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The study aimed to analyze the Journal of Hospital Librarianship (JHL) publications between 2001 and 2020 as indexed in Elsevier's Scopus database. The dataset was extracted on February 25, 2021 and 807 records were identified for data analysis. Various bibliometric indicators of the papers were assessed. There was an average of 1.32 citations per document. Sixty percent of the papers were single-authored, but the multi-author papers had a higher number of citations. The USA was identified as the country with the most contributions; Louisiana State University was the highest contributing institution, while Helen-Ann Brown Epstein was the most prolific author. [ABSTRACT FROM AUTHOR]

This paper reports findings from a qualitative study on the triggers of hospital social workers' moral distress at a large southern U.S. health system. Moral distress occurs when ethical conflict cannot be resolved in a way that aligns with an individual's personal and professional values and ethics. Participants indicated that moral distress derives from both individual interactions and the culture and climate of health systems. For example, participants expressed how sources of moral distress derived from client-centered decisions, such as end-of-life care and patient autonomy; interpersonal dynamics, including team or supervisory conflict; structural issues, such as insurance barriers or internal hospital policies; and organizational values, such as perceptions of institutional support and validation. Implications of this research suggest that health systems need to foster positive ethical environments that nurture clinicians' health and mental health through programs that aim to increase moral resilience, promote empowerment, and foster wellness. [ABSTRACT FROM AUTHOR]

Stuttering is a fluency disorder that is multidimensional because it involves more than speech difficulties. People who stutter can use the Internet to find out more about their condition and connect with other people in the same position, yet in Croatia, there are not nearly as many online sources on stuttering or as many possibilities to connect with other people who stutter as in the USA or Great Britain. If one does not speak English well, a lot of information about stuttering will simply be denied to them, especially to those who have never received speech therapy. The present study, the first of its kind in Croatia, was conducted in order to understand how often and for what reasons people who stutter search for Internet resources related to their condition. The study also assessed whether Internet use depended on age, experience with speech-language therapy, self-reported satisfaction with such therapy, and self-assessed severity of stuttering. An online questionnaire integrating the 9-Point Stuttering Severity Scale was developed for this study and administered to 51 individuals aged 18 years and older in Croatia. All collected data and findings on the internet searches come from the questionnaire. Age did not significantly affect the frequency or purpose of Internet searches. Individuals who were not attending speech therapy were more likely to search online sources about stuttering than those who received it before. People who rated their stuttering as severe were more likely to search online sources for stuttering than those who rated their condition as mild. These results suggest that there is a need for more useful, high-quality online content and materials in Croatian for people who stutter. Such resources would offer people who stutter a new world of support, mutual understanding, shared experiences and knowledge, and ways for them to help themselves. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Injection drug use carries significant risks for injury and infection, particularly when injection supplies are reused or shared. Syringe service programs and pharmacy nonprescription sale of syringes minimize this risk by promoting access to supplies. This study aimed to characterize how individuals accessing medical care obtain supplies and the impact of perceived barriers to accessing safer injection supplies. One hundred and twenty participants reporting past seven-day injection drug use were recruited from a large urban academic medical center. Participants completed a survey about their injection drug use practices, access to injection supplies, as well as barriers to accessing supplies. Most participants (68%) reported obtaining syringes from multiple sources over the past 3 months, most commonly syringe service programs (78%) or a pharmacy (68%). Few (3%) reported obtaining supplies from medical settings. Participants who found syringes easy to obtain were less likely to report reusing a syringe >10 times (25% vs. 81%, p <.001). More participants were comfortable obtaining syringes through syringe service programs (89%) than nonprescription sale of syringes (60%, p =.001). Perceiving syringe service programs as not convenient or not comfortable reduced the odds of obtaining syringes there by 90% (p <.001) and 88% (p <.003), respectively. Perceiving pharmacies as not comfortable or not affordable reduced the odds of obtaining syringes there by 82% (p <.001) and 75% (p <.002), respectively. Even in regions with legalized syringe service programs and nonprescription sale of syringes, barriers to accessing safer injection supplies remain, and may be partially addressed by expanding syringe service program hours and locations, addressing cost of nonprescription sale of syringes, pharmacy staff training, and expansion of injection supply distribution in medical settings. [ABSTRACT FROM AUTHOR]

