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Wednesday, June 12
 

12:00pm PDT

12:00pm PDT

Registration (12:00-6:00 pm)
Wednesday June 12, 2019 12:00pm - 6:00pm PDT
Atrium, Fromm Hall

1:00pm PDT

3:00pm PDT

3:00pm PDT

6:30pm PDT

No Host Drinks and/or Dinner at Barrel Head Brew House
Join your colleagues for drinks and/or dinner at Barrelhead Brew House (1785 Fulton Street www.barrelheadsf.com). We have a large table reserved in the bar area. Order food and drinks at the bar.

Wednesday June 12, 2019 6:30pm - 7:30pm PDT
Barrel Head Brew House 1785 Fulton Ave, San Francisco CA 94117
 
Thursday, June 13
 

8:00am PDT

Breakfast
Thursday June 13, 2019 8:00am - 9:00am PDT
Atrium, Fromm Hall

8:00am PDT

Registration (8:00am-12:00pm)
Thursday June 13, 2019 8:00am - 12:00pm PDT
Atrium, Fromm Hall

9:10am PDT

Welcome Address
Thursday June 13, 2019 9:10am - 9:30am PDT
Xavier, Fromm Hall

9:30am PDT

Plenary talk: Odette Harris
Dr. Odette Harris is a Professor of Neurosurgery at Stanford University School of Medicine and Director of Brain Injury for Stanford Medical Center. Dr Harris manages and coordinates the medical and surgical care of all patients suffering from traumatic brain injury that are admitted to the Stanford System. She focuses on implementing and streamlining current treatment algorithms aimed at improving the outcomes of this growing population. The primary focus is specific not only to mortality, but to functional outcome improvements. Dr Harris works in a collaborative manner with colleagues in Surgical Trauma, Neuro-Critical Care, Nursing, Rehabilitation and all related Specialties.

Plenary Speakers
avatar for Odette Harris

Odette Harris

Professor of Neurosurgery at Stanford University School of Medicine and Director of Brain Injury for Stanford Medical Center, Stanford University School of Medicine
Dr. Odette Harris is a Professor of Neurosurgery at Stanford University School of Medicine and Director of Brain Injury for Stanford Medical Center. Dr Harris manages and coordinates the medical and surgical care of all patients suffering from traumatic brain injury that are admitted... Read More →


Thursday June 13, 2019 9:30am - 10:30am PDT
Xavier, Fromm Hall

10:30am PDT

10:30am PDT

Exhibitors Hall Open
Come visit the following vendors in the exhibit hall:
Thieme
JoVE
Karger
LWW
IOS
Elsevier
NEJM
EBSCO
BMJ
NNLM PSR
TDS Health
VisualDx
McGraw-Hill

Thursday June 13, 2019 10:30am - 6:00pm PDT
Berman, Fromm Hall

11:10am PDT

Critical Data Studies Meets Critical Health Sciences Librarianship: Biomedical Big Data Hacking for Civic Health Awareness
In 2016, Purdue Libraries launched the Biomedical Big Data Hacking for Civic Health Awareness Project, an initiative focused on teaching research data management competencies and encouraging participants interested in working with big biomedical data to compete in extracurricular, library-sponsored healthcare hackathons and similar biomedical data challenges. Healthcare hackathons are live or virtual competitive events that rely on a multidisciplinary approach to accelerate the innovation of medical solutions and improve healthcare technology design. The project succeeded in its goal of creating biomedical data hacking challenges that attracted a diverse range of participants, including students in health sciences disciplines, early career health professionals, and members of the public. Across the project's challenges, 28% of participants have been either health professionals or students majoring in health sciences disciplines, 38% of attendees have been women, and 46% have been members of a racial minority group.

In the next phase of this project, we seek to design and launch a course that encourages an interdisciplinary group of students to apply critical pedagogy to big biomedical data, considering questions such as ‘who collects biomedical data?’; ‘where does biomedical data come from?’; ‘what challenges are associated with combining, formatting, storing, and analyzing big biomedical data from different systems?’; ‘who controls and owns biomedical data?’; and ‘what privacy concerns need to be addressed by health professionals using data from patient health records and hospital information systems?’ The researchers hypothesize that a focus on these issues will allow for robust discussions around algorithmic bias, informed refusal, and similar social justice issues.

In this paper presentation, we hope to engage the audience in a discussion around critical data studies and critical librarianship and seek audience feedback on what a course focused on crit lib and critical data science might look like.


Thursday June 13, 2019 11:10am - 12:00pm PDT
Maier Room, Fromm Hall

11:10am PDT

Historical Explorations and Connections: An Intimate Relationship Between Imperial Knowledge and Medical Libraries
For over a millennium, libraries have advanced research and knowledge of human science by diligently building and preserving collections and rich content. Historically, libraries have also aligned their institutional responsibilities to adhere to and support the values and virtues of empire-building regimes and colonial practices.

The archives and archival history have revealed such troubling and complicated past of institutional knowledge-building presented by scholarships in historical anthropology and the history of medicine. Library history has largely been relegated to the mistreatments and denials of access to marginalized groups. The global history of libraries in the health and medical sciences offer a far more complex study of how they have preserved research collections on colonial subjects. This paper explores the historical relationship between empire-building and medical libraries, and how the latter has been complicit in upholding imperial values and knowledge. The paper outlines the complex roles of libraries in shaping and contributing to the colonial discourse in medical and health science fields.

Drawing on archival research, collection assessment, fieldwork, and selected case studies from Early America to the British Empire, the paper argues that these institutions can be complicit to colonial practices by preserving and collecting scientific records and data from colonial subjects for the goal of expanding the knowledge of the human body. The paper applies critical discourse theory to understand the power structures of medical libraries and their collections in placing and reinforcing imperial values and priorities over human dignity. This topic highlights the role of critical health librarianship by asking educators, scholars and practitioners in the field today to question the nature of power and historical assumptions of medical libraries' role in global history, and to analyze the current problems in medical research derived from the past by drawing on the intimate connections between imperial knowledge and medical libraries.

Presenters

Thursday June 13, 2019 11:10am - 12:00pm PDT
Maier Room, Fromm Hall

11:10am PDT

Social Justice and Medical Library Institutional Repositories: Tactics and Outreach

Objective:
This paper discusses the experiences of an institutional repository (IR) manager at a multi-state health system. Launched in 2018 the IR aims to gather published articles, presentations, posters, etc. produced across the 50+ hospitals in the system. Since the IR is new, there is the opportunity to build social justice and critical librarianship in to the strategic planning from the beginning.

