NEWS

No. 109 January/February 2002

Table of Contents:

• From the Director
• New Procedures for FirstSearch Databases
• Free Database Searches Now Available
• Outreach News
• History of Medicine Associates Annual Research Award
• History of Medicine Associates Lecture Announced
• PubMed Class Schedule
• The View from the VA
• Arkansas Library Profile: Arkansas Children's Hospital Family Resource Library
• Arkansas Lives: Donna Waldron

From the Director

The UAMS Library has recently subscribed to two new Ovid-based tools designed especially for clinicians.

The first, Clineguide, is a point-of-care clinical decision support system that delivers diagnostic, management, and treatment guidance. Clineguide offers information specific to the patient and to the disease. Driven by the clinician's responses, an interactive question-and-answer process determines the treatment recommendations. At this point information on more than 360 diseases or syndromes are represented in Clineguide. Information on new diseases is added regularly; by July 2002 there will be 600 diseases represented. All content contains references to the primary literature so that a clinician can confirm that the best evidence-based recommendations are presented. In addition, Clineguide offers direct access to Medline through the Ovid search interface and to the full-text journals the Library subscribes to through Ovid.

Clineguide provides two pathways to information:

• The Disease option answers questions regarding specific conditions.
• The Drug option supports a clinician's choice of drug for treatment. All USDA-approved drugs are represented, as well as many not yet approved but intensely researched. All of this information can be retrieved quickly at the point of need.

The second tool, MedWeaver, integrates differential diagnosis tools with information resources to answer clinical questions. MedWeaver uses the DXplain decision support system, which incorporates information on more than 2,000 diseases, 4,500 clinical findings, and 65,000 interrelationships. Like Clineguide, it provides direct access to Medline and full-text journals through Ovid and even assists in the search formulation. A clinician can follow a differential diagnosis path to information or look up a specific disease. Both approaches bring up relevant information very quickly.

Both tools are available to all UAMS faculty, students, and staff. They can be accessed through the Ovid section of the Library's we site (www.library.uams.edu). We encourage everyone to look at these tools and explore their powerful features.

Mary L. Ryan
Library Director

New Procedures for FirstSearch Databases

UAMS-affiliated faculty, students, and staff who use the "additional" databases on FirstSearch are now required to register with the Library's Information Desk to receive an ID and password. These additional databases are any of the FirstSearch databases not listed on the Library's homepage on the Electronic Resources section, including databases such as Dissertation Abstracts, EconLit, General Science Index, and others. The Library is happy to make these databases available to the University community and needs some basic information on the users of this service.

To get a new password and ID, please call the Library's Information Desk (686-6734) with your request. You will be asked for your name, UAMS badge number, status (faculty, student, or staff), and college, if appropriate.

Passwords will expire in January and July, and users will need to re-register.

Other Database News

The Library also offers access to other non-biomedical databases through its ProQuest service. This can also be found on the Electronic Resources section of the Library homepage. The general ProQuest database is inclusive of all academic disciplines in the humanities, social sciences, and sciences. Access is also available to ABI Inform, one of the premier economics, business, and industry databases. To get to ABI Inform from the ProQuest main page, click on the Collections box in the upper left corner and chose the ABI Inform link. ProQuest is available on campus without ID or password.

New ProQuest CINAHL Database Available -
Full text to more than 270 nursing and allied health journals are availble on the Electronic Resources section of the Library's web site as well as through the Library's Catalog.

Peggy Morrison

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Free Database Searches Now Available

In support of clinical, research, educational and administrative activities, the UAMS Library is now providing free database searches for UAMS faculty, housestaff, research personnel, and administrative staff. The only exceptions are for very expensive databases, and requestors will be consulted in advance before any charges are incurred.

Searches will be performed by trained and experienced professional searchers. Clinical searches will have priority, but all searches will have quick turn-around time. Searches can be requested online via the Library's web site www.library.uams.edu/services/forms/eforms/cars.asp or by calling 686-6734. Search results can be e-mailed, faxed or printed.

Free searches are not provided for students, but searching classes and personal consultations are available to help students learn how to search various databases.

Charges will continue to be assessed for searches for unaffiliated health professionals.

For more information, contact Sally Kasalko at 686-6738 or KasalkoSallyG@uams.edu.

