scholarly journals Implementation of Proactive Chat Increases Number and Complexity of Reference Questions

2017 ◽  
Vol 12 (2) ◽  
pp. 172
Author(s):  
Sue F. Phelps
Keyword(s):  
Literature Review ◽  
Formal Analysis ◽  
Doctoral Degree ◽  
The United States ◽  
Published Data ◽  
Staffing Level ◽  
Chat Reference ◽  
Level 3 ◽  
Reference Service ◽  
Over Time

A Review of: Maloney, K., & Kemp, J. H. (2015). Changes in reference question complexity following the implementation of a proactive chat system: Implications for practice. College & Research Libraries, 76(7), 959-974. http://dx.doi.org/10.5860/crl.76.7.959 Abstract Objective – To determine whether the complexity of reference questions has changed over time; whether chat reference questions are more complex than those at the reference desk; and whether proactive chat increases the number and complexity of questions. Design – Literature review and library data analysis. Setting – Library of a doctoral degree granting university in the United States of America. Methods – The study was carried out in two parts. The first was a meta-analysis of published data with empirical findings about the complexity of questions received at library service points in relationship to staffing levels. The authors used seven studies published between 1977 and 2012 from their literature review to create a matrix to compare reference questions based on the staffing level required to answer the questions (e.g., by a nonprofessional, a generalist, or a librarian). They present these articles in chronological order to illustrate how questions have changed over time. They sorted questions by the service point at which they were asked, either through chat service or at a reference desk. In the second part of the study authors used the READ scale to categorize the complexity of questions asked at the reference desk and via proactive chat reference. They collected data for chat reference for six one-week periods over the course of eight months to provide a representative sample. They recorded reference desk questions for three of those same weeks. Both evaluators scored the data for a single week to norm their results, while the remaining data was coded independently. Main Results – The complexity of questions in the seven articles studied indicated change over time, shown in tables for desk and chat reference. One outlier, a study published in 1977 before reference tools and resources moved online, reported that 62% of questions asked could be answered by nonprofessionals, 38% by a trained generalist, and only 6% required a librarian. The six other studies were published after 2001 when most resources had moved online. Of the questions from these six, authors found a range of 74-90% could be answered by a non-professional, 12-16% by a generalist, and 0-11% required a librarian. Once chat reference was added there was more variation reported between studies, with generalist questions at 30-47% of those reported and 10-23% requiring a librarian. Though the underlying differences in the study designs do not allow for formal analysis, the seven studies indicate that more complex questions are asked via chat service than at the reference desk. Each staffing level was grouped and averaged for comparison. The 1977 study shows nonprofessional questions at 62%, generalist questions at 32%, and librarian questions at 6%. Reference desk questions in the post-2001 articles indicated 81% nonprofessional, 13% generalist, and 5% librarian questions. Post-2001 chat questions were at 49% nonprofessional, 36% generalist, and 15% at librarian level. In the second part of the study, the data coded using the READ scale and collected from the proactive chat system showed an increased number and complexity of questions. The authors identified 4% of questions were rated at a level 1 (e.g., directional, library hours), 30% at level 2 (e.g., known item searching), 39% at level 3 (e.g., reference questions), and 27% at level 4 requiring advanced expertise (e.g., using specialized databases or data sets). Authors combined questions at levels 5 and 6 due to low numbers, and did not describe these when reporting their study. In comparison, 15% of reference desk questions were at a level 3 on the READ scale, and 1% were at level 4. Conclusion – Proactive chat reference service increased the number and the complexity of questions over those received via the reference desk. The frequency of complex questions was too high for nonprofessional staff to refer questions to librarians, causing reevaluation of the tiered service model. Further, this study demonstrates that users still have questions about research, but for users to access services for these questions “reference service must be proactive, convenient, and expert to meet user expectations and research needs” (p. 972).