Methods:
How can a social justice lens inform what is added to an IR? If an IR aims to collect the entire body of research at an institution what steps can be taken to make sure works promoting diversity, equity, and inclusion (both authors and subject matter) are being found? What happens to the work of colleagues at our rural clinics versus the work of colleagues at well-funded research institutes who have the resources to publish articles?

Targeted outreach efforts undertaken to promote equity and representation will be examined, including successes and failures. Outreach at an individual author level, organizational departments, and employee affinity groups will be discussed. While PubMed searches capture most articles for inclusion, outreach and awareness is the main tactic to collect gray literature.

Results:
Without targeted outreach efforts and a social justice framework an IR will not provide representation, equity, and inclusion. Having these as part of the launch and strategic planning for the IR creates the space to devote staff time and energy and sees it as an intrinsic goal in the IR.

Conclusions:
There are no absolute conclusions, as this is an ongoing approach to medical library IR management and designed to open a conversation. Time will be included for an interactive think-pair share activity. Participants will be invited to brainstorm ideas to incorporate social justice in to medical library institutional repositories and to share experiences from their own institutions.

Presenters

Thursday June 13, 2019 11:10am - 12:00pm PDT
Maier Room, Fromm Hall

11:10am PDT

Critical Information Literacy in Health and Medicine
The presentation will summarily cover possibilities and limitations for critical information literacy in medical and health science library instruction, and builds on previous presentations that discussed professional degrees and critical pedagogy, as well as critical information literacy for professional students. The presentation will include three areas of focus: Access to information; Cataloging & MeSH terms; and Cultural humility. Students in medical and health science programs need access to health information. Similar to other research projects that critique other controlled vocabulary thesauri, MeSH terms need to be examined for effectiveness and accuracy. The concept of cultural humility was first introduced by healthcare professionals as an alternative to cultural competence, and adds self-reflection and lifelong learning to the work being done on cultural competence. Along with these possible topics of discussion, there is a need to examine limitations for critical information literacy in medicine and the health sciences. One of the limitations is the value placed on evidence-based medicine. Critiques of evidence-based medicine include: Limited, incomplete, and consolidative nature of research on immigrants and communities of color; Narrow definition of evidence; and Patient autonomy.

After this session, participants will be able to:
-Define possible areas of focus for critical information literacy in medical and health science library instruction
-Incorporate critical healthcare practices in their professional and instructional settings
-Begin developing critical information literacy sessions for medical and health science courses

Presenters

Thursday June 13, 2019 11:10am - 12:00pm PDT
Xavier, Fromm Hall

11:10am PDT

Diversity health consciousness: Librarians’ holistic approach to addressing social determinants of health in vulnerable populations.
Objectives:
The objective of this poster is to present what our Health Sciences Librarians are doing to support access to authoritative, relevant resources and services for our larger organization including Hospital Policy makers, Community Medicine Residents, clinicians and nurses. Medical centers are reshaping the health care process by identifying the unmet needs of vulnerable populations in the communities they serve. It is important to discern the right resources and learn more about the social determinants of health (SDH). To ascertain the broader determinants of health issues, it is necessary to look at the “cause of the causes,” related to health and socio-economic conditions in which people live and work.
Methods:
Through critical analysis of organizational needs, detailed review of existing resources and identification of gaps we were able to create and acquire resources to ensure our organization has the knowledge and tools necessary to address unmet SDH needs in the vulnerable communities we serve.
Results:
• Creation of Community Medicine/Public Health and other related Subject Guides
• Collection development efforts focused on the acquisition of titles on Community Medicine, SDH, cultural competency, healthcare inequality, underserved populations and minority health
• Sponsorship of National Library of Medicine Exhibits which address various social aspects relating to the health of our communities
• Research to support related clinical care, corporate strategy and research initiatives
Conclusions:
• Understand the needs and priorities of the communities we serve
• Understand the organization’s SDH related goals and initiatives
• Identify and disseminate authoritative, relevant resources
• Integrate within larger organization groups involved in SDH/health disparities/health inequality programs and research
• Create resources and training opportunities aligned with the organization’s initiatives to ensure decision-makers and clinicians are effective users of appropriate resources


Thursday June 13, 2019 11:10am - 12:00pm PDT
Xavier, Fromm Hall

11:10am PDT

Everyone Has Something to Share and Something to Learn: Using an LMS to Host Collaborative Reference Training for All Library Staff
The University Library identified a need to develop better training for the non-MLS holding staff members who were triaging basic reference services and conducting referrals. Since staff and librarians at all levels worked shifts at the service desk, the decision was made that everyone, regardless of previous experience, degrees, or job title, would be included in the training. However, there was a basic math problem: two campuses, two states, two time zones, 16 people to be trained, and only one librarian to manage it all! The coordination problem was solved by using the campus Learning Management System (LMS), Canvas. The LMS might have solved the math problem, but it opened a whole other can of worms in using an unfamiliar system when developing training in an efficient and effective manner for a highly diverse learning group. With a wide variety of skill and experience levels, as well as learning habits and characteristics, the training program needed to respect and integrate the learner’s experience, create opportunities for sharing and collaboration, and be accessible. Mistakes were made. But we also created a new, continuing, online training program based on adult learning principles, a focus on developing a community of practice, and feedback rich assessment. This session will teach key steps (and missteps to avoid) so you can balance the training equation with available resources, critical reflection of your goals and needs, respect for your staff's skills and knowledge, and hopefully not so much trial and error!

Presenters

Thursday June 13, 2019 11:10am - 12:00pm PDT
Xavier, Fromm Hall

12:00pm PDT

Lunchtime Session: NNLM PSR Update
Lunch and National Network of Libraries of Medicine Pacific Southwest Region update.

Presenters

Thursday June 13, 2019 12:00pm - 1:00pm PDT
Maraschi, Fromm Hall

1:10pm PDT

Common Ground & the Teachable Moment: What I learned participating in a longitudinal, evidence-based research study, and how I use these experiences in my library practice
Given the sparseness of current literature examining real word strategies for health literacy education, I would like to offer the opportunity for an open conversation about the realities of teaching health literacy in various clinical settings. As a public health nurse, I employed health literacy strategies, and believe there is transferable value to be gleaned by librarians seeking to foster health literacy, agency and empowerment. Librarians, like nurses, are trusted community members who share like-minded goals and a commonality of skills with the clinician: critical thinking, creative work, information management, transfer of knowledge, teaching, assessing, evaluating, facilitating access to information for an improved quality of life, and pursuit of equitable access to minimize disparity. All skills useful in collaboration and implementation of health literacy education.