A national movement has been developed in the last decade to use simulation training to train child welfare workers. This article reports on a practical measurement method, Daily Experience of Simulation Training (DEST), that the authors have used since 2018 to evaluate every cohort in a week-long statewide simulation training program for new child protection investigators. The DEST measures daily changes in trainees' self-report confidence, solicits feedback on the training team, and offers trainees the opportunity to reflect on their experience. Trainees report substantially increased confidence in 13 child protection skills, provided positive feedback to the training team, and offered a number of suggestions for improvement. We discuss methods for implementing a measurement system like the DEST, even for programs with limited resources. DEST results demonstrated considerable consistency across 27 training cohorts. [ABSTRACT FROM AUTHOR]

University faculty are considered trusted sources of information to disseminate accurate information to the public that abortion is a common, safe and necessary medical health care service. However, misinformation persists about abortion's alleged dangers, commonality, and medical necessity. Systematic review of popular media articles related to abortion, gun control (an equally controversial topic), and cigarette use (a more neutral topic) published in top U.S. newspapers between January 2015 and July 2020 using bivariate analysis and logistic regression to compare disclosure of university affiliation among experts in each topic area. We included 41 abortion, 102 gun control, and 130 smoking articles, which consisted of 304 distinct media mentions of university-affiliated faculty. Articles with smoking and gun control faculty experts had statistically more affiliations mentioned (90%, n = 195 and 88%, n = 159, respectively) than abortion faculty experts (77%, n = 54) (p = 0.02). The probability of faculty disclosing university affiliation was similar between smoking and gun control (p = 0.73), but between smoking and abortion was significantly less (Ave Marginal Effects – 0.13, p = 0.02). Fewer faculty members disclose their university affiliation in top U.S. newspapers when discussing abortion. Lack of academic disclosure may paradoxically make these faculty appear less 'legitimate.' This leads to misinformation, branding abortion as a 'choice,' suggesting it is an unessential medical service. With the recent U.S. Supreme Court landmark decision, Dobbs v. Jackson Women's Health Organization, and subsequent banning of abortion in many U.S. states, faculty will probably be even less likely to disclose their university affiliation in the media than in the past. [ABSTRACT FROM AUTHOR]

Objective: This study examined whether program climate factors, stressors, demographic, and institutional variables were associated with doctoral students' clinically significant generalized anxiety disorder and major depressive disorder symptoms. Participants: This study examined doctoral students' responses from the gradSERU survey, which was administered at five U.S. public research universities in 2017–2018 (n = 2,582). Methods: This study utilized confirmatory factor analysis and binary logistic regression. Results: Sense of belonging reduced doctoral students' odds of clinically significant anxiety and depression symptoms, while academic stressors, relationships stressors, and financial stressors increased such odds. There were no differences in the odds of clinically significant symptoms based on students' academic program. Students identifying as heterosexual or straight had significantly reduced odds of clinically significant symptoms for both disorders than lesbian, gay, bisexual, or questioning students. Conclusions: The results can aid institutional stakeholders in developing interventions that may be associated with the wellness of their students. [ABSTRACT FROM AUTHOR]

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Conclusions: This study recommends using soft surgical principal and round window insertion to protect residual hearing with favorable anatomical exposure. Further studies are needed to evaluate the impact of the electrical stimulation on the organ of corti and hearing. Objective: The objective of this study is to analyze various factors that impact on preservation of residual hearing post-implantation. Methods: A retrospective study was performed to analyze loss of residual hearing in a cohort of 225 patients implanted in a large academic center. Sixty-four patients met the inclusion criteria. The impact of age at implantation, gender, etiology of hearing loss, cochleostomy vs round window insertion, partial vs full insertion, and effect of initial stimulation were analyzed using appropriate statistical analysis. Results: The overall hearing preservation rate for all implanted patients was 64%. Loss of residual hearing was significantly more observed in cases of cochleostomy and/or non-soft surgical techniques. No correlation was observed with age at implantation, gender, side of implant, device manufacturer, and presence of pre-lingual deafness vs post-lingual, full or partial electrode insertion. In addition, there was a small but significant decrease in hearing between pre-stimulation and post-stimulation audiograms at 6000 Hz. [ABSTRACT FROM AUTHOR]

