scholarly journals 206Clinical Epidemiology Knowledge Retention in Accelerated Teaching and Learning

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Quinten Carfagnini ◽  
Madelyn Law ◽  
Michelle Zahradnik
Keyword(s):  
Teaching And Learning ◽  
Clinical Epidemiology ◽  
Knowledge Retention ◽  
University Administrators ◽  
Mixed Effect ◽  
Accelerated Courses ◽  
Effect Regression ◽  
Course Format ◽  
Therapeutic Research ◽  
Over Time

Abstract Background Accelerated courses continue to be part of the changing landscape in medical education despite limited evidence to support their efficacy in relation to knowledge retention. The purpose of this study was to determine if a difference in knowledge retention exists over time between students enrolled in a traditional versus an accelerated clinical epidemiology course. Methods The current study incorporated an epidemiologic prospective cohort design. The course in clinical epidemiology focused on evidence-based decision making for diagnostic and therapeutic research methods and problem-based learning. Knowledge retention was assessed at four-times points (baseline, three, six and 12 months) for students enrolled in either traditional (13 weeks) or accelerated (1 week) courses. Linear mixed-effect regression modeling was incorporated to examine the change in trajectory of knowledge retention over four points in time between students enrolled in traditional and accelerated teaching formats. Results A significant main effect of traditional versus accelerated course format on retention of knowledge over time was not found (β=-0.341, p = 0.410), suggesting that knowledge retention is not compromised regardless of teaching format. Furthermore, the greatest diminished knowledge retention was observed between baseline and 12 months (β = 10.595, p < 0.0001), followed by three months (β = 3.864, p < 0.0001) and six months (β = 1.180, p < 0.0001). Conclusion This study determined that accelerated course format does not compromise short- and long-term clinical epidemiology knowledge retention in students. Key message University administrators and faculty should not be suspicious of knowledge retention issues in accelerated courses and should endorse accelerated learning opportunities.

scholarly journals Human Sex Ratio at Birth: Mythical and Observable Trends

2020 ◽  
Author(s):  
Yanan Long ◽  
Qi Chen ◽  
Henrik Larsson ◽  
Andrey Rzhetsky
Keyword(s):  
Sex Ratio ◽  
The United States ◽  
Time Series Models ◽  
Agricultural Activity ◽  
Health Record ◽  
Sex Ratio At Birth ◽  
Regression Analyses ◽  
Mixed Effect ◽  
Effect Regression ◽  
Over Time

AbstractThe human sex ratio at birth (SRB) is defined as the ratio between the number of newborn boys to the total number of newborns per time unit. It is, typically, slightly greater than (more boys than girls) and fluctuates over time. In this study, we sought to “myth-check” previously reported associations (and test new hypotheses) using variants of mixed-effect regression analyses and time-series models on two very large electronic health record datasets, representing the populations in the United States and Sweden, respectively. Our results revealed that neither dataset supported models in which the SRB changed seasonally or in response to variations in ambient temperature, and that an increased level of a diverse array of pollutants were associated with lower SRBs. Moreover, we found that increased levels of industrial and agricultural activity, which served as proxies for water pollution, were also associated with lower SRBs.

scholarly journals Constancy of the angle between the Frankfort horizontal plane and the sella-nasion line: A nine-year longitudinal study

2013 ◽  
Vol 84 (2) ◽  
pp. 286-291 ◽  
Author(s):  
Young Jae Huh ◽  
Kyung-Hoe Huh ◽  
Hong-Kyun Kim ◽  
Shin-Eun Nam ◽  
Hye Yoon Song ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Horizontal Plane ◽  
Annual Change ◽  
Mixed Effect ◽  
Effect Regression ◽  
The Mean ◽  
Frankfort Horizontal Plane ◽  
Mixed Effect Regression Model ◽  
Over Time ◽  
Observation Period

ABSTRACT Objective: To investigate the constancy of the angle between the Frankfort horizontal plane (FH) and the sella-nasion line (SN) using longitudinal data. Materials and Methods: Longitudinal lateral cephalometric data of 223 children (116 girls and 107 boys) from 6 to 14 years of age were used. The angle between FH and SN (SNFH), the distance from FH to the nasion (NFH), the distance from FH to the sella (SFH), and the differences between the NFH and SFH (Δ) were also measured. All data were analyzed statistically using independent t-tests and mixed-effect regression model analysis. Results: The mean SNFH values showed some minor fluctuations, ranging from 9.26° to 9.74° in girls and 8.45° to 8.95° in boys. The mean NFH and SFH values gradually increased according to age irrespective of sex. There were statistically significant differences by sex for all measurements at several ages. The annual change in SFH and Δ showed sexual dimorphism. Conclusions: There are variations among individuals in the angle between the FH and SN. However, within an individual, the angle does not vary significantly over time during the observation period.

