In This Issue:
"Breath
of Life" Exhibition Opens
LOCATORplus
on the Web
Reading
Room, Rotunda Update
NGC
Web Site Goes Live
African-American
Health Issues, Voting Rights
Elizabeth
Blackwell, M.D.
Worthy
of Note
Louise
Darling Dies at 87
Lederberg's
Papers on "Profiles" Site
The
"Difficult Woman"
MLA
Time Capsule
HBCU
Explores Internet
Older
Adults and the Web
In Every Issue:
Names
in the News
Products
and Publications
NLM
in Print
|
National Guideline Clearinghouse Web Site Goes Live on
Internet
Information on Latest Clinical Practice Guidelines Now
Available
National Guideline Clearinghouse (NGC), an exciting new free web-
based library resource for up-to- date, evidence-based clinical
practice guidelines, went live on the Internet December 15, 1998 at
www.guideline.gov. Developed by the Agency for Health Care Policy
and Research (AHCPR), in partnership with the American Medical
Association and the American Association of Health Plans, the NGC is
designed to promote quality health care by making available
information on the latest clinical practice guidelines that are
based on scientific evidence, all in one easy-to-access
location.
The design of the NGC has incorporated previous research funded
by the Department of Health and Human Services. The classification
system for NGC is derived, in part, from NLM's Unified Medical
Language System. Bi-directional links exist between NLM's PubMed and
Health Services/Technology Assessment Text (HSTAT). The form of the
structured abstract of clinical practice guidelines in NGC was based
on research funded collaboratively between AHCPR and NLM. The
definition of what constitutes a clinical practice guideline was
taken from work completed by the Institute of Medicine under the
sponsorship of AHCPR.
Development of clinical practice guidelines has grown rapidly
over the last ten years. This growth reflects increased interest in
improving the quality of clinical practice, reducing uncertainty and
variability in health care decision making, and stemming rapidly
increasing health care costs. However, many health care
practitioners, health care systems, and health care purchasers have
difficulty gaining access to and keeping abreast of the many
clinical practice guidelines currently in use. This NGC web site is
the first to provide free and comprehensive access to objective,
detailed information on clinical practice guidelines.
Civil Rights is the Common Denominator
NLM celebrated African-American History Month this year with a
special program on February 11th in the Lister Hill Auditorium. Two
speakers were featured. Former NLM visiting scholar Dr. David
McBride now heads the African/African-American studies department at
Penn State University. For the first half- hour of the program, he
discussed "The African-American Medical Experience: Perspectives and
Prospects." He was followed by Elena Temple, press secretary for
Cong. Albert R. Wynn (D-MD). Temple filled in for her boss, who had
to remain on Capitol Hill for a key Commerce Committee vote. She
took a different tack from Dr. McBride's and discussed the
importance of all Americans, and blacks in particular, exercising
their right to vote.
In his thought-provoking lecture, Professor McBride examined the
divide that exists between many in the black community and the
medical establishment. He presented several troubling anecdotes of
African-American persons' encounters with the medical establishment
in the pre-civil rights era. In one, a girl named Audre had her
first experience with medical care at the age of three or four.
During an eye examination, a cold, unsmiling doctor offered no
explanation as he subjected her to medical instruments and
procedures that were strange and painful. Before leaving his office,
the frightened child overheard the doctor and his colleagues
discussing her "peculiar eyes" and the fact that "from the looks of
her, she's probably simple, too." The little girl, who grew up to be
poet Audre Lorde, was crestfallen. And those unpleasant moments at
the doctor's office would shape her views of medical care for the
rest of her life.
Such sentiments could be held by any one of the millions of
African Americans reared in the pre-Civil Rights era, according to
Dr. McBride.
"America has one of the largest and most scientifically advanced
health care systems in the world," he said, "yet throughout its
development, this medical care system has been unable to eliminate
serious gaps in the health status of America's largest racial
minority, African Americans." To illustrate his point, McBride noted
that in 1985 it was estimated that about 60,000 excess deaths
occurred among blacks, compared to whites. By 1990, the figure had
actually risen, to at least 80,000. These discrepancies persist
today, he explained, due to higher rates of cancer, heart disease,
stroke, diabetes, homicide and HIV among the black population. The
author of several books on health inequities among minority
populations, McBride has devoted much of his career to researching
why so many African Americans have fallen through the cracks of the
U.S. health care system and how improvements can be made in the
future.
