Vomiting, Pyloric Mass, and Point-of-Care Ultrasound: Diagnostic Test Accuracy for Hypertrophic Pyloric Stenosis-A Meta-Analysis.

BACKGROUND: Hypertrophic pyloric stenosis is a common cause of nonbilious vomiting in infants younger than 6 months. Its history, physical examination, and point-of-care ultrasound (POCUS) have not been compared for their diagnostic test accuracy. OBJECTIVE: The aim of this systematic review was to quantify and compare the diagnostic test accuracy of a history of vomiting, a pyloric mass on palpation, and POCUS. METHODS: We performed three searches of the literature from 1977 to March 2022. We evaluated bias using the QUADAS-2 (Quality Assessment Tool for Diagnostic Accuracy-2) tool. We performed a bivariate analysis. RESULTS: From 5369 citations, we identified 14 studies meeting our inclusion criteria. We quantified three diagnostic elements: POCUS, a pyloric mass on palpation, and vomiting. We identified five studies that analyzed POCUS, which included 329 patients. POCUS had a sensitivity of 97.7% (95% confidence interval (CI) 93.1-99.3%) and a specificity of 94.1% (95% CI 88.7-97.1%) for detecting pyloric stenosis. We identified six studies that analyzed the presence of a pyloric mass, which included 628 patients. The palpation of a pyloric mass had a sensitivity of 73.5% (95% CI 62.6-82.1%) and a specificity of 97.5% (95% CI 93.8-99.0%). We identified four studies that analyzed vomiting, which included 355 patients. Vomiting had a sensitivity of 91.3% (95% CI 82.1-96.0) and a specificity of 60.8% (95% CI 8.5-96.3). Both POCUS and palpation of a pyloric mass had a high positive likelihood ratio (LR+: 17 and 33, respectively). The LR+ for vomiting was 5.0. CONCLUSIONS: Both POCUS and palpable mass had high specificity and positive LR, whereas vomiting provided the lowest diagnostic test measures.

Climate disasters and oncology care: a systematic review of effects on patients, healthcare professionals, and health systems.

PURPOSE: Climate disasters have devastating effects on communities and society that encompass all aspects of daily life, including healthcare. Patients with cancer are particularly vulnerable when disaster strikes. As the number and intensity of disasters increases, it is important to understand the effects across the cancer care continuum. This systematic review investigates the effect of climate disasters on patients, the oncology healthcare workforce, and healthcare systems. METHODS: A medical librarian conducted a literature search in PubMed, Embase, CINAHL, and Web of Science from January 1, 2016, through May 11, 2022. Eligible studies included any published report on a climate disaster globally reporting on patient-, oncology healthcare workforce-, or healthcare systems-level outcomes. Study quality was assessed, and findings were narratively synthesized, given the diversity of reported evidence. RESULTS: The literature search identified 3618 records, of which 46 publications were eligible for inclusion. The most frequent climate disaster was hurricanes (N = 27) followed by tsunami (N = 10). Eighteen publications were from disasters that occurred in the mainland USA with 13 from Japan and 12 from Puerto Rico. Patient-level outcomes included treatment interruptions and inability to communicate with the healthcare team. At the workforce level, findings included distressed clinicians caring for others when their own lives have been affected by a disaster along with lack of disaster preparedness training. Health systems reported closures or shifting services post-disaster and a need to have improved emergency response plans. CONCLUSION: Response to climate disasters necessitates a holistic approach at the patient, workforce, and health systems levels. Specifically, interventions should focus on mitigating interruptions in care for patients, advanced coordination and planning for workforce and health systems, and contingency planning for allocation of resources by health systems.

The prevalence for the risk of serious infection in hypothermic infants ≤ 60 days: A systematic review.

BACKGROUND: Temperature abnormalities in infants may be a sign of a serious infection (SI) and there is literature regarding the workup of the febrile infant to help guide management. The prevalence of SIs in hypothermic infants and the development of established guidelines for this population has not been established. Our primary objective was to determine the prevalence of SI in hypothermic infants who are 60 days old or younger presenting to the emergency department (ED). In addition, we calculated the prevalence of SI by organ system and identified its microorganism. METHODS: We performed a systematic review by searching the literature in Medline, Embase, Web of Science, and CINAHL. We limited our search to infants ≤ 60 days with a rectal temperature <36.5°C who presented to the ED. We defined SI as bacteremia, urinary tract infection (UTI), meningitis, herpes simplex virus infections, or pneumonia. We calculated the prevalence of SI. Quality of studies and bias was assessed using QUADAS-2. Our study was registered with PROSPERO, 2020 CRD42020153477. RESULTS: We identified 1242 articles from our initial search in December 2019 followed by a second search in February 2021 to capture any recent publications. We identified four studies meeting our inclusion criteria. We estimated the prevalence of SI as 4.86% (95% confidence Interval [CI] 1.97-8.82) for infants ≤ 60 days old. In a subgroup analysis of infants ≤ 28 days (n = 16/374), we estimated the prevalence of SI as 5.15 (95% CI 0.95-12.0). The most common source for SI was UTI, with a prevalence of 2.16% (95% CI 1.18-3.60). CONCLUSION: The overall prevalence of SI was 4.86% in hypothermic young infants ≤ 60 days old presenting to the ED. Infants ≤ 28 days had a slightly higher prevalence of 5.15%. The most common source for serious bacterial infection was UTI.

