Practice variation in urine collection methods among pre-toilet trained children with suspected urinary tract infection: a systematic review

BACKGROUND

Urinary tract infections (UTIs) are a common cause of acute illness among infants and young children. There are numerous methods for collecting urine in children who are not toilet trained. This review examined practice variation in the urine collection methods for diagnosing UTI in non-toilet-trained children.

METHODS

A systematic review was completed by searching MEDLINE (Ovid), Embase (Ovid), CENTRAL (Ovid), PsycInfo (Ovid), CINAHL (EBSCO), and JBI (Ovid) from January 1, 2000 until October 9, 2021 and updated on May 24, 2023. Studies were included if they were conducted in an acute care facility, examined pre-toilet trained children, and compared one urine collection method with another for relevant health care outcomes (such as length of stay in an ED, or re-visits or readmissions to the ED) or provider satisfaction. Two independent reviewers screened the identified articles independently, and those included in the final analysis were assessed for quality and bias using the Newcastle-Ottawa Scale.

RESULTS

Overall, 2535 articles were reviewed and 8 studies with a total of 728 children were included in the final analysis. Seven studies investigated the primary outcome of interest, practice variation in urine collection methods to diagnose a UTI. The seven studies that investigated novel methods of urine collection concluded that there were improved health care outcomes compared to conventional methods. Novel methods include emerging methods that are not captured yet captured in clinical practice guidelines including the use of ultrasound guidance to aid existing techniques. Three studies which investigated healthcare provider satisfaction found preference to novel methods of urine collection.

CONCLUSIONS

There is significant practice variation in the urine collection methods within and between countries. Further research is needed to better examine practice variation among clinicians and adherence to national organizations and societies guidelines. PROSPERO registration number CRD42021267754.

Prescribing and deprescribing guidance for benzodiazepine and benzodiazepine receptor agonist use in adults with depression, anxiety, and insomnia: an international scoping review

Background

Clinical practice guidelines and guidance documents routinely offer prescribing clinicians' recommendations and instruction on the use of psychotropic drugs for mental illness. We sought to characterise parameters relevant to prescribing and deprescribing of benzodiazepine (BZD) and benzodiazepine receptor agonist (BZRA), in clinical practice guidelines and guidance documents internationally, for adult patients with unipolar depression, anxiety disorders and insomnia to understand similarities and discrepancies between evidence-based expert opinion.

Methods

A Scoping Review was conducted to characterize documents that offered evidence-based and/or consensus pharmacologic guidance on the management of unipolar depression, anxiety disorders, obsessive-compulsive disorders, post-traumatic stress disorders and insomnia. A systematic search was conducted of PubMed, SCOPUS, PsycINFO and CINAHL from inception to October 13, 2023 and supplemented by a gray literature search. Documents were screened in Covidence for eligibility. Subsequent data-charting on eligible documents collected information on aspects of both prescribing and deprescribing.

Findings

113 documents offering guidance on BZD/BZRA use were data-charted. Overall, documents gathered were from Asia (n = 11), Europe (n = 34), North America (n = 37), Oceania (n = 7), and South America (n = 4) with the remainder being "International" (n = 20) and not representative to any particular region or country. By condition the documents reviewed covered unipolar depressive disorders (n = 28), anxiety disorders, obsessive-compulsive disorder and post-traumatic stress disorder (n = 42) and Insomnia (n = 25). Few documents (n = 18) were sufficiently specific and complete to consider as de-prescribing focused documents.

Interpretation

Documents were in concordance in terms of BZD and BZRA not being used routinely as first-line pharmacologic agents. When used, it is advisable to restrict their duration to "short-term" use with the most commonly recommended duration being less than four weeks. Documents were less consistent in terms of prescriptive recommendations for specific drug, dosing and administration pattern (i.e regular or 'as needed') selection for each condition. Deprescribing documents were unanimously in favor of gradual dose reduction and patient shared decision-making. However, approaches towards dose-tapering differed substantially. Finally, there were inconsistencies and/or insufficiency of detail, among deprescribing documents, in terms of switching to a long-acting BZD, use of adjunctive pharmacotherapies and micro-tapering.

Funding

The authors received no funding for this work.

Cannabinoids for symptom management in children with cancer: A systematic review and meta-analysis

BACKGROUND

Despite the widespread use of medical cannabis, little is known regarding the safety, efficacy, and dosing of cannabis products in children with cancer. The objective of this study was to systematically appraise the existing published literature for the use of cannabis products in children with cancer.

