Session 1A: Retention of Former Residents in Librarianship: A Preliminary Exploration

Librarian residency programs have served as one means by which libraries have attempted to recruit people of color to the profession. These programs are aimed at recent graduates of MLS programs and are meant to provide them with professional experience, often by exposing them to different areas of librarianship through departmental rotations during a 1-3 year term position. While these programs are by no means new, there has been an increase in interest in residency programs, as evidenced in the recent creation of the Association of College and Research Libraries (ACRL) Diversity Alliance, a group of over 30 universities that have committed to creating residencies specifically for early career librarians from underrepresented groups. But how successful are residency programs in recruiting and retaining people of color to the librarian profession? There is a relatively small volume of literature on residency programs, though there are some personal narratives and general surveys of former residents that serve an important role in documenting the experiences of residency program participants. However, one area that has been particularly underrepresented in the literature is the retention of former library residents in the profession. This presentation will provide an overview of the history and present state of residency programs in the United States and will also begin to explore retention by looking at the positions of a sample of former library residents. Where possible, I will explore what types of positions former library residents hold (librarian and library-related positions vs. non-library positions, etc.) and attempt to tie these findings to the larger literature about librarian residencies and the retention of people of color in librarianship

The Effect of Visual Feedback on Lumbar Spinal Mobility in Subjects with Low Back Pain

Purpose: This study was designed to determine if visual feedback via a laser pointer would enhance quality of lumbar mobility exercise in quadruped. A secondary aim of this study was to compare mobility assessed using the valid and reliable Modified-Modified Schober Test (MMST) to mobility measured indirectly using the laser pointer. Subjects: 69 Methods: Adult participants with no low back pain (LBP) in the previous year or back surgery were randomly assigned to one of three groups for two sessions: Control (blindfolded during both), Intervention A (blindfolded then visual feedback), or Intervention B (visual feedback then blindfolded). Baseline standing lumbar flexion was assessed, then each participant assumed quadruped over a longitudinally oriented 44-inch floor grid while wearing a laser pointer attached to a waist belt. Participants performed alternating quadruped lumbar flexion (QLF) and extension (QLE), with each session \u3e48hrs apart. Visual feedback was provided via laser pointer. All attempts were video recorded. Results: Training using a laser pointer did not have a significant impact on lumbar excursion in quadruped (p = .106, p = .681, respectively). Mobility scores remained consistent for the control (p = .823) and intervention groups (p = .124). A moderate-to-strong correlation (r = .638) was found between MMST values and the average QLF. Conclusions: Visual feedback training using a laser transit was ineffective at increasing lumbar mobility. MMST flexion values were moderately correlated with QLF performance, suggesting the laser light transit shows potential to be used as a means of quantifying lumbar flexion range of motion

How does priority setting for resource allocation happen in commissioning dental services in a nationally led, regionally delivered system: a qualitative study using semistructured interviews with NHS England dental commissioners

Objectives: To understand approaches to priority setting for healthcare service resource allocation at an operational level in a nationally commissioned but regionally delivered service. Design: Qualitative study using semistructured interviews and a Framework analysis. Setting: National Health Service dentistry commissioning teams within subregional offices in England. Participants: All 31 individuals holding the relevant role (dental lead commissioner in subregional offices) were approached directly and from this 14 participants were recruited, with 12 interviews completed. Both male and female genders and all regions were represented in the final sample. Results: Three major themes arose. First, 'Methods of priority setting and barriers to explicit approaches' was a common theme, specifically identifying the main methods as: perpetuating historical allocations, pressure from politicians and clinicians and use of needs assessments while barriers were time and skill deficits, a lack of national guidance and an inflexible contracting arrangements stopping resource allocation. Second, 'Relationships with key stakeholders and advisors' were discussed, showing the important nature of relationships with clinical advisors but variation in the quality of these relationships was noted. Finally, 'Tensions between national and local responsibilities' were illustrated, where there was confusion about where power and autonomy lay. Conclusions: Commissioners recognised a need for resource allocation but relied on clinical advice and needs assessment in order to set priorities. More explicit priority setting was prevented by structure of the commissioning system and standard national contracts with providers. Further research is required to embed and simplify adoption of tools to aid priority setting

Variability in the clinical management of iron deficiency anaemia in older adults : results from a survey of UK specialists in the care of older people

Acknowledgements We would like to thank the British Geriatrics Society for hosting the survey link and formally endorsing the survey through its electronic communications. We gratefully acknowledge the participants of the survey. Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.Peer reviewedPublisher PD

An interconnection method for ultra-compliant electrodes

We are developing a novel interconnection method to form reliable joints between truly stretchable electrode mounts and rigid substrates. This is needed as the electrodes must be connected to implanted electronics if they are to be used for long term implantation, and the components are most often mounted on a rigid substrate and protected within a solid enclosure. In this paper we describe the concept and report on preliminary results. Eight test samples were prepared, four of which started the underwater test. Their initial impedance ranged from 107 to 413 and remained constant (standard deviation 6) for over two months submersion

