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Introduction This chapter describes one university library's exploration and imple - mentation of mobile services and its subsequent contributions to broader, campus-wide mobile services initiatives. Ryerson University is a mid-sized urban university with a diverse student population of 23,000 undergraduate and 1,950 graduate students enrolled in five faculties: the Faculty of Arts; the Faculty of Communication and Design; the Faculty of Community Services; the Faculty of Engineering, Architecture and Science; and the Ted Rogers School of Management. Ryerson also has more than 65,000 annual registrations in its G. Raymond Chang School of Continuing Education, which is the largest in Canada. The university is primarily a commuter campus, with the majority of the students using public transportation. The library has a staff of over 85, including 27 librarians with a strong service focus. The collection consists of over 500,000 books, 2,500 print serials and an extensive electronic collection of over 35,000 journals, 90,000 e-books and a wide array of online databases. Environmental scan Prior to fall 2008, the only true mobile service offered by the library was a text-messaging service from the catalogue that enabled users to text the title, location and call number of an item to their mobile phones. This information could then be viewed when the user was in the stacks, looking for the book. The moderate successes of this service and the subjective impression that students were increasingly using smart phones encouraged the library to look more closely at the mobile environment as a venue for its services. To confirm our sense that smart phones were becoming more popular, particularly amongst the student population, we looked at several surveys conducted in 2008. The Pew Internet and American Life Project's March 2008 report, Mobile Access to Data and Information , indicated that within the 18- to 29-year-old demographic 85% were using text messaging and 31% were accessing the internet on their mobile devices (Horrigan, 2008). And in July 2008 a Nielsen report stated that 15.6% of US mobile phone subscribers used the mobile internet (Covey, 2008). Because neither of these reports commented specifically on the Canadian situation we had some concerns that the higher cost of data plans in Canada and the late introduction of the iPhone (in July 2008) might result in a different adoption rate in our environment.

Presented at ECIUG, March 2008, University of Ottawa

This guide has been created to assist instructors in using the Public Domain Core Collection of texts and to provide some suggestions and examples of open assignments that can be created using these texts.

Objectives A national survey of the Australian pharmacy workforce was conducted to determine the extent to stress experienced, the extent to which it is work-related, how stress is managed, the barriers to getting help and how well prepared the workforce is for stressful situations. There were three objectives: provision of guidance on possible interventions; provision of a baseline for further studies; and provision of information to the Australian Health Practitioner Regulation Authority (AHPRA). Methods An online survey incorporating the 10-item Perceived Stress Scale was developed, piloted and launched in October 2016. Pharmacy-related organisations alerted their members to the voluntary survey. Popular pharmacy social media was used. Responses were analysed using SPSS and Excel. The a priori for significance was P < 0.05. Key findings In relation to the nature and extent of stress in the workforce and work-life balance, information provided by 1246 respondents out of a workforce of 29 819 revealed high levels of stress (PSS-10 score 20.1 ± 7.3), with those under 30 years of age and/or with 10 years or less in the pharmacy workforce reporting the highest levels. Just under half the respondents reported dissatisfaction with their work-life balances. Conclusions Workplace stress is high, particularly among younger members of the workforce. Professional pharmacy associations, schools of pharmacy at Australian universities and AHPRA have been alerted to this issue. The survey should be repeated reasonably soon to determine if any of the key characteristics have changed, particularly if interventions are made to reduce the occurrence of workplace-related stress.

Purpose Many older adults with a history of smoking and asthma develop clinical features of both asthma and COPD, an entity sometimes called asthma-COPD overlap (ACO). Patients with ACO may be at higher risk of poor health outcomes than those with asthma or COPD alone. However, understanding of ACO is limited in the primary care setting and more information is needed to better inform patient management. We aimed to compare the characteristics of patients with ACO or COPD in Australian general practices. Patients and methods Data were from the RADICALS (Review of Airway Dysfunction and Interdisciplinary Community-based care of Adult Long-term Smokers) trial, an intervention study of an interdisciplinary community-based model of care. Baseline demographic and clinical characteristics, pre- and post-bronchodilator spirometry, dyspnoea and St. George's Respiratory Questionnaire scores were compared between 60 ACO patients and 212 with COPD alone. Results Pre-bronchodilator Forced Expiratory Volume in 1 second (mean±SD 58.4±14.3 vs 67.5±20.1% predicted) and Forced Vital Capacity (mean 82.1±16.9 v 91.9±17.2% predicted) were significantly lower in the ACO group (p