Examining the Knowledge, Awareness, and Perceptions of Palliative Care in the General Public Over Time: A Scoping Literature Review

2019 ◽  
Vol 37 (6) ◽  
pp. 481-487 ◽  
Author(s):  
Priya Patel ◽  
Laura Lyons
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Literature Review ◽  
General Public ◽  
The United States ◽  
Close Friend ◽  
Poor Knowledge ◽  
The Public ◽  
Scoping Literature Review ◽  
Over Time

Background: The field of palliative care (PC) is growing as the world population ages and burden of chronic diseases increases. Thus, it is important that the general public is knowledgeable about PC and the benefits PC provides. Objective: The aim of this study is to describe the public’s knowledge, awareness, and perceptions of PC and determine whether these have changed over time. Methods: A scoping literature review was conducted from 1968 to May 2019 using PubMed, EMBASE, and MEDLINE databases. Results: Thirteen studies met inclusion criteria that originated from the United States, Canada, Scotland, Italy, New Zealand, Ireland, United Kingdom, Korea, and Sweden between years 2003 and 2019. Participants were adults and mostly younger than 64 years, women, and Caucasian. The majority of studies reported the public having poor knowledge (7/9 articles) and awareness (4/6 articles) of PC over the past 16 years. Top characteristics associated with increased levels of knowledge and/or awareness of PC included women (6/8 articles), age 40+ (6/8 articles), experience with a close friend and/or relative requiring PC (4/8 articles), and working in health-care and/or PC (4/8 articles). The most common perceptions of PC were associated with patients who have terminal illnesses and end-of-life care. Participants commonly received information about PC from the media, having a close friend or relative requiring PC, and working in a health-care setting. Conclusions: The public has poor knowledge and awareness about PC and several misperceptions exist. These findings have remained constant over time despite growth in the field of PC, which highlights the strong need for focused educational interventions.

Can “Seven Be The New Ten” - Adoption Of Restrictive Transfusion Strategies In a Community Hospital

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 2935-2935
Author(s):  
Rahul Singh ◽  
Charin Hanlon
Keyword(s):  
Conflicts Of Interest ◽  
The United States ◽  
General Medical Service ◽  
Published Data ◽  
Chi Square ◽  
Coronary Syndrome ◽  
Pre Treatment ◽  
New Guidelines ◽  
The Impact ◽  
Over Time

Abstract Background An estimated 13,785,000 units of packed red blood cells (PRBC) were transfused in the United States in 2011 of which an estimated 57.9% were found to be from the general medical service, the ICU or hematology/oncology. Risks of blood transfusion include infections, transfusion reactions circulatory overload, and transfusion-related immunomodulation. Furthermore, there is an economic cost to the administration of blood and a personal cost to those volunteers who give their time. There have been a number of guidelines published for the administration of PRBCs. In the past year, the American Association of Blood Banks released new guidelines for PRBC transfusion in hospitalized, hemodynamically stable patients. These guidelines set a threshold Hb of ≤7 g/dL in critically-ill patients, and a Hb ≤8 g/dL for surgical patients, for patients with pre-existing cardiovascular disease, or for patients with relevant symptoms. Symptoms were defined as tachycardia, chest pain or hypotension not corrected by crystalloids. We studied the potential impact on our inpatient hospital utilization of PRBC over time in relation to the publication of recent guidelines. Methods With IRB approval, a retrospective study of PRBC transfusion at New Hanover Regional Medical Center in Wilmington, NC was conducted. The primary endpoint of the study was to evaluate the impact of the new AABB guidelines on the transfusion utilization in the first 12 months. Secondary endpoints included a cost analysis, an evaluation of the use of PRBC for two pre-specified Hb levels, and a quantification of the number of units transfused. A total of 337 patients were reviewed. 116 were excluded due to one of the following reasons: anemia attributed to active blood loss, the presence of stage 5 chronic kidney disease, the presence of an acute coronary syndrome, the recent administration of outpatient transfusions, the use of blood products besides PRBCS, and the timing of a transfusion in the postoperative period. We randomly assigned two separate timeframes to review transfusions at ≤ 4 months and 8-12 months after the AABB guidelines were published. Data was analyzed using Chi-square and T tests. Results The average pre-treatment hemoglobin for the group ≤4 months was 7.82 ± 0.85 and 7.42 ± 0.92 for the 8-12 month group (p=0.0009). The average number of units transfused were 1.66 ± 0.53 and 1.78 ± 0.58 (P=0.1133), respectively. For those patients whose Hb was ≤ 7.0, there was a 21.6% reduction in inappropriate transfusions 8-12 months after the guidelines were released compared with the first 4 months (Chi-Square p = 0.0070). For those patients whose Hb was ≤ 8.0, the number of inappropriate transfusions went from 40.7% in the first group to 17.3% in the second group (Chi-Square p=0.0001). The total cost of transfusions to the patients was estimated to be $102,400 and $55,600 to the hospital. The potential savings if all transfusions were given according to the new guidelines is estimated to be $66,389 to the patients and $36,037 to the hospital. A total of 11,577 transfusions were given between 6/12/12-3/13/13. If the guidelines had been strictly followed, the number of transfusions would have been reduced to 3,855 transfusions. Discussion An improvement in adherence to AABB guidelines with a more restrictive PRBC transfusion strategy was found over time. This can be attributed to physicians practicing evidenced-based medicine. Data of transfusions at pre-treatment Hb ≤7, suggest that physicians are becoming more restrictive in their threshold for transfusions with a statistically significance in the drop of the average pre-treatment hemoglobin. Despite this restrictive pattern, physicians are still uncomfortable at transfusing 1 unit at a time. Although it was not statistically significant between the two groups, the average number of units transfused were ≥1.5, and 67% of the time 2 units were given. Overtransfusion with PRBCs is a problem that needs to be addressed. Physicians should give one unit and reassess for an appropriate response. This strategy will reduce cost to the patient and hospital. We feel that additional improvement is still possible and we are forming a blood management committee to promote better PRBC transfusion practice guidelines. We plan a series of educational presentations to each department along with a new Computerized Physician Order Set to improve patient care and reduce overall cost to the health care system. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Hong Kong’s Currency and Monetary Policy

