Confronting Inequity: Social Justice Dialogue in a Health Science Library

Objective: To demonstrate how a departmental social justice discussion group was successful in achieving its purpose in introducing and discussing health-related social justice narratives and perspectives with personal meaning to each department member. Methods: In the aftermath George Floyd’s death, the Assistant Director of Research and Education Services at a health sciences library proposed devoting a portion of staff meetings to discuss issues in social justice and anti-racism. Each department member would generate a topic and organize readings or links to media in an internal LibGuide. Initially, there was a total of seven discussions, each lasting an average of twenty minutes. Each staff member described their motivation in selecting their topic and accompanying resources and led the subsequent discussion. Results: Discussion topics included white fragility, racial disparities surrounding leg amputations of Black diabetes patients in Mississippi, transracial adoption, local food deserts, white privilege in medical school education, black transgender violence and discrimination, and pipeline institutional racism. The readings and discussions revealed marginalized group perceptions and reality are not necessarily willingly acknowledged or addressed by the privileged group. The topic of food deserts was identified for follow-up action because of the need in the residential area adjacent to the health sciences campus. Conclusions: Participants felt the topics were timely, thought-provoking and useful in understanding current imbalances in social equity in health-related areas. Each department member could identify and share a social justice area of concern. Many of the topics are addressed in critical librarianship scholarship, and lessons from the discussions could be applied to increased understanding of, and service to, marginalized users of their library’s community. Team members agreed to continue the discussions at staff meetings once per month on broader diversity and social justice topics

A Scoping Review of Institutional Policies and Recommendations for Trans Inpatient Mental Health Care

Introduction: Access to culturally sensitive care is critical for addressing known mental health disparities among trans-and gender-non- conforming (TGNC) individuals. Although there has been a proliferation of TGNC healthcare guidelines from accrediting bodies, policies have failed to address the needs of TGNC patients in inpatient psychiatric settings. Aim: To identify unaddressed needs in policies and policy recommendations for the care of TGNC patients to inform recommendations for change. Method: A scoping review protocol was developed following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 850 articles were reduced to seven relevant articles with six themes identified via thematic analysis. Results: Six themes were identified: lack of consistency in preferred and pronoun use, lack of communication among providers, lack of training in TGNC healthcare, personal bias, lack of formal policies, and housing segregation by sex rather than gender. Discussion: The creation of new guidelines or bolstering of existing guidelines to specifically address identified themes and gaps may improve the well-being and treatment outcomes of TGNC individuals in inpatient psychiatric settings. Implications for practice: To provide a foundation for future studies to integrate these identified gaps and inform the future development of comprehensive formal policies that generalize TGNC care in inpatient settings

Body Mass Index Paradox in Head and Neck Cancer: A Systematic Review and Meta-Analysis

The body mass index (BMI) paradox describes that among patients with certain cancers, higher pretreatment BMI may be associated with improved survival. We examine the impact of BMI on overall survival (OS) in head and neck squamous cell carcinoma (HNSCC) patients. A literature search was performed, and articles using hazard ratios to describe the prognostic impact of BMI on OS in HNSCC were included. Random-effects DerSimonian and Laird methods were employed for meta-analysis. Meta-analysis of OS indicated a lower hazards of death in the overweight (BMI: 25 kg/m2–30 kg/m2) compared to the normal weight (BMI: 18.5 kg/m2–25 kg/m2). This protective relationship loses significance when BMI exceeds 30 kg/m2. Underweight patients (BMI \u3c 18.5 kg/m2) demonstrate higher hazards of death compared to normal weight patients. Compared to HNSCC patients with normal weight, being overweight up to a BMI of 30 kg/m2 is a positive predictor of OS, while being underweight confers a prognostic disadvantage. Further studies are needed to determine the mechanisms by which increased body mass influences survival outcomes in HNSCC