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This paper examines the development of socio-technical strategies and practices for the study and display of marine mammals. It considers how techniques initially developed for terrestrial use were deployed under marine conditions, not least through the adaptation of strategies and habits originating in industry, commerce and the military, in order to facilitate researchers’ access to their subjects. In particular, it examines how these methodological developments intersected with the terrestrial display of marine mammals. Throughout, it shows how the agency of the animals under observation had a key role to play in the emergence of cetology as a profession and as a form of knowledge.

OBJECTIVE: This article is an overview of epidemiological and treatment studies suggesting that deficits in dietary-based omega-3 polyunsaturated fatty acids may make an etiological contribution to mood disorders and that supplementation with omega-3 fatty acids may provide a therapeutic strategy. METHOD: Relevant published studies are detailed and considered. RESULTS: Several epidemiological studies suggest covariation between seafood consumption and rates of mood disorders. Biological marker studies indicate deficits in omega-3 fatty acids in people with depressive disorders, while several treatment studies indicate therapeutic benefits from omega-3 supplementation. A similar contribution of omega-3 fatty acids to coronary artery disease may explain the well-described links between coronary artery disease and depression. CONCLUSIONS: Deficits in omega-3 fatty acids have been identified as a contributing factor to mood disorders and offer a potential rational treatment approach. This review identifies a number of hypotheses and studies for consideration. In particular, the authors argue for studies clarifying the efficacy of omega-3 supplementation for unipolar and bipolar depressive disorders, both as individual and augmentation treatment strategies, and for studies pursuing which omega-3 fatty acid, eicosapentaenoic acid (EPA) or docosahexaenoic acid (DHA), is likely to provide the greatest benefit. [ABSTRACT FROM AUTHOR]

The current study sought to add to the literature that has demonstrated a link between sexism and sexual prejudice. The study evaluated whether a community sample with an age range of 19-64 (n = 122), including 32% sexual minority participants, believe that dating, sex, and marriage with same-sex partners are perceived to be gender role violations. Results varied by participant sexual/gender identity (LGBTQ or heterosexual) and political ideology. Liberal LGBTQ persons do not see same-sex relationships as gender role violations; LGBTQ non-liberals and heterosexual liberals rated same-sex relationships as mild violations; and non-liberal heterosexuals perceive same-sex relationships as "moderate" violations. Our results suggest both positive movement in attitudes toward same-sex relationships, including same-sex marriage, and broader recognition that gender identity, gender role expression, and sexual orientation are separate and distinct components of one's overall sexual identity.

Background: Melancholia is positioned as either a more severe expression of clinical depression or as a separate entity. Support for the latter view emerges from differential causal factors and treatment responsiveness but has not been convincingly demonstrated in terms of differential clinical features. We pursue its prototypic clinical pattern to determine if this advances its delineation., Methods: We developed a 24-item measure (now termed the Sydney Melancholia Prototype Index or SMPI) comprising 12 melancholic and 12 non-melancholic prototypic features (both symptoms and illness correlates). In this evaluative study, 278 patients referred for tertiary level assessment at a specialized mood disorders clinic completed the self-report SMPI as well as a depression severity measure and a comprehensive assessment schedule before clinical interview, while assessing clinicians completed a clinician version of the SMPI items following their interview. The independent variable (diagnostic gold standard) was the clinician's judgment of a melancholic versus non-melancholic depressive episode. Discriminative performance was evaluated by Receiver Operating Characteristics (ROC) analysis of four strategies for operationalising the SMPI self-report and SMPI clinician measures, and with the former strategies compared to ROC analysis of the depression severity measure. The external validity of the optimally discriminating scores on each measure was tested against a range of clinical variables., Result: Comparison of the two self-report measures established that the SMPI provided greater discrimination than the depression severity measure, while comparison of the self-report and clinician-rated SMPI measures established the latter as more discriminating of clinically diagnosed melancholic or non-melancholic depression. ROC analyses favoured self-report SMPI distinction of melancholic from non-melancholic depression being most optimally calculated by a 'difference' score of at least four or more melancholic than non-melancholic items being affirmed (sensitivity of 0.69, specificity of 0.77). For the clinician-rated SMPI measure, ROC analyses confirmed the same optimal difference score of four or more as highly discriminating of melancholic and non-melancholic depression (sensitivity of 0.84, specificity of 0.92). As the difference score had positive predictive values of 0.90 and 0.70 (for the respective clinician-rated and self-report SMPI forms) and respective negative predictive values of 0.88 and 0.70, we conclude that the clinician-rated version had superior discrimination than the self-report version. External validating data quantified the self-rated and clinician-rated Index-assigned non-melancholic patients having a higher prevalence of anxiety disorders, a higher number of current and lifetime stressors, as well as elevated scores on several personality styles that are viewed as predisposing to and shaping such non-melancholic disorders., Limitations: Assigned melancholic and non-melancholic diagnoses were determined by clinician judgement, risking a circularity bias across diagnostic assignment and clinical weighting of melancholic and non-melancholic features. The robustness of the Index requires testing in primary and secondary levels of care settings., Conclusions: The clinician-rated SMPI differentiated melancholic and non-melancholic depressed subjects at a higher level of confidence than the self-report SMPI, and with a highly acceptable level of discrimination. The measure is recommended for further testing of its intrinsic and applied properties., (Copyright © 2012 Elsevier B.V. All rights reserved.)