Sally Kasalko

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Outreach News
ARHealthLINK: Interesting Statistics

ARHealthLINK, the consumer health information site produced by the UAMS Library and the Arkansas Consumer Health Information Network, is alive, well, and growing. Below is an update on how the ARHealthLINK web site did its first six months as a dynamic, database-driven site.

Utilizing the WebTrends statistical software, we can track important statistical data such as number of hits to the site, number of visitor sessions, most requested pages and much more. Eric Dousay, the Library's web master, has also created click through reports that allow us to track which outside links are being clicked on through ARHealthLINK. Below are some of the more interesting statistics for the July 1 - Dec. 31, 2001 period.

ARHealthLINK Use:

Hits - Entire Site - 71,084
Hits - Average Per Day - 386
Visitor Sessions - 7,249
Average Visitor Session Length - 6:58 [minutes:seconds]
International Visitor Sessions - 2.06%
# Visiting More Than Once - 776
Top Search Engine - Google - 47.34%
Most Used Browser - IE - 72.95%
Most Used Platforms - Win98 - 34.34%
Hits by Indexing Spiders - 2,503

Database: As of February 11th, there are 184 organization records in the database and 297 calendar event records.

Calendar: Please remember to let everyone in your organizations know about the statewide calendar feature. During the July - December time period the online calendar was used 679 times. It is a great way to publicize any health fairs, health screenings or seminars for the public. We will also post any CME or CE courses aimed at health professionals. You can submit an event via the online form at: www.arhealthlink.org/forms/event.asp.

Want to Help Spread the Word?
FREE ARHealthLINK brochures are available by contacting Susan Steelman, UAMS Library, 501-686-6737 or email: SteelmanSusanC@uams.edu.

FREE ARHealthLINK "prescription for information" pads are also available for health care professionals to use with patients.

If your group or organization has a web page, please consider linking to the ARHealthLINK web site at: www.arhealthlink.org.

Susan Steelman, MLIS

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History of Medicine Associates Annual Research Award

The History of Medicine Associates of the UAMS Library is once again offering a research award as it has done each year since 1985. The Medical Education Foundation for Arkansas generously provides partial funding for this award, which is in the amount of $1,000.

The goal of the award is to encourage original research that contributes to the history of the health sciences in Arkansas, and the award may be used for expenses related to the original research for which the prize is awarded.

The applicant must submit:

• a brief abstract (100 words) of the proposal,
• statement of the significance of the proposal,
• summary of the proposal (1-2 pages),
• detailed budget,
• anticipated completion date, and
• brief resume or curriculum vitae.

Proposals should be submitted to the Treasurer of the Associates by May 31, 2002. Guidelines are available from the Treasurer (Margaret Johnson, (501) 686 6733, johnsonmargareta@uams.edu ) or the Library's webpage section for the History of Medicine Associates: www.library.uams.edu/services/HRC/award.htm.

Margaret Johnson

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History of Medicine Associates Lecture Announced

The annual History of Medicine Associates Lecture will be on April 25th, 2002 at 4:00 p.m. in the Pauly Auditorium of Ed II. Dr. Berry Brenner, Chairman of the UAMS Department of Emergency Medicine, will be the guest speaker.

Margaret Johnson

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PubMed Class Schedule

Please note that free PubMed classes are being offered each month. These classes are open to any practicing health care professional in Arkansas. If you would like to register for one of these classes or schedule an individual class, please contact Susan Steelman, M.L.I.S. at 501-686-6737 or SteelmanSusanC@uams.edu.

Susan Steelman, MLIS

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The View from the VA

In my last column, I talked in general about the selection of databases available in the Virtual Library, which is available via the VA Intranet at CAVHS. As a reminder, the first click is to the CAVHS homepage. From there, you should click on the Library link. Once the Library homepage loads, you should then click on the Virtual Library link which will take you to the web page that serves as a portal to the resources.

The focus of this column is MD CONSULT, available at: http://home.mdconsult.com/groups/visn1615.html. This product allows the VA user access to a library of professional books via their personal computer. The full content of over 40 standard medical textbooks is searchable individually or collectively, and the fields covered range from Allergy to Urology. There is the added Table of Contents feature, which allows direct access to individual chapters.

Here are the books which are currently available, listed by specialty:

Allery, Asthma & Immunology
Middleton: Allergy: Principles and Practice, 5th ed. 1998 Mosby-Year Book, Inc.