METHODS

This systematic review, registered with the International Prospective Register of Systematic Reviews (CRD42020187433), searched four databases: MEDLINE, Embase, PsycINFO, and the Cochrane Library. Abstracts and full texts were screened in duplicate. Data on types of cannabis products, doses, formulations, frequencies, routes of administration, indications, and clinical and demographic details as well as reported efficacy outcomes were extracted. Data on cannabinoid-related adverse events were also summarized.

RESULTS

Out of 34,611 identified citations, 19 unique studies with a total of 1927 participants with cancer were included: eight retrospective chart reviews, seven randomized controlled trials, two open-label studies, and two case reports. The included studies reported the use of various cannabis products for the management of symptoms. Cannabinoids were commonly used for the management of chemotherapy-induced nausea and vomiting (11 of 19 [58%]). In controlled studies, somnolence, dizziness, dry mouth, and withdrawal due to adverse events were more commonly associated with the use of cannabinoids. Across all included studies, no serious cannabis-related adverse events were reported.

CONCLUSIONS

Although there is evidence to support the use of cannabis for symptom management, in children with cancer, there is a lack of rigorous evidence to inform the dosing, safety, and efficacy of cannabinoids. Because of the increasing interest in using cannabis, there is an urgent need for more research on medical cannabis in children with cancer.

Readiness of emergency departments for pediatric patients and pediatric mortality: a systematic review

BACKGROUND

Most children who need emergency care visit general emergency departments and urgent care centres; the weighted pediatric readiness score (WPRS) is currently used to evaluate emergency departments' readiness for pediatric patients. The aim of this study was to determine whether a higher WPRS was associated with decreased mortality and improved health care outcomes and utilization.

METHODS

We conducted a systematic review of cohort and cross-sectional studies on emergency departments that care for children (age ≤ 21 yr). We searched MEDLINE (Ovid), Embase (Ovid), the Cochrane Library (Wiley), CINAHL (EBSCO), Global Health (Ovid) and Scopus from inception until July 29, 2022. Articles identified were screened for inclusion by 2 independent reviewers. The primary outcome was mortality, and the secondary outcomes were health care outcomes and utilization. We used the Newcastle-Ottawa Scale to assess for quality and bias of the included studies. The I 2 statistic was calculated to quantify study heterogeneity.

RESULTS

We identified 1789 articles. Eight articles were included in the final analysis. Three studies showed an inverse association between highest WPRS quartile and pediatric mortality (pooled odds ratio [OR] 0.45, 95% confidence interval [CI] 0.26 to 0.78; I 2 = 89%, low certainty of evidence) in random-effects meta-analysis. Likewise, 1 study not included in the meta-analysis also reported an inverse association with a 1-point increase in WPRS (OR 0.93, 95% CI 0.88 to 0.98). One study reported that the highest WPRS quartile was associated with shorter length of stay in hospital (β -0.36 days, 95% CI -0.61 to -0.10). Three studies concluded that the highest WPRS quartile was associated with fewer interfacility transfers. The certainty of evidence is low for mortality and moderate for the studied health care outcomes and utilization.

INTERPRETATION

The data suggest a potential inverse association between the WPRS of emergency departments and mortality risk in children. More studies are needed to refute or confirm these findings.

PROTOCOL REGISTRATION

PROSPERO-CRD42020191149.

Considering Sex and Gender in Therapeutics throughout the Product Life Cycle: A Narrative Review and Case Study of Gilteritinib

Background

Biological sex-related factors influence pharmacokinetic, pharmacodynamic, and disease processes that may affect the predictability of drug dosing and adverse effects, which may in turn have clinical consequences for patients' lives. Nonetheless, sex-related factors are not always taken into account in clinical trial design or clinical decision-making, for multiple reasons, including a paucity of studies that clearly and objectively study and measure sex-disaggregated and sex-related outcomes, as well as gaps in regulatory and policy structures for integrating these considerations.

Objectives

To complete a narrative review and use a case study to understand available evidence, inform future research, and provide policy considerations that incorporate information on sex- and gender-related factors into clinician-facing resources.

Methods

A comprehensive review of available literature was conducted using a sex- and gender-based analysis plus (SGBA Plus) approach to identify sex- and/or gender-disaggregated information for gilteritinib, a chemotherapeutic agent. Systematic searches were performed in MEDLINE (Ovid), Embase (Ovid), CENTRAL (Wiley), International Pharmaceutical Abstracts (Ovid), Scopus, and ClinicalTrials.gov, from inception to March 18, 2021. The information was then summarized and compared with the Canadian product monograph for this drug.

