Jackie Phinney’s research while affiliated with Dalhousie University and other places

Background Non-alcoholic fatty liver disease (NAFLD) is common, can progress to cirrhosis and hepatic decompensation, and has no approved medical therapy in Canada. Objective We conducted a systematic review on whether glucagon-like peptide-1 receptor agonists (GLP-1RA) improve non-alcoholic steatohepatitis (NASH) compared to standard care in NAFLD. Methods We searched Medline Ovid, EMBASE(Elsevier), Cochrane CENTRAL, Clinical Trials.gov, and the World Health Organization International Clinical Trials Registry Platform in November 2023 for randomized controlled trials. Inclusion criteria included patients ≥13 years with NAFLD receiving GLP-1RA for ≥6 months compared to standard care/placebo. Cochrane risk-of-bias 2.0 tool was used for each outcome. After screening results in duplicate, we performed meta-analysis and reported odds ratios (OR) for dichotomous and mean difference of change score for continuous outcomes. Results Six studies with 478 patients met inclusion criteria; 3 studies reported on the primary endpoint resolution of NASH. GLP-1RA likely leads to resolution of NASH (OR 4.45 (95% CI 1.92, 10.3)) and reduction in liver steatosis on imaging (–5.09% (95% CI −7.49, −2.69), but little to no reduction in liver stiffness on imaging (mean difference –0.17 kPa (95% CI −0.34, 0)). Interpretation Treatment with GLP-1RA in NAFLD patients for ≥6 months can probably lead to improvement in NASH on liver biopsy and reduce liver steatosis on imaging. Whether improvements in steatosis on biopsy or imaging results in clinically significant outcomes need to be elucidated as the effects of GLP-1RA on liver fibrosis are unclear; larger ongoing trials may provide more definitive answers. Protocol Registration: PROSPERO–CRD42023472186.

Study Design Systematic review and clinimetric analysis. Objectives Frailty and sarcopenia predict worse surgical outcomes among spinal degenerative and deformity-related populations; this association is less clear in the context of spinal oncology. Here, we sought to identify frailty and sarcopenia tools applied in spinal oncology and appraise their clinimetric properties. Methods A systematic review was conducted from January 1 st , 2000, until June 2022. Study characteristics, frailty tools, and measures of sarcopenia were recorded. Component domains, individual items, cut-off values, and measurement techniques were collected. Clinimetric assessment was performed according to Consensus-based Standards for Health Measurement Instruments. Results Twenty-two studies were included (42 514 patients). Seventeen studies utilized 6 frailty tools; the three most employed were the Metastatic Spine tumor Frailty Index (MSTFI), Modified Frailty Index-11 (mFI-11), and the mFI-5. Eight studies utilized measures of sarcopenia; the three most common were the L3-Total Psoas Area (TPA)/Vertebral Body Area (VBA), L3-TPA/Height ² , and L3-Spinal Muscle Index (L3-Cross-Sectional Muscle Area/Height ² ). Frailty and sarcopenia measures lacked or had uncertain content and construct validity. Frailty measures were objective except the Johns-Hopkins Adjusted Clinical Groups. All tools were feasible except the Hospital Frailty Risk Score (HFRS). Positive predictive validity was observed for the HFRS and in select studies employing the mFI-5, MSTFI, and L3-TPA/VBA. All frailty tools had floor or ceiling effects. Conclusions Existing tools for evaluating frailty and sarcopenia among patients undergoing surgery for spinal tumors have poor clinimetric properties. Here, we provide a pragmatic approach to utilizing existing frailty and sarcopenia tools, until more clinimetrically robust instruments are developed.

