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This mapping study is the first bibliometric analysis of literature on Guillain–Barre Syndrome (GBS). By identifying core journals, analyzing cited references, categorizing journals into Zones, and...

Background: Scan-related anxiety (“scanxiety”) is distressing to people living with and beyond cancer. We conducted a scoping review to promote conceptual clarity, identify research practices and gaps, and guide intervention strategies for adults with a current or prior cancer diagnosis. Methods: Following a systematic search, we screened 6820 titles and abstracts, evaluated 152 full-text articles, and selected 36 articles. Definitions, study designs, measurement methods, correlates, and consequences of scanxiety were extracted and summarized. Results: The reviewed articles included individuals living with current cancer (n = 17) and those in the post-treatment phase (n = 19), across a breadth of cancer types and disease stages. In five articles, authors explicitly defined scanxiety. Multiple components of scanxiety were described, including those related to scan procedures (e.g., claustrophobia, physical discomfort) and scan results (e.g., implications for disease status and treatment), suggesting varied intervention approaches may be needed. Twenty-two articles used quantitative methods, nine used qualitative methods, and five used mixed methods. In 17 articles, symptom measures specifically referenced cancer scans; 24 included general measures without reference to scans. Scanxiety tended to be higher among those with lower education levels, less time since diagnosis, and greater baseline anxiety levels (three articles each). Although scanxiety often decreased immediately pre- to post-scan (six articles), participants reported the waiting period between scan and results to be particularly stressful (six articles). Consequences of scanxiety included poorer quality of life and somatic symptoms. Scanxiety promoted follow-up care for some patients yet hindered it for others. Conclusions: Scanxiety is multi-faceted, heightened during the pre-scan and scan-to-results waiting periods, and associated with clinically meaningful outcomes. We discuss how these findings can inform future research directions and intervention approaches.

OBJECTIVES To summarize current bleeding scales and their validation to assess applicability to bleeding in critically ill children. DATA SOURCES We conducted electronic searches of Ovid MEDLINE, Ovid EMBASE, Cochrane Library, and Web of Science Core Collection databases from database inception to 2017. STUDY SELECTION Included studies contained a bleeding score, bleeding measurement tool, or clinical measurement of hemorrhage. DATA EXTRACTION We identified 2,097 unique citations; 20 full-text articles were included in the final review. DATA SYNTHESIS Of the 18 studies that included subjects (two others were expert consensus definitions), seven (39%) were pediatric-only, seven (39%) were adult-only, and four (22%) included both adults and children. Nine (50%) occurred with inpatients (two studies in critical care units), seven (39%) involved outpatients and two (11%) included both inpatients and outpatients. Thirty-nine percent of the scales were developed for those with idiopathic thrombocytopenic purpura and only two (12%) described critically ill patients. The majority (80%) included need for treatment (either RBC transfusion or surgical intervention). The majority (65%) did not report measures of reliability or validation to clinical outcomes. CONCLUSIONS There is a lack of validated bleeding scales to adequately assess bleeding and outcomes in critically ill children. Validated scales of bleeding are necessary and urgently needed.

Increasingly physicians and patients express concern and frustration about the lack of time spent together during office visits. Some studies suggest a substantial number of patients fail t...

Clinical Medical Librarians at Weill Cornell Medicine (WCM), Samuel J. Wood Library provide unique health literacy services for patients, families, and caregivers on the Phyllis and David Komansky Center for Children’s Health pediatric floors of New York-Presbyterian Hospital (NYPH) by conducting twice weekly patient rounds and bringing consumer health information and services to bedsides. Although in its infancy, the Pediatric Consumer Librarian Service (PCLS) generates statements of appreciation from patients and parents, enthusiasm among stakeholders, and reports of increased job satisfaction by librarians. We report on experiences, methods, feedback from users, and plans for the future.