Results

Of 311 records screened, 3 provided SGBA Plus information as a component of outcomes, rather than just as categories or demographic characteristics. Of these, 2 were case studies, and 1 was a clinical trial. No studies from the ClinicalTrials.gov database that were in progress at the time of this review provided details about sex-disaggregated outcomes. The Canadian product monograph did not include sex-disaggregated outcome data.

Conclusions

The available evidence from clinical trials, other published literature, and guidance documents does not provide details about sex-disaggregated outcomes for gilteritinib. This paucity of available evidence may create a challenge for clinicians who are making decisions about the efficacy and safety of prescribed therapies in sex-specific populations that have not been well studied.

Sex, Gender, and the Regulation of Prescription Drugs: Omissions and Opportunities

The regulation of prescription drugs is an important health, safety, and equity issue. However, regulatory processes do not always consider evidence on sex, gender, and factors such as age and race, omissions that advocates have highlighted for several decades. Assessing the impact of sex-related factors is critical to ensuring drug safety and efficacy for females and males, and for informing clinical product monographs and consumer information. Gender-related factors affect prescribing, access to drugs, needs and desires for specific prescribed therapies. This article draws on a policy-research partnership project that examined the lifecycle management of prescription drugs in Canada using a sex and gender-based analysis plus (SGBA+) lens. In the same time period, Health Canada created a Scientific Advisory Committee on Health Products for Women, in part to examine drug regulation. We report on grey literature and selected regulatory documents to illustrate the extent to which sex and gender-based analysis plus (SGBA+) is utilized in regulation and policy. We identify omissions in the management of prescription drugs, and name opportunities for improvements by integrating SGBA+ into drug sponsor applications, clinical trials development, and pharmacovigilance. We report on recent efforts to incorporate sex disaggregated data and recommend ways that the management of prescription drugs can benefit from more integration of sex, gender, and equity.

A Sex- and Gender-Based Analysis of Adverse Drug Reactions: A Scoping Review of Pharmacovigilance Databases

Drug-related adverse events or adverse drug reactions (ADRs) are currently partially or substantially under-reported. ADR reporting systems need to expand their focus to include sex- and gender-related factors in order to understand, prevent, or reduce the occurrence of ADRs in all people, particularly women. This scoping review describes adverse drug reactions reported to international pharmacovigilance databases. It identifies the drug classes most commonly associated with ADRs and synthesizes the evidence on ADRs utilizing a sex- and gender-based analysis plus (SGBA+) to assess the differential outcomes reported in the individual studies. We developed a systematic search strategy and applied it to six electronic databases, ultimately including 35 papers. Overall, the evidence shows that women are involved in more ADR reports than men across different countries, although in some cases, men experience more serious ADRs. Most studies were conducted in higher-income countries; the terms adverse drug reactions and adverse drug events are used interchangeably, and there is a lack of standardization between systems. Additional research is needed to identify the relationships between sex- and gender-related factors in the occurrence and reporting of ADRs to adequately detect and prevent ADRs, as well as to tailor and prepare effective reporting for the lifecycle management of drugs.

The Number Needed to Vaccinate (NNV) against herpes zoster: a systematic review with meta-analysis

OBJECTIVES

The number needed to vaccinate (NNV) quantifies the effectiveness of vaccination programs. We summarised the published data on NNV against herpes zoster to inform vaccination policies.

METHODS

We systematically identified studies based on a priori established and registered methods. The main outcomes were the NNV against herpes zoster infection, hospitalisation and mortality. Where appropriate, we conducted meta-analyses using inverse variance, random-effects models, pooling estimated NNV with associated 95% confidence interval (CI). Statistical heterogeneity between pooled estimates was calculated using the I² statistic.

RESULTS

Out of 229 unique citations, we included eight nonrandomized studies. Among 50+ year-olds, the NNV against herpes zoster infection using the recombinant subunit vaccine was 11 (95%CI 8-14; I² = 0%; 3 studies) and variable (I² = 94.4%; 7 studies) using live attenuated vaccine, ranging from 10 (95%CI 1-19) to 58 (95%CI 49-67). Among 65+ year-olds, the NNV against herpes zoster infection using the recombinant subunit vaccine was 12 (95%CI: 9-15; I² = 0%; 2 studies) and variable (I² = 98.5%; 4 studies) using live attenuated vaccine, ranging from 14 (95%CI 5-23) to 75 (95%CI 66-84). The NNV against herpes zoster hospitalisation among 65+ year-olds using the live attenuated vaccine was 280 (95%CI 209-352; I² = 0%; 2 studies). There was a paucity of data to inform other meta-analyses.