Objective The objective of this review is to explore the research on factors that influence international undergraduate nursing students' experiences and perceptions of their learning environment. Introduction International nursing students bring valuable cultural and economic opportunities to universities and health care. It is important their clinical learning experiences are positive. Factors that influence nursing students' experiences may include cultural and communication differences, diversity related to health care systems, learning and teaching strategies, and programs to improve communication. International nursing students' experiences and perceptions are reported in terms of expressed confidence, perceived competence, and levels of satisfaction. A scoping review is required to identify what is known and to identify the knowledge gaps in this area. Inclusion criteria International nursing students are those who are enrolled in an undergraduate nursing program in a higher-education institution in a country other than their own. International students studying vocational nursing and exchange students will be excluded. The learning environment is considered to be one in which any person who may influence patient care learns. Primary research, both qualitative and quantitative methods, published since 1995 in any language that the research team can translate will be included. Methods This review follows the JBI methodology for scoping reviews. Data extraction will include the factors influencing students' experiences and the concepts that were explored. Data analysis will include frequencies of concepts and associations between them. Results will be presented in tabular form and mind maps. Scoping review registration number Open Science Framework (osf.io/r4v6q).

This qualitative research study explores the lived experiences of employees who have work experience of being employed in Yorkville, and reside in other areas around the Greater TorontoArea. The study examines how gentrification impacts neighbourhoods, and explores how the gentrification that shaped what Yorkville is today, impacts the employees of the neighbourhood.

Presented at the TRY 2009, University of Toronto, May 5th 2009.

Mobile Catalogues

Presented at Digital Odyssey, June 11, 2010.

Outline · What are QR Codes? · How do they work? · Uses of QR Codes · How Libraries can and do use QR Codes? · How to create your own QR codes

"What does your library website look like on a cell phone? What library services do your patrons want to access on a mobile device? The first question is easily answered. Unless your patron is using an iPhone or iPod Touch, your library website as viewed on their phone will have little resemblance to the carefully crafted site that displays on a laptop or desktop computer. The answer to the second question will depend very much on the types of users that frequent your library."

This book is based on the letters that Thomas Wilson, a civil engineer from the Borders of Scotland, wrote during the first World War while he was serving in East Africa.

BackgroundGPs have limited capacity to routinely provide smoking cessation support. New strategies are needed to reach all smokers within this setting.AimTo evaluate the effect of a pharmacist-coordinated interdisciplinary smoking cessation intervention delivered in Australian general practice.Design and settingSecondary analysis of a cluster randomised controlled trial (RCT) conducted in 41 Australian general practices.MethodIn all, 690 current smokers were included in this study: 373 from intervention clinics (n = 21) and 317 from control clinics (n = 18). A total of 166 current smokers had spirometry-confirmed chronic obstructive pulmonary disease (COPD). In the intervention clinics, trained pharmacists provided smoking cessation support plus Quitline referral. Control clinics provided usual care plus Quitline referral. Those with COPD in the intervention group (n = 84) were referred for home medicines review (HMR) and home-based pulmonary rehabilitation (HomeBase), which included further smoking cessation support. Outcomes included carbon monoxide (CO)-validated smoking abstinence, self-reported use of smoking cessation aids, and differences between groups in readiness-to-quit score at 6 months.ResultsIntention-to-treat analysis showed similar CO-validated abstinence rates at 6 months in the intervention (4.0%) and control clinics (3.5%). No differences were observed in readiness-to-quit scores between groups at 6 months. CO-validated abstinence rates were similar in those who completed HMR and at least six sessions of HomeBase to those with COPD in usual care.ConclusionA pharmacist-coordinated interdisciplinary smoking cessation intervention when integrated in a general practice setting had no advantages over usual care. Further research is needed to evaluate the effect of HMR and home-based pulmonary rehabilitation on smoking abstinence in smokers with COPD.

OBJECTIVE: The objective of this review is to identify and map the literature that describes the individual and environmental factors that influence nurses and midwives to stay in or leave their discipline within the first three years of practice. INTRODUCTION: The turnover rate of newcomers within their first three years of nursing and midwifery is higher than in later years and is contributing to a worldwide shortage. Both individual and environmental factors, often in combination, contribute to this attrition. Many studies demonstrate the associations of factors with turnover or intention to stay; however, the scope of factors has not been documented. INCLUSION CRITERIA: Newcomers are defined as registered nurses and registered midwives within the first three years of entering their discipline. Quantitative and qualitative studies and systematic reviews that explore individual or environmental factors that influence the decision to leave or to remain in nursing and midwifery in any context will be considered. Factors may include coping, anxiety, mindfulness, practice environment, or combinations such as resilience, satisfaction, and burnout. Articles must have been peer reviewed. Literature published since 1974 in English will be considered. Newcomers who have completed skills-based training will be excluded. METHODS: The JBI method for scoping reviews will be followed. An extensive search of multiple databases and gray literature will be undertaken. Retrieval of full-text studies and data extraction will be performed independently by two reviewers. Data extracted will be synthesized and results reported using a mind map, tables, and narrative form.

