Library Resources: Procurement, Innovation and Exploitation in a Digital World

The possibilities of the digital future require new models for procurement, innovation and exploitation. Emma Crowley and Chris Spencer describe the skills staff need to deliver resources in hybrid and digital environments. The chapter demonstrates the innovative ways that librarians use to procure and exploit the wealth of resources available in a digital world. They also describe the technological developments that can be adopted to improve workflow processes and they highlight the challenges faced on this fascinating journey

Management and Support of Uninsured Patients with Diabetes Type II Within a Nurse Managed Clinic

The purpose of the project was to improve the quality of care for the uninsured, Type II Diabetics residing in a Midwestern urban underserved community. Community Health in Partnership Services (CHIPS) was a nurse-managed clinic, located in that area, that sought to lessen the burden of being uninsured. An annual fee of $35.00 allowed an uninsured community member access to a variety of different health care providers including specialists. In order to utilize this health care team efficiently, it was necessary to implement nurse-led care coordination for patients diagnosed with Type II Diabetes. This quality improvement project followed the Plan Do Study Act (PDSA) cycle to implement a quasi-experimental uncontrolled before and after design involving a retrospective review. A conveniencesample of 24 patients was obtained from CHIPS clientele. After 60 days of implementation, following a PDSA cycle, the data were analyzed using Minitab Statistical Analysis program. Once the results were analyzedand theproject concluded, the null hypothesis stated that the mean difference in HbA1C before and after implementation of care coordination would not be impacted by the implementation of care coordination and seeing a primary care provider in 2019. The p-value presented a

Externalising behaviour problems and the influence of classroom environments in the early school years ; student-teacher relationships and teacher discipline: Their relation to the externalising behaviours of kindergarten to year 1 students

Some of the most influential people in a child\u27s life are the teachers who aid them in their transition into the education system and the complex social environment that it brings (Blancher & Eisenhower, 2006). Children who display externalising behaviours early in childhood often experience greater difficulties than other children when entering school and throughout their education experience (Hinshaw, Lahey & Hart, 1993; Liu, 2004). The student-teacher relationship established within the classroom and the disciplinary measures utilized by the teachers can have a profound impact on the child\u27s development both academically and socially (Galen & Underwood, 1997; Hamre & Pianta, 2001). Interventions focusing on these areas within the classroom can be essential resources in assisting to redirect the externalising behaviour problems displayed by children before more severe disorders develop later in adolescence and adulthood (Gottfredson & Hirschi, 1990; Moffitt, 1993). Children who display externalising behaviour problems often face difficulties in their academic and social development within the education system. Student-teacher relationships and teacher disciplinary techniques can be essential components of intervention strategies to redirect these externalising behaviours. This study used a crosssectional, correlational design to examine the influence of student-teacher relationships and teacher disciplinary techniques on students\u27 externalising behaviours. Results indicated student-teacher relationships as a significant predictor with closeness/warmth student-teacher relationships and intrinsic disciplinary techniques negatively correlating with externalising behaviours and conflict/negative interaction positively correlating with externalising behaviours. However, extrinsic disciplinary techniques unexpectedly negatively correlated with students\u27 externalising behaviours. Further research is needed on the relationships between student-teacher relationships and teacher disciplinary techniques

GP perspectives on hospital discharge letters : an interview and focus group study

Background: Written discharge communication following inpatient or outpatient clinic discharge is essential for communicating information to the GP, but GPs’ opinions on discharge communication are seldom sought. Patients are sometimes copied into this communication, but the reasons for this variation, and the resultant effects, remain unclear. Aim: To explore GP perspectives on how discharge letters can be improved in order to enhance patient outcomes. Design & setting: The study used narrative interviews with 26 GPs from 13 GP practices within the West Midlands, England. Method: Interviews were transcribed and data were analysed using corpus linguistics (CL) techniques. Results Elements pivotal to a successful letter were: diagnosis, appropriate follow-up plan, medication changes and reasons, clinical summary, investigations and/or procedures and outcomes, and what information has been given to the patient. GPs supported patients receiving discharge letters and expounded a number of benefits of this practice; for example, increased patient autonomy. Nevertheless, GPs felt that if patients are to receive direct discharge letter copies, modifications such as use of lay language and avoidance of acronyms may be required to increase patient understanding. Conclusion: GPs reported that discharge letters frequently lacked content items they assessed to be important; GPs highlighted that this can have subsequent ramifications on resources and patient experiences. Templates should be devised that put discharge letter elements assessed to be important by GPs to the forefront. Future research needs to consider other perspectives on letter content, particularly those of patients