2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Richard Fast
Keyword(s):  
Monetary Policy ◽  
Hong Kong ◽  
Literature Review ◽  
Central Bank ◽  
Interest Rates ◽  
Mainland China ◽  
The United States ◽  
Monetary Authority ◽  
Future Research ◽  
Over Time

This literature review is a synopsis of what has been written on the currency and monetary policy of Hong Kong since its relinquishment from Great Britain in 1999. In particular, this paper examines the role and policies of the Hong Kong Monetary Authority, the island province’s equivalent to a central bank. Since Hong Kong does not have a central bank per se, it is interesting to note how the money supply is created and maintained, and what its relationship is to mainland China. This institution makes Hong Kong unique among developed economies, which typically have a central bank that oversees monetary creation and policy. The Literature Review is composed of two parts: Part One will cover the revaluation of the Hong Kong Dollar with regard to its value relative to the currencies of China, Japan, Europe, and the United States, particularly during financial crises. This part of the literature review will cover the work of Chan (2002), Schenk (2004), Shah (1996), Cook and Yetman (2004), and Ma and Cheng (2014) as they use different measurement methods to monitor the change in the Hong Kong Dollar’s value over time, especially compared to the period before the creation of the Hong Kong Dollar. Part Two will cover the monetary and macro-economic policies and currency board effectiveness of the Hong Kong Monetary Authority in sustaining the value of the Hong Kong Dollar. This part of the literature review will cover the work of Chen (2001), Siregar and Walker (2000), Chen and Tsang (2020), Funke and Paetz (2000), and Huang and Shen (2017). This paper also includes a section on suggestions for future research, including what effect the shift of pegging the Hong Kong Dollar (HKD) to other currencies, such as the Euro or the Japanese Yen, or when interest rates in other countries are set at zero. The paper wraps up with an overview of the literature discussed and possible paths going forward, including recreating the studies over time to see how effective such a maneuver has been in practice when compared to competing currencies. Followers of the Hong Kong Dollar will especially find these results useful as they seek to exchange currencies for the highest value.

scholarly journals The majority of library clients still use person-to-person interaction when asking reference questions

