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Neurological conditions frequently affect hand activity impacting on independence in carrying out everyday tasks. Splinting is frequently completed in neurological rehabilitation to promote incorporation of the affected hand into everyday tasks and to prevent disability. Here we consider the evidence base, clinical reasoning, and application for functional splinting.

In response to the COVID-19 epidemic, universities were forced to shift to an online, remote delivery system. This paper presents the design and evaluation of two skills-based first-year units that were adapted to a predominantly asynchronous mode of delivery. The evaluation results indicate that student engagement was high, and that students felt well-supported by the strong teacher presence throughout their units. Furthermore, the impact of this engagement and support was evident in their final grades and the overall unit completion figures. These findings indicate that individualized support, teacher presence and flexibility are key factors in student success in an online environment. This suggests that asynchronous learning can be valuable to students from various academic backgrounds providing that the content and teacher are readily accessible in various formats and that the teachers are mindful of the complexities of students’ lives outside of an academic setting.

The expectation that tertiary education leads to employment is one that most commencing students hold. A problem arises when there is a gap between the knowledge and skills students expect to acquire and the knowledge and skills course designers and teachers expect students to develop. The present study interviewed 22 first year students and 12 final year students to explore their expectations and experiences of employability teaching and learning, and compared these to the conceptions of employability articulated in their institution’s policy documentation. The findings suggest that most students believed that, to achieve their career goals, their primary focus should be on completing their academic studies, and that all relevant knowledge and skills would be unveiled during this process. As such, they viewed their time at university as a distinct stage in their development, one that must be completed before they move on to engage with the challenge of employment. Such expectations differ in important ways from those of the institution at which participants were enrolled, which sets employability within the context of an ever-changing job market and the consequent need for life-long learning. Moreover, while the institution clearly articulates the skills that they believe are embedded within their units and courses, this is not being conveyed to students. Implications of this research highlight the need to carefully consider what expectations students are bringing with them regarding the enhancement of employability and how institutions can best act to bridge the gap between students’ expectations and their own.

The widely held view that higher education constitutes a gateway to employment has underpinned the dramatic widening of access to university in recent decades. However, globalisation and technological development have complicated the task of enhancing the employability of students, as the future world of work has become ever-more dynamic and unpredictable. Given such conditions, the delivery of employability teaching has become a central focus of many higher education providers (HEPs). To meet their responsibilities, HEPs must understand how students perceive their respective courses in relation to the employment pathways that they seek to follow. The present study aimed to gain an understanding of prospective students’ perceptions regarding this, but also to evaluate the accuracy of these perceptions. Because some course types are more narrowly vocational than are others, a subsidiary aim was to investigate whether or not student expectations and knowledge varied depending on course-type. The findings gathered from 462 students enrolled into a wide range of courses at 15 Australian universities were profound. They highlight that, while most students commence university with a career goal in mind, many have a poor understanding of the education-employment pathways on which they have embarked. Students demonstrated a limited understanding of the careers to which their courses might lead, and of the relevance of postgraduate study to their chosen career goals. These findings varied significantly across different course-types. Overall, these findings highlight the need for HEPs to educate their students explicitly about the education-employment pathways that are available to them.

This article examines the narratives that drive university staff understanding of the concerns and experiences of regional and remote students at five universities in Australia. Interviews were conducted with thirty university staff members over a period of three months in 2018. Reflexive thematic analysis of the stories told by staff of supporting regional students found that staff used the lens of access to create meaningful stories for themselves and others in how they supported students. Access is defined as a multi-faceted term encompassing access to people, Internet, study materials and equipment and study environments. Access is facilitated by a sense of belonging or identity as a student and limited by the lack of this. Our analysis of “belongingness” draws on Bourdieu’s concepts of habitas to start to unpick the interactions between higher education institutions and the student that develop student identities as scholars and centres the narrative on the student as a person, wrestling to gain many forms of access within complex social situations.