To translate, culturally adapt, and psychometrically test the EMpowerment of PArents in The Intensive Care-30 questionnaire in Australian pediatric critical care, neonatal, and pediatric ward settings.Cross-sectional, descriptive, multicenter study conducted in two phases; 1) translation and cultural adaptation and 2) validation of the EMpowerment of PArents in The Intensive Care-30 questionnaire.Two Western Australian sites, the PICU and two pediatric wards of a children's hospital and the neonatal unit of a women's and newborn hospital.Parents whose baby or child was admitted to the participating wards or units with a length of hospital stay greater than 24 hours.None.Phase 1: A structured 10-step translation process adhered to international principles of good practice for translation and cultural adaptation of patient-reported outcomes. Thirty parents participated in cognitive debriefing. Phase 2: A total of 328 parents responded to the EMpowerment of PArents in The Intensive Care-30-AUS questionnaire. Reliability was sufficient (Cronbach α at domain level 0.70 -0.82, for each clinical area 0.56-0.86). Congruent validity was adequate between the domains and three general satisfaction items (rs 0.38-0.69). Nondifferential validity showed no significant effect size between three patient or parent demographic characteristics and the domains (Cohen's d0.36). Between the different clinical areas, significant differences in responses were found in all domains.The translated and culturally adapted EMpowerment of PArents in The Intensive Care-30-AUS is a reliable and valid questionnaire to measure parent-reported outcomes in pediatric critical care, pediatric ward, and neonatal hospital settings. Using this questionnaire can provide a framework for a standardized quality improvement approach and identification of best practices across specialties, hospital services and for benchmarking similar health services worldwide.

Indonesia has one of the world’s largest populations, which creates a demand for buildings. Construction and operation of buildings have impacts on environment. To create sustainable cities, Indonesia applied the smart cities concept and selected Makassar as one of three role model cities. This chapter explores the current situation in Makassar with respect to green building adoption, the challenges faced and opportunities in market transformation. The Green Building Council of Indonesia (GBCI) in Makassar is heavily involved with market transformation for green building practices and has four main activities: market transformation, training and education, green building certification and stakeholder engagement. GBCI has developed the GREENSHIP rating tool, an assessment system covering categories associated with the green building concept as it applies to Indonesia. The embracing of the green building concept, however, is still low in Makassar. Market transformation is a challenging task, and there is still a lack of formal education programmes and courses available to architects, engineers and the construction industry to drive the transformation. The initial higher cost of green building presents as a major barrier to the uptake of green building even though these costs are mitigated after a period of 4–5 years through a reduction in operational costs. Government regulations that support green building practices and education of the community about the benefits of green building may support/improve uptake of green building.

We evaluated the effectiveness of an interdisciplinary, primary care-based model of care for chronic obstructive pulmonary disease (COPD).A cluster randomised controlled trial was conducted in 43 general practices in Australia. Adults with a history of smoking and/or COPD, aged ≥40 years with two or more clinic visits in the previous year were enrolled following spirometric confirmation of COPD. The model of care comprised smoking cessation support, home medicines review (HMR) and home-based pulmonary rehabilitation (HomeBase). Main outcomes included changes in St George's Respiratory Questionnaire (SGRQ) score, COPD Assessment Test (CAT), dyspnoea, smoking abstinence and lung function at 6 and 12 months.We identified 272 participants with COPD (157 intervention, 115 usual care); 49 (31%) out of 157 completed both HMR and HomeBase. Intention-to-treat analysis showed no statistically significant difference in change in SGRQ at 6 months (adjusted between-group difference 2.45 favouring intervention, 95% CI –0.89–5.79). Per protocol analyses showed clinically and statistically significant improvements in SGRQ in those receiving the full intervention compared to usual care (difference 5.22, 95% CI 0.19–10.25). No statistically significant differences were observed in change in CAT, dyspnoea, smoking abstinence or lung function.No significant evidence was found for the effectiveness of this interdisciplinary model of care for COPD in primary care over usual care. Low uptake was a limitation.