Praising the government's recently announced $400 million effort
to end disparities in health care by 2010, McBride said that two
strategies could go a long way toward closing the gaps in the U.S.
medical care system: development of more and better preventive
medicine models and increased involvement on the part of community
and private industry leaders. Elected in 1992, Rep. Albert Wynn
currently serves on the Commerce Committee, where he is a member of
the Subcommittee on Telecommunications, Trade and Consumer
Protection, as well as the Energy and Power Subcommittee. He is also
a Deputy Democratic Whip and a member of the Democratic Message
Group. Speaking on his behalf, his press secretary, Elena Temple,
talked about the long, difficult struggle of African Americans to
achieve equal voting rights. She urged their descendants not to take
the right to vote for granted. She also refuted an untrue rumor that
is circulating via e-mail and other media, that the 1965 Voting
Rights Act and the 15th amendment to the Constitution will expire in
2007, leaving blacks without the right to vote.
Temple urged her audience not to worry about preserving access to
the voting booth, but to make the best use of the access already
provided and guaranteed. "Assess your values, assess your actions,"
she said in closing. "Our enemy in the new millennium is
apathy."
Exhibit Examines Triumphs, Trials of Elizabeth Blackwell,
M.D.
One hundred and fifty years ago, on January 23, 1849, a young
woman ascended the platform of the Presbyterian church in Geneva,
N.Y., and received from the hands of the President of Geneva Medical
College a diploma conferring upon her the degree of Doctor of
Medicine. Thus, after many years of determined effort, Elizabeth
Blackwell became the first woman to complete a course of study at a
medical college and receive the M.D. degree.
In commemoration of this event, the National Library of Medicine
has mounted an exhibit entitled "'That Girl There Is Doctor in
Medicine': Elizabeth Blackwell, America's First Woman M.D." The
exhibit, curated by Carol Clausen of the Library's History of
Medicine Division (HMD), is located at the entrance to the HMD
Reading Room, just off the NLM lobby (Building 38). Items
illustrating Blackwell's admission to medical school, her
experiences as a medical student, her graduation, and her subsequent
medical career are displayed.
When her initial attempts to gain admission to a well-established
medical school met with failure, Elizabeth persevered, applying to a
dozen smaller colleges. As she recounted in her autobiography,
Pioneer Work in Opening the Medical Profession to Women, "At last,
to my immense relief (though not surprise, for failure never seemed
possible), I received the following letter from the medical
department of a small university town in the western part of the
State of New York." The single acceptance came from Geneva Medical
College in Geneva, N.Y. Accompanying the letter from the Dean was a
resolution by the students, affirming their support of her
endeavors. Displayed in the exhibit is a formal copy on parchment of
the acceptance letter and resolution, which Blackwell had copied
from the original and esteemed as "one of my most valued
possessions."
The exhibit includes items illustrating Blackwell's life as a
student at Geneva Medical College, including a set of her class
notes on materia medica, pictures of the Geneva College buildings, a
College circular, and class admission tickets. Most intriguing is
the manuscript syllabus of James Webster, professor of anatomy and
Elizabeth's strongest supporter. In her diary Elizabeth describes an
anatomy class on a day soon after her arrival as "a trying day ... a
terrible ordeal ... Some of the students blushed, some were
hysterical ... My delicacy was certainly shocked ..." The syllabus
reveals the source of embarrassment.
The academic career begun with such difficulty was completed in
triumph. Elizabeth had gained the support of the students, faculty,
and townspeople, and graduated first in her class. Her brother
Henry, who attended the graduation, described the ceremony in a
letter to his family and noted the special esteem in which she was
held. In his address to the graduating class, printed as a brochure,
Dean Charles A. Lee commended Elizabeth's "perseverance under
difficulties, and obstacles next to insurmountable." Her thesis, on
ship fever (i.e. typhus), was given the unusual honor of publication
in the Buffalo Medical Journal.
After two years of further study in Paris and London, Blackwell
settled in New York City. Her efforts to establish a medical
practice were met by what she described as "a blank wall of social
and professional antagonism." Instead, she turned to social and
hygienic reform and the promotion of the medical education of women.
She founded a free clinic, the New York Infirmary for Women and
Children, which still exists as the New York Infirmary/Beekman
Downtown Hospital, and the Woman's Medical College of the New York
Infirmary. The exhibit includes circulars and catalogues from both
of these institutions, some of Blackwell's own publications, and
several portraits of her.
Flyers about the exhibit are available at the NLM or by mail from
the History of Medicine Division, National Library of Medicine,
Bethesda, MD 20894. The exhibit will be on display until June 30,
1999.
Thanks to Carol Clausen, HMD Librarian, for contributing this
article.
