Medical Library Research Articles

Successful experience of hip arthroplasty with a unipolar endoprosthesis

Introduction. Fractures of the femoral neck occupy a significant place in traumatology and orthopedics and represent a serious pathological problem. Without surgical treatment, this pathology leads to complications and death of the patient within a year. Hip replacement is the choice of treatment method that allows the injured patient to be mobilized as early as possible. This promotes and has a positive effect on the timing and effectiveness of rehabilitation measures and minimizes the risk of developing possible complications. The purpose of this publication is to demonstrate the successful experience of treating a patient with a fracture of the right femoral neck with displacement of fragments using endoprosthetics. Materials and methods. To write the article, we used medical documentation data from a trauma hospital, the results of instrumental research and dynamic observation of the patient. A search was also carried out in the open electronic scientific databases PubMed of the US National Electronic Medical Library and the databases of the Russian scientific electronic library elibrary, using keywords and phrases: Results. Endoprosthesis replacement of the hip joint with a unipolar endoprosthesis was performed. On the sixth day after the surgical intervention, the patient was discharged in satisfactory condition for outpatient treatment by a traumatologist at his place of residence. The wound and sutures have no signs of inflammation, sensitivity and blood supply to the limb are preserved. The patient moves independently using a walker. Discussion. Analyzing the results of surgical treatment in the described clinical case, we can conclude that the method of hip replacement is highly effective in elderly people. Conclusion. Endoprosthesis replacement surgery is low-traumatic and allows the patient to be mobilized early. Our experience allows us to believe that treatment with endoprosthetics is effective for fractures of the femoral neck and allows us to achieve positive results in the early stages.

Four Alzheimer’s Apps to Implement into a Caregiver’s Daily Routine

Smartphones have become synonymous with modern living, providing users with countless apps to perform endless functions. Harnessing mobile technology to help caregivers of Alzheimer’s Disease patients offers users tools and resources to engage, organize and lessen the stress of caregiving. Medical Librarians, healthcare professionals, family and friends can all benefit from learning about four popular Alzheimer’s Disease caregiver apps to enable them to provide thoughtful recommendations to implement their use in caregivers’ daily lives.

Feasibility study of establishing an integrated geographic information system: a case study of medical libraries

PurposeMedical libraries can extend their resources’ accessibility by creating a network through web-based geographical information system (WEBGIS) that connects physical and non-physical resources. Geographical information system (GIS allows) libraries to create strong connections with other libraries by establishing a shared server for loading and using digital information. This research aims to explore the feasibility of creating a unified GIS-based service system for medical libraries.Design/methodology/approachThe target population for this study includes a total of 32 medical libraries across three medical universities (in this case called A, B and C). A researcher-designed 34-item questionnaire was applied in this study.FindingsFindings revealed that the libraries affiliated with University A have the highest average (46.54%) and better situation in terms of all of the needed infrastructures. Furthermore, in terms of the technical infrastructure required for implementing the integrated WEBGIS, the libraries of University B are in a better situation in comparison with other libraries (64.55%). Weak technical infrastructure belongs to libraries affiliated with University C, with 59.17% availability of infrastructure. The findings underscored the existing gaps in various aspects and highlighted the need for further improvements, particularly in financial and legal aspects, to enhance the overall availability of infrastructure.Originality/valueThis study was conducted for the first time in medical science libraries. The findings of this research shed light on the shortages within the surveyed universities in terms of human infrastructure. Results highlight the need for financial, legal and technical support to bridge the gap between the current status and the desired situation. By focusing on improving the various infrastructural aspects, libraries can foster a conducive environment for the effective utilization of spatial information systems, ultimately benefiting academic research, education and overall information management in the field of medical sciences.

Managing Health Science Libraries in a Time of Change, Medical Library Association Book Series

Managing Health Science Libraries in a Time of Change, Medical Library Association Book Series

Interventional Strategies to Mitigate Maternal Stress and Enhance Coping Skills During Neonatal Admission Into Intensive Care Units in Low- and Middle-Income Countries: A Scoping Review.

