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Issues in Science and Technology
Librarianship |
Summer 2000 |
Kenning Arlitsch
Head of the Digitization Center
J. Willard Marriott Library
University of Utah
karlitsc@library.utah.edu
Joan M. Gregory
Head of Technical Services
Spencer S. Eccles Health Sciences Library
University of Utah
joang@lib.med.utah.edu
Through funding from the Middle East Cancer Consortium, (MECC) and a partnership with the Spencer S. Eccles Health Sciences Library at the University of Utah, Cyprus medical libraries now have access to an electronic document delivery system and a full-text database of Cypriot cancer and health literature. This paper will describe the process of establishing these services. Because access to current health literature is essential for quality health care, the authors believe that international cooperation and collaboration of this type should be encouraged and expanded. The benefit to the smaller library with limited funding is dramatic and the impact on the larger library providing the service is minimal.
The effect of this division on Cypriots cannot be underestimated. It is a constant force, economically, culturally, and psychologically. The Green Line is a daily reminder of the precarious peace under which they live, and expressions of hope, regret, and resignation are common on faces and in conversations. Cypriots cannot normally cross the line, and tourists are allowed day passes only from south to north (i.e., a visitor who flies into an airport in the north will be denied a border crossing into the south by Greek Cypriot officials).
In this political climate, libraries naturally suffer with small budgets. In the case of government medical libraries, small budgets translate to potentially life-threatening shortages of current information sought by physicians and other researchers.
The library maintains 120 journal subscriptions, has 5,000 books, 2,000 World Health Organization (WHO) materials, and approximately 2,000 government documents. Three of the Cypriot hospitals have no librarian on site, requiring Mr. Savva to perform literature searching for health professionals in all four national hospitals.
Prior to the implementation of this project, a WHO gift subscription to SilverPlatter MEDLINE, CINAHL, PsychLit and HealthStar on CD-ROM had provided primary access to the literature. The library housed only one computer workstation. Internet access was limited to one workstation in the library office and the account was shared with another department in the hospital. As a result, patron access to the Internet was not available in the library. These factors limited access to current health literature and required time intensive searching by the Medical Librarian.
"Lack of staff is our main problem. I am the only qualified librarian (with two assistants) on the whole island to do the library administration, take care of the user services, technical services and activities of the library aimed at serving the information needs of the 2,000 physicians, 3,000 nurses, more than 500 student nurses, and physicians taking their specialization or pre-registration practice, etc. I am under constant stress."Andreas Savva, Medical Librarian
Nicosia General Hospital Library, Cyprus
September 29, 1999
The Cyprus Medical Association (CMA) has produced a journal continuously since 1982, the Cyprus Medical Journal (CMJ), which has never been indexed. While the Health Sciences Library at Nicosia General Hospital owns a nearly complete collection of CMJ, the only access to its information is through manual searching of individual issues. Cyprus hosts a number of conferences relating to cancer, but papers from these conferences have not been systematically collected or indexed. This prevents health professionals from searching or retrieving the information disseminated through these conferences. Additionally, health-related government documents are housed in the Health Sciences Library at Nicosia General Hospital, but they have not been indexed, leaving them essentially inaccessible to the patrons.
There has not been a great deal of organized cooperation or collaboration between the health sciences libraries and the CMA. Until recently, communication and cooperative projects were not frequent among libraries on the island. Communication between government agencies is not well organized. This situation requires individual librarians to be resourceful and take their own initiative in designing and offering new services.
The $15,000 grant funds were transferred to the Ministry of Health in Cyprus by MECC in June 1998. The funds were released to Mr. Savva for use in the project in May 1999, nearly one year after the funds were awarded and three months after implementation of the project.
After notification of the funding award, Mr. Arlitsch enlisted the help of Nancy Lombardo, Head of Systems at the Eccles Health Sciences Library. Her experience with health science resources and practices proved useful in finding solutions and meeting the needs of the Cyprus medical libraries.
The libraries of the University of Utah have a tradition of cooperation. Efforts are made to collaborate on projects and share information and resources. Experience has proven that many of the libraries' goals are similar and that creative synergy can result from librarians with different backgrounds working together. The library directors encourage communication, collaboration and cooperative projects. Having the support of the Eccles and Marriott Library directors has been essential to the success of this project.