In support of this discourse, I plan to deliver a Lightning Talk highlighting my experiences as a public health nurse participating in an evidence-based nurse home-visitation program for low-income, first-time mothers. The program provides the client with a nurse who follows them prenatally through their baby’s second birthday. A curriculum of information and learning activities focus on cultivating positive health behaviors, competent care of children, and maternal personal development. This longitudinal research study has proven to be efficacious, achieving positive and sustainable outcomes and behavioral change. The program is illustrative of how health literacy education is done in the trenches using teachable moments in varying contexts. Contextual variation requires individualized teaching techniques and we, as librarians, can offer research and resources that assist the clinician to effectively maximize their teaching strategies.


Presenters

Thursday June 13, 2019 1:10pm - 2:00pm PDT
Xavier, Fromm Hall

1:10pm PDT

Funny you should ask...how graphic medicine found me
This lightening talk will describe our experience integrating graphic medicine (or comics) as an educational tool, developing a dedicated GM collection, the rationale for the collection, general overview and exploration of the ways to integrate GM into med school curricula, collaboration with faculty to promote GM and narrative medicine in the curriculum.
The students participate fully in the curriculum, selectives and a designated emphasis in medical and health humanities are natural places where graphic medicine as an educational tool can be explored. However there was no blueprint on how to proceed. Our students train to work with diverse populations with a strong emphasis in the communities of this region. This region is also my hometown. This project is a work in progress but I'm approaching it with a different lens than before.

Presenters

Thursday June 13, 2019 1:10pm - 2:00pm PDT
Xavier, Fromm Hall

1:10pm PDT

Getting Started with LGBTQ+ Resources and Programming at Medical and Health Sciences Libraries
Do you want to support healthcare providers with LGBTQ+ health and cultural competency resources? Not sure where to start?

A librarian will discuss successful collaborations with a medical library and LGBTQ+ organizations to develop programming and resources for LGBTQ+ health and cultural competency for healthcare providers.

The presenter will review two ways for librarians to get involved with LGBTQ+ health and cultural competency at their institutions.
1. Creation of library guides and other resources.
2. Collaboration with LGBTQ+ organizations to develop programming.


Thursday June 13, 2019 1:10pm - 2:00pm PDT
Xavier, Fromm Hall

1:10pm PDT

A Reflection of an Embedded Nurse-Librarian During a Scoping Review and the Development of an Information Toolkit
Objective. A retrospective appraisal of a scoping review highlights tangible examples of community engagement and the subsequent bounty of a toolkit that continues to be fruitful.
This chronicle commences with a bedside clinician but transcends to a vision of many with the aim to make a difference in a vulnerable and fragile population. Necrotizing enterocolitis (NEC) is an insidious disease that afflicts 5-10 % of babies born weighing less than 1500 grams. Specifically, Hispanic and African American infants are at high risk of developing NEC. The NEC-Zero Project is focused on preventing and improving timely recognition of NEC. Current evidence suggests that some NEC risk factors are modifiable and vary from NICUs.
Methods. A critical theory lens examines a scoping review that was guided by the Translating Research into Practice (TRIP) framework and the development of a toolkit for information seekers.
Results. Critique highlights include lessons learned from the scoping review and the subsequent comprehensive technology-enabled and evidence-based toolkit. Findings discussed include 1. Information access (e.g., Spanish translation vetting & website accessibility), 2. Diversifying stakeholder inclusiveness during the scoping review (e.g., NEC parent stakeholders, librarian, and additional bedside nurses), 3. Expanding perspectives and product quality through partnerships and relationships (e.g., NEC-Society & student mentorship), and 4. Increasing reach (e.g., webinars, dual-audience website, infographics).
Conclusions. A critical lens perspective compliments the Translating Science into Practice (TRIP) framework and offers new insights while supporting and enhancing creative ventures and promoting information access.


Thursday June 13, 2019 1:10pm - 2:00pm PDT
Xavier, Fromm Hall

1:10pm PDT

Broadening the Pipeline: Offering Evidence Based Information Literacy Instruction to High School Health Sciences Magnet Programs in Underserved Areas
Objectives - Students in underserved non-white areas frequently do not have access to subscription databases or subject specialist librarians. A 2019 EdBuild report found a 23 billion dollar disparity between funding public schools in white neighborhoods and non-white neighborhoods in America and this discrepancy is particularly acute in California where there is an average difference in annual funding of $3,974 per child in poor non-white versus poor white neighborhoods.

It was thought that a health sciences librarian could address one challenge by teaching disadvantaged students attending health science magnet programs to begin to use evidence-based research methods which might both, ease their transition into higher education in the health sciences and improve the quality of their research now.

Methods - Health science magnet programs from across Northern California are invited to visit our university for tours of our health sciences programs. This project was conceived while meeting with a tour. I began offering to visit each school to present one-shot workshops, teaching methods for research that include the following: building a search strategy, understanding levels of evidence, different types of clinical queries, the PICOT method, and where to find high quality, open access resources. This is presented as a class lecture and group activities.

Results - The students express more confidence in searching for health science literature.

Conclusions - Finding quality, accessible evidence is a challenge for health sciences professionals; how much more so for those students without access to subscription databases or subject specialist librarians? Volunteering to work with area high schools that specialize in health sciences can help students get a leg up on the research process and increase their confidence as researchers. The program is new, beginning in 2019, and it is hoped that the workshops will also correlate to higher quality coursework.

Presenters

Thursday June 13, 2019 1:10pm - 2:00pm PDT
Xavier, Fromm Hall

1:10pm PDT

A Critical Examination of Crisis Data and Information Sharing in Support of Disaster Relief
In the aftermath of natural and man-made disasters, first respondents often aggregate data from social media platforms to better understand community response and to determine where help is needed. This approach is especially useful for humanitarian mapping and crisis map construction. However, scraping public-facing platforms for crisis data presents distinct ontological, epistemological, and ethical issues and can lead to the partial, incomplete telling of a story. This paper will present a critical examination of information-sharing and crisis data use in support of disaster relief efforts.

