U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE- Public Health Service

.Annual Report/ 1966

BOARD OF REGENTS,

William N. Hubbard, Jr., M.D.(Chairman)

William B. Bean, M.D.

Russell A. Dixon, M.S.D.

Herman H. Fussier, Ph.D.

Alfred A. Gellhorn, M.D.

Henry Harkins, M.D.

Walsh McDermott, M.D.

Morris Tager, M.D.

Stewart G. Wolf, Jr., M.D.

Barnes Woodhall, M.D.

NATIONAL LIBRARY OF MEDICINEFY 1966

University of Michigan Medical School

College of Medicine, State Universityof Iowa

College of Dentistry, Howard University

University of Chicago Library

College of Physicians & SurgeonsColumbia University

Department of Surgery, Universityof Washington

Cornell University Medical Center

Department of Microbiology, EmoryUniversity

School of Medicine, University ofOklahoma

Duke University Medical Center

Ex Officio Members

Lt. General R. L. Bohannon, M.C.

Vice Admiral Robert B. Brown, M.C.

Harve Carlson, D.P.H.

H. Martin Engle, M.D.

Lt. General L. D. Heaton, M.C.

L. Quincy Mumford, LL.D.

William H. Stewart, M.D.

Executive Secretary

Martin M. Cummings, M.D.

The Surgeon General, Department ofthe Air Force

The Surgeon General, Department ofthe Navy

Director, Division of Biologicaland Medical Sciences,National Science Foundation

Chief Medical Director, The VeteransAdministration

The Surgeon General, Department ofthe Army

The Librarian of Congress

The Surgeon General, U.S. PublicHealth Service

Director, National Library of Medicine

NATIONAL LIBRARY OF MEDICINE

ANNUAL REPORT

for the

FISCAL YEAR 1966

December 1966

8600 Rockvi Me PikeBethesda, Maryland 20014

TABLE OF CONTENTS

Key Personnel

Foreword

Chapter I. Office of the Director .............. 1Medical Library Assistance Act of 1965 .......... 1Board of Regents ..................... 2NLM Five-Year Program Plan ................ 3MEDLARS Centers ..................... 3Current Catalog ..................... 4New Computer System ................... 4Paper Preservation and Graphic Image Storage andRetrieval ....................... 4

Continuing Education ................... 5Committee on Scientific and Technical Information . . . . 5COSATI Report on Document Handling Systems ........ 6Herner Report ...................... 7Federal Library Committee ................ 7Library Surveys ..................... 8Public Information and Publications ........... 8Organizational Study ................... 9Financial Management ................... 10Personnel ........................ 10Office Services ..................... 11

Chapter II. Extramural Programs ............... 13Publications and Translations Division ......... 15Research and Training Division .............. 20Facilities and Resources Division ............ 26

Chapter III. Intramural Programs ............... 27Medical Subject Headings ................. 28Drug Literature Program ................. 34Technical Services,Division ............... 37Bibliographic Services Division ............. 43Information Systems Division ............... 46Reference Services Division ............... 49History of Medicine Division ............... 56

Appendices (following page 59) .

KEY PERSONNEL OP THE NATIONAL LIBRARY OF MEDICINE

June 30, 1966

OFFICE OF THE DIRECTORDirectorDeputy DirectorCoordinator for Dental AffairsContinuing Education OfficerSpecial Assistant to the Deputy DirectorExecutive OfficerAssistant Executive OfficerBudget OfficerManagement AnalystPersonnel OfficerProperty and Supply Officer

Assistant to the Director^ PublicInformation and PublicationsPublic Information Officer

EXTRAMURAL PROGRAMSAssociate DirectorAdministrative OfficerStaff AssistantPublications and Translations DivisionChiefResearch and Training DivisionChiefOperations Officer

INTRAMURAL PROGRAMSAssociate DirectorSpecial Assistant for Information CentersMedical Subject Headings StaffHeadDrug Literature ProgramHeadReference Services DivisionChiefDeputy ChiefHead, Reference SectionHead, Loan and Stack SectionHead, Photoduplication SectionActing Head, Preservation Section

Bibliographic Services DivisionChiefHead, Index SectionHead, Search Section

Dr. Martin M. CummingsMr. Scott AdamsDr. Kenneth C. LynnDr. Burnet M. DavisDr. Andrew SherringtonMr. James D. IsbisterMr. James D. LawrenceMr. James G. HillMr. Charles E. HerbertMr. Jerome N. KerkhofMr. Joseph McGroarty

Mr. Gerald N. KurtzMr. Robert Wilson

Dr. Marjorie P. WilsonMr. John P. SpainMrs. Maxine Hanke

Miss Mary Corning

Dr. Carl D. DouglassMr. David Kefauver

Dr. Joseph LeiterDr. Leonard Karel

Dr. Norman P. Shumway

Miss E. Winifred Sewell

Mr. Samuel WatersMr. Edward A. MillerMr. Charles A. RoosMr. Thomas R. GassidyMr. Svend A. AndersenMr. Thomas R. Cassidy

Dr. Clifford BachrachMr. Constantine GillespieMiss Charlotte Kenton

Information Systems DivisionActing ChiefInformation Systems EvaluatorHead, Programming SectionHead, Operations SectionHead, Input Unit

Technical Services DivisionChiefDeputy ChiefHead, Selection and SearchingHead, Acquisition SectionHead, Cataloging Section

History of Medicine DivisionChiefDeputy ChiefHead, Catalog Office

Mr. Paul C. RedmerMr. Frederick W. LancasterMr. Ronald BogartMr. Daniel BelsoleMrs. Audrey L. Milner

Mr. James P. RileyDr. Louis S. GerberDr. Galina ZarechnakMiss Elizabeth SawyersMiss Emily V. Wiggins

Dr. John B. BlakeDr. Peter D. OlchMr. Richard J. Durling

ii

FOREWORD

The Nation's medical libraries are a vital linkbetween medical education, practice and research. . .

Lyndon B. Johnson

Fiscal Year 1966 was a period of continued growth for theNational Library of Medicine. Services were expanded, and staff andbudget were increased in response to increased demands. Libraryprograms were evaluated and in some cases modified or strengthenedto meet future needs.

High point of the year was the passage by the eighty-ninthCongress of the Medical Library Assistance Act (Public Law 89-291),signed into law by President Johnson on October 22, 1965. The newlaw created broad responsibilities for the National Library ofMedicine to help the Nation's medical libraries provide vitalservices to medical education, research and practice. The impactof the legislation will be far reaching.

The Library staff developed comprehensive plans to improve andaccelerate the flow of biomedical information. A five-year programdesign was prepared, incorporating recommendations of the NationalLibrary of Medicine Board of Regents. The plan calls for theLibrary to provide support and guidance for the development of theexisting informal system of biomedical libraries into a responsive,efficient national network (Fig. 1).

Network development will begin under the impetus of the MedicalLibrary Assistance Act, with funds being made available to theNation's medical libraries for improved facilities, resources,training programs and research in information handling technology.Procedures have been established for grant application, review, andapproval. Several research, training, special scientific projects,and library resources grants have already been awarded.

NLM intramural activities to provide centralized resources forthe network (Fig. 2) were expanded in Fiscal Year 1966. The Libraryis placing a new emphasis on accumulating, controlling, anddisseminating broad categories of information in new forms (graphicimages, audiovisual materials) in addition to traditional forms ofpublished information.

Further decentralization of NLM's computer-based MEDLARS(Medical Literature Analysis and Retrieval System) during the pastyear represents an important step in network development.

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Supplementing the capability at NLM and the search centers alreadyestablished at the University of California at Los Angeles andthe University of Colorado in Denver, MEDLARS search centers arenow becoming operational at the University of Alabama, HarvardUniversity and the University of Michigan. (Fig. 3)

To provide a centralized cataloging service for medicallibraries and to speed their acquisitions programs, NLM intro-duced a new computer-produced publication - The National Libraryof Medicine Current Catalog. Issued biweekly since January 1966with quarterly and annual cumulations, the NLM Current Cataloglists citations to publications cataloged by the Library. Com-plete bibliographic data are included in each citation. The NLMCurrent Catalog will effect considerable savings in manpower anddollars for the Nation's medical libraries.

During the past year, NLM began publishing the annual cumu-lation of citations appearing in the Library's monthly Index Medicus.Cumulated Index Medicus, formerly published by the American MedicalAssociation, is now published by NLM through the GovernmentPrinting Office. It is printed from film copy provided by theLibrary's computer and prepared by GRACE, NLM's computer-drivenGraphic Arts Composing Equipment.

With increasing needs of scientists and clinicians for informa-tion on drugs, the Library was designated to join with other Federaland private organizations in a major effort to improve the communica-tion of information on drugs and chemicals. NLM's Drug LiteratureProgram participated in the development of several cooperativeprojects designed to support more efficient collection, processing,and dissemination of the published literature on the effects ofdrugs on man and animals. A pilot computer-produced toxicitybibliography was compiled and distributed to a group of expertsfor critical review.

The increasing volume of published basic and applied informa-tion in the health sciences has overloaded existing informationchannels. Requests for information from scientists, practitioners,and educators continue to increase. During Fiscal Year 1965, NLMprovided over 16,000 more individual reference, circulation, andbibliographic services than in the previous year, including analmost 100 percent increase in the number of computer-produceddemand bibliographies (from 1,623 in FY 65 to 3,035 in FY 66). Atotal of 265,000 reference and circulation transactions wasrecorded, representing a 6 percent increase over the previous year.

The first phase of NLM's program to accelerate the transmissionof information to health professionals was implemented late inFiscal Year 1966. The Library installed teletypewriter equipment,and established a format for using the facility to speed up thetransaction of interlibrary loan requests.

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A report by a National Bureau of Standards team and a conferenceof authorities from industry and government led to the expansion ofNLM's programs of microfilming biomedical literature which isendangered by paper deterioration. Pilot contracts were awarded forthe microfilming of 2 million pages of journal literature supple-menting NLM's in-house microfilming which was expanded to preserve2 million pages per year.

The staff of the NLM is confident that the Library's programsare making significant contributions to the advancement of medicaland related sciences, ultimately to improve the health of thepeople of the United States.

Martin M. Cummings, M.D.Director, NLM

CHAPTER I

O F F I C E O F T H E D I R E C T O R

Medical Library Assistance Act of 1965. The Medical LibraryAssistance Act of 1965 (PL 89-291) represents a milestone in theevolution of the National Library of Medicine and a new step inFederal support for comprehensive library-based biomedicalinformation services.

In the Act,Congress "finds and declares that (1) the unprece-dented expansion of knowledge in the health sciences within thepast two decades has brought about a massive growth in the quantity,and major changes in the nature of, biomedical information,materials, and publications; (2) there has not been a correspondinggrowth in the facilities and techniques necessary adequately tocoordinate and disseminate among health scientists and practitionersthe ever-increasing volume of knowledge and information which hasbeen developed in the health science field; (3) much of the valueof the ever-increasing volume of knowledge and information which hasbeen, and continues to be, developed in the health science fieldwill be lost unless proper measures are taken in the immediatefuture to develop facilities and techniques necessary to collect,preserve, store, process, retrieve, and facilitate the disseminationand utilization of, such knowledge and information."

To strengthen, develop and support the nation's biomedicallibrary system, the Medical Library Assistance Act authorizesappropriations of $10,000,000 annually for each of four yearsbeginning in FY 1967 for grants to assist in meeting the cost ofconstruction of medical library facilities and $65,000,000 over afive-year period beginning in FY 1966 for other support programsincluding: $1,000,000 per year for grants to individuals and insti-tutions for training in medical library and information sciences;$500,000 annually for grants to support physicians and other healthscientists in the compilation of existing, or writing of original,contributions relating to advancements in the health sciences;$3,000,000 a year for grants and contracts to support research inmedical library and related information sciences and for develop-ment of new techniques and systems for improved processing anddissemination of biomedical information; $3,000,000 annually forgrants to improve and expand the resources - including librarymaterials, services, equipment and technologies - of biomedicallibraries and related institutions; $2,500,000 per year for grantsto existing biomedical libraries to enable them to serve asregional medical libraries for the geographic areas in which theyare located; $1,000,000 per year for grants and contracts to supportbiomedical publications; and $2,000,000 annually to establish andoperate regional branches of the National Library of Medicine inareas where there are no existing medical libraries adequate toserve the needs of health scientists in those areas.

The Library prepared and defended a supplemental appropi-ation request to begin implementation of some of the programsauthorized by the Act during fiscal year 1966. $4,175,000 wasmade available in a supplemental appropriation act for fiscalyear 1966, and the Library began implementation of the Act.

Board of Regents. The Board of Regents held three meetingsduring the year: November 15-16, 1965; March 21-22, 1966;June 23-24, 1966. New members appointed were Dr. William B.Bean, Professor and Chairman of the Department of InternalMedicine at the State University of Iowa, and Dr. Stewart G.Wolfe, Professor and Chairman of the Department of Medicine,University of Oklahoma, replacing Drs. Norman Q. Brill and SaulJarcho. Dr. Hubbard, Dean of the University of Michigan MedicalSchool, continued as elected Chairman.

A principal action at the November meeting was the adoptionof the Board's Advisory Report on Policy. The Board recommendedthat the Library, in addition to being a primary resource forcollecting, organizing, and distributing recorded informationrelevant to the national health effort, also assume a central rolefor the multiple specialized health information centers designedto meet categorical needs. The Board also recommended that theLibrary function as the central component of a national biomedicalinformation network and that it assume leadership in the research,development*, and coordination necessary to the evolution of thisdecentralized national biomedical information system. ThisAdvisory Report on Policy was transmitted to the Surgeon Generalin December, and approved by him. See Appendix XXI for thetext of this report.

With the passage of the Medical Library Assistance Act, theBoard acquired additional statutory responsibilities as theNational Medical Libraries Assistance Advisory Board. At itsNovember meeting it reviewed its new role and at its March 1966meeting it took its first official action, reviewing andrecommending to the Surgeon General draft regulations and policiesguiding the implementation of the Act.

Exercising its program review and policy establishmentresponsibilities, the Board was involved with NLM's Five-YearProgram Plan; the establishment of MEDLARS search centers; MEDLARSevaluation; journal selection for the Index Medicus; relationshipswith COSATI and the Office of Science and Technology; graphicimage storage and retrieval, and continuing education. Individualmembers of the Board participated in site visits during the yearto Israel, India, and Korea.

NLM Five-Year Program Plan Design. The Library staffprepared a comprehensive five-year program plan outlining thesteps required to forge the advisory recommendations of theBoard of Regents to the Surgeon General into an operating planand to carry out the programs authorized by the Medical LibraryAssistance Act of 1965. The plan describes NLM programs designedto fulfill NLM's role in improving and accelerating biomedicalcommunications through development and support of a nationalbiomedical library network consisting of local, regional, andnational libraries.

In addition to financial assistance authorized by the MedicalLibrary Assistance Act of 1965, the NLM will assist in thesupport of the network with direct services through NLM'sfacilities and programs. NLM will develop and operate a newnational health information clearinghouse and referral systemwhich will encompass important unpublished biomedical informationand useful learning resources for medical research, education andpractice. A new Center for Biomedical Communications will beestablished to provide: (1) facilities for research and develop-ment in information science and communications related to medicine,(2) a base for developing new instruments and testing new techniquesto be used in systems of continuing education for health practi-tioner, and (3) a model for regional library services, includingthe distribution of continuing education materials to the sur-rounding geographic area. (Fig. 4)

The five-year plan was reviewed and accepted by the Boardof Regents and the Surgeon General,

MEDLARS Centers. To increase the power and productivity ofMEDLARS and provide for demonstration and testing under fieldconditions, a program to decentralize the search and retrievalcapability of the system was initiated in FY 1965. Contracts wereawarded to the University of California at Los Angeles and theUniversity of Colorado to operate MEDLARS retrieval centersusing duplicate MEDLARS tapes on local computer equipment toprovide bibliographic search services to users in their geographicarea. The UCLA contract also included converting the MEDLARSsearch and retrieval computer programs for use on equipment notdirectly compatible with the NLM's computer.

During FY 1966 geographic distribution of MEDLARS demandsearching was expanded to a total of five centers. These centerswill be fully operational in FY 1967. Also in FY 1966, searchservices were provided on an 'individual agreement basis to federaland non-federal institutions, and MEDLARS tapes were sold at thecost of tape conversion and copying to three educationalinstitutions.

Current Catalog. The Library reached the first majormilestone in automating its technical services on January 1, 1966,with the publication of the computer-generated biweekly CurrentCatalog. The biweekly publication with quarterly and annualcumulations makes NLM cataloging available to all medicallibraries in the shortest possible time, and is intended tominimize duplication of effort in cataloging. The quarterlycumulation makes the Library's cataloging readily available forretrospective searching.

The NLM Current Catalog has maintained an "on-time" schedulesince its initiation. The six months' experience during fiscalyear 1966 has indicated wide acceptance and use by medicallibrarians.

New Computer System. Five years have passed since the contractfor the design of MEDLARS was let in 1961. As a system, plannedand installed during a period of rapid increase in computertechnology, MEDLARS antedates random-access and on-line capabilitieswhich recent developments have made feasible. With rapid increases involume and kind of NLM's computer-generated information services,it was recognized that a new computer system with very largecapacity, on-line access capability, and random access storagedevices must be provided in the near future.

In June the Library awarded a contract to the AuerbachCorporation to develop performance requirements and general specifi-cations for the new computer system. The performance requirementswill accommodate: (1) an expansion and improvement of MEDLARSservices, (2) an on-line input system to MEDLARS to permit directcommunication between indexer and computer; (3) an automatedacquisition and cataloging system, (4) a graphic image storageand retrieval system closely linked to the MEDLARS computer searchcapability; (5) a drug literature program with chemical searchcapabilities added to MEDLARS; and (6) development of an intra-mural research and development program in information retrieval andscientific documentation.

At the end of fiscal year 1966, it was estimated that thedesign for the new system would be completed and the equipmentinstalled in late fiscal year 1968.

Paper Preservation and Graphic Image Storage and Retrieval. Alllibraries with large research collections and archival responsi-bilities face the loss of a large proportion of their resources dueto the rapid deterioration of the paper on which publications areprinted. In paper manufacturing used during the last 100 years thewood pulp is treated with chemicals containing an excessively highresidual acid content which renders the finished paper brittle.

Much of the paper becomes extremely fragile --so fragile thatmany publications must be withdrawn from circulation to avoidirreparable damage. Unfortunately, considerable information inthe NLM collection has already been lost. About five millionpages are critically deteriorated, and an additional 32 millionpages are in such poor condition that even one-time use willprobably result in losses.

In fiscal year 1966 the Congress appropriated $220,000, inaddition to the amount requested in the President's Budget, toserve as a base for a microfilm preservation program. InNovember 1965, a Graphic Image Storage and Retrieval Conferencewas held in Bethesda to consider the results of a collaborativestudy by the NLM and the National Bureau of Standards of theLibrary's photoduplication system requirements. On the basis ofinformation and specifications in the study report and therecommendations of the conference, the NLM accelerated its paperpreservation program, filming deteriorated materials on 35millimeter reel film. If necessary, the information can beconverted to another medium for incorporation into a new graphicimage storage and retrieval system. Two pilot contracts were letfor the filming of approximately one million pages each. Pro-duction for preservation purposes in the NLM's own photodup-lication plant has been increased to preserve one and a halfmillion to two million pages per year.

Continuing Education. Special attention was focused duringthe year on the Library's role in continuing education of thehealth professions. The position of Continuing Education Officerwas established, and filled by a medical officer, Dr. Burnet Davis,in October 1965.