Introduction Burn clinicians commonly experience ethical dilemmas as a direct result of a patient’s burn injury, yet literature on ethics in burns are scarce. A bibliometric analysis of literature on burn patients and ethics is necessary to support decision-making of burn-injured patients and their families. By identifying core journals, analyzing cited references, categorizing journals into Zones, and estimating database coverage, the results of this study informs burn specialists of the most relevant journals related to discussions about ethical issues in treating burn patients. Methods This study examined references during a three-year period (2016–2018) from a sample core of journals using the mapping protocol from the Nursing and Allied Health Resources Section (NAHRS) of the Medical Library Association (MLA). Following the prescribed steps in the NAHRS protocol, the investigators polled experts from the burn unit in a U.S. urban academic medical center inquiring about resources they believe contain the highest amount of content related to burns and ethics. Using the following search strategy, the investigators queried Scopus, a subscription-based discovery portal, to retrieve references from the source journals published during the years 2016–2018. Results Based on professional responses, analysis of journal impact factors from the Journal Citation Reports (JCR) provided by Clarivate Analytics and a search of burns and ethics articles in MEDLINE, three journals informed the source titles for this study: Burns, BMC Medical Ethics, and Journal of Medical Ethics. There were 225 cited references pulled from the bibliographies of source journal publications: 183 references were from journal articles; 99 of these published in Burns. The years 2009–2013 accounted for the highest number of references inclusive of all publication types (n=61), followed by 2014–2018 (n=52). According to Bradford’s Law of Scattering, the n for this study was 4.4 (49 journals in Zone 2 divided by the 11 journals in Zone 1). Each zone makes up approximately 33% of the total number of cited references in all journals. Conclusions Results of this mapping study reveal there is a need for further published research on burns and ethics. Advancing burn clinicians’ understanding of ethics and burns will improve the overall care of burn-injured patients and supports the clinician in meeting their own professional ethical obligations. Applicability of Research to Practice Directly applicable to practice.

Background Existing data on predictors of late mortality and prevention of sudden cardiac death after atrial switch repair surgery for D‐transposition of the great arteries (D‐ TGA ) are heterogeneous and limited by statistical power. Methods and Results We conducted a systematic review and meta‐analysis of 29 observational studies, comprising 5035 patients, that reported mortality after atrial switch repair with a minimum follow‐up of 10 years. We also examined 4 additional studies comprising 105 patients who reported rates of implantable cardioverter‐defibrillator therapy in this population. Average survival dropped to 65% at 40 years after atrial switch repair , with sudden cardiac death accounting for 45% of all reported deaths. Mortality was significantly lower in cohorts that were more recent and operated on younger patients. Patient‐level risk factors for late mortality were history of supraventricular tachycardia ( odds ratio [OR] 3.8, 95% CI 1.4–10.7), Mustard procedure compared with Senning ( OR 2.9, 95% CI 1.9–4.5) and complex D‐ TGA compared with simple D‐ TGA ( OR 4.4, 95% CI 2.2–8.8). Significant risk factors for sudden cardiac death were history of supraventricular tachycardia ( OR 4.7, 95% CI 2.2–9.8), Mustard procedure ( OR 2.2, 95% CI 1.1–4.1), and complex D‐ TGA ( OR 5.7, 95% CI 1.8–18.0). Out of a total 124 implantable cardioverter‐defibrillator discharges over 330 patient‐years in patients with implantable cardioverter‐defibrillator s for primary prevention, only 8% were appropriate. Conclusions Patient‐level risk of both mortality and sudden cardiac death after atrial switch repair are significantly increased by history of supraventricular tachycardia , Mustard procedure, and complex D‐ TGA . This knowledge may help refine current selection practices for primary prevention implantable cardioverter‐defibrillator implantation, given disproportionately high rates of inappropriate discharges.

Objective: The goal of this scoping review was to collect data on patient- and family-centered care (PFCC) programs and initiatives that have included the direct involvement of librarians and information professionals to determine how librarians are involved in PFCC and highlight opportunities for librarians to support PFCC programs.Methods: Systematic literature searches were conducted in seven scholarly databases in the information, medical, and social sciences. Studies were included if they (1) described initiatives presented explicitly as PFCC programs and (2) involved an information professional or librarian in the PFCC initiative or program. Based on the definition of PFCC provided by the Institute for Patient- and Family-Centered Care, the authors developed a custom code sheet to organize data elements into PFCC categories or initiatives and outcomes. Other extracted data elements included how the information professional became involved in the program and a narrative description of the initiatives or programs.Results: All included studies (n=12) identified patient education or information-sharing as an integral component of their PFCC initiatives. Librarians were noted to contribute to shared decision-making through direct patient consultation, provision of health literacy education, and information delivery to both provider and patient with the goal of fostering collaborative communication.Conclusions: The synthesis of available evidence to date suggests that librarians and information professionals should focus on patient education and information-sharing to support both patients or caregivers and clinical staff. The burgeoning efforts in participatory care and inclusion of patients in the decision-making process pose a unique opportunity for librarians and information professionals to offer more personalized information services.