2006 ◽  
Vol 1 (1) ◽  
pp. 92
Author(s):  
Suzanne Pamela Lewis
Keyword(s):  
Graduate Students ◽  
Literature Review ◽  
The United States ◽  
Health Sciences ◽  
End User ◽  
Virtual Reference ◽  
Reference Services ◽  
Digital Reference ◽  
Reference Service ◽  
The University

A review of: De Groote, Sandra L. “Questions Asked at the Virtual and Physical Health Sciences Reference Desk: How Do They Compare and What Do They Tell Us?” Medical Reference Services Quarterly 24.2 (Summer 2005): 11-23. Objective – To identify similarities and differences in the questions asked at the virtual and physical reference desks of a health sciences library, in order to better understand user needs and highlight areas for service improvement. Also to retrospectively analyze reference statistics collected over the previous six years. Design – Use study; retrospective study of reference statistics for the period July 1997 to June 2003; literature review. Setting – Large academic health sciences library in the United States. Subjects – All questions asked at the reference and information desks, plus questions submitted to the University-wide virtual reference service and answered by a health sciences librarian, over a period of one month. The questions were asked by faculty, staff, students and members of the public. Methods – A literature review was carried out to examine the types of information/reference questions typically asked in health sciences libraries both before and after the mass introduction of remote end-user searching of online resources and the establishment of virtual reference services. Next, the reference statistics collected at the University of Illinois at Chicago (UIC) Library of the Health Sciences between July 1997 and June 2003 were examined. For most of this period a digital reference service was offered using a listserv address to which patrons would submit email queries. Beginning in March 2003, a formal virtual reference service (chat and email) was provided using commercial software. Finally, data was gathered on questions answered by a health sciences librarian, and clients who asked the questions, at either the physical or virtual reference desk, during the month of November 2003 at the UIC Library of the Health Sciences. Library staff completed an online survey form for each question, and if a client asked more than one question, each question was coded individually. Data included: status of client using the service (faculty/staff, undergraduate student, graduate student, non-UIC, unknown); mode of submission (email, chat, phone, in person); and type of question asked (directional, ready reference, in-depth/mediated, instructional, technical, accounts/status and other). In subsequent analysis, the original seven types of questions were further broken down into 19 categories. Main results – It was not possible to undertake a meta-analysis or systematic review of the studies identified in the literature review because of differences in time frames, settings and the categories used to code reference questions. However the following trends emerged: directional questions accounted for between 30 and 35% of questions asked at both physical and virtual reference desks; the remainder of questions were generally about known item searches, library policies and services, research, database use and quick reference. The statistics collected at UIC Library of the Health Sciences over the period July 1997 to June 2003 were analyzed. Coded reference questions fell into one of four categories: ready reference, in-depth reference, mediated searches and digital reference. There was a noticeable drop in the number of reference questions received in 1999/2000 which reflects trends reported in some of the studies identified in the literature review. The number of mediated searches decreased from 154 in 1997/98 to 4 in 2002/2003, but the number of digital reference questions increased from 0 to 508 in the same period. Statistics were collected over the month of November 2003 for 939 questions asked at the reference and information desks which included: 38 e-mail; 48 chat; 156 phone; and 697 in person. The major findings were as follows: • approximately 55% of questions were reference questions (33.5% ready reference, 9.7% in-depth/mediated, 9.7% instructional); 30% were directional; and 10% were technical; it is not stated what the remaining 5% of questions were; • library clients who asked the questions comprised graduate students (26%), faculty (24%), undergraduate students (24%) and non-UIC patrons (22%); • all groups of clients were most likely to ask their reference questions in person; • graduate students were the largest users of email reference (34%), undergraduates were the largest group to use chat (35%) and faculty/staff were the largest group to use the telephone (39%); • 28% of the questions were answered from library’s staff’s general knowledge of the library; 22% using the online catalogue or electronic journal list; 22% by referring the patron to, or using, an online database or resource; 13% by referring the patron to another department in the library (such as circulation); 7% by consulting another individual; and 5% by using print resources. Conclusion – The results of the three parts of this study – literature review, study of 1997-2003 statistics, and in-depth collection of statistics for November 2003 – are difficult to compare with each other. However, the general trend emerging from the results is that some kinds of questions asked by health sciences library clients have remained very much the same regardless of the rise of remote end-user searching and the mode of transmission of the questions. These include questions about library policies and services, journal and book holdings, database searching and instructional support. Questions about citation verification and consumer health appear to be decreasing while technical questions and questions about accessing remote databases and online journals are increasing. The majority of reference questions are still asked in person.