Objectives: Our aim was to identify the diagnostic profile of patients classified as 'false positives' on two bipolar screening measures; the Mood Swings Questionnaire (MSQ) and the Mood Disorders Questionnaire (MDQ)., Methods: A total of 1534 patients attending the Black Dog Institute Depression Clinic completed the MSQ-46, and a smaller subset of 852 completed the MDQ. All patients underwent clinical assessment by one or more Institute psychiatrists., Results: Using clinical assignment (i.e. bipolar vs. unipolar) as the criterion measure for assessing the screening measures, the overall agreement rates were 84% for the MSQ-46 and 74% for the MDQ. Patients identified as 'false positives' were most likely to be clinically diagnosed as having a unipolar non-melancholic depression (37% for MSQ-46; 46% for MDQ), or a primary anxiety condition with secondary non-melancholic depression (19% for MSQ-46; 15% for MDQ). In addition, within the unipolar non-melancholic group, 46% of the MSQ-46 assigned false positives and 63% of the MDQ assigned false positives had co-morbid anxiety conditions., Conclusions: These findings suggest that patients with anxiety conditions account for a significant proportion of false positive diagnoses on bipolar screening tests - a finding that should be conceded in the development and refinement of such screening measures and in clinical assessment of the possibility of a bipolar disorder., (Copyright © 2012 Elsevier B.V. All rights reserved.)

Background: We report on the assessment and outcome of the first 1000 patients referred to a tertiary referral depression clinic established to assess the utility of diagnostic sub-typing on clinical course of illness., Methods: Diagnostic, treatment recommendations, prognostic judgments and 12-week outcome data were examined., Results: Nearly 40% of those with a primary mood disorder were diagnosed with bipolar disorder, of whom three-quarters received such a diagnosis for the first time. Alternative diagnoses or formulations were provided for 68% of the total sample, with the therapeutic paradigm altered for the majority (86%) of patients. Improvement rates were indicative of a higher level of improvement in those diagnosed with bipolar disorder (some 70%) compared to those with unipolar disorders (some 60%). Overall, however, rates of 'full remission' were low, being 2% and up to 12% for bipolar and unipolar patients respectively and perhaps reflecting the tertiary nature of the assessing clinical facility. Baseline clinician predictions were in the order of 60% accuracy in predicting outcome, irrespective of diagnostic grouping., Limitations: Anticipation factors (e.g. attending a specialist tertiary referral service) may have contributed non-specifically to outcome. Use of clinician-derived diagnoses rather than strict DSM-IV criteria limits comparisons to other studies., Conclusions: The high rates of a first-time bipolar diagnosis suggest that detection and diagnosis of this condition continues to be problematic. Low remission rates underline the chronic nature of many mood disorders, and the need for ongoing management given the high risk of relapse. Our findings offer support for the importance of identifying bipolar disorder and distinguishing depressive sub-types in order to shape more targeted treatments, a task that might be advanced by the establishment of more tertiary referral services., (Copyright © 2010 Elsevier B.V. All rights reserved.)

