A New England Science Bootcamp Experience

MAHSLIN Professional Development Award – Thank you!

Hi everyone,

I am pleased to be supported by the MAHSLIN Professional Development award – much appreciated!

And, I was fortunate enough to use this to attend a day of the New England Science Bootcamp for librarians – The 2016 conference took place on the UMass Dartmouth campus in Dartmouth, MA from Wednesday, June 15th – Friday, June 17th, 2016. I attended sessions on Thursday, June 16th.

Nathan Norris, MLS, AHIP

What is the Science Bootcamp?

From the program organizers:

“Science Boot Camp is a 2 ½ day immersion into science topics offering opportunities for librarians and library students interested in science, health sciences, and technology to learn, meet and network in a fun, laid-back atmosphere. Now in its eighth year, the New England Science Boot Camp has been hosted on multiple New England campuses and has been attended by librarians and library students from various regions of the US and beyond—and inspired the development of other Science Boot Camps in the West, Southeast, and Canada! Science Boot Camp provides a fun and casual setting where New England science faculty present educational sessions on their respective science domains to librarians.”

The planning committee for the program consisted of science librarians from a number of institutions including University of Massachusetts -Amherst, University of Massachusetts-Dartmouth, Tufts University, University of Connecticut, and College of the Holy Cross, University of Massachusetts –Boston, Worcester Polytechnic and the University of Massachusetts Medical School.

In addition to the main programming, the planning committee does a great job providing fun, local activities such as campus, library and museum tours. This time, the festivities included a trip to the New Bedford Whaling museum. I must also give kudos to the organizers for offering single day registrations which included meals, as well as the multiple day option which included meals and lodging – all very flexible and at a very reasonable cost!

The 3 science topics for this years’ conference were Nursing, Physics and Engineering.  Following the main presentations, there was a capstone program on science literacy which focused on finding, reading and understanding primary literature.

Each of the 3 main topic areas were covered by at least 2 speakers – the first speaker providing an overview of the field followed by a speaker presenting specific research.

While I attended a portion of the presentations on Physics, I will focus on the Nursing content of the program, which is the reason I attended this year.  For the Nursing segment, there were 3 speakers.

The first speaker presented a history of nursing. The second speaker discussed nurse training, the nature of the nursing field and broad areas of nursing research. The third presented specific nursing research.  I will provide an overview of each presentation.

Science Bootcamp Nursing Segment Overview:

Speaker: Sharon Keating

The first presentation was done by Sharon Keating. Sharon is a lecturer in the Department of Community Nursing at University of Massachusetts, Dartmouth.

Sharon provided attendees with a nursing timeline and historical milestones which marked specific nursing “eras”. In doing this, she provided us with background on a number of nursing luminaries such as Florence Nightingale, Clara Barton (American Red Cross Founder) and Lilian Walt (Considered the first “Public Health” Nurse).  Additionally, she provided attendees with context for the evolution of nursing roles care and how major events and legislation such as Medicare & Medicaid, the Vietnam War, the HIV/ AIDS epidemic and the effect of the Accountable Care Act (ACA) have changed the nursing field.

Sharon’s presentation has been posted to YouTube and can be viewed here:
https://www.youtube.com/watch?v=wVpQBW3J1bU&index=3&list=PLulU88m3MzaS6lTbtqQsPVM8LZirpBF-N

While Sharon didn’t discuss much of this in her talk, her research interest is in the use of technology and social media to improve adolescent/emerging adult health and healthcare.  You can read one of her articles on text messaging as a health intervention for adolescents here (free):

Systematic review of text messaging as an intervention for adolescent obesity
Keating, Sharon R., McCurry, Mary K. Journal of the American Association of Nurse Practitioners. Volume 27, Issue 12, pages 714–720, December 2015.

Speaker: Stephen Padgett

The second presentation (and latter portion of the “nursing overview”) was done by Stephen Padgett. Stephen is an assistant professor in the Department of Community Nursing at University of Massachusetts, Dartmouth.

Stephen provided attendees with a good overview of the various “pathways” to nursing practice – both historically and currently.  He also highlighted the importance of nursing as a career which requires “lifelong learning” and detailed various paths to graduate nurse training and careers based on those fields of study.