N/A

The qualitative objective of this systematic review is to identify and synthesize the best available evidence on experiences of acute non-surgical pain, including pain management, of children (between four to 18 years) when they present to a healthcare facility for treatment.The specific objectives are to identify:The International Association for the Study of Pain defines pain as "an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage". The pain experience is multifaceted and complex, extending beyond the physiological interpretation of a noxious stimulus, encompassing other dimensions, including; psychological, cognitive, sociocultural, affective and emotional factors. Pain can be described as chronic (persisting for three months or more) or acute (a time limited response to a noxious stimuli). Over the past 50 years clinical research has made revolutionary contributions to better understanding pediatric pain. The once pervasive erroneous notion that infants do not experience pain the same way as adults has been firmly dispelled. We now know that nervous system structures associated with the physiological interpretation of pain are functional as early as fetal development. Despite this critical knowledge and the growing global commitment to improving pediatric pain management in clinical practice, evidence repeatedly suggests that pain management remains suboptimal and inconsistent, a phenomenon commonly referred to as oligoanalgesia. Research evidence has linked poorly managed pain in the pediatric population to negative behavioral and physiological consequences later in life. Effective pain management is therefore a priority area for health care professionals. Improved understanding of children's experiences of acute non-surgical pain may lead to improved pain management and a reduction in oligoanalgesia.In the 1970s and 1980s, studies began exploring the subjective experiences of pediatric pain and discovered children's abilities to articulate their pain experiences, and to link causes and consequences of their pain. Developmental trends or age related patterns with regards to children's expressions and experiences of pain were identified. Recent studies have also recognized apparent trends in children's understanding and expressions of pain; these follow an age and cognitive development trajectory in line with Piaget's theories of development.For many children psychosocial aspects of pain, including emotions like fear, stress and anxiety, are often more unpleasant than the painful experience itself. Emotional responses such as distress and anxiety are commonly associated with the anticipation of pain, can exacerbate and intensify the pain experience, and can significantly lower a child's pain threshold. One study utilized an observational pain assessment tool to explore children's pain experiences. The findings indicated that children who underwent "non-painful" procedures (such as restraint) had equal, and in some cases higher, pain scores than those who underwent painful procedures (such as intravenous cannulation).Several studies exploring pediatric pain within health care settings (including, but not limited to, general practitioners, hospitals, emergency departments and outpatient clinics) have adopted quantitative methods, some examined parents' perspectives, and others explored nurses' perceptions. While results of such studies have added to the existing body of knowledge that supports the need to focus on improving pediatric pain management, it has been suggested that failing to ask children directly risks not capturing subjective experiences of pain from the children's perspectives in their entirety. Seeking the children's perspectives could provide a more reliable and adequate means of gaining insight into their needs and expectations when they are in pain.A single centered study in Singapore used semi-structured face-to-face interviews (n=15) to explore children's experiences of pain management postoperatively. While the children, aged between six and 12 years, identified the role of analgesia in managing their pain, they also placed significant emphasis on the role of parents and health care professionals in implementing non-pharmacological interventions in pain management. These results are relevant as they provide insights into how children experience and express pain, and their expectations of health care professionals in managing their pain. These findings draw attention to effective pain management approaches when caring for children. Similarly, a UK study adopted a cross sectional descriptive design using the draw and write technique aimed at investigating children's views on what helped when they were in pain. The children (n=71) were aged between four and 16 years. Findings revealed that children viewed themselves as active agents in pain management, while also placing significant emphasis on the importance of parents and nurses in managing their pain. In both studies, children valued nurses for social interactions, such as kindness and humor, rather than the provision of clinical care, including analgesia administration. Adjunct therapies such as distraction, visualization and music have also been shown to be effective in managing the pain experience in children.Not only do these findings demonstrate the complexity of the pain experience for the child, they also support the notion that improved pain management may come from research that is designed to better understand the entire pain experience from the child's perspective. While there are systematic reviews on interventions for managing children's pain, and one explored children's experiences in the postoperative context, none have considered children's experiences of acute non-surgical pain when they present for treatment. This qualitative systematic review aims to identify and synthesize results of studies exploring children's experiences of pain and pain management.

Background In recognising the capability and rights of children to express their experiences, 'draw, write and tell' (DWT) has emerged as a participatory qualitative research method. DWT enables children to communicate their experiences by drawing, writing words and telling the story of their pictures in response to interview questions. Aim To discuss the challenges and benefits of using DWT to explore children's experiences of pain. Discussion Aspects that affect the quality of data in DWT include the materials used and the influences of the primary caregiver. Experience suggests that if trust between the child and researcher has been established, the duration of the interview is unimportant. Conclusion While many methods of analysis can be used with data gathered using DWT, it is important to ensure children's perspectives are represented accurately. Furthermore, children's capacity as active participants in research should be reflected. Implications for practice Future studies could examine the potential of using drawings to share information in adult and paediatric clinical settings.

