Integrating information literacy in health sciences curricula: a case study from Québec.

OBJECTIVE: To portray an information literacy programme demonstrating a high level of integration in health sciences curricula and a teaching orientation aiming towards the development of lifelong learning skills. The setting is a French-speaking North American university. METHODS: The offering includes standard workshops such as MEDLINE searching and specialised sessions such as pharmaceutical patents searching. A contribution to an international teaching collaboration in Haiti where workshops had to be thoroughly adapted to the clientele is also presented. Online guides addressing information literacy topics complement the programme. RESULTS AND EVALUATION: A small team of librarians and technicians taught 276 hours of library instruction (LI) during the 2011-2012 academic year. Methods used for evaluating information skills include scoring features of literature searches and user satisfaction surveys. DISCUSSION: Privileged contacts between librarians and faculty resulting from embedded LI as well as from active participation in library committees result in a growing reputation of library services across academic departments and bring forth collaboration opportunities. Sustainability and evolution of the LI programme is warranted by frequent communication with partners in the clinical field, active involvement in academic networks and health library associations, and reflective professional strategies.

Continuum of Care for Older Adults With Concurrent Hearing and Vision Impairment: A Systematic Review.

Background and Objectives: A global report estimates up to 2% of the world population experience concurrent hearing and vision impairment (dual sensory impairment [DSI]). Older adults with DSI are often frequent users of health care, yet the evidence is limited to inform care delivery for this population. This systematic review aimed to synthesize evidence on tools and strategies for screening, assessment, and interventions that promote a continuum of care for older adults with DSI. Research Design and Methods: The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews. Electronic databases (CINAHL, Embase, MEDLINE, PsycINFO, Cochrane Library, Global Health, and Web of Science) and clinical trial registries (ISRCTN Registry, WHO ICTRP, and ClinicalTrials.gov) were searched. The quality appraisal was performed using the Mixed Methods Appraisal Tool. Results: Of 4,775 identified references, 28 records were selected. The review identified 7 tools and 7 strategies for DSI-specific screening, assessments, and/or interventions. Some of the most promising tools were the interRAI Community Health Assessment with deafblind supplement, adapted Montreal Cognitive Assessment, and the Severe Dual Sensory Loss screening tool. Useful strategies included the use of alternative forms of communication, assistive devices or technology, education and training for service providers, and training of older adults on the use and maintenance of assistive aids/technology. However, quality appraisal indicated a need for more robust evidence to inform clinical practice. Discussion and Implications: Reviewed evidence pinpointed the need for training for health care providers on DSI-specific challenges and supports and the use of integrated multidisciplinary care for older adults. Future studies need to explore the development and evaluation of tools and interventions to improve the continuum of care for this group. Systematic Review Registration: PROSPERO registration # CRD42020180545.

Posttraumatic stress disorder prevalence in medical populations: A systematic review and meta-analysis.

OBJECTIVE: PTSD is increasingly recognized following medical traumas although is highly heterogeneous. It is difficult to judge which medical contexts have the most traumatic potential and where to concentrate further research and clinical attention for prevention, early detection and treatment. The objective of this study was to compare PTSD prevalence in different medical populations. METHODS: A systematic review of the literature on PTSD following medical traumas was conducted as well as a meta-analysis with final pooled result and 95% confidence intervals presented. A meta-regression was used to investigate the impact of potential effect modifiers (PTSD severity, age, sex, timeline) on study effect size between prevalence studies. RESULTS: From 3278 abstracts, the authors extracted 292 studies reporting prevalence. Using clinician-administered reports, the highest 24 month or longer PTSD prevalence was found for intraoperative awareness (18.5% [95% CI=5.1%-36.6%]) and the lowest was found for epilepsy (4.5% [95% CI=0.2%-12.6%]). In the overall effect of the meta-regression, only medical events or procedures emerged as significant (p = 0.006) CONCLUSION: This review provides clinicians with greater awareness of medical contexts most associated with PTSD, which may assist them in the decision to engage in more frequent, earlier screening and referral to mental health services.

A Meta-Analysis of the Effect of Paper Versus Digital Reading on Reading Comprehension in Health Professional Education.