Aim:To examine differences in the types of teaching activities performed during rounds between the most effective and least effective inpatient teaching attendings. Methods:Participants included 56 attending physicians supervising 279 trainees. Trained observers accompanied teams during rounds and recorded the frequencies of educational activities that occurred. Students and residents then rated their satisfaction with the teaching on rounds. Results:Attending physicians with the highest learner satisfaction scores performed significantly more teaching activities per patient than attending physicians who were rated as average or less-effective (2.1 vs. 1.4 vs. 1.5;p = .03). There were significant differences in the frequencies of 3 out of the 9 specific teaching activities observed, including answering specific patient-care related questions (77% vs. 66% vs. 47%;p = .003), teaching on learner chosen topics (8% vs. 2% vs. 2%;p = .02), and providing feedback (31% vs. 10% vs. 0.1%;p = .001). Conclusions:Specific categories of teaching activities—patient-specific teaching, teaching on learner-identified topics, and providing real-time feedback—are performed more frequently by the highest-rated attending physicians, which can guide faculty development. [ABSTRACT FROM PUBLISHER]

Introduction. Vasopressors (epinephrine and vasopressin) are associated with return of spontaneous circulation (ROSC). Recent retrospective studies reported a greater likelihood of ROSC when vasopressors were administered within the first 10 minutes of arrest. However, it is unlikely that the relationship between ROSC and the timing of vasopressor administration is a binary function (i.e., ≤10 vs. >10 minutes). More likely, this relationship is a function of time measured on a continuum, with diminishing effectiveness even within the first 10 minutes of arrest, and potentially, some lingering benefit beyond 10 minutes. However, this relationship remains undefined. Objective. To develop a model describing the likelihood of ROSC as a function of the call receipt to vasopressor interval (CRTVI) measured on a continuum. Methods. We conducted a retrospective study of cardiac arrest using the North Carolina Prehospital Care Reporting System (PREMIS). Inclusionary criteria were all adult patients suffering a witnessed, nontraumatic arrest during January–June 2012. Chi-square and t-tests were used to analyze the relationships between ROSC and CRTVI; patient age, race, and gender; endotracheal intubation (ETI); automated external defibrillator (AED) use; presenting cardiac rhythm; and bystander cardiopulmonary resuscitation (CPR). A multivariate logistic regression model calculated the odds ratio (OR) of ROSC as a function of CRTVI while controlling for potential confounding variables. Results. Of the 1,122 patients meeting inclusion criteria, 542 (48.3%) experienced ROSC. ROSC was less likely with increasing CRTVI (OR = 0.96, p < 0.01). Compared to patients with shockable rhythms, patients with asystole (OR = 0.42, p < 0.01) and pulseless electrical activity (OR = 0.52, p < 0.01) were less likely to achieve ROSC. Males (OR = 0.64, p = 0.02) and patients receiving bystander CPR (OR = 0.42, p < 0.01) were less likely to attain ROSC, although emergency medical services response times were significantly longer among patients receiving bystander CPR. Race, age, ETI, and AED were not predictors of ROSC. Conclusions. We found that time to vasopressor administration is significantly associated with ROSC, and the odds of ROSC declines by 4% for every 1-minute delay between call receipt and vasopressor administration. These results support the notion of a time-dependent function of vasopressor effectiveness across the entire range of administration delays rather than just the first 10 minutes. Large, prospective studies are needed to determine the relationship between the timing of vasopressor administration and long-term outcomes. Keywords: Epinephrine, cardiac arrest, emergency medical services, paramedic, resuscitation, CPR [ABSTRACT FROM AUTHOR]

Phenomenon:Previous studies have not explored factors associated with decisions among neurology residents to pursue subspecialty training within neurology. Understanding career choices among neurology residents, particularly decisions regarding subspecialty training, is critical, as neurologists with specialized knowledge can help meet the needs of patients with specific disease conditions. This study addresses the knowledge gap about subspecialty training decisions by examining factors associated with neurology residents' interest in pursuing subspecialty training and the types of subspecialty training neurology residents consider.Approach:We surveyed a geographically stratified sample of neurology residents in U.S. training programs using a two-stage survey design. In Stage 1, we randomly sampled half of the accredited neurology residency programs stratified by U.S. census region; Stage 2 involved a survey of neurology residents within these programs.Findings:The majority (approximately 81%) of residents expressed interest in subspecialty training. Resident demographic characteristics and educational debt did not influence interest in pursuing subspecialty training. Residents were more likely to express interest in subspecialty training when they participated in any neurology research (odds ratio [OR] = 2.39), 95% confidence interval (CI) [1.13, 5.07],p= .02, and indicated more interest in careers involving teaching (OR= 8.33), 95% CI [1.64, 42.19],p= .01. Considering the “medical content of subspecialty” as a more important factor approached but did not reach statistical significance (OR= 3.12), 95% CI [0.97, 10.06],p= .06.Insights:Participation in any neurology research and interest in careers involving teaching are associated with interest in subspecialty training among neurology residents. Further research is needed to determine whether exposure to research and teaching stimulates interest in subspecialty training and whether residents believe that subspecialty training is instrumental in pursuing an academic career. [ABSTRACT FROM AUTHOR]

