Jourhavande bibliotekarie

Myndigheten för Sveriges nätuniversitet beviljade hösten 2002 medel till projektet Jourhavande bibliotekarie med projekttiden jan 2003 dec 2004. Eftersom alltfler studenter läser kurser och utbildningar som inte är beroende av närvaro på campus har syftet varit att erbjuda högskolestudenter och anställda nätbaserad personlig vägledning i informationssökning. Tjänsten bygger på chatt med co-browsing, (student och bibliotekarie delar samma webbfönster) som kompletteras av en e-postfunktion. Projektet har bedrivits som ett samverkansprojekt mellan högskole- och universitetsbiblioteken i Jönköping, Kungl Tekniska högskolan, Mitthögskolan och Lund. Tanken har varit att skapa en nationell tjänst på kvällar och helger som är de tider då det är kostsamt att hålla öppet för att nå kostnadseffektivitet och kunna dra nytta av olika kompetenser. Femton högskole- och universitetsbibliotek deltar idag i tjänsten, ytterligare två har anmält sitt deltagande med start 2005. Alla deltagande bibliotek har som komplement motsvarande lokala tjänster under dagtid för det egna lärosätets studenter och anställda. Resultatet av de två enkätomgångar som har vänt sig till användare visar att de allra flesta är nöjda med den sökhjälp och vägledning de fått. Bland de som valt chatt anser nästan alla att de haft en fungerande chattdialog med bibliotekarien. Överhuvudtaget värderas chatt som en mycket bra eller bra kommunikationsform i jämförelse med andra sätt att kommunicera. Ett annat intressant resultat av enkäterna är att mer än hälften av användarna uppger att de är campusstudenter, 10% svarar att de är distansstudenter medan 20% att de är anställda. Användningen av tjänsten har stadigt ökat men statistiken visar fortfarande ett relativt lågt användande. Tänkbara förklaringar är att tjänsten är ny och att det krävs tid för att etablera nya arbetssätt. Avgörande för nyttjandegraden är självklart att våra målgrupper högskolestudenter och anställda känner till och enkelt hittar en ingång till tjänsten. Fortsatt marknadsföring i olika sammanhang på universitet och högskolor är av största vikt liksom via folkbibliotekens informationsdiskar och via landets lärcentra

A systematic review of educational programs and consumer protection measures for gambling : an extension of previous reviews

Introduction: Besides supply reduction, preventive interventions to reduce harm from gambling include interventions for the reduction of demand and to limit negative consequences. Several interventions are available for gamblers, e.g. limit-setting. Reviews have been published examining the evidence for specific measures as well as evaluating the effect of different measures at an overall level. Only a few of these have used a systematic approach for their literature review. The aim of this systematic review and meta-analysis is twofold. First, to assess the certainty of evidence of different preventive measures in the field of educational programs and consumer protection measures, including both land-based and online gambling. The second is to present shortcomings in eligible studies to highlight what type of information is needed in future studies. Method: This systematic review included measures administered in both real-life settings and online. Twenty-eight studies fulfilled our inclusion criteria and had low or moderate risk of bias. Results: The results showed that only two measures (long term educational programs and personalized feed-back) had an impact on gambling behavior. Follow-up period was short, and measures did not include gambling as a problem. The certainty in most outcomes, according to GRADE, was very low. Several shortcomings were found in the studies. Discussion: We concluded that the support for preventive measures is low and that a consensus statement regarding execution and methods to collect and analyze data for preventive gambling research is needed. Our review can serve as a starting point for future responsible gambling reviews since it evaluated certainty of evidence

Psychological, pharmacological, and combined treatments for binge eating disorder : A systematic review and metaanalysis

Objective: To systematically review the efficacy of psychological, pharmacological, and combined treatments for binge eating disorder (BED). Method: Systematic search and meta-analysis. Results: We found 45 unique studies with low/medium risk of bias, and moderate support for the efficacy of cognitive behavior therapy (CBT) and CBT guided selfhelp (with moderate quality of evidence), and modest support for interpersonal psychotherapy (IPT), selective serotonin reuptake inhibitors (SSRI), and lisdexamfetamine (with low quality of evidence) in the treatment of adults with BED in terms of cessation of or reduction in the frequency of binge eating. The results on weight loss were disappointing. Only lisdexamfetamine showed a very modest effect on weight loss (low quality of evidence).While there is limited support for the longterm effect of psychological treatments, we have currently no data to ascertain the long-term effect of drug treatments. Some undesired side effects are more common in drug treatment compared to placebo, while the side effects of psychological treatments are unknown. Direct comparisons between pharmaceutical and psychological treatments are lacking as well as data to generalize these results to adolescents. Conclusion: We found moderate support for the efficacy of CBT and guided selfhelp for the treatment of BED. However, IPT, SSRI, and lisdexamfetamine received only modest support in terms of cessation of or reduction in the frequency of binge eating. The lack of long-term follow-ups is alarming, especially with regard to medication. Long-term follow-ups, standardized assessments including measures of quality of life, and the study of underrepresented populations should be a priority for future research