Investigating the effects of antiepileptic drugs on the electrophysiology of vision

The principal aim of this work was to examine the effects of antiepileptic drugs (AEDs) on vision. Vigabatrin acts by increasing GABA at brain inhibitory synapses by irreversibly binding to GABA-transaminase. Remacemide is a novel non-competitive NMDA receptor antagonist and fast sodium channel inhibitor that results in the inhibition of the NMDA receptors located in the neuronal membrane calcium channels increasing glutamate in the brain. Vigabatrin has been shown to cause a specific pattern of visual field loss, as one in three adults taking vigabatrin have shown a bilateral concentric constriction. Remacemide has unknown effects on vision. The majority of studies of the effects of AEDs on vision have not included the paediatric population due to difficulties assessing visual field function using standard perimetry testing. Evidently an alternative test is required to establish and monitor visual field problems associated with AEDs both in children and in adults who cannot comply with perimetry. In order to test paediatric patients exposed to vigabatrin, a field-specific visual evoked potential was developed. Other tests performed on patients taking either vigabatrin or remacemide were electroretinograms, electro-oculograms, multifocal VEPs and perimetry. Comparing these tests to perimetry results from vigabatrin patients the field specific VEP was found to have a high sensitivity and specificity, as did the 30Hz flicker amplitude. The modified VEP was also found to provide useful results in vigabatrin patients. Remacemide did not produce a similar visual field loss to vigabatrin although macular vision was affected. The field specific VEP is a useful method for detecting vigabatrin associated visual field loss that is well tolerated by young children. This technique combined with the ERG under light adapted (30Hz flicker) condition is presently the superior method for detecting vigabatrin-attributed peripheral field defects present in children below the developmental age of 9. The effects of AEDs on vision should be monitored carefully and the use of multifocal stimulation allows for specific areas of the retina and visual pathway to be monitored

The Web of Death: Scavenger Communities and Interactions on Carrion in Australian Landscapes

Carrion is a nutrient-rich resource that attracts a diverse community of organisms, from insects and vertebrates to microbes. These organisms engage in a series of complex interactions, as they compete for a shared resource that is generally ephemeral and patchy in distribution. Carrion consumers may also interact with surrounding ecosystems, as they contribute to nutrient cycling and dispersal, and to carrion removal, which can limit potential disease spread. Further, as most animals that interact with carrion also take on predatory roles, carrion may impact local environments by enhancing or redirecting predation or fear effects. These interactions are largely shaped by the ecosystem context in which the carcass is situated. Yet there remains a paucity of data on the different environmental drivers affecting carrion ecology generally, especially in Australian environments. This thesis addressed this gap by exploring key aspects of the carrion community in Australia. It applies a large-scale standardised survey of the vertebrates and insects associated with over 120 experimentally positioned kangaroo (Osphranter and Macropus spp.) carcasses in three distinct biogeographic regions across Australia. Overall, this work comprises the largest replicated carrion ecology experiment on mainland Australia to date. The findings reveal novel insights into the structure and function of carrion communities across a range of bioregions. They also highlight the context dependency of carrion communities and their various interactions. I suggest that future work focuses on enhancing the spatial, temporal, and taxonomic scales upon which carrion research is focused, and support the development of global, standardised carcass monitoring surveys to build a more in-depth understanding of the factors that influence carrion community dynamics and ecosystem processes linked to decomposition

Effects of Moderate Intensity Interval Training on Cognitive Function

ABSTRACT Purpose: The purpose of this study was to investigate if exercise in the form of moderate intensity interval training had an effect on memory by comparing the performance of number of words recalled after the implementation of an exercise condition and a control condition. Methods: The investigators tested a total of 20 participants. All participants completed an informed consent document prior to testing. Participants had three minutes to memorize a list of 15 words. This was followed by either 15 minutes of interval training or 15 minutes of sitting in a controlled environment. All participants participated in both the control and experimental conditions. A paired samples t-test was used to determine statistical significance. Results: The participants were able to recall an average of 11±3 words in the control condition and an average of 9±4 words in the exercise condition. The results showed no statistical significance between control and exercise performance (p=0.10), nor was there any statistically significance difference in the performance between genders. Conclusion: The study results show there was no effect on cognitive function performance (specifically short term memory) from moderate intensity interval training. This study failed to confirm that moderate intensity interval training evokes cognitive function benefits equivalent to those demonstrated in previous studies on continuous moderate intensity aerobic exercise and high intensity interval training. Future studies should look into the effect of varying duration and intensity of the interval training to find a possible correlation