In January 1966 an Ad Hoc Consultant Group was called togetherto consult with the Director and his staff regarding the Library'srole in continuing education. During 1% days of deliberations,recommendations were developed which have since served as programguidelines.

These recommendations placed emphasis on:Support of programs aimed at developing the capacity for in-

dependent learning among professional students;Improvement of the resources and strengthening the role of

community hospital libraries in serving practitioners;Research and development on techniques for reaching the prac-

titioner through library resources, including new learning resourcessuch as visual materials and programmed instruction;

Support of one or more demonstration centers for developingand testing new techniques in the context of an active medicalcomplex;

Training of specialized information agents, librarytechnologists, and research workers in educational and communi-cation techniques;

Development and testing of a usable abridged Index Medicus.

Following the guidelines and stimulus of the consultant group,the Continuing Education Officer identified a number of activitiesin both the intramural and extramural programs of the Librarywhich contribute to continuing education, and worked with Librarystaff to maximize their contribution. For example, efforts weremade toward improvement of the recurring bibliographies andliterature searches produced and published directly by the Libraryor in cooperation with other agencies or organizations.

The Library's major resource, however, for contributing tothe improvement of continuing education programs was identifiedin the extramural programs authorized by the Medical LibraryAssistance Act of 1965. For example, the construction and resourcesupport grant programs can encourage provision of space, equipment,and commitment of staff resources to continuing education. Theresearch and training grant program can encourage and supportprojects to improve techniques and skills in this area. In bothof these programs close working relationships are needed and arebeing developed with the Division of Regional Medical Programs ofthe National Institutes of Health. At the same time, theContinuing Education Officer worked closely with extramuralprogram staff in providing consultation and staff assistanceregarding projects in this area.

Committee on Scientific and Technical Information. Throughoutthe year the Director attended meetings of the Committee onScientific and Technical Information (COSATI) of the Federal Councilon Science and technology as an observer, supplementing the work ofDr. Ellis Johnson, the Departmental representative, and Dr. F.Ellis Kelsey, his alternate.

The Director served on the COSATI Panel on InternationalInformation Activities. Mr. Charles Austin was a member of thePanel on Information Science and Technology, and Mr. Paul Redmerwas a member of the Panel on Operational Techniques and Systems.

COSATI Report on Document Handling Systems. Based onextensive studies by Systems Development Corporation, a COSATIreport issued in November 1965 called for the development ofnational document handling systems in science and technologyunder the leadership of the Office of Science and Technology.The report was accepted by the Federal Council on Science andTechnology and referred to the National Science Foundation forfurther study relating to its implementation/ As the agency with

responsibilities for developing national document handlingsystems in the biomedical sciences, the National Library ofMedicine has an active role to play. The Library's broadobjectives, as described in its Five-Year Program Plan, arecompatible with the document handling functions proposed in theCOSATI report.

Herner Report. In endorsing the Medical Library AssistanceAct, the Bureau of the Budget expressed uncertainty as to thepossible future course of development of biomedical libraries inview of rapid advances being made in techniques for the indexing,storage, and retrieval of information. The BOB requested astudy of future biomedical library needs, at the same timerecommending deferment of a program of medical library construc-tion until 1967 to permit time for the completion of the study.The Office of Science and Technology was designated to implementthis study. The Office of Science and Technology assembled apanel of advisers, drafted the specifications for the study, andarranged through the National Science Foundation for a contractwith Herner and Company of Washington, D. C. A preliminary versionof the Herner study was received and reviewed in February.Following discussions with Office of Science and Technology, thestudy was remanded for further development.

Conducted concurrently with the Library's development of itsFive-Year Program Plan, the Herner report differed in severalparticulars. A fundamental difference lay in the approach to anational system, conceived by the Library to develop throughcooperative planning from existing non-federal institutions, andby Herner to be created and managed by the Federal Government.A revision of the Herner report was in progress at the end of theyear.

Federal Library Committee. The Federal Library Committee wasestablished under the joint auspices of the Bureau of the Budgetand the Library of Congress in July 1965 to consider policies andproblems relating to Federal libraries. The National Library ofMedicine is a permanent member of the Committee. The Committeeoperates through several task forces which conduct inquiries intovarious aspects of Federal library operations. During the yearvarious members of the NLM staff participated in these task forces.Mr. Scott Adams served as Chairman of the Task Force on Missionand Standards; Mr. Samuel Lazerow and Miss Elizabeth Sawyersserved on the Task Force on Procurement Procedures; Mr. PaulRedmer on the Automation Task Force; Dr. David Kronick and Mr.Edward Miller on the Interlibrary Loan Task Force, and Dr. LouisGerber on the Acquisitions and Statistics Task Force.

Library Surveys. In accordance with a Presidential commit-ment made to the Government of South Korea, the Agency forInternational Development requested the services of the NationalLibrary of Medicine in investigating library resources for anexpanded program of medical education- in Korea. Mr. Scott Adams,joined by two members of the Board of Regents, Dr. William N.Hubbard, Jr., and Dr. Alfred A. Gellhorn, visited Korea medicalschools in May 1966. Mr. Adams submitted a report calling forAID action in assisting the Korean medical schools to developtheir libraries. In addition, Mr. Adams visited Vietnam toreview with AID officials the implementation of their plans foran enlarged medical library at the University of Saigon.

Public Information and Publications. The position ofAssistant to the Director was filled in February 1966 by Mr.Gerald N. Kurtz. This office has broad responsibilities forpublic information and publications. Mr. Daniel Carangi joinedthe Library staff as Exhibits Director, replacing Mr. Robert Cohen,and a new position, Staff Assistant for Publications Management,was established and filled by Mr. Robert Mehnert.

In the latter part of the fiscal year, public information andpublication activities were reorganized and a broad informationprogram was planned to provide widespread dissemination of newsabout Library activities to all communications media. Nationalmagazines have been contacted about feature stories and a possibledocumentary program has been discussed with a TV network.

To prepare a progressive public information program, however,it has been necessary to revise, redesign and produce up-to-datebasic information materials. A new Library brochure, film, andmajor exhibit have been prepared and are now in production. A newLibrary symbol, or logotype,

N A T I d N A l I I B R A H Y O r M E D I C I N E will appear on all new publications and

exhibits. Traditional information channels have been utilized bysending releases to the press and biomedical communications media onimportant Library developments. During fiscal year 1966, announce-ments were released on the passage of the Medical Library AssistanceAct, key staff appointments, and exhibits at NLM.

Exhibitions at NLM in the past year, set up with the assistanceof the Information Office, included presentations on Conrad Gesner,Leonardo da Vinci, the Hollywood film, "Fantastic Voyage," andMedical Symbolism. An NLM exhibit shown at the American DentalAssociation annual meeting in Las Vegas received an award forexcellence.

The position of Tour Guide Coordinator was filled in FY 1966by Mrs. Hilda Fried. Tours of the Library have been arranged andconducted for approximately 2,700 visitors.

A ceremony was held at NLM on June 24 honoring Dr. PaulDudley White. A portrait of Dr. White was presented to theGovernment, and was accepted by Dr. William H. Stewart, SurgeonGeneral. The ceremony was attended by the NLM Board of Regentsand the National Advisory Heart Council.

The responsibility for the management and promotion of publi-cations was transferred to the Office of the Assistant to theDirector in the past fiscal year. The promotion of publications hasbecome especially important with publication of the new NLMCurrent Catalog. Press releases, announcements sent out on mailinglists, and distribution at professional meetings have beenemployed to build circulation for the Current Catalog.

During the year NLM began to acquaint the biomedicalcommunity with the availability of bibliographies which, althoughcompiled in response to individual requests, are considered bythe Library to be of interest to a wider audience. The availabilityof these Selected Literature Searches from NLM is announcedmonthly in JAMA, Drug Research Reports and the NLM News. TheLibrary has received 7,313 requests for the series of 47 LiteratureSearches produced so far.

The NLM News has received a face-lifting: a new masthead andmore liberal use of photographs have been employed to make theNews a more attractive publication and to inform the librarycommunity more effectively of developments at NLM.

Organizational Study. At the request of the National Library ofMedicine, a Management Analyst from the Office of the SurgeonGeneral conducted a comprehensive study of the organization of theLibrary. The Analyst, Mr. Morrill Donnald, submitted his reportand recommendations in July 1965. Mr. Donnald's twenty-fourrecommendations were designed to provide the NLM with an improvedorganizational structure to meet new and expanded program Tesponsi-bilities and perform existing program activities more effectively.Acting on the recommendations, the Library consolidated stafffunctions in the Office of the Director, appointed an AssociateDirector for Intramural Programs to direct and coordinate theactivities of the five library service divisions, and establisheda structure of three divisions to administer the extramuralprograms. The Extramural Program divisions are the Research andTraining Division, the Facilities and Resources Division, and the

Publications and Translations Division. In addition toimplementing those major recommendations, the Library adopteda number of other recommendations designed to clarify operatingresponsibilities, improve intra-NLM communications, and facil-itate the management of NLM program activities.

Financial Management. In August 1965, President Johnsondirected each Federal agency to develop a modern planning-programming-budgeting (PPB) system. In describing the systemthe President stated:

"Once in operation, the new planning-programming-budgeting system will enable us to:

(1) Identify our national goals with precisionand on a continuing basis;

(2) Choose among these goals the ones that aremost urgent;

(3) Search for alternative means of reachingthose goals most effectively at the least cost;

(4) Inform ourselves not merely on next year'scosts--but on the second, and third, and subsequentyear's costs—of our programs;

(5) Measure the performance of our programs toinsure a dollar's worth of service for each dollarspent. . .."

In 1966, the Library participated in the HEW Department-wide effort to develop a PPB system. The Office of the SurgeonGeneral established a PPB Task Force to develop instructions andprocedures for implementing the planning-programming-budgetingsystem within the Public Health Service.

In May 1966, the Library submitted its Five-Year Program andFinancial Plan to the Office of the Surgeon General. Implementationof the PPB system Government-wide is a major undertaking and theactions taken in 1966 have been largely preparatory.

Personnel. Forty-five new positions in the President'sbudget and sixteen more positions in the supplemental appropri-ation for implementation of the Medical Library Assistance Actwere authorized for Fiscal Year 1966, making continuing expansionpossible. During Fiscal Year 1966, the following key staffappointments were made:

Dr. Clifford Bachrach, Chief, Bibliographic Services DivisionDr. Carl-Eric Elwin, Visiting Scientist, Drug Literature

ProgramDr. Fritz P. Gluckstein, Commissioned Officer, Technical

Services Division

10

Mr. Charles Herbert, Management Analyst, AdministrativeServices

Mr. James G. Hill, Budget Officer, AdministrativeServices

Mr. James D. Isbister, Executive Officer, AdministrativeServices

Mr. David Kefauver, Chief, Research and Training DivisionMr. Gerald Kurtz, Assistant to the Director, Public

Information OfficeMr. Frederick Lancaster, Information Systems Evaluator

Information Systems DivisionDr. Joseph Leiter, Associate Director for Intramural

ProgramsMr. James P. Riley, Chief, Technical Services DivisionDr. Andrew Sherrington, Visiting Scientist, Office of the

DirectorDr. Norman P. Shumway, Head, Medical Subject Headings StaffMr. Norman Smith, Staff Assistant, Intramural Programs

Training. Fifty employees participated in in-service trainingincluding orientation programs at the Library; eleven participatedin training programs at other government agencies, and thirty-sixstudied at non-governmental facilities. This training required atotal of 276 man-days as compared with 165 last year.

Summer Employment. Eight students under the President's YouthOpportunity Program, three under the Commissioned Officers' StudentTrainee Program, and eight appointed from the Civil Service Clerk-typist and Clerk-stenographer registers supplemented the Library'swork force during the summer months and provided summer jobs for atotal of nineteen students.

Quality Increases and Awards. An additional within gradestep increase for superior performance was awarded to elevenemployees. They ranged in grade from GS-5to GS-14. Superiorperformance awards were given to Mr. Robert Cohen ($216),Mrs.Marjorie Wright ($277), and Mrs. Thelma Charen ($300). Mr.Earl Kinslow received $25 for his design of a rack for the storageof buckram rolls used for on-premise binding.

Office Services. Arrangements were made during Fiscal Year1966 for the rental of approximately 7,500 square feet of officespace to house the NLM's extramural program staff. The rentalspace is located in the Blackwell Building, 7758 WisconsinAvenue, Bethesda, Maryland (approximately one-half mile from theNLM building).

Repairs and Improvements:

1. The Staff Parking Lot located west of the Library building

11

was enlarged to allow an additional 36 parking spaces for staffmembers and others working in the Library building.

2. Two new rest room facilities were constructed on "C?

level. The expanded facilities were required because of theadditional staff located on 'C' level.

3. A contract to paint the public areas was awarded late inFiscal Year 1966 with completion scheduled for the middle ofAugust. Painting included the underside of the high roof, mainreading room, History of Medicine's reading room, Board Room,Auditorium, stairwells, and the Lunch Room.

4. A contract was awarded for enlarging the Lunch Roomfacilities at NLM to expand the seating capacity in the Lunch Roomby 44 percent.

5. A contract to convert the space adjacent to the History ofMedicine Division stacks to office space was awarded in May 1966.

6. A contract to renovate Room A-54 (old Binding Work area)was awarded in November 1965. The space will provide offices forthe Drug Literature Program and the Medical Subject Headings Group.

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CHAPTER II

E X T R A M U R A L P R O G R A M S

The most significant event of the past year was the enactmentof the Medical Library Assistance Act of 1965 (PL 89-291) which wassigned by President Lyndon B. Johnson on October 22, 1965. Originallyintroduced on January 19, 1965,by Senator Lister Hill in the Senateas S.597 and by Congressman Oren Harris in the House as H.R. 3142,the legislation provides a program of Federal assistance for theNation's biomedical libraries. Congressman John R. Fogarty, whointroduced an identical bill, H.R. 6001 on March 19, 1965, describedthe underlying philosophy of the Act in his own testimony in the Housein support of it as follows: "It wisely assumes that private, local,and state resources will continue to carry most of the expense of ourNation's library system. At the same time it assumes that the leader-ship role of the NLM should be recognized, utilized and strengthened."

Hearings in the Senate were held on the pending legislation onJune 14-15, 1965. Hearings in the House of Representatives were notheld until September 14, 1965. The major staff effort early in thefiscal year was devoted to activities associated with Congressionalconsideration and passage of the new legislation. These activitiesincluded staff liaison with the Senate Committee on Labor and PublicWelfare, the House Interstate and Foreign Commerce Committee, theLegislative Services Branch, Division of Public Health Methods; thewriting of reports and preparation of extensive background materialsfor DHEW and PHS officials and other staff work required in thelegislative endeavor.

Rarely has a health legislative program received such extensiveand unanimous support as PL 89-291. Numerous organizations cameforward strongly in favor of its enactment. Some of the major organi-zations testifying in support of the legislation included: theAssociation of American Medical Colleges, the American Medical Associa-tion, the American Dental Association, the American Association ofDental Schools, the Medical Library Association, the Special LibrariesAssociation, the American Heart Association, the American College ofPhysicians, the Association of Research Libraries, the AmericanPodiatry Association, and the American Optometric Association.

The Congressional committees received letters in support of thelegislation from many medical schools, universities and such organiza-tions as the following: the American Public Health Association, theAmerican Hospital Association, the American Nurses' Association, theAmerican Association of Colleges of Pharmacy, the American MedicalWriters' Association, the American Thoracic Society, and the AmericanPsychiatric Association.

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After passage of the Act, regulations necessary for itsimplementation were developed and written in collaboration withrepresentatives of the Office of the General Counsel. Policy guide-lines, informational materials, procedures, application forms andall other necessary documents were developed and published. Tofacilitate review and approval of regulations and policy guidelinesby the Board of Regents, a Subcommittee for Extramural Programs wasappointed and first met with the Extramural staff on February 18, 1966,to review preliminary drafts of these official documents. FullBoard review and approval was obtained at the regular meeting,March 21-22, 1966. After clearance through official channels of thePublic Health Service and Department, the regulations were publishedin the Federal Register July 13, 1966.

The Board of Regents Subcommittee for Extramural Programscontinues to meet just prior to the regular Board of Regents meetingsto discuss and review special problems and program developments in theExtramural area.

The overall plan for administration of the Extramural Programs,including planning the review process for grants and awards, wascoordinated with the Grants Policy Office in the Office of the SurgeonGeneral. The NLM Associate Director for Extramural Programs continuesas a full voting member of the Interbureau Advisory Committee forExtramural Programs under the Chairmanship of the Grants Policy Officer,OSG.

During the course of the year, the Director, NLM establishedtwo Advisory Committees relating to Extramural Program activities.These committees will provide initial review of applications forgrants and awards prior to final review by the Medical LibrariesAssistance Advisory Board which is the Board of Regents. The twonewly established initial review committees are the Manpower andTraining Committee and the Facilities and Resources Committee.Training grants and fellowships will be reviewed by the former;construction grants, resources grants and regional library grants willbe reviewed by the latter. In keeping with the decision to haveresearch and development grants and publications support grantsreviewed through the Division of Research Grants, the AdvisoryCommittee on Scientific Publications was transferred from the Publi-cations and Translations Division, Extramural Programs, NLM, to theDivision of Research Grants, NIH, effective November 1, 1965.Negotiations with the Division of Research Grants have been carriedon to broaden the responsibility of the Committee to include reviewof projects in information science and rename it the Committee onScientific Communications. The expanded committee will be chargedwith responsibility for initial review of the broad area of Eesearchand development in information science, as well as review of appli-cations for the support of special publications. Discipline and

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NLM EXTRAMURAL PROGRAM

Fig. 5

categorically oriented Study Sections of the Division of ResearchGrants will be asked to review NLM research and publicationsprojects when appropriate.

Organization of Extramural Programs. Special sections of the MedicalLibrary Assistance Act cover construction, expansion and renovationof facilities, grants for improvement and expansion of basic libraryresources, regional library grants, special scientific projects,research and development, manpower development, and publicationssupport. In addition, the Extramural Program retains the previouslyavailable authority of Section 301 of the Public Health Service Actfor support of research and training (See Fig. 5 ). Also the ExtramuralProgram has been delegated the responsibility for planning andcoordination of the Special Foreign Currency Program activities ofthe PHS relating to the support of publications. Previously twoDivisions existed, the Publications and Translations Division andthe Research and Training Division. In addition, during the courseof the past year, a Facilities and Resources Division was approvedby the Public Health Service, April 7, 1966. In support of these threeprogram and functionally oriented Divisions, and the Office of theAssociate Director for Extramural Programs, a Grants and ContractsManagement Office was established with a Management Officer,Mr. John P. Spain. This Office not only provides grants andcon-tracts management but all administrative land supportive services forthe Extramural Program. Included in this will be all grants processingfunctions, committee management, and fiscal and budgetary developmentand management.

PUBLICATIONS AND TRANSLATIONS DIVISION

Domestic Program. The Publications and Translations Division con-tinued to review and analyze the substantive aspects of the publicationssupport program and to develop cooperative arrangements with otherelements of the Public Health Service, DHEW, government agencies, andnational and international scientific and professional bodies.

