John Cyrus

Healthcare professionals' views on discussing fertility preservation with young cancer patients: a mixed method systematic review of the literature

In spite of efforts to guarantee patients are adequately informed about their risk of fertility loss and offered treatment for fertility preservation (FP), previous studies have reported that this topic is not routinely discussed with patients, especially with younger patient populations. A mixed method systematic review was undertaken to explore the factors shaping the discussion of FP with children (0–15 years) and adolescents/young adults (16–24 years) with cancer.

A Review of Recent Research on Internet Access, Use, and Online Health Information Seeking

The 2013 data from the Pew Research Center’s Internet and American Life project show that 85% of United States adults use the Internet. This includes 86% of non-Hispanic whites, 85% of non-Hispanic blacks, and 76% of Hispanics interviewed. Eighty-six percent of urban and suburban respondents report Internet use. Nevertheless, some groups lag behind. Internet use in rural areas is estimated to be 80%, and seniors (65 years and older), Hispanics, and those with a high school education or less or making less than

Clinical outcomes of HIV care delivery models in the US: a systematic review

30,000 per year all report lower Internet usage rates than other age, racial, educational attainment, or household income groups (1). The 15% of American adults that report no Internet usage, of which 49% of this group of nonusers are Americans 65 years and older, cite a number of reasons, including relevance (34%), usability (32%), price (19%), and availability (7%) (2). The similarities between groups that are low or nonusers of the Internet and those that are historically medically underserved are striking. Further data from the Pew Research Center highlight the increasing importance of the Internet when it comes to patients finding health information. Seventy-two percent of participants reported searching for health information online within the past year, with 55% looking for information about a particular condition and 43% looking for information about a treatment or procedure. Within the participants looking for health information

Mobile Technology: Implications for Privacy and Librarianship

ABSTRACT With over 1 million people living with HIV, the US faces national challenges in HIV care delivery due to an inadequate HIV specialist workforce and the increasing role of non-communicable chronic diseases in driving morbidity and mortality in HIV-infected patients. Alternative HIV care delivery models, which include substantial roles for advanced practitioners and/or coordination between specialty and primary care settings in managing HIV-infected patients, may address these needs. We aimed to systematically review the evidence on patient-level HIV-specific and primary care health outcomes for HIV-infected adults receiving outpatient care across HIV care delivery models. We identified randomized trials and observational studies from bibliographic and other databases through March 2016. Eligible studies met pre-specified eligibility criteria including on care delivery models and patient-level health outcomes. We considered all available evidence, including non-experimental studies, and evaluated studies for risk of bias. We identified 3605 studies, of which 13 met eligibility criteria. Of the 13 eligible studies, the majority evaluated specialty-based care (9 studies). Across all studies and care delivery models, eligible studies primarily reported mortality and antiretroviral use, with specialty-based care associated with mortality reductions at the clinician and practice levels and with increased antiretroviral initiation or use at the clinician level but not the practice level. Limited and heterogeneous outcomes were reported for other patient-level HIV-specific outcomes (e.g., viral suppression) as well as for primary care health outcomes across all care delivery models. No studies addressed chronic care outcomes related to aging. Limited evidence was available across geographic settings and key populations. As re-design of care delivery in the US continues to evolve, better understanding of patient-level HIV-related and primary care health outcomes, especially across different staffing models and among different patient populations and geographic locations, is urgently needed to improve HIV disease management.

Disparities in the completion of steps to kidney transplantation: protocol for a systematic review

As use of mobile devices continues to expand and users take advantage of new technologies available on these platforms, it becomes necessary to examine how these technologies will affect user privacy, and in turn, how librarianship will respond to these challenges. This paper addresses the history and expectations of privacy in our society, the relationship of libraries to privacy, current and emerging mobile technologies, and how librarianship can address new challenges to user privacy.

Barriers and Facilitators to Breast and Cervical Cancer Screening Among Immigrants in the United States

Introduction Disparities in access to transplantation have been well documented. The extant literature, however, focuses largely on disparities and related barriers for African-American patients and none has used the steps to transplantation as a guiding framework. This review will catalogue disparities in the steps to transplantation as well as the barriers and facilitators to completion of each step identified in the extant literature. The results of the review will be used to generate recommendations for future research to improve equity in access to kidney transplantation. Methods and analysis Standard procedures will be used in the conduct of the review. Searches will be performed using the following electronic databases: PubMed/Medline, PsycINFO, CINHAL, EMBASE, Cochrane library and Web of Science. Reports of original research will be eligible for inclusion if they are published from 2005 to present, written or available in English language, performed in the USA, enrol adult participants (18 years of age or more), and employ descriptive or observational designs. Two authors will independently screen retrieved articles for inclusion. MaxQDA will be used for data analysis and management. All included reports will be coded for article characteristics; disparities identified; barriers and motivators of completion of steps to transplantation; and proposed solutions to disparities and barriers. Each report will be coded independently by two authors and discrepancies resolved by discussion among the full team. A qualitative approach to data analysis is planned. Risk of bias will be assessed using standard procedures. Ethics and dissemination The findings will provide crucial information on the current status of disparities in access to transplantation. PRISMA guidelines will be followed in reporting the results of the review. It is anticipated that these results will inform research which seeks to increase parity in access to transplantation. Systematic review registration PROSPERO CRD42014015027.