CONCLUSION

Evidence on the NNV against herpes zoster is scarce. Vaccination with the recombinant subunit herpes zoster vaccine may be more effective than with the live attenuated vaccine in preventing infection among 50+ year-olds. More studies are needed for a stronger evidence base for decision-making.

Canadian Data Platform: Developing an Algorithm Inventory for Health and Social Measures

IntroductionThe SPOR (Strategy for Patient-Oriented Research) Canadian Data Platform aims to facilitate multi-jurisdictional research through a variety of activities, including the development of standardized algorithms for health conditions, health service use, and the determinants of health. An initial step towards standardization was to identify existing health measures that have been validated or assessed for feasibility of implementation in multi-jurisdictional research, document features of these measures, and describe the methods used to validate or assess feasibility. Objectives and ApproachWe constructed an inventory of published algorithms to measure population health, health services use, and the determinants of health. A systematic review of published literature identified algorithms from validation or feasibility studies in two or more Canadian provinces/territories. The search strategy was applied to Medline, Embase, and Scopus. The Algorithms and Harmonized Data Working Group of the Canadian Data Platform identified relevant fields for data extraction, including study type, population characteristics, data source, jurisdictions, and algorithm details. A searchable online resource was created to maintain and share the algorithms. ResultsOf the 2758 articles retrieved, 1998 articles underwent title and abstract review and 60 articles were selected for full review. A total of 8 validation and 26 feasibility studies were assessed; they contributed over 140 algorithms. Chronic physical health conditions, such as diabetes, depression, hypertension and dementia, were most often represented in the algorithms. British Columbia and Manitoba were the jurisdictions most frequently represented in the studies. Methods to facilitate automated searching of the on-line resource are under development. Conclusion / ImplicationsOur inventory of algorithms provides valuable information for researchers interested in conducting multi-jurisdictional studies, and reveals gaps where further algorithm development could be undertaken. This comprehensive collection of existing algorithms will support future studies aimed at improving population health and monitoring health service use in Canada.

Disease-Associated Costs in Children With Inflammatory Bowel Disease: A Systematic Review

BACKGROUND

As a chronic noncurable disorder often diagnosed in childhood or adolescence, inflammatory bowel disease (IBD) confers a significant financial lifetime burden. The objective of this systematic review was to determine the disease-associated costs (both direct and indirect) associated with IBD in children and young adults.

METHODS

We conducted a systematic review of the literature and included any study reporting direct health services-related costs or the indirect economic burden of IBD in persons aged ≤19 years (PROSPERO protocol number CRD2016036128). A technical panel of experts in pediatric gastroenterology and research methodology formulated the review questions, reviewed the search strategies and review methods, and provided input throughout the review process.

RESULTS

Nine studies met criteria for inclusion, 6 of which examined direct costs, 1 of which examined both direct and indirect costs, 1 of which assessed indirect costs, and 1 of which assessed out-of-pocket (OOP) costs. Inflammatory bowel disease-associated costs were significantly higher compared with costs in non-IBD populations, with wide variations in cost estimates, which prevented us from conducting a meta-analysis. Costs in Crohn's disease were higher than in ulcerative colitis. Overall, direct costs shifted from inpatient hospitalization as a major source of direct costs to medications, mainly driven by anti-tumor necrosis factor agents, as the leading cause of direct costs. Predictors of high costs included uncontrolled disease, corticosteroid treatment in the previous year, and comorbidity burden.

CONCLUSIONS

The pediatric literature examining IBD-attributable costs is limited, with widely variable cost estimates. There is a significant knowledge gap in the research surrounding indirect costs and OOP expenses.

A failed attempt at developing a search filter for systematic review methodology articles in Ovid Embase

OBJECTIVES

This paper describes the development, execution, and subsequent failure of an attempt to create an Ovid Embase search filter for locating systematic review methodology articles.

METHODS

The authors devised a work plan, based on best practices, for search filter development that has been outlined in the literature. Three reference samples were gathered by identifying the OVID Embase records for specific articles that were included in the PubMed Systematic Review Methods subset. The first sample was analyzed to develop a set of keywords and subject headings to include in the search filter. The second and third samples would have been used to calibrate the search filter and to calculate filter sensitivity and precision, respectively.