Somewhere between 50-80% of stroke survivors have upper limb symptoms after acute stroke1 and persistent difficulty in using the upper limb is a major contributor to ongoing physical disability.2 A commonly held view is that most recovery from stroke occurs over the first three to six months after which little improvement is possible, especially at the level of impairment.3-6 We argue that this may be a self-fulfilling prophecy resulting in lack of provision of potentially helpful rehabilitation.

The literature indicates that collaborative activities can support professional learning (PL) for academics teaching in higher education (HE). Nevertheless, limited approaches for collegial PL exist that can be embedded in the day-to-day work of busy academics. This paper reports on an evidence-based approach to practice that was undertaken to develop an authentic, structured, collegial approach to PL for academics. This involved a review and synthesis of relevant literature, which revealed that collegial PL could be supported through self-initiated communities of academics; collaborative, social interaction with peers; safe, non-judgemental, supportive, conversations; critical reflection; sustained inquiry into practice; an exploration of perspectives; and bespoke resources. These findings informed the development of the Collaborative Peer-Observation Learning Circles (CPO/LC). The approach includes a four-stage process and adaptable template resources designed to facilitate academics' collegial PL while also meeting the needs of accreditation requirements in HE.

Objective – To answer two research questions: 1) What is the relationship between the visual design of a consumer health information web site and perceptions of the credibility of information found on it? 2) Is there a relationship between brand recognition, visual design preference, and credibility judgments?Design – Qualitative (correlation of rating of response to stimulus) and quantitative (credibility coding of participant comments)Setting – Not stated; assumed to be academic institutions in the United States.Subjects – Thirty-four participants over the age of 35 (34 for statistical power and age over 35 on the hypothesis that this age group is most likely to seek health information on the Internet).Methods – Screen shots of 31 consumer health information sites chosen from the results of a Google search using the term “consumer health information” were converted to slide format and shown to participants. The 31 sites included 12 of the top ranked consumer health information sites derived from three sources: the Consumer and Patient Health Information Section (CAPHIS) of the Medical Library Association (MLA), the MLA itself, and Consumer Reports. Participants were read and shown a script explaining the process prior to being asked to view and rate the 31 sites. Participants were first shown a blank slide with a crosshair to focus attention. Then a stimulus slide was shown for 2.8 seconds. A blank black screen was shown while they determined their rating. Participants were first asked to rate the visual design and aesthetics of the 31 web sites using a rating scale of -4 to -1 for negative judgments and +1 to +4 for positive judgments. Then they were asked to remember why they had made positive or negative ratings and why some web sites were preferred to others. The process was repeated with the slides re-ordered, and participants were asked to rate the credibility of the sites using the same rating scales. Upon completion, participants were asked to recall their reasons for positive or negative credibility ratings. All ratings were converted to positive numbers and a scale of 1-8 was used to present results. A variety of statistical analyses were carried out on the data, including correlation, means ratings, and rankings. In addition, all solicited comments on credibility were coded using Fogg’s four types of credibility (surface, earned, presumed, and reputed) in order to try to understand why participants rated the credibility of sites as they did.Main Results – For the first question, concerning the relationship between visual design preferences and perceived credibility, the results are complicated. A statistically significant correlation was reported between visual design preference and perceived credibility in 8 of the 31 sites (26%). In these instances where visual design is rated highly, so is credibility. When visual design ratings were ranked highest to lowest, credibility ratings followed the same pattern. Similarly, when credibility ratings were ranked highest to lowest, visual, design ratings followed. A t-test confirmed that sites perceived to have higher credibility were also perceived to have better visual design. Furthermore, when design and credibility ratings were compared to site traffic rankings, as measured by Alexa (http://www.alexa.com), the trend was for both visual design and credibility ratings to decline as the site traffic ranking declined. This finding was also confirmed by a t-test. While there is not an exact relationship, the tendency is for sites with higher visual design ratings to also receive higher ratings for perceived credibility.On the second question, concerning the relationship between brand recognition and visual design and perceived credibility judgments, the results suggest a possible influence of brand name. This relationship is not clear, and as visual designs were always presented and rated first, there is possibly a co-founder. The analysis of participant comments found that participants performed credibility judgments in a very short time using a variety of criteria, including visual design, source of the site, reputation of the site, and prior use. There were negative reactions to the use of advertisements, drug and insurance company sponsorship, and dot com sites, as well as some suspicion that non-US consumer health information sites were less trustworthy.Conclusions – Visual design judgments bore a statistically significant similarity to credibility ratings. Sites with recognizable brands were highly rated for both credibility and visual design, but this relationship was not statistically significant. The relationship is complicated and more research is needed on what visual design cues are important to credibility judgments.

