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101.
OBJECTIVE: An updated systematic review was carried out of research studies looking at the value and impact of library services on health outcomes for patients and time saved by health professionals. METHODS: A comprehensive systematic search was undertaken of the published literature to September 2003 in ERIC, LISA, MEDLINE, PREMEDLINE, EMBASE, the Cochrane Controlled Trials Register and Google. Some handsearching was carried out, reference lists were scanned and experts in the field were contacted. Twenty-eight research studies of professionally led libraries for health-care staff, including clinical librarian projects, met the inclusion criterion of at least one health or 'time saved' outcome. Papers were critically appraised using internationally accepted criteria. Data were extracted and results were summarised using a narrative format as the studies were heterogeneous and precluded a statistical analysis. RESULTS: There is evidence of impact from both traditional and clinical librarian services. The higher quality studies of traditional services measured impacts of 37-97% on general patient care, 10-31% on diagnosis, 20-51% on choice of tests, 27-45% on choice of therapy and 10-19% on reduced length of stay. Four studies of clinical librarian projects suggested that professionals saved time as a result of clinical librarian input, and two of these studies showed evidence of cost-effectiveness. However, the clinical librarian studies were generally smaller, with poorer quality standards. CONCLUSIONS: Research studies suggest that professionally led library services have an impact on health outcomes for patients and may lead to time savings for health-care professionals. The available studies vary greatly in quality but the better quality studies also suggest positive impacts. Good practice can be gathered from these studies to guide the development of a pragmatic survey for library services that includes the direct effects for patients among the outcome measures.  相似文献   
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Abstract This paper examines the effect of participating in a web-based health programme that promotes personal tracking of high school students' own measurements of a number of health-related parameters. Danish cross-sectional survey data were used to examine the effects of the health programme on various health measures. Both quantile regression models and standard ordinary least squares (OLS) models were used to explore the correlations between the students' participation in the health programme and their body mass index (BMI), body fat percentage, aerobic fitness, and well-being. Participation in the health programme increased BMI and aerobic fitness among students with a BMI or an aerobic fitness value ranging from the 25th percentile to the 75th percentile and reduced body fat percentage among students with the highest percentages of body fat. In addition, the health programme led to an increased feeling of wellbeing among students, especially those with high BMI levels and poor aerobic fitness. As the schools participated in the health programme on voluntary basis and at a financial cost to themselves, the positive effects of participation found can only be stated to be valid among students from committed schools.  相似文献   
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Research on knowing in childbirth has largely been a quantitative process. The purpose of this study was to understand the ways first-time mothers learn about birth. A phenomenological approach, using a feminist view, was used to analyze two in-depth interviews and journals to understand nine first-time expectant mothers' experiences of knowing in childbirth. The findings demonstrated a range of knowledge that contributed to issues of control and conflict. The participants also described an increased dependency on their mothers and a lack of their own intuition contiguous to the birth process. These findings contribute understanding to how expectant mothers know birth, suggesting that their knowing does not diminish conflict surrounding the event and may even exacerbate it when not combined with learning skills to manage conflict. Childbirth educators may want to include instruction on negotiating power differential in relationships encountered during childbirth in order to strengthen a first-time mother's ability to receive the care she wants. Educators may also want to assess the expectant mother's view of birth and her expectations for birth. Schools of nursing should consider the inclusion of women-centered care curricula at both the undergraduate and graduate levels. The mothers' responses in this study clearly reveal that the politics surrounding birthing remain in place and must be removed in order to provide a supportive environment for normal birth.  相似文献   
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This paper explores the ways in which sixth‐form students in Milton Keynes negotiate their identities and the symbolic significance they attach to leisure activities in the process of doing this. The paper draws upon qualitative, young‐person‐centred interviews with sixth formers in state and private schools. We address the investments of sixth formers in constructing themselves as autonomous individuals and argue that they do so from a position of middle‐class subjects‐in‐the‐making. Through an inversion of Willis’ (1977 Willis, P. 1977. Learning to labour, Aldershot: Gower.  [Google Scholar]) (focus, our concern is to make explicit the implicitly middle‐class identities sixth formers were forging. We argue that the identity‐work of sixth formers plays a part in the reproduction of school‐based class inequalities by pathologising working‐class students while constructing themselves as bourgeois liberal individuals.  相似文献   
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Background: Various methods of impact assessment for health library services exist, including a toolkit developed for the UK. The Knowledge, Resource and Information service (KRIS) for health promotion, health service commissioning and public health (Bristol area, UK) commissioned an independent team at Aberystwyth University to provide an impact assessment and evaluation of their services and to provide evidence for future planning. Objective: The review aimed to provide an action plan for KRIS through assessing the impact of the current service, extent of satisfaction with existing services and views on desirable improvements. Methods: Existing impact toolkit guidance was used, with an adapted impact questionnaire, which was distributed by the KRIS staff to 244 users (response rate 62.3%) in early 2009. The independent team analysed the questionnaire data and presented the findings. Results: Users valued the service (93% considered that relevant information was obtained). The most frequent impacts on work were advice to patients, clients or carers, and advice to colleagues. Literature searching and current awareness services saved staff time. Many users were seeking health promotion materials. Conclusion: The adapted questionnaire worked well in demonstrating the service impacts achieved by KRIS, as well as indicating desirable improvements in service delivery.  相似文献   
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This study seeks to present data and discussion arising from a case study of a school in Finland renowned for its practice in the inclusion of learners with additional support requirements due to cognitive and physical disabilities. It aims to establish how the school staff understand their practice with inclusion through day-to-day professional experiences. The process of reflexive dialogue has enabled authors to reconceptualise our understanding of inclusive education through gaining deep contextual insight. The case study emerges as an inspiring effort to reduce exclusion and isolation through skilful manipulation of physical, institutional and communicative contexts, from which we may draw valuable lessons. The case study demonstrated high levels of personal motivation in teachers and assistants, used as a force for participation in inclusive education – bottom-up, via dialogue, consultation, voluntary involvement and transformation by exposure. This democratic approach was evident in and supported through leadership and management, teaching and learning, and the involvement of the wider community.  相似文献   
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