"iMedicalApps is the leading online publication for medical professionals, patients, and analysts interested in mobile medical technology and health care apps. Our physician editors lead a team of physicians, allied health professionals, medical trainees, and mHealth analysts in providing reviews, research, and commentary of mobile medical technology. Our publication is heavily based on our own experiences in the hospital and clinic setting."
"In the interest of providing the medical community with concise information about the rapidly changing SARS-CoV-2/COVID-19 situation, Sanford Guide has made its resources related to the pandemic available without a digital subscription." Access is available on the Web, on IPhone or IPad, and Android devices.
"Learn when you want, where you want, and how you want. Access is your personal medical resource library that makes studying easier and more efficient. Currently available in its preview phase, as early adopters, you have the opportunity to shape the future of optimized and personal medical education. Access personalizes and tailors your medical education experience, giving you the healthcare content you need, on the go, even when you’re offline."
Be sure to create an account on Access Medicine first (on a desktop) and then use those credentials to log into the app.
Inclusive Language & Mental Health Environments
Healthcare is an ever-changing and dynamic environment. It is important that providers in all fields learn the language and skills to compassionately care for patients of vast backgrounds and mental health status. The following PDFs are crafted by the American Hospital Association to help healthcare workers practice such language. Take a look and feel free to print, share and spread the word in your department.
Check out the Medical Algorithms Project, now called Medal The Medical Algorithms Company.
It has been around for over a decade, and has 1,000s of medical care algorithms for over 45 different specialties in medicine and nursing.
It was developed by Dr. Sriram Iyengar, Ph.D., of the School of Health information Systems, University of Texas, Houston, and the Institute for Algorithmic Medicine. For individuals, it is still freely accessible at the URL below.
You will need to register to gain access; it has iOS and Android apps available. This is an evidence-based clinical decision support tool, with over 22,000 plus calculators and risk scores.
Reading Lists for January, May & August 2023 are now available!
Access the electronic readings lists below. Note, there will be no August reading list. The Library will no longer be providing print copies of the articles, but we will announce the full reading lists here with live links to each citation.
This blog covers all publications within the American Academy of Pediatrics. Subjects of posts include the latest news in diagnoses, social inequalities and other important topics in children's health.
"This new Annals multimedia feature accompanies selected systematic reviews. These short videos are designed to make it easier for busy clinicians to digest the findings of selected articles in a short 3-4 minute animated video."
"In “Not Otherwise Specified,” Dr. Lisa Rosenbaum, cardiologist and national correspondent for the New England Journal of Medicine, defies our sound-bite culture to go deep with some of medicine’s most innovative thinkers. Her guests’ stories and ideas about health care’s toughest challenges and greatest promise may change the way you think about medicine, health, and society."
"A podcast on children’s health from the AAP. Each episode features interviews about new research and hot topics in the field of pediatrics. Hear about the most important innovations in pediatrics, from the people who are behind them. While designed for pediatricians and other health professionals, the podcast will also appeal to parents, caregivers and anyone else interested in the science behind children’s health."
"Press, Play, Connect is the official podcast of the Medical Library Association. Join Sally Gore and Emily Hurst as they interview librarians and discuss ideas from the medical library world. Sally is the Manager of Research and Scholarly Communication Services at the Lamar Soutter Library at UMass Medical School. Emily Hurst is Director and Associate Dean of the Tompkins-McCaw Library for the Health Sciences at Virginia Commonwealth University."
Kok, N. , Zegers, M. , Teerenstra, S. , Fuchs, M. , van der Hoeven, J. , van Gurp, J. & Hoedemaekers, C. (2023). Effect of Structural Moral Case Deliberation on Burnout Symptoms, Moral Distress, and Team Climate in ICU Professionals: A Parallel Cluster Randomized Trial*. Critical Care Medicine, 51 (10), 1294-1305. doi: 10.1097/CCM.0000000000005940.
Moral case deliberation (MCD) is a team-based and facilitator-led, structured moral dialogue about ethical difficulties encountered in practice. This study assessed whether offering structural MCD in ICUs reduces burnout symptoms and moral distress and strengthens the team climate among ICU professionals.
This is a parallel cluster randomized trial.
Six ICUs in two hospitals located in Nijmegen, between January 2020 and September 2021.
Four hundred thirty-five ICU professionals.
Three of the ICUs organized structural MCD. In three other units, there was no structural MCD or other structural discussions of moral problems.