Alternative Medicine
Blumenthal: The Complete German Commission E Monographs; Therapeutic Guide to Herbal Medicines, 1st ed. 1998 American Botanical Council.

Anesthesiology & Pain Management
Miller: Anesthesia, 5th ed. 2000 Churchill Livingstone, Inc.

Cardiology
Braunwald: Heart Disease: A Textbook of Cardiovascular Medicine, 6th ed. 2001 W.B. Saunders Company

Wagner: Marriott's Practical Electrocardiography, 10th ed. 2001 Lippincott Williams & Wilkins.

Dermatology
Habif: Clinical Dermatology, 3rd ed. 1996 Mosby-Year Book, Inc.

Emergency Medicine
Ellenhorn's Medical Toxicology, 2nd ed. 1997 Williams & Wilkins.

Roberts: Clinical Procedures in Emergency Medicine, 3rd ed. 1998 W.B. Saunders Company

Rosen: Emergency Medicine: Concepts and Clinical Practice, 4th ed. 1998 Mosby-Year Book, Inc.

Endocrinology & Metabolism
Wilson: Williams Textbook of Endocrinology, 9th ed. 1998 W. B. Saunders Company.

Family Medicine
Dambro: Griffith's 5-Minute Clinical Consult, 2001 ed. 2001 Lippincott Williams & Wilkins.

Goroll: Primary Care Medicine, 4th ed. 2000 Lippincott Williams & Wilkins.

Noble: Textbook of Primary Care Medicine, 3rd ed. 2001 Mosby, Inc.

Pfenninger: Procedures for Primary Care Physicians, 1st ed. 1994 Mosby-Year Book, Inc.

Gastroenterology
Feldman: Sleisenger & Fordtran's Gastrointestinal and Liver Disease, 6th ed. 1998 W.B. Saunders Company.

Geriatric Medicine
Duthie: Practice of Geriatrics, 3rd ed. 1998 W.B. Saunders Company.

Hematology
Lee: Wintrobe's Clinical Hematology, 10th ed. 1999 Lippincott Williams & Wilkins.

Infectious Disease
Mandell: Principles and Practice of Infectious Diseases, 5th ed. 2000 Churchill Livingstone, Inc.

Internal Medicine
Goldman: Cecil Textbook of Medicine, 21st ed. 2000 W.B. Saunders Company.

Rakel: Conn's Current Therapy 2001, 53rd ed. 2001 W.B. Saunders Company.

Washington Manual of Medical Therapeutics, 30th ed. 2001 Department of Medicine, Washington University School of Medicine.

Nephrology
Brenner & Rector's The Kidney, 6th ed. 2000 W.B. Saunders Company.

Neurology
Goetz: Textbook of Clinical Neurology, 1st ed. 1999 W.B. Saunders Company.

Obstetrics & Gynecology
Gabbe: Obstetrics - Normal and Problem Pregnancies, 3rd ed. 1996 Churchill Livingstone, Inc.

Ryan: Kistner's Gynecology & Women's Health, 7th ed. 1999 Mosby, Inc.

Oncology
Abeloff: Clinical Oncology, 2nd ed. 2000 Churchill Livingstone, Inc.

Pizzo and Poplack: Principles and Practice of Pediatric Oncology, 3rd ed. 1997 Lippincott-Raven Publishers.

Ophthalmology
Yanoff: Opththalmology, 1st ed. 1999 Mosby International Ltd.

Orthopedic Surgery
Canale: Campbell's Operative Orthopaedics, 9th ed. 1998 Mosby, Inc.

Rockwood & Green's Fractures in Adults, 4th ed. 1996 Lippincott-Raven Publishers.

Pathology
Cotran: Robbins Pathologic Basis of Disease, 6th ed. 1999 W.B. Saunders Company.

Raven: Clinical Laboratory Medicine, 6th ed. 1995 Mosby-Year Book, Inc.

Pediatrics
AAP 2000 Red Book; Report of the Committee on Infectious Diseases, 25th ed. 2000 American Academy of Pediatrics.

Behrman: Nelson Textbook of Pediatrics, 16th ed. 2000 W.B. Saunders Company.

Johns Hopkins: Harriet Lane Handbook, 15th ed. 2000 Mosby, Inc.