Management of postoperative pain remains an important clinical problem throughout the world. Using the PAIN-OUT acute pain registry database to examine perioperative pain management in orthopedic surgery patients, we compared patient-reported outcomes (PROs) in a pooled sample obtained from four American hospitals ( N = 473) with PROs in a pooled sample of 20 European institutions ( N = 8799). Most American hospitals consistently assess acute pain in surgical patients due to Joint Commission accreditation guidelines. Therefore, we hypothesized that this practice would create a climate of clinical staff sensitivity to patients' pain and a greater readiness to intervene when pain is higher than one would find in Europe as a whole. American institutions might then provide better control of postoperative pain after orthopedic surgery than European institutions. Because of the large sample sizes, our analyses focused on effect size rather than statistical significance. Evaluation of the pain PROs revealed that European patients reported much lower Worst Pain on the first day after orthopedic surgery than American patients. The mean Worst Pain (± SD) for Europeans was 5.4 (2.5) but for Americans the mean was 7.4 (2.7), p < .0001, a large effect size. Europeans also reported significantly less emotional discomfort, less interference of pain with activity and lower Least Pain. Nonetheless, 98.3% of American patients received opioids on the ward on the first postoperative day compared to 70.2% of European patients, and 41.1% received regional analgesia on the ward while 15.9% of European patients received regional analgesia (both small effect sizes). Overall, the results are clear in demonstrating much better pain control in the ensemble of European countries as compared to the United States. [ABSTRACT FROM AUTHOR]

Background: Logbooks are used by US medical schools to evaluate curricular objectives and meet accreditation requirements, but research supporting their utility is conflicting. Aims: The goal of our study was to examine the relationship between volume of clinical rotation experiences as reported in a logbook and clerkship grades within a longitudinal integrated clerkship. Methods: We conducted a retrospective cohort study of third-year (clinical) medical students during academic year 2008-2009. We tracked student entries in a pocket-sized logbook (number of clinical encounters per clerkship, total number of exams, and procedures over the academic year). We performed correlation analyses between logbook entries and clerkship grades. Results: We enrolled 36 students, who reported a total of 2992 encounters, 2262 exams, and 2342 procedures. Correlation coefficients between volume of clinical experience and clerkship grades were less than 0.4, indicating low correlation. We found borderline statistical significance for the Neurology, OB/Gyn, and Surgery clerkships. Sensitivity analyses showed little correlation between low-reporting activity and clerkship grades. Conclusions: Even within an integrated longitudinal clerkship framework, our findings are consistent with previous studies showing a negligible relationship between logbooks as an educational process measure and how they relate to educational outcomes. [ABSTRACT FROM AUTHOR]

Aims: Concepts that may be effective in alleviating negative alcohol-related consequences among college students are protective behavioural strategies (PBSs), such as alternating alcoholic and non-alcoholic drinks. Our study used an innovative hypothesis-testing statistical technique (structural equation modelling, SEM) to examine the relationship of PBSs, drinking behaviour and school performance among college student drinkers. Methods: We used confirmatory factor analysis and SEM to explore the relationship between drinking behaviour, PBSs and school performance among a sample of college students ( N == 371) who reported drinking alcohol in the past 30 days. Findings: Results indicated that PBSs were positively associated with school performance and drinking behaviour mediated the relationship. Based on the combinatory rules for standardized root mean square residual (SRMR) and comparative fit index (CFI), this model represented a good fit to the data ( χ2 == 34.4, df == 17, SRMR == 0.03 and CFI == 0.98). Conclusions: Our study extends the line of research examining the relationship between drinking behaviour, including PBSs, and academic performance of college students by showing the usefulness of an innovative hypothesis-testing statistical technique - SEM. Researchers might want to consider utilizing SEM when examining such relationships in the future. In addition, based on the results of our analyses, colleges and universities with an interest in the academic performance of their students may want to consider implementing and promoting programmes that concern increasing the awareness of PBSs. [ABSTRACT FROM AUTHOR]