RESULTS

Technical shortcomings, database indexing practices, and the fuzzy nature of keyword terminology relevant to the topic prevented us from designing the search filter.

CONCLUSION

Creating a search filter to identify systematic review methodology articles in Ovid Embase is not possible at this time.

Use of mobile devices and medication errors in acute care: a systematic review protocol

REVIEW QUESTION/OBJECTIVE

The objective of this review is to synthesize the best available evidence on the effects of healthcare providers using mobile devices at any stage of medication provision on medication errors in acute care settings. Provision of medication includes prescribing, dispensing or administrating medicine in the acute care setting.

An output evaluation of a health research foundation's enhanced grant review process for new investigators

BACKGROUND

We assessed the ability of the Manitoba Medical Service Foundation (MMSF, a small not-for-profit foundation affiliated with Manitoba Blue Cross) to determine the best candidates for selection to receive research funding support among new researchers applying to the Research Operating Grants Programme (ROGP).

METHODS

Using bibliometric and grants funding analyses, we retrospectively compared indices of academic outputs from five cohorts of MMSF-funded and not MMSF-funded applicants to the annual MMSF ROGP over 2008 to 2012, from 1 to 5 years after having received evaluation decisions from the MMSF enhanced grant review process.

RESULTS

Those researchers funded by the MMSF competition (MMSF-funded) had a statistically significant greater number of publications, a higher h-index and greater national Tri-Council (TC) funding, versus those not selected for funding (not MMSF-funded). MMSF-funded applicants and the Manitoba research community have created a strong and rapid (within 1 to 5 years of receiving the MMSF grant) local economic return on investment associated with the MMSF ROGP that supports new investigators, of approximately nine-fold for TC grants by the principal investigator, and of 34-fold for the principal investigator on collaborative (total) TC grants.

CONCLUSIONS

The use of small amounts of seed money for competitive research grants at early stages of an MMSF-funded applicant's career correlates with future short-term success of that applicant. The ability to correctly select promising candidates who subsequently demonstrate greater academic performance after the MMSF funding shows the selection process and the ROGP to be of merit. Multiple components may have contributed to this outcome, including a direct presentation and interview process of the candidate with five-person selection subcommittees, plus an assessment by an external reviewer (the enhanced grant review process). The selection methods used here may add value to the research grant selection processes of new researchers.

Analysis of a librarian-mediated literature search service

Librarian-mediated literature searching is a key service provided at medical libraries. This analysis outlines ten years of data on 19,248 literature searches and describes information on the volume and frequency of search requests, time spent per search, databases used, and professional designations of the patron requestors. Combined with information on best practices for expert searching and evaluations of similar services, these findings were used to form recommendations on the improvement and standardization of a literature search service at a large health library system.

Information needs of public health students

BACKGROUND

The number of public health degrees and programmes is growing rapidly. This means that a diverse and multidisciplinary group of students are in need of expert library services to navigate the complicated world of public health information.

OBJECTIVE

To better understand the information needs of public health students, a group that has not previously been studied in the information needs literature.

METHODS

An online survey.

RESULTS

Of the 153 students, 38 responded (25% response rate). Their responses indicated a strong need for more tailored library instruction sessions at the point of need as opposed to general stand-alone sessions offered at the beginning of a term. It was also found that many students were unaware of public health specific resources available that could greatly aid them in their information needs. Suggestions were made on how to improve the library subject guide, specifically in the areas of more instructions related to locating hard to find resources (e.g. statistics, grey literature), and direct linking to resources (e.g. databases and relevant articles).

CONCLUSION

The information needs of public health students are diverse and complex. It is imperative that the library has a solid understanding of their needs and is able to offer them targeted and relevant library services.