scholarly journals Clinically significant substance use and residential stability among homeless or vulnerably housed persons in Canada: a longitudinal cohort study

2020 ◽  
Author(s):  
Trudy E Nasmith ◽  
Anne Gadermann ◽  
Denise Jaworsky ◽  
Monica Norena ◽  
Matthew J To ◽  
...  
Keyword(s):  
Substance Use ◽  
Residential Stability ◽  
Mixed Effect ◽  
Negatively Associated ◽  
Effect Regression ◽  
Transition Study ◽  
Clinically Significant ◽  
Using Data ◽  
Drug And Alcohol ◽  
Over Time

Abstract Background We examined clinically significant substance use among homeless or vulnerably housed persons in three Canadian cities and its association with residential stability over time using data from the Health and Housing in Transition study. Methods In 2009, 1190 homeless or vulnerably housed individuals were recruited in three Canadian cities and followed for 4 years. We collected information on housing and incarceration history, drug and alcohol use, having a primary care provider at baseline and annually for 4 years. Participants who screened positive for substance use at baseline were included in the analyses. We used a generalized logistic mixed effect regression model to examine the association between clinically significant substance use and residential stability, adjusting for confounders. Results Initially, 437 participants met the criteria for clinically significant substance use. The proportion of clinically significant substance use declined, while the proportion of participants who achieved residential stability increased over time. Clinically significant substance use was negatively associated with achieving residential stability over the 4-year period (AOR 0.7; 95% CI 0.57, 0.86). Conclusions In this cohort of homeless or vulnerably housed individuals, clinically significant substance use was negatively associated with achieving residential stability over time, highlighting the need to better address substance use in this population.

scholarly journals Mythical and Observable Trends in Human Sex Ratio at Birth

2020 ◽  
Author(s):  
Yanan Long ◽  
Qi Chen ◽  
Henrik Larsson ◽  
Andrey Rzhetsky
Keyword(s):  
Sex Ratio ◽  
The United States ◽  
Time Series Models ◽  
Agricultural Activity ◽  
Health Record ◽  
Sex Ratio At Birth ◽  
Regression Analyses ◽  
Mixed Effect ◽  
Effect Regression ◽  
Over Time

AbstractThe human sex ratio at birth (SRB) is defined as the ratio between the number of newborn boys to the total number of newborns per time unit. It is, typically, slightly greater than (more boys than girls) and fluctuates over time. In this study, we sought to “myth-check” previously reported associations (and test new hypotheses) using variants of mixed-effect regression analyses and time-series models on two very large electronic health record datasets, representing the populations in the United States and Sweden, respectively. Our results revealed that neither dataset supported models in which the SRB changed seasonally or in response to variations in ambient temperature, and that an increased level of a diverse array of pollutants were associated with lower SRBs. Moreover, we found that increased levels of industrial and agricultural activity, which served as proxies for water pollution, were also associated with lower SRBs.

scholarly journals Potential of community-based risk estimates for improving hospital performance measures and discharge planning

2021 ◽  
Vol 10 (2) ◽  
pp. e001230
Author(s):  
Michael Reid ◽  
George Kephart ◽  
Pantelis Andreou ◽  
Alysia Robinson
Keyword(s):  
Discharge Planning ◽  
Care Transitions ◽  
Hospital Setting ◽  
Hospital Performance ◽  
Case Mix ◽  
Readmission Rates ◽  
Mixed Effect ◽  
Adjusted Risk ◽  
Community Risk ◽  
Effect Regression

BackgroundRisk-adjusted rates of hospital readmission are a common indicator of hospital performance. There are concerns that current risk-adjustment methods do not account for the many factors outside the hospital setting that can affect readmission rates. Not accounting for these external factors could result in hospitals being unfairly penalized when they discharge patients to communities that are less able to support care transitions and disease management. While incorporating adjustments for the myriad of social and economic factors outside of the hospital setting could improve the accuracy of readmission rates as a performance measure, doing so has limited feasibility due to the number of potential variables and the paucity of data to measure them. This paper assesses a practical approach to addressing this problem: using mixed-effect regression models to estimate case-mix adjusted risk of readmission by community of patients’ residence (community risk of readmission) as a complementary performance indicator to hospital readmission rates.MethodsUsing hospital discharge data and mixed-effect regression models with a random intercept for community, we assess if case-mix adjusted community risk of readmission can be useful as a quality indicator for community-based care. Our outcome of interest was an unplanned repeat hospitalisation. Our primary exposure was community of residence.ResultsCommunity of residence is associated with case-mix adjusted risk of unplanned repeat hospitalisation. Community risk of readmission can be estimated and mapped as indicators of the ability of communities to support both care transitions and long-term disease management.ConclusionContextualising readmission rates through a community lens has the potential to help hospitals and policymakers improve discharge planning, reduce penalties to hospitals, and most importantly, provide higher quality care to the people that they serve.