IntroductionUp to half of all smokers develop clinically significant chronic obstructive pulmonary disease (COPD). Gaps exist in the implementation and uptake of evidence-based guidelines for managing COPD in primary care. We describe the methodology of a cluster randomised controlled trial (cRCT) evaluating the efficacy and cost-effectiveness of an interdisciplinary model of care aimed at reducing the burden of smoking and COPD in Australian primary care settings.Methods and analysisA cRCT is being undertaken to evaluate an interdisciplinary model of care (RADICALS — Review of Airway Dysfunction and Interdisciplinary Community-based care of Adult Long-term Smokers). General practice clinics across Melbourne, Australia, are identified and randomised to the intervention group (RADICALS) or usual care. Patients who are current or ex-smokers, of at least 10 pack years, including those with an existing diagnosis of COPD, are being recruited to identify 280 participants with a spirometry-confirmed diagnosis of COPD. Handheld lung function devices are being used to facilitate case-finding. RADICALS includes individualised smoking cessation support, home-based pulmonary rehabilitation and home medicines review. Patients at control group sites receive usual care and Quitline referral, as appropriate. Follow-ups occur at 6 and 12 months from baseline to assess changes in quality of life, abstinence rates, health resource utilisation, symptom severity and lung function. The primary outcome is change in St George’s Respiratory Questionnaire score of patients with COPD at 6 months from baseline.Ethics and disseminationThis project has been approved by the Monash University Human Research Ethics Committee and La Trobe University Human Ethics Committee (CF14/1018 – 2014000433). Results of the study will be disseminated in peer-reviewed journals and research conferences. If the intervention is successful, the RADICALS programme could potentially be integrated into general practices across Australia and sustained over time.Trial registration numberACTRN12614001155684; Pre-results.

Review question The aim of the project is to conduct a comprehensive review of scholarly literature detailing the experiences of adult cancer patients in patient navigation programs. The specific questions are: 1) What are the experiences of patients with cancer in patient navigation programs? 2) How do patient navigators impact the challenges patients encounter in the cancer care continuum? Inclusion criteria Types of participants The types of participants of interest are adult cancer patients aged 18 years and over who are receiving or have received standard cancer care, for example, chemotherapy, radiation therapy and/or hormonal therapy and are in a patient navigation program or had been in a hospital patient navigation program. Exclusion criteria Studies examining patient navigation programs targeted at the following will be excluded: improving screening rates for cancer, timeliness from positive screening to diagnosis and recruitment and retention for clinical trials, because the patients will not have experienced the complexities of the healthcare system at this point and thus have not had relevant experience. Types of intervention(s)/phenomena of interest The phenomena of interest are the experiences of adult cancer patients who used patient navigation programs in hospital and the impact of patient navigators on the challenges the patients encountered in the cancer care continuum.

Providing care in the home is very demanding, particularly where people with a primary malignant brain tumour (PMBT) are concerned, as there are physical, cognitive and behavioural alterations that can make significant demands on family caregivers. Aim: The aim of this article is to consider carers' access to information following diagnosis of a PMBT and information on managing the caring role. Method: A grounded theory approach was used, with 22 open-ended interviews carried out with active carers at the time of the interview. Findings: Carers identified a lack of attention to their need for information particularly regarding medication, caring and working, and becoming a carer. They develop strategies such as using the Internet to search for information and support and using friends to filter information so they are not overwhelmed with depressing information. Using these strategies, carers reduce uncertainty, alleviate stress and find a way to continue to hope. Conclusions: Carers lack guidance on how to access information at different stages of the caring journey. However, they are resourceful in finding support and information and expect health services to include and signpost them to the most appropriate sources of information.

Objective. To confirm, in a randomized controlled trial (RCT), the efficacy of high-intensity progressive resistance training (PRT) in restoring muscle mass and function in patients with rheumatoid arthritis (RA). Additionally, to investigate the role of the insulin-like growth factor (IGF) system in exercise-induced muscle hypertrophy in the context of RA. Methods. Twenty-eight patients with established, controlled RA were randomized to either 24 weeks of twice-weekly PRT (n = 13) or a range of movement home exercise control group (n = 15). Dual x-ray absorptiometry-assessed body composition (including lean body mass [LBM], appendicular lean mass [ALM], and fat mass); objective physical function; disease activity; and muscle IGFs were assessed at weeks 0 and 24. Results. Analyses of variance revealed that PRT increased LBM and ALM (P < 0.01); reduced trunk fat mass by 2.5 kg (not significant); and improved training-specific strength by 119%, chair stands by 30%, knee extensor strength by 25%, arm curls by 23%, and walk time by 17% (for objective function tests, P values ranged from 0.027 to 0.001 versus controls). In contrast, body composition and physical function remained unchanged in control patients. Changes in LBM and regional lean mass were associated with changes in objective function (P values ranged from 0.126 to