Objective – To determine whether the use ofPubMed methods-based filters and topic-basedfilters, alone or in combination, improvesphysician searching.Design – Mixed methods, surveyquestionnaire, comparative.Setting – Canada.Subjects – Random sample of Canadiannephrologists (n=153), responses (n=115),excluded (n=15), total (n=100).Methods – The methods are described in detailin a previously published study protocol by asubset of the authors (Shariff et al., 2010).One hundred systematic reviews on renaltherapy were identified using theEvidenceUpdates service(http://plus.mcmaster.ca/EvidenceUpdates)and a clinical question was derived from eachreview. Randomly-selected Canadiannephrologists were randomly assigned aunique clinical question derived from thereviews and asked, by survey, to provide thesearch query they would use to searchPubMed. The survey was administered untilone valid search query for each of the onehundred questions was received. The physician search was re-executed and compared to searches where either or both methods-based and topic-based filters were applied. Nine searches for each question were conducted: the original physician search, a broad and narrow form of the clinical queries therapy filter, a broad and narrow form of the nephrology topic filter and combinations of broad and narrow forms of both filters.Significance tests of comprehensiveness (proportion of relevant articles found) and efficiency (ratio of relevant to non-relevant articles) of the filtered and unfiltered searches were conducted. The primary studies included in the systematic reviews were set as the reference standard for relevant articles.As physicians indicated they did not scan beyond two pages of default PubMed results, primary analysis was also repeated on search results restricted to the first 40 records.The ability of the filters to retrieve highly-relevant or highly-cited articles was also tested, with an article being considered highly-relevant if referenced by UpToDate and highly-cited if its citation count was greater than the median citation count of all relevant articles for that question – there was an average of eight highly-cited articles per question.To reduce the risk of type I error, the conservative method of Bonferroni was applied so that tests with a pMain Results – Response rate 75%. Physician-provided search terms retrieved 46% of relevant articles and a ratio of relevant to non-relevant articles of 1:16 (pConclusion – The use of PubMed search filters improves the efficiency of physician searches and saves time and frustration. Applying clinical filters for quick clinical searches can significantly improve the efficiency of physician searching. Improved search performance has the potential to enhance the transfer of research into practice and improve patient care.