An Analysis of Fraudulent Qui Tam Actions Over Time in the United States

2007 ◽  
Author(s):  
Karen A. Fitzner ◽  
Charlie Bennett ◽  
June McKoy ◽  
Cara Tigue
Keyword(s):  
United States ◽  
The United States ◽  
Over Time

Forecasting Interconnections in International Housing Markets: Evidence from the Dynamic Model Averaging Approach

2020 ◽  
Vol 42 (1) ◽  
pp. 37-103
Author(s):  
Hardik A. Marfatia
Keyword(s):  
Dynamic Model ◽  
Model Averaging ◽  
Housing Markets ◽  
The United States ◽  
Forecasting Model ◽  
Change Over Time ◽  
The United Kingdom ◽  
Novel Approach ◽  
Dynamic Model Averaging ◽  
Over Time

In this paper, I undertake a novel approach to uncover the forecasting interconnections in the international housing markets. Using a dynamic model averaging framework that allows both the coefficients and the entire forecasting model to dynamically change over time, I uncover the intertwined forecasting relationships in 23 leading international housing markets. The evidence suggests significant forecasting interconnections in these markets. However, no country holds a constant forecasting advantage, including the United States and the United Kingdom, although the U.S. housing market's predictive power has increased over time. Evidence also suggests that allowing the forecasting model to change is more important than allowing the coefficients to change over time.

The New Economic Populism and the Future of Inequality in the United States

2017 ◽  
Author(s):  
William W. Franko ◽  
Christopher Witko
Keyword(s):  
United States ◽  
Federal Government ◽  
Labor Unions ◽  
Republican Party ◽  
The United States ◽  
The Public ◽  
Empirical Results ◽  
Income Disparities ◽  
The Face ◽  
Over Time

The authors conclude the book by recapping their arguments and empirical results, and discussing the possibilities for the “new economic populism” to promote egalitarian economic outcomes in the face of continuing gridlock and the dominance of Washington, DC’s policymaking institutions by business and the wealthy, and a conservative Republican Party. Many states are actually addressing inequality now, and these policies are working. Admittedly, many states also continue to embrace the policies that have contributed to growing inequality, such as tax cuts for the wealthy or attempting to weaken labor unions. But as the public grows more concerned about inequality, the authors argue, policies that help to address these income disparities will become more popular, and policies that exacerbate inequality will become less so. Over time, if history is a guide, more egalitarian policies will spread across the states, and ultimately to the federal government.

Biopsychosocial Patterning of Multimorbidity and Its Consequences

2018 ◽  
pp. 220-236
Author(s):  
Elliot Friedman ◽  
Beth LeBreton ◽  
Lindsay Fuzzell ◽  
Elizabeth Wehrpsann
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Functional Outcomes ◽  
The United States ◽  
Chronic Medical Conditions ◽  
Quality Of Life Research ◽  
Increased Risk ◽  
Over Time

By many estimates the majority of adults over age 65 have two or more chronic medical conditions (multimorbidity) and are consequently at increased risk of adverse functional outcomes. Nonetheless, many older adults with multimorbidity are able to maintain high levels of function and retain good quality of life. Research presented here is designed to understand the influences that help ensure better functional outcomes in these older adults. This chapter presents findings that draw on data from the Midlife in the United States study. The independent and interactive contributions of diverse factors to multimorbidity and changes in multimorbidity over time are reviewed. The degree that multimorbidity increases risk of cognitive impairment and disability is examined. The role of inflammation as a mediator is considered. Multimorbidity is increasingly the norm for older adults, so better understanding of factors contributing to variability in multimorbidity-related outcomes can lead to improved quality of life.

