Exploring Accessibility Practices in Institutional Repositories

Institutional repositories (IRs) provide open access and availability to research and scholarship. One area that needs improvement is ensuring the accessibility of this digital content to people with disabilities. In the fall of 2019, a team of librarians from six universities and organizations administered a survey to better understand current practices in this area and gauge the current landscape of accessibility efforts in IRs. The specific focus of this project looked at accessibility to the digital content itself stored in the repository, rather than the repository platform. This presentation discusses the key findings from the survey, lessons learned, and potential next steps. In addition to presenting our findings, we hope to gather feedback and suggestions from the community

Volume 43, Number 2, June 2023 OLAC Newsletter

Digitized June 2023 issue of the OLAC Newsletter

Motivational interviewing for the prevention of alcohol misuse in young adults

Background Alcohol use and misuse in young people is a major risk behaviour for mortality and morbidity. Motivational interviewing (MI) is a popular technique for addressing excessive drinking in young adults. Objectives To assess the effects of motivational interviewing (MI) interventions for preventing alcohol misuse and alcohol‐related problems in young adults. Search methods We identified relevant evidence from the Cochrane Central Register of Controlled Trials (CENTRAL) (2015, Issue 12), MEDLINE (January 1966 to July 2015), EMBASE (January 1988 to July 2015), and PsycINFO (1985 to July 2015). We also searched clinical trial registers and handsearched references of topic‐related systematic reviews and the included studies. Selection criteria We included randomised controlled trials in young adults up to the age of 25 years comparing MIs for prevention of alcohol misuse and alcohol‐related problems with no intervention, assessment only or alternative interventions for preventing alcohol misuse and alcohol‐related problems. Data collection and analysis We used the standard methodological procedures expected by Cochrane. Main results We included a total of 84 trials (22,872 participants), with 70/84 studies reporting interventions in higher risk individuals or settings. Studies with follow‐up periods of at least four months were of more interest in assessing the sustainability of intervention effects and were also less susceptible to short‐term reporting or publication bias. Overall, the risk of bias assessment showed that these studies provided moderate or low quality evidence. At four or more months follow‐up, we found effects in favour of MI for the quantity of alcohol consumed (standardised mean difference (SMD) −0.11, 95% confidence interval (CI) −0.15 to −0.06 or a reduction from 13.7 drinks/week to 12.5 drinks/week; moderate quality evidence); frequency of alcohol consumption (SMD −0.14, 95% CI −0.21 to −0.07 or a reduction in the number of days/week alcohol was consumed from 2.74 days to 2.52 days; moderate quality evidence); and peak blood alcohol concentration, or BAC (SMD −0.12, 95% CI −0.20 to 0.05, or a reduction from 0.144% to 0.131%; moderate quality evidence). We found a marginal effect in favour of MI for alcohol problems (SMD −0.08, 95% CI −0.17 to 0.00 or a reduction in an alcohol problems scale score from 8.91 to 8.18; low quality evidence) and no effects for binge drinking (SMD −0.04, 95% CI −0.09 to 0.02, moderate quality evidence) or for average BAC (SMD −0.05, 95% CI −0.18 to 0.08; moderate quality evidence). We also considered other alcohol‐related behavioural outcomes, and at four or more months follow‐up, we found no effects on drink‐driving (SMD −0.13, 95% CI −0.36 to 0.10; moderate quality of evidence) or other alcohol‐related risky behaviour (SMD −0.15, 95% CI −0.31 to 0.01; moderate quality evidence). Further analyses showed that there was no clear relationship between the duration of the MI intervention (in minutes) and effect size. Subgroup analyses revealed no clear subgroup effects for longer‐term outcomes (four or more months) for assessment only versus alternative intervention controls; for university/college vs other settings; or for higher risk vs all/low risk participants. None of the studies reported harms related to MI. Authors' conclusions The results of this review indicate that there are no substantive, meaningful benefits of MI interventions for preventing alcohol use, misuse or alcohol‐related problems. Although we found some statistically significant effects, the effect sizes were too small, given the measurement scales used in the included studies, to be of relevance to policy or practice. Moreover, the statistically significant effects are not consistent for all misuse measures, and the quality of evidence is not strong, implying that any effects could be inflated by risk of bias.info:eu-repo/semantics/publishedVersio