Objective – To explore the role and expectations of patrons and staff about the role of a public library in enabling citizens’ “health information work.” This involves helping citizens take responsibility for their own health care by finding and using health information.Design – Case study.Setting – A single, UK public library with a self-service delivery model based in a city centre in the spring of 2006. Self-service also applies to reference services and is designed to “empower users to locate and use information on their own.”Subjects – 202 library visitors who came to the library specifically to find health information completed a questionnaire, 15 of these visitors were later interviewed; 19 library staff (10 librarians, 6 library officers and 3 senior managers).Methods – Mixed quantitative and qualitative methods. A print questionnaire was administered to adult library users (age 18 and over). Semi-structured interviews were conducted with fifteen randomly selected library users who completed the questionnaire, sixteen library staff who worked directly with library users, and with three librarians in senior management positions in the library. Descriptive statistics were calculated from the questionnaire, recorded interviews were transcribed, and the text analyzed to identify recurring themes.Main Results – While all respondents came to the library to seek health information results from the questionnaire found that half (50%) of respondents came to the library to look for information on a specific health problem; 37% of respondents had tried finding information elsewhere before coming to the library; 40% usually searched the Internet when they needed health information or advice although only 32% reported trusting the Internet somewhat or completely; 67% intended to borrow books; only 4% indicated that they had planned to ask library staff for help; and 59% reported finding what they were looking for by themselves.Results from the interviews found users, front line staff, and managers in general agreement about the role of the library as a starting point for health information, and that the library was a neutral and non-threatening environment. There was also agreement among the three groups interviewed that the public library fills a gap when health care providers, particularly doctors, are unable to meet the information needs of some of their patients. Library staff were concerned about interpreting information as well as the impact of a self-service philosophy on the quality and length of interactions with users, and seemed unclear about their role in relation to health information provision. Library staff had no training in supporting health information and limited or no knowledge of authoritative online health resources and how to use them, and their approach to Internet searching was similar to users. This lack of training and expertise appeared obvious to library users. Users did not identify interpretation of information by librarians as an issue but did reference the impact of self-service and the Internet on the role and morale of the library staff. Neither library users nor library staff identified librarians as a resource to be used when seeking health information. The value of the library for users was the book collection and they saw the library as second only to physicians as a source of trustworthy information.Conclusion – Uncertainty about the role of librarians in health information provision was evinced by both librarians and library users. Both groups were also uncertain about the relationship between self-service and technology, and the way in which librarians and their work are almost invisible. Health policies emphasize personal responsibility for health yet individuals are not enabled to find answers to their questions. The absence of health knowledgeable front line staff in public libraries is “worrisome.” The obvious trust users have in the library suggests that efforts to develop consumer health information in these settings continue to be a worthwhile response to the “pressures on citizens to take responsibility for their health”.

Objective – To compare the completeness and accuracy of information about osteosarcoma in Wikipedia to information found on the patient and health professional versions of the U.S. National Cancer Institute (NCI) website.Design – Comparative study, test against 20 item questionnaire and expert opinion.Setting – n/aSubjects – n/aMethods – The authors developed a 20-item questionnaire to test the completeness and accuracy of information on osteosarcoma in Wikipedia and on the "patient version and the health professional version of the National Cancer Institute's website as 'official' reference websites" (p. 373). Three independent observers, two surgeons specializing in musculoskeletal tumour surgery and a medical student, tested the English language version of Wikipedia and the NCI “websites” on April 3, 2009. Answers to the 20 questions found on the websites were scored from zero to three and were discussed with a member of the "German board for guidelines in musculoskeletal surgery" (p. 373) and verified against international guidelines published by the World Health Organization. Data was analyzed using SPSS and group comparisons were performed using Mann-Whitney U test with p-values of less than 0.05 significance. Main Results – The quality of information about osteosarcoma found in the English language version of Wikipedia was good but inferior to the patient information from NCI. Out of a total of 60 points Wikipedia scored 33, NCI patient information 40 and NCI professional information 50. There was no significant difference between the NCI patient information and Wikipedia but a significant difference (p=0.039) between Wikipedia and NCI professional information.Conclusion – Non-peer reviewed websites providing health information, such as Wikipedia, should include links to sites such as NCI and other more definitive sources such as professional and international organizations. Frequent checks should be used to ensure external links are of the highest quality.