Several notable developments took place during FY 1966. Theabstracting of specialized foreign literature by Biological SciencesInformation Services and Excerpta Medica and the translation ofselected Soviet literature by the Federation of American Societiesfor Experimental Biology had been supported for several years undercontract. In FY 1965, a principle had been adopted that supportfor abstracting and translating activities should be given primarilyfor the intellectual preparation of the material and those costswhich were concerned with publication aspects should be assumedpreferably by appropriate professional scientific organizations. InFY 1966 it was decided that the long-term support for these abstractingand translation activities should be gradually phased out. These

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three abstracting services were asked to develop proposals whichwould provide for phase-out of support over the next three yearswith the attainment of self-sufficiency during this period of time.Biological Abstracts and Excerpta Medica accepted this concept andpresented plans and budgets for a program for FY 1966 through 1968.The Excerpta Medica proposal was complete enough so that a contractcould be negotiated for 1966 with options for support for two ad-ditional years. Biological Abstracts submitted a three-year proposalbut only one year was negotiated. Support of the FASEB TranslationSupplement was extended for a terminal year.

Considerable attention was paid during FY 1966 to betterdefinition of the scope of the research contracts for abstractingand translating the foreign literature and improving the feed-backon scientific content from the contractors. This not only facilitatedproject evaluation but provided information of value in identifyingand translating the most significant foreign literature.

A detailed staff analysis of the subject matter distribution ofthe Soviet research articles being abstracted by Biological Abstractsdemonstrated that a very significant proportion related to agricul-tural and wildlife literature with no basic health-related components.These were not within the Library's immediate area of responsibilityand, as a result of more precise specifications, it is estimatedthat for FY 1966 the number of health-related abstracts of Sovietliterature prepared by Biological Abstracts under the NLM contractwill be increased by about twenty-five percent. At the same timethe contractor has continued to cover Soviet agricultural and wild-life literature.

More substantive subject-oriented reports are now requiredunder the contracts. The staff developed and incorporated specifi-cations which require information on the foreign journals covered,the yield of articles judged to be of interest to U.S. biomedicalscientists for each journal for the period covered, and the subject-matter distribution of the abstracts and translated articlesproduced. This provides one index of the potential U.S. interestin specific Soviet and Japanese health-related journals, and therelative significance of the Soviet and Japanese research effort indifferent areas.

The Excerpta Medica report will cover Excerpta Medica's entireSoviet and Japanese abstract effort, even though NLM supports onlypart of this total effort. The FASEB contract calls for a detailedreport which will include both quantitative and qualitative elements

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for the total NLM support period 1962-1966. The scientist-membersof the Editorial Board of the project will assess the strengths andweaknesses of the Soviet literature in their subject areas.

The Bibliography of_ Medical Translations (BMT) was changedfrom a quarterly supplement to a semi-monthly publication beginningwith the July 30, 1965, issue. During FY 1966, a backlog ofcitations to translations was published in two Quarterly Supplements,9 and 10, covering July-December 1964, and Volume II, Part 1,covering January-June 1965.

The format of the BMT was changed to conform with the broadsubject headings established by the Clearinghouse for FederalScientific and Technical Information and citations are listed alpha-numerically under each category by the COSATI accession numberrather than by author for easier listing and ordering purposes. Asanother improvement, the compilation of a cumulated permuted titleindex for subject entry into the bibliography for the 1965 issueswas initiated. Two other innovations were made in the publication:a listing of all issues of the BMT on the back cover and the use ofa self-mailer to reduce handling and mailing costs.

In FY 1966, resources in the amount of $545,000 were initiallymade available for publications contracts. A supplemental appropria-tion of $200,000 for grants was received in June 1966.

Special Foreign Currency Program. The objective of the SpecialForeign Currency Program is to make the biomedical foreignlanguage literature more readily and easily available to U.S.scientists and thereby increase scientist-to-scientist communica-tion.

Prior to FY 1966, the NLM Special Foreign Currency Program wasexecuted solely through the National Science Foundation and itsoverseas contractors. The FY 1966 NLM-NSF agreement was rewrittento include recognition of independent NLM program activity. Thedirect operation was effected with program activities negotiatedthis year in Poland and Israel. Two major programming trips weremade: one to Poland and Yugoslavia and one to Israel and India.

Critical Reviews. One of the most significant accomplishmentsduring the past year was the establishment of a program of criticalreviews. This activity is designed to identify trends and tostimulate future research. The critical review is more than asummarization of the literature of recorded research; it is also ascholarly creative analysis and synthesis prepared by a leading

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scientist. As a result of such analysis, the scientist identifiesthe present status of research, the advances which have been made,problems which need to be examined, and research opportunities forthe future. To emphasize the cooperative aspect of this effort,the NLM has encouraged the preparation of such reviews jointly bya foreign scientist in cooperation with a colleague in the UnitedStates.

The following critical reviews in Poland are in preparation:

a. "The Application of Metabolic and Excretion Kineticsto the Problems of Industrial Toxicology" byDr. J. Piotrowski, Institute of Occupational Medicine,Lodz.

b. "Organization of Clotting Processes" byHugon Kowarzyk, M.D., Medical Academy, Wroclaw.

c. "Myoplastic Amputation and the Use of an ImmediateProsthesis" by M. A. Weiss, M.D., Holder of the Chairin Rehabilitation at the Medical Academy in Warsaw, andHead, Rehabilitation Clinic in Konstancin.

In Yugoslavia, a programming trip was made to identifyscientists and topics for critical reviews. The Yugoslav Academyof Arts and Sciences in Zagreb has assumed responsibility for thistask. It has held one meeting and will hold another meeting at theend of June at which time a choice, of themes and suggestions forcollaboration will be made.

The National Library of Medicine is in the process offormalizing an agreement in Israel with the Editorial Board of theIsrael Journal of Medical Sciences. The IJMS will assume responsi-bility for identifying scientists and subjects appropriate forcritical reviews. The Editorial Board will serve as a scientificstudy group for critical review proposals before submission to theNLM for consideration.

Special Projects. In FY 1966 two projects were undertaken inresponse to U.S. needs in the drug information field. These wereexploratory projects: one at the request of the Surgeon General,the Drug Digest project; and the other in cooperation with theFood and Drug Administration, Drug Toxicity Abstracts.

The Drug Digest project is a one-year experiment to: a) makeimportant research on drugs published in the foreign languagesmore readily available to U.S. scientists, and b) explore theeffectiveness of packaging the information in the form of "digests".

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The "drug toxiclty" abstracting project in Israel is a cooperativeeffort between the NLM and the FDA for the preparation of abstractsfrom 25 foreign journals in the drug field not now covered by theFDA in its Medical Literature Branch Journal ojE Literature Abstractsor by any other major abstract service.

As a result of these two experimental projects and the successof the initial efforts, NLM has made the following programmingcommitments for FY 1967:

a. The original contract for FDA activities will befollowed by a three-year program of expanded scopeand increased journal coverage.

b. The Drug Digest Bulletin will be continued for anothertwo years which will include evaluation and finaldecision on the ultimate future of this project.

The establishment of Oral Research Abstracts in April 1966was the direct result of a cooperative effort undertaken by the NLM, theNational Institute of Dental Research, the Division of Dental Health,and the American Dental Association. Abstracts from the world'sliterature relating to dental research are prepared initially inIsrael with the NLM Special Foreign Currency Program providing abasis for support.

Translations. The translation of the History of Physicians isbeing edited in Israel for submission to the NLM in the fall of1966. A decision on the method of printing will then be made.The NLM has cooperated with the Bureau of State Services in obtain-ing the translation publication of the monthly Russian journal,Gigiena JL Sanitariya (Hygiene and Sanitation), and has obtainedthe translation and publication of Staub, a monthly German journalfor which the Bureau of State Services obtained the license.

In Poland, the NLM supports the translation and publication inEnglish of ten biomedical Polish journals and, in Yugoslavia, threeYugoslav journals. Special effort has been made to reduce the timelag between the appearance of the original and the English languageedition to a maximum of six months, to include abstracts with allpublished articles, and to provide English language reprints ofthese.articles to the authors. The NLM has also developed anexpanded, specialized distribution of these publications to insurethat they are more readily available to the U.S. biomedicalcommunity.

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In Israel, support was provided for a special issue of theIsrael Journal of Medical Sciences which contained the ConferenceProceedings of the International Symposium on the Impact of BasicScience on Medicine, 21-28 June 1965.

RESEARCH AND TRAINING DIVISION

During FY 1966, the activities of the Research and TrainingDivision had two objectives:

1. Strengthening and expansion of programs of support whichhad been initiated and carried forward in a limited way under theauthority of Section 301 of the Public Health Service Act;and

2. Implementing new programs authorized by the MedicalLibrary Assistance Act of 1965 (PL 89-291).

Awards for research grants, training grants and fellowshipswere first made in FY 1965. These included six research grants,two training grants and one fellowship, which totaled $119,897.Three research contracts in the amount of $63,663 were also negotiated.In FY 1966, resources in the amount of $430,000 were initially madeavailable for grants and contracts. These funds were designatedto be used for research in History of Medicine and Drug Information.A supplemental appropriation was received in June 1966 of $1,800,000for research and development, training and fellowships, and specialscientific projects, all of which were authorized by PL 89-291.

Manpower Development and Training. In the United States and Canada,of the 2,188 graduates from the 36 accredited library schools in1963, 1,839 were identifiable as known placements. Of these, 24 wereplaced in medical libraries and 13 in hospital libraries. It is notknown how many of these had specific training in medical librarianship.Serious as the quantitative problems are, simply adding more schoolswhich offer a course in medical bibliography will not solve the infin-itely more far-reaching problems. Training programs are needed whichgo beyond the basic traditional training in library science andpro-vide the student with an educational experience that combines furthertheoretical depth with either research or practical experience, alldirectly related to servicing requirements of medical science.Rapid retrieval of drug information, continuing education of thephysician, provision of regional services, library "backup" forspecialized information centers such as those in Parkinsonism,brain research, diabetes, and cardiovascular disease are the typesof services needed. With the growing concept of the learning resourcecenter in the medical complex, the medical library will no longer be

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limited to books and journals but responsible for servicing newerinstructional media. Medical science information centers broadlyconceived and functioning will be required in modern health sciencescomplexes.

Fiscal year 1966 was the initiation of support of projectsdirected at the training of manpower to meet a variety of criticalneeds of the health information field. During fiscal year 1966,two training grants in the history of medicine were supported.Responsibility for support of a training program in BiomedicalLibrarianship and Information Service at UCLA, which had previouslybeen supported by the National Institute of General Medical Sciences,was assumed in 1966. Six new programs were funded by NLM in FY 1966in the broad area of health information service. The hallmark ofthis group of projects is diversity in content. Advantage is takenin all of unique talents or situations in providing opportunitiesfor training individuals to pursue careers of service, teaching andinvestigation in the field of health science information. As anexample, the training program at the University of Chicago willutilize a research project in which the information needs of theSchool of Medicine faculty will be studied and techniques for satis-fying them will be utilized as a laboratory for training. In allinstances, the training programs are specifically directed to health-related information activities and are designed to accommodatetrainees who have strong career commitments to the health informationfield or to develop these commitments in those who may not alreadyhave them. Training grants initiated in 1966 are listed inAppendix XIV.

Biomedical Communications Research and Development. The ExtramuralProgram of Research and Development of NLM is one of support forprojects directed at improving information services to theirultimate users—the practitioner, the research scientist, and thestudent. Funds to initiate this aspect of the program were firstavailable in FY 1966. Projects are supported by both research grantand contract. There are three general areas into which theseprojects fall: (1) the requirements of users in biomedical informa-tion; (2) the improvement of access to the store of biomedicalinformation; and (3) the interrelationships of institutions servingthe biomedical information field. Examples of projects beingsupported in each of these areas are: "Experimental Disseminationof Biomedical Literature" conducted,by Don Swanson, Ph.D. of theUniversity of Chicago; "Total System Computer Program for MedicalLibraries" under the direction of Robert T. Divett, University ofNew Mexico; and "Relationships of Biomedical Information Services"

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being carried out by Vern Pings, Ph.D. of Wayne State University.Studies necessary for the initiation of the new support programof the NLM were instituted by way of research contracts. Theseare discussed below.

In addition to projects dealing with biomedical informationbroadly, the research and development program is responsible forthe conduct of support in the program areas of the history ofmedicine and drug information.

During fiscal year 1966, 17 research projects in history ofmedicine were supported by research grants. These projects andtheir titles are included in Appendix XV. Particularly noteworthyis a project being conducted by Genevieve Miller of the ClevelandMedical Library Association on the "Teaching of Medical History inthe U.S. and Canada". Results of this project will fill a keenlyfelt need for timely, accurate and comprehensive information on thestatus of medical history in medical education today.

A project designed to collect important historical material bydirect interview with individuals who have had great influence inthe progress of the health sciences in this country was initiatedduring FY 1966. Harlan Phillips, Ph.D., principal investigator forthis project, has had extensive experience in the technique ofcollecting oral historical data from eminent persons, preservingfor posterity their own personal recollections and interpretationof critical events.

Two training grants in medical history were supported. NLMassumed support of these programs in FY 1965 and continued them in1966. One is at the Johns Hopkins University under the director-ship of Professor Oswei Temkin and the other at Yale Universityunder Lloyd G. Stevenson, M.D., Ph.D.

Support for several new projects related to the improvement ofthe flow of information on drugs was made possible by the appropria-tion of funds in FY 1966 specifically designated for this area. Atraining grant was funded to support a training program in theDepartment of Pharmaceutical Chemistry, School of Pharmacy, Univer-sity of Tennessee in which trainees who hold graduate degrees inlibrary sciences and who have backgrounds in the physical biologicalsciences are assigned to a specific research team to act as theinformation resource person to it. Trainees will be given specialinstruction in the information requirements of, scientists and inmechanisms for meeting these needs. A research project on the"Automatic Indexing of Drug Information", being carried out at

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c. A research program should be directed at the use andfunction of the hospital library, e.g.

1) The physician and his use of his own and thehospital library.

2) Better reference retrieval systems for librariesof small and medium size hospitals.

3) Performance standards including collection sizeand form and library services.

3. To serve continuing education effectively, the library mustextend its scope beyond the traditional one of a document repository.It should become agressive and not remain passive in continuingeducation. The library should concern itself with additional waysof supplying information such as oral essays, audiovisual materials,etc. The library should encompass the concept of the "informationcenter" and add the element of judgment and evaluation to the infor-mation it provides to the practicing physician. It should have anactive role in the stimulation and production of materials and thedissemination of these in various forms.

a. A test and demonstration center (or centers) is needed toprovide a laboratory for:

1) Research and development so that generalization canbe established on the basis of valid data ratherthan opinions.

2) Testing various modalities for the provision oflibrary and related services and continuing educa-tion programs to practitioners.

b. Such a demonstration center could be utilized mosteffectively if related to an active medical complexwhich could provide actual field work, i.e., thequestions would be asked, the response formulated,and the response evaluated in the context of apractical working situation.

4. A variety of personnel must be trained (educated) to becapable of transforming the traditional library into a learningresource which can effectively serve continuing education.

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Rutgers University, is being supported. The New York Academy ofSciences will hold a series of interdisciplinary conferences ondrug information as a result of a grant from NLM.

In August 1965, a small NLM staff committee was established,under the chairmanship of Carl D. Douglass, Ph.D., to consider therole of NLM in the field of continuing education for the biomedicalprofessions. In the course of two meetings of this committee, anumber of ideas were generated and preliminary plans were made fora meeting of an ad hoc advisory group.

In October 1965, Dr. Burnet Davis oame on duty as ContinuingEducation Officer and, after reviewing the work of the Committee,took over the responsibility for organizing the proposed meeting ofthe advisory group.

On January 14 and 15, 1965, a group of distinguished medicaleducators and scientists was called together, under the chairmanshipof Dr. Robert Ebert, Dean, Harvard Medical School, to discuss"The Role of the Medical Library in Continuing Education". At theconclusion of the session, the following principles were identifiedand recommendations made:

"1. A central issue in continuing education is the developmentin the individual of the capacity for independent learning. Supportshould be given to institutions which bring forth experimental waysof training professional students so that they may effectively useinformational resources.

29 A variety of individuals should be reached throughprograms of continuing education (including physicians rangingfrom the younger more sophisticated physician to the graduate of25 years ago; members of the other health professions, e.g. dentistry;and personnel in the paramedical and ancillary health services).The community hospital appears to be the primary educational resourceof the practicing medical community.

a. Hospital libraries should receive support for the improve-ment and expansion of resources at a sufficient level tomake a significant impact on continuing education.

b. A variety of community hospitals and their libraryfunctions and services should be studied to evaluate theimpact of such support on continuing medical education.

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a. Train individuals capable of acting as agents of thelearning resource center in carrying information andsources of information directly to the practitioner.

b. Train individuals who can manage large learning resourcecenters.

c. Encourage the training of library technologists.

d. Train individuals in the utilization and evaluation ofthe educational process and techniques. These individuals,particularly, should be well qualified to conductresearch on the process whereby the practicing physicianobtains information and to implement techniques whichfacilitate his acquisition of additional knowledge.

5. More sophisticated specifications for an abridgedIndex Medicus should be developed to provide a ready referenceretrieval tool suitable for office use.

6. In operational terms, the role of the National Library ofMedicine can to a large extent be expressed within the broad conceptof regional health care."

Staff recruitment, budget development, long and short rangeprogram planning, the establishment of advisory committees, theappointment of consultants and a great variety of similar activitiesrequired constant staff attention throughout the past year. Aspecial effort required for the institution of these new programswas the initiation of studies to establish functional guidelinesfor the construction of health science libraries, and to developobjective standards based on the services to users by which tomeasure library performance. Agreements were entered into withthe Association of American Medical Colleges to accomplish the firstand with the Institute for the Advancement of Medical Communicationfor the second. These are listed in Appendix XVI.

A most important part of the establishment of all of these newprograms has been the numerous consultations held with individualsrepresenting institutions which have needs related to the varioussupport programs. In addition, several professional and specialmeetings have been attended at which detailed explanations of theprovisions of the Act, followed by question and answer sessions,have been held. The Division was fortunate to recruitMr. David F. Kefauver who joined the staff September 1, 1965, havingbeen previously associated with the National Institutes of Health.Mr. Kefauver became Chief of the Research and Training Division onJuly 3, 1966.

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FACILITIES AND RESOURCES DIVISION

In order to facilitate the administration of the MedicalLibrary Assistance Act (PL 89-291), it was necessary to establisha new Division of Facilities and Resources, having responsibilityfor those programs designed to aid in the construction, renovation,and expansion of facilities, grants for expansion and improvementof basic library resources, and the support of regional libraries.The Division was described and authorized during FY 1966 but didnot become functional until the close of the fiscal year.Carl D. Douglass, Ph.D., formerly Chief of the Research and TrainingDivision, was appointed Chief of the Facilities and Resources Division.Mrs. Maxine Hanke, formerly Special Assistant to the AssociateDirector for Extramural Programs,became Medical Library ResourcesGrant Program Officer.

In addition, Mr. Robert Walkington and Dr. Louis Gerber willbecome associated with the construction program and the regionallibrary program respectively, shortly after the beginning of thenew fiscal year.

In the supplemental appropriation for FY 1966, $2,000,000 wasincluded for the award of medical library resource grants, to remainavailable through FY 1967. From this, three resource grants wereawarded within FY 1966 in order to initiate the program. These arelisted in Appendix XVII.

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CHAPTER III

I N T R A M U R A L P R O G R A M S

During FY 1966, the Intramural Programs initiated a number ofsignificant activities which further advanced the evolution of theNational Library of Medicine from a traditional library to an activeinformation service center.