Stephen’s presentation provided context for current nursing practice in the era of evidence-based practice and opportunities for nurses as practitioners, researchers, administrators, etc. During this section, he covered topics such as licensure, certification and the nature of professionalism exhibited through nursing knowledge, service, code of ethics and documentation such as policy statements, scope and standards of practice, ethics, etc.  We learned also about nursing specialization and the “barriers” that nurses face in healthcare such as numerous professional organizations, varying levels of education, and external conflict with other healthcare organizations (AMA, for example).

Stephen also provided an overview of the various types of research studies, breaking them out by design, level, and type of article produced. And, finally Stephen informed participants of various challenges in conducting nursing research, such as the difficulties in measuring effectiveness.

Stephen’s presentation has been posted to YouTube and can be viewed here:

https://www.youtube.com/watch?v=G1Qj6zEKnzc&index=4&list=PLulU88m3MzaS6lTbtqQsPVM8LZirpBF-N

Selected articles by Stephen Padgett (PubMed – RSS Feed):

http://www.ncbi.nlm.nih.gov/entrez/eutils/erss.cgi?rss_guid=1xwHDH4bpEYa6ZLV4SFQELRAu8hpQe416xUupINBLxI0yqoEza

Speaker: Kristen Sethares

The final segment on a specific research project was presented by Kristen Sethares. Kristen is a professor in the College of Nursing and director of the PhD Program at University of Massachusetts, Dartmouth.

Kristen has also worked as a cardiac nurse, and her research involves patients with chronic heart failure (CHF). The goal of her work is to have CHF patients improve “self-care” to reduce hospital re-admissions. From her description, the purpose of the study is “To improve symptom self-care in heart failure patients with the use of cell phone apps and sensors in the home setting.”  For this case, Kristen defined “Self-care” as the process of recognizing, interpreting and treating CHF.

CHF is very costly condition and the leading cause of hospital admission for patients over 65 years of age. It is also a major factor contributing to degradation of quality of life, and symptoms include fluid retention, shortness of breath and fatigue. 60 – 80% of CHF patients also have mild cognitive impairment. Patients can avoid going to the hospital if they do effective self-care and get treatment, as needed, without being admitted. One of the reasons for this type of research has been the failure of telehealth efforts to teach patients self-care. More interest has been paid to her research now that hospital readmissions within 30 days for the same condition are not being compensated by CMS.

Kristen’s research has been 13 years of collaboration between the Engineering and Nursing departments at UMass Dartmouth. She worked with a couple of engineers at UMass Dartmouth to put together a mobile monitoring device and software app. The device provides a continuous electrocardiogram (ECG) (as well as other types of monitoring), and the app provides a method for patients to record their own perceptions about their health status. The thought process is that this system can provide continual health data to the researchers and the app can aid patients in recognizing problem symptoms and empower them to manage them appropriately.

Kristen outlined the development and refinement of this app to measure how well patients were employing self-help methodologies.  And, she used the self-care of heart failure Index (SCHFI) (developed by Barbara Riegel and Victoria Dickson – Riegel & Dickson, 2008) as the basis for her research. This model includes 3 parts – self-care maintenance, self-care management and self-care confidence.

So far, Kristen has been very pleased with her research results, and the methods developed seem to be approachable for this patient population.

Kristen’s presentation has been posted to YouTube and can be viewed here:

https://www.youtube.com/watch?v=jA7XIY03c6o&index=5&list=PLulU88m3MzaS6lTbtqQsPVM8LZirpBF-N

Selected articles by Kristen Sethares (PubMed – RSS Feed):

http://www.ncbi.nlm.nih.gov/entrez/eutils/erss.cgi?rss_guid=1nGQFE-05NkT5g0xX0iSOwkg-Tt0LHc5i_b4zhtVl4iLHdmgFU

The conference was very well organized and very interesting – I would highly recommend it for science-related topics of interest!

To learn more on the Science Bootcamp and for some suggested references on heart failure from Kristen Sethares, see the links below.

Eighth Annual New England Science Bootcamp Site (Libguide)


Heart Failure References:

American Association of Heart Failure Nurses

American Heart Association (for clinical practice guidelines)

Centers for Medicare and Medicaid Service

Heart Failure Society of American (HFSA)

Heart and Lung (Journal)

Journal of Cardiac Failure

Journal of Cardiovascular Nursing

Self-Care of Heart Failure bibliography (Barbara Riegel)

Updated Clinical Practice Guidelines on Heart Failure: An International Alignment

The Healthcare Landscape – Burning questions find answers!