Background: As melancholia has resisted symptom-based definition, this report considers possible explanations and options for moving forward. Clinician-assigned melancholic and non-melancholic groups were initially compared to refine a candidate set of differentiating symptoms alone for examination against a set of non-clinical validators. Analyses then examined the capacity of both the refined symptom and validator sets to discriminate the assigned melancholic and non-melancholic subjects., Methods: Subjects completed measures assessing symptoms and correlates (putative validators) of diagnostic sub-type, and were assessed independently by two psychiatrists., Results: Analyses identified 14 severity-based symptoms as discriminating clinically-diagnosed groups - with melancholic subjects differing significantly from non-melancholic subjects across a number of validators. Such symptom-based discrimination was superior to DSM-IV and Newcastle Index assignment in a study sub-set. While the refined symptom set had an overall accurate classificatory rate of 68%, use of the combined sets of refined symptoms and validators improved classification to 80%., Conclusions: Melancholia definition is improved by the use of correlates in addition to depressive symptoms, suggesting that melancholia may be mapped more precisely by use of multiple co-ordinates or data sources., (Copyright 2009 Elsevier B.V. All rights reserved.)

Women are depleted of omega-3 polyunsaturated fatty acids (n-3 PUFAs) during the perinatal period due to fetal diversion. An association has been shown between lowered n-3 PUFAs and depression in general. We therefore hypothesise that women with lower n-3 PUFA levels are at greater risk of depression during pregnancy. Sixteen depressed and 22 non-depressed women were recruited during the third trimester and fasting bloods were taken for plasma fatty acid analysis. High docosahexaenoic acid (DHA), high total n-3 and a low n-6:n-3 ratio were associated with significantly lower odds of depression. After adjustment for parity, age and education level, those with high DHA still had significantly lower odds of being depressed. Those with high total n-3 and a low n-6:n-3 ratio were also at significantly reduced risk of depression, although the magnitude of the difference was reduced. Study results quantified women with lower omega-3 PUFA levels as being six times more likely to be depressed antenatally, compared to women who had higher omega-3 PUFA levels. The prophylactic benefits of supplementation either prenatally or during pregnancy require close study to assess whether omega-3 PUFAs play a role in the prevention of perinatal depression.

Objective: Epidemiological, biological marker and treatment studies, as well as neuroscientific theories, indicate a possible link between omega-3 fatty acids and perinatal depression (PND). Hence the aim of the present study was to assess whether omega-3 fatty acid treatment is superior to placebo in the treatment of PND., Method: A double-blind randomized placebo-controlled trial was undertaken. Women with major depression during the perinatal period received either fish oil or placebo for six weeks. Changes in depression scores were recorded weekly., Results: A total of 26 subjects were recruited and there was no significant difference in depression scores between those receiving fish oil and those receiving the placebo., Conclusions: This is formally a negative study, suggesting that there is no benefit for omega-3 fatty acids over placebo in treating PND. The reason could be that the study was underpowered due to recruitment difficulties and therefore we suggest that it may be unwise to interpret this result as conclusive. Omega-3 is a natural product that is a safe and well-tolerated treatment. Further research is therefore needed in this area to establish whether omega-3 fatty acids are an effective treatment for PND.

Purpose of Review: There is increasing evidence from epidemiological, case-control and randomized clinical trials for a link between omega-3 deficiency and the development of mood disorders. This article examines recent evidence for this association., Recent Findings: During the past year our understanding of the effect of omega-3 depletion on the structure and function of the brain has been furthered by research examining human brain tissue and by studies utilizing animal models of depression. Human and animal research has also provided further evidence for omega-3 affecting mood via its anti-inflammatory effects. Previous clinical trials indicated that omega-3 can be effective as an adjunctive treatment for those with treatment-resistant depression. More recent clinical trial data indicate that omega-3 may also be an effective monotherapy for childhood depression and for depressed mood in patients who engage in recurrent self-harm. The recent clinical trial data regarding omega-3 as a treatment for bipolar disorder are inconclusive, however, and clinical trials in postnatal depression are still lacking., Summary: This article reviews the most important recent papers in this burgeoning and interesting research area.

We present a rare case of renal cell carcinoma (RCC) in a horseshoe kidney presenting as an acute left sided varicocele. A left sided varicocele is a well-described presentation of RCC, usually caused by tumour thrombus extending along the renal vein with resultant testicular vein occlusion. However, in our case a tumour in the lower pole of a horseshoe kidney caused an acute varicocele by direct involvement and occlusion of the testicular vein.