1. The new computer-produced NLM Current Catalog provides bi-weekly citations (with quarterly cumulations) of recent NLM acqui-sitions to the nation's medical libraries as a cataloging and acqui-sitions tool. The introduction of NLM's express cataloging serviceaccelerates the acquisitions program and permits rapid disseminationof cataloging information through the NLM Current Catalog. The de-velopment of a computer-generated file in this operation will providea base for the establishment of a fully automated selection, acqui-sition, and cataloging service in the next few years.

2. Microfilm standards have been developed as a prerequisitefor the preservation of the Library's collection, for the controlof input for an NLM graphic image program now under development,and for the provision of the microfilm resources required in theimplementation of the Medical Library Assistance Act. Since thesestandards greatly exceed current commercial standards, a number ofpilot production contracts were established. These projects con-firmed the feasibility of providing high-quality images on a pro-duction scale.

3. Decentralized MEDLARS centers have been established toextend the bibliographic resources of the National Library ofMedicine. While production of NLM computer-generated bibliographicsearches nearly doubled in FY 1966, due to increased demand, asubstantial backlog of these demand searches developed. The de-centralized centers, expected to be fully operational in FY 1967,will supplement the Library's search capability using NLM tapes tomake MEDLARS services available on a regional basis.

4. Cumulated Index Medicus appeared in 1966 for the firsttime as a computer-produced publication. Previously published bythe American Medical Association, CIM was reestablished as an NLMpublication and responsibility.

5. The Auxiliary Chemical File was created for the DrugLiterature Program. Prototype for the development of expandedMEDLARS capabilities, the Auxiliary Chemical File when operationalwill permit greater flexibility in retrieval through greaterspecificity and synonym lists.

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6. Stimulated by their involvement in the construction of theNLM Five-Year Plan, and by the expanding role and responsibilitiesof the Library as identified by the plan, the staff of the Intra-mural Programs began development of a new computer system for MEDLARS.An evaluation of MEDLARS was started. A contract was written withan independent consulting organization for the compilation of speci-fications for new computer hardware which will have an expandedmemory core, extended on-line capabilities, and will respond betterto the increasing information needs of the health professions.

M E D I C A L S U B J E C T H E A D I N G S ( M E S H )

Early in Fiscal Year 1966, the Medical Subject Headings groupresponsible for the development and updating of headings for MEDLARS,was administratively separated from the Bibliographic Services Divi-sion and became directly responsible to the Associate Director forIntramural Programs. Dr. Norman P. Shumway was appointed to headthe group succeeding Dr. Peter Olch, who joined the History ofMedicine Division.

1966 Revision of MeSH. The July 1st closing date for acceptanceof new headings and changes provided adequate time for preparationof the revision, making a preprint of the alphabetized MeSH availablefor indexing in October. The group completed work on the 1966 revi-sion on December 11, and Medical Subject Headings 1966 was publishedas Part 2 of Index Medicus, January 1966.

A noteworthy change was the reinstitution of the use of topicalsubheadingsjwhich had been dropped in favor of coordination of mainheadings when MEDLARS was initiated in January 1963. The responseof librarians in general was one of approval of the increased spec-ificity and easier searching which the subheadings made possible inIndex Medicus. The revision included a subject heading analysisresulting in 455 new subject headings and 245 deletions from thesubject heading list.

MeSH Revision 1967. Acceptance of new headings and changes wasterminated June 30, 1966. Principal attention in the revision wasgiven to provisional headings. Extensive changes in the categorizedlists developed as an outcome to the structuring of subcategories(particularly Chemicals and Drugs; Analytical, Diagnostic andTherapeutic Techniques and Equipment; Physical Sciences; Humani-ties; and Communication, Library Science, and Documentation), newheadings recommended by the Ad Hoc Committee on Epidemiology Termi-nology, a few nursing and dentistry headings, and new subheadings.

Provisional Headings. The list of provisional headings number-ing close to 900 at the end of FY 1965 was reduced sharply when 251became main headings and those used infrequently were deleted. Only531 remained after the 1966 revision. In 1966, 123 were added fora total of 654 at the end of FY 1966.

28

Provisional headings which attracted ten or more citationswere reported periodically to the Section beginning in 1965 andconstituted a major source of new main headings. Of 480 suchheadings 229 (47.7 percent) became main headings in the 1966 revi-sion and an additional 100 (20.8 percent) are to become main head-ings in 1967; 45 (9.5 percent) have been deleted (usually becauseof the addition of subheadings which render a more specific head-ing unnecessary) so that only 106 (22.1 percent) from the 1965provisional headings will remain on the MEDLARS Dictionary Tape.

In 1966 the parameter of the large-volume provisional headingreport was changed so that provisional headings were reported onlyafter they had been used 20 times, rather than 10 times as in 1965.Seventy-eight such headings were reported before the closing datefor the 1967 revision; 51 (65 percent) are to become main headingsin 1967.

All provisional headings remaining on the files in 1966 weredefined and a list of these headings with their definitions orscope notes and their indexing instructions was issued in January1966. Supplements for new headings added during 1966 have beenissued monthly and a cumulative index has been prepared each monthfor all provisional headings added since the revision.

The list of Medical Subject Headings with Provisional Headingswas printed by GRACE on September 24, 1965, January 24, 1966, andMay 2, 1966. Copies were distributed to Indexers, Searchers, andthe MeSH mailing list on October 7, 1965, February 2, 1966, andMay 24, 1966.

7366 (FY 1966)

7000

6000

5000

4000

3000

2000

1000

0

Headings

6556 (FY 1966)

Main Headings

GROWTH OF

HEADINGS ON

MEDLARS

DICTIONARY TAPE

Provisionals at beginning of each (calendar) year

\• 654 (January 1966)

1963 1964 1965

i1966

29

Trees. The development of hierarchical structures for thevarious categories proceeded during this fiscal year and by theend of the year all of the trees for the majority of categorieshad been input to the computer files and file maintenance com-pleted; and most structures for the Chemicals and Drugs subcatego-ries were ready to be input. This involved changing 3,205 classnumbers or approximately one-third of the estimated total (9,194)changes to be made. In addition a revised and more complete listof geographic headings was developed based upon the official namesestablished by the Board of Geographic Names.

The Information Services Division wrote a computer program toprint out the tree structures using the Honeywell High Speed Print-er and also to provide a GRACE printout. Not only do these programsprovide a most satisfactory presentation of the hierarchies suitablefor publication if desired, but also prompt updating of tree struc-tures is achieved without the heavy expenditure in clerical timepreviously required. Because the trees are a major requirement forsearching the MEDLARS tapes, this will permit the Library to supplyto the search staff and those of the MEDLARS centers the new treestructures along with the Medlars Dictionary Tape as soon as itreflects the annual revision changes.

Cross References. Anticipating a major expansion in thenumber of cross references to be added to the MDT the MeSH Sectionhas requested a computer program addition which will speed upinputting in two ways: (1) by accepting main heading codes asalternatives to main headings in English, and (2) by inputting for-ward and back references with a single transaction rather than twotransactions.

ENTRIES ON THEMEDLARS DICTIONARYTAPE

June 30, 1966

/Geographic Headings,)Check Tag, and Tag^Override of One*

1 Headings

5.8%

3%

-'Tag Override 01 One headingsare headings tagged so that they

cannot be used in indexing, but can beretrieved in search.

30

New Medical Subject Headings. The first section of New MedicalSubject Headings, 1963-1966, a list of new headings added to theMEDLARS Dictionary Tape subsequent to the initiation of MEDLARS in1963, was distributed in May 1966 to the NLM Search Section and toISD Liaison for the regional centers. The list at the present timeincludes:

1. Main headings added in 1966 with indexing instructions forthe period before they were entered.

2. All provisional headings through March 1, 1966.

3. Main headings which superseded deleted headings which hadto be retained on the MDT because file maintenance couldnot be done to the new headings.

The list is maintained on a visible index to facilitate continualrevision. It will be updated after the 1967 revision is concludedand distributed again.

Usage of Headings in Indexing. The annual statistical reporton the 1965 usage of MeSH headings in MEDLARS showed a ratio of73.8 Index Medicus citations per subject heading in comparison with74.8 in 1964. Comparative figures for the two years follows:

Number Citation/Index Medicus Non IM Total Subject Subject

Citations Citations Citations Headings Heading (IM)

1964 434,499 519,916 954,415 5,812 74.8

1965 465,759 518,583 1,047,342 6,345 73.8

The usage of main headings and provisional headings according tocategory has been tabulated and found approximately the same as1964. The largest number of citations appeared under the main head-ing ANTIBIOTIC (1275), followed by TISSUE CULTURE (965), MUSCLE (952),INFANT, NEWBORN, DISEASES (948) and ERYTHROCYTES (903). The use ofsubheadings in 1966 is expected to subdivide these large groups ofcitations.

Intralibrary Communications. Weekly meetings for the 1967MeSHrevision, scheduled from late April to the end of the fiscal yearwith representatives of Indexing, Search, Cataloging, and occasionallythe Drug Literature Program, have provided a forum in which differencesof opinion were reconciled.

The same mechanism was adopted earlier with the Indexing andSearch Section on a year-round basis whenever new provisional headingswere circulated for comment. These meetings have given the sections

31

a better understanding of the overall problems in subject headingusage through exchange of opinions on the acceptance of new termsas provisional headings, review of definitions and scope notes,and the approval of indexing instructions.

Extramural Communications. The Medical Subject Heading staffcontinued to consult with professional advisers from the scientificcommunity during the year, chiefly through ad hoc task forces re-presenting professional associations or individuals working undergrants or contracts with the National Institutes of Health.

The final meeting of the Epidemiology Committee in Septemberproduced a report for the Epidemiology Section of the American PublicHealth Association which resulted in a number of provisional head-ings for the January Index Medicus. Ten of these headings werechosen for introduction as permanent subject headings for the 1967revision. Dr. Schweitzer, Chairman of the Committee, continued hisinterest in the development of a search strategy for a recurringbibliography in the field. He was also instrumental in establish-ing the Committee on Medical Care of the American Public HealthAssociation.

The Committee on Medical Care met first in March and hasalready developed the framework for a new category with subcatego-ries. Provisional headings will be introduced for the indexingof citations starting in the fall of 1966, permitting a review oftheir usage through the spring of 1967. A preliminary draft reportto the Medical Care Section APHA is expected in October; the recom-mendations of the final report will be incorporated into the 1968revision of MeSH.

The National Academy of Sciences, under contract to the NationalLibrary of Medicine, in December 1965 after a year of planning,appointed a task force to address itself to the improvement of MeSHin the fields of Psychiatry, Psychology, Sociology, and Anthropology.The first meeting in February provided for assignments of respon-sibility. Representatives from the Human Relations Area Files andthe Center for Applied Linguistics spent time with members of theMeSH staff, reviewing library practices and preparing plans for thedevelopment of vocabularies, relating to language disorders andanthropology to be submitted to the September 19, 1966 meeting.Preparation for a fall 1966 study in sociology has al§o been made.

Dr. Grant Liddle of Vanderbilt University, Nashville, Tennessee,began work on a vocabulary of terms relating to the pituitary andadrenal glands under contract to the National Institute of Arthritisand Metabolic Diseases, as a cooperative effort with the MeSH groupat NLM. Dr. Liddle selected a research associate to spend six weeksat the Library learning indexing and search techniques and develop-ing a plan of cooperative work with the MeSH staff.

32

Liaison was maintained with the National Institute of Neurol-ogical Diseases and Blindness Information Network. Representativesfrom UCLA and Columbia University presented the preparation of theirvocabularies, both of which are based on MeSH terms. Full machineimplementation of a hierarchic display is not yet possible foreither vocabulary, not have they been collated; but the final develop-ment promises to be very useful not only to the NLM but to the fieldgenerally.

A paper by Miss McCann and Dr, Elwin of NLM and Mr. Clevelandand Miss Reilly of the American Hospital Formulary Service, readin June at the Drug Information Association meeting, described thecollaboration of these representatives in a review of all drugclass headings. Changes were made in both information systems tostandardize headings so that the same class headings would be usedfor the same drugs. Mr. Don Walker of the Drug Literature Programhas undertaken an intensive study of the headings for organicchemicals. Several members of the DLP staff were very helpful inmaking recommendations for new subheadings to be added in 1967 andin preparing documentation to substantiate the recommendations.

Informal discussions have been held during the year withrepresentatives from a variety of disciplines with a view to develop-ing advisory groups in the future, notably in Bioengineering, CysticFibrosis, Nutrition, Population, and Cardiology; liaison has beenmaintained with representatives of the various National Institutesof Health responsible for recurring bibliographies sponsored bythem and efforts have been made to incorporate needed concepts intothe new medical subject headings. In addition much assistance inthe development of nursing terms has resulted from frequent com-munication with the representatives of the American Nurses Associa-tion.

Medical Subject Headings Training. To assist in the full de-velopment of NLM's training services, the MeSH Section prepared asyllabus for training in Medical Subject Headings theory andpractices. It outlines training at both basic and advanced levels.Two weeks participation would be minimal for either level.

MeSH 'training was provided to trainees from UCLA and KarolinskaInstitutet MEDLARS centers in September 1965 and to a trainee from theUniversity of Colorado Medical School in May 1966.

Second Generation £f MEDLARS. The MeSH staff reviewed thepractices and policies governing the program with representativesof the Auerbach Company. This has provided a most salutary atmos-phere for reconsideration of many of the problems that have beenposed during the past several years particularly in respect tothe various methods of displaying MeSH, the rapid communicationof information concerning changes to the various groups and organi-zations dependent upon it, and the development of programs whichwill permit the most efficient use of data processing principles.

33

D R U G L I T E R A T U R E P R O G R A M

During FY 1966 the Drug Literature Program developed from aproject headed by one professional assigned to develop a systemfor the accumulation and dissemination of literature on drugs intoan operational team of eleven. Considerable time was devoted toorganizational and technical matters, staffing, and training. AnAd Hoc Advisory Panel was convened on April 20. This group, com-posed of educators, hospital employees and members of individualorganizations representing the various disciplines concerned withthe development and distribution of drugs, provided programguidance.

The MEDLARS Auxiliary Chemical Module was brought from theplanning stage into detailed design and implementation phases.Mechanisms were established for communicating with the variety ofprogram audiences through representative consultants and formaland informal contacts with key professional societies. Studieswere initiated to identify gaps in the Library's holdings of drug-related literature and systematic procedures were set up to assurethe completeness of the collection. Pharmacy and pharmacy-relatedjournals were analyzed with a view to compiling a list of thoserecommended for indexing. In work with the MeSH group, new headingsand subheadings for the improvement of drug terminology were rec-ommended. A pilot toxicity bibliography was published and distri-buted for critical review.

Progress in Attaining Program Objectives

1. Collection of All Published Literature on Drugs. By theend of the fiscal year, over 700 orders amounting to $25,370 hadbeen placed for drug or drug-related literature, including mono-graphs, periodicals, card services, and compendia of various kinds.

2. Expansion of Coverage of Drug Publications. A study wasmade of journals published throughout the world. A list of thosenot now being indexed for MEDLARS will be submitted to a panel ofexperts for review and recommendations as to those which should beconsidered to broaden MEDLARS coverage.

3. Vocabulary Improvement. To achieve deeper and more preciseindexing of drug-related journals, much effort was devoted to im-proving pharmacological terminology in Medical Subject Headings.Several headings and subheadings were recommended by the DLP staff,and a coordinated effort was initiated with the American Societyof Hospital Pharmacists to bring MeSH terminology into greater

34

coincidence with that of the Hospital Formulary Service. Incooperation with the American Society for Pharmacology and Experi-mental Therapeutics, a panel was initiated to advise the Libraryon autonomic drug terminology. Another panel was established incooperation with the Society for Toxicology to advise on toxico-logy terminology. Several meetings are planned for each committeeduring the Fiscal Year 1970.

A major factor in the strengthening of MEDLARS indexing andsearching functions in the drug area will be the Auxiliary ChemicalModule. Meetings were held with the Food and Drug Administration,National Science Foundation, and Chemical Abstracts Service. Aresulting contract with Chemical Abstracts Service was signed atthe end of the year. A contract had also been signed with Infor-matics for necessary reprogramming to link chemical information inthe Auxiliary Chemical Module to MEDLARS. By the end of the year,extensive work had been done on the technical details of systemsand procedures and on other preparation of material for the commondata base, which will initially contain 40,000 terms. When opera-tional, the Auxiliary Chemical Module will permit the compilationof synonym lists; input of drug and chemical names without ref-erence to authority files; the retrieval of all references to adrug regardless of the name used and whether or not it is a MeSHheading; the publication of lists of new drugs; and a semi-automatic means of updating MeSH drug headings when the frequencyof mention of a drug in the literature signals the desirabilityof adding it to MeSH.

4. Expansion of Reference and Search Service. In addition tomanual and machine searches performed on an individual basis,specialized monthly bibliographies on drug toxicity have beensupplied to such organizations as the American Medical Associationand the Food and Drug Administration throughout the year. At themeeting of the Ad Hoc Advisory Panel in April, it was recommendedthat NLM issue a pilot toxicity bibliography. The publicationwould be distributed to a selected group of experts who would makerecommendations for its development before formal publication andgeneral distribution. By the end of the fiscal year, sample copieswere being printed artd the mailing list had been prepared.

Plans were also well under way for the publication of a CancerChemotherapy Bibliography in cooperation with the Research Com-munications Branch of the National Cancer Institute.

35

The number of drug searches handled increased in proportion tothe total number of searches, being approximately 30 percent ofthe total. (See table below for comparison of the months of Mayand June.)

Comparison of Percentage of Drug-Related SearchesMay and June 1965 and 1966

May-June Searches Released Drug-Related PercentageTotal Searches Released

2 months-1965 396 109 282 months-1966 538 156 29

With a view to expanding the Library's search service beyondwhat can normally be handled internally, a formal agreement hasbeen signed with the Pharmaceutical Manufacturers Association forfour two-year library traineeships. Under this arrangement, threeindividuals with library training and one with a systems and com-puter orientation will be employed by the PMA, and, working withDLP and other NLM program staff members, will learn MEDLARS in-dexing, searching, and programming procedures. During and afterthe training period, they will serve as liaison between theAssociation and the Library to facilitate the extension of MEDLARSservices to the pharmaceutical industry.

5. Provision of Support for Other Services. The DLP has beenconcerned with the support of abstracts done under an NLM Extra-mural Program contract with the Israel Program for ScientificTranslations. Eight issues of Drug Digests, a pilot project pro-viding summaries of foreign articles in the drug area were dis-tributed and this program is being evaluated. The Library hasalso supported the production in Israel of abstracts. These havebeen used by the Food and Drug Administration for its MedicalLiterature Branch Abstracts.

A contract has been signed with the Chemical Abstracts Servicefor the editing of the second edition of the Russian Drug Index,compiled by Stanley Jablonski. The Head of the DLP has beennamed Project Officer. It is hoped that this edition will bepublished in the Fall.

6. Training. During the next fiscal year, the DLP staff willcontinue their training program in order that their technicalrecommendations be based on full knowledge of MEDLARS and the(Library. Now that the program has been well launched and theinitial training effort made, the proportion of training effortto total manhours expended should level off and decline I,..orethe end of the year, releasing more time for program activities.

36

T E C H N I C A L S E R V I C E S D I V I S I O N

On November 14, 1965, Mr. James P. Riley succeded Mr.Samuel Lazerow as Chief of the Division.