  • Are you aware of what the Affordable Care Act means to your organization and to the public, and what the latest changes are?
  • What are some of the best resources for librarians to help people find out about the ACA?
  • How do you choose and use the vast array of tools that rate providers and health care organizations?
  • How have medical education and residency requirements changed over the last few years . . . and what does that mean to health services libraries?

If all these questions make you feel like you are lost in the sea of medical change – you are not alone! Please join your fellow librarians on Wednesday, September 30, 2015 from 9:30am-12:30pm at Brigham and Women’s Faulkner Hospital, 1153 Centre Street, Boston, MA in the Huvos Auditorium on the 3rd Floor. (Click for Directions)

Our MAHSLIN/Joint Consortia Meeting – The Healthcare Landscape: Changes Afloat – will address these and other pressing questions. This educational event features presentations that you will not want to miss by Raymond Hurd, Regional Administrator, Centers for Medicare & Medicaid Services, Regions I & II; Janice A. Singer, MA, MPH, Vice President for Programs, Massachusetts Health Quality Partners; and Len Levin, MS LIS, MA, AHIP, Head, Education & Clinical Services, Instructor, Department of Family Medicine and Community Health, Lamar Soutter Library, University of Massachusetts Worcester.

The event includes a light breakfast and lunch, and is followed by optional consortia meetings from 1:00pm-2:00pm. The program is free for all MAHSLIN or consortia members. If you do not belong to either, the fee is $25. Click here for the registration form. No refunds after the registration deadline of Friday, September 11, 2015. On behalf of BBLC, we look forward to welcoming everyone to what we know will be a valuable and thought-provoking meeting.

Curing your Headache in Two Hundred Years: An Archival Exploration

Submitted by Cara Marcus, Past President, MAHSLIN

I woke up with a headache. Not a debilitating headache, mind you, but certainly an annoying one. While my head pounded, I decided to take a few moments to read through some of the texts in the library archives in search of the wisdom of how our forefathers handled their headaches.

I decided to start at about fifty years or so ago and work my way backwards, one text at a time. The first book I picked up was a slim 86 page volume from the American Lecture Series entitled The Common Headache Syndrome: Biochemistry, Pathophysiology, Therapy [1]. Despite that daunting title, the front cover (which actually looked typewritten) reassures readers, “This is an intensely personal book – an outgrowth of the author’s own experience in dealing with the common headache syndromes. It will leave the reader with a deeper appreciation of the true nature of the problem.”

Dr. Ostfeld begins with some vignettes of typical headache patients. His patient “may sit with a furrowed brow . . . her hands may grip the chair; she is intent and she scarcely moves.” He theorized that “prolonged use of the eyes, coupled with intense concentration as in reading or auto driving, may . . . induce tension headache.” Remember that this was long before the days of librarians “reading” computer screens all day. I looked away from my computer screen to ponder this thought and felt better already. While his book contained a chapter on “new” medicines for headache, including chlorpromazine and methysergide, the overarching message of his book was that a psychotherapist could help patients with headache by changing their attitudes or life experiences or both. Ostfeld concludes, “The most important medical ingredient in the treatment situation is not in the physician’s technical knowledge or his scholarship. It is his humanness . . .”

Shifting back a decade to the 1950s, the next book I selected was by none other than the esteemed Honorary Physician and Clinical Assistant to King Edward VII, Dr. Nevil Leyton. While I felt that Dr. Ostfeld’s book from the 1960s certainly was true to its “talk it all out” period, I was curious to see what I would glean from a more serious time in our history from Migraine and Periodic Headache: A Modern Approach to Successful Treatment [2]. Focusing mainly on migraine headaches, this book espoused medical treatment to “turn a sour, dispirited and unhappy patient into a happy and useful member of society,” although the author believed that, “The average prognosis given in cases of migraine is gloomy.” And the “commonest method of treatment of severe migraine in use to-day” was said to be the exhibition of ergotamine tartrate, and anti-histamine preparations were up-and-coming treatments. The author then went on to provide a series of case reports, mostly of females with “house duties” who were cured of their headaches by various medication and hormone therapies. While I didn’t feel particularly better after reading this book, I did feel somewhat less “sour” and “gloomy.”