Volume 42, Number 4, December 2022 OLAC Newsletter

Digitized December 2022 issue of the OLAC Newsletter

Volume 43, Number 3, September 2023 OLAC Newsletter

Digitized September 2023 issue of the OLAC Newsletter

Volume 43, Number 1, March 2023 OLAC Newsletter

Digitized March 2023 issue of the OLAC Newsletter

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Accessibility in Institutional Repositories

Purpose Institutional repositories (IRs) are widely used for archiving, preserving, and disseminating scholarly works and making them available on the web. Much of the research and development in IRs has focused on platforms, workflows, and policies for adding content. In this study, the focus is to gauge practices to ensure accessibility of the digital content made available in IRs. The purpose of this study is to: 1. Understand the current landscape of accessibility practices in institutional repositories in academic libraries. 2. Identify the average level of content accessibility implemented in institutional repositories in academic libraries. For the purpose of this study, we have focused on the digital content collected in institutional repositories and workflows at academic libraries, rather than the websites and software platforms. The results of this study will establish a baseline measurement of current accessibility practices for IRs at academic libraries, and the potential for a longitudinal study of emerging best practices and standards. Anonymized data from our survey is available in the Texas Data Repository, https://doi.org/10.18738/T8/LUGYPO

Ethical Considerations of Including Gender Information in Open Knowledge Platforms

In recent years, galleries, libraries, archives, and museums (GLAMs) have sought to leverage open knowledge platforms such as Wikidata to highlight or provide more visibility for traditionally marginalized groups and their work, collections, or contributions. Efforts like Art + Feminism, local edit-a-thons, and, more recently, GLAM institution-led projects have promoted open knowledge initiatives to a broader audience of participants. One such open knowledge project, the Program for Cooperative Cataloging (PCC) Wikidata Pilot, has brought together over seventy GLAM organizations to contribute linked open data for individuals associated with their institutions, collections, or archives. However, these projects have brought up ethical concerns around including potentially sensitive personal demographic information, such as gender identity, sexual orientation, race, and ethnicity, in entries in an open knowledge base about living persons. GLAM institutions are thus in a position of balancing open access with ethical cataloging, which should include adhering to the personal preferences of the individuals whose data is being shared. People working in libraries and archives have been increasingly focusing their energies on issues of diversity, equity, and inclusion in their descriptive practices, including remediating legacy data and addressing biased language. Moving this work into a more public sphere and scaling up in volume creates potential risks to the individuals being described. While adding demographic information on living people to open knowledge bases has the potential to enhance, highlight, and celebrate diversity, it could also potentially be used to the detriment of the subjects through surveillance and targeting activities. In this article we seek to investigate the changing role of metadata and open knowledge in addressing, or not addressing, issues of under- and misrepresentation, especially as they pertain to gender identity as described in the sex or gender property in Wikidata. We report findings from a survey investigating how organizations participating in open knowledge projects are addressing ethical concerns around including personal demographic information as part of their projects, including what, if any, policies they have implemented and what implications these activities may have for the living people being described

Development of a Visit Facilitator Role to Assist Physicians in an Ambulatory Consultative Medical Practice

Objective: To decrease the electronic health record (EHR) clerical burden and improve patient/clinician satisfaction, allied health staff were trained as visit facilitators (VFs) to assist the physician in clinical and administrative tasks. Patients and Methods: From December 7, 2020, to October 11, 2021, patients with complex medical conditions were evaluated by an internal medicine physician in an outpatient general internal medicine (GIM) consultative practice at a tertiary care institution. A VF assisted with specific tasks before, during, and after the clinical visit. Presurvey and postsurvey assessments were performed to understand the effect of the VF on clinical tasks as perceived by the physician. Results: A total of 57 GIM physicians used a VF, and 41 (82%) physicians and 39 (79%) physicians completed the pre-VF and post-VF surveys, respectively. Physicians reported a significant reduction in time reviewing outside materials, updating pertinent information, and creating/modifying EHR orders (P<.05). Clinicians reported improved interactions with patients and on-time completion of clinical documentation. In the pre-VF survey, “too much time spent” was the most common response for reviewing outside material, placing/modifying orders, completing documentation/clinical notes, resolving in-baskets, completing dismissal letters, and completing tasks outside of work hours. In the post-VF survey, “too much time spent” was not the most common answer to any question. Satisfaction improved in all areas (P<.05). Conclusion: VFs significantly reduced the EHR clinical burden and improved GIM physician practice satisfaction. This model can potentially be used in a wide range of medical practices