Change, innovation, and re-evaluation of existing processesmarked the Technical Services Division operations during theFiscal Year 1966. Following concentrated study of problems andtheir proposed solutions, several recommendations were made forimprovements to increase productivity, improve efficiency, andprovide the biomedical community with faster and more comprehen-sive service during Fiscal Year 1967. Significant program develop-ments were: (1) the design and implementation of the computerizedInterim Catalog Module; (2) publication of the biweekly CurrentCatalog; (3) establishing the Express Cataloging Service; (4)increased cooperation in acquisition and cataloging with theLibrary of Congress and the National Agricultural Library; and(5) expanding the National Library of Medicine's scope andcoverage to include veterinary medicine.

Plans were developed to (1) increase blanket orders placedwith publishers and book dealers, (2) revise the Serial Record,(3) revise acquisition procedures and controls, (4) increase ex-change activity, and (5) automate the searching and procurementfunctions.

Design and Implementation of the Computerized Interim CatalogModule. Following a detailed study of technical services proceduresand visits to other medical libraries (Yale, Harvard, Columbia,Washington University), the library at Florida Atlantic University,and the Library of Congress to observe methods of selection, acqui-sition and cataloging, a computer system design linking the phasesof selection, citation searching, acquisition, cataloging, andmaintenance of serial records was completed in October 1965. TheNLM assigned first priority to the cataloging phase: the InterimCatalog Module. The term "interim" was chosen because implementa-tion of the total system for the Division is expected to change thecatalog module. The Interim Catalog Module produces the NationalLibrary of Medicine Current Catalog (published biweekly, withquarterly and annual cumulations) and catalog cards for the NLMpublic card catalog.

Publication of a Biweekly Current Catalog. In January the Li-brary began to publish the National Library £f Medicine CurrentCatalog. This constitutes a current selection, acquisition, andcataloging tool for the biomedical community. The annual

37

cumulation of the new Current Catalog supersedes the earlier NLMCatalog, published annually since 1956. The NLM Catalog will makeits final appearance in 1966 as a sexennial volume incorporatingall NLM catalog cards issued from 1960 through 1965.

For the NLM Current Catalog, major American medical book pub-lishers furnish the Library with an advance copy of every newtitle immediately upon publication. The Library catalogs thesepublications with all possible speed (Express Cataloging Service)and processes the information on its computers to produce a bi-weekly listing of citations to all new books and serial titlescataloged during the preceding two weeks.

Catalog citations contain the same bibliographic informationthat appears on the Library's catalog cards, thereby providingother libraries with catalog copy for their own use. Citationsinclude the cost of the item when available.

Biweekly issues of the Current Catalog contain author/titlecitations to publications cataloged and a directory of publishers.Quarterly and annual cumulations have both an author/title sectionand a subject section.

NLM's computer-driven GRACE (graphic arts and composing equip-ment) prepares film copy from which Government Printing Officecontract printers produce the NLM Current Catalog by photo-offset.The NLM Current Catalog is sold by subscription by GPO for $15.(See Appendix XI for the complete list of publications.)

Establishing an Express Cataloging Service (ECS). In an effortto list in the NLM Current Catalog the most up-to-date informationregarding biomedical publications, seventy-six medical book pub-lishers, both in the United States and abroad, have agreed to sendadvance copies to the Library. When these publications reach theLibrary, they are speedily processed through the Express CatalogingService Program; this assures their being cataloged within 48hours. Thus, the Current Catalog often provides full catalogingdata for publications even before the publisher's actual releasedate.

Increased Cooperation with the Library of Congress and theNational Agricultural Library. There has been an unprecedentedeffort during the past year to increase and strengthen interlibrarycooperation. Staff members of the three libraries met to discussshared cataloging and cooperative acquisition programs, with thehope of eliminating some duplication in these areas. It is recog-nized, however, that the requirements of each library's clientele

38

probably necessitate some overlap in scope and coverage and incataloging. Arrangements were made for NLM to assist theLibrary of Congress in its national program for acquisitionsand cataloging (Title II C of the Higher Education Act, 1965)by forwarding card catalog copy for each publication catalogedhere. When libraries request cataloging information pertainingto those titles which LC records indicate are in the NLM col-lection, LC will request the publication through interlibraryloan, and thus preclude the purchase of that item for its owncollection.

Discussions have been held with National AgriculturalLibrary staff on the cooperative development of a thesaurus ofveterinary medicine. The first step has been to organize acommittee with representatives of NAL and NLM and outsideconsultants.

The Library continues to receive duplicates in substantialquantity and quality from both national libraries of currentAmerican medical books. In addition, the staff of the threenational libraries have participated in meetings of the Acqui-sition Task Force and the Procurement Task Force of the FederalLibrary Committee.

Expanding Scope and Coverage to Include Veterinary Medicine.With the appointment of a Coordinator for Veterinary Affairs inJanuary, the Library began to expand its scope and coverage inveterinary medicine, animal husbandry, and zoology. Material inveterinary medicine will be collected exhaustively; material inthe other two categories will be collected far more sparingly,except for genetics.

SELECTION AND SEARCHING SECTION

Selection Activities. Under the direction of the Coordinatorfor the Development of the Collections, monthly conferences wereheld to review, interpret, and expand the scope and coverage policyand to answer specific questions concerning the selection of non-core materials. A revision of the Library's scope and coveragemanual is planned.

Bibliographic control of bibmedical literature is ensured, asin the past, by having area specialists select titles from nationalbibliographies and other publications. In addition, publishers'participation in the Express Cataloging Service promises to alleviatesome of the area specialists' selection problems. Plans are beingdeveloped to reduce the time-consuming burden of selection byinitiation of blanket orders with reputable book dealers throughoutthe world. Such blanket orders would direct the dealers to selectand supply directly to the Library all biomedical publications

39

except those which are received from publishers participating inthe ECS.

The collection was considerably strengthened by the acquisi-tion of materials requested through interlibrary loans and foundto be wanting.

Exchange. The Selection and Searching Section has the respon-sibility for all foreign exchange operations. To insure smoothoperation and a steady flow of materials from exchange sources,procedures were established for monitoring and evaluating exchangeagreements. The major NLM publications used for exchange in thepast were Index Medicus and Bibliography of Medical Reviews.Added to these during the year were the NLM Current Catalog andindexes published in cooperation with outside organizations, suchas Index to Dental Literature and International Nursing Index.

New Chinese Bibliography. The NLM Current Holdings £f Main-land Chinese Journals, a bibliography of the Library's holdings ofcurrent Mainland Chinese serials up to October 1965, was compiledby Stephen Kim, Oriental Area Specialist.

New Bibliographic Sources. Eight bibliographic sources wereadded to the list of prospects examined for regular selection,bringing the total of such bibliographies to 236. The new sourcesare:

1. Union Catalog of Philippine Publications on Science andTechnology. Manila, Philippines. National Institute ofScience and Technology. Division of Documentation, irr.Z7407.P5 qP552u

2. Nijhof information; books and periodicals from the Nether-lands in foreign languages - Livres et periodiques...Bucher and Zeitschriften...Hague, 1965- b-m.

3. Sci-Tech book profiles. New York, Bowker. m. Ref.Z/7401/S412

4. Medical book profiles. New York, Bowker. m.Ref/ZWl/M486S.

5. Index to Indian Medical Periodicals., New Delhi,s-a. ZW1 13855

6. Euratom Information. Dusseldorf. m. Wl EU575.

7. The Monthly List of Chinese Books. Taipei. National Cen-tral Library. Taipei, Taiwan, v.l- 1959- a.

40

8. Tartu. Ulikool. Teaduslik Raamatukogu. Bibliograffa.Tartu, a. Z2533 T195t.

ACQUISITION SECTION

Approximately 15,000 orders were placed during the year for$165,000. Included in this sum was an obligation of $25,000 forpurchase of materials for the Drug Literature Program.

Serial Record. The transfer in late Fiscal Year 1965 ofIndex Medicus journal data from the Serial Record Kardex to aseparate tub file has provided better control of checking andclaiming these important titles. Arrangements were made to shipby air freight all Index Medicus journals published in WesternEurope (about 1,250), starting with Fiscal Year 1967; this willreduce the shipping time from 6-8 weeks to 3-4 days and expeditethe checking-in-process.

Plans were developed to completely rearrange the serial recordfile and the Kardex. The new system will be easier to use, providemore space for unit record data and will require less space. Thenew system is being designed with an eye toward future automation.

CATALOGING SECTION

With the initiation of the Interim Catalog Module, the CatalogMaintenance Section was absorbed by the Cataloging Section. Thetransition was smooth. Personnel were able to adapt easily to thenew procedures and practices dictated by the computerized catalogingprogram. This, however, required both a training and learning per-iod for the entire staff and experiments to determine work flowand measurement. Even though the training and experiments proceededsmoothly, there was a loss of cataloging time, so that fewer itemswere cataloged than in the previous fiscal year.

The first six months of the Current Catalog have been successful:the cataloging staff met the estimated production demands (400-500)titles cataloged during each ten-day working period) and kept up therigid schedule demands of input and corrections; the first quarterlycumulation was produced and dismounted and work was completed forthe second quarterly; and many libraries began to use it for theircataloging and classification. The Veterans Administration, inparticular, converted its entire cataloging to the NLM system andthe Bibliotheque Nationale of France has recommended that allFrench medical libraries begin using the Current Catalog for itscataloging and classification. Also, the Medical Library Associ-ation and American Hospitals Association have praised and promotedthe work highly, recommending that biomedical librarians use it for

41

selecting, acquisition, cataloging, and interlibrary loansource. At the end of Fiscal Year 1966, there were 800subscribers.

NLM Classification. With the publication of the CurrentCatalog, a growing number of medical libraries, both here andabroad have announced plans to adopt the NLM Classification.An updated edition which would include a new modified Library ofCongress classification for non-medical and related materials,is planned.

Special Projects

NLM Current Catalog Promotion. The Division Chief addressedthe Technical Services Directors of Large Research Libraries,ALA, the Association of the American Medical Book Publishers,the Medical Library Association/NLM Liaison Committee, and the65th Annual Meeting of the MLA on the Current Catalog. Thereaction to the publication has been generally enthusiasticand, often, grateful.

In addition, 4,000 sample copies with subscription announce-ments were mailed to members of the Medical Library Association,Special Libraries Association, and American Hospital Association,and to those on the NLM Publications and Translations Divisionmailing list.

AID/NLM Agreement. Through an interagency agreement with theLibrary, the Agency for International Development is making avail-able a number of services to U.S. AID Health Missions. Developingcountries are thus helped to expand the intensify their biomedicallibrary programs in order to make directly accessible the relevantpublished information concerning specific problems of nutrition,population growth, and better health. (See Appendix XX f°r listof participating countries.)

Present services include the following: (1) interlibrary loanservice (subject to NLM regulations); (2) bibliographic searcheson medical subjects, made in response to direct requests from investi-gators, physicians, or librarians in a host country, of officialsof AID; (3) one hundred subscriptions to Index Medicus, availableto AID to help improve the bibliographic capabilities of a medicallibrary in a host country; and (4) fifty thousand U.S. BookExchange credits, made available by the Library for requestingsurplus journals, books, and monographs from USBE.

The agreement has been quite satisfactory to date, and U.S.AID recommends that its Missions stimulate and encourage biomedicalprofessional personnel and medical libraries in host country toutilize NLM services.

42

B I B L I O G R A P H I C S E R V I C E S D I V I S I O N

In May 1966,Clifford A. Bachrach, M.D. , transferred from theNational Heart Institute, National Institutes of Health, to becomeChief, Bibliographic Services Division. He succeeded Leonard Karel,Ph.D., who became Special Assistant to the Associate Director,Intramural Programs, in charge of Specialized Information Centers.

During FY 1966more medical articles were indexed than everbefore. In FY 1966,164,545 journal articles were indexed ascompared with 151,633 for FY 1965. The total number of articlecitations retrievable by computer search increased by more than50 percent from approximately 300,000 to over 450,000.

Demand Searches. The number of demand bibliographies producedupon request during the year was approximately twice as great asin the previous year, increasing from 1,623to 3,035. This may beattributed to a more widespread public knowledge of the availabilityof this bibliographic service, as well as to the increasing valueof these searches as the MEDLARS file expands. The increased demandbibliography output is gratifying in the light of the other burdensimposed upon the Search Section during the year. Toward the endof the fiscal year, increasing requests resulted in a backlog makingit necessary to defer all foreign requests except those coming fromAID countries.

In April 1966, the Veterans Administration closed its MEDLARSUnit, which was located at the National Library of Medicine underDr. Charles Chappie, and the VA requests were absorbed by the NLM'sSearch Section.

More complex search formulations resulting from computerprogram limitations in handling searches involving subheadingscaused a major slowdown. A new card input program for processingdemand searches was delivered in May and parallel testing beganin June. This new procedure is designed to simplify search formula-tion, and is expected to cut the processing time considerably, andwill diminish the number of searches rejected by the computer.

As the year progressed, the training and MEDLARS regionalcenter liaison functions demanded more and more personnel time.

Recurring Bibliographies. The most important recurring bibliog-raphies in this expanding program are Index Medicus, Cumulated IndexMedicus, and Bibliography of Medical Reviews. In addition, there arebibliographies on broad subjects, produced in cooperation withnational organizations which agree to publish' and distribute thebibliographies widely on a nonprofit basis. At the end of FY1965,

43

there were Cerebrovascular Bibliography, Index of Rheumato1ogy,Fibrinolysis, Thrombolysis, and Blood Clotting and Index to DentalLiterature. Added during FY 1966 were Medical Education and theInternational Nursing Index. Over a dozen additional recurringbibliographies are in various stages of negotiation, or in pre-liminary stages of formulation.

Several new computer capabilities were made available suchas the printing of tracings accompanying the citations, andcomputer-produced author and subject indexes to the citations.

The production of recurring bibliographies has proved to bemore complicated than seems to have been anticipated, partly becausecustomer needs and MeSH terms are never static, and partly becausethe process of initiating the necessary changes is unduly burden-some with the present computer programs. Steps are being taken toovercome the latter difficulty.

Recurring Demand Searches. To meet the need for a current aware-ness service that is too specific to qualify as, or to justify, arecurring bibliography, the Library began providing recurring demandbibliographies in 1965. Sixteen recurring demand searches are beingissued at regular intervals.

Indexing. Articles were indexed at the same rate as last year(5.7 articles/hour). The tremendous increase in the number ofarticles to be indexed, the increased scope of journal coverageand the shortage of qualified indexers, however, necessitated theuse of overtime. Overtime produced 22,829 articles at an averagerate of 11.7 articles per hour and made possible an increase of12,910 articles over FY 1965, for a total of 164,545 biomedicaljournal articles indexed for FY 1966.

During the year, staff members of the American Dental Associa-tion and the American Journal of Nursing Company were trained asindexers. These persons now index journals for inclusion in IndexMedicus, and additional journals in their particular subject areasfor inclusion only in recurring bibliographies.

Revision. Because a high proportion of indexing is now beingdone by trainees, or by indexers with limited experience, 66 percentof indexing was revised in FY 1966 to insure accuracy and consistency.This is about the same as the 65 percent in FY 1965, but greatlyexceeds the 44 percent of indexing revised in FY 1964 when sub-stantially less indexing was done by fewer persons, a higher propor-tion of them fully experienced.

44

Occupational Health Abstracting Project. The agreement toprovide the Bureau of State Services, Public Health Service, withabstracts of all American articles on occupational health andindustr&l medicine was continued. Five hundred and fifty-oneabstracts from 69 journal issues were prepared here and sent tothe Robert A. Taft Sanitary Engineering Center in Cincinnati, Ohio.Abstracts of three hundred and thirty-eight articles were sent inFY 1965.

Cyrillic Bibliographic Project. The Index Section providedthe Library of Congress with Xerox copies of bibliographic anddata abstracts for all East European and Russian articles indexedfor Index Medicus, this year over 150,000 articles. The projectcarried on under an agreement with the Library of Congress wasdiscontinued in May 1966,although formal discontinuance had notbeen received at the end of the fiscal year.

Bibliography of Medical Reviews. Indexing for Volume 11, 1966,of the Bibliography of Medical Reviews was completed on October 8,1965, with the completion of indexing for the 1965 issues of IndexMedicus. Volume 11 contains 4,071 review articles.

List of Journals Indexed in Index Medicus (LJI). The 1966 ed-tion of List of Journals Indexed in Index Medicus contained entriesfor 2,419 journals; this represents the addition of 75 new titlesfor indexing and the deletion of 109 titles not received at NLMfor the past three years or longer. Publication of the separateedition of LJI was delayed in order to include two new sections:a subject list of journals indexed, and a geographic list of journalsindexed. These two new sections, in addition to the regular abbrevia-tion and full-title listings of journals indexed, will add greatlyto the usefulness of the LJI.

An ad hoc panel of extramural advisors met with the Librarypersonnel three times during the year to evaluate critically thequality and scope of the periodicals to be included in Index Medicus.The deletion of 160 periodicals and the addition of 502 others wasrecommended. The panel urged that this additional periodical index-ing be begun at the earliest possible time.

Training. Classes for indexing and search training have beenorganized on a regular schedule. The full combined training wasinitially planned as a six-month course. This was reduced to fourmonths, but further experience led to reversion to the six-monthschedule. Mrs. Thelma Charen of the Index Section and Miss CharlotteKenton of the Search Section, with selected assistants, have conductedthe classes.

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I N F O R M A T I O N S Y S T E M S D I V I S I O N

In September 1965 the Data Processing Division was renamed Informat-ion Systems Division. In addition to continued expansion of MEDIARS oper-ations at the Library and in decentralized search centers, the Division'sstaff implemented the Interim Catalog Module which produces the NLM CurrentCatalog on the Library's computer equipment. New activities in the Div-ision included the design of an evaluation project for MEDIARS demandsearches, systems design for an Auxiliary Chemical Module, and initiationof an effort to produce specifications for a new computer system. TheDivision's programming, input, and computer operations staffs have beenengaged in support of these new and expanded activities as well as incontinuing MEDLARS operations. Mr. Paul C. Redmer has been acting Chiefof the Division since April 1966 when Mr. Charles J. Austin left to jointhe staff of the Secretary, D-HEW.

MEDIARS Expansion. During Fiscal Year 1966 the Division continuedto improve and expand MEDLARS operations. Subheadings were introducedin Index Medicus in January 1966. Special Author and Subject Indexesas an option for recurring bibliographies were developed. The averagemonthly volume of demand searches by the end of the year was over 300.The number of articles cited in the monthly issues of Index Medicus rosefrom 156,783 in FY 1965 to 167,947 in FY 1966. The 1965 Cumulated IndexMedicus, a four-volume set of 6,327 pages was processed utilizing thecomputer and GRACE. The same equipment was used to produce seven recur-ring bibliographies during the year. The MEDLARS Compressed CitationFile which is used for demand search processing contains 422,000 citationson magnetic tape covering the period of January 1964 through June 1966.

MEDIARS Decentralization. MEDLARS expansion included three newcontracts to provide decentralized search centers. The University ofAlabama Medical Center, the University of Michigan, and Harvard Univ-ersity all entered the training phase of their development. The Univ-ersity of Colorado Search Center expanded its coverage to the RockyMountain states and UCLA began initial processing of demand searches.Overseas, a search Lending Library of Science and Technology and theUniversity of Newcastle-upon-Tyne. A second overseas search centeris developing at the Karolinska Institutet in Sweden.

Interim Catalog Module. Implementation of the Interim CatalogModule in January 1966 gave the Library a major new automation cap-ability. Utilizing the existing MEDLARS computer, the Divisionprogramming staff met its schedule for initial production of thebiweekly and quarterly NLM Current Catalog as well as catalog cardsfor the Library's public catalog. By the end of the fiscal year,

46

13 biweekly issues and the first quarterly issue of the NLM CurrentCatalog had been produced and a total of 6,017 citations were storedon magnetic tape. A total of 80,000 catalog card images were prod-uced on photographic paper using GRACE. Microfilm, Xerox, Copyflow,and cutting operations in the Reference Services Division completedphysical preparation of the cards.