MEASUREMENTS AND MAIN RESULTS:
The primary outcomes investigated were the three burnout symptoms—emotional exhaustion, depersonalization, and a low sense of personal accomplishment—among ICU professionals measured using the Maslach Burnout Inventory on a 0–6 scale. Secondary outcomes were moral distress (Moral Distress Scale) on a 0–336 scale and team climate (Safety Attitude Questionnaire) on a 0–4 scale. Organizational culture was an explorative outcome (culture of care barometer) and was measured on a 0–4 scale. Outcomes were measured at baseline and in 6-, 12-, and 21-month follow-ups. Intention-to-treat analyses were conducted using linear mixed models for longitudinal nested data. Structural MCD did not affect emotional exhaustion or depersonalization, or the team climate. It reduced professionals’ personal accomplishment (−0.15;p< 0.05) but also reduced moral distress (−5.48;p< 0.01). Perceptions of organizational support (0.15;p< 0.01), leadership (0.19;p< 0.001), and participation opportunities (0.13;p< 0.05) improved.
Although structural MCD did not mitigate emotional exhaustion or depersonalization, and reduced personal accomplishment in ICU professionals, it did reduce moral distress. Moreover, it did not improve team climate, but improved the organizational culture.
Emala, C. , Tawfik, V. , Lane-Fall, M. , Toledo, P. , Wong, C. , Vavilala, M. , Fleisher, L. & Wood, M. (2023). The Anesthesiology Physician-Scientist Pipeline: Current Status and Recommendations for Future Growth—An Initiative of the Anesthesia Research Council. Anesthesia & Analgesia, 137 (4), 728-742. doi: 10.1213/ANE.0000000000006520.
The limited number and diversity of resident physicians pursuing careers as physician-scientists in medicine has been a concern for many decades. The Anesthesia Research Council aimed to address the status of the anesthesiology physician-scientist pipeline, benchmarked against other medical specialties, and to develop strategic recommendations to sustain and expand the number and diversity of anesthesiology physician-scientists. The working group analyzed data from the Association of American Medical Colleges and the National Resident Matching Program to characterize the diversity and number of research-oriented residents from US and international allopathic medical schools entering 11 medical specialties from 2009 to 2019. Two surveys were developed to assess the research culture of anesthesiology departments. National Institutes of Health (NIH) funding information awarded to anesthesiology physician-scientists and departments was collected from NIH RePORTER and the Blue Ridge Medical Institute. Anesthesiology ranked eighth to tenth place of 11 medical specialties in the percent of “research-oriented” entering residents, defined as those with advanced degrees (Master’s or PhDs) in addition to the MD degree or having published at least 3 research publications before residency. Anesthesiology ranked eighth of 11 specialties in the percent of entering residents who were women but ranked fourth of 11 specialties in the percent of entering residents who self-identified as belonging to an underrepresented group in medicine.There has been a 72% increase in both the total NIH funding awarded to anesthesiology departments and the number of NIH K-series mentored training grants (eg, K08 and K23) awarded to anesthesiology physician-scientists between 2015 and 2020. Recommendations for expanding the size and diversity of the anesthesiology physician-scientist pipeline included (1) developing strategies to increase the number of research intensive anesthesiology departments; (2) unifying the diverse programs among academic anesthesiology foundations and societies that seek to grow research in the specialty; (3) adjusting American Society of Anesthesiologists metrics of success to include the number of anesthesiology physician-scientists with extramural research support; (4) increasing the number of mentored awards from Foundation of Anesthesia Education and Research (FAER) and International Anesthesia Research Society (IARS); (5) supporting an organized and concerted effort to inform research-oriented medical students of the diverse research opportunities within anesthesiology should include the specialty being represented at the annual meetings of Medical Scientist Training Program (MSTP) students and the American Physician Scientist Association, as well as in institutional MSTP programs. The medical specialty of anesthesiology is defined by new discoveries and contributions to perioperative medicine which will only be sustained by a robust pipeline of anesthesiology physician-scientists.
Adashi EY, Gruppuso PA, Cohen IG. Affirmative Action Ruled Unconstitutional: Options for Building a Diverse Health Care Workforce. JAMA. 2023;330(11):1031–1032. doi:10.1001/jama.2023.14886
"On June 29, 2023, the Supreme Court of the United States decided Students for Fair Admissions, Inc v President and Fellows of Harvard College.1 In so doing, the Court held that “Harvard’s and UNC’s [University of North Carolina’s] admissions programs violate the Equal Protection Clause of the Fourteenth Amendment.”1 Although centered on college admissions, the verdict also stands in the way of attaining a racially and ethnically diverse health care workforce. A recent survey of the diversity of the national medical student body during the past 4 decades concluded that the “percentage of enrollees from Black, Hispanic, and other racial and ethnic groups that are underrepresented in medicine remain well below the percentages of these groups in the national census.”2 This analysis identified the limited diversity of the applicant pool as a prime contributor to the limited diversity of the medical student body. Thus, medical schools will be challenged to achieve racial and ethnic diversity on 2 fronts: limits placed on medical school admission policies and procedures and similar constraints placed on colleges, which will likely degrade the diversity of the applicant pool.