More Academic Librarians in Arkansas with Faculty Status and Rights but Decreased Benefits and Increased Responsibility

A Review of: Vix, H. M., & Buckman, K. M. (2011). Academic librarians: Status, privileges, and rights. Journal of Academic Librarianship, 38(1), 20-25. doi: 10.1016/j.acalib.2011.11.004 Objective – To provide cross-comparable information on the number of students per librarian, salary, faculty status, contract lengths, and maternity benefits of academic librarians. Design – Online questionnaire. Setting – Four-year private, four-year public, and two-year public academic institutions in Arkansas. Subjects – Academic library deans and directors were surveyed three times over a six-year period. Methods – Three surveys were sent to library deans and directors of four-year private, four-year public, and two-year public academic institutions in Arkansas in 2007, 2009, and 2011. The surveys were created by the College and University Library Division of the Arkansas Library Association, with questions created based on reports from the Association of College and Research Libraries (e.g., Standards and Statements). Committee members tested the survey before distribution. Over the course of the six-year period the questions were modified and were chosen to ensure that respondents could easily answer them (i.e., no questions on topics such as retirements, vacation, which can vary significantly from librarian to librarian). All responses were confidential. Main Results – The 2007 survey had a 78% response rate (n=35/45); the 2009 survey had a 93% response rate (n=42/45); and the 2011 survey had a 90% response rate (n=44/49). While the survey covered a number of topics (shown in supplementary material online), the article focused on five areas of interests and had the following findings. 1) The number of students per librarian is increasing at four-year private and two-year public institutions. While the data shows a decrease in the ratio at four-year public institutions the authors believe this is due to the addition of new institutions in the follow-up surveys, one of which had a very low study-to-librarian ration. 2) Tenured librarians make more than non-tenured librarians. 3) The number of institutions granting faculty status is increasing at a statistically significant rate at four-year private and two-year public institutions, and has remained relatively constant at four-year public institutions. 4) Most libraries have 12-month contracts for librarians, although this has decreased slightly over the survey period. 5) The number of institutions providing paid maternity leave has decreased. Conclusion – This study provides a broad overview of the changing state of academic librarians’ rights and benefits in Arkansas over the last six years. Some of the trends demonstrated, such as an increase in the number of students per librarian, are potentially troubling and may have a negative impact on the quality of service provided by individual institutions. Other trends, such as increases in institutions granting faculty status to librarians and decreasing the number of 12-month contracts, may signal that some institutions are beginning to acknowledge the significance and impact of librarian research. Ultimately, this article provides a starting point for other states and provinces to begin collecting similar data in an attempt to understand changing trends in academic libraries.

Undergraduate Library Instruction in the Humanities Increases the Use of Books Over Journals

Objective – To assess the impact of in-class library instruction sessions on the quantity, quality, and format of resources cited by undergraduate students. Design – Citation analysis and literature review. Setting – A public university in the United States with approximately 9,000 undergraduate students. Subjects – Undergraduates in eight first-year Composition I classes and five upper-level Humanities classes at Florida Gulf Coast University (FGCU). Methods – This study consisted of three components. In the first, first-year students with little to no academic library experience from eight classes of first-year Composition I were divided into two groups: those who received library instruction and those who did not. The instruction sessions were all taught by the same librarian, were one-hour hands-on classes held in a computer lab, and focused on basic library information, searching the catalogue, as well as searching journal databases. Later in the term, the citation pages from papers submitted by the students as a class assignment were analyzed by the authors who looked at the average number of citations employed in each paper, the frequency of scholarly citations, and the frequency of source/format type (e.g., book, article, website, etc.). SPSS was used for data recording, storage, and to calculate statistics (although it should be noted that the authors do not include any of the descriptive statistics that can be generated by SPSS). In the second component, which attempted to discern if there were any differences in the citations used by students from the different disciplines, the same form of citation analyses was performed on bibliographies from upper-level students enrolled in five History, Art History, Art, and English classes who had participated in a library instruction session in the past. The results of the two citation analyses (Composition I versus upper-level students) were then compared. The third component compared the results of the citation analyses to data extracted from five similar studies in order to determine if the FGCU findings were typical of undergraduate students or deviated from the norm. Main Results – The comparison of citations from the Composition I students showed that students who received a library instruction session had more average citations per paper (5.3 to 3.2); used slightly more scholarly sources (51.7% to 49.4%); were much more likely to use books (25.6% vs. 6.3%) or magazines and newspapers (18.5% vs. 9.6%) as a source; and were less likely to cite journal articles (16.3% vs. 27.3%) than their counterparts who received no library instruction. Students who had not received instruction were more likely to use videos (5.4% vs. 2.8%) or course texts and handouts (11.7% vs. 0%). Both groups exhibited a preference for material that could be accessed online, and web sites were the most frequently cited source, accounting for nearly one-third of all citations. When the results from the Composition I students who received library instruction were compared to upper-level students who had received instruction in the past, it was found that the average number of citations increased as the course level got higher (i.e., fourth year students used more citations than third year, who used more than second year, etc.). In general, the number of scholarly sources also increased as the course level did. The analysis also showed a strong preference for books over journal articles throughout all classes and course level. Preference for other formats (e.g., web sites, reference sources) varied a great deal and in many cases could be attributed to the nature of the assignments. In order to determine whether the FGCU findings were typical of the undergraduate experience, the citation analyses were compared to five other institutions across the U.S. Results show that the FGCU findings were similar in some aspects; two other institutions also displayed a preference for books, but usage of journal articles in upper-level courses was either the same or lower at FGCU compared to other institutions. Conclusion – For many academic liaison librarians, instruction is an important and time-consuming part of their job. The nature of many library instruction sessions – frequently one-time classes at the beginning of a semester – means instruction is often given without much attention to the impact of the session on the quality of students’ work. This study addresses this issue in order to determine whether library instructions sessions should continue at FGCU in their present format. The findings broadly indicate that library instruction has a large impact on the number of books used and the overall number of resources cited, and a very small impact on the number of scholarly sources cited. It appears that the increased reliance on books by students comes at the expense of journal articles, which were much more frequently used by students who had not received instruction. The study also found that as students progress in their studies, they cite more material and use more scholarly material. This finding is seen in a number of other citation analysis studies located through a literature search. Ultimately, the authors believe that this study demonstrates the usefulness of the library sessions to students, as it causes them to cite more sources, to cite a wider variety of sources, and to cite more books. It is possible that some of the negative findings of the study, specifically related to low journal usage, may be used to alter the structure or content of future library sessions offered by FGCU librarians.