Objectives: To consider the possible rationale and utility of omega-3 fatty acids as a treatment for depression in the perinatal period., Method: A review of published and unpublished research was undertaken, using electronic databases, conferences proceedings and expert informants., Results: Relevant bodies of evidence include an epidemiological link between low fish intake and depression. Laboratory studies show correlations between low omega-3 fatty acid levels and depression, as well as reduced levels of omega-3 in non-depressed women during the perinatal period. Treatment studies using omega-3 in patients with mood disorders further support an omega-3 contribution, as do neuroscientific theories. Research into omega-3 and infant development also highlights potential effects of depletion in the perinatal period and supports infant safety and benefits of supplementation., Conclusions: There is a relative lack of knowledge about the safety of standard antidepressants in the perinatal period. There is a clear need for more research into alternative treatments, such as omega-3 fatty acids, in the management of depression in the perinatal period.

In psoriasis, the earliest observable electron microscopic changes are in the dermal papillary vasculature. The flashlamp-pumped pulsed tunable dye laser can achieve selective photothermolysis of the dermal vasculature. This laser was used to treat eight patients with chronic plaque psoriasis, as it was hypothesized that the ablation of dermal papillary vasculature would arrest the early events leading to the evolution of psoriasis, and produce resolution of the plaques. At the final assessment, performed 10 weeks after three fortnightly laser treatments, five of the eight patients recorded an improvement of > or = 50%, and one showed complete resolution of the treated plaques of psoriasis. Although not practicable in the treatment of widespread psoriasis, we conclude that selective photothermolysis of the dermal vasculature by pulsed tunable dye laser offers an alternative new therapy for chronic plaque psoriasis, and also demonstrates the pivotal role of the vasculature in the pathogenesis of psoriasis.

Political, legal, ethical, social, economic, and technological changes in the twentieth century have produced a profound effect on the health care and health status of Americans and the way in which physicians and patients communicate. In the latter half of this century, the responsibility for individual health care has shifted from a physician-oriented, paternalistic approach to a patient-centered one. Patients now assume two identities: health consumers and active participants in the medical decision-making process. This phenomenon has created an environment where consumer demand for information has shifted from a single focus on symptoms, diagnosis, and treatment of diseases to an increasing preoccupation with cost, quality, and access to health care. This shift emphasizes the critical role played by medical librarians in the dissemination of needed information, and it challenges librarians to take a leadership role in opening newer channels of communication between physicians and patients. The 1992 Janet Doe Lecture analyzes the evolutionary change in the physician-patient relationship and its modes of communication, projects future roles for medical librarians, and provides an extensive list of references for further reading.

Surveys of medical school libraries made over a twenty-year period (1960-61 through 1980-81) were analyzed. As indicated by growth in both number and support, medical school libraries have evolved from a period of stability through expansive growth and subsequent leveling off. Expenditures and resource development have been affected by historical developments, especially recent massive federal and state aid to medical education.

Preoperative radiography was performed on 667 consecutive patients undergoing elective non-cardiopulmonary surgery in a large hospital in Wales. Of all significant findings reported 54% were due to cardiomegaly and 19% to chronic respiratory disease, and no appreciable abnormality was found in any patient under 30. Out of a subsample of 152 examined prospectively, 38% had received a chest radiograph within the last year, and the maximum marrow dose had been exceeded in 12-5%. It is concluded that the procedure, as presently practised, is not only being considerably overused but is also exposing many recipients to the potentially harmful effects of over-irradiation. The findings provide further evidence in support of the Royal College of Radiologists' proposal that a national multicentre study of diagnostic radiology should be set up with some urgency.

No abstract available for this article.

An analysis of the content of sixty popular health periodicals covered in 1986 by the Consumer Health & Nutrition Index was made to identify the characteristics and concerns of popular health magazines and newsletters. The literature mirrors the health values and anxieties of the American public. While some of the literature diverges from mainstream allopathic medicine, most popular publications succeed in presenting coherent, reasoned, and documented viewpoints. Because there is no consensus on many medical problems, it is important that individuals have the freedom to read dissenting and alternative points of view and consider multiple options before making informed and reasoned health decisions. The popular literature is a valuable yet inexpensive source of reliable information on topics of current concern. The publications are not as well known as they deserve to be because they have not been adequately indexed, while they have not been indexed because they are not well known. The Consumer Health & Nutrition Index now provides expanded subject access to sixty health-related periodicals plus all health-related articles in sixteen general interest magazines.

Two patients with rheumatoid arthritis who developed obliterative bronchiolitis are described. Both patients had received penicillamine. The first patient died in respiratory failure 4 months after the onset of her breathlessness and the diagnosis was confirmed at post-mortem. The second patient was diagnosed with appropriate lung function tests and has been started on azathioprine. Although she is still disabled by breathlessness 12 months after presentation, her condition has stabilised.