The aim was to investigate the effects of a 48 h period of fluid, energy or combined fluid and energy restriction on salivary IgA (s-IgA) responses at rest and after exercise. Thirteen healthy males (age 21 (sem1) years) participated in four randomised 48 h trials. In the control trial participants received their estimated energy (12 154 (sem230) kJ/d) and water (3912 (sem140) ml/d) requirements. On fluid restriction (FR) participants received their energy requirements and 193 (sem19) ml water/d to drink and on energy restriction (ER) participants received their water requirements and 1214 (sem25) kJ/d. Fluid and energy restriction (F+ER) was a combination of FR and ER. After 48 h, participants performed a 30 min treadmill time trial (TT) followed by rehydration (0–2 h) and refeeding (2–6 h). Unstimulated saliva was collected at 0, 24 and 48 h, post-TT, and 2 and 6 h post-TT. Saliva flow rate (sflw) and s-IgA (ELISA) remained unchanged in control conditions and on ER. However, 48 h on FR decreased sflw (64 %) which most probably accounted for the increase in s-IgA concentration (P sem2); 24 h: 12 (sem2) μg/min;P

Background Opt-out HIV testing is a novel concept in Australia. In the opt-out approach, health care providers (HCPs) routinely test patients for HIV unless they explicitly decline or defer. Opt-out HIV testing is only performed with the patients’ consent, but pre-test counselling is abbreviated. Australian national testing guidelines do not currently recommend opt-out HIV testing for the general population. Non-traditional approaches to HIV testing (such as opt-out) could identify HIV infections and facilitate earlier treatment, which is particularly important now that HIV is a chronic, manageable disease. Our aim was to explore HCPs’ attitudes toward opt-out HIV testing in an Australian context, to further understanding of its acceptability and feasibility. Methods In this qualitative study, we used purposeful sampling to recruit HCPs who were likely to have experience with HIV testing in Western Australia. We interviewed them using a semi-structured guide and used content analysis as per Graneheim to code the data. Codes were then merged into subcategories and finally themes that unified the underlying concepts. We refined these themes through discussion among the research team. Results Twenty four HCPs participated. Eleven participants had a questioning attitude toward opt-out HIV testing, while eleven favoured the approach. The remaining two participants had more nuanced perspectives that incorporated some characteristics of the questioning and favouring attitudes. Participants’ views about opt-out HIV testing largely fell into two contrasting themes: normalisation and routinisation versus exceptionalism; and a need for proof versus openness to new approaches. Conclusion Most HCPs in this study had dichotomous attitudes toward opt-out HIV testing, reflecting contrasting analytical styles. While some HCPs viewed it favourably, with the perceived benefits outweighing the perceived costs, others preferred to have evidence of efficacy and cost-effectiveness. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-2229-9) contains supplementary material, which is available to authorized users.

Objective to ponder afresh what makes a good birth experience in a listening manner. Design a hermeneutic approach that first explores the nature of how to listen to a story that is already familiar to us and then draws on Heidegger's notion of the fourfold to seek to capture how the components of a'good birth' come together within experience. Setting primary birthing centre, New Zealand Participants the focus of this paper is the story of one participant. It was her second birth; her first birth involved a lot of medical intervention. She had planned to travel one hour to the tertiary birthing unit but in labour chose to stay at the Birth Centre. Her story seems to portray a ‘very good birth'. Findings in talking of birth, the nature of a research approach is commonly to focus on one aspect: the place, the care givers, or the mode of care. In contrast, we took on the challenge of first listening to all that was involved in one woman's story. We came to see that what made her experience ‘good' was'everything' gathered together in a coherent and supportive oneness. Heidegger's notion of the fourfold helped reveal that one cannot talk about one thing without at the same time talking about all the other things as well. Confidence was the thread that held the story together. Key conclusions there is value in putting aside the fragmented approach of explicating birth to recognise the coming together of place, care, situation, and the mystery beyond explanation. Women grow a confidence in place when peers and community encourage the choice based on their own experience. Confidence of caregiver comes in relationship. Feeling confident within ‘self' is part of the mystery. When confidence in the different dimensions holds together, birth is ‘good'. Implications or practice one cannot simply build a new birthing unit and assume it will offer a good experience of birth. Experience is about so much more. Being mindful of the dimensions of confidence that need to be built up and sheltered is a quest for wise leaders. Protecting the pockets where we know ‘good birth' already flourishes is essential.

