The value and impact of information provided through library services for patient care: a systematic review

OBJECTIVE: An updated systematic review was carried out of research studies looking at the value and impact of library services on health outcomes for patients and time saved by health professionals. METHODS: A comprehensive systematic search was undertaken of the published literature to September 2003 in ERIC, LISA, MEDLINE, PREMEDLINE, EMBASE, the Cochrane Controlled Trials Register and Google. Some handsearching was carried out, reference lists were scanned and experts in the field were contacted. Twenty-eight research studies of professionally led libraries for health-care staff, including clinical librarian projects, met the inclusion criterion of at least one health or 'time saved' outcome. Papers were critically appraised using internationally accepted criteria. Data were extracted and results were summarised using a narrative format as the studies were heterogeneous and precluded a statistical analysis. RESULTS: There is evidence of impact from both traditional and clinical librarian services. The higher quality studies of traditional services measured impacts of 37-97% on general patient care, 10-31% on diagnosis, 20-51% on choice of tests, 27-45% on choice of therapy and 10-19% on reduced length of stay. Four studies of clinical librarian projects suggested that professionals saved time as a result of clinical librarian input, and two of these studies showed evidence of cost-effectiveness. However, the clinical librarian studies were generally smaller, with poorer quality standards. CONCLUSIONS: Research studies suggest that professionally led library services have an impact on health outcomes for patients and may lead to time savings for health-care professionals. The available studies vary greatly in quality but the better quality studies also suggest positive impacts. Good practice can be gathered from these studies to guide the development of a pragmatic survey for library services that includes the direct effects for patients among the outcome measures.     

Multitrait-multimethod investigation of a novel body image measurement technique

A multitrait-multimethod (MTMM) matrix was used to evaluate validity evidence for a digital image manipulation (DIM) body image measurement technique in young women. One hundred one young women completed the DIM procedure and the Thompson and Gray (1995) Contour Drawing Rating Scale to measure self-ideal discrepancy and size perception accuracy components of body image. Seven-day test-retest reliability was acceptable (R = .81-.95). Convergent validity for self-ideal discrepancy was higher (r = .74) than the corresponding heterotrait, monomethod coefficients (r = .46, r = .23) and heterotrait-heteromethod coefficients (r = .18, r = .12). However, the convergent validity coefficient for size perception accuracy was r = .12. The pattern of correlations in the MTMM matrix met the criteria of Campbell and Fiske (1959) for validity of these procedures to measure self-ideal discrepancy but not size perception accuracy. The DIM procedure addresses some of the criticisms associated with figure-rating scales, such as unrepresentativeness of the figures, scale coarseness, and restriction of range in responses. DIM, therefore, represents a realistic, valid alternative to figure-rating scales for measuring self-ideal discrepancy.     

Analysis of a laminar-flow diffusional mixer for directed self-assembly of liposomes

The present work describes the operation and simulation of a microfluidic laminar-flow mixer. Diffusive mixing takes place between a core solution containing lipids in ethanol and a sheath solution containing aqueous buffer, leading to self assembly of liposomes. Present device architecture hydrodynamically focuses the lipid solution into a cylindrical core positioned at the center of a microfluidic channel of 125 × 125-μm² cross-section. Use of the device produces liposomes in the size range of 100–300 nm, with larger liposomes forming at greater ionic strength in the sheath solution and at lower lipid concentration in the core solution. Finite element simulations compute the concentration distributions of solutes at axial distances of greater than 100 channel widths. These simulations reduce computation time and enable computation at long axial distances by utilizing long hexahedral elements in the axial flow region and fine tetrahedral elements in the hydrodynamic focusing region. Present meshing technique is generally useful for simulation of long microfluidic channels and is fully implementable using comsol Multiphysics. Confocal microscopy provides experimental validation of the simulations using fluorescent solutions containing fluorescein or enhanced green fluorescent protein.     

Validity and reliability of GPS for measuring instantaneous velocity during acceleration, deceleration, and constant motion

In this study, we assessed the validity and reliability of 5 and 10 Hz global positioning systems (GPS) for measuring instantaneous velocity during acceleration, deceleration, and constant velocity while straight-line running. Three participants performed 80 running trials while wearing two GPS units each (5 Hz, V2.0 and 10 Hz, V4.0; MinimaxX, Catapult Innovations, Scoresby, VIC, Australia). The criterion measure used to assess GPS validity was instantaneous velocity recorded using a tripod-mounted laser. Validity was established using the standard error of the estimate (± 90% confidence limits). Reliability was determined using typical error (± 90% confidence limits, expressed as coefficient of variation) and Pearson's correlation. The 10 Hz GPS devices were two to three times more accurate than the 5 Hz devices when compared with a criterion value for instantaneous velocity during tasks completed at a range of velocities (coefficient of variation 3.1-11.3%). Similarly, the 10 Hz GPS units were up to six-fold more reliable for measuring instantaneous velocity than the 5 Hz units (coefficient of variation 1.9-6.0%). Newer GPS may provide an acceptable tool for the measurement of constant velocity, acceleration, and deceleration during straight-line running and have sufficient sensitivity for detecting changes in performance in team sport. However, researchers must account for the inherent match-to-match variation reported when using these devices.     

The effects of exercise in hypoxic and normoxic conditions on endothelin-1 and arterial compliance

The purpose of this study was to determine the effects of short-term normoxic and hypoxic exercise on plasma endothelin-1 and nitric oxide levels, and the relationship of arterial compliance and pulmonary artery pressure to endothelin-1. Seven endurance-trained males completed two incremental and two steady-state exercise tests performed at ventilatory threshold in normoxia and hypoxia (fraction of inspired oxygen = 0.14). Plasma endothelin-1was measured throughout steady-state tests. Arterial compliance using applanation tonometry, plasma nitric oxide and pulmonary artery pressure using Doppler echocardiography were measured before and after exercise. Small arterial compliance and pulmonary artery pressure significantly increased following exercise. There were no main effects of condition or time for plasma endothelin-1and nitric oxide levels. There were no significant relationships between plasma endothelin-1 and arterial compliance or pulmonary artery pressure. In conclusion, mechanisms other than the endothelial system may play a role in the exercise-induced changes in small artery compliance in this study population. Moderate hypoxia and a 30-minute steady-state exercise have limited effects on plasma endothelin-1 in endurance-trained males.     

The 'mandarin-missionary' strategy: Robert Kennicott, Spencer Fullerton Baird and specimen collection in the Hudson's Bay Territory

In 1859, Robert Kennicott, one of the most promising specimen collectors and young naturalists in the United States, was dispatched to Hudson's Bay Territory by Spencer Fullerton Baird, the Assistant Secretary of the Smithsonian. Kennicott was chosen because of previous experience in Canada, the familiarity with biota of the American Midwest, and because he had a boundless, infectious, enthusiasm for natural history that was typical among Baird's closest protégées. Kennicott was a natural scientific envoy--or missionary--to the officers of the Hudson's Bay Company, and many officers were enthusiastically 'converted' to the cause of collecting and/or overseeing the collection of natural history specimens. Due to this collaboration between Baird, Kennicott and the officers of the Hudson's Bay Company, the Smithsonian became a leading center of Canadian natural history in the Western hemisphere.