The glucocorticoid receptor protein present in the high-speed supernant fraction of rat thymus tissue is extremely unstable, having a half-life of about 2 h at 4 degrees C. It was found that the decline in steroid-binding capacity could be slowed, though not arrested completely, by the addition of sulphydryl-protecting agents such as 2-mercaptoethanol or dithiothreitol, and by EDTA. The inactivation was also partly reversed by these agents. 0.5 mM N-ethylmaleimideor p-chloromercuriphenylsulphonic acid inactivated the recptor at 4 degrees C, but the presence of bound steroid protected the receptor against this inactivation. Bound steroid did not protect the receptor against the action of higher concentrations of these reagents. Treatment of intact thymus cells with 2,4-dinitrophenol resulted in a reduction in the steroid-binding capacity of the supernatant fraction derived from these cells. This effect of 2,4-dinitrophenol could not be reversed by the presence of dithiothreitol in the extraction buffer. It is concluded that the inactivation of the receptor in vitro is at least partly due to the oxidation of one or more sulphydryl groups necessary for steroid binding; the process of oxidation does not account for the reduction in steroid binding observed in intact thymus cells under conditions of energy deprivation.

The extent of library service and the character of the library staff of hospitals in the United States are reported from the results of a survey conducted by the American Hospital Association in 1968. These data supplement the data reported on the nonhospital institutional population to make up a composite picture of health sciences library manpower today. Only 2,918 hospitals (48.5 percent) out of a total of 6,018 surveyed reported the existence of a library of any kind, though some of the hospitals reported multiple libraries. For all of these libraries only 2,872 individuals were reported under the rubric for "librarians," and of these only 726 were reported as having the master's degree or better. Of the total staff almost half are non-salaried (volunteer or contributory) and almost half of the salaried staff are half time. It is obvious, therefore, that hospital libraries must be substantially strengthened if they are to fulfill their important function in the biomedical information network.

In order to plan adequately for education in health science librarianship and to be able to project future demands and needs we need to know a great deal more about existing manpower in health science libraries. This paper, the first in a series of reports on an investigation to gather this data, discusses the research methodology and the development of an inventory of the institution-program population upon which the survey is based. An analysis in terms of geographic location, type (educational, research, etc.), administrative control, and primary cognate area of these institutions is presented, and their distribution through the various Regional Medical Library areas is noted. Preliminary estimates are made, based on a questionnaire to the libraries, on the size of the library population, their relationship to reporting programs or institutions, exclusive of the hospital population which is being covered in an independent survey. A questionnaire to library personnel is underway which will establish, along with the other questionnaires, a basis for exploring the relationships which exist between institutions or programs, libraries and manpower.

The major findings and conclusions of a survey of manpower in health sciences libraries of the United States in 1969 are summarized. Although there does not appear to be a serious manpower shortage in terms of budgeted positions which are unfilled (demand), the manpower situation can still be considered serious when we introduce into our evaluation of the situation the question of existing levels of training and the urgent requirement (need) to bring manpower levels to a point at which adequate information services can be provided to the whole health sciences community. This is the final paper in a series of papers on a manpower study which also summarizes and analyzes the manpower data obtained by the American Hospital Association survey of 1968 and presents a number of general conclusions and recommendations for manpower planning for health sciences libraries.

As part of an investigation of health sciences library manpower, the universe of health-related institutions and programs (excluding hospitals) was surveyed by postcard questionnaire to produce an inventory and description of libraries providing services to these institutions and programs. Seventysix percent (5,215) of the institutions reported access to library resources, indicating usage of some 2,207 non-hospital libraries. Eighty percent (2,431) of the institutions reported that the library used was "within" their own institution; 20 percent (608) noted that the library was "outside" of their institution. The distribution of health-related institutions and libraries is shown by RML districts, together with relevant census data. A classification of libraries, based on the degree of involvement of the libraries' facilities, resources and personnel in supplying services to health-related institutions, was developed. It is concluded that projections of manpower needs should take into account institutions and programs not at present possessing health sciences libraries as well as documented demand in existing health sciences libraries.