Systems Activities. Among new activities in the Division wasthe preparation of a test design for a project to evaluate the per-formance of MEDLARS demand search retrievals in terms of user satisfac-tion. The design was submitted to an advisory committee for criticismand improvement and a pre-test was conducted. This project will in-volve data collection and analysis of 400 demand searches in FY 1967.It is anticipated that the findings will have a major influence onfuture improvements to MEDLARS.

Systems design work for an Auxiliary Chemical Module for MEDLARSas part of the Library's Drug Literature Program was completed. ThisModule will take advantage of the registry system at Chemical AbstractsServices and will provide the Library's users with a number of products,including bibliographies produced by MEDLARS after searching of anAuxiliary Chemical File. At the end of the year, a contract for pro-gramming assistance was signed with Informatics, Inc. to minimize theimplementation period for this effort.

Planning for a new computer system capable of meeting all theLibrary's data processing requirements began in FY 1966. To supple-ment its small systems staff, a contract was signed with AuerbachCorporation to produce equipment specifications and a broad design forfunctions of the new system. This effort will also produce definitionof subsystems and on implementation schedule. An initial new computerequipment installation is anticipated in FY 1968. The Division will beengaged in detailed design and conversion programming in late FY 1967.

Programming Activities. In addition to the major programming effortsrepresented by the Interim Catalog Module and special index capabilitiesfor recurring bibliographies (ititially used in the CerebrovascularBibliography), the Division's programming staff successfully implementedthe changes necessary for utilization of subheadings in MEDLARS andproduction of special literature searches of general interest on GRACEcopy for broad distribution. Numerous minor improvements, such asthe ability to print tree-structures of Medical Subject Headings onGRACE were also made to MEDLARS. A number of significant improvementsto the Demand Search Module were in final testing at the end of theyear. These will remove many current restrictions on search formulation,convert search input from paper tape to card media, and reduce computertime used for demand searches.

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Operations. The Input Unit typed and proofread 167,947 citationsappearing in the FY 1966 issues of Index Medicus, an increase of 7percent over FY 1965. This Unit also typed and proofread 6,017 citat-ions appearing in the NLM Current Catalog during the last six monthsof the year. In addition, approximately 3,000 demand searches weretyped and proofread during the year. Backlogs were kept to an operatingminimum most of the year and personnel turnover was markedly reducedcompared to previous years.

Computer operations expanded to a three-shift basis, includingmost weekends. GRACE was more heavily used as indexes to NASA'sSTAR were added to its production load. GRACE was used to produce56,394 pages as the Computer Unit met 70 publication and proof-copydeadlines during the year. Equipment performance continued basicallygood, although GRACE was inoperative for a two-week period in Maydue to mechanical difficulties which required factory assistance.Tape copying for search centers with IBM computer equipment wasinitiated on a routine basis in FY 1966.

COMPUTER UTILIZATION

Production

Program Checkout

System Testing

Use by Other Agencies

Lost Time

Total Use

Machine Downtime

Performance

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R E F E R E N C E S E R V I C E S D I V I S I O N

Mr. Samuel T. Waters was appointed Chief, Reference ServicesDivision, on June 27, 19 6, succeeding Dr. David A. Kronick whoresigned, effective November 30, 19 5, to become Librarian of theSouth Texas Medical School. Dr. John B. Blake served as ActingChief from December through March, and Mr. Edward A. Miller servedfrom April through June.

There were two significant changes in program responsibilityduring FY 1966. The preparation of comprehensive conventionalbibliographies was transferred to the Bibliographic ServicesDivision, and the preservation program was expanded ,in volume andin scope. Prerequisite to expansion of the preservation programwas the development of a sound foundation for a graphic imageprogram through contract filming. This required a sizeable effortfor the development of specifications, orientation of contractors,and evaluation of proposals.

NLM/NBS PROJECT TASK FORCE FOR GRAPHIC IMAGE STUDY

In October 196 the Library entered into a first phase technicalconsulting service agreement with the Center for Computer Science andTechnology of the National Bureau of Standards. The agreement pro-vided for studies to improve the quality of NLM photoduplicationproducts and the development of specifications for microimages suit-able for current preservation work and practical for future graphicimage systems. The accomplishments of the team are partly relatedin a November 19 5 publication of the National Bureau of Standards--A Study of Requirements and Specifications for Serial and MonographicMicrorecording; A Report to the National Library of Medicine, byEdward J. Forbes and Thomas C. Bagg. This 68 page report, issued ina limited edition, furnished the basis for the technical specificationsfor both contract and in-house filming operations. In addition, thetask force modified and rehabilitated existing equipment and designeda voltage regulation system for individual cameras and a fine voltagecontrol for preservation work. Installation of these components ofthe power supply system was about 60 percent completed at year's end.Additional improvements to all cameras are under study.

PHOTODUPLICATION SECTION

Output of microfilm from the Photoduplication Section increasedby almost 20 percent over the previous year, reflecting modifications

49

and better maintenance of cameras and increased staff authorizationand appointments. While production of copy for interlibrary loanheld almost even with last year, filming for preservation purposesincreased by 600,000 pages, to a level of 1,300,000 pages filmed andprocessed during the year.

The Section introduced many improvements in instrumentation andcontrol last year: the reduction ratio was standardized at 12 to 1;cameras were pinned and lenses were fine-tuned; a regulated powersupply system with fine voltage control was designed and tested;quality control measures were installed; new filming routines wereadopted. Despite numerous problems as changes were made, productionfor interlibrary loan and internal operations moved on schedule withrelatively minor disruption. A large part of these accomplishmentswere due to the work of Messrs. Thomas Bagg, James Strohlein,Leonard Cahn, James McNally and Joseph Brown, EBS engineers andtechnicians, who evaluated a mass of technical data, designed andinstalled electronic and mechanical components, and assisted theSection on the occasions when major breakdowns imperiled production.

Card Production. Xerographic production of cards increased by77 percent during the past year. The total production of over 222,000card units included 80,000 3 x 5 inch cards for the name, subjectand shelflist catalogs and 1 2,000 cards for the selection andordering processes. The catalog card process, inaugurated inDecember, is a by-product of the biweekly catalog program. GRACEprintouts of bibliographic citations for the Current Catalog areconverted into 3^5 inch card sets for the various Library files,with the six-point GRACE type enlarged to eight-point size duringthe process.

Film Processing. When the Versamat film processor was acquiredtwo years ago to process the phototypesetting product of the GRACEcomponent of MEDLARS, the machine was also considered capable ofprocessing intermediate microfilm uised for hard copy production.During twenty-one months of microfilm processing, productionremained fairly constant, averaging 11,000 feet per month. The1966 total was 13 ,000 feet. Production of phototypesettingproducts increased dramatically from a monthly average of 1,500feet in FY 1965 to h,"JOO feet in 1966, primarily reflecting theintroduction of the catalog card procedure described above. Thetotal for 1966 was 56, -00 feet. Use of the Versamat for processingof preservation film has not been attempted because of equipmentand chemistry problems.

Film Duplication. A Kalvar Multi-Mode Reproducer was acquiredfor production of service and distribution copies of KLM cameranegatives. The machine is capable of producing a direct or reversed

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image in a single generation. Dtiring FY 1966, 89? reels wereduplicated,, including 756 for NLM service files. The remaining

reels were external orders.

Pictorial Service. Responsibility for press photography andquality reproduction of NLM art materials was transferred to theExhibits Director in mid-September.

Equipment .CopyFlo. The capacity of the CopyFlo printer has been

doubled. The conversion in February required installation of newdrive motors, a special cooling Device for the paper drive rollers,and modification of the heater power supply system (cost $3 000)-A modification of the feed roller mechanism permits the use ofreground rollers at an estimated saving of $100 perset.

Microfilm Reader. A Lodestar Cartridge Reader wasacquired for more efficient retrieval from high-usage film filessuch as the Dictionary File of BSD and the unprinted Index-Cataloguesubject and biography files.

Maintenance and Repairs. Inadequate local repair and maintenance1

service for such key items as the Versamat, slow repair service onother items, plus needed repairs of NLM modified stock items havecreated a number of critical problems in maintaining production.The immediate solution has been to increase the spare parts inventoryand increase in-house preventive1 maintenance measures. During thepast year, machine parts and components were also borrowed from thePatent Office, National Bureau of Standards, National Institutes ofHealth, and the National Geographic Society as need arose. Inaddition, the machine shop facilities of several government agencieswere utilized for emergency service.

Film Deterioration. Though the causes of film deteriorationare better understood, we lack information as to the efficacy ofrecommended control measures. Methodology for determining blemishappearance in films fixed with the newer chemistry will be developedduring the coming year. Detection of deterioration of older filmsappears to be impracticable at this time in view of the microscopicnature of the blemishes.

REFERENCE SECTION

Reorganization. Recommendations of the Donnald Report (seeorganizational study, page 9) were implemented. The BibliographicServices Division assumed the responsibility for the preparation oflong bibliographies and response to questions involving extensiveresearch. Six Reference Services Division positions were transferred

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to Bibliographic Services Division to handle this program. TheSection was restructured to respond to shorter reference inquiries.Although one-fourth of the mail requests for reference serviceswere diverted from the Section to BSD, reader and phone requestsincreased. The total number of requests surpassed the previousyear.

Reader Service. The number of readers registered increasedby 2.5 percent over the previous year. Service to readers fromthe stack areas increased 13A percent. The seating capacity ofthe Reading Room overflowed on several occasions into office space.Sampling of the reader's register and comparisons with previousstudies revealed that the student ratio has risen in two yearsfrom 4l-5 percent to 68 percent. Further study showed substantialstudy hall usage by non-biomedical students. These users now arebeing identified, and are asked to relinquish their space to bio-medical personnel when necessary.

Annunicator. The annunciator system for notifying readers ofmaterial ready for pickup has 32 positions which is only one-quarterthe capacity needed. Peakloads often exceeded 100. Methods forexpanding the system are being developed.

Special Facilities. Thirteen study rooms are available forinvestigators with special requirements. Three immediately adjacentto the Reading Room are assigned on a daily basis for groupconferences, typing, dictating or use of audiovisual materials.The remaining ten, located in stack areas, are assigned on longerterm basis to authors and mission-oriented project teams. Eightadditional study units (carrels surrounded by screens) on A-levelare available for users with special needs. The demand for thesefacilities continues to exceed the supply. The study unit facilitywill be expanded to l6 units during the next fiscal year. Furtherexpansion of study rooms is under consideration.

LOAN AND STACK SECTION

Overall use of the collectioni increased during the year by5-6 percent to a new total high of over 2 3,000 requests filled.Six thousand more interlibrary loan requests were received than inFY 1965- The adoption of a stricter policy of rejections formaterial known to be available locally and for excessive use byindividual borrowers prevented an even greater increase. Inter-library loan requests for unavailable materials declined from 13-5percent in FY 1965 ° H-l percent. Reader requests for unavail-ables were dropped from 10.6 percent to 8.1 percent. A large partof the decline apparently resulted from bypassing catalog maintenancewith volumes returned from the bindery and thus reducing the backlog

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of materials held in TSD. Othei- important factors were theorientation talks and professional reviews of non-availablesinstituted at the beginning of jbhe year to increase the pages'awareness of the non-available problem; the assignment of anadditional library assistant tolfollow-up searching; and theaddition of Indexing Section to the areas searched for non-availables. Collection control|problems have increased sub-stantially in the last few years as new programs developed andolder programs expanded. To obtain further improvement in therate of requests located, the Division has suggested theacquisition of multiple copies, improving inter-divisionalrouting and processing procedures, and development of a contin-uing shelfreading program.

Stack Maintenance. A shelfreading program on B-level wasinstituted late in FY 19£>5, to locate misshelved volumes and tocollect deteriorated or unbound materials for binding or filming.The program was successfully continued until the end of November,at which time 30 ranges had been completed; in December, a haltwas imposed by staff shortages and the assignment of professionaland supervisory staff time to the expanded microrecords program.Since December, several trucks of newly acquired theses alsoaccumulated on B-level. These remained unshelved. Within thenext months it is planned that this program will be completedand shelfreading will be resumed. About Jf^00 of the theses havealready been sorted and filed by summer students.

The serial collection is increasing, and virtually all theA-level shelf space has been filled. This collection will haveto be relocated. Because shifting the collection will createconsiderable confusion and because a sizeable number of people(100 man days estimated) will be needed to complete the job, themove must be made during non-working hours so that there will beminor disruption of loan operations.

Use of Kalvar Microfilm for Interlibrary Loan. The expandedmicrofilm program provides filmed copies of older journals whichLoan and Stack is able to use fo|r interlibrary loan, therebyeliminating a filming and copying operation. Such film loanscan be made because of infrequent calls for the older volumes--there is little likelihood of requests for material on loan--and because of the ease and low cost of film reproduction whichmakes the possibility of loss in the mail less crucial.

Equipment. Trial use of bo|ok trucks equipped with hardrubber tires showed a substantial, improvement in mo'hility. Tensets have now been installed and the remainder will be convertedduring FT 196?-

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Use of Teletype Facility for Interlibrary Loan. The installationof a teletypewriter makes it possible for NLM to accept interlibraryloan requests via TWX. The facility became operational in mid-Mayand was announced in the June issuel of the NLM News. Reaction fromother libraries has been favorable and increased use is anticipated.

Air Mail. To speed the flow of information to requestors, theLibrary has instituted a policy of [sending interlibrary loans byair mail whenever feasible.

PRESERVATION! SECTION

Microrecords Unit. There was a greater emphasis on Microrecordswork during FY 1966. With added stlaff for preparation and filmingand supplemented by contracts for outside filming, it has beenpossible to begin an expanded program of microfilm preservation. Theformer program of filming isolated |small runs of extremely deterioratedsegments of the collection,, with destruction of the originals, hasbeen abandoned. The new program callls for complete filming of titles;evaluation of sets by RSD and HMD fpr archival and reference value;and retention of originals and gap-tilling on the basis of thisevaluation. The eventual goal is complete filming of the olderportions of the collection under th!e highest technical and biblio-graphic standards possible. One important facet of the program isthe reporting of completed work to the National Register of MicroformMasters so that copies of the film eventually will be available toother libraries.

The training of new personnel and establishment of new routineswas begun in November. Since that iti^e, approximately 1,023,000 pageshave been collected and collated for in-house filming and 73 reels ofpreservation film have been edited,1 reported, and stored.

Contract Filming. In addition to the material filmed byPhotoduplication Section, two contracts for the filming of 1,000,000pages each were signed during the vear. University Microfilms, Inc.,began work in April, with a contract completion date of October 15,1966. The first shipment is expected in July. The second contract,awarded to Microcard Corporation, was signed late in June and calledfor delivery of 30*000 pages in July. With the two outstandingcontracts, plus a third to be written for 2,000,000 pages, a totaloff-premise production of over 4,060,000 pages is expected in FYin addition to an estimated in-house output of 2 to 3 million pages:in all, an increase of 6 to 7 million pages in its film collection.

Binding Unit. Two important improvements in binding procedureswere instituted during the year. The first resulted from anautomationprocedure for serials by the Library's binding contractor, the

54

Hertzberg-New Method Company, WLM can now identify titles onbinding instruction slips using a preassigned number only, thuseliminating the requirement for typing spine lettering on theslip. This is particularly advantageous with complex titles andcorporate bodies. The second improvement was the adoption of theAvery cloth label, a pressure-sensitive label which can beprepared on a typewriter. Application of this label has provedmuch faster than either the old method of stylusing or use ofthe heat-applied label provided in the Council of Library Resources'Selin System. New labels on the books sent to the Reading Room,where use is heaviest, have been closely inspected and no cases ofpeeling have been discovered. The appearance as well as thelegibility of the Avery label are an improvement over the stylusedmarkings. During FY 1966 18,775 volumes were bound on contractat an estimated cost of $52,000.

Injury to Filmed Materials. The Library's new microrecordsproject has resulted in damage to some of the original materialduring filming. Of the 20 titles (698 volumes) forwarded toBinding Unit by Microrecords, 269 volumes were too badly injuredfor continued use and 98 required rebinding.

The use of the damaged materials must be restricted. Copiesfor interlibrary loan must be made only from the film copy. Thedamaged materials have been marked to indicate when a volume isrestricted to use with careful handling, or for Reader Service onlywhen special requirements are involved (such as a need to examinecolored plates). The use of special archival quality containersor wrappers for damaged materials is under study.

Routing of Bound Volumes. In August, Preservation and CatalogMaintenance Sections worked out a plan under which no more than aweek's supply of volumes to be shelflisted would be delivered byBinding Unit to Catalog Maintenance. Under this plan, excess volumesare sent directly to the stacks. A duplicate copy of the bindinginstruction slip is sent to Cataloging to serve as a transactionand recall document. One thousand and eight-hundred volumescurrently await shelflisting. An undesirable result of thisprocedure is the amount of time Loan and Stack must spend inrecovering and reshelving the volumes called for by CatalogMaintenance. This disadvantage is, however, offset by the reductionof the TSD backlog of newly-bound volumes still charged to Binding,which formerly, when needed, were either considered unavailable orhad to be searched. The new procedure reduced unavailables due tomaterials being charged to Binding from 5,121 in 19&5 "t° 2,178 inFY 1966.

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H I S T O R Y O F M E D I C I N E D I V I S I O N

The time of the staff of the History of Medicine Divisionis devoted largely to the tasks of acquisition, cataloging,reference, reader service, and interlibrary loan. Theseactivities are pursued for the support which they provide,actually or potentially, for study, research, and understandingof the history of the biomedical sciences and health professions.The history of medicine is a relatively small academic discipline,in terms of the number of professorships and candidates fordegrees. Its interest, however, extends to a much broaderaudience, as the growing membership of the American Associationfor the History of Medicine, for example, testifies. Apparentlyan increasing number of physicians, scientists, and medicaladministrators are turning to history for some insight into thebackground of modern medicine in its broad contexts. The trendis slow, the changes are not spectacular, but a number of eventsduring the past year illustrate the direction of movement. Thechief of the Division, Dr. John Blake, was called upon to takepart in three informal conferences outside the Library, on libraryresources for the history of the life sciences, on manuscriptsources, and on problems in the history of the behavioral sciences.The Library cooperated with the Josiah Macy, Jr. Foundation insponsoring a Conference on Education in Medical History. Twentyparticipants took part in a lively two-day discussion of goalsand means, to be published in the coming year. More concretely,the substantially increased circulation statistics provide directevidence of increasing use of the Library's historical collections.

Hundreds of visitors to the Library were also exposed to theLibrary's collections and to the history of medicine throughexhibits held in the lobby and prepared largely by staff membersfrom HMD. These included exhibits on "Animal Experimentation inMedicine through the 18th Century"; on Conrad Gesner, in honor ofthe quatercentenary of his death; and on "Medical Symbolism inBooks of the Renaissance and Baroque." In each case a catalogdescribing the books was published and distributed widely. HMDalso gave assistance in the preparation of an exhibit and catalogon "Leonardo da Vinci and Medicine" prepared by Dr. Raymond S.Stites of the National Gallery of Art. A number of smallerexhibits, shown in the corridor in HMD, featured recent acquisitions.