Psychiatry
Tasman: Psychiatry, 1st ed. 1997 W.B. Saunders Company.

Pulmonary Medicine
Murray & Nadel: Textbook of Respiratory Medicine, 3rd ed. 2000 W.B. Saunders Company.

Radiology
Juhl: Paul and Juhl's Essentials of Radiologic Imaging, 7th ed. 1998 Lippincott Williams & Wilkins.

Rheumatology
Ruddy: Kelley's Textbook of Rheumatology, 6th ed. 2001 W.B. Saunders Company.

Surgery, General
Townsend: Sabiston Textbook of Surgery, 16th ed. 2001 W. B. Saunders Company.

Urology
Walsh: Campbell's Urology, 7th ed. 1998 W.B. Saunders Company.

George M. Zumwalt,
Chief, Learning Resources Service

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Arkansas Library Profile:
Arkansas Children's Hospital Family Resource Library:
a Center for Pediatric Consumer Health Information

Background:

Arkansas Children's Hospital is the only pediatric medical center in the state of Arkansas. Patient age ranges from birth to twenty-one years old, and patients come from every county of the state and other states in the country. Each year, more than 250,000 patients are treated in the hospital and in the out-patient clinics.

Arkansas Children's Hospital established a resource room for patients in the early 1990's and a pamphlet collection was maintained. But usage was low due to the lack of knowledge about its existence among patients and hospital staff. In July 1992, the ACH administration made a decision to fund an information center within the Medical Library, and in April 1993, the Family Resource Library was established as a center for pediatric consumer health information, and information on its existence was publicized throughout ACH. The Family Resource Library's mission is to provide patients, health professionals and the general public with information about pediatric health, growth and development.

Resources:

Although the focus of Family Resource Library's collection is on children's health, adult health materials to serve the health information needs of hospital staff and the community are also collected. At present, the Family Resource Library houses over 800 consumer health books, 300 consumer health videos, 500 pamphlets, and 20 journal subscriptions. Electronic resources include Web access to the Health Reference Center database and the National Organization of Rare Diseases Database, and local access to the Clinical Reference System's Pediatric Advisor and Behavioral Advisor databases. Pediatric Advisor and Behavioral Advisor are two pamphlet databases covering common childhood illnesses in English and Spanish. Due to a growing number of Spanish speaking patients in the hospital, there has been an urgent need for Spanish health information. These databases and some selected Spanish Health web sites have certainly answered this need. The Family Resource Library also has its own web site listing both library resources and Internet consumer health resources at: http://www.archildrens.org/gotohosp/gotolibrary.html.

Successful consumer health service is determined by many factors. In addition to a strong collection, interview skills and search strategies are also of particular importance. In an article on consumer health information ^[1], it was mentioned that when the patient is newly diagnosed, very basic information covering diverse aspects of the disease is needed. After the patient has been involved in the treatment, information needs may become more complex and focused. The interviewing done by the staff enables them to assess the extent of users' current knowledge and their need for further information. Based on these initial findings, library staff formulates a search strategy that is likely to yield the best result. Usually the place to start is with sources of general and broad coverage, such as the Health Reference Center database, consumer health books, and web sites, then, move on to medical books and MEDLINE databases for specific treatment information. Whenever possible, two items from different sources are selected so that the reader can have a balanced point of view.

To evaluate the services provided through the Family Resource Library, a reference question log analysis was recently conducted. Main findings from April 1998 to April 2000 revealed a high success rate of reference transactions and identified the top 5 frequently requested subjects: birth defects, heart disease, psychology, cancer, and respiratory diseases. Requests came from patients, employees, school nurses, and people in the community. The log also identified the Health Reference Center database as the mostly often used source due to its large selection of health related journals, and full-text books. The National Organization of Rare Diseases Database was another heavily used source, with over 1,500 pamphlets on birth defects, rare diseases, their causes, diagnosis, and treatments.

In addition to consumer health literature, visitors also have access to the medical collection and databases in the Medical Library since the two libraries are located in the same building. Some medical textbooks provide specific clinical information on recent advances in treatments, complications and outcomes that cannot be found in consumer health literature. In addition, many parents of children with chronic illness already have extensive knowledge of the disease and want to use the medical literature for updated clinical information. Some parents are health care professionals and are quite familiar with medical database searching. Having both libraries in the same location allows users to access medical information at different levels as necessary.

