I’m Baaaaack

It is 2015 and the blog is going retro.  While I liked the look of the skin I was using, it was causing all sorts of havoc with my site. Some places are now blocking my blog as it says it is sending out spam malware which I don’t think it was but I think the skin was maybe sending out advertising cookies that some systems did not like. Well you get what you pay for.

So I went back to the skin design that was last known to work and have few problems over the years.  My hope is that I can get things straightened out and get back to writing because there are so many interesting things happening that I want to write about.

I apologize for being AWOL on the Blog wall.

I Think I Can

Over the past couple of weeks helpful people have been telling my that my site was running slow, the search box took forever, and various other wonky things.  Last week everything just went kaput.  My site went offline and it definitely was server issue.

Thankfully, Blake at LISHost was quick to figure out the problem and got me up and running.  I think everything is back to normal so I think I can resume posting and my site will not go off the deep end again.  If you start to notice some weirdness let me know and I will try and get on it. (BTW weirdness with the site, not me.)

Friday Fun: A Little Editing and Anything Can Be Said or Sung

I am stretching the focus of my blog today.  While this has nothing to do with libraries or medicine, it makes me giggle.  I think it is funny, so it loosely fits into the blog through a Friday Fun post.

The Tonight Show with Jimmy Fallon has been having a little fun with Brian Williams and his news casts. Through the use of editing, they have gotten Brian Williams to perform various rap songs.  Here are my two favorites.

Brian Williams rapping “Baby Got Back”

Brian Williams and Lester Holt rapping “Rapper’s Delight”


According to Jimmy there is some poor guy who is very good at editing who sits in the back room searching for all of the words and piecing them together.

If you are like me and can’t get enough of Brian’s rapping check him out rapping these other tunes.  NOt only are the funny to me but I am in awe at how much time and effort it probably took to do it.

Have a good weekend and thanks for letting me take a break from the medical and library stuff to some Friday Fun.


Newbie Medlibs: Experiences

One of the reasons I like Twitter is that I can follow or read about new people with interesting ideas.  On Monday, Steven Chang tweeted a link to his blog post about his experiences and reflections on his first month of being a hospital librarian.

Steven Chang's tweet about being a new hospital librarian

His blog post had me thinking about newbie medical librarians and the support (or lack of support) they have as they start their new jobs. Steven is a medical librarian in Australia, so his library school experience might be a bit different than those of us who got the MLS (or equivalent) in the United States.  I can only speak of my experiences of when I was in library school.  That was many many years ago, I have been a professional medical librarian for over 15 years. My first job out of library school was in a hospital library. While it was a eye opening experience, I feel that I was more prepared than other newbie librarians entering the medical library workforce. I was lucky because the University of Missouri’s School of Information Science & Learning Technologies had several courses for those interested in medical librarianship. Unfortunately, now they only have a course on Consumer Health :(  My course work wasn’t the only thing that helped me.  The wonderful librarians at the J. Otto Lottes Health Sciences Library at the University of Missouri were the people who helped connect the crucial dots in my medical librarianship training.  I did a practicum there and quite frankly that experience helped me out tremendously.

Reflecting on my time in library school got me thinking about things I wouldn’t have known had I not had course and practicum work focused on medical librarianship.

Things that I wouldn’t have known about:

Docline – Medical librarians use a totally different Interlibrary Loan system than every other librarian I know of.  While we do use OCLC for books, almost all of our ILL requests are journal articles and the National Library of Medicine has its own unique ILL system (Docline) that deals with this and this is what every other medical library uses to get articles.

Controlled vocabulary – Oh I learned about it sort of while taking the required cataloging class and my optional indexing and abstracting class. While some databases use subject terms, very few library databases have the structure and the type of control over search terms that MEDLINE does. I did not fully “get” the idea of controlled vocabulary for searching until I started really working a lot with MEDLINE.

The IRB – The institutional review board is the ethical review board that is used to officially approve, monitor, review research involving humans.  Almost any study or survey done within Hospitals and academic medical centers needs to be run by the IRB. This also means your library surveys might need to be run by the IRB.  Since librarians are not studying drugs, therapies, or treatments on patients, it is usually is a pretty straight forward approval process or they simply give you a letter saying you don’t need IRB approval.  However, it is always best to check before you do your own survey or study. This was never ever mentioned in library school. I don’t know of public librarians needing board approval for a study.