Objective. Despite a rise in the use of digital education in health professional education (HPE), little is known about the comparative effectiveness of paper-based reading and its digital alternative on reading comprehension. The objectives of this study were to identify, appraise, and synthesize the evidence regarding the effect of how media is read on reading comprehension in the context of HPE.Methods. Observational, quasi-experimental, and experimental studies published before April 16, 2021, were included if they compared the effectiveness of paper-based vs digital-based reading on reading comprehension among HPE students, trainees, and residents. Random-effects meta-analyses were performed using standardized mean differences.Results. From a pool of 2,208 references, we identified and included 10 controlled studies that had collectively enrolled 817 participants. Meta-analyses revealed a slight but nonsignificant advantage to students reading paper-based HPE texts rather than digital text (standardized mean difference, -0.08; 95% CI -0.28 to 0.12). Subgroup analyses revealed that students reading HPE-related texts had better reading comprehension when reading text on paper rather than digitally (SMD = -0.36; 95% CI -0.69 to -0.03). Heterogeneity was low in all analyses. The quality of evidence was low because of risks of bias across studies.Summary. Current evidence suggests little to no difference in students' comprehension when reading HPE texts on paper vs digitally. However, we observed effects favoring reading paper-based texts when texts relevant to the students' professional discipline were considered. Rigorous studies are needed to confirm this finding and to evaluate new means of boosting reading comprehension among students in HPE programs.

Pharmacokinetics of Commonly Used Antimicrobials in Critically Ill Adults During Extracorporeal Membrane Oxygenation: A Systematic Review.

PURPOSE: Adequate dosing of antimicrobials is critical to properly treat infections and limit development of resistance and adverse effects. Limited guidance exists for antimicrobial dosing adjustments in patients requiring extracorporporeal membrane oxygenation (ECMO) therapy. A systematic review was conducted to delineate the pharmacokinetics (PK) and pharmacodynamics (PD) of antimicrobials in critically ill adult patients requiring ECMO. METHODS: Medline, EMBASE, Global Health, and All EBM Reviews databases were searched. Grey literature was examined. All studies reporting PK/PD parameters of antimicrobials in critically ill adults treated with ECMO were included, except for case reports and congress abstracts. Ex vivo studies were included. Two independent reviewers applied the inclusion and exclusion criteria. Reviewers were then paired to independently abstract data and evaluate methodological quality of studies using the ROBINS-I tool and the compliance with ClinPK guidelines. Patients' and studies' characteristics, key PK/PD findings, details of ECMO circuits and co-treatments were summarized qualitatively. Dosing recommendations were formulated based on data from controlled studies. RESULTS: Thirty-two clinical studies were included; most were observational and uncontrolled. Fourteen ex vivo studies were analysed. Information on patient characteristics and co-treatments was often missing. The effect of ECMO on PK/PD parameters of antimicrobials varied depending on the studied drugs. Few dosing recommendations could be formulated given the lack of good quality data. CONCLUSION: Limited data exist on the PK/PD of antimicrobials during ECMO therapy. Rigorously designed and well powered populational PK studies are required to establish empiric dosing guidelines for antimicrobials in patients requiring ECMO support. PROSPERO REGISTRATION NUMBER: CRD42018099992 (Registered: July 24th 2018).

Patient satisfaction with E-Oral Health care in rural and remote settings: a systematic review protocol.

BACKGROUND: Individuals living in rural and remote settings face oral health problems and access-to-care barriers due to the shortage of oral health care providers in these areas, geographic remoteness, lack of appropriate infrastructure and lower socio-economic status. E-Oral Health technology could mitigate these barriers by providing the delivery of some aspects of health care and exchange of information across geographic distances. This review will systematically evaluate the literature on patient satisfaction with received E-Oral Health care in rural and remote communities. METHODS: This systematic review will include interventional and observational studies in which E-Oral Health technology is used as an intervention in rural and remote communities of any country worldwide. Conventional oral health care will be used as a comparator when provided. Patient satisfaction with received E-Oral Health care will be considered as a primary outcome for this review. Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and Global Health will be searched using a comprehensive search strategy. Two review authors will independently screen results to identify potentially eligible studies and independently extract the data from the included studies. A third author will resolve any discrepancies between reviewers. Two independent researchers will assess the risk of bias and the Grading of Recommendations Assessment, Development, and Evaluation. DISCUSSION: The potential implications and benefits of E-Oral Health care can inform policymakers and health care professionals to take advantage of this technology to address health care challenges in these areas. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42016039942 .