Caption: Curator Carol Clausen (second from
left) shows the Elizabeth Blackwell exhibition to three
distinguished holders of degrees from Hobart and William Smith
Colleges. Dr. Blackwell's medical college was affiliated with Geneva
College, the forerunner of those two schools. Pictured with Ms.
Clausen are (from left): Steven J. Phillips, MD (Hobart '62),
consultant to the NLM Board of Regents and Medical Director, Iowa
Heart Center, Des Moines; NLM Board of Regents Chair Dr. Tenley E.
Albright (honorary doctorate from Hobart and William Smith, '65);
and Kent A. Smith, NLM Deputy Director (Hobart '60).
A recent case report in the journal Lancet (Feb. 6, 1999, p. 462
- see full reference in "NLM in Print," below) mentions the
successful MEDLINE search conducted by an intern at the Department
of Medicine, Kaplan Medical Centre, Rehovot, Israel. A recent
citation in the NLM database helped the young doctor unlock the
secret of an otherwise healthy 24-year-old student suffering from
bloody diarrhea, abdominal pain, vomiting and weight loss. The
patient was determined to have superimposed cytomegalovirus (CMV)
colitis presenting as a flare-up of her ulcerative colitis (similar
to the case reported in the MEDLINE reference). Ganciclovir was
administered intravenously twice a day for 21 days and the patient
eventually regained her health and displayed a weight gain of 10%.
(This article, by Ami Schattner, is titled, "Medline solution.")
The University of Pennsylvania Cancer Centers' online database,
Oncolink, presented its Editor's Choice award for January 1999 to
MEDLINEplus, NLM's new online site for consumers. The award is made
on a regular basis to the providers of the highest quality cancer
information on the Internet. "We wanted you to know that the reason
for the selection is the particular emphasis we at OncoLink place on
patients and families who empower themselves with information about
cancer and cancer prevention. Your site is exemplary of this
philosophy."
Founding Librarian of UCLA Biomedical Library Was Frequent
Collaborator with NLM
Louise M. Darling, founding librarian of the UCLA Biomedical
Library, died March 21, 1999 at the age of 87. Miss Darling set up
the first decentralized MEDLARS search center in 1965. She was also
one of the original Regional Medical Library Directors in the
National Network of Libraries of Medicine, establishing the Pacific
Southwest Regional Medical Library Service in 1969.
Miss Darling was serving in the U.S. Army Library Service in the
Philippines when, in 1947, UCLA University Librarian Lawrence Powell
asked her to come to the school to establish the new Biomedical
Library. She guided this multidisciplinary library until her
retirement in 1978. In 1987, the library was renamed in her honor,
to recognize her many years of dedication and service.
Caption: This 1954 photograph of Louise Darling
shows the pioneering librarian perusing a Vesalius text. (Courtesy
of Louise M. Darling Biomedical Library, UCLA.)
During her long and distinguished career, Miss Darling served the
profession in many capacities, including as President of the Medical
Library Association in 1963-64, and received many awards. MLA's
Louise Darling Medal for Distinguished Achievement in the Collection
Development in the Health Sciences was established in her honor. As
the UCLA press release about her death noted, [the Darling
Library's] "distinguished collections bear witness to Darling's
personal interest in collection development, but her primary concern
throughout her long career was people: library users and especially
the staff who provide service to them." Miss Darling had a major
interest in the education of health sciences librarians and created
a highly successful internship program at the UCLA Biomedical
Library. At the request of Martin M. Cummings, then NLM Director,
she conducted a review of NLM's Associate Program shortly after her
retirement from UCLA, which served as a basis for major changes in
the program.
Although her accomplishments spanned virtually all areas of
medical librarianship, including pioneering efforts in library
automation, Miss Darling's most important contribution may have been
her ability to recognize, train, develop, and encourage future
leaders. Many of those who began their careers as interns or staff
members in Miss Darling's library later served NLM directly as
employees, Regional Medical Library Directors, and members of
advisory groups and planning panels. This distinguished group
includes but is by no means limited to: Lois Ann Colaianni, former
NLM Associate Director for Library Operations; Anthony Aguirre,
Director, Taubman Medical Library, University of Michigan; Robert M.
Braude, Ph.D., Director, Cornell Medical Library; Naomi Broering,
Director, Houston Academy of Medicine - Texas Medical Center
Library; Alison Bunting, Associate University Librarian for
Sciences, UCLA; Sherrilynne Fuller, Ph.D, Acting Director,
Informatics, University of Washington; Phyllis Mirsky, Acting
University Librarian, University of California, San Diego; the late
Daniel T. Richards, former Director, Dartmouth College Biomedical
Library; and Gloria Werner, University Librarian, UCLA. |