Nutrition, Food Science, and Dietetics Faculty Have Information Needs Similar to Basic and Medical Sciences Faculty – Online Access to Electronic Journals, PubMed/Medline, and Google

Objective – To determine the information needs of nutrition, food science, and dietetics faculty members by specifically examining how they locate and access information sources and which scholarly journals are consulted for teaching, research, and current awareness; and identifying any perceived information service needs (e.g., training). Design – Online survey questionnaire. Setting – Four senior colleges within the City University of New York (CUNY) system. Subjects – Nutrition, food science, and dietetics faculty members. Methods – Using institutional websites and the assistance of relevant affiliated librarians, 29 full-time and adjunct nutrition, food science, and dietetics faculty members were identified at Queens College, Brooklyn College, Hunter College, and Lehman College (all part of the CUNY system). A survey was emailed in June and July 2007 and had 14 (48.4%) responses. The study was temporarily halted in late 2007. When resumed in January 2009, the survey was re-sent to the initial non-respondents; five additional responses were received for a final 65.5% (n=19) response rate. Main Results – The majority of respondents held a PhD in their field of study (63.1%), were full-time faculty (no percentage given), and female (89.5%). Information sources were ranked for usage by respondents, with scholarly journals unsurprisingly ranked highly (100%), followed by conference and seminar proceedings (78.9%), search engines (73.6%), government sources (68.4%), and information from professional organizations (68.4%). Respondents ranked the top ten journals they used for current awareness and for research and teaching purposes. Perhaps due to a lack of distinction by faculty in terms of what they use journals for, the two journal lists differ by only two titles. The majority browse e-journals (55.6%) rather than print, obtain access to e-journals through home or work computers (23.6%), and obtain access to print through personal collections (42.1%). Databases were cited as the most effective way to locate relevant information (63.1%); PubMed was the most heavily used database (73.7%), although Medline (via EBSCO), Science Direct, and Academic Search Premier were also used. Respondents were asked how they preferred to obtain online research skills (e.g., on their own, via a colleague, via a librarian, or in some other way). The linked data does not answer this question, however, and instead supplies figures on what types of sessions respondents had attended in the past (44.4% attended library instruction sessions, while others were self-taught, consulted colleagues, attended seminars, or obtained skills through their PhD research). Conclusion – Strong public interest in nutritional issues is a growing trend in the Western world. For those faculty members and scholars researching and teaching on nutrition and related areas, more work on their information needs is required. This study begins to address that gap and found that nutrition, food science, and dietetics faculty share strong similarities with researchers in medicine and the other basic sciences with regard to information needs and behaviours. The focus is on electronic journals, PubMed/Medline, and online access to resources. Important insights include the fact that print journals are still in modest use, researchers use grey literature (e.g., government sources) and other non-traditional formats (e.g., conference proceedings and electronic mail lists) as information sources, and training sessions need to be offered in a variety of formats in order to address individual preferences.