Objective – To provide an action plan for the Knowledge, Resource and Information Service (KRIS) based on an impact assessment of current services, satisfaction with current services, and views on desirable improvements to service and service delivery.Design – Questionnaire for KRIS service users and interviews with KRIS staff.Setting – Two locations served by KRIS in the north and south of Bristol City in the UK – one a health promotion service and one a National Health Service (NHS) teaching hospital.Subjects – A convenience sample of a total of 244 users of the library services at the two locations, 121 users at the health promotion service site and 123 users at the hospital site.Methods – A questionnaire designed for a previous NHS library service impact study was adapted for use with staff other than health workers, since teachers and youth workers, for example, also used the health promotion service. The researchers circulated the questionnaire by mail and email to prospective respondents. The questionnaire asked participants to reflect on the most recent time they had used KRIS services and provide details on the purpose of use, what elements of the service they used, satisfaction with the service or the information provided, the immediate impact on their work, and its probable contribution to future work. It also asked about desirable improvements and how KRIS contributed to the respondents’ work and continuing professional development. The researchers interviewed KRIS staff face to face and asked for their views on the history of the service and future developments.Main Results – The overall response rate was 62.3% (152/244), with similar responses from each site. Community nurses and midwives were the largest group of respondents (n=31, 20.4%), followed by managers and administrators (n=24, 15.8%).Both sites reported health promotion activities as the dominant reason for use. Health promotion leaflets (n=94, 61.8%) and resources for loan (n=57, 37.5%) were the top two service elements used, with literature searching third (n=46, 30.3%).The service completely met the needs of 93% (n=141) of respondents, with 97.4% (n=148) reporting being wholly satisfied that information was delivered in time.In terms of the immediate cognitive impact of the information obtained, 93% (n=141) reported obtaining relevant information, 76% (n=115) current information, and 72% (n=109) accurate information. Nearly 70% were distributing information or resources to other people, and 68% were sharing or discussing information provided with colleagues. Nobody claimed that they had found little or nothing of value.Advice to patients, clients or carers was the most frequently cited impact category (n=104, 68%), followed by advice to colleagues (n=84, 55.3%).The main strengths of the service were the perceived reliability of the service, the current awareness and alerting service run from one site, and literature searching support for commissioning and public health enquiries. Respondents reported saving time, and the main cognitive impact was the perceived relevance of the information obtained. Service weaknesses identified related to accessibility issues such as parking, opening hours, and staff coverage, and outreach was identified as the main service development opportunity.Conclusion – The adaptation of an existing questionnaire provided a clear assessment of the effectiveness of a primary health care information service to a broad spectrum of users. Respondents identified what they valued about the service and how it could be improved.

Objective – To explore and analyze, against three theoretical frameworks of information behaviours, how people with HIV/AIDS, their friends, and their family living in rural communities find information on HIV/AIDS.Design – Qualitative, individual, in‐depth, semi‐structured interviews.Setting – Two rural regions in Ontario, Canada.Subjects – Sixteen participants; 10 people with HIV/AIDS (PHAs) and 6 family members or friends.Methods – Participants were recruited through health care providers, social service agencies and through snowball sampling. Semi‐structure interviews were conducted focusing on participants’ experience with HIV/AIDS, how they find and use information on HIV/AIDS, networks for information exchange and the effect of technology on information exchange. Interviews were taped, transcribed, analyzed qualitatively using NVivo software. Results were compared to three theoretical frameworks for information behaviour: 1. purposeful information seeking (i.e., the idea that people purposefully seek information to bridge perceived knowledge gaps); 2. non‐purposeful or incidental information acquisition (i.e., the idea that people absorb information from going about daily activities); and 3. information gate keeping (i.e., the concept of private individuals who act as community links and filters for information gathering and dissemination).Main Results – Consistent with the theories:•PHAs prefer to receive information from people they have a personal relationship with, particularly their physician and especially other PHAs.•PHAs’ friends and families rely on their friends and family for information, and are particularly reliant upon the PHA in their lives.•Fear of stigma and discrimination cause some to avoid seeking information or to prefer certain sources of information, such as healthcare providers, who are bound by codes of professional conduct.•Emotional support is important in information provision and its presence supersedes the professional role of the provider (social workers and counsellors were identified as key information sources over medical professionals in this instance). Participants responded negatively to the perceived lack of support from providers including doubting the information provided.•PHAs monitor their worlds and keep up to date about HIV/AIDS.Inconsistent with theories:•Reliance on caregivers for information is not solely explained by fear of stigma or exposure. Rather, it is the specialized knowledge and immersion in HIV/AIDS which is valued.•The distinction between peer or kin sources of information and institutional information sources is less clear and relationships with professionals can turn personal over time.•Inter‐personal connections include organisations, not just individuals, particularly AIDS Service Organizations and HIV specialist clinics.•Relatively few incidents of finding useful information about HIV/AIDS incidentally were described. The concept of information just being “out there” was not really applicable to rural settings, likely due to the lack of discussion within participant communities and local media. When it was discussed, participants reported being more likely to gain misinformation through their personal networks.•Incidental information acquisition originates mostly from professional and organisational sources. Participants identified posters, leaflets, and, for those who interacted with organisations, information via mail as contributing to current awareness.•The gate keeping concept does not capture all the information sharing activities undertaken by “gate keepers” in rural areas, and neither does it include formal providers of information, yet all PHAs interviewed identified formal providers as key sources.Conclusion – The findings reinforce some of the existing analytical framework theories, particularly the importance of affective components (i.e. emotional supports) of information seeking, the presence of monitoring behaviours, and of interpersonal sources of information. However, alternate theories may need to be explored as the role of institutional information sources in the lives of PHAs doesn’t match the theoretical predication and the “gate keeper” concept doesn’t capture a significant portion of that role in rural HIV/AIDS information exchange.