Acquisitions. The number of early imprints added to thecollections during the past year increased slightly over theprevious year, but was still well below the average number duringthe 1950's. Library-financed acquisitions have been supplemented,however, by an increase in the number of gifts during the past year.We are particularly indebted to Dr. Stanhope Bayne-Jones, whosedonations strengthened the Library's holdings in a number of fields.Of particular importance were a collection of works by and about

56

Jean Paul Marat, French physician and scientist and revolutionary;the first edition of Francesco Redi's Esperienze Intorno aliagenerazione degl' insetti, Florence, 1668, as well as a Latintranslation of 1671, and five works of Anthony van Leeuwenhoek.Other welcome gifts of early imprints were received from Col.T. D. Boaz, Jr., Mr. John T. Fishburn, Miss Jeannette M. Francis,and Dr. Joseph I. Waring.

Mention of Redi's work points up the fact that, despite itsrichness in the historical literature of medicine, the Librarystill lacks a number of important and well-known works. Othersacquired during the year, all works deemed worthy of listing inGarrison and Morton's Medical Bib1iography, were the first Greekedition of Dioscorides' De materia medica (Venice, 1499), thesecond edition of Johann Wier's De praestigiis daemonum (Basel,1564), Johannes Goedaert's Metamorphosis et historia naturalisinsectorum (Middelburg, 1700), and Conrad Gesner's Historiaeanimalium (Zurich, 1551-87). Other lamentable gaps now filledinclude the first edition of the Saggi (Florence, 1667) of theAccademia del Cimento, Herman Boerhaave's Index piantarum(Leyden, 1710), and David Ramsay's History of South Carolina(Charleston, 1809), which contains one of the earliest significantAmerican contributions to medical historiography.

Other kinds of material added represent works which individ-ually are not as significant contributions to the biomedicalsciences as those mentioned above, but which illustrate popularknowledge or public actions in relation to health and disease.Often these are ephemeral, and surviving copies tend to beextremely rare. One notable example acquired in the past year isa broadside almanac for Nuremberg for 1487, which includes exten-sive directions for bloodletting. As Sir William Osier has noted,these bleeding calendars "are among the rarest items in earlyprinting"; according to Goff's Census, there is no other copy ofthis one in the United States. Of a similar ephemeral nature, andalmost equally rare, were a 1636 broadside proclamation of KingCharles I promulgating orders against the plague, two 16th centuryplague tracts, one by Johann Klainmtiller, the other by AndreasEllinger, and an anonymous regimen for midwives, Schwangerer,kreistender, wochnerin unnd seugender Regiment (Halle, 1591).

Altogether 245 editions were added to the early imprint collec-tions: 2 incunabula, 26 16th century, 64 17th century, 145 18thcentury, and 8 Americana. Perhaps half are medical in a narrowsense; the others reflect the interdisciplinary nature of medicinein the broad sense, and of the materials needed for research inthe history of the biomedical sciences and health professions:botany, chemistry, natural philosophy; dentistry, pharmacy, andveterinary medicine.

57

Cataloging. The most important achievement of the catalogingprogram during the year was completion of the manuscript for the16th century catalog. It is now in press, with publicationscheduled for early 1967.

Prints and Photographs. The Library's pictorial resourceswere significantly enriched this year, particularly with theacquisition of a collection of 264 prints, drawings, and otheritems relating to dentistry. The collection included etchings,engravings, woodcuts, and lithographs from the 16th through the19th century, among them being three Goyas, a Hogarth, and about25 caricatures. Other accomplishments include the cataloging of asubstantial backlog of pictures and inauguration of a program forimproved mounting and preservation of fine prints.

Early Manuscripts. Substantial accessions were made to themicrofilm holdings of early manuscripts. Nine reels containing 48Arabic manuscripts were obtained from Damascus. These were selectedand acquired through the cooperation of Dr. Sami Hamarneh, aspecialist in medieval Arabic medical history at the SmithsonianInstitution. Substantial collections of Latin manuscripts, eachcontaining at least one Galenic text, were acquired on microfilmfrom the Bibliotheque Nationale and the Biblioteca MediceaLaurenziana (Florence), and orders have been placed for severalothers.

Analysis of acquisitions to date by Mr. Richard J. Burling,Curator of Early Western Manuscripts, has shown the catalog ofHermann Diels (1905-07) to be in some respects unreliable and hassubstantiated the need for a new account of the Latin transmissionof Galenic and pseudo-Galenic writings. Mr. Durling's researchesin this area will eventually be incorporated in the Galen articlewhich he is preparing for the Catalogus Translationum etCommentariorum.

Modern Manuscripts. Continued progress was made during theyear in cataloging the backlog of modern manuscript materials inthe Library's existing collections. During the year 117 manu-script groups were processed, ranging in size from a single volumeor manuscript box to one collection of 54 manuscript boxes.Fourteen groups were acquired during the year, totalling approxi-mately 23,250 pieces. Among these were a collection of papersfrom Dr. William Bean; a collection from Mrs. James D. Doull,including several letters of William Budd; and significantadditions to the collections of Henry Leber Coit papers, fromMiss Eleanor G. Coit and Miss Edith N. doit, and to the ChaunceyLeake papers. Donors of other collections, to whom the Library'sthanks are also acknowledged, include Theodore Wiprud, Mrs.Ernest Lyman Scott, and Miss Anna E. Muddiman.

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During the year the Library also initiated an oral historyprogram, through a contract with a historian - interviewer,using Extramural Program funds. At the end of the year, thefirst interview was in progress. This will lead to the acqui-sition of additional manuscript material as well as tape-recordedand transcribed interviews, enriching the Library's resources forresearch in recent medical history.

Bibliography. The first annual bibliography of the historyof medicine was prepared during the year and ready to go to pressas the year ended. The bibliography is intended to provide anannual selective guide to the literature of medical history, withfive-year cumulations to enhance its permanent reference value.Citations have been selected from MEDLARS and other sources,including literature in other academic disciplines not ordinarilyreceived in NLM. It is arranged in such a fashion as to giveusers biographical, topical, chronological, geographical, andauthor approaches to the literature.

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A P P E N D I C E S

I. Acquisition Statistics

II. Collection Statistics

III. Cataloging Statistics

IV. Bibliographic Services Statistics

V. Reference Requests and Binding Statistics

VI. Circulation Statistics

VII. Photographic Services StatisticsTable I - External OrdersTable II - Internal OrdersTable III - Total ProductionTable IV - Orders Completed as Interlibrary Loans

VIII. History of Medicine

IX. NLM Literature Searches

X. Recurring Demand Searches

XI. Publications

XII. Staff Publications

XIII. Extramural Programs: Abstracting Contracts

XIV. Extramural Programs: Training Grants

XV. Extramural Programs: Research Grants

XVI. Extramural Programs: Contracts and Agency reimbursements

XVII. Extramural Programs: Resource Grants

XVIII. Personnel StatisticsTable I - Personnel on DutyTable II - Personnel Actions

XIX. Finanacial Statistics: ObligationsTable I - Summary of ProgramTable II - Obligation by Object

XX. Financial Statistics: Appropriations

XXI. Advisory Report on Policy from the Board of Regents to theSurgeon General

SITION ACTIVITIES

1964 1965 1966

Prospects considered foracquisition, not in library 29,494 27,151 32,919

Prospects considered foracquisition, Library has 15,468 21,470 13,087

TOTAL 44,962 48,621 46,006

OPDE S LACED 14,555 14,803 14,755

AERIAL RECORD

New titles added 1,511 1,299 1,925

Titles currently received(as of end of year) 15,358* 16,557* 18,482*

•PUBLICATIONS ADDED

Serial Pieces 71,323 77,406 80,611

ather 19,782 13,405 17,839

TOTAL PUBLICATIONS ADDED 91,105 90,811 98,450

OBLIGATIONS EOR PUBLICATIONS $108,000 $124,114 $161,286

(Included for rare books) 14,007 12,234 26,319

* At least one issue received since January1959.

NATIONAL U3PAPY OF ITDICINE

GPOT;ffli OF COLLECTIONS

FISCAL YEAR 1965/1966

CURRENT YEAP

ROOK MATERIAL

1. Bound Monographs

a. H1*D

b. 1801-1913

c. 1914-

Subtotal (1)

2. Bound Serials

Total Bound Volumes(1 + 2)

3. Theses (includingunsearched theses)

4. Pamphlet volumes

Subtotal (3+4)

TOTAL BOOK 11ATCPIAL

NON-ROOK MATERIAL

1. Microfilms

2. Portraits and Pictures

COLLECTION TOTALS

Added

265

111

8,623

8,999

12,256

21,255

5,368

26

5,394

26,649

443

1,376

1,819

With- Netdrawn Gain

47 218

17 94

32 8,591

96 8,903

49 12,207

145 21,110

0 5,368

0 26

0 5,397

145 26,504

0 443

1 1,375

1 1,818

30 June 30 June1965 1966

35,409 35,627

88,443 88,537

182,990 191,581

306,842 315,745

298,859 311,066

605,701 626,811

285,151 290,519

167,576 167,602

452,727 458,121

1,058,428 1,084,932

4,150 4,593

59,241 60,616

63,391 65,209

15,000 15,000

TOTAL NON-BOOK MATERIAL 1819

BOUND VOLUME EQUIVALENTS

GRAND TOTAL 28,468 146 28,322 1,136,819 1,165,141

II

Q\TALOGI1IG STATISTIC*

1964 1965 1966

COMPLETED CATALOGING

New Titles

Pecataloged Titles

TOTAL

Volumes PeclassifiedTransferred

Catalog Cards Filed

Volumes Shelflisted

Volumes "ithdrawn

NATIONAL

rfein entries

Added Fntries

Name cross-Eeferences

11,326

2,831

14,157

and/or873

102,871

99,841

360

LIBRARY OF MEDICINE

(ANNUAL)1963 1964

11,59? 12,832

4,566 6,112

2,856 4,212

10,174

4,742

14,916

2,125

163,203

53,697

387

CATATJOG

1965*

16,523'

7,293

3,103

10,063

2,160

12,223

1 959

210,820

36,230

95

Cumulation1960-1965

93,964

32,641

22,273

The 1965 entries were not published separately, but wereincluded in the 1960-1965 cumulated edition.

Ill

BIBLIOGRAPHIC SERVICES DIVISIONFY 1966

FY 1964 FY 1965 FY 1966

Articles Indexed 144,057 151,635 164,545Backlog as of June 30 11,860 22,870 40,916 I/

Articles Revised 63,598 98,777 108,681Percent of All Articles 44.1 65.1 66.0

Journal Issues Receivedfor Indexing 14,486 15,577 17,390

Journal Titles Indexedin Index Medicus 2,299 2,441 2,436

Cyrillic BibliographyProject 20,004 18,321 15,526

MEDLARS Searches Performed 536 1,623 3,035

Recurring Bibliographies 3 6 9

JL/ This figure reflects approximately a 10 percent increase dueto a new method of estimating backlogs during FY 1966.

IV

REFERENCE SERVICES

1964 1965 1966

Requests by Telephone 9,866 9,8lO 9,971Government (5,64l) (5,621) (5,38l)Non-Government (4,225) (4,189) (4,590)

Requests by Mail 1,592 2,077 1,489Government ( 204) ( 274) ( 192)Non-Government (1,388) (1,803) (l,297)

Readers Assisted 8,696 9,044 10,4llGovernment (3,364) (3,650) (3,934)Non-Government (5,332) (5,394) (6,Vf7)

Total 20,15 20,931 21,871Government (9,209) (9,5 5) (9,507)Non-Government (10,9 5) (11,386) (l2,36U)

Readers counted 26,133 26,779 27,4l8

BINDING STATISTICS

Volumes sent to binder

Volumes returned frombinder and processed

New volumesRebinds

Volumes bound at NLM

Volumes repaired at NLM

Volumes and pieceslettered

Pieces mounted

1964

17,3 0

16,933

(12,933)(4,000)

2,807

2,513

66,5 6

199

1965

17,800

18,328

(14,480)(3,848)

3, 5

4,138

41,037

82

1966

18,775

17,773

(15,(2,

3,529

4,373

28,413

145

574)199)

V

CIRCULATION STATISTICS 1966

1964 1965

Requests received 243,464

Requests filled 213,711

Requests unfilled 29,753

RejectedN.A.

Percentage ofrequests filled 87-1

ITEMS USED BY MAJOR CATEGORY

263,464

229,297

3^,167

(5,973)(23,780)

(1,218)(32,9^9)

(8,652)(26,264)

87.J

Reader's requests

Interlibrary Loans

PhotocopyOriginalGovernmentNon-Government

83,156

130,555

(124,569)(5,986)(3,164)(2,822)

80,739

148,558

(142,452)(6,106)(3,350)(2,756)

91, 537

151,787

(145,076)(6,711)(3,170)(3,541)

UNAVAILABLES

By percentageof total

unavailables

Already on loanlot in CollectionAt binderyMissingDoes not circulateNot identifiedIn process

1964

9.632.221.013-^9-43-510.9

100.0

1965

8.429.820.022.85.14.49-5

100.0

1966

10.534.412.43.45-96.227-2

100.0

By percentageof total

requests accepted1 9 ~ £ 5 1 9 ^ 5 1 9 ^ 6

0.93-22.21-30.90.4l.l

1.13-72.42.80.60.61.2

1.03.41.20-30.50.62.7

10.0 9-7

VI

PHOTOGRAPHIC SERVICES

TABLE I - EXTERNAL ORDERS

EXTERNAL ORDERS COMPLETED

By type of order:Interlibrary loanCoupon, paid, special

By type of service:MicrofilmCopyFloPhotostatXerox 914 CopierPhotoprintsPhotographs and slides

PAGES DUPLICATED FOR ORDERS

Microfilm: 1For CopyFlo ordersFor microfilm orders

CopyFlo (from film file)PhotostatXerox 9l4 CopierPhotoprintsPhotographs and slides

1964

126,327

(124,569)( 1,758)

( 23)(124,121)( 567)( 1,184)( 289)( 143)

,94o, io4 2(1,934,490)( 5,614)

9,4513,28211,2572,415604

1965

143,374

(142,452)( 922)

( 33)(140,093)( 722)( 1,969)( 423)( 134)

,094,823(2,084,074)( 10,749)

13,9483,25017, 9193,073933

1966

145,295

(145,076)( 219)

( 27)(141,575)( 278)( 2,950)( 339)( 126)

2,074,353(2,069,165)( 5,188)

7,8481,30026,2013,481765

Total 1,967,113 2,133,946 2,113,948

CARDS

MicrofilmCopyFlo

Total

2,8052,805

5,610

0£

0

00

VII

PHOTOGRAPHIC SERVICES

TABLE II

1964

INTERNAL ORDERS

1965 1966

Microfilm pages 1,297,876 729,235 1,302,092For film file ( 228,321) (212,498) ( 190,378)For poor paper program (l,062,433) (480,011) (1,102,837)For interoffice orders ( 7,122) (36,726) ( 8,877)

Paper reproduction pages 107,376Photostat ( 476)CopyFlo ( 20,782)PhotoprintsXerox 914 Copier

Photographs and slides

58)86,060)

258,212( 696)( 51,542)( 8)(205,966)

2,471

258,097( 1,071)( 37,569)( 8)( 219,449)

3,555

Cards - Microfilm- CopyFlo

144,825146, 080

137,236125,621

222,090222,203

TABLE III - TOTAL PRODUCTION

MicrofilmCopyFlo pagesPhotostat pagesXerox 914 CopierPhotoprintsPhotographs and slidesCards - Microfilm

- CopyFlo

1964

3,237,9801,964,7233,758

97,3172,4732,155

147,630148,885

1965

2,824,0582,149,564

3,946223,8853,08l3,4o4

137,236125,621

1966

3,376,4452,114,582

2,371245,6503,4894,320

222,090222,203

TABLE IV - ORDERS COMPLETED AS INTERLIBRARY LOANS

GOVERNMENT

Metropolitan Washington 19,795Outside Washington (U.S.A.) 23,774Overseas 5,868

Total 49,437

1966

NON-GOVERNMENT

6,75568,33220,552

95,639

TOTAL

26,55092,10626,420

145,076

Vll-a

HISTORY OF MEDICINE DIVISION

ACQUISITIONS 1964 1965 1966

Editions searched ,565 2,222 2,0*4-1Editions ordered 553 4-30 314-Editions added to collection 4-52 226 2-4-5Manuscript items * * 23,257

CATALOGING

Editions cataloged 2,305 2,1 9 772Card mats typed 3,HI 4-,680 1,781Catalog cards filed 15,683 53,74-6 26,001

REFERENCE

Reference requests * * 84-7

CIRCULATION

Readers - 34-2 382 852Volumes charged 1,111 1,103 2,,588

Interlibrary loan andphotoduplication orders T4-84- 4-97 823Original material (217) (227) (109)Photocopies (26?) (270) (714-)

PAGES FILMED

For special orders 4-, 04-1 9,609 2,765For security / loan 198,729 205,511 168,4-99For acquisition 0 0 0

202,770 215,120 171,264-

PRINTS AND PHOTOGRAPHS

Items added to collection 593 298 1,4-33Pictures supplied 980 1,090 597Reference requests 281 196 2-4-1

Not previously counted

VIII

IX

NLM LITERATURE SEARCHES

These bibliographies on selected subjects are the productof literature searches requested by physicians, scientists, andother health professionals. They have been chosen as beingof interest to a wide audience. The literature searches areannounced through monthly notices in the following periodicals:Journal of the American Medical Association (Book Forum), DrugResearch Reports, and Pub1ic Health Reports. Single copies ofthe listed bibliographies may be ordered by title and numberfrom NLM.

RECURRING DEMAND SEARCHES

as of June 30, 1966

IssuesReleased

12

12

12

12

10

8(Temporarily discontinued 6/17/66)

Primates, Apes, and Monkeys 12

Dental Literature (3 parts) 4

Schizophrenia 12

Programmed Instruction 1

Title

Smoking, Tobacco, Nicotine

Sudden Death

Venereal Diseases

Gastroenterology

Toxicology Bibliography

Toxicology Bibliography

Requester

Division of Chronic Diseases,PHS

National Institute of ChildHealth and Human Develop-ment, NIH

Communicable Disease Center,Atlanta, Georgia

National Institute of Arthritisand Metabolic Diseases, NIH

Food and Drug Administration,Washington, D.C.

American Medical Association,Chicago, Illinois

University of Washington PrimateInformation Center,Seattle, Washington

National Library of Medicine,Dentistry

Lafayette Clinic, Detroit,Michigan

Lafayette Clinic, Detroit,Michigan

History of MedicineSemi-annual 2

Monthly 12

Vital and Health Statistics 16

Malaria 6

Epilepsy and Anti-convulsants

All Citations Written in 6Chinese

Medical Education Bibliography 2

Germ Free Life - Life Islands

Resuscitation

Hospital Acquired Infections

Specified Categories 11(Temporarily discontinued5/26/66)

History of Medicine, NationalLibrary of Medicine

National Center for HealthStatistics, PHS

Gorgas Memorial Laboratory,Balboa Heights, CanalZone , Panama

Michigan Epilepsy Centerand Association, Detroit,Michigan

Pan American Health Organiza-tion, Washington, B.C.

National Institute of Al-lergy and InfectiousDiseases, NIH

Department of Agriculture,Beltsville, Maryland

Office of Science andTechnology, Washington,D.C.

U.S. Biological Center,Fort Detrick, Maryland

X

PUBLICATIONS

As a leader in modern biomedical communications, the Librarycontributes to the advance of the health sciences through abroad publications program.