Critical data studies considers the ethical, legal, socio-cultural, epistemological and political aspects of big data and digital infrastructure. It encourages deeper consideration of democratic and participatory approaches to algorithm design and responsible data management, curation and dissemination. Critical data studies offers an ethical lens for considering crisis data use and information sharing, particularly for ontological, epistemological, and ethical issues.

Ontological. Tracking disasters via social media posts and hashtag analysis provide an immediate but truncated understanding of the disaster relief process. This in-the-moment focus makes it difficult to understand the precursors to a disaster event, the long-term disaster recovery process, and post-disaster implications. How can we find the balance between the immediate, short-term benefits provided by social media and the challenges of accurately capturing the total disaster story?

Epistemological. Social media helps illustrate how people communicate during disasters but is prone to bias. Older, less affluent, and vulnerable voices are often missing or underrepresented; Twitter algorithms favor tweets based on the number of followers or social networks, and people tweet in cultural-specific contexts that can be difficult for outsiders to understand. How do we ensure that the voices of the marginalized are heard?

Ethical Issues. How do we respect privacy and consent when scraping and reusing social data that might include personal information?

Presenters

Thursday June 13, 2019 1:10pm - 2:00pm PDT
Maraschi, Fromm Hall

1:10pm PDT

Satisfying the cultural and linguistic competency requirements of Assembly Bill 1195: How hospital librarians support diverse continuing medical education at a major health care institution
Objective
In 2005, the California Assembly passed AB 1195, Coto. Continuing education: cultural and linguistic competency. The bill mandated that all physicians and surgeons practicing in California demonstrate knowledge in the subjects of cultural and linguistic competency in the practice of medicine. This is commonly called continuing medical education, or CME. This research will explore hospital librarian's support of CME in relation to culturally competent care and AB1195 at a large healthcare organization.
Methods
This study gathered examples and data of culturally competent education assistance provided by librarians from 2012 to 2019. The authors focused on assistance provided to CME committees, physician speakers, and CME coordinators. A simple survey was distributed to CME departments at affiliated hospitals to determine their knowledge of library services as it relates to AB1195 and cultural competency.
Results
Pending results of survey and data review.
Conclusions
Hospitals continue to care for increasingly diverse populations shaped by patients with varied social and cultural backgrounds. Health professionals must be prepared to provide effective care that incorporates the patient’s health beliefs and linguistic needs in a manner that is culturally responsive and inclusive. Hospital librarians play a major role in the evidence gathering process by supporting health professional’s education. This is supported through literature searches, health disparities analysis, and document retrieval for CME courses which address culturally responsive care. Providing physicians and surgeons with culturally competent information resources serves to not only improve the quality of care provided for these patients, satisfies the mandate decreed with California Assembly Bill No. 1195, but also provides an environment fostering effective care for patients from diverse cultures, groups, and communities from across California.


Thursday June 13, 2019 1:10pm - 2:00pm PDT
Maraschi, Fromm Hall

1:10pm PDT

Scholarly Publishing, Information Dissemination, and Doctor of Nursing Practice Students
Doctor of Nursing Practice (DNP) graduates should be prepared to contribute to the scholarly conversation in nursing. DNP degree requirements often include the submission of manuscripts to scholarly nursing journals. These manuscripts, along with the written final DNP Project report, are used to evaluate student scholarship outcomes. However, DNP students may have varying levels of comfort and expertise with scholarly writing and publishing, and students who have been working in a clinical setting for an extended period of time often need support transitioning to an academic environment with a different set of communication practices. For many DNP students, the acquisition of scholarly writing skills is an ongoing process, and depending on their educational and professional experience they may not be ready to submit a manuscript to a scholarly journal when required to by their academic program.

This paper reports on a multi-step project undertaken by librarians and faculty at ____ that aimed to better understand the scholarly publishing outcomes of past DNP students, and to better support the publishing and dissemination endeavors of current and future DNP students. The project included three main components: the evaluation and analysis of the publishing outcomes of all past DNP students; the institution of a program-wide alternative method of disseminating doctoral student work that utilizes the institutional repository; and the development of a written case study and worksheet that aims to advance the publishing literacy of novice authors.
This presentation will address scholarly publishing and information dissemination through a critical lense, and will utilize critical teaching methods, including small group discussion and reflection.

Presenters
avatar for Claire Sharifi

Claire Sharifi

Reference Librarian, University of San Francisco
Gleeson Library, Geshke Center, University of San Francisco


Thursday June 13, 2019 1:10pm - 2:00pm PDT
Maraschi, Fromm Hall

2:10pm PDT

Hosting a Student Diversity Center in the Medical Library
In 2016, a need was expressed by medical students for a place where minority students could gather in times of need for support, companionship and comfort. The Diversity Center of Representation and Empowerment (D-CORE) grew out of this request. Housed in the Lane Library at Stanford School of Medicine, this student-run center, which opened in October 2017, provides a space where any member of the Stanford Medicine community interested in issues of inclusion and diversity can hold meetings and events, or just hang out. This presentation
chronicles how the Lane Medical Library helped students develop the space and
continues to support the center by serving on the D-CORE Advisory Council, helping create guidelines for use of the space, and working with students to develop a collection of resources for the community served by D-CORE.
This presentation will share some of the challenges and expectations as well
as recommend best practices for creating and maintaining, student-run spaces in a medical library.


Thursday June 13, 2019 2:10pm - 3:00pm PDT
Xavier, Fromm Hall

2:10pm PDT

Trippin’ into privilege: Critical library instruction with dental medicine students
The purpose of this paper is to discuss the evolution of teaching about privilege, race, and concepts of cultural competence and cultural humility over three-years with first-year dental medicine students. This paper will explore the experiences of a health sciences librarian teaching about these themes in an annual one-shot instruction session for a first-year patient communication course. The paper will explore creating lecture content, in class activities, and dental student uptake of this content

Presenters

Thursday June 13, 2019 2:10pm - 3:00pm PDT
Xavier, Fromm Hall

2:10pm PDT

Words matter: Interpretations and implications of “para” in paraprofessional and paralibrarian


Objectives:
1. To determine the identification term or terms (e.g. paraprofessional or library staff) preferred by non-librarian library staff.
2. To determine how library staff interpret terms, such as paraprofessional or library staff.