Background: Frailty and sarcopenia predict worse surgical outcomes among spinal degenerative and deformity-related populations; this association is less clear in the context of spinal oncology. Here, we identified frailty and sarcopenia tools applied in spinal oncology and appraised their clinimetric properties. Methods: A systematic review was conducted from January 1 st , 2000, until June 2022. Study characteristics, frailty tools, measures of sarcopenia, component domains, individual items, cut-off values, and measurement techniques were collected. Clinimetric assessment was performed according to Consensus-based Standards for Health Measurement Instruments. Results: Twenty-two studies were included (42,514 patients). The three most employed frailty tools were the Metastatic Spine tumor Frailty Index (MSTFI), Modified Frailty Index-11 (mFI-11), and the mFI-5. The three most common sarcopenia measures were the L3-Total Psoas Area (TPA)/Vertebral Body Area (VBA), L3-TPA/Height ² , and L3-Spinal Muscle Index (L3-Cross-Sectional Muscle Area/Height ² ). Frailty and sarcopenia measures lacked content and construct validity. Positive predictive validity was observed in select studies employing the HFRS, mFI-5, MSTFI, and L3-TPA/VBA. All frailty tools had floor or ceiling effects. Conclusions: Existing tools for evaluating frailty and sarcopenia in surgical spine oncology have poor clinimetric properties. Here, we provide a pragmatic approach to utilizing existing frailty and sarcopenia tools, until more clinimetrically robust instruments are developed.

Quantitative sensory testing (QST) refers to a group of noninvasive psychophysical tests that examine responses to a range of calibrated mechanical and thermal stimuli. Quantitative sensory testing has been used extensively in adult pain research and has more recently been applied to pediatric pain research. The aims of this scoping review were to map the current state of the field, to identify gaps in the literature, and to inform directions for future research. Comprehensive searches were run in 5 databases. Titles, abstracts, and full texts were screened by 2 reviewers. Data related to the study aims were extracted and analyzed descriptively. A total of 16,894 unique studies were identified, of which 505 were screened for eligibility. After a full-text review, 301 studies were retained for analysis. Date of publication ranged from 1966 to 2023. However, the majority of studies (61%) were published within the last decade. Studies included participants across the developmental trajectory (ie, early childhood to adolescence) and most often included a combination of school-age children and adolescents (49%). Approximately 23% of studies were conducted in healthy samples. Most studies (71%) used only one QST modality. Only 14% of studies reported using a standardized QST protocol. Quantitative sensory testing in pediatric populations is an emerging and rapidly growing area of pain research. Future work is needed using comprehensive, standardized QST protocols to harness the full potential that this procedure can offer to our understanding of pediatric pain.

Objective: Health professionals have an ongoing need for continuing education (CE). Health Science Librarians (HSLs) are accustomed to support the learning needs of others in a variety of contexts and are well situated to provide CE. To better understand the current extent of these activities, we undertook a scoping review to determine how HSLs instruct practicing clinicians and health sciences faculty in support of their CE. Methods: We searched for published and unpublished literature. Sources included PubMed (NCBI), Embase (Elsevier); Dissertations and Theses (ProQuest); Cumulative Index to Nursing and Allied Health Literature Full Text (EBSCO); Library, Information Science and Technology Abstracts (EBSCO); and Library Literature and Information Science Full Text (EBSCO). To identify unpublished sources, we searched Google and contacted two health sciences library listservs. Results: The included sources were published between 1970 to 2021 and covered a range of topics. Those related to evidence based practice (EBP) appeared around 2001 and bibliometrics and bioinformatics arose after 2016. HSLs teaching CE most commonly occurred in academic settings. The most common population taught was nurses, followed by physicians. Most sources did not report using an information literacy framework or instructional design model, undertaking needs assessments, or reporting formal objectives or assessment. Conclusion: While HSLs are active supporters of EBP, we need to apply the same principles to our own professional practice. Formal structure of programming and program assessment combined with clear, detailed reporting can help to build a more robust evidence base to support future CE provision.

