ObjectiveTo characterise clinical questions raised by providers in the care of complex older adults in order to guide the design of interventions that can help providers answer these questions.Materials and methodsTo elicit clinical questions, we observed and audio recorded outpatient visits at three healthcare organisations. At the end of each appointment, providers were asked to identify clinical questions raised in the visit. Providers rated their questions based on their urgency, importance to the patient's care and difficulty in finding a useful answer to. Transcripts of the audio recordings were analysed to identify ageing-specific factors that may have contributed to the nature of the questions.ResultsWe observed 36 patient visits with 10 providers at the three study sites. Providers raised 70 clinical questions (median of 2 clinical questions per patient seen; range 0–12), pursued 50 (71%) and successfully answered 34 (68%) of the questions they pursued. Overall, 36 (51%) of providers’ questions were not answered. Over one-third of the questions were about treatment alternatives and adverse effects. All but two clinical questions were motivated either directly or indirectly by issues related to ageing, such as the normal physiological changes of ageing and diseases with higher prevalence in the elderly.ConclusionsThe frequency of clinical questions was higher than in previous studies conducted in general primary care patient populations. Clinical questions were predominantly influenced by ageing-related issues. We propose a series of recommendations that may be used to guide the design of solutions to help providers answer their clinical questions in the care of older adults.

Purpose University of Utah has created various partnerships to improve health literacy and health outcomes among patient populations, employees and community members. Health sciences librarians have been key members of these partnerships. This paper aims to describe and share several of these partnerships, including training programs, research efforts and advocacy initiatives, to encourage others to engage in similar activities. Design/methodology/approach Case studies include outreach projects and partnerships to foster health literacy and promote healthy living such as: highly visible information resource provision and associated outreach for patients and families; community health fairs; research on providing point-of-need information for vulnerable community populations; health literacy awareness and resources for professionals; health literacy education for interprofessional students; and a competition for interprofessional students to create health videos to address a variety of topics in multiple languages. Findings Partnerships and outreach efforts lead to improved awareness by institutional personnel of the importance of health literacy. Research on using health literacy to empower patients and increase patient satisfaction can demonstrate how to lower institutional costs and improve guideline compliance, as well out health outcomes. Originality/value Librarians’ instructional skills create personal health educational content for patients and professionals; engaging colleagues to address health literacy lowers health care costs, institutional costs and increases patient compliance and satisfaction.

2012 Amos, Mower, James, Weber, Yaffe, and Youngkin. This is an Open Access article distributed under the terms of the Creative Commons-Attribution-Noncommercial-Share Alike License 2.5 Canada (http://creativecommons.org/licenses/by-nc-sa/2.5/ca/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly attributed, not used for commercial purposes, and, if transformed, the resulting work is redistributed under the same or similar license to this one. AbstractObjective -The research project sought to explore the value of data on publication patterns for decision-making regarding scholarly communications and collection development programs at a research-intensive post-secondary institution, the University of Utah in the United States.Methods -Publication data for prolific University of Utah authors were gathered from Scopus for the year 2009. The availability to University of Utah faculty, staff, and students of the journals in which University of Utah authors published was determined using the University of Utah Libraries' catalogue; usage was estimated based on publisher-provided download statistics and requests through interlibrary loan; and costs were calculated from invoices, a periodicals directory, and publisher websites and communications. Indicators of value included the cost-per-use of journals to which the University of Utah Libraries subscribed, a comparison of interlibrary loan costs to subscription costs for journals to which the University of Utah Libraries did not subscribe, the relationship between publishing venue and usage, and the relationship between publishing venue and cost-per-use.

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