Utilizing the Newest Vital Sign (NVS) to Assess Health Literacy at a Regional Academic Medical Center's Family Medicine Clinic.

Researchers examined the correlation between the physician's subjective assessment of health literacy rates and actual health literacy rates among patients as determined by the Newest Vital Sign (NVS). A sample of n = 150 patients, 18 years of age or older, were verbally interviewed using NVS tool before seeing their physician. After the physician met with the patient, the physician was asked to measure that patient's level of health literacy on a Likert-type scale and a "yes/no" scale. Frequency and percentage statistics were performed in SPSS to describe the distributions of patient and physician responses. Between-subjects statistics were used. Analysis of the patient surveys revealed one in 4 patients has a high likelihood of low health literacy. Analysis revealed there were significant positive correlations between physician response to perception of a patient's low health literacy risk and NVS survey responses. Despite the risk of limited literacy, 97.3% of physicians perceived the patient to understand what the physician was saying. Physicians should use teach-back and other health literacy principles with each patient, regardless of perceived risk.

The significance of the library's physical space: how COVID-19 impacted a consumer health service.

Background: During the beginning of the COVID-19 pandemic, many consumer health libraries were forced to close their doors to patrons. At the Health Information Center in Knoxville, Tennessee, the physical space closed, while health information services continued to be provided via phone and email. To examine the impact of lack of access to a physical library for consumer health information, researchers analyzed the number of health information requests pre-COVID-19 pandemic compared to during the initial phase of the pandemic. Case Presentation: Data from an internal database was collected and analyzed. Researchers divided the data into three time periods: March 2018 to February 2019 (Phase 1), March 2019 to February 2020 (Phase 2), and March 2020 to February 2021 (Phase 3). Data was de-identified and duplicate entries were removed. The type of interaction and request topics were reviewed in each phase. Conclusion: In Phase 1, there were 535 walk-ins to request health information and 555 walk-ins in Phase 2. In Phase 3, there were 40 walk-ins. The number of requests through phone and email varied but remained steady. There was a 61.56% decrease in requests between Phase 1 and Phase 3 while there was a 66.27% decrease between Phase 2 and Phase 3 due to the lack of walk-in requests. The number of phone and email requests did not increase despite the closure of the physical library space to the public. Access to the physical space plays a significant role in providing health information requests to patients and family members.

Medical librarians and little free libraries: Connecting rural communities to health information.

BACKGROUND: Consumer health libraries connect communities to reliable and accurate health information while Little Free Libraries (LFL) provide communities globally with access to free books with a 'take one leave one' type policy. OBJECTIVES: To discuss how medical librarians used already established LFLs as outreach opportunities to provide consumer health books to rural locations in East Tennessee's Appalachia region in the United States. METHODS: Researchers reviewed the population's literacy levels, the Index of Medical Underservice scores, and the availability of established LFLs. Twenty-two established LFL locations were selected and one new LFL was built for an eye clinic. Eleven health books were purchased for each established LFL, and 33 books were purchased for the new LFL. RESULTS: Researchers went back to each location 5 months after delivery. 90% of the books were taken from the already established LFLs. Ten books were taken from the new LFL. DISCUSSION: Using already established LFLs is a great opportunity to provide relevant health information to rural communities. The new LFL allowed for a partnership between the library and a rural eye clinic. CONCLUSION: By distributing health books to already established LFLs, researchers brought relevant health information books to rural and medically underserved communities.

Drosophila Stat92E Signaling Following Pre-exposure to Ethanol.

Repeated exposure to alcohol alters neuromolecular signaling that influences acute and long-lasting behaviors underlying Alcohol Use Disorder (AUD). Recent animal model research has implicated changes in the conserved JAK/STAT pathway, a signaling pathway classically associated with development and the innate immune system. How ethanol exposure impacts STAT signaling within neural cells is currently unclear. Here, we investigated the role of Drosophila Stat92E in ethanol-induced locomotion, signaling activity, and downstream transcriptional responses. Findings suggest that expressing Stat92E-RNAi causes enhanced ethanol-induced hyperactivity in flies previously exposed to ethanol. Furthermore, alternative splicing of Stat92E itself was detected after repeated ethanol exposure, although no changes were found in downstream transcriptional activity. This work adds to our growing understanding of altered neuromolecular signaling following ethanol exposure and suggests that STAT signaling may be a relevant target to consider for AUD treatment.

Looking at Library Resource Usage Trends in Medical Residents & Fellows: Survey Results from 2006-2021.

Since 2006, the University of Tennessee's Preston Medical Library has collected survey feedback from exiting residents through targeted emails or at the required exit process in the library. Questions ask residents which types of articles or sources they use to find information and address the resident's use of the library's physical space. Survey results from 2006 to 2021 were examined for trends and changes in resident utilization of resources to better inform future library decisions on instruction and marketing. Resident resource usage varied over time and demonstrated an encouraging increase in attention to evidence-based tools. UpToDate's consistent popularity shows the durability of the product. A reported increase in use of reviews, randomized controlled trials, case reports, and practice guidelines reflects greater employment of more in-depth resources than merely expert opinion. At the same time, residents clearly valued the library's physical space. Survey results will inform future outreach focus.

