The impact of the clinical librarian: a review

The historical development of clinical librarian roles is outlined. Recent literature on the impact of clinical librarian services is described, the practical difficulties of impact evaluation discussed, and some suggestions of future trends suggested

Talking about professional failure: what can we learn from each other?

This article presents a brief overview of the literature about professional failure, impostor syndrome, perfectionism, burnout, and resilience, literature which also informed a workshop at the EAHIL Conference held in Cardiff, UK, on 12 July 2018. The workshop brought together 20 participants from across Europe who ranged in age and in career experiences. It aimed to enable participants to feel comfortable talking about and sharing their experiences of professional failure for medical or health librarians and information professionals, and drawing out solutions to those failures. This article shares the outcomes of the workshop, and includes suggestions for ways to manage professional failure

Incidence of medication-related harm in older adults following hospital discharge: a systematic review

Objectives To determine the incidence, severity, preventability and risk factors for medication-related harm (MRH)in community-dwelling older adults following hospital discharge. Design: Systematic review Setting: A search of Medline, EMBASE, CINAHL, and the Cochrane Library was undertaken without time restrictions Participants Older adults (average age 65 years) participating in observational studies investigating adverse drug reactions (ADR) or adverse drug events (ADE)post-discharge within a defined follow-up period Measurements The abstracts of all articles were initially screened by one author to exclude obviously irrelevant articles. The remaining articles were independently screened by two authors for inclusion. Data extraction,including study characteristics, MRH incidence and risk factors, and, critical appraisal was performed by two authors independently, and verified by a third reviewer. Disagreements were resolved through discussion. Results Out of 584 potentially relevant articles, eight studies met our inclusion criteria; five North American and three European. Most of the included studies were of moderate quality. There was a wide range in MRH incidence, from 0.4% to 51.2% of patients, and 35% to 59% of MRH was preventable. The MRH incidence within 30 days post-discharge ranges from 167 to 500 events per 1000 patients discharged (17-51% of patients. Substantial methodological heterogeneity exists across multiple domains of the studies, including ADR and ADE definitions, characteristics of recruited populations, the follow-up duration post-discharge, and data collection. Conclusions Medication-related harm is common following hospital discharge in older adults. However, a clear understanding of the epidemiology is hampered by methodological inconsistencies between studies and a paucity of data on risk factors. There is need for international consensus on conducting and reporting MRH studies.Data from large, multicentre studies examining a range of biopsychosocial risk factors could add insight to this important area of patient safety

Focused screening identifies different sensitivities of human TET oxygenases to the oncometabolite 2-hydroxyglutarate

Ten-eleven translocation enzymes (TETs) are Fe(II)/2-oxoglutarate (2OG) oxygenases that catalyze the sequential oxidation of 5-methylcytosine to 5-hydroxymethylcytosine, 5-formylcytosine, and 5-carboxylcytosine in eukaryotic DNA. Despite their roles in epigenetic regulation, there is a lack of reported TET inhibitors. The extent to which 2OG oxygenase inhibitors, including clinically used inhibitors and oncometabolites, modulate DNA modifications via TETs has been unclear. Here, we report studies on human TET1–3 inhibition by a set of 2OG oxygenase-focused inhibitors, employing both enzyme-based and cellular assays. Most inhibitors manifested similar potencies for TET1–3 and caused increases in cellular 5hmC levels. (R)-2-Hydroxyglutarate, an oncometabolite elevated in isocitrate dehydrogenase mutant cancer cells, showed different degrees of inhibition, with TET1 being less potently inhibited than TET3 and TET2, potentially reflecting the proposed role of TET2 mutations in tumorigenesis. The results highlight the tractability of TETs as drug targets and provide starting points for selective inhibitor design