Mothers of high-risk neonates experience tremendous stress during neonatal intensive care unit (NICU) admission. This stress has a negative impact on mothers' participation in neonatal care activities, psychological health and coping skills in the NICU. To determine the impact of interventional strategies to reduce maternal stress and enhance coping skills during neonatal admission to the NICU. A scoping review was carried out following the methodological framework outlined by Arksey and O'Malley. This scoping review was conducted as per the Joanna Briggs Institute guidelines, including a quality appraisal checklist for randomised and nonrandomised controlled trials. Patterns, advances, gaps, evidence for practice and research recommendations from the review (PAGER framework) were used to report the results. The following international databases were used to search for primary articles: Medline via PubMed, EBSCOhost via CINAHL, Scopus, Web of Science and the ProQuest Medical Library. Original studies published in English between January 2011 and January 2023 from low- and middle-income countries (LMICs) that assessed maternal stress and coping skills during neonatal NICU admission were included in the review. The review included 15 articles from LMICs, of which 60% were from middle-income, 25% were from lower-middle-income and 15% were from low-income countries. Interventional strategies were described under five categories. Maternal stress decreased significantly across all three subscales of the PSPS: 'sight and sound', 'baby looks and behavior' and 'parental relationship with baby and role alteration' during neonatal NICU admission. Interventional strategies involving family-centred care and emotional and psychological supportive care have been reported to have a consistently positive impact on alleviating maternal stress and enhancing coping skills in the NICU. Healthcare professionals, especially nurses, are pivotal in promptly recognising maternal stress and NICU stressors. The participation of mothers in neonatal care, such as through family-centred care and emotional support interventions, significantly reduces maternal stress and enhances coping skills.

Resilience Practices in Health Science and Medical Libraries During the Early Stages of the COVID-19 Pandemic

This paper uses the concept of resilience engineering as an organizing principle to discuss best practices that evolved within health science/medical libraries in the United States during COVID-19 crisis, focusing on the period March – August 2020. Protection of library staff, assistance to medical staff, reducing the circulation of misinformation and public health consumerism all required substantial changes to standard processes. These process changes had to arise in the context of both physical isolation and information overload. Some practices became widespread due to their utility, and these are the focus of this report.

Protocol for a systematic review and meta-analysis of interventions aimed at delabeling low-risk penicillin allergies with consideration for sex and gender

BackgroundApproximately, 10% of people report a penicillin allergy; however, more than 90% can safely undergo delabeling after a detailed history, oral challenge, or other investigations such as penicillin skin testing (PST). Although PST is the gold standard, the results can be heterogeneous, and awaiting specialist assessment may take an inordinate amount of time. Therefore, oral provocation challenge has become acceptable for individuals with low-risk penicillin allergy histories. There also appears to be an association with increased prevalence of adverse drug reaction reporting in female individuals, which may translate to penicillin allergy prevalence; however, the evidence has not been assessed through a sex and gender lens. This systematic review will identify and synthesize the findings from studies that report measures of effectiveness and safety of interventions aimed at delabeling penicillin allergies in low-risk individuals. Information related to sex and gender will be extracted, where available, to understand potential differences in allergy reporting and patient outcomes.MethodsThe Cochrane Handbook for Systematic Reviews of Interventions and the Centre for Review and Dissemination’s Guidance for Undertaking Reviews in Health Care will be used as frameworks for conducting this systematic review. The literature search will be conducted by a medical librarian (B. M. M.) and will consist of a search strategy to identify and retrieve published studies that meet our inclusion criteria. Studies that require penicillin skin testing (PST) as a step prior to other interventions will be excluded. Integrated knowledge translation involving co-design was carried out for this systematic review protocol creation. Data extraction will be conducted at four levels: (1) study level, (2) patient level, (3) intervention level, and (4) outcome level. A narrative descriptive synthesis of results and risk of bias of all included studies will be provided, and, if relevant, a meta-analysis will be performed.DiscussionThe dissemination of findings from this knowledge synthesis to various stakeholders is intended to inform on options for evidence-based interventions to aid in delabeling penicillin allergies in individuals with a low risk of experiencing a hypersensitivity reaction. Detailed reporting on the characteristics of delabeling interventions as well as the effectiveness of similar interventions will benefit policy makers considering the implementation of a penicillin allergy delabeling protocol. Additionally, findings from this systematic review will report on the current evidence regarding the role of sex and gender in both the prevalence and outcomes associated with the presence of penicillin allergies.Systematic review registrationPROSPERO CRD42022336457.