Liaising in the 21st Century: The Shifting Role of the Education Librarian

This paper will examine the findings of a survey on the job roles and responsibilities of Education librarians (academic librarians with liaison responsibilities for the field of Education). Existing literature on Education librarianship has focused on particular facets of the job role, including the unique instructional needs of Education students and specific instruction and outreach initiatives. However, the literature lacks a comprehensive picture of the full spectrum of contemporary Education librarianship. This article provides a snapshot of the diverse educational backgrounds and varied responsibilities of Education librarians related to instruction and instructional design, reference, embedded librarianship, outreach, collaboration, and collection development

Incidence and Cost of Acute Kidney Injury in Hospitalized Patients with Infective Endocarditis

Acute kidney injury (AKI) is a frequent complication of hospitalized patients with infective endocarditis (IE). Further, AKI in the setting of IE is associated with high morbidity and mortality. We aimed to examine the incidence, clinical parameters, and hospital costs associated with AKI in hospitalized patients with IE in an endemic area with an increasing prevalence of opioid use. This retrospective cohort study included 269 patients admitted to a major referral center in Kentucky with a primary diagnosis of IE from January 2013 to December 2015. Of these, 178 (66.2%) patients had AKI by Kidney Disease Improving Global Outcomes (KDIGO) serum creatinine criteria: 74 (41.6%) had AKI stage 1 and 104 (58.4%) had AKI stage ≥ 2. In multivariable analysis, higher comorbidity scores and the need for diuretics were independently associated with AKI, while the involvement of the tricuspid valve and the need for vasopressor/inotrope support were independently associated with severe AKI (stage ≥ 2). The median total direct cost of hospitalization was progressively higher according to each stage of AKI ($17,069 for no AKI;$37,111 for AKI stage 1; and $61,357 for AKI stage ≥ 2; p \u3c 0.001). In conclusion, two-thirds of patients admitted to the hospital due to IE had incident AKI. The occurrence of AKI significantly increased healthcare costs. The higher level of comorbidity, the affection of the tricuspid valve, and the need for diuretics and/or vasoactive drugs were associated with severe AKI in this susceptible population

Ethical issues in cluster randomized trials conducted in low- and middle-income countries: an analysis of two case studies.

BACKGROUND: Cluster randomized trials are common in health research in low- and middle-income countries raising issues that challenge interpretation of standard ethical guidelines. While the Ottawa Statement on the ethical design and conduct of cluster randomized trials provides guidance for researchers and research ethics committees, it does not explicitly focus on low- and middle-income settings. MAIN BODY: In this paper, we use the lens of the Ottawa Statement to analyze two cluster randomized trials conducted in low- and middle-income settings in order to identify gaps or ethical issues requiring further analysis and guidance. The PolyIran trial was a parallel-arm, cluster trial examining the effectiveness of a polypill for prevention of cardiovascular disease in Golestan province, Iran. The PASTAL trial was an adaptive, multistage, parallel-arm, cluster trial evaluating the effect of incentives for human immunodeficiency virus self-testing and follow-up on male partners of pregnant women in Malawi. Through an in-depth case analysis of these two studies we highlight several issues in need of further exploration. First, standards for verbal consent and waivers of consent require methods for operationalization if they are to be employed consistently. Second, the appropriate choice of a control arm remains contentious. Particularly in the case of implementation interventions, locally available care is required as the comparator to address questions of comparative effectiveness. However, locally available care might be lower than standards set out in national guidelines. Third, while the need for access to effective interventions post-trial is widely recognized, it is often not possible to guarantee this upfront. Clarity on what is required of researchers and sponsors is needed. Fourth, there is a pressing need for ethics education and capacity building regarding cluster randomized trials in these settings. CONCLUSION: We identify four issues in cluster randomized trials conducted in low- and middle-income countries for which further ethical analysis and guidance is required

Omega-3, omega-6 and polyunsaturated fat for cognition: systematic review & meta-analysis of randomised trials