A Loansome Doc account was established for the Medical Librarian, Andreas Savva, to serve the four government hospital libraries in Cyprus. The account allows online ordering of articles and document delivery through the Eccles Health Sciences Library at the University of Utah. A free trial period was established allowing up to 50 free documents per month from March through May of 1999. The trial period helped the borrowing and lending institutions establish effective procedures and communication.
Using this service, Mr. Savva is able to search the free PubMed service on the Internet and place orders directly from the online literature search results. Physicians and health professionals submit their own PubMed searches to the Librarian who places requests for the articles selected. For materials not found in PubMed, Mr. Savva is able to place requests using the Eccles Library electronic ILL request forms on the library's web site. While it is technically possible for the individual health professionals to place their orders directly, a centralized ordering procedure has been established to allow Mr. Savva to track usage and costs and to ensure accurate accounting.
Documents are delivered electronically from the Eccles Library to the Nicosia General Hospital Library via e-mail. Print articles are scanned using the Research Libraries Group's Ariel software, a flatbed scanner and networked computer at the Eccles Library. The Ariel software is easily configured to send the scanned material through e-mail, and the process is fast and efficient. The articles arrive as attachments in graphic TIF format and are opened using the Kodak Imaging for Windows software, a standard accessory with Windows 95, 98 and NT operating systems. Imaging is a multi-page TIF viewer, allowing articles of multiple pages to be displayed as a single document. Mr. Savva's PC was configured to use the Imaging software as the default program for all files with the TIF extension, allowing a simple double click on the attachment link in the e-mail message to open the file. Once displayed, the article is printed on a laser printer and distributed. Mr. Savva is responsible for tracking the orders and delivering the articles as they arrive. After the trial period, a per article charge was established at $5 for documents owned by Eccles Library and $10 for documents not owned by Eccles Library.
The Horizon system allows the creation of "locations" and "collections" which allow users to limit a search to a specific group of materials. A new "location" and seven new "collections" were established to allow Cypriot users to search their own collection if desired. Template work forms were developed for articles, pamphlets, and proceedings, which simplified the indexing process. The work forms allow novice indexers to more easily identify the required indexing information.
The Cypriot materials offer additional challenges because many of the articles are written in Greek. Transliterations and translations of titles and translations of abstracts were thought necessary. Horizon technical representatives indicated the system would have Greek character capabilities in the near future.
The Horizon system includes a Web interface, WebPAC. The WebPAC interface can be customized to provide searching limited to the Cyprus medical libraries' materials. This web interface can also be designed to present a unique look for the Cypriot user. Combined with the limiting features, this will allow the Cyprus libraries to have a distinct catalog, or index, to local materials.
The types of materials to be included were articles from the Cyprus Medical Journal, proceedings from Cypriot medical conferences and medical pamphlets published by the Cypriot government. An estimated 10,000 individual pieces were expected for the database. Materials were to be scanned and loaded onto the Eccles web server in portable document format (PDF). Records would be entered directly into Horizon based on templates, or work forms, and 856 field hyperlinks would provide direct access to the full text of the literature. Samples of each type of material were used as prototypes for scanning and indexing.
The articles were scanned on a flatbed scanner at 300 pixels per inch (ppi) with document feeder and were saved as PDF files. Experimentation determined that scanning at less than 300 ppi produced PDF files in which the edges of the text were not crisp. Scanned file sizes for articles ranged from 100 KB to 1.5MB, and pamphlets, some of which exceeded 30 pages in length, were even bigger. The pamphlets were slow to transfer over the Internet, even across T1 connections at the University of Utah, so Optical Character Recognition (OCR) software options were explored as an attempt to reduce files sizes by creating text files.
Universal OCR from Language Force, which claimed to translate numerous languages, including Greek, worked beautifully on English at the University of Utah; however, it never worked with Greek text. Undaunted, and thinking this was simply because Greek fonts were not installed on the local system, the team took the software to Nicosia.
Mr. Arlitsch and Ms. Lombardo were trained to index using the Horizon library system by Joan Gregory, Head of Technical Services at the Eccles Health Sciences Library. Procedures were established for indexing monographs, journal articles, conference proceedings, government documents and pamphlets. Work forms were prepared to simplify the procedure and allow for remote indexing to be submitted via the Internet. Procedures for Horizon client installation were documented, and a manual was prepared to use while training Mr. Savva. Additional resources were organized and linked on a Cyprus Medical Library Project web page.