Back now to the 1940s to Dr. Wolff’s book, Headache and Other Head Pain. [3] It is a scholarly book with over 150 figures and data charts that are quite amazing considering that they were drawn by hand; this was considered among the best contributions to the field of headache medicine of its time. Chapter references spanned back to the 1800s (and remember that researchers did not have online databases or DOCLINE back then) and the first hundred pages or so were an in-depth and fascinating illustrated look at all the brain, nerves and organs responsible for causing headache. Dr. Wolff, like Dr. Ostfeld, felt that life situations had an impact on headache, especially migraine, and also that some personality features were common among migraine sufferers, such as orderliness and inflexibility. It is interesting to note that in future editions of this book, personality traits were discussed more in a historical setting or as reactions to headache. [4]

Ergotamine tartrate, which was also recommended by Dr. Leyton, was considered to relieve headache by Dr. Wolff within an hour in 90% of cases. [5] Dr. Wolff also recommended many other approaches to treatment, including dietary methods, glandular therapy, surgery and preventive therapy that included “the management of work and rest periods.” Relaxation included watching “suitable moving pictures” (as movies were known by in the 1940s), although Dr. Wolff advised that watching those that “depict ‘gangster warfare’ were apt to precipitate headaches through inducing fear, tension or horror.”

All this research spurred my interest in going even further back in time. In the 1899 edition of Practice of Medicine by Sir William Osler [5] (the first professor of medicine at Johns Hopkins University and known as one of the most influential physicians in history), migraine was considered a synonym of “sick headache” and women and members of “neurotic families” were most frequently attacked. Recommended treatments were quite different than those from the next century; headache sufferers from the late 1800s may have been treated with bromides, iron, arsenic, nitroglycerin, a saline cathartic, caffeine, chloroform, citrate, nux vomica, and ergot (which appears to be the predecessor of ergotamine tartrate used half a century later). Dr. Osler’s recommendation for the most “satisfactory remedy” was Cannabis indica, but he stated that, “Electricity does not appear to be of much service.” Some of the medicinal treatments suggested – arsenic, nox vomica, chloroform – are considered poisons today; the only treatments from this list that are still cautiously recommended nowadays are caffeine – many headache specialists state that having some coffee may improve symptoms, although caffeine may also contribute to headache, and ergots. [6, 7]

Still curious, and having just read the oldest textbook in my library’s print collection, I perused an online textbook from two-hundred years ago. Headaches were considered a malady of “women in the higher ranks of life, and those of a delicate constitution” during monthly cycles by Dr. Alexander Hamilton (not the United States President, but a fellow of the Royal College of Physicians) in his 1813 book A Treatise on the Management of Female Complaints. [8] Interestingly, this book provides no therapy for headache sufferers, other than implying the affected women partake in some good exercise and manual labor.

My archival exploration of headache gave me an appreciation of the advances medicine has made in the understanding of and treatments for this common condition, and yes, my headache symptoms did seem to improve while writing it! In addition, reading older textbooks this way resulted in an observation that physicians seemed influenced by the cultural mores and prevailing thoughts of their times and that this was reflected in their writings. Care providers could benefit from reading books and journals from distant times to learn from what therapies have been tried in the past and are no longer in use. Libraries that retain specialized archival collections are doing more than just shelving older books – they are providing a unique window to the past that may very well provide a key to new treatments in the future.

References:

1. Ostfeld AM. The common headache syndromes: biochemistry, pathophysiology, therapy. Springfield, IL: Thomas, 1962.

2. Leyton N. Migraine and periodic headache: a modern approach to successful treatment. Springfield, IL: Thomas, 1954.

3. Wolff HG. Wolff’s headache and other head pain. New York: Oxford University Press, 1948.

4. Wolff HG, Dalessio DJ, Silberstein SD, Wolff HG. Wolff’s headache and other head pain. 6th ed. New York: Oxford University Press, 1993.

5. Osler W. The Principles and Practice of Medicine, Designed for the use of practitioners and students of medicine. 3d ed. New York: D. Appleton and Company, 1898.

6. Rizzoli P, Loder E, Neporent L. The migraine solution: a complete guide to diagnosis, treatment, and pain management. New York: St. Martin’s Griffin, 2012.

