Richard D. Carr

Antiphospholipid antibodies and the risk of recurrence after a first episode of venous thromboembolism: a systematic review

Laboratory evidence of antiphospholipid antibodies (APLA) in patients with a first episode of venous thromboembolism (VTE) is often considered an indication for indefinite anticoagulant therapy, but it is uncertain if this practice is justified. We performed a systematic review to determine whether the presence of APLA in patients with a first VTE is associated with an increased risk of recurrence. We searched PubMed, CINAHL, Cochrane, EMBASE, and Web of Knowledge through February 2012 and included prospective studies that met prespecified design criteria. There were 109 recurrent VTE in 588 patients with APLA and 374 recurrent VTE in 1914 patients without APLA (relative risk 1.41; 95% confidence interval [CI], 0.99 to 2.36). The unadjusted risk ratio for recurrent VTE after stopping anticoagulant therapy in patients with an anticardiolipin antibody was 1.53 (95% CI, 0.76-3.11), and with a lupus anticoagulant was 2.83 (95% CI, 0.83-9.64). All studies had important methodologic limitations and we judged the overall quality of the evidence as very low. Although a positive APLA test appears to predict an increased risk of recurrence in patients with a first VTE, the strength of this association is uncertain because the available evidence is of very low quality.

Library and Informatics Skills Competencies Statements from Major Health Professional Associations

Every major health profession now provides competency statements for preparing new members for their respective professions. These competency statements normally include expectations for training health professions students in library/informatics skills. For purposes of this article, searches were conducted using various sources to produce a comprehensive 32-page Compendium that inventories library/informatics-related competency statements. This compendium should aid readers in integrating their library/informatics skills training into various health professions education curricula.

Public health informatics training in New Mexico

The information needs and information-seeking behavior of public health practitioners has not been researched extensively. Exploratory investigations of the information needs of the US public health workforce, however, recommend providing greater awareness of and training in accessing public health information resources [1–4]. This case study describes the University of New Mexico (UNM) Health Science Library and Informatics Centers evidence-based public health (EBPH) informatics training for public health practitioners in New Mexico. The training sessions, intended both to raise awareness about and to provide hands-on searching experiences related to EBPH, occurred from August 2005 through March 2006.

Pediatric non-tuberculous mycobacterial cervicofacial adenitis: A systematic review

acquired bacteremia who have low levels of C-reactive protein ( 20 mg/L). J Infect 2014;68(2):149e55. 2. Wang HE, Shapiro NI, Griffin R, Safford MM, Judd S, Howard G. Inflammatory and endothelial activation biomarkers and risk of sepsis: a nested case-control study. J Crit Care 2013;28(5): 549e55. 3. Rintala EM, Aittoniemi J, Laine S, Nevalainen TJ, Nikoskelainen J. Early identification of bacteremia by biochemical markers of systemic inflammation. Scand J Clin Lab Invest 2001;61: 523e30. 4. Eden E, Srugo I, Gottlieb T, Navon R, Boico O, Cohen A, et al. Diagnostic accuracy of a TRAIL, IP-10 and CRP combination for discriminating bacterial and viral etiologies at the emergency department. J Infect 2016. S0163e4453(16)30086-X. 5. Oved K, Cohen A, Boico O, Navon R, Friedman T, Etshtein L, et al. A novel host-proteome signature for distinguishing between acute bacterial and viral infections. PLoS One 2015;10(3): e0120012.

Response to Kelly Near and Ann Duesing's letter: "Informatics Training for Public Health Practitioners".

Kelly Near and Ann Duesing have performed a great service by attempting to replicate the authors’ randomized controlled trial on the effects of training on information-seeking behavior among public health professionals [1]. They have served the profession even further by reporting in their letter the challenges that they encountered in replicating our study and for reporting their interesting yet divergent results [2]. We had recommended further replication of our study, because we asked important questions that trended toward the affirmative for the two hypotheses tested but could not be confirmed at the level of statistical significance. While Near and Duesing were able to use our practical advice in replicating our study, their letter suggests that differences in their population in southwestern Virginia and unexpected problems with administering a consistent incentive system for participants probably explain the differences between the two studies. We found that public health health care practitioners viewed PubMed as useful for answering their native questions. As reported elsewhere [3,4], our trainees anonymously highly valued their PubMed training in both immediate and follow-up evaluations two months later. We were intrigued that Near and Duesing did not make the same observation, which might have been due to the involvement of different populations. This additional discrepancy between the two studies also deserves further investigation with public health practitioner populations elsewhere. Evidence-based practice guidelines [5] indicate that our study currently offers the best evidence to support existing library or informatics training programs. Clearly, readers of the Journal of the Medical Library Association need to continue to offer training programs, unless later studies convincingly suggest otherwise. Our study suggests support for the two hypotheses. To test these hypotheses successfully, a future study will need to recruit enough participants to reach statistical significance, while providing all participants with equal incentives to submit their questions. Our study suggests that without incentives to submit questions, participants will not take the time away from their many work-related demands to fully record their questions. Near and Duesing’s study could not achieve equal status for incentives because of the decentralized local health system in southwestern Virginia. In contrast, a system capable of providing a consistent incentive and administrative system could ensure the existence of conditions conducive for a randomized controlled trial. The National Association of County and City Health Officials profiles of local health departments suggest that the states of Arkansas, Delaware, Florida, Mississippi, South Carolina, and Vermont have strong state-centric authority over local health departments [6]. These states possibly offer the potential for replication because these states could likely ensure consistent administration of incentives, although we encourage others to test our hypotheses in other contexts. Unified, large, urban-area public health departments represent other plausible environments for rigorously replicating our study successfully. We will gladly share our detailed study protocols and any pragmatic advice, as we did for Near and Duesing, with any interested colleagues to ensure that any replications conducted elsewhere proceed smoothly.