Arginine and Caries Prevention : A Systematic Review

Objectives: To evaluate the available evidence that the use of arginine-containing dental care products prevents the development of new caries lesions and the progression of existing lesions. Search Methods: We performed a systematic literature search of databases including PubMed, the Cochrane Library and EMBASE. Selection Criteria: We selected randomized controlled trials of treatment with arginine in fluoride-containing dental products measuring dental caries incidence or progression in children, adults and elderly subjects. Data Collection and Analysis: Two review authors independently assessed trials for risk of bias and evaluated overall study quality using the GRADE classification. Main Results: Due to conflicts of interest and weak transferability to Swedish conditions, no conclusions can be drawn from studies on the effects of arginine-fluoride toothpaste in children. Arginine-containing toothpaste costs about 40% more than basic fluoride toothpaste; to determine whether it is more cost-effective, the higher cost must be considered in relation to any additional caries-preventive effect. The literature review also disclosed some questionable research ethics: in several of the studies, the children in the control group used non-fluoride toothpaste. Toothpaste without fluoride is not as effective against dental caries as the standard treatment - fluoride toothpaste - which has a well -documented effect. This contravenes the fundamental principles of research ethics. Conclusion: At present there is insufficient evidence in support of a caries-preventive effect for the inclusion of arginine in toothpastes. More rigorous studies, and studies which are less dependent on commercial interests, are required. (C) 2016 S. Karger AG, Base

Treatment of humerus fractures in the elderly: A systematic review covering effectiveness, safety, economic aspects and evolution of practice.

OBJECTIVES:The objective of this Health Technology Assessment was to evaluate effectiveness, complications and cost-effectiveness of surgical or non-surgical treatment for proximal, diaphyseal or distal fractures of the humerus in elderly patients. Secondary objectives were to evaluate the intervention costs per treatment of proximal humerus fractures (PHF) and to investigate treatment traditions of PHF in Sweden. METHODS AND FINDINGS:The assessment contains a systematic review of clinical and health economic studies comparing treatment options for humerus fractures in elderly patients. The results regarding the effectiveness of treatments are summarized in meta-analyses. The assessment also includes a cost analysis for treatment options and an analysis of registry data of PHF. For hemiarthroplasty (HA) and non-operative treatment, there was no clinically important difference for moderately displaced PHF at one-year follow-up regarding patient rated outcomes, (standardized mean difference [SMD]) -0.17 (95% CI: -0.56; 0.23). The intervention cost for HA was at least USD 5500 higher than non-surgical treatment. The trend in Sweden is that surgical treatment of PHF is increasing. When functional outcome of percutaneous fixation/plate fixation/prosthesis surgery and non-surgical treatment was compared for PHF there were no clinically relevant differences, SMD -0.05 (95% CI: -0.26; 0.15). There was not enough data for interpretation of quality of life or complications. Evidence was scarce regarding comparisons of different surgical options for humerus fracture treatment. The cost of plate fixation of a PHF was at least USD 3900 higher than non-surgical treatment, costs for complications excluded. In Sweden the incidence of plate fixation of PHF increased between 2005 and 2011. CONCLUSIONS:There is moderate/low certainty of evidence that surgical treatment of moderately displaced PHF in elderly patients has not been proven to be superior to less costly non-surgical treatment options. Further research of humerus fractures is likely to have an important impact

Treatment of radius or ulna fractures in the elderly: A systematic review covering effectiveness, safety, economic aspects and current practice.

BACKGROUND:The objective of the present study was to evaluate effectiveness, complications and cost-effectiveness of any surgical or non-surgical treatment for radius or ulna fractures in elderly patients. Secondary objectives were to analyze present treatment traditions of distal radius fractures (DRF) in Sweden and to calculate resource usage for its treatment. METHODS AND FINDINGS:The assessment contains a systematic review of clinical and health economic studies comparing treatment options for radius or ulna fractures. The results regarding the effectiveness of the treatments are summarized in meta-analyses. In addition, the assessment contains a cost analysis for different treatment options commonly used for DRF care, and an analysis of registry data on the incidence and treatment of DRF. In total 31 randomized controlled trials were included in meta-analyses. When comparing functional outcome for plate fixation versus non-surgical treatment for DRF, there were no clinically important differences at one-year follow-up (mean difference [MD], -3.29, 95% CI, -7.03; 0.44). Similar results were found when comparing plating and percutaneous methods with respect to functional outcome (standardized mean difference [SMD], -0.07, 95% CI, -0.21; 0.07) and grip strength (MD, -3.47, 95% CI, -11.21; 4.28). There were no differences for minor complications, (risk difference [RD], -0.01, 95% CI, -0.07; 0.05) whereas major complications were less common for the percutaneous group, (RD, 0.02, 95% CI, 0.02; 0.03). Given the low number of studies, the evidence above was rated as moderate certainty. The cost for plate fixation versus plaster cast was estimated to 1698 compared to 137 US dollars. For DRF, plate fixation increased in Sweden between 2005 and 2013, and was the most common surgical method in 2013. CONCLUSIONS:Surgical treatment of moderately displaced distal radius fractures in elderly patients offers no clear benefit compared to non-surgical treatment. Plating procedures have become more common during the second millennium and involve higher costs and higher risk of major complications than percutaneous options