Methods:
We conducted a literature review to determine terms used to refer to non-librarian library. We identified terms such as library staff, library support staff, paraprofessional, paralibrarian, and nonprofessional. There are no recent studies attempting to identify the terms preferred by library staff. One 1991 ALA study indicated that library staff interpret “nonprofessional” as demeaning, and are divided on “paraprofessional,” with some participants interpreting the latter as demeaning as well.

We created an online survey in Qualtrics with the purpose of identifying current terms preferred by library staff. We distributed via an anonymous link to medical and health sciences library listservs and social media outlets.

Survey participants include full- and part-time medical and health sciences library staff in any non-librarian position. We did not accept responses from librarians.

Results:
Two hundred and twenty two (222) people responded to the survey. Results indicate that the number one choice of participants is library staff, preferred over paraprofessional, paralibrarian, and library support staff. Thirty-three (33) of the 105 participants who completed the comments section specifically indicated that “para” in paraprofessional and paralibrarian is either demeaning, degrading, insulting, strange, or confusing, or had never heard of the terms before.

Conclusions:
We conclude that terms like “paraprofessional” should no longer be used to refer to non-librarian library staff in literature or by medical and health sciences library organizations, associations, and institutions.

Terms like “paraprofessional” and “paralibrarian” may have once made sense due to past library organizational structures, but these terms are now outdated. Library staff is more inclusive and less divisive, encompassing the wide range of non-librarian and librarian positions.


Thursday June 13, 2019 2:10pm - 3:00pm PDT
Xavier, Fromm Hall

2:10pm PDT

Transgender Allyship in Library Instruction

Special content session:
This session will provide an introduction to transgender identities, terminology, and allyship practices. Participants will explore strategies for making library instruction inclusive and welcoming to students on the transgender spectrum.

Objectives:
* Review terminology surrounding gender identity
* Learn how to integrate pronoun go-rounds into library sessions
* Explore methods for discussing problematic subject terms

Methods:
* Group activities
* Reflection
* Discussion

Results & Conclusions:
Participants will gain an understanding of how to create transgender inclusive classes. Additional resources on gender identity will be provided.

Presenters

Thursday June 13, 2019 2:10pm - 3:00pm PDT
Maraschi, Fromm Hall

3:10pm PDT

(Poster) Beyond Therapy: Teaching Evidence-Based Medicine Fundamentals to Internal Medicine Residents
Background

As the application of Evidence Based Medicine (EBM) in the world continues to grow, integrating the best available evidence into clinical decision making, so grows the importance of teaching fundamentals of EBM to first-year residents. Until recently, most of our training endeavors in this area were centered on Therapy, with little time dedicated to the areas of Diagnosis and Prognosis, or to the in-depth analysis of Systematic Reviews. This presentation describes the planning process and challenges encountered in the development of an expanded EBM training program for first-year Internal Medicine residents.

Description

To be presented at the meeting.

Conclusion

To be presented at the meeting.

Learning Outcomes

• Participants will gain practical knowledge of a step-by-step process of planning, developing, organizing, and implementing an expanded program teaching fundamentals of Evidence-Based Medicine to the first-year residents.

• Participants will learn about our attempts to identify degree of basic knowledge of evidence-based medicine among post-graduate medicine learners.

• Participants will be able to apply knowledge gained from this presentation to process of planning similar programs at their institutions


Thursday June 13, 2019 3:10pm - 4:00pm PDT
Atrium, Fromm Hall

3:10pm PDT

(Poster) Bridging The Gap: The Critical Role of Librarians in Reducing Health Disparities
This presentation will highlight the application of critical librarianship as it relates to the health sciences, particularly addressing the role of the librarian in reducing health and health care disparities. Health disparities are the gaps in the quality of health and healthcare among vulnerable populations as it is related to differential access to medical care, treatment modalities, and disparate outcomes. Addressing health disparities is encouraged by action through effective interventions. As a library and information science student, I explored opportunities for librarians to be engaged in reducing health disparities through community level initiatives and medical education. Topics that were explored included 1) the role of public libraries in promoting health literacy, 2) delivering storytelling projects to reduce the knowledge gap, 3) integrating a critical pedagogy framework in medical instruction, and 4) the role of librarians in medical humanities to promote social justice in medicine. Findings include the need for specialized training for public librarians; community partnerships with academic librarians for outreach efforts; the importance of delivering narratives over traditional informational approaches; and reflection of information literacy programs in medical education based on professional competencies to be addressed. Librarians in diverse settings have various opportunities to be part of interventions and educational programming to reduce health disparities whether it be through community health initiatives or training the next generation of medical professionals to be social justice warriors.

Presenters

Thursday June 13, 2019 3:10pm - 4:00pm PDT
Atrium, Fromm Hall

3:10pm PDT

(Poster) Building partnership with an editor in publishing a special series
Objective:
To describe how partnership with a librarian and use of Covidence software can support a multi-faceted program of systematic reviews.

Method:
A faculty member is both on the JPSM editorial board and the editor of the Special Series titled “Science in Action: Evidence and opportunities for palliative care across diverse populations and care settings. The Special Series is comprised of systematic reviews of opportunities and/or effectiveness of palliative care in specific populations. The librarian partnered with the faculty and develop a work-flow to facilitate good methodologic rigor for systematic reviews and which leveraged Covidence software as a platform to complete those reviews. Over a series of ten months and through partnership with the National Research Committee for the American Academy of Hospice and Palliative Medicine (AAHPM-NRC), the series editor invited trainees and clinicians in different disciplines and across multiple institutions across the United States to participate in the project. Of note, other than the Series Editor, no participants had previously conducted a systematic review and thus they relied heavily on the workflow plan developed by the librarian and Series Editor. The workflow had multiple steps to facilitate methologic rigor, including: (a) formulation of PICOTS question, (b) review and approval of all PICOTS questions by the AAHPM-NRC, (c) registry of all systematic reviews on PROSPERO, (d) adherence to PRISMA guidelines, and (e) close collaboration with the librarian for training in Covidence and all literature searches. The librarian was included as an active member of each systematic review team, including being a co-author on the final manuscript. By leveraging Covidence software, the librarian was able to monitor the progress and provide proactive support for each systematic review.

Result & Conclusion:
Eight systematic reviews are already in-progress for this series with the first article being already in-press.



