Telemedicine as a technology has been available for nearly 50 years, but its diffusion has been slower than many had anticipated. Even efforts to reimburse providers for interactive video (IAV) telemedicine services have had a limited effect on rates of participation. The resulting low volume of services provided (and consequent paucity of research subjects) makes the phenomenon difficult to study. This paper, part of a larger study that also explores telemedicine utilization from the perspectives of referring primary care physicians and telemedicine system administrators, reports the results of a survey of specialist and subspecialist physicians who are users and nonusers of telemedicine. The survey examined self-assessed knowledge and beliefs about telemedicine among users and nonusers, examining also the demographic characteristics of both groups. Statistically significant differences were found in attitudes toward telemedicine between users and nonusers, but in many respects the views of the two groups were rather similar. Physicians who used telemedicine were aware of the limitations of the technology, but also recognized its potential as a means of providing consultation. Demographic differences did not explain the differences in the knowledge and beliefs of user and nonuser consultant physicians, although some of the differences may be explained by other aspects of the professional environment.

In their recent article, N. Spillane and G. Smith (2007) suggested that reservation-dwelling American Indians have higher rates of problem drinking than do either non–American Indians or those American Indians living in nonreservation settings. These authors further argued that problematic alcohol use patterns in reservation communities are due to the lack of contingencies between drinking and “standard life reinforcers” (SLRs), such as employment, housing, education, and health care. This comment presents evidence that these arguments were based on a partial review of the literature. Weaknesses in the application of SLR constructs to American Indian reservation communities are identified as is the need for culturally contextualized empirical evidence supporting this theory and its application. Cautionary notes are offered about the development of literature reviews, theoretical frameworks, and policy recommendations for American Indian communities.

Purpose The purpose of this paper is to advocate for change in academic library space assessment and use philosophy in favor of a more user-centered approach emphasizing space designed for and by users themselves. This goal is achieved by analyzing the implementation of a recent space assessment project at the University of Northern Colorado Libraries to investigate specific patterns of library space utilization. Design/methodology/approach This paper presents a case study for which data were collected through a multi-method approach, including flip chart and whiteboard questions, brief semi-structured “tabling” interviews, and more in-depth “roving” interviews. Findings The current library literature on space assessment does not encompass broader, more holistic approaches to how library space is used by students, faculty, staff and community users. The findings from this study highlight the diversity of ways patrons may use an academic library, many of which are related to academic work. However, visitors also come to the library for other purposes, such as socializing or attending an event. It is imperative that the space be adequately equipped to meet varied visitor needs and to create a welcoming environment for all patrons. Originality/value The paper has several implications for planning and managing the operations of medium-sized academic libraries. It contributes to the larger conversation in higher education about the importance of user research for enhancing visitor experience through data-informed decision-making. Furthermore, the project it details is not an isolated assessment effort but part of the library’s ongoing space assessment work.

Although extensive research has looked at first-generation college students' experiences, very little has examined the role of the library. This article reports the results of an asset-based exploratory study understanding the experiences of first-generation college students at three universities. Key findings of this study focus on themes of self-advocacy, sense of belonging, library customization, and integration of the library with the larger campus. This article discusses these key themes in the context of improving library services and spaces, ultimately providing more inclusive resources for all student groups. Implications and recommendations for professional practice are discussed.

Post-acute care (PAC) occurs in a variety of settings-skilled nursing facilities (nursing homes), rehabilitation facilities, and home health agencies. To evaluate the impact of care processes on clinical outcomes and implement changes designed to improve outcomes, one must begin by measuring outcomes in a valid, reliable manner that allows for comparisons to reference or benchmarking data. Currently, several data sets exist in PAC settings for the purpose of outcome measurement. However, there is a need for comparable information across settings to ensure the quality and continuity of care. This article reviews various existing data sets used in PAC settings, examines ongoing projects to create a single set of measures, and suggests some directions for future research.