Relationship between radiofrequency-electromagnetic radiation from cellular phones and brain tumor: meta-analyses using various proxies for RF-EMR exposure-outcome assessment

IntroductionThe authors conducted meta-analyses regarding the association between cellular and mobile phone use and brain tumor development by applying various radiofrequency-electromagnetic radiation (RF-EMR) exposure subcategories. With changing patterns of mobile phone use and rapidly developing Wireless Personal Area Network (WPAN) technology (such as Bluetooth), this study will provide insight into the importance of more precise exposure subcategories for RF-EMR.MethodsThe medical librarian searched MEDLINE (PubMed), EMBASE, and the Cochrane Library until 16 December 2020.ResultsIn these meta-analyses, 19 case-control studies and five cohort studies were included. Ipsilateral users reported a pooled odds ratio (OR) of 1.40 (95% CI 1.21–1.62) compared to non-regular users. Users with years of use over 10 years reported a pooled OR of 1.27 (95% CI 1.08–1.48). When stratified by each type of brain tumor, only meningioma (OR 1.20 (95% CI 1.04–1.39)), glioma (OR 1.45 (95% CI 1.16–1.82)), and malignant brain tumors (OR 1.93 (95% CI 1.55–2.39)) showed an increased OR with statistical significance for ipsilateral users. For users with years of use over 10 years, only glioma (OR 1.32 (95% CI 1.01–1.71)) showed an increased OR with statistical significance. When 11 studies with an OR with cumulative hours of use over 896 h were synthesized, the pooled OR was 1.59 (95% CI 1.25–2.02). When stratified by each type of brain tumor, glioma, meningioma, and acoustic neuroma reported the pooled OR of 1.66 (95% CI 1.13–2.44), 1.29 (95% CI 1.08–1.54), and 1.84 (95% CI 0.78–4.37), respectively. For each individual study that considered cumulative hours of use, the highest OR for glioma, meningioma, and acoustic neuroma was 2.89 (1.41–5.93) (both side use, > 896 h), 2.57 (1.02–6.44) (both side use, > 896 h), and 3.53 (1.59–7.82) (ipsilateral use, > 1640 h), respectively. For five cohort studies, the pooled risk ratios (RRs) for all CNS tumors, glioma, meningioma, and acoustic neuroma, were statistically equivocal, respectively. However, the point estimates for acoustic neuroma showed a rather increased pooled RR for ever-use (1.26) and over 10 years of use (1.61) compared to never-use, respectively.DiscussionIn this meta-analysis, as the exposure subcategory used became more concrete, the pooled ORs demonstrated higher values with statistical significance. Although the meta-analysis of cohort studies yielded statistically inconclusive pooled effect estimates, (i) as the number of studies included grows and (ii) as the applied exposure subcategories become more concrete, the pooled RRs could show a different aspect in future research. Additionally, future studies should thoroughly account for changing patterns in mobile phone use and the growing use of earphones or headphones with WPAN technology.

Harnessing the Power of Scientists and Livestreaming: Health Information Outreach in a Medical Library

ABSTRACTOver the last two decades, medical libraries have shifted from being careful suppliers of health information for consumers and patients to taking on prominent roles in outreach initiatives. The emerging livestreaming technology provides opportunities for medical libraries to disseminate health information and facilitate dialogues between health professionals and the public. This article presents a case study of Fudan University Medical Library's innovative approach to health information outreach through livestreaming. By leveraging the expertise of health professionals and embracing the livestreaming technologies, the library successfully engaged a broad audience, surpassing the limitations of traditional outreach methods. Based on the case, the article discusses the transformative potential of livestreaming in reshaping health information outreach and promoting health.