Thursday June 13, 2019 3:10pm - 4:00pm PDT
Atrium, Fromm Hall

3:10pm PDT

(Poster) Critical themes in MLA conference abstracts
This poster will describe a content analysis of Medical Library Association Annual Meeting abstracts from 2001-2018. Abstracts were searched for themes relating to critical librarianship, such as gender and sexuality, race and ethnicity, class and economic status, and other indicators of critical approaches in health sciences librarianship. This poster will describe a content analysis of Medical Library Association Annual Meeting abstracts from 2001-2018. Abstracts were searched for themes relating to power and privilege, systems of oppression, structural inequalities, marginalized identities, and other indicators of critical themes in health sciences librarianship practice. Results will be presented at the joint meeting.Results will be presented at the joint meeting.

Presenters

Thursday June 13, 2019 3:10pm - 4:00pm PDT
Atrium, Fromm Hall

3:10pm PDT

(Poster) Critical trivia: Creating inclusive games for students and librarians
The first game, Build a Leader (Build a Mentor, Build a Researcher) is designed to facilitate discussions about leadership qualities in a low-stakes way. The game is extendable to different topics including mentoring or research. Build a Leader was used in a librarian faculty mentor group to explore leadership. A list of leadership qualities and trivia questions related to leadership generally and in libraries was developed. Pairs of mentors and mentees formed teams; each team received a box with a paper body cut out and leadership qualities. Teams then had to answer trivia questions to build a leader. The first team to complete their leader won prize. Leadership can be a difficult topic to discuss. Build a Leader is designed to open up discussions about leadership in a social atmosphere that is encouraging instead of intimidating.
The second game, Operate your research skills, is a trivia game, developed for outreach with undergraduate health sciences students. Students answer trivia questions related to library services, their institution, and health sciences school. The Milton Bradley game, Operation, adds an element of fun. Participants who correctly answer can remove a piece from the Operation game. Students win a sticker or prize. Operate your research skills is designed to promote library services, and school spirit in an inviting and non-threatening manner. This game also increases goodwill among students and librarians and promotes inclusion. Both games are examples of engaging in critical librarianship. Questions posed in both trivia games are developed using a critical lens, to address diverse populations. Both games are flexible and can be adapted.


Presenters

Thursday June 13, 2019 3:10pm - 4:00pm PDT
Atrium, Fromm Hall

3:10pm PDT

(Poster) Do(n’t) Label Me: Critical Assessment of Generational Perceptions Among Health Sciences Librarians
Generational labels are often used to help define patron groups in library research, but what happens when the tables are turned and Librarians are asked to examine generational groupings applied to themselves and their workplaces? This poster examines the results of an international survey regarding generational group membership conducted amongst health sciences librarians and health information professionals. The survey was built using Pew Research Center year ranges and definitions for the generations, and participants were asked to indicate what generation they belonged to by year of birth, and whether they agreed with the characteristics and labels assigned to their year of birth. The results of this survey indicate that whether or not health sciences librarians agree with the generations as a label and grouping, the strong opinions and wildly varying responses demonstrate that this is a subject worthy of further examination. Generational labels are used in this poster as a way to look at intergenerational intersections in the Health Sciences workplace, and are not meant to supersede or stand alone among other important identity markers. Generational grouping can be part of a larger understanding of the intersectional ways that life experience and cultural background come together in the work place and during interactions between information professionals and the groups they serve. Critically examining how librarians understand generational labels can be helpful for building relationships between librarians, library users, and library stakeholders in a profession that has a large number of individuals with decades of work experience.


Thursday June 13, 2019 3:10pm - 4:00pm PDT
Atrium, Fromm Hall

3:10pm PDT

(Poster) Expanding our roles: Opportunities to reduce health literacy gaps in underserved communities
Objective:
This poster explores non-traditional settings in which Health Sciences Librarians can utilize information seeking skills. Skills necessary to teach and educate underserved community members on how to access health information. Librarians are used to providing health information to patients and community members in traditional spaces, such as hospitals, education centers, clinics and campuses. The uninsured and underserved community members do not receive health information in these traditional spaces. They are often at a disadvantage to receiving preventative care and services, have poor health outcomes, increased poverty and go without proper treatment or have knowledge of existing chronic diseases.
Using their information seeking skills and knowledge of existing consumer health resources, librarians can identify the right resource for the right person. Reducing the health literacy gap and alleviating the social determinants of health that surround these communities.
Methods:
By exploring health literacy outreach opportunities in a California community, a free medical clinic was identified and supported in 2018. California Care Force – Sacramento provided medical, vision, and dental services to community members in need of care.

Results:
Health information and follow up instructions were provided to patients receiving care. Handouts with instructions addressing post-surgical care, diabetes, glaucoma, and hypertension were distributed in various languages, utilizing the National Library of Medicine’s MedlinePlus database. For patients who were unable to read, a video was shown depicting instructions and self-care in a language they could understand.

Conclusions:
We hope this should encourage health sciences librarians to look past brick and mortar walls and step outside traditional library spaces to experience the provision of health information in non-traditional settings. Librarians can play a vital role in making health happen anywhere. Whether it’s a parking lot, a tent, side-walk or fair ground, health happens here too.

Presenters

Thursday June 13, 2019 3:10pm - 4:00pm PDT
Atrium, Fromm Hall

3:10pm PDT

(Poster) Exploring Demographic Data and All Things Elided: An Interactive Poster Experience
This interactive poster demonstrates how an informal learning opportunity can engage health sciences students in thinking about how demographic and health data is not neutral but instead is based on social and political constructs. Users would be invited to build a ‘census’ with category size and structure limitations representative of the U.S. decennial census. They will be provided with category labels from the census as well as category labels that are representative of how communities understand and label themselves. After building the census, users will be invited to walk through scenarios as either community members attempting to answer the census (some of whom are in highly vulnerable situations in relation to these categories) or as researchers attempting to develop an understanding of population health based on the potentially available data. Users will then be asked to rebuild the survey under certain limitations reflecting political or social factors that constrain acknowledgment of various communities and identities. Finally, users will be invited to self-reflect on the census they built themselves, the constrained census, and the scenarios, including reactions from both their perspective as health care providers and from the perspective of potential community members. The poster will include a discussion of the intended audience, learning outcomes, and student reception of the original activity, as well as exploring the value of informal learning opportunities within library spaces.