Resources – Ok this is sort of a catch all. My library school’s reference class provided a sort of “fly by” of all types of resources that one would in encounter in a general academic or public library. I found that to be a very helpful class as it gave me a sampling of what I need to know to learn the basics of reference and to understand the concept of the reference interview.  However, there are WAY more medical resources out there.  It wasn’t until I did a medical resources class and my practicum did I begin to scratch the surface of medical resources.  BTW my library school life was way before UpToDate, MDConsult (now ClinicalKey), Scopus, Web of Science, etc.  Journals were just starting to go electronic and there were no ebooks.  The Internet and online publishing and multi-media have exploded the amount of and type of medical resources available online compared to when I was in library school.

Carla Funk mentioned at a meeting (I want to say Section Council) at 2013 MLA.  She said that MLA has an interesting generational shift.  She said MLA has lots of librarians with lots of experience (and close to retirement) and lots of librarians just starting off and relatively new to the profession.  There are fewer librarians in the middle of their career.  Both Carla’s unofficial reporting of the MLA demographics and Steven’s blog post has me more wondering more about fostering and mentoring librarians to be medical librarians.  I know we have all heard of the “great retirement” when all of these so called older librarians will all suddenly retire creating massive employment opportunities for new librarians and librarian advancement.  I know because “they” were spouting this theory even when I was in library school over 15 years ago.  Honestly I think we are starting to see it happen.  It isn’t a mass exodus as “they” predicted, but I have seen a lot of directorship and assistant directorship positions posted recently.  I am noticing a large group of new librarians at MLA that are eager to get involved.

I know MLA has several mentorship opportunities:

  • You can find/be a mentor according certain expertise areas of medical librarianship such as administration, continuing education, research, etc.
  • You can also decide to get your provisional AHIP membership in which case you would need an AHIP mentor.

Several posters were presented at the 2014 annual meeting on mentorship or new medical librarianship learning opportunities.

I have found the #medlibs Twitter group and MEDLIB-L to be very helpful too.

I have several questions that I want to bounce off of readers.

  • What are the things that weren’t taught in library school that are unique to medical libraries that new medical librarians need to know?
  • What are other ways we can help or mentor new librarians?
  • Do you think there should be some sort of mentoring to MLA? Similar in spirit to the New Members/Attendees Breakfast that is done at the annual meeting.  But instead of it being about the annual meeting it is about MLA as whole, how it works, what groups are what, the ins and outs of Sections, etc.  If so what is a good way to do that?

I look forward to hearing back from people. Either comment on this blog or my Facebook page or tweet me @krafty.

MLA Has a New Website

Last week MLA rolled out its new website.  The old site was long overdue for an update, and this new site is a bit of a change.  As with all new site changes, the new version is going to take some getting used to. MLA wants your thoughts https://www.mlanet.org/about/mlanet_update.html on the new website.

What are some of the “show stopper” issues or missing information.

What is a “show stopper?”  A show stopper is a fundamental problem with a website that makes it or important parts of it totally unusable.  Some examples with this site are:

  • Browser compatibility problems – While it is difficult to design down to IE 7 (which unfortunately many hospitals still have) there seems to be some other problems regarding how it displays with Firefox on Macs.
  • The Forgot Password link doesn’t work. You click on it and you go nowhere.  This aspect is of getting your password is unusable.

Now MLA does know about the browser compatibility problems and the Forgot Password link, so you don’t have to report those again.

What kind of information is missing?  Please remember we can’t have everything on the front page (and we probably already have to much there now) but are there links or other bits of information that you use that you can’t find?For example:

  • The link to the MLA webinar on systematic reviews was missing.
  • The link to the MLA 14 program planner was missing.

MLA has since fixed these two missing links….but are there others that they don’t know about?

Please look at the website https://www.mlanet.org/ and notify MLA of any problems or thoughts at [email protected]

IF you can remember try and also list the problems on the comments on this website.  The list in the comments isn’t meant to dissuade anyone from reporting something that somebody else found (by all means if you think it is important that MLA knows about it, tell them) I just thought it might be helpful to have an unofficial list of issues so that others can learn from what was found.


Trust No Guideline That You Did Not Fake Yourself

Yesterday I read an interesting piece by Oliver Obst, “Trust no guideline that you did not fake yourself.” (Journal of EAHIL. 2013. v9 (4) p25)  Obst references the German newspaper Frankfurter Allgemeine Zeitung, which reported several cases of fake practice guidelines.   I don’t read German and it appears you must pay to access FAZ’s article archive, but if you read German and have access to the archive, the link to the article is here.  According Obst’s summation of the article and Google Translate’s translated version of the abstract, the newspaper attributes thousands of deaths in Europe due to guidelines from the European Society of Cardiology and scientific misconduct.