Consumers increasingly use social media including online videos to seek answers to health questions (1, 2). Among the many online video tools to choose from, YouTube is the most popular and evidenc...

Background: Cardiac rehabilitation (CR) is a cornerstone of secondary prevention of ischemic heart disease. It is critically important in low- and middle-income countries (LMIC), where the burden of ischemic heart disease is substantial and growing. However, the availability and utilization of CR in LMIC is not systematically known. Objectives: This study sought to characterize the availability, use, and barriers to the use of CR. Methods: Electronic databases (Cochrane Library, EMBASE, PubMed, Web of Science) were searched from January 1, 1980 to May 31, 2013 for articles on CR in LMIC. Citations on availability, use, and/or barriers to CR were screened for inclusion by title, abstract, and full text. Data were summarized by region or country to determine the characteristics of CR in LMIC and gaps in the peer-reviewed biomedical publications. Results: Our search yielded a total of 5,805 citations, of which 34 satisfied full inclusion and exclusion criteria. The total number of CR programs available ranged from 1 in Algeria and Paraguay to 51 in Serbia. Referral rates for CR ranged from 5.0% in Mexico to 90.3% in Lithuania. Attendance rates ranged from 31.7% in Bulgaria to 95.6% in Lithuania, and CR attendance was correlated with higher educational background. The most commonly cited barrier to CR in LMIC was lack of physician referral. Conclusions: Our results illustrate that the published reports reflects heterogeneity of CR availability and use in LMIC. Overall, CR is insufficiently available and underutilized. Further characterization of CR in LMIC, especially in Asia and Africa, is necessary to develop targeted strategies to improve availability and utilization. Patient, physician, and systems factors must be addressed to overcome barriers to participation in CR in LMIC. Highlights Availability of cardiac rehabilitation in LMIC does not match the growing burden of CVD. Utilization of cardiac rehabilitation is suboptimal; physician referral is a prominent barrier. Interventions to improve cardiac rehabilitation availability and use must address local context.

Objective: The authors explored the feasibility and possible benefit of tablet-based educational materials for patients in clinic waiting areas.Methods: We distributed eight tablets preloaded with diagnosis-relevant information in two clinic waiting areas. Patients were surveyed about satisfaction, usability, and effects on learning. Technical issues were resolved.Results: Thirty-seven of forty patients completed the survey. On average, the patients were satisfied in all categories.Conclusions: Placing tablet-based educational materials in clinic waiting areas is relatively easy to implement. Patients using tablets reported satisfaction across three domains: usability, education, and satisfaction.

Background and aims The recent opioid epidemic has prompted renewed interest in opioid use disorder treatment, but there is little evidence regarding health-related quality-of-life (HRQoL) outcomes in treatment programs. Measuring HRQoL represents an opportunity to consider outcomes of opioid use disorder treatment that are more patient-centered and more relevant to overall health than abstinence alone. We conducted a systematic literature review to explore the extent to which the collection of HRQoL by opioid treatment programs is documented in the treatment program literature. Materials and methods We searched PubMed, Embase PsycINFO and Web of Science for papers published between 1965 and 2015 that reported HRQoL outcome measures from substance abuse treatment programs. Results Of the 3014 unduplicated articles initially identified for screening, 99 articles met criteria for further review. Of those articles, 7 were unavailable in English; therefore 92 articles were reviewed. Of these articles, 44 included any quality-of-life measure, 17 of which included validated HRQoL measures, and 10 supported derivation of quality-adjusted life year utility weights. The most frequently used validated measure was the Addiction Severity Index (ASI). Non-U.S. and more recent studies were more likely to include a measure of HRQoL. Conclusions HRQoL measures are rarely used as outcomes in opioid treatment programs. The field should incorporate HRQoL measures as standard practice, especially measures that can be used to derive utility weights, such as the SF-12 or EQ-5D. These instruments provide policy makers with evidence on the impact of programs on patients' lives and with data to quantify the value of investing in opioid use disorder treatments.