With the rapid development of computer technology, the Internet has become a valuable tool for distributing consumer health information. Web sites sponsored by government agencies and medical associations are providing accurate medical information to consumers in a timely fashion. In the Family Resource Library, the Internet is used as a secondary tool to compliment local resources. The origin and currency of each source is carefully evaluated, and visitors are told that the printout comes from a web site. Visitors can also use library computers themselves to search local databases or the Internet. Library staff will show them how to navigate the Internet and refer them to their health care providers if they have further questions about the medical information located.

Access for all:

When the Family Resource Library was first established, it was intended for hospital patients and their families. Former Medical Director, Dr. Betty Lowe, experienced the power of information first hand and she had a bigger dream for the library. Once, a young patient's father showed her a crumbled and yellowed note she had given him a year ago, telling him the things he needed to do for his child . He told her he followed everything she wrote and the kid was doing better than ever. Dr. Lowe believed that well-informed parents are better prepared to care for their children and to keep them in good health. She envisioned an information center to serve all children in Arkansas and urged the library to grow in size and services.

Today with the help of the Internet, the Library is able to reach a broader audience:

• The online catalog lists all the books and videos available from the Family Resource Library.
• The ACH Library web site includes library pamphlets, Spanish consumer health materials, library databases and links to reputable health web sites.
• People needing information can use the electronic request form to submit their requests and results can be emailed, faxed or snail mailed to them. The Library has received email requests from people in other states as well as in Arkansas.
• Individuals can also come in and use the library resource during work hours, and interlibrary loan can be arranged with school and public libraries.
• Health agencies, school libraries, and public libraries are supported by providing materials in certain topics or by helping them with collection development.

Just as they say "it takes a village to raise a child", it takes more than a hospital to keep Arkansas children in good health. Libraries should be a part of it too, and we CAN make a difference.

Reference:

1: R. Lewis, Consumer health information: challenges from the patient perspective. Colorado Libraries. Summer 1994: 8-10.

Biographic information:

Lily Liu received her MLS from the School of Library and Information Sciences at Texas Women's University in 1993. she has worked at UAMS Library as a Cataloging Assistant and at St. Vincent Infirmary Medical Center as a medical librarian. She started working as a medical librarian at Arkansas Children's Hospital Library in March 1997, managing both the Medical Library and the Family Resource Library.

News Editor's note:
This article was originally published in a slightly different format in Arkansas Libraries as: Liu, Lily. "Arkansas Library Profile: Arkansas Children's Hospital Family Resource Library: a Center for Pediatric Consumer Health Information", Arkansas Libraries 58(6):26-28, December, 2001. It is part of a continuing series in Arkansas Libraries, and it is reprinted here with the permission of the Publications Committee, Arkansas Library Association.

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Arkansas Lives: Donna Waldron

Edited by Jane Thompson, Arkansas State Library

Speaking with Donna Waldron shortly after the events of September 11th, our conversation turned to the tragedy and, while perhaps insignificant in the broader context, the loss of so many special library collections housed in the World Trade Center's legal and financial firms. Noting that a library is a place where one is free to explore whatever he or she might wish, Donna commented that now, more than ever, "libraries are a place where people convene and pursue their interests. And yet, we're at a point in our nation's history that such a thing can be dangerous. We hope that terrorism and general fear won't force people away from places where they will get information."

On Monday, October 22, 2001, the Resource Library at the Donald W. Reynolds Center on Aging at University of Arkansas for Medical Sciences (UAMS) was officially dedicated. Speaking to a gathering of staff, visitors, volunteers, and benefactors of the library, Reynolds Center Director David A. Lipschitz, M.D., thanked Reynolds Center librarian Donna Waldron, together with Mary Ryan, Jan Hart, and the UAMS library staff for their efforts in bringing together Arkansas's one-of-a-kind collection devoted to all aspects of the aging process.

The purpose of the Resource Library is "to support the Donald W. Reynolds Center on Aging in addressing the health concerns of older adults by providing clinicians, patients, and the general public access to reliable medical information from a variety of sources."

