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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.  相似文献   
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This exploration of the role of information in helping people to develop and sustain feelings of belonging, or a sense of place, is based on a study that investigated the reasons for the high population turnover in the Northern Territory of Australia. The Northern Territory along with Darwin, its capital, has a number of unusual characteristics including geographical isolation. A key component of the theoretical framework for the research focuses on social information, which has similarities to the more commonly termed everyday life information. The specific concern is with the kind of information that helps people connect to a community and is clearly linked with social networking. The sample for the major empirical component for the article was recruited at Darwin's Mindil Beach Market. In telephone phone interviews with those who had agreed to participate, participants discussed how they learned about Darwin and the Northern Territory, and their views of Darwin as a place to live. Interpersonal contacts, including at the Market and at special events, were most often mentioned in relation to information, confirming literature findings on the importance of family and friends as an information source. Other sources were newspapers and physical markers around the City of Darwin. The conclusion is that the processes of social networking, which work well for some residents, could be enhanced through the use of information grounds, a concept widely discussed in the library and information science literature. Obvious information grounds in Darwin, where the usual processes could be enhanced by the distribution of information by formal information providers, include Mindil Beach Market and the special events for which Darwin is renowned.  相似文献   
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ABSTRACT

This article explores the influential role of planning on recognition-primed decision-making. Considerable prior thinking occurs and there is a need to trace and account for the cognitive processes that precede and guide decisions in dynamic outdoor environments. Seven expert leaders from four countries were interviewed about memorable decisions made on outdoor journeys with an educational focus on land, sea and ice. Four stages of planning were identified: (1) long-term preparation; (2) formal leadership meetings; (3) day-by-day planning on route and (4) thinking immediately prior to the event. The stages sequentially capture the planning progression, illuminating the cognitive processes at each stage to culminate in option selection. In each decision situation, planned goals and actions were implemented through the creation and re-creation of micro-plans. As windows of opportunity presented themselves, the flexible execution of plans was a key feature. Planning provided the solid bedrock upon which decisions were made.  相似文献   
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Estimation of the direct effect of an exposure on an outcome requires adjustment for confounders of the exposure–outcome and mediator–outcome relationships. When some of the latter confounders have been affected by the exposure, then standard regression adjustment is prone to possibly severe bias. The use of inverse probability weighting under so-called marginal structural models has recently been suggested as a solution in the psychological literature. In this article, we show how progress can alternatively be made via G-estimation. We show that this estimation method can be easily embedded within the structural equation modeling framework and could in particular be used for estimating direct effects in the presence of latent variables. Moreover, by avoiding inverse probability weighting, it accommodates the typical problem of unstable weights in the alternative estimation approaches based on marginal structural models. We illustrate the approach both by simulations and by the analysis of a longitudinal study in individiduals who ended a romantic relationship. In this example we explore whether the effect of attachment anxiety during the relationship on mental distress 2 years after the breakup is mediated by rumination or not.  相似文献   
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Several investigators have interpreted method effects associated with negatively worded items in a substantive way. This research extends those studies in different ways: (a) it establishes the presence of methods effects in further populations and particular scales, and (b) it examines the possible relations between a method factor associated with negatively worded items and several covariates. Two samples were assessed: 592 high school students from Valencia (Spain), and 285 batterers from the same city. The self-esteem scales used were Rosenberg's Self-Esteem Scale, the State Self-Esteem Scale, and Self-Esteem 17. Anxiety was also assessed with the State-Trait Anxiety Inventory, and gender and educational level were taken into account. The models were conducted using a multiple indicators and multiple causes (MIMIC) model framework. The evidence in this research pointed out that method effects were present across the different measures of self-esteem. Moreover, a significant and negative effect of anxiety on method effects was present across scales and samples, whereas no effects of age or educational level where found.  相似文献   
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Seventy-six children ages 3 to 5 were individually read two storybooks that had been specially formatted to contain salient printed words within the text, and illustrations and text on left or right-facing pages. The reader pointed to each word while reading to half of the children. After each book, children were asked to recognize elements of the illustrations and the specially formatted text elements from among a set of foils. Videotaped sessions were coded for the time children spent looking toward the pages with print versus illustrations. Analyses showed that the percentage of time looking at print was less than 2% in the no-pointing condition but increased with age. Pointing to the words increased print-looking time for all age groups and print target recognition for 4-year-olds. After controlling for receptive vocabulary, visual memory, and maturation associated with these scores, emergent orthography and letter-word identification predicted time looking at print and recognition of the print elements.  相似文献   
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Changes in the profession of medicine are creating the demand for a substantive reexamination of current practices in medical education. Many of the major issues in addressing this challenge are structural and political rather than scientific; here we address one critical scientific issue that will be important to (though not by itself adequate for) guiding such changes. The factor we address is the development of a global performance assessment: a standardized mechanism to assess individual skills and abilities that can be used to evaluate alternative educational interventions. We discuss the issues involved in developing such a system, and describe a set of principles for defining desired outcomes and developing assessment tools, including (a) wide clinical scope, (b) direct relationship to actual clinical performance, (c) reliability and repeatability, and (d) non-longitudinal measurement. We discuss the role of simulation, reflective practice, and portfolios of work in developing such a system, and argue that whatever form such metrics take, a system of global performance assessment will develop from close collaboration between clinicians and educators with innovative ways of thinking about performance and expertise.  相似文献   
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