Background Because of complications and its invasive nature, fundoplication is often a treatment of last resort for children with gastroesophageal reflux. Gastroesophageal reflux testing does not always predict who will benefit from antireflux surgery. Furthermore, there are no studies to determine whether a higher preoperative reflux burden, including acid and nonacid reflux, is associated with an improved postfundoplication outcome. The aim of the study was to determine predictors of fundoplication outcome including acid and nonacid reflux burden. Patients and Methods We retrospectively reviewed preoperative pH-multichannel intraluminal impedance tracings and medical records of 34 patients who underwent fundoplication. Patients were categorized as improved or not improved, and the demographic and reflux characteristics were compared between groups. Multivariate analysis was performed to determine predictors of outcome. Results No single reflux marker, including the number of acid, nonacid, total events, or the percentage of time that reflux was in the esophagus, predicted fundoplication outcome (P >0.1). Neither a positive symptom index nor a positive symptom sensitivity index predicted postoperative improvement (P >0.4). Receiver operating characteristic curve analysis failed to reveal an ideal value to maximize sensitivity for either the symptom index or the symptom sensitivity index. Conclusions pH- multichannel intraluminal impedance testing may not be a useful tool in predicting fundoplication outcome.

Libraries over the years have developed best practices for planning, organising, promoting and evaluating exhibitions. Many are based on practices in museums. These best practices have been written into policies and shared with libraries worldwide. However, just as there has been an acknowledgement that some museum practices must be modified to suit the needs of libraries, the same applies to exhibition best practices across countries and libraries with different budgets. Small island developing states are particularly challenged by, among other things, limited resources, high cost of transportation and energy and vulnerability to natural disasters, which can have a direct or indirect impact on libraries and their ability to carry out functions like curating exhibitions. The University of the West Indies (UWI), Mona Library, located on the island of Jamaica and founded in 1948, has a long tradition of curating exhibitions. Planning and executing physical exhibitions at The UWI are guided by Library-adapted policies and guides, recently formalised in an exhibition policy. A review of some of the exhibitions curated by The UWI Mona show that the physical exhibits are, for the most part, executed in keeping with international best practices, but the Library has had to make adjustments primarily because of financial challenges. These financial challenges affect the availability of resources for exhibits, exhibition space, dedicated exhibition staff, how special collections items are used and the magnitude of exhibitions mounted. Exhibition reports, annual reports, photographs and visitor comments books reveal that the Library attempts to follow best practices with regards to planning, designing, executing and evaluating physical exhibitions. On the other hand, the Library is in the early stages of converting its physical exhibitions to digital formats but may have to establish more formal guidelines to ensure that online exhibitions are planned, designed and evaluated in keeping with international best practices to be successful. Successful exhibitions not only satisfy Library organisers and ‘edutain’ users but also build a good reputation for the Library and lead to further collaboration with faculty and benefit students, administrators and sometimes the general public. These practices at The UWI that are guided by policies can serve as an example to other institutions with small budgets on how to successfully plan and deliver physical exhibitions and build relationships with faculty and the wider community. The Library would need to ensure that formal guidelines and practices are followed for online exhibitions to be as effective and successful.

Purpose – The purpose of this paper is to assess the recent outreach service efforts of the University of the West Indies (UWI) Main Library in the form of a Hall of Residence Librarian Programme. The aim of the programme was to minimize library anxiety through partnership with the Office of Students Services. Design/methodology/approach – The transition from the secondary to the tertiary level is not always the smoothest for some students. On the islands of the English-speaking Caribbean, such as Jamaica, it can be especially difficult as some matriculants have never used an automated library. These students often experience great difficulty in effectively using the library which may result in them shying away from doing so and thus negatively impact the quality of their work. The UWI, the UWI Main Library, Mona campus, Jamaica has sought to address this challenge through the development of an outreach project to the first-year students entitled the Halls of Residence Librarian (HRL) programme. Findings – This new form of library outreach on The UWI Mona campus has yielded the offering of library services in new locations, strategic partnerships, increased interactions with the first-year students and a greater awareness of these students ' needs. Most importantly, it was very effective in reducing library anxiety among the first-year students. Research limitations/implications – The “low” turnout to Research Rescue was largely attributed to the fact that this programme was entirely optional for the students, and it was not affiliated with any compulsory course or class. There was also the issue of a lack of incentives to boost student attendance at these sessions. Originality/value – This initiative is untested in the English-speaking Caribbean. The paper explores the outreach efforts of the library at the Mona campus of The UWI and seeks to add to the limited body of literature on Academic Library Outreach in the Caribbean.

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