Awareness of plagiarism: Adaption, validity, and reliability of questionnaires in Iranian medical sciences for post-graduate students

BACKGROUND: Academic plagiarism affects the ethical aspects of research and can be in relation with valid health information distribution. The aim of this research is designing, validating, and standardizing the plagiarism awareness questionnaire for awareness of plagiarism. MATERIALS AND METHODS: This study is cross-sectional and was done in medical sciences post-graduate students. Adaption, validity, and reliability were done. The validation population were 11 experts (one linguistics and ten medical library and information sciences). The reliability population includes 333 post-graduate students in Ahvaz Jundishapur University of Medical Sciences in 2022. Cultural adaption, face and content validity, reliability (exploratory and confirmed factor analysis), and correlation (Pearson coefficient) were checked using SPSS and Amos software ver24. RESULTS: Cultural adaption was confirmed based on the experts’ viewpoint using translation and re-translation. The CVR was 0.81, and content validity was confirmed. Exploratory factor analysis was conducted for a model with six factors and 30 items. Confirmatory factor analysis confirmed a model with six factors and 28 items (items 3 and 29 were removed). Cronbach’s alpha was 0.86. The plagiarism awareness model (PAM) has six factors, “authenticating”, “citing”, “understanding”, “insight”, “paraphrasing”, and “attitude”, which can explain 54.353% of variances. IFI = 0.759, CFI = 0.755, NFI = 0.717, AGFI = 0.789, GFI = 0.826, and RMSEA = 0.073, and the PAM model was confirmed. The results of Pearson correlation showed a significant correlation between all factors. CONCLUSION: The PAM model has six factors and 28 items and was confirmed for plagiarism awareness study. This model can be considered by managers and can be used in health promotion research studies. PAPER TYPE: Research Article.

Abstract B165: Psychosocial support needs of racially diverse sexual and gender diverse cancer survivors: a systematic review and call for more intersectional research

Abstract Background: Due to discrimination and marginalization, sexual and gender diverse (SGD) cancer survivors in the U.S. experience inequities across the cancer care continuum, including in prevention, screening, treatment, and survivorship care, compared with their cisgender- heterosexual counterparts. Despite calls to reduce cancer inequities among SGD populations, disparities in access to psychosocial support remain persistent, especially for racially diverse SGD cancer survivors. SGD cancer survivors experience minority stressors, which have been linked to higher levels of social isolation, weaker social networks, and poorer mental health outcomes. Purpose: This scoping review critically evaluates the literature on psychosocial support among SGD cancer survivors and describes the cancer-specific psychosocial support needs and experiences of SGD people using an intersectional lens. Methods: A systematic search was conducted in CINAHL®, Medline/PubMed®, PsycINFO, and SocINDEX. Research articles were retrieved from peer-reviewed, primary research studies and (1) published between 2013 and the present day, (2) available online in full text, and (3) written in English. Articles excluded were not related to the study’s purpose, non-peer-reviewed work such as editorial papers and dissertations, or other literature reviews. The databases and key search terms were identified in consultation with a medical librarian. Criteria for the review process followed PRISMA guidelines. The Covidence Systematic Review Tool was used for record screening, the full-text review was conducted manually, and qualitative analysis was employed to extract themes by one researcher. Results: Our literature search revealed 16 studies that met the review criteria. Of these, 6 were quantitative, 5 were qualitative, and 5 were mixed methods. Themes included (1) recognition and inclusion of unique social networks like chosen families by providers and oncology care systems, (2) barriers to psychosocial support such as identity (non)disclosure and negative assumptions from providers, (3) diverse sources of psychosocial support, comprising family, peers, community, providers, and institutions, (4) support needs may present differently depending on the cancer type, (5) the role of coping mechanisms and resilience strategies to navigate minority stressors, and (6) gaps in understanding the role of intersectionality in psychosocial support. Conclusion: Addressing the structural lack of psychosocial support for SGD people navigating cancer care in the U.S. is critical to reducing health disparities among the population. Future research should prioritize intersectionality and resilience frameworks to better understand the nuanced experiences of SGD cancer survivors and inform targeted interventions that promote holistic well-being and equitable access to care. Citation Format: John A. Fuller. Psychosocial support needs of racially diverse sexual and gender diverse cancer survivors: a systematic review and call for more intersectional research [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B165.

