Public library use of free e-resources

This article describes a multi-method research project examining the use of various freely available online collections and projects, such as Project Gutenberg, the Internet Archive, and Creative Commons-licensed ebooks, by public libraries. This research begins with the questions: what are libraries doing with freely available materials? Are there barriers to incorporating them into the collection? What role are librarians playing in expanding access and awareness of these resources

Incidence and prevalence of falls in adults living with an intellectual disability living in the community: A systematic review

Review question/objective: The objective of this review is to synthesize the best available evidence to determine the incidence and prevalence of falls in adults with intellectual disability living in the community

Evaluation of the national policy of single screening and treatment for the prevention of malaria in pregnancy in two districts in Eastern Indonesia: health provider perceptions

Background Malaria in pregnancy has devastating consequences for both the expectant mother and baby. Annually, 88.2 (70%) of the 125.2 million pregnancies in malaria endemic regions occur in the Asia–Pacific region. The control of malaria in pregnancy in most of Asia relies on passive case detection and prevention with long-lasting insecticide-treated nets. Indonesia was the first country in the region to introduce, in 2012, malaria screening at pregnant women’s first antenatal care visit to reduce the burden of malaria in pregnancy. The study assessed health providers’ acceptability and perceptions on the feasibility of implementing the single screening and treatment (SST) strategy in the context of the national programme in two endemic provinces of Indonesia. Methods Qualitative data were collected through in-depth interviews with 86 health providers working in provision of antenatal care (midwives, doctors, laboratory staff, pharmacists, and heads of drug stores), heads of health facilities and District Health Office staff in West Sumba and Mimika districts in East Nusa Tenggara and Papua provinces, respectively. Results Health providers of all cadres were accepting of SST as a preventive strategy, showing a strong preference for microscopy over rapid diagnostic tests (RDTs) as the method of screening. Implementation of the policy was inconsistent in both sites, with least extensive implementation reported in West Sumba compared to Mimika. SST was predominantly implemented at health centre level using microscopy, whereas implementation at community health posts was said to occur in less than half the selected health facilities. Lack of availability of RDTs was cited as the major factor that prevented provision of SST at health posts, however as village midwives cannot prescribe medicines women who test positive are referred to health centres for anti-malarials. Few midwives had received formal training on SST or related topics. Conclusions The study findings indicate that SST was an acceptable strategy among health providers, however implementation was inconsistent with variation across different localities within the same district, across levels of facility, and across different cadres within the same health facility. Implementation should be re-invigorated through reorientation and training of health providers, stable supplies of more sensitive RDTs, and improved data capture and reporting

Expanding Disease Definitions in Guidelines and Expert Panel Ties to Industry:A Cross-sectional Study of Common Conditions in the United States

BACKGROUND: Financial ties between health professionals and industry may unduly influence professional judgments and some researchers have suggested that widening disease definitions may be one driver of over-diagnosis, bringing potentially unnecessary labeling and harm. We aimed to identify guidelines in which disease definitions were changed, to assess whether any proposed changes would increase the numbers of individuals considered to have the disease, whether potential harms of expanding disease definitions were investigated, and the extent of members' industry ties. METHODS AND FINDINGS: We undertook a cross-sectional study of the most recent publication between 2000 and 2013 from national and international guideline panels making decisions about definitions or diagnostic criteria for common conditions in the United States. We assessed whether proposed changes widened or narrowed disease definitions, rationales offered, mention of potential harms of those changes, and the nature and extent of disclosed ties between members and pharmaceutical or device companies. Of 16 publications on 14 common conditions, ten proposed changes widening and one narrowing definitions. For five, impact was unclear. Widening fell into three categories: creating “pre-disease”; lowering diagnostic thresholds; and proposing earlier or different diagnostic methods. Rationales included standardising diagnostic criteria and new evidence about risks for people previously considered to not have the disease. No publication included rigorous assessment of potential harms of proposed changes. Among 14 panels with disclosures, the average proportion of members with industry ties was 75%. Twelve were chaired by people with ties. For members with ties, the median number of companies to which they had ties was seven. Companies with ties to the highest proportions of members were active in the relevant therapeutic area. Limitations arise from reliance on only disclosed ties, and exclusion of conditions too broad to enable analysis of single panel publications. CONCLUSIONS: For the common conditions studied, a majority of panels proposed changes to disease definitions that increased the number of individuals considered to have the disease, none reported rigorous assessment of potential harms of that widening, and most had a majority of members disclosing financial ties to pharmaceutical companies. Please see later in the article for the Editors' Summar

