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The purpose of this paper is to increase understanding of how patient deterioration is detected and how clinical care escalates when early warning score (EWS) systems are used.

The authors critically review a recent National Early Warning Score paper published in IJHCQA using personal experience and EWS-related publications, and debate the difference between detection and escalation.

Incorrect EWS choice or poorly understood EWS escalation may result in unnecessary workloads forward and responding staff.

EWS system implementers may need to revisit their guidance materials; medical and nurse educators may need to expand the curriculum to improve EWS system understanding and use.

The paper raises the EWS debate and alerts EWS users that scrutiny is required.

Resource sharing is an important element in the national planning of library and information services to meet the needs of information, education and culture of the whole community at all levels. An overview of resource sharing practices is presented, with particular reference to the British scene. It is also argued that, with the approach of the Single Market in 1992, resource sharing should now be considered on a European scale. In conclusion, some problems associated with the practice of resource sharing are considered.

Library assistants were originally considered to be professional librarians in the making, and were trained accordingly. With the expansion of libraries and librarianship, Britain's “apprenticeship” system of qualification gave way to formal library school education, and a new category of “non‐professional staff” was created, of people who were unwilling or unable to proceed to graduate‐level qualification. The development of non‐professional certificates of competence in the UK is described against parallel developments in the US, Canada and Australia; the COMLA training modules are also examined. The theoretical and practical issues surrounding training are discussed, training schemes and qualifications in the four countries analysed, and the relative merits of in‐house training and external certificate programmes argued.

The problems of One‐Man‐Bands (OMBs) began to be taken seriously in the early 1980s when the Aslib OMB group was formed. The group received considerable attention in the professional press, and became the object of a study by Judith Collins and Janet Shuter who identified them as “information professionals working in isolation”. Many of the problems identified in the Collins/Shuter study remain — not least of these being the further education and training needs of OMBs. These needs are studied in this report. The author has firstly done an extensive survey of the literature to find what has been written about this branch of the profession. Then by means of a questionnaire sent to the Aslib OMB group and the National Council for Voluntary Organisations (INVOG), training and education needs have been pinpointed. Some of these needs have then been explored in greater detail by means of case studies. The author found that the most common deterrents to continuing education and training were time, cost, location, finding suitable courses to cover the large variety of skills needed and lastly, lack of encouragement from employers. The author has concluded by recommending areas where further research is needed, and suggesting some solutions to the problems discussed.

STRAWS IN THE WIND seem to be moving shakily towards the prospect of a tax on books. Official noises are being made about ‘bringing the UK into line’ with EEC countries by VAT‐ing books—taxes range from 5% in France to 15% in Denmark. There was also a veiled hint in Mr Denis ‘Soak‐em’ Healey's speech to the Labour Party's Blackpool conference about extending VAT to a number of zero‐rated commodities.

This paper describes the development of satellite television and information access in Australia, principally within Australian higher education institutions. Client groups and basic technologies are overviewed as well as the role of the library in the provision of satellite services.

The paper aims to describe a network of training centres (TCN‐LIS) to support continuing professional development (CPD) of library and information specialists in countries of Central and Eastern Europe and Central Asia, funded by the Open Society Institute (OSI). It also aims to draw some general lessons for CPD in the library/information sector.

The paper reviews the development and activities of the training centre network, and reflects on issues raised and lessons learned.

The paper finds that TCN‐LIS has been effective in raising standards of professional competence among library and information specialists in the countries of the OSI region. General conclusions can be drawn about good practice for CPD, in issues including the most appropriate topics to be covered, most appropriate methods for teaching and learning, situation of CPD training centres, and relations between CPD and formal education.

The study is based on a network of training centres in 23 countries between 1999 and 2006.

This is the only paper describing TCN‐LIS, and the library/information training activities supported by OSI. It provides a unique perspective for considering library/information CPD issues.

To determine and compare approaches to the education and training of librarians for work in digital libraries. More precisely, to identify – in general terms, rather than specifically – the important competencies required by information professionals in creating and managing digital libraries, and in facilitating their use, and to assess how these competencies are treated in LIS education and training, and therefore how the capacities of the information professions are being developed.

Literature analysis of the skill sets required by librarians working with digital materials. Evaluation of formal education and of professional development programmes in the UK and in Slovenia, to assess how these needs are being met.

Both formal education and continuing development training are adapting to cover aspects of the digital library environment, both in the UK and in Slovenia. This is happening as part of the normal process of the redesign of degree programmes and of training courses. Digital library skills and knowledge – embodying conceptual, semantic, syntactic and technical aspects – are being included in existing courses, for the most part, rather than in entities labelled “digital library”. This approach has strengths and also weaknesses. While there is some agreement on core topics, there is much variation in how they are presented, and in the relative importance given to them.

Based on comparison of education and training programmes in two countries, the UK and Slovenia.

Recommendations for curricula are made.

Provides an insight into education and training needs in a developing and important area.

The development of reference services in public libraries is described and the importance of standards accentuated. The need for proper marketing and systematic evaluation, both qualitative and quantitative, is explained. An unobtrusive telephone test of 15 libraries is analysed and the results of interviews with 455 users of 13 public reference libraries given. Satisfactory results were obtained for straightforward questions but an occasional tendency towards flippancy by staff was highlighted. A further disquieting feature which came to light was the number of people who did not approach staff for help.

This research aims to explore the fine-grained relationships between nurse staffing and hospital operational performance with respect to care quality and operating costs. The authors also investigate the moderation effect of competition in local hospital markets on these relationships.

A six-year panel data is assembled from five separate sources to obtain information of 2,524 USA hospitals. Fixed-effect (FE) models are used to test the proposed hypotheses.

First, nurse staffing is initially associated with improved care quality until nurse staffing reaches a turning point, beyond which nurse staffing is associated with worse care quality. Second, a similar pattern applies to the relationship between nurse staffing and operating costs, although the turning point is at a much lower nurse staffing level. Third, market competition moderates the relationship between nurse staffing and care quality so that the turning point of nurse staffing will be higher when the degree of competition is higher. This shift of turning point is also observed in the relationship between nurse staffing and operating costs.

The study identifies three ranges of nurse staffing in which hospitals will likely experience simultaneous improvements, a tradeoff or simultaneous decline of care quality and operating costs when investing in more nursing capacity. Hospitals should adjust nurse staffing levels to the right directions to achieve better care or reduce operating costs.

Nurses constitute the largest provider group in hospitals and profoundly impact care quality and operating costs among all health care professionals. Optimizing the level of nurse staffing, therefore, can significantly impact the care quality and operating costs of hospitals.