Digital transformation of reading behaviors among allied health students: insights from medical libraries in Pakistan

Purpose The purpose of this paper is to assess the digital transformation of students' reading preferences and behaviors, considering the significant impact of digital resources accessible through the internet among allied health students. Design/methodology/approach The researchers used a structured questionnaire to collect data. The study focused on undergraduate allied health students from medical universities in Pakistan. The researchers used a convenient sampling technique. Data analysis was performed using statistical software packages R and SPSS. Findings The results indicate that allied health students frequently use databases, e-books and e-journals to fulfil their academics and research needs, aiding in the acquisition of up-to-date information and supporting various academic research pursuits. The study emphasizes the positive effects on the reading habits of allied health students, attributing these improvements to factors such as enhanced online databases, a broader array of materials and the integration of digital tools. However, challenges arise from the limited availability of relevant e-resources and the dispersion of information across various library sources. Originality/value This study provides valuable insights into the availability and utilization of e-resources among allied health students in Pakistan. It highlights the crucial role that digital resources play in shaping reading behaviors within the educational landscape. This study holds significance as it contributes to educational enhancement, proves beneficial for the improvement of university library resources and services and aids in the development of policies in health-care education.

Recommendations for Academic Health Libraries Outreach and Engagement Programs with Indigenous Peoples at Collaboration and Empowerment Levels: Striving for Empowerment

A Review of: Cruise, A., Ellsworth-Kopkowski, A., Villezcas, A. N., Eldredge, J., & Rethlefsen, M. L. (2023). Academic health sciences libraries’ outreach and engagement with North American Indigenous communities: A scoping review. Journal of the Medical Library Association, 111(3), 630–656. https://doi.org/10.5195/jmla.2023.1616 Objective – To identify trends and themes in literature sources on interventions for engagement and outreach by academic health sciences libraries with Native Americans, Alaska Natives, First Nations, and Indigenous peoples in the United States, Canada, and Mexico, in order to identify and share effective practices. Design – Scoping review. Setting – Academic health sciences libraries in the United States, Canada, and Mexico. Subjects – Sixty-five reports of 45 engagement and outreach programs spanning 1982-2022. Methods – Researchers conducted a scoping review guided by Arksey and O’Malley’s framework (2005) and the JBI Manual for Evidence Synthesis. They first established inclusion and exclusion criteria then developed a search strategy and ran it across seven bibliographic databases and a library and information science repository. The research team also searched specific journals, conference proceedings, and websites, to find unpublished materials and grey literature; they used mailing lists and personal contacts to find further sources. The researchers used Covidence to screen sources from the bibliographic databases, with English language sources screened by two reviewers and non-English language sources screened by at least one reviewer who could read that language. Sources found via other search methods were screened using Google Sheets, which was also used for data extraction. The researchers analyzed the data using the International Association for Public Participation (IAP2) Spectrum of Public Participation, summarizing programs within the two highest levels to synthesize effective practice. Main Results – The authors identified 45 programs with 27 types of interventions. Training was the most common intervention at 25.5%. They identified 130 different partners; government organizations, both federal and tribal, were the most common at 23.1%. Using the IAP2 Spectrum of Public Participation, a tool designed to assess the level of participation and role of the public in public participation processes, the research team found that five programes (11.1%) engaged with the community at the two highest and also most effective and meaningful levels of collaborate and empower. From these five programs the researchers identified the following areas of effective practice: 1) partnership building and building trust with tribal communities including respecting the knowledge and expertise of the community partners, 2) prioritising and understanding the needs of the tribal communities including developing awareness of cultural differences, 3) partnering with multiple organisations to increase infrastructure, resources, and funding, and, where possible, 4) building on preexisting partnerships and relationships. Conclusion – The authors concluded that libraries are likely to struggle to reach the two highest levels of the IAP2 Spectrum of Public Participation, due to issues with infrastructure, resources, long-term funding, and previous troubled relationships between governments, organizations, and researchers with Native and Indigenous populations, leading to challenges with building and sustaining partnerships. They recommend that libraries initiate any engagement and outreach programs with a needs assessment, with the goal of involving the community partners as collaborators or empowering them as owners and decision makers. The researchers also recommend engaging programs with data sovereignty to increase IAP2 levels and give communities control over their own data.