A novel approach to welfare interventions in problem multi-cat households

BackgroundThousands of injured, stray and relinquished cats are received at the RSPCA Greater Manchester Animal Hospital each year. A significant and challenging proportion of these cats are confiscated from multicat households by RSPCA Inspectors, due to the owners’ inability to care for them. These households share many characteristics of animal hoarding, including poor owner compliance with suggested welfare improvements and recidivism. The relatively poor adoption potential of animals from such households are a perennial problem for the charity.The aim of this study was to determine if offering female cat neutering assistance to multi-cat owners significantly improved colony welfare.ResultsTen multicat households with a history of public complaint to the RSPCA were recruited. An RSPCA veterinary surgeon (VS) initially assessed the overall welfare of each household’s cat population, individual cat welfare and the living environment. All entire female cats aged over 8 weeks were neutered and basic animal care education provided. Follow up visits were completed two and 12 months later to reassess welfare parameters and population numbers.The total number of cats was 176 across ten households (range 7–33, median 16). All owners consented to having all entire female cats spayed. At the first visit, mean individual cat welfare scores ranged from 5.4–8.7/ 16 across the 10 households, where 16 represented best possible welfare.Overall household mean welfare scores were significantly improved at both the 2 month and 12 month revisits (p = 0.011 and p = 0.01 respectively) when compared to the initial visits. By the end of the study period, three out of the ten households had voluntarily relinquished all of their cats, and overall there was a 40% reduction in the number of cats.ConclusionsAnimal hoarding has previously been an intractable welfare concern with little evidence informing intervention techniques. These results show that positive veterinary engagement on site, focused on preventative care and population control, can yield significant improvement in welfare scoring systems in relatively short timescales. Promptly collecting and neutering all female cats at a site, combined with advice and support, show promise in improving welfare

Trial feasibility and process evaluation of a motivationally-embellished group peer led walking intervention in retirement villages using the RE- AIM framework: the residents in action trial (RiAT)

Objective: The Residents in Action Trial (RiAT; ACTRN12616001177448) was a 16-week motivationally-embellished peer-led walking intervention designed to increase walking, reduce sitting, and improve mental health and well-being in insufficiently active residents in retirement villages. In this paper we report on 1) trial feasibility and acceptability, and 2) evaluate the processes involved in the implementation of the intervention using the RE- AIM framework. Method: A mixed methods design was employed, consisting of data from accelerometers, surveys, (individual, pair-based and focus group) interviews, and participant logbooks. Participants included 116 walkers (M(SD) age=78.37(8.30); 92% female), 8 peer leaders (i.e. ambassadors) and 3 retirement village managers from 14 retirement villages. Descriptives and linear mixed modelling were used to analyse the quantitative data and inductive thematic analyses were employed to analyse the interview data. Results: The intended cluster randomised controlled design became quasi-experimental due to insufficient numbers of recruited ambassadors. The perceived burden of the number and frequency of research assessments was a frequently mentioned reason for a poor recruitment. Facilitators to walking maintenance were the use of self-monitoring, goal setting, social support, and having a routine. Reach was modest (about 14% of eligible participants were recruited from each village), but retention was excellent (92%). The motivational strategies taught appeared to have been implemented, at least in part, by the ambassadors. The walkers in the main experimental condition increased marginally their step counts, but there were no group differences on mental health and well-being outcomes, partly because of low statistical power. Conclusions: Walkers and ambassadors who did take part in the study suggested that they enjoyed the programme and found it useful in terms of becoming more active and making social connections. However, the group format was not appealing to some participants, hence, other delivery options should be explored in the future

Back to school for malaria prevention: a new tool in the era of malaria elimination?