Higher Education Librarians Are Comfortable and Confident With their Teaching Responsibilities and Pedagogical Knowledge

Objective – The primary objective of this study was to gather quantitative information on the need, development, acquisition, and application of pedagogical knowledge by academic librarians with teaching responsibilities. Design – Online survey questionnaire. Setting – Higher-education (HE) institutions (i.e., post-secondary institutions such as colleges and universities) in the United Kingdom. Subjects – Subject librarians from 82 HE libraries (one from each). Methods – Of the 191 HE institutions in the United Kingdom (determined via a now-unavailable directory), 137 supplied an online staff directory with contact information. One subject librarian from each HE institution was contacted; librarians were selected from the online directory by taking a name systematically from a different point in each listing (i.e., first, second, third, etc). Each librarian was sent an email that contained an introductory message as well as a link to the questionnaire. The online questionnaire was created using Survey Monkey and piloted before and after input. It employed mostly multiple-choice tick boxes as well as open-ended questions and comment boxes. The 35-question survey questionnaire was developed in part through email interviews with two leading researchers in the field (identified via the literature). Responses were received from 82 librarians (60%). The answers were analyzed and cross-tabulated using SPSS. Komogorov-Smirnov tests were done to determine the significance of some results. Open-ended questions and comment boxes were placed into categories using Microsoft Excel to identify patters and themes. Main Results – The 82 librarians who responded to the survey came from a wide variety of backgrounds: the majority were subject librarians from Arts & Humanities (31%), had spent more than ten years in their position (38%), worked full-time (71%), were members of pre-1992 HE institutions (59%), and went by the job title of Subject Librarian (30%) (or a slight variation thereof). Respondents indicated a significant amount of variation in terms of the number of hours spent preparing and teaching each week, ranging from 0 to 25 hours per week (FT staff) and 0 to 12 hours (PT staff). Eleven librarians spent 40% or more of their time teaching. Due to the high standard deviation (5.71), however, and the fact that many librarians indicated difficulty providing precise figures, these percentages should only be used as general estimates. The study found that librarians were involved in a variety of teaching settings, including on-the-spot support, writing materials, teaching small groups, conducting one-on-one instruction, and teaching large groups. Evaluation was not indicated as a regular practice. With regard to pedagogical development, most training was of an informal nature learned on the job (75%) or through trial and error (61%). Other training methods included short courses or training programs, conferences, peer-support groups, and committee work. The most valuable lessons librarians took from their training were awareness of different learning styles (37%), the use of new techniques (29%), and contribution of planning and preparing (27%). A Kolmogorov-Smirnov test was performed on the correlation between involvement in formal training and knowledge of designing learning activities or teaching and learning theories (97.4% and 100% likelihood of a significant impact, relatively). While the authors state in the article that a Chi-square test was done, the original thesis upon which the article is based (available via http://dagda.shef.ac.uk/dissertations/2006-07/External/Cox_Laura_MALib.pdf), notes that the test was not completed as more than 20% of the expected counts were less than five (a frequent limiting constraint of the test). The vast majority felt their work was either important or very important; that they were sufficiently qualified and knowledgeable; and that they were confident providing the sessions. Responses were mixed when it came to determining whether additional training would improve their confidence or aid them in their teaching role. The majority of respondents also felt they had reasonable or extensive knowledge of topics related to their teaching roles (e.g., delivering sessions and information literacy). Indeed, when questioned as to what could improve the effectiveness of their teaching only 36 (44%) responses were given: subject knowledge and e-learning/new technologies were indicated as the most helpful. Librarians indicated that their preferred delivery methods when learning new skills were (in order of popularity): formal sessions, on-the-job development; short courses; and other options (e.g., increased library school training). The majority of respondents noted there were enough opportunities available for them to develop their teaching skills. When asked at the end for additional comments on teaching knowledge and development in general, responses were varied, although many offered suggestions for ways of improving the development and provision of teaching skills within the library profession as a whole. Conclusion – The authors posit that information literacy instruction has become a major component of the job requirement of a subject librarian. Survey results indicate that subject librarians recognize the value of pedagogical knowledge but question the importance of the theoretical aspects; spend a significant amount of time on various types of instruction; learn on-the-job; feel they are sufficiently knowledgeable in their role and feel confident providing instruction; and favour short-courses or formalized programs for continued learning. Future studies would benefit from interviews, additional tools to track instruction details, and perhaps a larger scale.