An investigation of the manpower requirements of health sciences libraries and of educational programs appropriate to these manpower needs was begun in March 1968. To date, 4,727 libraries have been identified as being used by 14,000 health sciences institutions and programs. Of this total, 2,628 are hospital libraries; 1,328 are health sciences libraries and collections located outside of hospitals; and 771 are academic or public libraries. Within these libraries some 14,938 persons are directly involved, either full- or part-time, in the delivery of health sciences library services. Of the total work force, 5,861 persons are employed in hospital libraries and 9,077 are employed in health sciences libraries and collections. The ratio between professional and nonprofessional employees is 1:2; professional and nonprofessional status was assigned by the chief librarian. Survey data indicate a 7 percent manpower shortage in positions classified as professional, and a 3 percent shortage in positions classified as nonprofessional.

A survey was performed to elicit details about attendees of the continuing education program given in Denver at the 1968 MLA Annual Meeting. Factors considered included sex, age, geographic distribution, professional mobility, educational background, current jobs, and interest in further continuing education.

Users of information in science and technology have been studied in great detail with respect to material read, amount of time spent in reading and searching the literature, categories of questions asked, and so on. Probing for this information has been undertaken by means of structured and unstructured interviews, diaries, surveys, and questionnaires.Although a large amount of data has emerged on information usage and flow, the subjective response of scientists furnishes comment only on the satisfaction produced by present information services and does not yield insight into the extent to which needs remain unsatisfied. Relevance figures based upon the response of systems to questions cannot be equated with satisfaction of needs, since questions constitute, in most cases, inadequate representations of underlying information needs. Assessment of the needs of users of medical libraries and information systems must, in fact, be made in relation to the observed behavior and experience of biomedical scientists. There is room for well-designed experimentation which can explore the interaction of both psychological and environmental factors. Significant differences in information needs exist among and between individuals such as researchers and clinicians in the same environment. With respect to environment, it is hypothesized that the information needs of medical practitioners in remote areas might differ significantly from those of their colleagues working in large metropolitan centers in close proximity to medical schools, research institutions, and other rich sources of information fallout. It is anticipated that experimentation will eventually result in a methodology which will permit the determination and prediction of the information needs of any identified groups of users in a specific environment.

A statistical description based on a mail survey of personnel in 2,099 health sciences libraries located outside of the hospital setting is reported. Respondents to the survey were divided into three groups: professionals (those possessing a graduate library degree); nonprofessionals (those not possessing a graduate library degree); and chief librarians (those responsible for a library's operations). Survey items dealt with education, sex, age, salary, job mobility and preference for continuing education programs. Some 60 percent of the respondents were professionals; 40 percent were nonprofessionals. Seven hundred and twenty-eight chief librarians were identified in the population: 57 percent were professional librarians while the remainder were without a graduate library degree. Approximately (1/5) of all survey respondents were men. The age distribution for the work force tended to be bimodal, reflecting the career patterns of women and the later entry of men into librarianship. The annual salary for male professionals was calculated at $12,732; for female professionals at $10,044; for male nonprofessionals at $7,878; and for female nonprofessionals at $6,313. Male professionals were found to have the highest rates of job and geographic mobility. Conversely, female nonprofessionals were lowest in mobility. In expressing a preference for continuing education programs in library science, professionals tended to request courses dealing with the organization of libraries, health sciences institutions and their relationships, while nonprofessionals inclined towards courses in technical processing.

THE PRESENT SYSTEM OF EDUCATION FOR MEDICAL LIBRARY PRACTICE IN THE UNITED STATES CONSISTS OF FOUR MAJOR COMPONENTS: graduate degree programs in library science with specialization in medical librarianship; graduate degree programs in library science with no such specialization; postgraduate internships in medical libraries; continuing education programs. Data are presented illustrating the flow of graduates along these several educational pathways into medical library practice.The relevance of these educational components to the current medical library work force is discussed with reference to manpower data compiled for Ohio. The total number of medical library personnel in Ohio in 1968 is 316. Of this total, only forty-two (approximately 14 percent) have received any formal library training. Seventy persons have only a high school education. From these figures, it is concluded that there is no standard or essential qualification which is universally accepted as educational preparation for work in medical libraries; that the comparative sophistication of the educational programs in medical librarianship has yet to be reflected widely in general medical library practice; that an increasingly large number of non-professional or ancillary personnel are being, and will continue to be, utilized in medical libraries; that large numbers of untrained persons have sole responsibility for medical libraries; and that appropriate educational programs will have to be designed specifically for this type of personnel.