The Potential of Librarians to Impact Patient Activation Through Health Information and Health Literacy

To summarize the literature on barriers and facilitators to breast and cervical cancer screening among immigrants to the US. A literature review was conducted for studies on breast and cervical cancer screening among immigrant populations. A thematic analysis of 180 studies identified a variety of barriers and facilitators to screening at the personal and system levels. Personal barriers included lack of knowledge and insurance coverage, high cost of care, and immigration status. System barriers included poor access to services, lack of interpreter services, and insensitivity to patient needs. Facilitators to screening included knowledge of disease, access to information sources, physician recommendation, and social networks. Cultural norms and resource availability at the individual and system levels influence screening among immigrants. Health insurance coverage was found to be an important predictor of preventative screening use. Future research should seek to identify the best way to address this and other barriers to cancer screening among immigrants groups.

Systematic review of health care costs related to mental health conditions among cancer survivors.

It is widely recognized that health information and health literacy outreach play important roles in health care. Libraries, health sciences and hospital in particular, have long been integral in connecting people to health information (1). According to Duhon and Jameson, who surveyed academic librarians in the United States, 86% of health science librarians at an institution affiliated with a hospital provided health information outreach (2). Still, for many patients, obtaining quality, relevant health information is a problem. Similarly, librarians play a key role in efforts to improve health literacy among patients as well as the public (3). Low health literacy has been linked to patient outcomes such as increased use of emergency care, more frequent hospitalization, and higher all-cause mortality as well as self-efficacy outcomes such as reduced ability to take medication as prescribed and misinterpretation of labels (4). At the intersection of health information seeking and health literacy research are the concepts of patient engagement and patient activation. International studies have linked higher patient activation to lower health care costs, positive health behaviors such as healthier eating and regular exercise, and to better patient outcomes including lower BMI, blood pressure, and hemoglobin A1c (5). At the same time researchers and practitioners believe that increasing patient engagement in their own health care has the potential to increase the quality and efficacy of health care (6). Even though these concepts are widely known within health care and libraries, there seem to be few applications of these concepts to the research conducted by librarians on health information and literacy outreach. This article discusses research on the relationship between health information seeking, health literacy, patient engagement, and patient activation. In addition, it discusses the implications of this body of research for library-led research on health information seeking and health literacy initiatives.

Seeing the Big Picture: Sustaining Success in Liaison Services

ABSTRACT Introduction: This systematic review examines healthcare costs associated with mental health conditions among cancer survivors in the United States. Areas covered: Ten published studies were identified. Studies varied substantially in terms of population, mental health conditions examined, data collection methods, and type of cost reported. Cancer survivors with mental health conditions incurred significantly higher total medical costs and costs of most service types compared to cancer survivors without a mental health condition. Additionally, the total healthcare expenditure related to mental health was higher among cancer survivors compared with people without history of cancer. Expert commentary: Mental health conditions are associated with increased healthcare costs among cancer survivors. Future examination of other components of economic burden, including patient out-of-pocket costs, nonmedical costs, such as transportation, childcare, and productivity losses for patients and their caregivers, will be important. Additionally, evaluation of economic burden by cancer site, stage at diagnosis, duration of survivorship, and treatment(s) will increase understanding of the overall impact of mental health conditions on cancer survivors and on the healthcare system.

Health Care Politics, Policy, and Services: A Social Justice Analysis, 2nd ed. edited by Gunnar Almgren

ABSTRACT While the liaison program at the Tompkins-McCaw Library for the Health Sciences has existed for more than 15 years, it has yet to be fully evaluated. This article seeks to evaluate the scope and impact of the program at a broad level using quantitative and qualitative data. Descriptive statistics to summarize liaison activity were collected for the fiscal years 2012–2016. In addition, liaisons and users were surveyed to gain insight into the effectiveness and the perception of the program. Program statistics show that users’ engagement with liaisons is high and growing. Qualitative data reveals that while better methods are needed to assess the extent of the program’s impact, users appreciate the value that liaisons bring by supporting the educational and research missions of various programs.