Roles of Health Literacy in Relation to Social Determinants of Health and Recommendations for Informatics-Based Interventions: Systematic Review.

BACKGROUND: Health literacy (HL) is the ability to make informed decisions using health information. As health data and information availability increase due to online clinic notes and patient portals, it is important to understand how HL relates to social determinants of health (SDoH) and the place of informatics in mitigating disparities. OBJECTIVE: This systematic literature review aims to examine the role of HL in interactions with SDoH and to identify feasible HL-based interventions that address low patient understanding of health information to improve clinic note-sharing efficacy. METHODS: The review examined 2 databases, Scopus and PubMed, for English-language articles relating to HL and SDoH. We conducted a quantitative analysis of study characteristics and qualitative synthesis to determine the roles of HL and interventions. RESULTS: The results (n=43) were analyzed quantitatively and qualitatively for study characteristics, the role of HL, and interventions. Most articles (n=23) noted that HL was a result of SDoH, but other articles noted that it could also be a mediator for SdoH (n=6) or a modifiable SdoH (n=14) itself. CONCLUSIONS: The multivariable nature of HL indicates that it could form the basis for many interventions to combat low patient understandability, including 4 interventions using informatics-based solutions. HL is a crucial, multidimensional skill in supporting patient understanding of health materials. Designing interventions aimed at improving HL or addressing poor HL in patients can help increase comprehension of health information, including the information contained in clinic notes shared with patients.

Informationists and Nurse Educators Partner to Integrate a Virtual Dissection Table into a Nursing Curriculum.

Informationists and nurse educators launched a pilot program that integrates a Sectra Virtual Dissection Table into a Critical Care Nurse Residency Program (CCNRP) curriculum. CCNRP is a mandatory education program for novice, critical care registered nurses at the University of Cincinnati Medical Center (UCMC). After nurses complete the seven-week course, they take a post-course survey. This survey measures satisfaction with the virtual dissection table and resident perception of anatomical knowledge gained. In total, 106 nurses have utilized and evaluated the Sectra Table. This paper will discuss Sectra Table education within the CCNRP and lessons learned from the post-course survey.

Pregnancy outcomes in women with kidney transplant: Metaanalysis and systematic review.

BACKGROUND: Reproductive function in women with end stage renal disease generally improves after kidney transplant. However, pregnancy remains challenging due to the risk of adverse clinical outcomes. METHODS: We searched PubMed/MEDLINE, Elsevier EMBASE, Scopus, BIOSIS Previews, ISI Science Citation Index Expanded, and the Cochrane Central Register of Controlled Trials from date of inception through August 2017 for studies reporting pregnancy with kidney transplant. RESULTS: Of 1343 unique studies, 87 met inclusion criteria, representing 6712 pregnancies in 4174 kidney transplant recipients. Mean maternal age was 29.6 ± 2.4 years. The live-birth rate was 72.9% (95% CI, 70.0-75.6). The rate of other pregnancy outcomes was as follows: induced abortions (12.4%; 95% CI, 10.4-14.7), miscarriages (15.4%; 95% CI, 13.8-17.2), stillbirths (5.1%; 95% CI, 4.0-6.5), ectopic pregnancies (2.4%; 95% CI, 1.5-3.7), preeclampsia (21.5%; 95% CI, 18.5-24.9), gestational diabetes (5.7%; 95% CI, 3.7-8.9), pregnancy induced hypertension (24.1%; 95% CI, 18.1-31.5), cesarean section (62.6, 95% CI 57.6-67.3), and preterm delivery was 43.1% (95% CI, 38.7-47.6). Mean gestational age was 34.9 weeks, and mean birth weight was 2470 g. The 2-3-year interval following kidney transplant had higher neonatal mortality, and lower rates of live births as compared to > 3 year, and < 2-year interval. The rate of spontaneous abortion was higher in women with mean maternal age < 25 years and > 35 years as compared to women aged 25-34 years. CONCLUSION: Although the outcome of live births is favorable, the risks of maternal and fetal complications are high in kidney transplant recipients and should be considered in patient counseling and clinical decision making.

Luminescent Chains Formed from Neutral, Triangular Gold Complexes Sandwiching TlI and AgI. Structures of {Ag([Au(µ-C2,N3-bzim)]3)2}BF4·CH2Cl2, {Tl([Au(µ-C2,N3-bzim)]3)2}PF6·0.5THF (bzim = 1-Benzylimidazolate), and {Tl([Au(µ-C(OEt)═NC6H4CH3)]3)2}PF6·THF, with MAu6 (M = Ag+, Tl+) Cluster Cores.

It has been found that several trinuclear complexes of AuI interact with silver and thallium salts to intercalate Ag+ and Tl+ cations, thereby forming chains. The resulting sandwich clusters center the cations between the planar trinuclear moieties producing structures in which six AuI atoms interact with each cation in a distorted trigonal prismatic coordination. The resultant (B3AB3B3AB3)∞ pattern of metal atoms also shows short (∼3.0 Å) aurophilic interactions between BAB molecular centers. These compounds display a strong visible luminescence, under UV excitation, which is sensitive to temperature and the metal ion interacting with the gold. X-ray crystal structures are reported for Ag([Au(µ-C2,N3-bzim)]3)2BF4·CH2Cl2 (P [Formula: see text] , Z = 2, a = 14.4505(1)Å; b = 15.098(2)Å; c = 15.957(1)Å; α = 106.189(3)°; ß = 103.551(5)°; γ = 101.310(5)°); Tl([Au(µ-C2,N3-bzim)]3)2PF6·0.5C4H8O (P [Formula: see text] , Z = 2, a = 15.2093(1)Å; b =15.3931(4)Å; c = 16.1599(4)Å; α = 106.018(1)°; ß = 101.585(2)°; γ=102.068(2)°); and Tl([Au(µ-C(OEt)═NC6H4CH3)]3)2PF6·C4H8O (P2(1)/n, Z = 4, a = 16.4136(3)Å; b = 27.6277(4)Å; c = 16.7182(1)Å; ß = 105.644(1)°). Each compound shows that the intercalated cation, Ag+ or Tl+, coordinates to a distorted trigonal prism of six AuI atoms. The counteranions reside well apart from the cations between the cluster chains.