Coincidentally, the University of Utah Middle East Center was seeking applications for research travel grants. An application was prepared and the team was awarded $1,200, which covered the cost for Ms. Lombardo. The directors of the Eccles Health Sciences and Marriott Libraries were very supportive of the project and offered to assist with any travel expenses not covered by the two funding sources.
On February 23, 1999, Ms. Lombardo and Mr. Arlitsch went to Nicosia, Cyprus to work with Mr. Savva in implementing the proposal. They stayed in Nicosia at the Cyprus American Archaeological Research Institute (CAARI), a hostel for visiting scholars and the place where Mr. Arlitsch had lived for the six months of his 1997-98 fellowship.
Computer | Scanner | Printer |
IBM Pentium II 450 MHz |
HP 5200 C flatbed |
HP Laserjet 4000 |
17-inch monitor |
Automatic Document Feeder |
17ppm |
8.4 GB HDD |
600 x 1200 ppi |
1200 ppi |
128 MB RAM |
36-bit color processing |
|
Windows NT 4.0 |
8.5 x 14 inch scan area |
|
32X CD-ROM |
HP PrecisionScan 2.0 software Caere PageKeeper Standard Ed. |
|
56.6 Kb modem |
While Windows NT 4.0 was a requirement of the Horizon client, it caused problems with Internet connections and with the scanner, and more delays resulted. Technicians from the vendor came to the library to reinstall the operating system. There were problems with the local dial-up Internet connection which the same technicians were able to resolve.
There were also problems with the laser printer. Printing seemed to require a mysterious sequence of button pushing that defied logic. The manuals were not particularly helpful; they were bilingual, but the two languages were French and Turkish and no one on the team spoke either.
When the scanner arrived, there were problems connecting it to the NT machine. The scanner was supplied with a USB cable, but there was an NT incompatibility issue and additional delays resulted while the team waited for a SCSI card to be delivered. In the meantime, the scanner was connected to Mr. Savva's original library computer. This caused the computer to crash and be removed to the shop for major reformatting, leaving the team with only one computer for several days. The scanner came with two software possibilities, in addition to the Universal OCR purchased by the team. Of these three, only one worked correctly. Problems with the other two included inverted colors (white text, blue background) and different character sets. The idea of creating text files with OCR was abandoned when it became clear that recognition of Greek characters was not working, and the focus turned to PDF.
Once it was determined that PDF would be the format of choice, Adobe Acrobat 4.0 was used as the scanning software. Acrobat has an Import Scan feature which works with the scanner software to allow multiple pages to be scanned into one file and opened directly as a PDF. With a document feeder on the scanner an entire article or pamphlet can be scanned at a rate of approximately five pages per minute. Once pages have run through the scanner they are processed into one file and displayed by Acrobat, at which point they can be cropped if necessary.
Cropping was sometimes necessary because of stray marks left by the copy machine; these marks can increase the sizes of files. This issue is the result of a trade off. On high-volume jobs like this a document feeder is a necessity, but using it requires either that the articles be photocopied or the binding be chopped off each journal issue so that the pages can be fed through the feeder in a stack. Photocopying wastes paper and can produce stray marks that must be cleaned up in the software, but chopping off a binding destroys the journal issue. Since many of the Cyprus Medical Journal issues in the Nicosia General Hospital were single copies, they could not be destroyed, and were thus photocopied. In an age when virtually every journal becomes electronic at some point in the publishing process the obvious best solution is to generate PDF and HTML files directly from the publishing software. Not only are the PDFs cleaner but the file sizes are much smaller than those digitized with a scanner. It is hoped that future submissions to the database, whether they are journal articles, pamphlets, or conference proceedings, will be in some electronic format.
Internet access was very limited compared to the ubiquitous access enjoyed at the University of Utah. Mr. Savva's existing modem was a 28.8Kbps and his dial-up Internet account was shared between the library and another hospital department. This led to some confusion when a physician accidentally downloaded some of the documents e-mailed to the library. Not only did the physician discard the documents, not knowing what they were, but he was also annoyed at having waited for 20 minutes for the attachments to download. Obviously, a shared account is not ideal for this kind of project. Mr. Savva has since been able to secure a separate library account.