7. Green MW, Green LM, Rothrock JF. Managing your headaches. 2nd ed. New York, NY, USA: Springer, 2005.

8. Hamilton A and Hamilton J. A treatise on the management of female complaints. Edinburgh: Hill, 1813.

 

Medical Libraries Matter – MAHSLIN Annual Meeting on April 11, 2014

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You plan, manage, direct, supervise, collect, acquire, process, catalog, index, abstract, research, search, write, review, link, teach, instruct, present, blog, tweet, email, film, embed, disseminate, create, innovate, arrange, design, prepare, administer, train, educate, oversee, purchase, buy, classify, copy, print, sort, coordinate, tag, list, file, summarize, extract, evaluate, connect, tutor, lecture, show, demonstrate, distribute, circulate, publish, organize, weed, inform, alert, procure, categorize, inventory, record, condense, abridge, obtain, help, assist, greet, explain, operate, deliver

Your library provides, gathers, amasses, showcases, displays, bonds, exhibits, unites, welcomes

because of you . . .

Your patrons read, review, research, study, search, research, write, present, administer, treat, teach, instruct, manage, supervise, direct, strategize, train, investigate, seek, create, analyze, evaluate, examine, lecture, publish, practice, govern, inform, report, address, edit, achieve

because of your library . . .

Your institution functions, invents, guides, creates, initiates, plans, proposes, focuses, enlightens, proves, facilitates, leads

because of your library . . .   

The world becomes healthier, improves, benefits, thrives

because of your library . . .

 

MEDICAL LIBRARIES MATTER!!!

Come to the MAHSLIN Annual Meeting on April 11 to find out more and join the discussion

Click here to register

 

Innovation on a Shoestring: A Lot to Learn and Much to Think About

Contributed by Olga Lyczmanenko, Library Director, New England Baptist Hospital

There was a lot to learn and much to think about at the most recent BBLC/MAHSLIN -sponsored Meeting – “Innovation on a Shoestring: High Impact Ideas for a Limited Budget”. 

Brandy King, owner of Knowledge Linking and independent consultant, guided the audience into the world of social media and very ably demonstrated the possibilities.  She showed that the power of Facebook, Linked-in and Twitter can be tapped successfully to promote library services – in ways many of us had not considered.  Connecting to thought leaders, adding professional groups to our contacts, and promoting information resources can all be accomplished with these social apps. 

Kate Donovan, currently at Children’s Hospital and a former Apple “genius”, introduced a number of free, easy to use, dynamic I-Pad apps.  Want to create an e-book? Just use IBooks Author www.apple.com/ibooks-author ).  Similarly, use Flipboard   (flipboard.com)  to create a personalized magazine.  Thinglink (www.thinglink.com) allows video creation with step-by-step instructions.  With a little creativity and with the help of these friendly apps, pushing out library news or patient education will never be the same again. 

3D Printing and its intricacies were very expertly explained via a webcast featuring  Patricia Anderson , Emerging Technologies Librarian from the University of Michigan, and Kimberly Barker, Manager for Technology Education & Computing at University of Virginia’s Moore Health Science Libraries.  Patricia, focused mainly on the explosive growth of 3D printing and its dramatic use in many areas, especially in anatomy and orthopedics; Kimberly addressed her library’s experience with its 3D printer, about funding and general public response to the printer.  

Quite coincidentally, just a few days after this presentation, an NPR story aired that highlighted a successful  windpipe implant fashioned from a 3 D printer.  Link to the NPR story

As always, this meeting was well organized, well attended and provided much to think about.

Thank you to everyone who made it possible.

 

Olga

 

 

A Library in Paradise – “My Way”

[Contributed by Cara Marcus, MAHSLIN president]

Whenever I take a vacation, I enjoy visiting their local libraries to expand my horizons and gain new insights from all locales.  My most recent trip was to beautiful Palm Springs, where nestled among the glorious mountains, canyons and palm trees, I glimpsed the Medical Library at Desert Regional Medical Center.  I say glimpsed as the medical librarian was away when I was in the area (perhaps she was skiing the snow-capped New England slopes for her own holiday getaway while I was there). 

 I found the medical center on the way to an outdoor wellness park complete with a walkable labyrinth and scented healing herb garden (believe me – I came back quite relaxed after this vacation!)  As I walked through the hospital, which was founded in 1948, I was struck by the serene tiled hallways and open architecture that let nature indoors.  Disappointed that the library was closed, I visited the gift shop to buy a poolside reading book.  It turned out that the gift shop volunteer also volunteered in the library, and told me about how well-utilized it was and how much she enjoyed volunteering there.  While she couldn’t open it for me, she told me that if I stood on the veranda, I would be able to see it through the windows.