Extracorporeal life support for severe leptospirosis: Case series and narrative review

Introduction: Leptospirosis can be associated with multi-system organ failure (MSOF) and significant morbidity and mortality. Extracorporeal life support (ECLS) has been used as salvage therapy for severe leptospirosis complicated by acute respiratory distress syndrome (ARDS). Current knowledge in this field is limited, with no standardized treatment approaches. We aim to describe the literature to date on the use of ECLS in patients with leptospirosis, highlighting associations, outcomes, and complications. Methods: We report on the successful use of ECLS in two cases of severe leptospirosis and conduct a narrative review of the literature. Using a search strategy developed in consultation with a medical librarian and validated across pre-selected articles, several databases were searched. We included case reports, case series, cohort studies, and prospective studies of adult patients with confirmed leptospirosis undergoing ECLS. Editorials, surveys, or opinion articles without primary patient data were excluded. Overall mortality was our primary outcome. Results: Two cases of previously healthy males presenting with ARDS due to leptospiral infection are described. Literature review identified 25 articles containing 43 reported cases of patients treated with ECLS for severe leptospirosis. Patients were mostly young and male. Overall mortality was 16%. The most common complication recognized was acute renal failure requiring renal replacement therapy. Additional complications included diffuse intravascular coagulation, necrotizing pancreatitis, and limb ischemia. Conclusion: Leptospirosis should be considered in patients with epidemiologic exposure(s) presenting with critical illness, including ARDS and MSOF. ECLS is a viable rescue strategy in severe leptospirosis, even with established MSOF.

Further Reflective Conversations: Medical Library Usage in the Context of Career Transition

ABSTRACT This article is a literature driven reflection about a radiologist’s experience of using health libraries in England’s National Health Service, as a consultant after returning from a Clinical Fellowship in New Zealand. It is a collaboration between a Consultant Interventional Radiologist and two Academic Librarians. It attempts to reflect on the lived experience of the radiologist and locate that experience within the wider Library and Information Science (LIS) context. Findings include new suggestions about how librarians can support staff in career transition and apply their experience of the COVID-19 pandemic to forge pragmatic relationships within the health care community.

Family Medicine Resident Scholarly Activity Infrastructure, Output, and Dissemination: A CERA Survey.

Meeting scholarly activity requirements continues to be a challenge in many family medicine (FM) residency programs. Studies comprehensively describing FM resident scholarship have been limited. We sought to identify institutional factors associated with increased scholarly output and meeting requirements of the Accreditation Council for Graduate Medical Education (ACGME). Our goals were to: (1) describe scholarly activity experiences among FM residents compared with ACGME requirements; (2) classify experiences by Boyer's domains of scholarship; and (3) associate experiences with residency program characteristics and scholarly activity infrastructure. This was a cross-sectional survey. The survey questions were part of an omnibus survey to FM residency program directors conducted by the Council of Academic Family Medicine Educational Research Alliance (CERA). All ACGME-accredited US FM residency program directors, identified by the Association of Family Medicine Residency Directors, were sampled. Of the 691 eligible program directors, 298 (43%) completed the survey. The respondents reported that 25% or more residents exceeded ACGME minimum output, 17% reported that 25% or more residents published their work, and 50% reported that 25% or more residents delivered conference presentations. Programs exceeding ACGME scholarship requirements exhibit robust infrastructure characterized by access to faculty mentorship, scholarly activity curricula, Institutional Review Board, medical librarian, and statistician. These findings suggest the need for codified ACGME requirements for scholarly activity infrastructure to ensure access to resources in FM residency programs. By fostering FM resident engagement in scholarly activity, programs help to create a culture of inquiry, and address discrepancies in funding and output among FM residency programs.

Determinants of clinical nurses’ patient safety competence: a systematic review protocol

IntroductionPatient safety has become a fundamental element of healthcare quality. However, despite the ongoing efforts of various organisations, patient safety issues remain a problem in the healthcare system. Given the...

