figure.2 A study by the American Medical Association in 1964, on the cost of medical care also indicated a greater intensity in use of the clinical laboratory over time. The mean units of lab procedures per study admission increased from 3.19 in 1946 to 6.36 in 1961.3 Again, the data apply only to the hospital setting and explanation for changes reported was somewhat limited.A recent study on the use of the laboratory in a teaching hospital points to the clinical laboratory as a major contributor to today's hospital costs. This study indicates major increases over the past decade in type and volume of tests performed in hospital laboratories and suggests that new patterns of laboratory use may bear little relation to the needs of the patient. Furthermore, follow-up laboratory studies are often excessive.4 An editorial in the same journal asked whether the enormous expansion in the use and costs of clinical laboratory services has resulted in a commensurate benefit to the patient or more effective care.5None of the studies cited above provided any data on changes in the use of the laboratory for outpatient care. Presumably, important changes have taken place, but the information to identify these changes and evaluate their impact on the medical care system is not readily available. This study concentrates primarily on analyzing the use of the laboratory for outpatient care in a comprehensive group practice setting. Specifically, the study analyzes changes over time in total laboratory services and in the use of the laboratory by department, by type of test and by morbidity. The extent to which there are differences in the patterns of lab use by physicians and the consistency of the individual physician's pattern of lab use over time are studied. Finally, the relationship between physician characteristics and laboratory use patterns is analyzed.

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PurposeInformal screencasting (i.e., capturing your actions on a computer screen with the goal of showing others how to accomplish tasks on a website or in a given software environment) is defined and described. Customer-satisfaction survey results from 103 faculty, staff, and students are presented. Design/methodology/approachAn online survey revealing customer satisfaction with informal screencasts was made available in spring 2010 to faculty, staff, and students of a mid-sized public university in Arlington, Texas, USA. Results are compiled, analyzed, and presented here. FindingsMost participants' reactions to the librarian's informal screencasts were positive or quite positive, but many participants still noted that they would prefer to receive email instructions in answer to their questions. Research limitations/implicationsThe survey was not distributed to a representative sample of the population; instead, the author solicited participants via email, so the participant pool was a convenience sample, which could introduce bias in the results. Originality/valueThis survey is the first to assess academic library customers' attitudes toward informal screencasting as an instructional tool, as far as the author has been able to determine after an extensive literature search.

Digitizing rare and unique historical documents so they can be shared online is mission-critical work for most cultural heritage institutions, but it can be difficult to complete this work, especially intellectual property rights management, at a scale that matches user demand. The authors of this open educational resource offer guidance for creating scalable cross-functional workflows using a risk-management approach that increases efficiency and distributes responsibility for rights assessment work more equitably across stakeholders. It includes advice for navigating knowledge gaps, building an engaged team with the right skillsets, reimagining workflows, and rethinking traditional archival processing workflows to build capacity for rights analysis during arrangement and description. Each chapter includes a helpful exercise for implementing this guidance in your own institution.

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