Coping with loss is an unfortunate reality faced by healthcare professionals, and the COVID-19 pandemic exacerbated this challenge for those who worked on the frontlines. Our scoping review aimed to comprehensively map the existing literature pertaining to the experiences of grief among nurses and physicians in the context of the pandemic. Six bibliographic databases were searched in 2022, and a targeted search of gray literature and citation chasing was also performed. After screening a total of 2920 records, we included 173 evidence sources in this review. Data was both analyzed descriptively (e.g., frequency counts and percentages) and using a qualitative content analysis approach. Our findings illuminate the myriad losses experienced by nurses and physicians throughout the pandemic. While the literature portrays the coping mechanisms healthcare professionals have developed personally, there is a pronounced need for increased institutional support to alleviate the burdens they carry.

In Fall 2020, while working remotely due to the COVID-19 pandemic, we initiated a Community of Practice (CoP) model for library school interns working on a video tutorials accessibility project for Dalhousie University Libraries. This feature outlines the background of the project, our approach to training interns remotely on Camtasia software, the development of the CoP, and our key takeaways as supervisors. While the CoP was originally intended as a source of support for the group of interns, the experience ended up being incredibly beneficial to us in our development as supervisors as we learned to mentor at a distance. We reflect on how our mentorship styles changed throughout the project and explore future directions for continuing the project with a new cohort of library interns.

Background: Globally, the updating of donor policies in relation to gay, bisexual and other men who have sex with men (gbMSM), transgender, and gender diverse populations remains an important public health issue. The purpose of this scoping review was to determine how Canada and other OECD countries are addressing this issue in relation to plasma and whole blood donation policies. Methods: The scoping review included English-language peer-reviewed empirical studies from OECD countries from 1997 to 2020 to better understand the shifts in donor policies over this time period. Initial search criteria resulted in 3,974 abstracts and titles. Researchers reviewed abstracts according to eligibility criteria which yielded a total of 51 published studies for full review. Data charting was based on Arksey and O’Malley’s framework for scoping reviews. Results: Key considerations included the reliance on mathematical modeling and behavioural risk surveillance data as a means of continuing with the status quo in informing donor policies which continue to ban sexually active gbMSM from donating. In addition, there is a lack of focus on the unique concerns facing transgender, gender diverse, and racially diverse populations who may wish to donate whole blood or plasma. Conclusions: There is a growing international policy shift in reducing the lifetime donor ban and/or removing the ban for gbMSM to donate blood. More needs to be done to both clarify the rationale for such policies in the face of current scientific evidence and testing and to ensure inclusion of transgender, gender diverse, and racially diverse populations in the formation of policies and information about both whole blood and plasma donations. Finally, blood operators need to work more closely with diverse donor communities to ensure the approach taken is in keeping with the needs of gbMSM, transgender, and gender diverse populations.

Introduction: Students in Undergraduate Medical Education (UGME/UME) programs face a variety of stressors that can impact well-being. To address this, the Committee on Accreditation of Canadian Medical Schools (CACMS) mandates that medical schools offer support and programming that promotes student well-being. Academic librarians are accustomed to providing outreach that meets their faculties’ needs. Therefore, the goal of this study was to explore if Canadian undergraduate medical education librarians are supporting medical student wellness at their medical schools, and how they are doing so. Methods: A bilingual, electronic survey containing multiple choice and open-ended questions was distributed across two Canadian health sciences library listservs during the summer of 2020. Librarians supporting UGME/UME programs now or within the last three years were invited to participate. Results: 22 Responses were received, and 17 complete datasets were included in the final results. The majority of respondents have encountered a medical student in distress (n=10) and have adjusted their teaching style or materials to help reduce stress in medical students (n=9). Other initiatives such as resource purchasing, wellness-themed displays, planning wellness-themed events and spaces, and partnerships on campus in support of medical student wellness were less common. Discussion: The data in this study provides evidence that Canadian undergraduate medical education librarians are mindful of medical student well-being, and are taking steps to provide relevant support to this learner group. Librarians could adopt similar initiatives at their libraries to show support for learner wellness, and enhance their programs’ accreditation efforts in this area.