Unfortunately this is not a single incident, Obst reports “many more examples can be found in a disturbing report by Jeanne Lenzer in the British Medical Journal, ‘Why we cannot trust clinical guidelines.”  Lenzer’s article reports that doctors with ties to pharma companies are writing the guidelines.  Since most guidelines are written by a large group of doctors you would think it would be difficult to have financial bias make any sort of impact on the guidelines.  However, Lenzer discovered a survey showing that it is entirely possible.

“A recent survey found that 71% of chairs of clinical policy committees and 90.5% of co-chairs had financial conflicts.12 Such conflicts can have a strong impact: FDA advisers reviewing the safety record of the progestogen drospirenone voted that the drug’s benefits outweighed any risks. However, a substantial number of the advisers had ties to the manufacturer and if their votes had been excluded the decision would have been reversed.13

The Cochrane Collection is not immune either according to Lenza.

Early 1990’s-Reinforced by a Cochrane review, high dose steroids became the standard of care for acute spinal cord injury. The Cochrane Collaboration, permitted Michael Bracken, “who declared he was an occasional consultant to steroid manufacturers Pharmacia and Upjohn, to serve as the sole reviewer.”

The standard was just reversed in March 2013 with the Congress of Neurological Surgeons new guidelines. They found, “There is no Class I or Class II medicine evidence supporting the benefit of [steroids] in the treatment of acute [spinal cord injury]. However, Class I, II, and III evidence exists that high-dose steroids are associated with harmful side effects including death.”11

Lenza believes another example of biased guidelines is beginning to emerge regarding stroke and the use of alteplase.

“American College of Emergency Physicians with the American Academy of Neurology (jointly)18 and the American Heart Association,19 separately, issued grade A level of evidence guidelines for alteplase in acute stroke. The simultaneous recommendation by three respected professional societies would seem to indicate overwhelming support for the treatment and consistent evidence. However, an online poll of 548 emergency physicians showed that only 16% support the new guidelines.20

Lenza points out that “claims of benefit rest on science that is contested. Sceptics say that baseline imbalances, the use of subset analyses, and chance alone could account for the claimed benefit.24 26 31 32 33 They also note that only two of 12 randomised controlled trials of thrombolytics have shown benefit and five had to be terminated early because of lack of benefit, higher mortality, and significant increases in brain haemorrhage.”33  Lenza also notes that “13 of the 15 authors had ties to the manufacturers of products to diagnose and treat acute stroke; 11 had ties to companies that market alteplase.”19

So what does this mean for librarians as we try and find the best research out there for our doctors, nurses and patients?  This is a problem. Even if you take out the pharma bias, bio-medical scientific literature rarely publishes work on failures.   Add the pressure from pharma wanting and promoting positive outcome research to published, we have even fewer examples of “what didn’t work” research articles and quite possibly what we thought was good evidence isn’t as good as we thought.

As Obst notes, librarians must be aware of this issue and to keep our patrons informed.  Unfortunately this may be the only thing we can do and even then it might not be enough.  Lenza ends her article by saying;

“Yet these and other guidelines continue to be followed despite concerns about bias, because as one lecturer told a meeting on geriatric care in the Virgin Islands earlier this year, ‘We like to stick within the standard of care, because when the shit hits the fan we all want to be able to say we were just doing what everyone else is doing—even if what everyone else is doing isn’t very good.”

Potential New Tool to Measure Cognitive Labor of Research

This week I was at the SCC/MLA annual meeting in Fort Worth teaching a class. I got in a little early and I was glad I did.
Karen Keller, Dena Hanson, Lynne Harmon, and Barbara Steffensen at Cook Children’s Medical Center presented a paper on the creation of a tool for non-academic health sciences librarians to measure the value of research performed by librarians. The tool attempts to measure the value and establish an ROI of librarian expertise. The abstract of the paper can be found in their online program(pg 25 of 36 in PDF viewer)
I found this to be really interesting. Medical librarians have been looking for ways quantify what we do and put a value on it to our administration. I did not get a chance to listen to the actual paper presentation. I found out about it because I attended the Hospital Librarianship Forum where we discussed ideas and issues facing hospital librarians. In the forum Karen mention her tool. Unfortunately the tool is not available. The are still testing it.
Even though it it isn’t ready for prime time I wanted to blog about it to make sure it is on the radar for librarians who might also be interested. So keep your eyes and ears open.

Louise Darling Award Deadline Nov1st

November 1st seems to be the deadline for a lot of things.  So if you are thinking about applying for something, nominating somebody, or presenting something at MLA 2014, you better start checking your deadlines.