Kidney function decline is associated with an accelerated increase in plasma homocysteine in older adults: a longitudinal study

2021 ◽  
pp. 1-21
Author(s):  
Hui Zhang ◽  
Yi Li ◽  
Meng Hao ◽  
Xiaoyan Jiang ◽  
Jiucun Wang ◽  
...  
Keyword(s):  
Kidney Function ◽  
Repeated Measurements ◽  
Baseline Survey ◽  
Mixed Effect ◽  
Pronounced Increase ◽  
Crude Model ◽  
The Mean ◽  
Kidney Function Decline ◽  
Over Time

Abstract Background: Few studies have been conducted to investigate the association of kidney function decline with the trajectories of homocysteine (Hcy) over time, using repeated measurements. We aimed to investigate the association of kidney function with changes in plasma Hcy levels over time. Methods: Data were collected from the Rugao Longevity and Ageing Study. In detail, plasma Hcy and creatinine levels were measured in both waves (waves 2, 3 and 4) during the 3.5-year follow-up (N = 1135). Wave 2 was regarded as the baseline survey. The estimated glomerular filtration rate (eGFR) was calculated based on creatinine. Subjects were categorized into four groups according to quartiles of eGFR at baseline. Linear mixed-effect models were used to investigate the association of eGFR with subsequent plasma Hcy levels. Results: The mean eGFR at baseline was 90.84 (11.42) mL/min/1.73 m2. The mean plasma Hcy level was 14.09 (6.82) at baseline and increased to 16.28 (8.27) and 17.36 (10.39) μmol/L during follow-ups. In the crude model, the interaction between time and eGFR at baseline was significant (β = −0.02, 95% CI: −0.02 to −0.01, p = 0.002). After adjusting for confounding factors, a significant relationship remained (β = −0.02, 95% CI: −0.02 to −0.01, p = 0.003), suggesting that kidney function decline at baseline was associated with a faster increase in Hcy levels. Conclusion: Kidney function decline is associated with a more pronounced increase in plasma Hcy levels. Further studies with longer follow-up periods and larger sample sizes are needed to validate our findings.

scholarly journals Changes in serum TG levels during pregnancy and their association with postpartum hypertriglyceridemia: a population-based prospective cohort study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Yandi Zhu ◽  
Haiyan Zhu ◽  
Qinyu Dang ◽  
Qian Yang ◽  
Dongxu Huang ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Pregnant Women ◽  
Blood Lipid ◽  
Roc Curves ◽  
Population Based ◽  
Linear Mixed Effect Model ◽  
Mixed Effect ◽  
Adverse Pregnancy ◽  
Stratified Analysis ◽  
Over Time

Abstract Background Blood lipid increases during gestation are considered a physiological adaption, and decrease after delivery. However, some adverse pregnancy outcomes are thought to be related to gestational lipid levels. Therefore, it is necessary to have a reference range for lipid changes during gestation. The present study aims to describe triglyceride (TG) changes during pregnancy and 42 days postpartum and to find cut-off points for TG levels during the first, second, and third trimesters. Methods A total of 908 pregnant women were followed from recruitment to 42 days postpartum, and their serum lipids were collected at gestational weeks 6–8, 16, 24, and 36 and 42 days postpartum. The major outcome was postpartum hypertriglyceridemia. The association between gestational and postpartum TG levels was analysed by stepwise multiple linear regression. A two-stage approach including a linear mixed-effect model and linear or logistic regression was conducted to explore the contribution of the changes in TG over time in pregnancy to postpartum hypertriglyceridemia. Logistic regression was constructed to examine the association between gestational TG levels and postpartum hypertriglyceridemia. Cut-off points were calculated by receiver operating characteristic (ROC) curves. Results There was a tendency for serum TG to increase with gestational age and decrease at 42 days postpartum. Prepregnancy overweight, obesity, and GDM intensified this elevation. Higher TG levels at gestational weeks 6–8, 16, 24, and 36 were positively associated with a higher risk of postpartum hypertriglyceridemia [OR 4.962, 95 % CI (3.007–8.189); OR 2.076, 95 % CI (1.303–3.309); OR 1.563, 95 % CI (1.092–2.236); and OR 1.534, 95 % CI (1.208–1.946), respectively]. The trend of the change in TG over time was positively associated with the TG level and risk of postpartum hypertriglyceridemia [OR 11.660, 95 % CI (6.018–22.591)]. Based on ROC curves, the cut-off points of serum TG levels were 1.93, 2.35, and 3.08 mmol/L at gestational weeks 16, 24, and 36, respectively. Stratified analysis of prepregnancy body mass index (pre-BMI) and GDM showed that higher gestational TG was a risk factor for postpartum hypertriglyceridemia in women with normal pre-BMI and without GDM. Conclusions Gestational TG and its elevation were risk and predictive factors of postpartum hypertriglyceridemia, especially in pregnant women with normal pre-BMI or without GDM.

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