In this paper, we describe the maker concept, movement and culture and its impact on and relationship with libraries. We provide a comprehensive review of library makerspaces in North America supported by several case studies. We intend this review to be used as a reference resource or tool for libraries planning to implement a new makerspace.

Background There is increasing interest in the contribution of the quality of nursing care to patient outcomes. Due to different casemix and risk profiles, algorithms for administrative health data that identify nursing-sensitive outcomes in adult hospitalised patients may not be applicable to paediatric patients. The study purpose was to test adult algorithms in a paediatric hospital population and make amendments to increase the accuracy of identification of hospital acquired events. The study also aimed to determine whether the use of linked hospital records improved the likelihood of correctly identifying patient outcomes as nursing sensitive rather than being related to their pre-morbid conditions. Methods Using algorithms developed by Needleman et al. (2001), proportions and rates of records that identified nursing-sensitive outcomes for pressure ulcers, pneumonia and surgical wound infections were determined from administrative hospitalisation data for all paediatric patients discharged from a tertiary paediatric hospital in Western Australia between July 1999 and June 2009. The effects of changes to inclusion and exclusion criteria for each algorithm on the calculated proportion or rate in the paediatric population were explored. Linked records were used to identify comorbid conditions that increased nursing-sensitive outcome risk. Rates were calculated using algorithms revised for paediatric patients. Results Linked records of 129,719 hospital separations for 79,016 children were analysed. Identification of comorbid conditions was enhanced through access to prior and/or subsequent hospitalisation records (43% of children with pressure ulcers had a form of paralysis recorded only on a previous admission). Readmissions with a surgical wound infection were identified for 103 (4.8/1,000) surgical separations using linked data. After amendment of each algorithm for paediatric patients, rates of pressure ulcers and pneumonia reduced by 53% and 15% (from 1.3 to 0.6 and from 9.1 to 7.7 per 10,000 patient days) respectively, and an 84% increase in the proportion of surgical wound infection (from 5.7 to 10.4 per 1,000 separations). Conclusions Algorithms for nursing-sensitive outcomes used in adult populations have to be amended before application to paediatric populations. Using unlinked individual hospitalisation records to estimate rates of nursing-sensitive outcomes is likely to result in inaccurate rates.

Objective To determine the effect of 6 years of routine management on body composition, physical functioning, and quality of life, and their interrelationships, in men with idiopathic vertebral fracture. Methods Twenty men with idiopathic vertebral fracture (patients: mean ± SD age 58 ± 6 years) were age and height matched to 28 healthy controls with no known disease. The primary outcome was skeletal muscle mass (appendicular lean mass by dual x-ray absorptiometry) assessed at 2 visits (0 and 6 years). Physical functioning and quality of life domains were assessed by the Senior Fitness Test and Short Form 36 (SF-36) questionnaire at visit 2 only. Data were analyzed by repeated-measures analysis of variance, independent t-tests, and correlation. Results At visit 1, appendicular lean mass was 9% lower in patients than controls. Although patients better maintained appendicular lean mass between visits (interaction P = 0.016), at visit 2 appendicular lean mass remained 5% lower in patients than controls. Furthermore, patients' appendicular lean mass change was correlated with femoral neck bone density change (r = 0.507, P = 0.023). Physical function tests were 13–27% lower in patients compared with controls (P = 0.056 to 0.003), as were SF-36 quality of life physical domains (13–26% lower; P = 0.028 to

To determine the effect of a 48-h period of either fluid restriction (FR), energy restriction (ER), or fluid and energy restriction (F + ER) on 30-min treadmill time trial (TT) performance in temperate conditions.Thirteen males participated in four randomized 48-h trials (mean +/- SD: age, 21 +/- 3 yr; VO2max 50.9 +/- 4.3 mL x kg(-1) x min(-1)). Control (CON) participants received their estimated energy (2903 +/- 199 kcal x d(-1)) and water (3912 +/- 500 mL x d(-1)) requirements. For FR, participants received their energy requirements and 193 +/- 50 mL x d(-1) water to drink, and for ER, participants received their water requirements and 290 +/- 20 kcal x d(-1). F + ER was a combination of FR and ER. After 48 h, participants performed a 30-min treadmill TT in temperate conditions (19.7 +/- 0.6 degrees C). A separate investigation (N = 10) showed the TT to be highly reproducible (CV 1.6%).Body mass loss (BML) was 0.6 +/- 0.4% (CON), 3.2 +/- 0.5% (FR), 3.4 +/- 0.3% (ER), and 3.6 +/- 0.3% (F + ER). Compared with CON (6295 +/- 513 m), less distance was completed on ER (10.3%) and F + ER (15.0%: P0.01). Although less distance was completed on FR (2.8%), this was not significantly different from CON.These results show a detrimental effect of a 48-h period of ER but no significant effect of FR on 30-min treadmill TT performance in temperate conditions. Therefore, these results do not support the popular contention that modest hypohydration (2-3% BML) significantly impairs endurance performance in temperate conditions.