(reposted with persmission)

Please consider nominating a colleague for the Louise Darling Medal for Distinguished Achievement in Collection Development in the Health Sciences!

The Louise Darling Medal is presented annually to recognize distinguished achievement in collection development in the health sciences. The award was established in 1987 and first awarded in 1988, with a contribution by Ballen Booksellers International, Inc. The recipient receives an engraved medal, a certificate, and a $1,000 cash award.

If you want to nominate a deserving colleague, please go to www.mlanet.org/awards/honors/ for more information and online nomination forms. The deadline for applications is November 1. Please contact jury chair Jeff Williams at jeffrey.williams [atsign] nyumc [dot org] with any questions.

Call for Applications: NLM/AAHSL Leadership Fellows Program

(reposted from Midwest MLA listserve)

The Association of Academic Health Sciences Libraries (AAHSL) is pleased to announce the 2013-2014 year of the leadership program jointly sponsored by the National Library of Medicine (NLM) and AAHSL. The NLM/AAHSL Leadership Fellows Program is focused on preparing emerging leaders for the position of library director in academic health sciences libraries.

Fellows will have the opportunity to develop their knowledge and skills in a variety of learning settings, including exposure to leadership in another environment. They will be paired with mentors who are academic health sciences library directors. In addition to the individual relationship with their mentors, fellows benefit from working collaboratively with other fellows and mentors. Experienced program faculty and mentors will provide content and facilitation for the cohort. The program takes advantage of flexible scheduling and an online learning community to minimize disruption to professional and personal schedules. The sponsors will provide financial support for a small cohort of fellows and will underwrite travel and meeting expenses.

Fifty-five fellows have participated in the program in the first eleven classes. To date, twenty-two fellows have been appointed to director positions.

Program Overview

The one-year program design is multi-faceted: three in-person leadership institutes; attendance at an Association of American Medical Colleges (AAMC) annual meeting; a yearlong fellow/mentor relationship; webinars and discussions on issues related to library leadership; and two weeks of site visit to the mentor’s home library.

The program is designed to:

  •  Introduce fellows to leadership theory and practical tools for implementing change at organizational and professional levels;
  • Introduce fellows to critical issues facing academic health sciences libraries;
  • Develop meaningful professional relationships between fellows and mentors that give fellows access to career guidance and support;
  • Expose fellows to another academic health sciences library and its institutional leadership under the guidance of their mentors;
  • Examine career development and provide models of directors to fellows;
  • Create a cohort of leaders who will draw upon each other for support throughout their careers;
  • Promote diversity in the leadership of the profession; and
  • Offer recognition to emerging leaders and enhance the competitive standing of fellows as they pursue director positions.


The NLM/AAHSL Leadership Fellows Program is currently accepting applications and nominations for the August 1, 2013, deadline for potential fellows for the 2013-2014 experience. Candidates for fellow should have a strong interest in pursuing a directorship in academic health sciences libraries, as well as significant management experience. Applications are welcomed from professionals working in academic health sciences libraries, hospital libraries, or other library-related settings. Applications from qualified minority candidates are encouraged.

Directors with at least five years’ experience as director of an academic health sciences library should indicate preliminary interest in being matched as a mentor by contacting the AAHSL Future Leadership Committee by August 1.

The program brochure, including information on program design, schedule, and application process, is available at http://www.aahsl.org/assets/documents/2013/2013-2014_nlm_aahsl_lfp.pdf.



Moderate a #Medlibs Discussion

The last month we have had some really good #medlibs discussions on Twitter.  Many have been moderated by guest #medlibs who host the discussion on a specific topic. 

Previous Topics:

I hosted the Apps and Tablets discussion (as well as several previous ones) it is not only fun but pretty darn easy to do.  You welcome everybody to the group discussion and then you get the ball rolling with a question, thought or talking point that you post.  From there the discussion almost takes on a life of its own.  If there are specific points or topics you want to make sure you hit, then you monitor the discussion and throw them in either when the discussion moves that way or after a certain amount of time. 

One important thing you need to know is you don’t have to be an expert in the topic to moderate.  You just have to have an inquisitive mind and the ability to ask questions.  The rest of the group will take the discussion and move with it.  Often there are several people with many different perspectives that can help educate you and the rest of the group.

So if there is a topic you are dying to discuss, please become a #medlibs moderator.  (Remember I said it is very easy.) Go to the #medlibs Calendar and click on a date that works for you.  Then enter your topic and information in the details link.  Once you have done that, you are on the schedule and we will look forward to tweeting with you.