Children and pregnant women are vulnerable groups for malaria. Among children, research to date has focussed on pre-school children (aged <5 years) because this group bears the brunt of malaria illness and deaths. With changing malaria endemicity, however, vulnerability patterns among children of different age groups may change.1 Furthermore, children aged 5-15 years predominantly have the highest risk of asymptomatic malaria and gametocytaemia, and yet low use of long-lasting insecticide treated nets which puts them at risk.1,2 As part of global efforts to reduce and eliminate malaria transmission, it is only logical to find effective malaria prevention strategies for school children

Differences in physical activity and sedentary time in relation to weight in 8-9 year old children.

BACKGROUND: The health benefits of physical activity for children are well established. Although objective measures of physical activity are increasingly used there is still a lack of adequate data on physical activity in children. Sex differences in physical activity have been consistently demonstrated and lower levels of physical activity in obese than non-obese children have been shown. However, differences across the whole weight spectrum have not been examined in detail. The aim of this study was to assess associations between physical activity and sedentary time across the weight spectrum in children, and to determine whether the associations differed by sex. METHODS: Participants in the current study were 176 boys and 169 girls aged 8-9 years old taking part in a longitudinal study of associations between eating behaviours, physical activity and weight gain during childhood. Height, weight and waist circumference were measured, and physical activity data were collected using an Actigraph model GT1M worn for 5 consecutive days. Associations between sex, weight and physical activity were analysed using linear regression models. RESULTS: Boys had higher total activity (mean difference = 119, p < 0.001) and more minutes of moderate and vigorous physical activity (MVPA) (mean difference = 25, p < 0.001) than girls. A higher percentage of boys (72%) than girls (30%) met current physical activity guidelines of 60 minutes MVPA per day. In boys, weight status significantly predicted total activity (p = 0.001) and MVPA (p = 0.001) but there were no significant associations in girls. There was no significant difference in time spent sedentary between boys and girls, and weight status did not predict sedentary time. CONCLUSION: In boys, physical activity was progressively lower across the weight spectrum, but in girls physical activity was consistently low across all weight categories. Intervention is required prior to 8 years old to prevent weight-related declines in physical activity in boys and further research is required to determine at what age, if ever, weight related differences in physical activity are apparent in girls.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

Challenges and opportunities associated with the introduction of next generation long lasting insecticidal nets for malaria control: a case study from Burkina Faso.

BACKGROUND Reductions in malaria incidence in Africa can largely be attributed to increases in malaria vector control activities; predominately the use of long lasting insecticidal nets (LLINs). With insecticide resistance affecting an increasing number of malaria endemic countries and threatening the effectiveness of conventional LLINs, there is an increasing urgency to implement alternative tools that control these resistant populations. The aim of this study was to identify potential challenges and opportunities for accelerating access to next generation LLINs in Burkina Faso, a country with areas of high levels of insecticide resistance. METHODS An analytical framework was used to guide the selection of interviewees, data collection and analysis. Semi structured interviews were carried out with key informants in April 2014 in Burkina Faso. Interviews were conducted in French and English, audio recorded, transcribed and entered into NVivo10 for data management and analysis. Data were coded according to the framework themes and then analysed to provide a description of the key points and explain patterns in the data. RESULTS Interviewees reported that the policy architecture in Burkina Faso is characterised by a strong framework of actors that contribute to policymaking and strong national research capacity which indirectly contributes to national policy change via collaboration with internationally led research. Financing significantly impacts the potential adoption, availability and affordability of next generation LLINs. This confers significant power on international donors that fund vector control. National decisions around which LLINs to procure were restricted to quantity and delivery dates; the potential to tackle insecticide resistance was not part of the decision-making process. Furthermore, at the time of the study there was no World Health Organisation (WHO) guidance on where and when next generation LLINs might positively impact on malaria transmission, severely limiting their adoption, availability and affordability. CONCLUSIONS This study shows that access to next generation LLINs was severely compromised by the lack of global guidance. In a country like Burkina Faso where WHO recommendations are relatively quickly adopted, a clear WHO recommendation and adequate financing will be key to accelerate access to next generation LLINs. Key Words: Malaria, Next generation long lasting insecticidal nets, LLINs, PBO nets, Policy Analysis, Vector Control, Burkina Faso