov/pnr/serhold/ftp.select.html. Changes sent to us since July will not be there, but rest easy that changes are in the version of SERHOLD used by DOCLINE. (We'll also refresh these FTP lists when we get the new data.)

Instructions for updating your SERHOLD list are at: http://www.nnlm.nlm.nih.gov/pnr/serhold/.

If you do not have access to the Web or to FTP and need your list or the updating information on paper, please let the NN/LM PNR know and we will provide whatever pieces you need.

We want to make SERHOLD updating simple and efficient for you.

Dragonfly, Winter 1999 -- Vol. 30, Number 1 (posted on PNRNews March 3, 1999)

Don't charge extra for LDD requests!

As PubMed gets easier and better, more and more of our library users will find out about good articles and will want an effective way to request those articles from their libraries. Loansome Doc is perfect--especially for the librarian! What would you rather receive: 1) a scratchy note with misspellings and an unreadable date or 2) a perfect request that comes to you through a medium you already use every day--DOCLINE?

You can't tell if a Loansome Doc request from another library (an LDD request) is from the library's primary users or an outsider. The vast majority of Loansome Doc requests in our region are made by primary users who are requesting articles from their own institution's library. Similarly, a non-LD DOCLINE request might very well be for an unaffiliated, paying customer of the requesting library.

So, please don't penalize your fellow librarians who have learned to take advantage of Loansome Doc! If you need to know if a user is affiliated with the requesting library, you'll have to find another way (perhaps asking the requesting library to tell you in the comment line). Nothing about Loansome Doc requests reveals affiliation or lack thereof!

Dragonfly, Winter 1999 -- Vol. 30, Number 1 (posted on PNRNews March 23, 1999)

Try being a Loansome Doc USER!

Whether you are the library director, an ILL technician, or at a one-person library, this little exercise is sure to give you insight into NLM's fast-growing Loansome Doc service. It's free, and it could be very educational! Find out what your patrons do when they request articles from you.

Start by doing a search in PubMed and selecting an article to order -- just click in the little box next to an article. You can just follow the instructions on the screen, but I've also listed all the steps here:

Click on the [Order] button ("ORDER documents on this page through Loansome Doc").
Loansome Doc preview screen shows what documents you have selected. Click on the [Order] button to procede."
Under the "If you are new... Learn about registering," select "USA," then click on the [Go] button.
Click on the [Registration] (at the bottom of the page).
Fill out the registration form. Use your own library's ID as the Ordering Library ID, and make up a patron--make up whatever you want for the name, address, userid and password. Then click on [Register].
You will get a Loansome Doc Confirmation Screen that says, "Registration Successful."
Click on [Send Order].
You will get a Loansome Doc Confirmation Screen that says "Order Accepted."

The request will show up in your library's DOCLINE. To read the request choose DOCLINE menu option #7: LD Receipt.

Do another search, order, and enter your userid and password--as a patron does when he or she is already registered. You will find out how simple it is for your patrons to request articles.

Since these are fake requests, just update as FILLED. (Your statistics will improve!)

Dragonfly, Winter 1999 -- Vol. 30, Number 1 (posted on PNRNews March 24, 1999)

New Feature for Our Web Newsletter

Beginning with Winter 1999 Dragonfly, you can now print out the entire issue--to date--in one fell-swooping print statement. Just remember that we keep adding to an issue all quarter long, so the issue you print won't be complete until the quarter has ended. Look for the new link following the list of articles in current issue's index.

Dragonfly, Winter 1999 -- Vol. 30, Number 1 (posted on PNRNews April 1, 1999)

Produced by NN/LM PNR.

Nancy Press, Editor
Michael Boer, Publication Manager

This publication is funded in whole with Federal funds from the National Library of Medicine, National Institutes of Health, under Contract No. NO1-LM-1-3516.

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NN/LM PNR | nnlm@u.washington.edu | Revised: October 19, 1999