Objectives: Neurocognitive function may be influenced by polyunsaturated fat intake. Many older adults consume omega-3 supplements hoping to prevent cognitive decline. We assessed effects of increasing omega-3, omega-6, or total polyunsaturated fats on new neurocognitive illness and cognition. Design and inclusion criteria: We carried out a systematic review and meta-analysis of randomized controlled trials (RCTs) in adults, with duration ≥24 weeks, assessing effects of higher vs lower omega-3, omega-6, or total polyunsaturated fats and outcomes: new neurocognitive illness, newly impaired cognition, and/or continuous measures of cognition.  Methods: We searched MEDLINE, Embase, Cochrane CENTRAL, and trials registers (final update of ongoing trials December 2018). We duplicated screening, data extraction, and risk of bias assessment. Neurocognitive measures were grouped to enable random effects meta-analysis. GRADE assessment, sensitivity analyses, and subgrouping by dose, duration, type of intervention, and replacement were used to interrogate our findings.  Results: Searches generated 37,810 hits, from which we included 38 RCTs (41 comparisons, 49,757 participants). Meta-analysis suggested no or very little effect of long-chain omega-3 on new neurocognitive illness [risk ratio (RR) 0.98, 95% confidence interval (CI) 0.87-1.10, 6 RCTs, 33,496 participants, I 2 36%), new cognitive impairment (RR 0.99, 95% CI 0.92-1.06, 5 RCTs, 33,296 participants, I 2 0%) or global cognition assessed using the Mini-Mental State Examination (MD 0.10, 95% CI 0.03-0.16, 13 RCTs, 14,851 participants, I 2 0%), all moderate-quality evidence. Effects did not differ with sensitivity analyses, and we found no differential effects by dose, duration, intervention type, or replacement. Effects of increasing α-linolenic acid, omega-6, or total PUFA were unclear.  Conclusions: This extensive trial data set enabled assessment of effects on neurocognitive illness and cognitive decline not previously adequately assessed. Long-chain omega-3 probably has little or no effect on new neurocognitive outcomes or cognitive impairment. Implications: Long-chain omega-3 supplements do not help older adults protect against cognitive decline

Combined interventions for the testing and treatment of HIV and schistosomiasis among fishermen in Malawi: a three-arm, cluster-randomised trial.

Background Undiagnosed HIV and schistosomiasis are highly prevalent among fishermen in the African Great Lakes region. We aimed to evaluate the efficacy of lakeside interventions integrating services for HIV and male genital schistosomiasis on the prevalence of schistosomiasis, uptake of antiretroviral therapy (ART) for HIV, and voluntary male medical circumcision (VMMC) among fishermen in Malawi. Methods We conducted a three-arm, cluster-randomised trial in 45 lakeshore fishing communities (clusters) in Mangochi, Malawi. Clusters were defined geographically by their home community as the place where fishermen leave their boats (ie, a landing site). Eligible participants were male fishermen (aged ≥18 years) who resided in a cluster. Clusters were randomly allocated (1:1:1) through computer-generated random numbers to either enhanced standard of care (SOC), which offered invitation with information leaflets to a beach clinic offering HIV testing and referral, and presumptive treatment for schistosomiasis with praziquantel; peer education (PE), in which a nominated fisherman was responsible for explaining the study leaflet to promote services to his boat crew; or peer distribution education (PDE), in which the peer educator explained the leaflet and distributed HIV self-test kits to his boat crew. The beach clinic team and fishermen were not masked to intervention allocation; however, investigators were masked until the final analysis. Coprimary composite outcomes were the proportion of participants who had at least one Schistosoma haematobium egg observed on light microscopy from 10 mL of urine filtrate and the proportion who had self-reported initiating ART or scheduling VMMC by day 28. Outcomes were analysed by intention to treat; multiple imputation for missing outcomes was done; random-effect binomial models adjusting for baseline imbalance and clustering were used to compute unadjusted and adjusted risk differences, risk ratios (RRs) and 95% CIs, and intracluster correlation coefficients for each outcome. This trial is registered with ISRCTN, ISRCTN14354324. Findings Between March 1, 2022, and Jan 29, 2023, 45 (65·2%) of 69 clusters assessed for eligibility were enrolled in the trial, with 15 clusters per arm. Of the 6036 fishermen screened at baseline, 5207 (86·3%) were eligible for participation: 1745 (87·6%) of 1991 in the enhanced SOC group, 1687 (81·9%) of 2061 in the PE group, and 1775 (89·5%) of 1984 in the PDE group. Compared with the prevalence of active schistosomiasis in the enhanced SOC group (292 [16·7%] of 1745), 241 (13·6%) of 1775 fishermen in the PDE group (adjusted RR 0·80 [95% CI 0·69–0·94]; p=0·0054) and 263 (15·6%) of 1687 fishermen in the PE group (0·92 [0·79–1·07]; p=0·28) had schistosomiasis at day 28. 230 (13·2%) in the enhanced SOC group, 281 (16·7%) in the PE group, and 215 (12·1%) in the PDE group initiated ART or were scheduled for VMMC. ART initiation or VMMC scheduling was not significantly increased with the PDE intervention (0·88 [0·74–1·05); p=0·15) and was marginally increased with the PE intervention (1·16 [0·99–1·37]; p=0·069) when compared with the enhanced SOC group. No serious adverse events were reported in this trial. Interpretation We found weak evidence for the use of peer education to increase uptake of ART and VMMC, but strong evidence for the added distribution of HIV self-test kits to promote high engagement with services and reduce the prevalence of active schistosomiasis, suggesting a high potential for scale-up in hard-to-reach communities across Malawi