UK guideline for the use of HIV post-exposure prophylaxis 2021

We present the updated British Association for Sexual Health and HIV (BASHH) guidelines for post-exposure prophylaxis (PEP) to HIV following sexual exposures, occupational exposures and other nonoccupational exposures in the community. This serves as an update to the 2015 BASHH guideline on PEP following sexual exposures and the 2008 Expert Advisory Group on AIDS guidelines on HIV PEP. We aim to provide evidence-based guidance on best clinical practice in the provision, monitoring and support of PEP for the prevention of HIV acquisition following sexual, occupational and other nonoccupational exposures in the community. The guideline covers when to prescribe PEP, what antiretroviral agents to use and how to manage PEP. This includes (i) evidence of PEP efficacy; (ii) evidence relating to individual-level efficacy of antiretroviral therapy to prevent the sexual transmission of HIV; (iii) data on the detectable (transmissible) prevalence of HIV in specific populations; (iv) risk of HIV transmission following different types of sexual and occupational exposure; (v) baseline risk assessment; (vi) drug regimens and dosing schedules; (vii) monitoring PEP; (viii) baseline and follow-up blood-borne virus testing; (ix) the role of PEP within broader HIV prevention strategies, for example, HIV pre-exposure prophylaxis (PrEP). The guideline also covers special scenarios such as PEP in pregnancy, breastfeeding and chronic hepatitis B virus infection, and when PEP should be considered in people using HIV PrEP. The guidelines are aimed at clinical professionals directly involved in PEP provision and other stakeholders in the field. A proforma to assist PEP consultations is included. A public consultation process was undertaken prior to finalizing the recommendations

Seeing sharper and deeper: JWST's first glimpse of the photometric and spectroscopic properties of galaxies in the epoch of reionisation

We analyse the photometric and spectroscopic properties of four galaxies in the epoch of reionisation (EoR) within the SMACS 0723 JWST Early Release Observations field. Given the known spectroscopic redshifts of these sources, we investigated the accuracy with which photometric redshifts can be derived using NIRCam photometry alone, finding that F115W imaging is essential to distinguish between z~8 galaxies with high equivalent width (EW) [O III] {\lambda}5007 emission and z~10 Balmer break galaxies. We find that all four sources exhibit strong (> 0.6 mag) F356W-F444W colours, which sit at the extreme end of theoretical predictions from numerical simulations. We find that these galaxies deviate (by roughly 0.5 dex) from the local correlation between [O III] {\lambda}5007/H\beta and [Ne III] {\lambda}3869/[O II], which is consistent with the predictions from simulations of high-redshift galaxies. We measure the [O III] {\lambda}5007 rest-frame equivalent widths both directly from the spectroscopy, and indirectly as inferred from the strong F356W-F444W colours, finding large [O III] {\lambda}5007 EWs of 400-1000 {\AA}. The [O III] {\lambda}5007 and H\beta EWs are consistent with those seen in extreme, intensely star-forming dwarf galaxies in the local Universe. Our structural analysis indicates that these galaxies are resolved, exhibiting irregular shapes with bright clumps and colour gradients. In line with the predictions from the FLARES hydrodynamic simulations, such intense star formation and extreme nebular conditions are likely the norm, rather than the exception, in the EoR. Finally, although star-forming galaxies and AGN often occupy similar regions within the [O III] {\lambda}5007/H\beta-[O II]/H{\delta} plane, we find that AGN exhibit distinct, red colours in the F150W-F200W, F200W-F277W plane.Comment: 14 pages, 8 figure

Land, history or modernization? Explaining ethnic fractionalization

Ethnic fractionalization (EF) is frequently used as an explanatory tool in models of economic development, civil war and public goods provision. However, if EF is endogenous to political and economic change, its utility for further research diminishes. This turns out not to be the case. This paper provides the first comprehensive model of EF as a dependent variable. It contributes new data on the founding date of the largest ethnic group in each state. It builds political and international variables into the analysis alongside historical and geoclimatic parameters. It extends previous work by testing models of politically relevant EF. In addition, this research interprets model results in light of competing theories of nationalism and political change. Results show that cross-national variation in EF is largely exogenous to modern politico-economic change. However, the data are inconclusive with respect to competing geoclimatic, historical institutional and modernist theories of ethnogenesis