Non-Breast Implantable Medical Devices and Associated Malignancies: A Systematic Review.

Innovation in healthcare has led to the development of numerous implantable medical devices (IMDs). However, advances in our knowledge of breast implant-associated malignancies have raised questions about the prevalence, etiology and management of malignancies associated with non-breast IMDs. The objective of this study was to examine the prevalence and characteristics of malignancies associated with non-breast IMDs. An expert medical librarian developed the search strategy for this review. Databases included MEDLINE (National Library of Medicine, Bethesda, MD; date range of search: 1946 to June 21, 2023), EMBASE (Elsevier, Amsterdam, the Netherlands; date range of search: 1946 to June 21, 2023), and Cochrane Central Register of Controlled Trials (CENTRAL; Cochrane Library, Wiley, Hoboken, NJ; date range of search: 1946 to June 21, 2023). In addition, grey literature sources were searched and relevant references from systematic reviews and meta-analyses were included. The PRISMA guideline was used to guide the review. Risk of bias was evaluated using the JBI Critical Appraisal tools. A total of 12,230 articles were reviewed with a total of 77 meeting inclusion criteria. Risk of bias was highest with case reports (moderate, average of 65.1% with range of 37.5 to 100%) and low for the remaining study types. In total, 616 cases of IMD-associated malignancies were identified. Malignancies associated with IMDs were reported in the head/neck (543, 88.1%), lower extremity (57, 9.6%), thorax (9, 1.4%), abdomen (3, 0.5%), and genitourinary system (2, 0.3%). The most common malignancy type in the lower extremity was sarcoma, in the head and neck was squamous cell carcinoma, and in the thorax was lymphoma. This study is the first comprehensive systematic review of its kind. Overall, the oncologic risk of IMDs is low. The discussion of malignancy is an important part to the overall consent process and malignancy should be considered with any new signs or symptoms in the anatomic area of an implant. More data is needed to better understand how primary malignancies occur around IMDs and how to reduce this risk.

Early identification of vascular access site complications and frequent heart rate and blood pressure monitoring after cardiac catheterization: A scoping review

BackgroundNurses perform frequent heart rate (HR) and blood pressure (BP) monitoring, a widespread and longstanding practice, after cardiac catheterization (CC) to identify vascular access site complications for femoral and radial arterial approach in adult patients. ObjectiveThe objective of this scoping review was to answer two questions: (1) how does the available evidence support frequent HR and BP monitoring after CC via femoral and radial approach in adult patients and (2) how does this practice prompt bedside nurses in identifying the procedure's major vascular access site complications, including bleeding, hematoma, and pseudoanurysm? MethodFollowing the scoping review approach, literature search was conducted (PubMed, CINAHL, Google Scholar) by two co-authors and medical librarian. We reviewed, evaluated, and analyzed the evidence from twenty articles. ResultsThe reviewed medical and nursing literature revealed findings challenging the present practice. Out of fifteen research studies, five found frequent HR and BP monitoring after CC to be uninformative while the remaining ten did not report frequent vital signs. Two research articles reported that vascular complications after CC were discovered by RNs directly assessing the access site or by the patients themselves, unrelated to HR and BP. Five non-research articles were included, which all recommended frequent HR and BP monitoring. ConclusionsFrequent HR and BP assessment during the recovery period is not supported by empirical research despite being consistently recommended by nursing guidelines and expert opinion articles. Current evidence supports frequent vascular access site assessments and patient education.

"It's not just teaching for the sake of teaching anymore": a quality improvement project for online instruction in a hospital library.

Medical libraries had to swiftly change how instruction services were provided in response to the COVID-19 pandemic. This article describes a Quality Improvement (QI) project to assess one hospital library's move to virtual instructional services. Information was gathered via a survey to Canadian hospital library workers and a focus group with internal staff with instructional responsibilities. Moving to online instruction increased audience attendance and garnered positive feedback, however library instructors report experiencing uncertainty about quality and effectiveness of online instruction. The article concludes with a description of planned actions to improve online instructional services in an urban research and teaching hospital library environment.