It is the redress of these realities that is impacted by the recent Court decision. This decision calls into question the legality of “holistic review” admission policies, which comprise “scholastically blind” interviews, as well as efforts to address unconscious racial bias. In this Viewpoint we review how the recent Court decision affects extant medical school admission policies that seek to actively enhance the diversity of the national medical student body and its derivative national health care workforce."
Tattersall, M. C. , Hughey, C. M. , Piasecki, T. M. , Korcarz, C. E. , Hansen, K. M. , Ott, N. R. , Sandbo, N. , Fiore, M. C. , Baker, T. B. & Stein, J. H. (2023). Chest, 164 (3), 757-769. doi: 10.1016/j.chest.2023.03.047.
The acute cardiovascular and pulmonary effects of contemporary electronic nicotine delivery systems (ENDS) in long-term users are not known.
What are the cardiovascular and pulmonary responses to an acute 15-min product use challenge with ENDS and combustible cigarettes in regular nicotine-containing product users compared with control participants who do not use tobacco or vape?
Study Design and Methods
Observational challenge study before and after nicotine-containing product use of 395 individuals who used ENDS exclusively (n = 164; exhaled carbon monoxide level, < 5 parts per million [ppm]; positive urine NicCheck I [Mossman Associates] results, 82%; fourth-generation ENDS), participants who smoked cigarettes exclusively (n = 117; carbon monoxide level, > 5 ppm; positive urine NicCheck I results), and control participants (n = 114; carbon monoxide level, < 5 ppm; negative urine NicCheck I results).
During the 15-min product challenge, cigarette users took a median of 14.0 puffs (interquartile range [IQR], 9.3 puffs); ENDS users took 9.0 puffs (IQR, 7.5 puffs;P< .001). After product challenge, compared with control participants, ENDS users showed greater increases in adjusted mean differences in systolic BP (5.6 mm Hg [95% CI, 4.4-6.8 mm Hg] vs 2.3 mm Hg [95% CI, 0.8-3.8 mm Hg];P= .001), diastolic BP (4.2 mm Hg [95% CI, 3.3-5.0 mm Hg] vs 2.0 mm Hg [95% CI, 1.1-3.0 mm Hg;P= .003), and heart rate (4.8 beats/min [95% CI, 4.0-5.6 beats/min] vs –1.3 beats/min [95% CI, –2.2 to –0.3 beats/min];P< .001) and greater reductions in brachial artery diameter (–0.011 cm [95% CI, –0.013 to 0.009 cm] vs –0.006 cm [95% CI, –0.004 to –0.009 cm];P= .003), time-domain heart rate variability (–7.2 ms [95% CI, –10.5 to –3.7 ms] vs 3.6 ms [95% CI, 1.6-9.3 ms];P= .001), and FEV1(ENDS: –4.1 [95% CI, –5.4 to –2.8] vs control participants: –1.1 [95% CI, –2.7 to 0.6];P= .005) with values similar to those of cigarette users. ENDS users performed worse than control participants on all exercise parameters, notably metabolic equivalents (METs; adjusted mean difference, 1.28 METs [95% CI, 0.73-1.83 METs];P< .001) and 60-s heart rate recovery (adjusted mean difference, 2.9 beats/min [95% CI, 0.7-5.0 beats/min];P= .008).
ENDS users had acute worsening of blood pressure, heart rate, and heart rate variability, as well as vasoconstriction, impaired exercise tolerance, and increased airflow obstruction after vaping, compared to control participants.
As of November 2021, all publications via the AAP have been on a single platform All journals subscribed to by the Library will be housed on the following pages, which will be made available on the Library site:
Anti-Thrombotic Guidelines and other guidelines and resources
Official Government Guidelines
The US government's National Guideline Clearinghouse is a repository of US clinical practice guidelines as well as some international guidelines with the goal of improving patient safety standards and healthcare measures. Click on the NGC links below to take you to the URLs, to the link for the Agency for Healthcare Research and Quality, and to the link to the US government site for the Preventive Taskforce guidelines.