Point-of-care communication for patients with limited language proficiency: A scoping review of healthcare interpretation applications.

OBJECTIVE: Linguistic diversity has the potential to create barriers for limited language proficiency (LLP) patients when navigating the healthcare system. When a verified interpretation method is utilized, there are improvements in LLP patient outcomes. The purpose of this scoping review is to identify articles that outline applications used for point-of-care tasks between LLP patients and providers. METHODS: The Arksey and O'Malley methodologic framework was utilized for study selection, data charting and analysis. Each application was evaluated on patient and provider satisfaction, overall feasibility, and time associated with interpretation. RESULTS: Eight peer-reviewed journals are included (four pilot studies, one prospective study, two participatory studies, and one mixed methods design). Applications ranged in number of unique phrases (32-1800 phrases) and number of languages supported (1-39 languages). Overall, the applications were feasible to use and assisted with basic communication between providers and patients. CONCLUSIONS: As patients and families become more comfortable with using technology, interpretation applications provide an innovative approach to streamline the interpretation process for point-of-care healthcare encounters. PRACTICE IMPLICATIONS: Interpretation applications may increase an LLP patient's access to interpretation tools which can improve outcomes. Further studies should focus on implementing robust evaluation methods to assess these tools and evaluate the LLP patient's perspectives of interpretation applications.

Genes for highly abundant proteins in Escherichia coli avoid 5' codons that promote ribosomal initiation.

In many species highly expressed genes (HEGs) over-employ the synonymous codons that match the more abundant iso-acceptor tRNAs. Bacterial transgene codon randomization experiments report, however, that enrichment with such "translationally optimal" codons has little to no effect on the resultant protein level. By contrast, consistent with the view that ribosomal initiation is rate limiting, synonymous codon usage following the 5' ATG greatly influences protein levels, at least in part by modifying RNA stability. For the design of bacterial transgenes, for simple codon based in silico inference of protein levels and for understanding selection on synonymous mutations, it would be valuable to computationally determine initiation optimality (IO) scores for codons for any given species. One attractive approach is to characterize the 5' codon enrichment of HEGs compared with the most lowly expressed genes, just as translational optimality scores of codons have been similarly defined employing the full gene body. Here we determine the viability of this approach employing a unique opportunity: for Escherichia coli there is both the most extensive protein abundance data for native genes and a unique large-scale transgene codon randomization experiment enabling objective definition of the 5' codons that cause, rather than just correlate with, high protein abundance (that we equate with initiation optimality, broadly defined). Surprisingly, the 5' ends of native genes that specify highly abundant proteins avoid such initiation optimal codons. We find that this is probably owing to conflicting selection pressures particular to native HEGs, including selection favouring low initiation rates, this potentially enabling high efficiency of ribosomal usage and low noise. While the classical HEG enrichment approach does not work, rendering simple prediction of native protein abundance from 5' codon content futile, we report evidence that initiation optimality scores derived from the transgene experiment may hold relevance for in silico transgene design for a broad spectrum of bacteria.

Assessment of Library Services in Pediatric Hospitals in the United States and Canada.

This study reports on a 2022 survey of pediatric hospital librarians in the U.S. and Canada to assess the status of staffing, resources, and services in their libraries. The report compares the data against the MLA Hospital Library Caucus Standards (2022) and the Canadian Hospital Library Association Standards (2020). The report also provides a comparison of the libraries' rankings using the Regional U.S. News & World Report Best Children's Hospitals and Magnet status. This approach is intended to determine how librarians and library services at hospitals that are recognized by the above programs differ from those that are not recognized.

Assessment of Library Services at Top-Performing Pediatric Hospitals in the Southeast United States.

The authors compare and contrast the structure and function of librarians and library services using a convenience sample online survey of pediatric hospitals in the Southeast based on the rankings from the Regional U.S. News & World Report Best Children's Hospitals and Magnet status. This approach is intended to determine how librarians and library services at hospitals that are recognized by the above programs differ from those that are not recognized.

A Collaborative Effort to Build an Evidence-Based Practice Project Repository.

The establishment of an Evidence-based Practice (EBP) project repository for clinical nurses to access via a hospital intranet allowed for hospital librarians to collaborate with nurse scientists. This project resulted in not only a repository but also led to the involvement of librarians earlier in the research process and led to more options to track how the completed projects were utilized by clinicians. These two outcomes in particular allowed for further involvement of librarians in the Magnet reaccreditation process. Additionally, the contributions of the librarians raised awareness of the roles they can take in EBP and Magnet efforts.

Enhancing Clinical Librarian Work Processes and Communicating Service Impact with REDCap and Data Visualization.

Due to staffing changes, clinical librarians in a large pediatric health care system needed to streamline how user requests were received and how best to handle the shared workflow. This article describes how REDCap and SAS were implemented to improve the management of requests, capture comprehensive user statistics, and convey the value of the library services through enhanced reporting.

Got value? Journal collection analysis is worth the effort.

This article presents a case study of the efforts of librarians at a pediatric hospital system to cut journal costs while increasing value for patrons. First, the worth of the libraries was proven to system leaders using a cost-benefit analysis. Then, librarians used a survey of library users and analysis of usage patterns to reevaluate the number and format of individual journal subscriptions. The results included cutting substantial costs and unpopular resources, adding more relevant resources, and garnering the respect and support of hospital leaders.