 I found out the library was part of the Sinatra Education Center, with funds donated by Frank Sinatra in memory of his father Anthony Martin (Marty) Sinatra.  Old Blue-Eyes had lived in Palm Springs, and in the dedication of the Education Center shared, “This splendid structure is my dad’s kind of dream, just as it is yours and mine.” (Nancy Sinatra, Frank Sinatra, My Father, Simon and Schuster: 1986, p 224). 

 It was a beautiful medical library, with burnished wood shelves and carrels, a glass display case showcasing archival treasures, stately stands for oversized dictionaries, coffee-table books of photos, collections of textbook, periodical and audiovisual materials elegantly displayed, and a prominent reference desk.  What I didn’t see in the library were computers – there were 3 workstations tucked away in the back and a separate computer room down the hall.  While library services included electronic resources for both providers and patients (with instruction sheets in racks outside the door), it seemed that visitors to the library itself could quietly read, study and think in a serene setting.  Maybe it was just as well the library was closed, or I may have disappeared to browse and peruse for hours while the California sun beckoned outside.

 As I left the library and walked into the sunshine, I could almost hear Frank Sinatra singing, “The summer wind came blowin’ in from across the sea . . .” Happy New Year MAHSLIN!

The More Things Change, The More They … Change

[Contributed by Cara Marcus, MAHSLIN President]

As you know, it’s MAHSLIN’s 30th birthday this year.  Where were you 30 years ago?  Some of you weren’t even born yet, while others were working in the same libraries you are now, although the job itself has changed dramatically.  As for myself, 30 years ago I wasn’t yet a medical librarian, or even a librarian, but a very happy library assistant in a lovely small-town public library in New York.  That library has changed completely too – a whole new building, new staff, new services – but I remember it like it was yesterday.

30 years ago (1983) was a pivotal time for many libraries – mine included.  That was the year we AUTOMATED.  Big boxy computers were brought in, trainers followed them, and existing and new staff were instructed on how to enter all the holdings and all the patrons into these formidable machines.  Actually, they weren’t too formidable – they reminded me somewhat of the “pong” game we had on the TV with their big black screens and blinking green cursers.  Still – I was happy when I was told I was not going to be one of the staff chosen for the data entry project (my time that summer was spent sublimely creating large paintings of Curious George and Winnie the Poo for the Summer Reading Club).

So what did automation replace in 1983?  There would be no more manual checking for reserves, which had to be done every time a book came back.  We used to have a large rotating carousel with index cards, and every time a patron returned a book, one of the assistants had to check the for title to see if someone had reserved it.  Another time consuming task that would go by the wayside was sorting and alphabetizing card-catalog cards, which we did in long A-Z trays with lift-up slats.  But I don’t think anyone could foresee how much computers would change any and every aspect of library work.

I remember so much about that library with warmth and nostalgia.  We showed reel films every month (reel – meaning they played on motion picture projectors).  There were only a few staff in the library that knew how to run the equipment, and it seemed like the whole town turned out when they were offered.  There were two small glass-walled rooms with typewriters that students and businesspeople had to sign up to use in half-hour blocks.  These were almost always in use.  Library newsletters were printed on mimeograph machines, with trademark purple ink.  Once they were printed, my colleagues and I would spend hours hand-folding them.  And yes, we used library paste to affix the sign-out card pockets to the backs of the books.

How did the reference librarians find information in 1983 before there were databases and electronic resources?  They read, and read and read, to learn the content of the material in their collections, and used bulky print indices for various subject literature.  Librarians at a small library like mine would have to spend a lot of time calling and writing (not emailing – writing) to other librarians to see who may have a particular resource.  It was not unusual for reference questions to take weeks to be answered.

If you were working in a library 30 years ago, I’m sure you have similar memories and stories.  No one could have foretold how much our profession would change.  When MAHSLIN created their first Union Lists at that time, the librarians involved were paving the way for the future.  Now we can access hundreds of thousands of resources nearly instantaneously, and we often think nothing of it.

What will our profession look like 30 years from now in 2043?  Perhaps a doctor in the operating room will ask, “Is Oraparythivesamine contraindicated by Mono-limeo-M25d?”  This query will be picked up by his wristPED and immediately transmitted to the librarian in her virtual office on an idyllic Caribbean beach.  She will expertly tell her iSearch the precise search strategy, and then the iSearch will transmit the perfect article back to the doctor’s wristPED, just in time to avert a fatal adverse reaction!   Only time will tell . . . .


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