Presenters

Thursday June 13, 2019 3:10pm - 4:00pm PDT
Atrium, Fromm Hall

3:10pm PDT

(Poster) More than Padding: A Critical Look at the Role of the Part-time and Temporary Academic Librarian
Part-time librarians embody a range of experiences, from novice to seasoned, but, regardless of experience, the realities of the temporary and/or part-time library position are ever-present and impact both the librarian and the institution. Reasons for choosing part-time library employment vary, but all encounter opportunities and obstacles unique to their service. As it is often early-career librarians who are employed in these positions, it is important for the profession to critically consider the nature of the part-time librarianship. For some librarians in these positions, there is an inherent imbalance and vulnerability that is not often addressed in the literature or in practice.

In support of strengthening the library profession through reflective practice and critical librarianship, this poster seeks to stimulate discourse on the inequalities and unrealized possibilities inherent to temporary and part-time positions within the academic library organization. The poster will include a review of the current literature examining the state of modern day, part-time librarianship in the academic setting, emphasizing the professional challenges faced by this under-represented population. Along with a literature review, preliminary exploratory research on the observations, perceptions, and experiences of PTALs (part-time academic librarian) will also be presented.

With many libraries embracing a strategic mission to foster inclusivity and minimize disparity, an examination of how the profession scaffolds and obstructs these concepts within its own discipline is warranted. Exploring the experiences of this growing body of professionals will shed light on the unique position of the PTAL within the culture and social structure of the academic library profession. Enhanced understanding contributes to the development of library models that embrace the next generation, build on strengths, cultivate competence, and minimize limitations through the act of employing and nurturing motivated, thoughtful, intelligent people who bring fresh perspective and innovative ideas to the library.

Presenters

Thursday June 13, 2019 3:10pm - 4:00pm PDT
Atrium, Fromm Hall

3:10pm PDT

(Poster) Research Development Webinar Series: A Collaboration Amongst Touro College and University System Libraries
This collaboration amongst Touro College and University System (TCUS) libraries began as a pilot project in spring 2018 as an initiative of the Touro College New York Research Council, whose mission was to seek ways to pursue the President’s vision to increase the research footprint through the TCUS. The Information Literacy Director at Touro College – Midtown Library, came up with the idea to offer webinars on a range of research topics, and the library director at Touro University Nevada (TUN) asked if the webinars could be offered at other TCUS sites. The Information Literacy Director was interested to proceed with this collaboration as a pilot project.

The Information Literacy Director created a Workshops guide and developed an initial flyer, which the TUN Library Director adapted and distributed to TUN deans, directors, and faculty. Announcements regarding the research development series were also made at various meetings in the monthly TUNews online newsletter. Group meeting rooms were scheduled, in addition to the option to participate anywhere, via Zoom conferencing.

The response by TUN faculty was overwhelmingly favorable. The initial webinar series consisted of seven, 45-minute webinar topics. Participants were thrilled with the topics, but suggested that session times be adjusted for the various time zones, and that sessions be recorded. Following the initial pilot project, it was decided to invite TCUS libraries in California and at other New York locations to participate and to expand the research topics. Thus, in fall 2018, the research series included 18 webinars, contributed by five TCUS libraries, on such topics as: altmetrics; data management; open educational resources; ORCID; PubMed; and systematic reviews. Webinar times were adjusted for the various time zones, and sessions were recorded and linked from the libguide, whenever possible.

This collaboration amongst TCUS libraries has been a huge success. Together, we have been able to offer excellent webinars and videos, on a variety of research topics. It has also increased the value and visibility of our libraries. In the future, we hope to adapt research topics for course-integrated instruction or to offer session snippets at selected committee and departmental meetings. In addition, we would like to conduct pre- and post-test assessments in order to determine the impact that these research sessions have on faculty, staff, and student participants, and on library user satisfaction, overall.


Thursday June 13, 2019 3:10pm - 4:00pm PDT
Atrium, Fromm Hall

3:10pm PDT

(Poster) Services and Staffing Practices within Academic Libraries Serving College of Osteopathic Medicine Programs: A Mixed Methods Study
Objectives: To conduct a systematic assessment of services and staffing practices within academic libraries serving College of Osteopathic Medicine programs. To provide a description of core library services, detect trends in new services being offered, justify the need for additional services and staffing, and assist leadership within developing medical schools in planning for their future academic health sciences libraries.

Methods: Mixed methods study pursued through three phases. The first phase involved the identification of osteopathic medical schools and the contact information for the library directors, via publicly-facing websites. Phase two consisted of a review of the literature and survey of library directors of academic libraries serving college of osteopathic medicine programs. Additional questions developed for library leaders through phone interviews, which comprised the third phase of the study.

Results: There were a total of 35 COM libraries identified. While many of the COM library websites were easy to locate and provided useful information, some were hard to find and lacking in detail. In Phase Two of the study, 30/35 surveys were returned, the data is being analyzed, and details regarding the services and staffing will be provided. In Phase Three, in-depth questions were asked, and a summary of the results will be provided.

Conclusions: This study provides a comparison of services and staffing within academic libraries serving College of Osteopathic Medical programs. Library leaders, not only those affiliated with new medical schools, but also those affiliated with long-standing, and more traditional schools, can use this data to make a case for new resources, services, or staffing. In addition, medical school administrators may find opportunities in this study’s results for more productive collaborations with the library, in areas such as curriculum-integrated instruction, research development, and scholarly publishing. Finally, leaders within developing schools will become better informed about current library services being provided, and staffing trends, in order to plan for an appropriate budget and staffing for their future health sciences libraries.


Thursday June 13, 2019 3:10pm - 4:00pm PDT
Atrium, Fromm Hall

3:10pm PDT

(Poster) There will be no crying here: Privilege and power in libraries
Librarians exist in a professional and social world in which the vast majority of power holders are typically white, with white women being the largest group of librarians and white males holding the majority of authoritative positions within the profession. With a limited amount of literature currently published on the experiences of librarians bullied by their co-workers, there are many areas of possible research, including but not limited to, issues surrounding diversity and equity, the role and power of seniority, and generational experience. By examining the literature in other female dominated fields, such as nursing or other allied health professions, it is possible for librarians to look for proven strategies for working within an environment where power is inequality distributed and seniority is used to disenfranchise. This poster will present a review of the literature available on library work place bullying, a comparative review of the literature on allied health work place bullying, and make suggestions based on the collected research on how to more successfully cope, prevent, and address bullying experiences in the library workplace. The role of junior and senior librarians will be examined, as well the role and responsibilities of management and administration.