Another Internet issue had to do with the amount of server space allotted by the local Internet Service Provider (ISP), Cytanet. The default for individual accounts was 2 megabytes. When those 2 MB were filled, a warning message was automatically sent out to the subscriber via e-mail. With the first document delivery, Mr. Savva received numerous messages indicating that he had filled his allotted space. A call to Cytanet and explanation of the project was met with a generous boost of the account space to 10 MB, with the understanding that going over the limit was not a problem as long as the documents were not stored on the server.
It was evident immediately that the document delivery service would become very popular among the health professionals at the Nicosia General Hospital. Those who placed orders during the first week were astounded when the full text of the articles were delivered to them in less than 48 hours. Managing the new document delivery service will have its challenges for Mr. Savva. While the service has the potential to allow each individual health professional to place document requests, there is also potential for confusion and difficulty matching documents with the requesting individual. Billing issues also present a challenge. As long as the library is responsible for payment for all orders requested through its Docline account, Mr. Savva prefers to centralize the ordering in the library so that he can maintain records and track the usage.
Ms. Lombardo and Mr. Arlitsch observed the workload of Mr. Savva during their visit. The library is very busy and Mr. Savva has very little support. What assistance he does receive is from inconsistent and unqualified staff. Managing this new service will require a substantial amount of time each day and will add to his already busy work day. However, Mr. Savva showed tremendous enthusiasm for the project and has continued to allow the service to grow during the past year. This is a demonstration of his strong personal commitment to providing the best possible service to his patrons.
Mr. Savva was trained to enter the indexing information into the prepared work forms for the three types of materials: articles, proceedings, and pamphlets. The training went slowly, as Ms. Lombardo was an inexperienced indexer and Mr. Savva had many procedural questions. For example, each MARC tag had to be explained. The existing standards for use of the MARC tags were not as flexible as Mr. Savva would have liked. Indexing is a complex process. Preliminary searching of the database for matching titles, using the authority files, and entering the correct information in the correct field turned out to be quite time consuming.
After the initial training was completed, Mr. Savva indexed one sample from each of the three categories. During the training, a variety of issues arose, including transliteration, abstracting and selection of MeSH headings. Transliteration of titles is not useful to the Cypriots. Because Cypriot health professionals are bilingual, there is no need for an intermediate interpretation. Most of the materials do not have prepared abstracts, which means the indexer must write the abstract. Writing a succinct and accurate abstract requires careful reading of each article and thoughtful selection of all appropriate keywords. Finally, MeSH headings have to be selected. There were frequent discussions about the difficulty of finding just the right MeSH headings for the material being indexed.
Because the library is extremely busy, there were constant interruptions during the indexing process. One item could take up to four hours to index completely. Occasionally, records were saved when only partially completed. It became clear that Mr. Savva would require personnel assistance with the indexing component of the project.
Most of the visit was spent training and practicing the new skills and testing the new services. Two potential assistants were identified and given a brief overview of the indexing process on the final day of Ms. Lombardo's visit. At that time, the funds had still not been released by the Cypriot government for Mr. Savva's use in paying for the computer equipment or in hiring assistants. The funds were finally released in the end of May, 1999. By that time, the two potential assistants were no longer available and much of the training in the indexing process had gone unused. Additional training will be necessary if the materials are to be digitized and indexed in Cyprus.
Date | Number of Documents Delivered |
May 2000 |
44 |
April 2000 |
68 |
March 2000 |
92 |
February 2000 |
95 |
January 2000 |
161 |
December 1999 |
100 |
November 1999 |
100 |
October 1999 |
106 |
September 1999 |
189 |
August 1999 |
172 |
July 1999 |
76 |
June 1999 |
124 |
May 1999 |
57 |
April 1999 |
78 |
March 1999 |
81 |
February 1999 |
27 |
The document delivery model has been extended to two other countries. Eccles Health Sciences Library is now serving health sciences libraries in Macedonia and Bulgaria. This method of document delivery is easy to employ and fills a critical need for libraries in underserved countries.
The only drawback stems from the additional traffic generated by the project's success. Mr. Savva recently reported that he now returns to his office for an additional 2-3 hours each evening, without additional pay, to maintain control over the workload. It has made more work for him and he remains short-staffed.
The long-term goal is for all indexing to be done in Nicosia by an indexer who will be hired from the remainder of the MECC grant. The entire database will also eventually be moved to an ISP in Cyprus, giving the Cypriots greater control over their own resources. As the database grows it will take its place among the country's information resources, not only for its value as a medical resource, but also for its preservation of locally-produced literature.
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