Calling the dedication a "red letter day," Donna noted that while the library had already been functioning, the dedication provided recognition that "we have gotten to the point that we have the core of a truly good collection. Now, through media coverage and increased awareness, the general public will know what we have." Tucked away in the ground level of the Reynolds Center at the edge of the UAMS campus, many people pass through the center to attend workshops, classes, seminars, and other programs on geriatrics. Donna notes that these people "are coming to the Resource Library, as well-taking a look at what we have with an eye to their own needs, as well as the possibility of forming a similar collection elsewhere in the state."

By definition, the library's thrust is not general information; rather, as Donna describes it, "specific information about a specific subject--in this case, health and aging, as well as disease and aging." While offering some professional resources and access to medical databases, the collection is designed to accommodate the lay person. Reynolds Center physicians and staff suggest items they want to have their patients read or watch. With the focus geared to the public, AETN's televised series, Aging Successfully with Dr. David is, at present, garnering the lion's share of attention among Resource Library customers.

Initially, Susan Steelman, Outreach Librarian at UAMS, suggested material for purchase-books, videotapes and subscriptions. This, supplemented by suggestions from the Center's clinicians, has formed the current core of the primarily print collection. While the collection maintains academic reference resources and texts on anatomy and physiology, as well as medical dictionaries, the bulk of the book and video collection is aimed toward specific conditions, with a heavy emphasis on caregiver issues. The library brochure notes that the collection "emphasizes consumer information about health matters of concern to aging adults and their families. Some of the areas covered are: Alzheimer's disease, arthritis, cancer, caregiver support, depression, diabetes, high blood pressure, Parkinson's disease, and women's health issues." Donna describes the Center's collection of pamphlets and brochures as a wealth of information that is "probably our biggest drawing card right now. People can come in and get a succinct bit of information from a reliable source that addresses one specific disease or issue." Rounding out the collection are subscriptions to a wide variety of medical newsletters as well as the major databases such as Ovid and ARHealthLINK.

While the library's collection is not yet available to the larger library community via inter-library loan, it is available to the public on a walk-in basis. Ultimately the Center hopes to share its resources with the six or seven Area Health Education Centers throughout the state. Holdings are on OCLC and the collection is accessible through the UAMS library.

Developing a new library is a challenge in and of itself, both in terms of developing a physical space, identifying and accessioning materials for the collection, and securing financing to not only start the facility, but to insure its continued operation. Donna notes the importance of setting priorities, commenting that it would be impossible to do everything at once. She continues to add that while "at first it seemed for such a long time that nothing was happening, we now see progress on a steady basis."

Books, videotapes, and periodicals are located in the collection room, just inside the main library entrance. Two computer workstations and a videotape player with wireless headphones are also located in this room. Flyers and booklets are found in the literature room at the opposite end of the library. A table and chairs provide a place to review the material. A small room between the two larger areas is designed for group videotape use and discussion. The area contains a table and chairs, a videotape player, and a whiteboard.

Donna credits Jan Hart, head of the UAMS Learning Resource Center, as the individual who has gone to great lengths to insure the success of the Reynolds Center Resource Library. At present, she believes that through the efforts of all involved in launching the library, "we have come to the point where we are serving the purpose here as part of the grander scheme." She adds, "I think that people in the center now have come to know who we are and to feel as if they can let us handle our job without worry. It's nice to know that what we have to offer is approved of by those people who know what should be here."

A 22 year veteran of the UAMS Library, Donna states that her significant preparation for this project was simply 'growing older." She adds, "While you need to have younger people around who will challenge you in all directions, I really do think it helps to be older to be working with older people. I know what it's like to hurt and to slow down. I don't think that you know until you get there that you realize some of the problems with aging."

The Resource Library is open from 9:00 a.m. until 3:00 p.m., Monday through Friday. It is closed all holidays observed by the University of Arkansas for Medical Sciences. Additional information regarding the Resource Library is available by telephoning 501/526-6287.

News Editor's Note:
This article originally appeared as "Arkansas Lives: Donna Waldron", Arkansas Libraries 58(6): 23-25, December, 2001. It is one in a series of columns edited by Jane Thompson of the Arkansas State Library. It is reprinted here with the permission of the Publications Committee, Arkansas Library Association.

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UAMS Library: Editor, Amanda Saar
Soundwords: Editor, Fred Bassett
Contributors: Fred Bassett, Margaret Johnson, Sally Kasalko, Lily Liu, Peggy Morrison, Mary Ryan, Susan Steelman, Jane Thompson, and George M. Zumwalt

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