Thursday June 13, 2019 3:10pm - 4:00pm PDT
Atrium, Fromm Hall

3:10pm PDT

(Poster) We are not neutral! Increasing social justice awareness in science libraries through a series of interactive posters
In response to recent polarizing sociopolitical events, including initiatives to reverse DACA and discriminatory demonstrations, the Science Libraries created a series of interactive posters to promote campus inclusivity. The intent is to raise awareness and dismantle library neutrality in science libraries, and to create a space for social justice conversations. Our outreach initiatives included interactive exhibits and posters to engage patrons with social justice themes connected to science. So far our series has addressed: immigrant contributions in the sciences, an interactive campus community map, raising awareness about textbook costs, and highlighting national awareness months such as men’s health and poverty. This is an ongoing series and we plan to engage with future themes such accessibility/disability awareness, women in science, access to health resources for border refugees, socioeconomic effects of climate change, and more. Initial response has been enthusiastic, including a successful food drive, positive feedback through survey forms, and an observed increase in student engagement and conversation. The assessment of our initial series illustrates that our sciences community is actively interested in critically engaging with social justice issues, and the library can provide a safe space for these conversations.


Thursday June 13, 2019 3:10pm - 4:00pm PDT
Atrium, Fromm Hall

3:10pm PDT

(Poster) “Be Bold” and “Let’s Change That”: Wikipedia Engagement as a Critical Librarianship Practice
Wikipedia provides opportunities to discuss and take direct action on crit lib issues such as information privilege and systematic biases in publishing and on the Wikipedia site itself. For the past few years at my current institution, I’ve hosted a Wikipedia Edit-A-Thon during Women’s History Month. Our edit-a-thons have focused on editing Wikipedia articles related to women and art, but edit-a-thons focusing on women in science (https://go.nature.com/2w9nXuW) are also important. My poster presentation will outline the who, what, when, where, and most importantly, why you need to hold a Wikipedia Edit-A-Thon or engage in other wikipedia-related teaching and outreach. Not only do Wikipedia edit-a-thon participants learn the inner workings of a resource they use on a near daily basis, they become information activists equip with knowledge and tools to break down barriers to information and improve representation on Wikipedia and beyond.

Presenters

Thursday June 13, 2019 3:10pm - 4:00pm PDT
Atrium, Fromm Hall

4:00pm PDT

Reception
Thursday June 13, 2019 4:00pm - 6:00pm PDT
Atrium, Fromm Hall
 
Friday, June 14
 

8:00am PDT

Breakfast
Friday June 14, 2019 8:00am - 8:45am PDT
Atrium, Fromm Hall

8:00am PDT

Registration
Friday June 14, 2019 8:00am - 9:00am PDT
Atrium, Fromm Hall

8:45am PDT

Welcome Address
Friday June 14, 2019 8:45am - 9:00am PDT
Xavier, Fromm Hall

9:00am PDT

Plenary talk: Nicole A. Cooke
Dr. Nicole A. Cooke is an Associate Professor and the MSLIS Program Director at the School of Information Sciences, the University of Illinois at Urbana-Champaign. She holds an M.Ed in Adult Education from Pennsylvania State University, and an MLS and a Ph.D. in Communication, Information and Library Studies from Rutgers University. Her research and teaching interests include human information behavior (particularly in an online context), critical cultural information studies, and diversity and social justice in librarianship (with an emphasis on infusing them into LIS education and pedagogy). She was named a “Mover & Shaker” by Library Journal in 2007, and was the 2016 recipient of the American Library Association’s (ALA) Equality Award, and the 2017 Achievement in Library Diversity Research Award presented by ALA’s Office for Diversity, Literacy & Outreach. Her latest works are Information Services to Diverse Populations (Libraries Unlimited, 2016) and Fake News and Alternative Facts: Information Literacy in a Post-Truth Era (ALA Editions. 2018). http://www.nicolecooke.info/

Plenary Speakers
avatar for Nicole A. Cooke

Nicole A. Cooke

Associate Professor and MS/LIS Program Director, University of Illinois at Urbana-Champaign
Dr. Nicole A. Cooke is an Associate Professor and the MSLIS Program Director at the School of Information Sciences, the University of Illinois at Urbana-Champaign. She holds an M.Ed in Adult Education from Pennsylvania State University, and an MLS and a Ph.D. in Communication, Information... Read More →


Friday June 14, 2019 9:00am - 10:00am PDT
Xavier, Fromm Hall

10:00am PDT

Snack Break
Friday June 14, 2019 10:00am - 10:30am PDT
Berman, Fromm Hall

10:00am PDT

Exhibitors Hall Open
Friday June 14, 2019 10:00am - 12:30pm PDT
Berman, Fromm Hall

10:10am PDT

Vendor Lightning Talks
NEJM: Mike Tavares
Lippincott, Williams, and Wilkins (LWW): John Schwartz
EBSCO: Andrea Spector

Friday June 14, 2019 10:10am - 11:00am PDT
Maraschi, Fromm Hall

11:10am PDT

#critlib@work: How Can We Apply #critlib to Our Jobs?
Format: Unconference - All are welcome!

Purpose: This unconference is an interactive forum to provide structure for generating practical ideas to apply critical librarianship in the health sciences.

Description: This special content session will introduce participants to the format of a participatory-style unconference session as we collaboratively imagine ways to implement critical librarianship in the health sciences. After a brief overview of applied critical librarianship, participants will generate topics of discussion, break into groups, and brainstorm ideas to include critical librarianship in various aspects of the work we do. These groups will be facilitated by the authors and, at the end of the session, each team’s strategies will be documented and shared.

Participants will:
1. Critique our current practices of health sciences librarianship through the lens of critical librarianship.
2. Translate our existing knowledge and practices into a health sciences critical librarianship framework.
3. Strategize and document practical ways to incorporate critical librarianship into our everyday work.
4. Share small group outcomes.


Friday June 14, 2019 11:10am - 12:00pm PDT
Xavier, Fromm Hall

12:00pm PDT

Lunchtime Session: MLA/NNLM Panel
Lunch and MLA/NNLM Panel with a focus on critical librarianship in health sciences libraries,  Amanda Wilson (NNLM) an Beverly Murphy (MLA), Chris Shaffer (moderator)


Friday June 14, 2019 12:00pm - 1:30pm PDT
Maraschi, Fromm Hall

1:40pm PDT

MLGSCA Business Meeting
Friday June 14, 2019 1:40pm - 2:30pm PDT
Maraschi, Fromm Hall

1:40pm PDT

 
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