scholarly journals The Epidemiology and Genetics of Hyperuricemia and Gout across Major Racial Groups: A Literature Review and Population Genetics Secondary Database Analysis

2021 ◽  
Vol 11 (3) ◽  
pp. 231
Author(s):  
Faven Butler ◽  
Ali Alghubayshi ◽  
Youssef Roman
Keyword(s):  
Literature Review ◽  
Risk Allele ◽  
Statistical Significance ◽  
Elevated Serum ◽  
The United States ◽  
Allele Frequencies ◽  
Racial Groups ◽  
1000 Genomes Project ◽  
1000 Genomes ◽  
Risk Alleles

Gout is an inflammatory condition caused by elevated serum urate (SU), a condition known as hyperuricemia (HU). Genetic variations, including single nucleotide polymorphisms (SNPs), can alter the function of urate transporters, leading to differential HU and gout prevalence across different populations. In the United States (U.S.), gout prevalence differentially affects certain racial groups. The objective of this proposed analysis is to compare the frequency of urate-related genetic risk alleles between Europeans (EUR) and the following major racial groups: Africans in Southwest U.S. (ASW), Han-Chinese (CHS), Japanese (JPT), and Mexican (MXL) from the 1000 Genomes Project. The Ensembl genome browser of the 1000 Genomes Project was used to conduct cross-population allele frequency comparisons of 11 SNPs across 11 genes, physiologically involved and significantly associated with SU levels and gout risk. Gene/SNP pairs included: ABCG2 (rs2231142), SLC2A9 (rs734553), SLC17A1 (rs1183201), SLC16A9 (rs1171614), GCKR (rs1260326), SLC22A11 (rs2078267), SLC22A12 (rs505802), INHBC (rs3741414), RREB1 (rs675209), PDZK1 (rs12129861), and NRXN2 (rs478607). Allele frequencies were compared to EUR using Chi-Square or Fisher’s Exact test, when appropriate. Bonferroni correction for multiple comparisons was used, with p < 0.0045 for statistical significance. Risk alleles were defined as the allele that is associated with baseline or higher HU and gout risks. The cumulative HU or gout risk allele index of the 11 SNPs was estimated for each population. The prevalence of HU and gout in U.S. and non-US populations was evaluated using published epidemiological data and literature review. Compared with EUR, the SNP frequencies of 7/11 in ASW, 9/11 in MXL, 9/11 JPT, and 11/11 CHS were significantly different. HU or gout risk allele indices were 5, 6, 9, and 11 in ASW, MXL, CHS, and JPT, respectively. Out of the 11 SNPs, the percentage of risk alleles in CHS and JPT was 100%. Compared to non-US populations, the prevalence of HU and gout appear to be higher in western world countries. Compared with EUR, CHS and JPT populations had the highest HU or gout risk allele frequencies, followed by MXL and ASW. These results suggest that individuals of Asian descent are at higher HU and gout risk, which may partly explain the nearly three-fold higher gout prevalence among Asians versus Caucasians in ambulatory care settings. Furthermore, gout remains a disease of developed countries with a marked global rising.

scholarly journals Thirty-Day Laboratory-Based Surveillance for Carbapenem-Resistant Enterobacteriaceae in the Minneapolis-St. Paul Metropolitan Area

2014 ◽  
Vol 35 (4) ◽  
pp. 423-425 ◽  
Author(s):  
Edwin C. Pereira ◽  
Kristin M. Shaw ◽  
Paula M. Snippes Vagnone ◽  
Jane E. Harper ◽  
Alexander J. Kallen ◽  
...  
Keyword(s):  
United States ◽  
Metropolitan Area ◽  
The United States ◽  
Carbapenem Resistant ◽  
Over Time ◽  
Carbapenem Resistant Enterobacteriaceae

Carbapenem-resistant Enterobacteriaceae (CRE) are a growing problem in the United States. We explored the feasibility of active laboratory-based surveillance of CRE in a metropolitan area not previously considered to be an area of CRE endemicity. We provide a framework to address CRE surveillance and to monitor changes in the incidence of CRE infection over time.

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