Physical Activity during Pregnancy and Newborn Body Composition: A Systematic Review.

The current literature demonstrates that not only is exercise during pregnancy safe, but it has substantial maternal and infant benefits and appears to influence infant growth/size throughout pregnancy and at birth. However, many existing studies have investigated only the effects of prenatal exercise on birth weight. The purpose of this review was to determine the impact or association of maternal physical activity during pregnancy on neonatal body composition assessed between birth and two weeks of age. Electronic database searches were conducted on 29 July 2019 for randomized control trials and cohort studies, with an updated search completed on 8 January 2021. A total of 32 articles that met eligibility criteria were selected for review. Overall, prenatal exercise was not associated with infant body composition at birth. Yet, five of the studies identified suggest that infant body composition could be influenced by higher volumes of mid-to-late term prenatal physical activity. This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered in PROSPERO (Registration No. CRD42020160138).

The status of scholarly efforts of librarians on health literacy: a bibliometric analysis.

Objective: In order to determine the status of scholarly efforts on health literacy by librarians, researchers examined the characteristics of health literacy publications authored by librarians from 2000 to 2020. Methods: Bibliometric analysis was used to assess the indicators of productivity, affiliation, collaboration, and citation metrics of librarians in health literacy-related research. Data were collected using the Scopus database; articles were screened for inclusion before importation into Microsoft Excel for analysis. SPSS software was used to run basic descriptive statistics. Results: Of 797 search results, 460 references met the inclusion criteria of librarian authorship. There was a significant linear trend upward in publications since 2001 with an average increase of 1.52 papers per year. The number of publications per year peaked in 2019 (n=59). Journal of Consumer Health on the Internet was the most prolific journal. The majority of references were authored by at least two authors and by multidisciplinary teams. Nineteen percent (n=107) of the librarian authors were responsible for more than one publication, and 84.1% of publications were cited at least once. Conclusions: In the last two decades, librarian involvement in health literacy publications has exponentially increased, most markedly in the years following 2014. The productivity, multidisciplinary collaboration efforts, and consistent growth in literature indicate that librarians are engaged in health literacy scholarship. Further research is needed to explore the work of librarians whose impacts on health literacy may not be reflected within well-indexed, peer-reviewed publications.

Pharmacists' Perceived Barriers to Human Papillomavirus (HPV) Vaccination: A Systematic Literature Review.

About 45:000 cancers are linked to HPV each year in the United States alone. The HPV vaccine prevents cancer and is highly effective, yet vaccination coverage remains low. Pharmacies can play a meaningful role in increasing HPV vaccination access due to their availability and convenience. However, little is known about pharmacists' perceived barriers to HPV vaccination. The objective of this systematic review was to summarize existing literature on perceived barriers to administering HPV vaccination reported by pharmacists. Barriers identified from selected studies were synthesized and further grouped into patient, parental, (pharmacist's) personal, and system/organization barrier groups. Six studies were included in this review. The cost of the HPV vaccine, insurance coverage and reimbursement were commonly reported perceived barriers. Adolescent HPV vaccination barriers related to parental concerns, beliefs, and inadequate knowledge about the HPV vaccine. Perceived (pharmacist's) personal barriers were related to lack of information and knowledge about HPV vaccine and recommendations. At the system/organization level, barriers reported included lack of time/staff/space; difficulty in series completion; tracking and recall of patient; perceived competition with providers; and other responsibilities/vaccines taking precedence. Future strategies involving pharmacy settings in HPV-related cancer prevention efforts should consider research on multilevel pharmacy-driven interventions addressing barriers.

Design and Validation of Patient-Centered Communication Tools (PaCT) to Measure Students' Communication Skills.

Objective. To develop a comprehensive instrument specific to student pharmacist-patient communication skills, and to determine face, content, construct, concurrent, and predictive validity and reliability of the instrument. Methods. A multi-step approach was used to create and validate an instrument, including the use of external experts for face and content validity, students for construct validity, comparisons to other rubrics for concurrent validity, comparisons to other coursework for predictive validity, and extensive reliability and inter-rater reliability testing with trained faculty assessors. Results. Patient-centered Communication Tools (PaCT) achieved face and content validity and performed well with multiple correlation tests with significant findings for reliability testing and when compared to an alternate rubric. Conclusion. PaCT is a useful instrument for assessing student pharmacist communication skills with patients.

Draft Genome Sequence of Pseudomonas sp. Strain DrBHI1 (Phylum Proteobacteria).

Here, we report the draft genome sequence of Pseudomonas sp. strain DrBHI1. The total assembly length is 5,649,751 bp in 146 contigs. This strain was isolated from zebrafish (Danio rerio) feces.