Healthcare team communication training in the United States: A scoping review.

The purpose of this literature review was to identify interventions designed to improve healthcare team communication in the United States. We conducted a review of peer-reviewed, English-language articles describing interventions aimed at improving healthcare team communication. We analyzed articles that met pre-specified inclusion and exclusion criteria and characterized who is testing communication interventions, the rationale for testing, and ways of measuring effectiveness. We descriptively categorized the strength and types of study findings. Thirty articles were retained in our analysis. Most assessments were conducted by academic medical centers, the Veterans Health Administration, and teaching hospitals. Interventions sought to improve teamwork, patient safety, clinical outcomes, costs of care, and enhance provider job satisfaction and well-being. Intervention strategies included didactic lectures, simulation, Crew Resource Management, quality improvement, or a combination of these approaches. The vast majority employed a pre-post survey design and measured outcomes using participant feedback. Many assessments failed to utilize a social science theory or communication-specific measures. Interventions with the best training content were conducted at academic medical centers, used a pre-post design, and utilized statistical analysis to analyze results. While interventions for improving healthcare team communication are diverse and have uneven effectiveness, early markers of success merit continued development and assessment.

An analysis of ALA-accredited MLS curricula indicates deficiencies in the initial training provided for public librarians.

BACKGROUND: Public librarians often address patron inquiries regarding health concerns. However, prior research indicates that public librarians may be unprepared to meet the health information requests of patrons. OBJECTIVE: This study examined the availability of health-themed courses in American Library Association (ALA) accredited Master of Library and Information Studies/Science (MLIS) programs. METHODS: Accredited MLIS programs were identified using the ALA directory. Curricula were reviewed for health content and public librarianship, children's, and young adult concentrations. Descriptive and bivariate analyses assessed the percent of programs that offered various health-related course content and the differences in availability of such content. RESULTS: Of the 59 accredited MLIS programs, only 35 (59.32%) listed at least one health elective and none listed a required health course. No MLIS programs that had a public library concentration (n = 21) listed a required or elective health course, two programs with a children's concentration (n = 25) listed health course electives, and one program with a young adult concentration (n = 25) listed a health course elective. CONCLUSION: ALA-accredited MLIS programs should consider increasing their offerings or requiring health-related courses to improve the training of public librarians to meet the health information needs of communities.

Pandemic-Proofing Your Library: Disaster Response and Lessons Learned from COVID-19.

The COVID-19 pandemic has affected libraries across the globe, including academic health sciences libraries, in many ways. This manuscript describes the challenges, solutions, and practices employed by the Stony Brook University Health Sciences Library in order to maintain continuity of services to patrons including faculty, hospital staff, students, and clinicians while operating in one of the earliest epicenters of the pandemic. Some of the major changes the library underwent in response to the pandemic included implementing new online anatomy resources, contactless circulation, remote interlibrary loan services and modified operating practices.

An Investigation of the Backgrounds of Health Sciences Librarians.

The purpose of this study was to investigate the educational and professional backgrounds of health sciences librarians currently working in the U.S. and Canada. A survey consisting of 15 questions was created using the software program Qualtrics. 389 total surveys were received. Respondents reported having a wide variety of educational and professional backgrounds. Only about 22% of respondents reported having health sciences work experience prior to entering the field. Recruitment into the field of health sciences librarianship should take a broad approach, and professional development efforts should appeal to a wide array of experience levels.

Leveraging Survey Results in Support of a Library Renovation: A Case Study.

The Health Sciences Library (HSL) at Stony Brook University along with the School of Medicine were motivated to make improvements in seating and hours based on survey results from an LCME self-study. Preparation for the site visit from the Liaison Committee for Medical Education helped to garner resources and support for this initiative. To meet the evolving needs of the HSL patrons, librarians completed an overdue collection assessment project which allowed for 142 new seats, including newly designed spaces and furnishings. Ongoing assessment of the redesigned space will be conducted to evaluate success and areas for continued improvement.

A partnership between academic and public librarians: "What the Health" workshop series.

BACKGROUND: Public librarians are in a unique position to assist the general public with health information inquiries. However, public librarians might not have the training, detailed knowledge, and confidence to provide high-quality health information. CASE PRESENTATION: The authors created and delivered three workshops to public librarians in Suffolk County, New York, highlighting several National Library of Medicine resources. Each workshop focused on a different topic: general consumer health resources, genetics health resources, and environmental/toxicology resources. At the end of each workshop, participants were asked to complete the Training Session Evaluation form provided by the National Network of Libraries of Medicine (NNLM). All participants reported that they learned a new skill or about a new tool, that their ability to locate online health information improved, and that they planned to use the knowledge they gained in the future. Online tutorials covering the major resources from each workshop were created and made accessible to the public on several organizations' websites. Virtual reference services were initiated for public librarians who need further assistance with these resources and will continue to be provided on an ongoing basis. Financial support for the equipment and software utilized in each of these tasks was awarded by NNLM. CONCLUSIONS: Based on attendance and participant feedback, this model of health information outreach appears to have been successful in furthering the educational needs of public librarians and may be useful to others in creating a similar program in their communities.

Genetics Home Reference: A Review.

Genetics Home Reference is a free, online resource created and maintained by the National Library of Medicine. It is designed to provide genetic information to a wide variety of audiences, particularly the general public. The site consists of original information and links to other curated resources.