Objective – To describe and categorize the status of librarians at 119 American research libraries using a typology of librarian status first developed for 50 U.S. land grant universities.Design – Survey.Setting – U.S. research universities.Subjects – 119 American research universities. Included are those universities whose library is a member of the Association of Research Libraries (ARL), in addition to land grant universities who are not also ARL members, and any flagship state universities who are neither ARL nor land grant universities. All subjects are classified as either “research – very high” or “research – high” in the Carnegie Classification of Institutions of Higher Education. The 119 institutions represent a total census of the selected population.Methods – The websites of the 119 institutions were surveyed and data on institutional characteristics such as governance, size and geography collected. Additionally, data describing librarian status characteristics such as administrator title, rank systems and tenure status was gathered from sources such as promotion and tenure documentation, faculty handbooks, and policy manuals available on websites. Data was compiled on a spreadsheet and imported into SPSS which was used to create frequencies and cross tabulations. Data was categorised and cross‐tabulated using a typology of status originally applied to 50 land grant universities in a previous study. The typology comprises four possible status types for librarians: Type 1 – Faculty: Professorial ranks. Type 2 – Faculty: Other ranks with tenure. Type 3 – Faculty: Other ranks without tenure.Type 4 – Non‐faculty: Professional or academic staff.Main Results – In the 119 institutions surveyed, librarians held faculty status at 74 (62%) institutions, of which 63 (51%) provided tenure track positions. At the remaining 45 (38%) institutions, librarians were considered non‐faculty.Of the 50 “land grant” institutions in the population, 40 (80%) had librarians with faculty status and 35 (70%) provided tenure track. Ten universities (20%) considered librarians non‐faculty.Of the 97 ARL libraries in the population, 55 (57%) had librarians with faculty status and 44 (45%) provided tenure track. Non‐faculty librarians were found at 42 (43%) of these institutions.Of the 90 public institutions in the population, 68 (76%) had librarians who were faculty, 57 (64%) provided tenure track, and 22 (24%) had non‐faculty librarians. Among the 29 private institutions the status ratios were reversed with only 4 (13%) institutions having librarians ranked as tenure track faculty (type 1 or type 2) and 23 (80%) having non‐faculty librarians.In the total population (119) type 3 “Faculty: Other ranks without tenure” was the least common category, 48% (57) of libraries were headed by a dean, 67% (80) of institutions had librarian representation on faculty senate and as the size of an institution increased the likelihood of librarians having faculty rank decreased. “Dean” was the most popular administrator title in the population; it correlated with professorial rank and was strongly associated with tenure. Having tenure was, in turn, strongly associated with faculty senate representation. In the Northeast census region type 4, non‐faculty staff predominated while type 1 was rare; in the Midwest there was an almost even split between type 1 and type 4; in the South there was a fairly even spread across all four types, and in the West a fairly even spread across types 1, 2 and 4. Finally, the data showed that as the size of an institution increased, the likelihood of librarians having faculty rank decreased.Conclusion – The typology created for land grant universities can be extended and applied to a wider population. It is valid and reliable both for organizing information about librarian status and for comparing institutions and population segments.