NLM's bibliographies, indexes, catalogs, and other guides tomedical literature can be purchased from the Superintendent ofDocuments, U. S. Government Printing Office, Washington, B.C. 20402.

Index Medicus, a monthly bibliographic listing of references tocurrent articles from approximately 2,400 of the world's biomedicaljournals. Each issue contains subject and name sections and aseparate Bibliography of Medical Reviews. Price: $40 annualsubscription ($49 foreign); single issues, $3.75.

Cumulated Index Medicus, a cumulation in one author volume and threesubject volumes of the articles cited in twelve monthly issues ofIndex Medicus. Volume 6, 1965, cites 171,437 articles. Price: $40per set ($50 foreign).

Medical Subject Headings, published as Part 2 of the January IndexMedicus. Subject headings are arranged alphabetically with crossreferences and in categorized lists. Price: $2.50.

List of Journals Indexed in Index Medicus, 1966, contains fourseparate listings of journals indexed for Index Medicus in 1965:title, abbreviation, subject, geographic location. Price: $0.75.

Bibliography of Medical Reviews, annual cumulation of current reviewarticles cited in monthly Index Medicus, listed by subject. Pricefor Volume 11, 1966: $1.25 (volumes 1-10 also available at varyingprices).

Bibliography of Medical Translations, published semimonthly as aguide to the location of available translations from the foreignlanguage biomedical literature. Price: $4.50 annual subscription($5.75 foreign); annual cumulative index, $0.50.

NLM Current Catalog, began publication in January 1966 (supersedesNational Library of Medicine Catalog). Issued biweekly, withquarterly and annual cumulations. Biweekly issues contain an authorand title listing of publications cataloged during the preceding twoweeks and also provide a subject listing of publications cataloged.Price: $15 annual subscription ($20 foreign) includes biweeklies,quarterlies, and hard-bound annual. (Annual cumulation availableseparately: $4.50).

National Library of Medicine Catalog, an author and subject indexto books and serials cataloged by the Library from 1950 through1965. Further information on this series of three cumulations(1950-54, 1955-59, 1960-65) is available from the Library.

XI

STAFF PUBLICATIONS

Adams, Scott. The National Library of Medicine's role in biomedicalCommunications. BioScience 15: 585-8, September 1965.

Trends in bibliographic organization in the biomedicalsciences. Wilson Libr. Bull. 40:714-8. April 1966.

Austin, C. J. Dissemination of information and problems of graphicpresentation (a talk presented at the 31st Meeting andCongress of the International Federation for Documentation,October 13, 1965, Washington, D. C. which is to be published).

Experience with the GRACE system. Automation and Electronicsin Publishing, edited by Hattery & Bush, Spartan Books, Inc.,Washington, D. C., December 1965, pp. 61-70.

Blake, John B. The library and dental history. Alabama J Med Sci.3: 91-5, 1966.

Clements, Raymond D. Avicenna, the prince of physicians. MinnesotaMed. 48' 1567-8, 1965; 187-92, 1966.

A sixteenth century psychologist on the immortality of thesoul: Juan Luis Vives. Bibliotheque d'humanisnme etrenaissance; travaux et documents 28: 78-88, 1966.

Cummings, Martin M. The National Library of Medicine and thepractitioner. Postgraduate Med. 39: 327-8.

Durling, Richard J. Conrad Gesner's Liber Amicorum, 1555-1565.Gesnerus 22: 134-59, 1965.

Durling, Richard J. and Durling, Sheila M. An Ulm unicum of 1501in the National Library of Medicine. Library, 5th ser.,20: 55-57, 1965. plates.

Elwin, Carl-Eric. The use of MEDLARS by the pharmacologist:some aspects of terminologic problems. Pharmacologist 8,summer 1966.

Kenton, Charlotte. The recurring bibliographies program of MEDLARS.Bull. Med. Lib. Assn. 54: April 1966.

Lancaster, F.W. Evaluation of systems by comparison testing.College & Research Libraries, pp. 219-21, May 1966.

XII

Redmer, Paul C. Publication by GRACE. Methods of Informationin Medicine. 4: 136-40, September 1965.

Sewell, Winifred. The needs of industry for library servicesbeyond that expected of its own special libraries andresources available to them. Libr. Trends 14: 226-35,January 1966.

U. S. National Library of Medicine. Animal experimentation inmedicine through the 18th century. An exhibition (compiledby Ellen B. Wells), Bethesda, Maryland (1965), 17 p.

Conrad Gesner, a quartercentenary exhibit (compled byRichard J. Durling), Bethesda, Maryland (1965), 20 p. illus.

Medical symbolism in books of the renaissance and baroque,

An exhibit (compiled by Peter Krivatsy), Bethesda, Maryland(1966), 22 p. illus.

Wells, Ellen B. 't1 Gevoel: a toothpulling scene. Visual Med.1(1): 51, March 1966.

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PERSONNEL STATISTICS

TABLE I - PERSONNEL ON DUTY

Personnel authorizedPersonnel on duty (June 30)Average number of persons

employed

FY 1964

268259

247

FY 1965

291269

269

PERSONNEL ON DUTY

Office of the DirectorExtramural ProgramsIntramural ProgramsOffice of the Associate

DirectorMedical Subject HeadingsDrug Literature ProgramTechnical Services DivisionBibliographic Services Div.Information Systems DivisionReference Services DivisionHistory of Medicine Division

419

209

4013216

FY 1966

352320

294

5121248

---

(60)(29)(37)(70)(13)

---

(59)(32)(41)(69)(15)

( 4)( 8)(11)(57)(32)(50)(68)(18)

259 269 320

TABLE II - PERSONNEL ACTIONS

AccessionsLossesConversion to Career-Conditional or Career

PromotionsReassignmentsDemotionsPay Adjustments

FY 1964

6548

17655707

FY 1965

7462

177031039

FY 1966

12372

371212805

XVIII

FINANCIAL STATISTICS: OBLIGATIONS

FY 1966

Table I. Summary of Program

1966 ActualMedical Library Assistance:

Research and development grants 605,940Fellowship grants 33,504Training grants. „ 431,665Construction grants ...Publications and library support grants 223,998Regional medical library grants ...

Subtotal, grants 1,295,107

Direct Operations:Intramural library operations 4,466,5HExtramural contracts 6o4,244Review and approval of grants and contracts 123,266

Subtotal, direct operations 5,194,021

Total, National Library of Medicine 6,489,128

Table II. Obligation by Object

1965 Actual 1966 Actual11 - Personnel compensation 1,980,211 2,289,52212 - Personnel benefits 151,656 174,79521 - Travel and transportation of persons 35,656 58,07822 - Transportation of things 3,l42 3,83523 - Rent, communications, and utilities 114,820 124,24824 - Printing and reproduction 163,835 , 242,64325 - Other services I,139,l82±/ 90,064

Project contracts ... 1,242,399Services of other agencies ... 189,366Payment to National Institutes ofHealth Management Fund ... 4l8,4o6

26 - Supplies and materials 87,253 103,54731 - Equipment 164,803 257,118

(Literature) (125,244) (166,862)Grants, subsidies, and contributions 119,897 1,295,107

Appropriation transfer to LC 8,000 ...

Total 3,968,455 6,489,128

I/ Project contracts, services of other agencies, payment to NIH are~~ included in this total.

XIX

FINANCIAL STATISTICS: APPROPRIATIONS

FY 1966

Regular 1966 Appropriation, NLM1966 Supplemental Appropriation, NLM

Transferred to the Office of the SurgeonGeneral, Salaries and Expenses

Reimbursement for goods and services renderedto other federal agencies

Appropriation: Buildings and Facilities(Repairs and Improvements)

Scientific Activities OverseasAppropriation:IndiaIsraelPolandYugoslavia

Allotment from Agency for InternationalDevelopment

$5,510,0004,175,000$9,685,000

-1,000

+25,000

$9,709,000

$106,000

$5,80116,28039 ,20085,100

$501,381

$35,000

AID HOST COUNTRIES

Far East

KoreaLaosPhilippinesThailandViet Warn

Latin America

BoliviaBrazilChileColombiaCosta RicaEquadorEl SalvadorGuatemalaMexicoNicaraguaPanamaParaguayPeruSurinamVenezuela

Near East

IndiaIranJordanNepalPakistanTurkey

Africa

CameroonChadEthiopiaLiberiaNigeriaTunisiaUpper VoltaSudanSenegalUganda

XX

ADVISORY REPORT ON POLICY FROM THE BOARD OF REGENTSOF THE NATIONAL LIBRARY OF MEDICINETO THE SURGEON GENERAL OF THE

UNITED STATES PUBLIC HEALTH SERVICE

GENERAL POLICIES

1. The National Library of Medicine should be responsiblefor collecting, organizing, processing and distributingrecorded information relevant to human health, serving as theprimary national resource for these functions.

2. The National Library of Medicine should be the centralrespository and the coordinating agent for the multiple specializedinformation centers designed to meet categorical information needsrelated to human health.

3. The National Library of Medicine should be the heart of anational biomedical information system which is designed tofunction as a component of a future national science informationnetwork.

4. The National Library of Medicine should be responsible forthe research, organization, development and coordination necessaryto the evolution of a more effective decentralized national systemfor the dissemination of information in medicine and relatedfields.

These general policies are consistent with the characteristicsof the National Library of Medicine:

1. The greatest repository of medically related information inthe world is contained in the National Library of Medicine and itscapacity to disseminate this information is unequalled.

2. The National Library of Medicine functions as the capstoneof our present system of medical libraries and has well establishedinterlibrary relationships for exchange and sharing of its collections,

3. The National Library of Medicine has been in the forefrontinternationally in placing into operation advanced systems of infor-mation processing suited to serve students, investigators andpractitioners in the broad fields of knowledge related to humanhealth.

4. The mission orientation of improving human health givesunique quality to the National Library of Medicine, setting it apartfrom information systems concerned entirely with physical events orwith general knowledge.

XXI

5. The rising expectations of the American people forgreater access to comprehensive health service gives pressingurgency to the need for the National Library of Medicine torespond more effectively to the rapidly increasing demands placedupon it by both public and governmental agencies.

OPERATING POLICY

There are six areas of operating policy, within the contextof general policy, which deserve specific statement:

I. Service

II. Technical Standards

III. Research and Development

IV. Education and Training for Library Personnel

V. Library Resources for Education in the Health Professions

VI. Medical Information Network of a National ScienceInformation System

I. Service

The National Library of Medicine has functioned by giving itsservices in the public interest to governmental and non-profitagencies, organizations and institutions or alternatively upon aloan, exchange or charge basis. Medical libraries throughout thecountry, historically structured in the "free public library" pattern,because of increased demands and under-support in recent years, havebeen compelled to make charges for library loan and reference services.Assuming no legal impediments, the following service policies shouldbe given effect:

1. Access^ to the Information in the National Library of Medicineshould be available to all qualified users without charge as apublic service.

2. The National Library of Medicine's services should be viewedas part of the total responsibility of the Federal Government forthe health of the people.

3. All cooperative service programs between the National Libraryof Medicine and other agencies, institutions or organizations shouldreflect these service policies. As such a national resource, it canand should play a major role in supporting and improving both basicand continuing education of the health professions by providinginformation and communication resources essential to the educationalprocess.

II. Technical Standards

Multiple subsystems will compose the ultimate nationalscience information system. The concern with human healthidentifies the national subsystem which should have the NationalLibrary of Medicine as its center. Technical standards must giveprimary attention to the real functions of the subsystem whileassuring that it will have effective linkages to and be an integralpart of a national science information network. The followingpolicies for establishment of technical standards should be giveneffect:

1. The National Library of Medicine should be the represent-ative and agent for the biomedical information system in all effortsto standardize communication modalities on a national or inter-national s^cale.

2. The National Library of Medicine, with appropriate techni-cal advice, should have the responsibility for determining thecommunication modalities and technologies most suitable for thesubsystem serving students, researchers and practitioners concernedwith human health.

3. The National Library of Medicine should have the responsi-bility for assuring that to the fullest extent consistent withserving the needs of the health related workers, its informationsystem will be compatible and/or convertible with the modalitiesand technologies selected for federally supported information sub-systems in other fields of science and library practice.

III. Research and Development

The National Library of Medicine has demonstrated its effectiveconcern with introducing new and improved means of informationprocessing. Current demands by users of biomedical information areheavily moderated by their preconceptions of the difficulty oflocating and retrieving an item, thus even the heavy currentdemands do not reflect the actual need for information. The presentsystem, however, is not without value and is a suitable substratefor the evolution of a system designed to meet actual needs ratherthan simply react to current demands. The objective of research anddevelopment under the aegis of the National Library of Medicineshould be:

1. To develop models of advanced systems for acquiring,codifying, indexing, cataloging, abstracting, storing and disseminatingrecorded information.

2. To accelerate and guide the adaptation of these models to a

decentralized national system which utilizes the existing bio-medical libraries as its framework.

3. To determine the nature and-extent of user needs and theacceptability of new modalities and technologies to the students,researchers and practitioners whose informational requirements arepeculiar to their respective roles.

To this end the following policy should be given effect:

1. The National Library of Medicine should support experi-mental programs, both intramural and extramural, to test multipleapproaches to meeting the needs for biomedical information.

2. The National Library of Medicine should be a nationalresource for information systems research and development relevantto human health.

3. The National Library of Medicine should serve as aclearinghouse and coordinating agency for information systems Rand D within the Public Health Service.

IV. Education and Training for Library Personnel

There is an urgent need for manpower which will require re-training of existing library staffs, revision of educationalprograms in schools of library science and tne introduction ofcommunications technologists and specialists. Because of itscentral role in developing and decentralizing models of improvedinformation processing, the National Library of Medicine will be animportant resource for the educational and training programs thatwill be essential for staffing. In order to give operatingreality to its developmental efforts, the following policies guidingeducation and training should be given effect:

1. The National Library of Medicine should support intramuraland extramural educational and training programs relevant toimproving biomedical communication systems.

2. Internships, fellowships and exchange of personnel shouldbe available to support the intramural training programs of theNational Library of Medicine, with preference given to staffs ofdecentralized units of the subsystem of which the National Libraryof Medicine is the center.

3. The National Library of Medicine should make institutionalgrants to those academic organizations capable of offering sophisti-cated educational programs to those who will be the new generationof biomedical communications specialists as well as to presentlibrarians who seek retraining.

V. Library Resources for Education in the HealthProfessions

As a primary national resource for biomedical communications,the National Library of Medicine can and should utilize fully itsintramural and extramural programs to foster the optimum utiliza-tion and application by the individual health worker of the vaststore of existing knowledge in all forms. To achieve this end,the National Library of Medicine should develop and support,directly and through regional and local biomedical libraries,research, experiments, and demonstrations to improve educationaltechniques enhancing such application and extend new modalitieseffective in the continuing education of health workers. TheLibrary's educational mission should, however, not be conceivednarrowly. Modalities of education developed for purposes ofcontinuing education are applicable as well to its basic educa-tional mission directed toward students and teachers of medicine,as well as toward researchers.

VI. Medical Information Network of a National ScienceInformation System

The larger extension of communications systems concepts havefocused attention on the desirability of creating a NationalScience Information System. Other government agencies are currentlysupporting studies relating to the design of such systems in variousareas of science and engineering. In this process, the relation-ships between federal interests, and the interests of the industrialand academic communities are being explored. The fundamentalpurpose appears to be so to organize information resources andtheir intercommunication facilities that the results of government-sponsored research and development in the sciences and engineeringcan be made more readily available for the advance of the economyand the welfare of the people.

While many of these studies are still on the drafting board,the field of health has such a national communication system inbeing. Historically-evolved, the existing medical library networkis in fact a communications system with traditional linkages andlong operating experience. In relation to this system the NationalLibrary of Medicine has developed a central role through providingthe bibliographic apparatus on which the system functions, andguaranteeing the ultimate availability of resources the systemrequires.

The following policies should be given effect in developingthe medical library network of a national science informationsystem:

1. The Federal Government should improve, supplement andstrengthen the existing national medical library system as thebasis of a medical information network.

2. The National Library of Medicine's role in developmentof the medical information network should be to cooperate with thejpublic and private institutions which constitute active nodes inthe system, giving special attention to the development ofcompatible and synergistic relationships between existing anddeveloping modalities and technologies.

3. The National Library of Medicine should assure that newsystems will guarantee improved access to health related informationby all citizens who have use for it - students, researchers,teachers, practitioners and the general public.

The Board of Regents would, finally, advise the Surgeon Generalof their concern that the organizational position of the NationalLibrary of Medicine within the Public Health Service be such thatit can fulfill its mission. The coordinating functions, the role ofa clearinghouse and the responsibility for development of technicalstandards suggest a need for a position in the Public HealthService that involves it directly and continuously in policydecision making.

The present and future responsibilities of the National Libraryof Medicine imply such major increments in budget, staff andfacilities that it would be useful for the National Library ofMedicine to be authorized to exercise coordinating and controlfunctions over the activities for which it is responsible. Thedifference between the mission of the National Library of Medicineat the time it came under the responsibility of the Surgeon Generalof the United States Public Health Service and the mission whichthe Board of Regents has recommended in this advisory statement isso vast that a reassessment of the organizational relationships toother operating units of the Public Health Service seems reasonable.The name National Library of Medicine itself conjures up an archaicand restricted image of the true mission and consideration mightbe given to establishing a Center for Biomedical Communicationswithin the National Library of Medicine. Such a center would providethe broader base upon which to build the new programs recommendedby the Regents.*

*The Board is aware that the National Library of Medicine has beenconcerned for several years with broader communications conceptsand potential program responsibilities than those contemplated bytraditional research libraries. The following studies and papersserve to illustrate the Library's changing role in relation to thebroad problems of biomedical communication:

The Board of Regents is sensitive to the fact that admini-strative matters such as the Library's organizational placementfall outside its proper purview and refers to them only toillustrate the nature of its concern for the capacity of theNational Library of Medicine to fulfill its mission. In thiscontext the Board of Regents wishes to reaffirm its belief thatthe National Library of Medicine should be closely linked to theprincipal national health effort which serves the research, teaching,and practicing medical communities.

(1) U.S. President's Commission on Heart Disease, Cancer andStroke. Report... Vol. 2. Washington, February 1965. Aprogram for developing medical libraries, p. 379-99. Issuedonly as a reprint.

(2) Guidelines for medical school libraries. J. Med.Educ. 40(1, pt. 1): 5-64, 1965.

(3) Information Dynamics Corporation, Wakefield, Mass. The researchlibrary and specialized information centers; a preliminary studyof their relationships. Report to the National Library ofMedicine. March 1964. 64, 4 p. (IDC-3015)

(4) National Research Council. Division of Medical Sciences.Communication problems in biomedical research: report of astudy. Fed Proc 23:1117-76; 1297-1331, 1964. Six of thestudy papers. Richard H. Orr, Director of Studies.

(5) Forbes, E. J., Bagg, T. C. A study of requirements and specifi-cations for serial monograph microrecording; a report to theNational Library of Medicine. Washington, November 8, 1965.68 p. (National Bureau of Standards Technical Note 268)

(6) West, K.M. Role of the library in learning to learn clinicalmedicine. J Med Educ 39:910-17, 1964.

(7) Wilson, M. P., Cummings, M. M. The National Library of Medicine:relationships to medical education and research. J Med Educ 40:225-32, 1965.

(8) Leake, C. D. The role of the medical school library in themedical school reaching program. Bull Med Libr Ass 41:369-78,1953.

(9) Adams, Scott. Hospital libraries: underdeveloped base forcontinuing education. Hospitals 38(12):52-4, June 1^. 1964.

GPO 917- 313