A review of intravenous minocycline for treatment of multidrug-resistant Acinetobacter infections.

Options for treatment of multidrug-resistant (MDR) Acinetobacter baumannii infections are extremely limited. Minocycline intravenous is active against many MDR strains of Acinetobacter, and Clinical and Laboratory Standards Institute breakpoints exist to guide interpretation of minocycline susceptibility results with Acinetobacter. In addition, minocycline intravenous holds a US Food and Drug Administration indication for treatment of infections caused by Acinetobacter. There is an accumulating amount of literature reporting successful use of minocycline intravenous for treatment of serious MDR Acinetobacter infections, particularly for nosocomial pneumonia. These results, coupled with the generally favorable tolerability of minocycline intravenous, support its use as a viable therapeutic option for treatment of MDR Acinetobacter infections.

Diversity considerations for promoting early childhood oral health: a pilot study.

Objectives. Several groups in Manitoba, Canada, experience early childhood caries (ECC), including Aboriginal, immigrant, and refugee children and those from select rural regions. The purpose of this pilot study was to explore the views of parents and caregivers from four cultural groups on early childhood oral health and ECC. Methods. A qualitative descriptive study design using focus groups recruited parents and caregivers from four cultural groups. Discussions were documented, audio-recorded, transcribed, and then analyzed for content based on themes. Results. Parents and caregivers identified several potential barriers to good oral health practice, including child's temperament, finances, and inability to control sugar intake. Both religion and genetics were found to influence perceptions of oral health. Misconceptions regarding breastfeeding and bottle use were present. One-on-one discussions, parental networks, and using laypeople from similar backgrounds were suggested methods to promote oral health. The immigrant and refugee participants placed emphasis on the use of visuals for those with language barriers while Hutterite participants suggested a health-education approach. Conclusions. These pilot study findings provide initial insight into the oral health-related knowledge and beliefs of these groups. This will help to inform planning of ECC prevention and research strategies, which can be tailored to specific populations.

A review of cardiovascular and renal function monitoring: a consideration of older adults with HIV.

The prevalence of human immunodeficiency virus (HIV) infection in older and elderly adults is significant worldwide. This population poses new challenges and opportunities in the management of HIV. In addition to the risks affecting HIV patients of all ages, including risk of opportunistic infection and medication resistance, age-related changes in physiology, higher comorbidity burdens, increased use of medications, and potential adverse drug reactions to HIV medications all factor into the care of older adults with HIV. The risk and progression of cardiovascular and renal comorbidities may be higher in the older adult HIV population and in patients taking specific HIV medications. Understanding these risks is essential when managing a new type of patient: the older adult with HIV.

A retrospective Evaluation of fluconazole for the treatment of Candida glabrata fungemia.

BACKGROUND: Candida glabrata accounts for 21% of Candida bloodstream isolates in the United States and ranges from susceptible-dose-dependent to resistant to fluconazole. A fluconazole dose of 800 mg/d ( approximately 12 mg/kg per day) is predicted to produce peak plasma concentrations that surpass the susceptible-dose-dependent MIC breakpoint of 16 to 32 mug/mL. Accordingly, the Infectious Diseases Society of America treatment guidelines for candidiasis recommend fluconazole 12 mg/kg per day as an alternative option for treatment of C glabrata fungemia. OBJECTIVE: The main objective of this study was to evaluate fluconazole retrospectively as a treatment for C glabrata fungemia. METHODS: Data were collected through a database that stores patient information electronically and can be accessed and queried, and chart review at Barnes-Jewish Hospital (St. Louis, Missouri) from January 1999 to August 2002. Eligible patients who had at least 1 positive blood culture for C glabrata and received at least 1 dose of fluconazole were identified through the electronic query. Chart reviews of these patients followed. The primary outcomes were fungemia eradication and in-hospital mortality. RESULTS: Of the total 124 cases of C glabrata fungemia identified, 54 patient charts were evaluable. Chart review revealed that 65% (17/26) of patients receiving fluconazole as the sole antifungal therapy had successful bloodstream eradication of C glabrata, whereas approximately 54% (15/28) of patients who were changed from fluconazole to an amphotericin B formulation had successful bloodstream eradication. Although no association was found between fluconazole dose and fungemia eradication in the entire study population, higher doses of fluconazole (> or =400 mg/d) were more likely to achieve fungemia eradication than lower doses (< or =400 mg/d) in the subset of patients who received only fluconazole (P = 0.042). Mortality rates were approximately 24% (4/17) and 40% (6/15) in patients having successful bloodstream eradication with fluconazole alone and with fluconazole followed by amphotericin B, respectively, compared with 38% (3/8) in patients with persistent fungemia who received fluconazole alone. CONCLUSIONS: Fluconazole was a viable therapy for C glabrata fungemia, with bloodstream eradication in 65% of patients and mortality rates of 24% to 40% in this retrospective chart review.