The Body Mass Index Paradox in Head and Neck Cancer: A Systematic Review and Meta-Analysis.

The body mass index (BMI) paradox describes that among patients with certain cancers, higher pretreatment BMI may be associated with improved survival. We examine the impact of BMI on overall survival (OS) in head and neck squamous cell carcinoma (HNSCC) patients. A literature search was performed, and articles using hazard ratios to describe the prognostic impact of BMI on OS in HNSCC were included. Random-effects DerSimonian and Laird methods were employed for meta-analysis. Meta-analysis of OS indicated a lower hazards of death in the overweight (BMI: 25 kg/m2-30 kg/m2) compared to the normal weight (BMI: 18.5 kg/m2-25 kg/m2). This protective relationship loses significance when BMI exceeds 30 kg/m2. Underweight patients (BMI < 18.5 kg/m2) demonstrate higher hazards of death compared to normal weight patients. Compared to HNSCC patients with normal weight, being overweight up to a BMI of 30 kg/m2 is a positive predictor of OS, while being underweight confers a prognostic disadvantage. Further studies are needed to determine the mechanisms by which increased body mass influences survival outcomes in HNSCC.

Providing health sciences education through virtual reality experiences.

In 2020 - 2021 the Robert B. Greenblatt, M.D. Library at Augusta University implemented two projects leveraging virtual reality (VR) technology to provide immersive experiential learning opportunities for health sciences students. The projects shared some commonalities in spite of having differing objectives and desired outcomes. These common facets led to the success of both projects and will be helpful for other institutions considering implementing VR projects.

Library tools at the nurses' station: exploring information-seeking behaviors and needs of nurses in a war veterans nursing home.

Objectives: Analyze the information-seeking practices and identify the information and education needs of nurses in a war veterans nursing home. Develop an online toolkit for use at the nurses' stations to meet nurses' health information needs. Methods: Investigators employed mixed methods to determine the health information needs of the participating nurses at the skilled nursing facility using an online questionnaire and in-person observations. Resulting data was compared to determine how nurses' self-reported data corresponded with investigator observations. Results: Twenty-seven out of a total of thirty-five nurses responded to the online questionnaire. The study principal investigator also observed a total of twelve nurses working across all shifts. The online questionnaire asked nurses to identify when they need health information for an acute clinical scenario. Nurses self-reported feeling most confident in assessing falls and pain, followed by medication adherence and skin integrity. Issues most frequently encountered during observation of nurses were falls, interventions surrounding cognitive ability or dementia, and use of antibiotics. Nurses reported and were observed to consult colleagues most frequently, followed by drug handbooks and relying on nursing experience. Conclusion: Nurses in skilled nursing facilities will benefit from ready online access to current drug handbooks as well as information resources surrounding commonly encountered clinical issues and stated needs. An outcome of this project is an online toolkit site using a LibGuide created specifically for this purpose. Researchers purchased laptop computers that were installed at each of the nurses' stations to provide ready access to the toolkit site.

Partnering to Analyze Selection of Resources by Medical Students for Case-Based Small Group Learning: A Collaboration between Librarians and Medical Educators.

Librarians and medical educators analyzed the quality of information resources used by first- and second-year medical students in their case-based small group learning summaries. Librarians provided instruction on using library resources and gave formal feedback to students about appropriate resources for basic science and clinical questions. The team found that students used a high number of clinical and basic science journal articles and textbooks with a number of factors influencing their resource choices. The study demonstrates numerous areas where librarians can play a key role in assisting students to find and assess information to answer clinical questions.

A scoping review of institutional policies and recommendations for trans inpatient mental health care.

WHAT IS KNOWN ON THE SUBJECT?: International guidelines for trans-and-gender-non-conforming (TGNC) exists in outpatient settings. Compared to cisgender and heterosexual people, TGNC individuals are at a higher risk of mental health difficulties and have higher rates of inpatient mental health treatment. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: An international scoping review identifying the lack of guidelines existing for TGNC individuals in inpatient mental health settings. Compared to psychiatrists and psychologists, mental health nursing has the most contact with patients admitted for inpatient psychiatric treatment. The study identifies unaddressed needs in gender affirming policies and outlines preliminary policy recommendations to assist mental health staff in improving TGNC patient quality of care within the United States. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Reforming existing guidelines or creating new guidelines based on the identified themes and gaps to improve the well-being and treatment outcomes of TGNC individuals in inpatient psychiatric settings within the United States. ABSTRACT: INTRODUCTION: Access to culturally sensitive care is critical for addressing known mental health disparities among trans-and gender-non-conforming (TGNC) individuals. Although there has been a proliferation of TGNC healthcare guidelines from accrediting bodies, policies have failed to address the needs of TGNC patients in inpatient psychiatric settings. AIM: To identify unaddressed needs in policies and policy recommendations for the care of TGNC patients to inform recommendations for change. METHOD: A scoping review protocol was developed following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 850 articles were reduced to seven relevant articles with six themes identified via thematic analysis. RESULTS: Six themes were identified: lack of consistency in preferred and pronoun use, lack of communication among providers, lack of training in TGNC healthcare, personal bias, lack of formal policies, and housing segregation by sex rather than gender. DISCUSSION: The creation of new guidelines or bolstering of existing guidelines to specifically address identified themes and gaps may improve the well-being and treatment outcomes of TGNC individuals in inpatient psychiatric settings. IMPLICATIONS FOR PRACTICE: To provide a foundation for future studies to integrate these identified gaps and inform the future development of comprehensive formal policies that generalize TGNC care in inpatient settings.

Public safety redefined: Mitigating trauma by centering the community in community mental health.

The summer of 2020 marked a shift in public perception of police brutality and racism in the United States. Following the police murder of George Floyd and ensuing social unrest, the appropriate role and function of the police in communities have been a frequent topic of debate. Of particular concern is the intersection of policing and mental health where we see a pattern of police using excessive force disproportionately against persons with disabilities, especially mental health disabilities (Autistic Self Advocacy Network, 2017). The introduction of race only exacerbates this disparity (Saleh et al., 2018). Given the realities of these mental health inequities, the aim of this scoping review is to explore first response models/programs that emphasize a therapeutic intervention as an alternative to policing. Seventeen articles were selected for inclusion in the review, six exploratory or experimental studies and 11 review or discussion articles. Using findings from the review, we offer recommendations to help reimagine this country's approach to emergency response. We urge psychologists and other health care providers to step out of the clinic and engage the community in the development of crisis responses for mental health emergencies that are therapeutic rather than inflammatory, healing rather than harming. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Gathering Health Perspectives of the Justice Involved: A Multisite Needs Assessment Survey.

The well-being of justice-involved individuals must be of high priority to achieve health equity, reduce health disparities, and improve community health. To better understand the health interests and needs of justice-involved individuals, a survey was administered inquiring about health information-seeking behavior and health topics of interest. The survey was administered using secure tablet computers and completed by 1,888 incarcerated participants in 35 jails in 17 states. Salient themes that emerged from this research include the relatively equal use of the internet and health care providers as resources for health information; the extensive interest in learning about multiple health care topics; and demographic variations in health information-seeking behaviors and health topics of interest. Tailoring correctional health education programs to coincide with the interests and needs of the justice-involved population may attract more participants and thus result in better self-care management skills and health outcomes upon reentering communities.