Background Research into nursing-sensitive outcomes using administrative health data has focussed on hospitalised adults. However, we developed algorithms for the identification of 13 paediatric nursing-sensitive outcomes, which we seek to examine for clinical utility. The aims were to determine the rates of paediatric nursing-sensitive outcomes in a Western Australian hospital and ascertain sociodemographic and clinical characteristics associated with a greater risk of developing nursing-sensitive outcomes in hospitalised children. Method A retrospective cohort study used linked administrative data of all Western Australian children ≤18 years admitted to the only tertiary paediatric hospital in Perth between 1999 and 2009. Rates per 1,000 hospital separations and per 10,000 patient days were calculated for the following nursing-sensitive outcomes: lower respiratory tract infection (LRTI), gastrointestinal (GI) infection, pneumonia, sepsis, arrest/shock/respiratory failure, central nervous system complication, central venous line infection, infectious disease, pressure ulcer, failure to rescue, surgical wound infection, physiologic/metabolic derangement, and postoperative cardiopulmonary complications. Poisson multiple regression models were fitted to estimate rate ratios (RR) and 95% confidence intervals (CI) for suspected risk factors. Results Linked records of 129,719 hospital separations were analysed. Rates ranged from 0.5/1,000 for pressure ulcer to 14.0/1,000 hospital separations for GI infections. Age was significantly associated with the risk of a nursing-sensitive outcome: compared with adolescents, toddlers had greater risk of GI infection (RR 9.89; 95% CI 6.24, 15.69); infants had 7.74 times greater risk of LRTI (95% CI 5.11, 11.75), while neonates had lower risks for sepsis (RR 0.26; 95% CI 0.08, 0.90) and physiologic/metabolic derangement (RR 0.12; 95% CI 0.04, 0.35). The risk of surgical wound infection was 7.78 times greater (95% CI 5.10, 11.86) for emergency admissions than elective admissions. Conclusions Seven of the 13 defined nursing-sensitive outcomes occurred with sufficient frequency (>100 events over the 10 year study period) to be potentially useful for monitoring the quality of nursing care. These nursing-sensitive outcomes are: LRTI, GI infection, pneumonia, surgical wound infection, physiologic/metabolic derangement, sepsis and postoperative cardiopulmonary complications. When used for quality improvement or to benchmark with other agencies, data need to be adjusted for, or stratified by age and admission type, to ensure equitable comparisons.

Infrastructure Investment in Indonesia: A Focus on Ports presents an important and original collation of current material investigating the efficient facilitation of major infrastructure projects in Indonesia and Australia, with an emphasis on infrastructure investment and a focus on port planning and development. This interdisciplinary collection - spanning the disciplines of engineering, law and planning - draws helpfully on a range of practical and theoretical perspectives. It is the collaborative effort of leading experts in the fields of infrastructure project initiation and financing, and is based on international research conducted by the University of Melbourne, Universitas Indonesia and Universitas Gadjah Mada. The volume opens with a macroscopic perspective, outlining the broader economic situations confronting Indonesia and Australia, before adopting a more microscopic perspective to closely examine the issues surrounding major infrastructure investment in both countries. Detailed case studies are provided, key challenges are identified, and evidence-based solutions are offered. These solutions respond to such topical issues as how to overcome delays in infrastructure project initiation; how to enhance project decision-making for the selection and evaluation of projects; how to improve overall efficiency in the arrangement of project finance and governance; and how to increase the return provided by investment in infrastructure. Special focus is given to proposed improvements to the portal cities of Indonesia in the areas of major infrastructure project governance, policies, engagement, operation and processes. By rigorously investigating the economic, transport, finance and policy aspects of infrastructure investment, this book will be a valuable resource for policy makers and government officials in Indonesia and Australia, infrastructure investment organisations, and companies involved in exporting services between Indonesia and Australia. This book will also be of interest to researchers and students of infrastructure planning and financing, setting a solid foundation for subsequent investigations of financing options for large-scale infrastructure developments.

The purpose of this poster is to provide insight into the processes involved in creating an interdisciplinary online exhibition focused on a unique chapter of Canadian history from World War I. The exhibition focuses on the Colebourn Family Archive comprising digitized photographs and ephemera of Canadian soldier and veterinarian Harry Colebourn (1887–1947) who purchased a pet bear named Winnie who later became A. A. Milne’s inspiration for the classic Winnie-the-Pooh children's book series