scholarly journals Increasing adolescent firearm homicides and racial disparities following Florida’s ‘Stand Your Ground’ self-defence law

2019 ◽  
Vol 26 (2) ◽  
pp. 187-190 ◽  
Author(s):  
Michelle Degli Esposti ◽  
Douglas J Wiebe ◽  
Jason Gravel ◽  
David K Humphreys
Keyword(s):  
Racial Disparities ◽  
Black Adolescents ◽  
Interrupted Time Series ◽  
Time Varying ◽  
Series Design ◽  
Firearm Suicide ◽  
The Mean ◽  
The Law ◽  
Negative Controls ◽  
Interrupted Time Series Design

Establishing whether specific laws impact rates of firearm homicide in adolescents is critical for identifying opportunities to reduce preventable adolescent death. We evaluated Florida’s Stand Your Ground law, enacted October 2005, using an interrupted time series design from 1999 to 2017. We used segmented quasi-Poisson regression to model underlying trends in quarterly rates of adolescent (15–19 years) firearm homicide in Florida and disaggregated by race (Black/White). We used synthetic and negative controls (firearm suicide) to address time-varying confounding. Before Florida’s Stand Your Ground law, the mean quarterly rate was 1.53 firearm homicides per 100 000 adolescents. Black adolescents comprised 63.5% of all adolescent firearm homicides before and 71.8% after the law. After adjusting for trends, the law was associated with a 44.6% increase in adolescent firearm homicide. Our analysis indicates that Florida’s Stand Your Ground is associated with a significant increase in firearm homicide and may also exacerbate racial disparities.

scholarly journals Impact of problem-based charting on the utilization and accuracy of the electronic problem list

2018 ◽  
Vol 25 (5) ◽  
pp. 548-554 ◽  
Author(s):  
Ron C Li ◽  
Trit Garg ◽  
Tony Cun ◽  
Lisa Shieh ◽  
Gomathi Krishnan ◽  
...  
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Interrupted Time Series ◽  
Problem List ◽  
Patient Encounter ◽  
Series Design ◽  
Before And After ◽  
Electronic Medical Record Systems ◽  
The Mean ◽  
Interrupted Time Series Design

Abstract Objective Problem-based charting (PBC) is a method for clinician documentation in commercially available electronic medical record systems that integrates note writing and problem list management. We report the effect of PBC on problem list utilization and accuracy at an academic intensive care unit (ICU). Materials and Methods An interrupted time series design was used to assess the effect of PBC on problem list utilization, which is defined as the number of new problems added to the problem list by clinicians per patient encounter, and of problem list accuracy, which was determined by calculating the recall and precision of the problem list in capturing 5 common ICU diagnoses. Results In total, 3650 and 4344 patient records were identified before and after PBC implementation at Stanford Hospital. An increase of 2.18 problems (>50% increase) in the mean number of new problems added to the problem list per patient encounter can be attributed to the initiation of PBC. There was a significant increase in recall attributed to the initiation of PBC for sepsis (β = 0.45, P < .001) and acute renal failure (β = 0.2, P = .007), but not for acute respiratory failure, pneumonia, or venous thromboembolism. Discussion The problem list is an underutilized component of the electronic medical record that can be a source of clinician-structured data representing the patient’s clinical condition in real time. PBC is a readily available tool that can integrate problem list management into physician workflow. Conclusion PBC improved problem list utilization and accuracy at an academic ICU.

scholarly journals Police-involved Deaths and the Impact on Homicide Rates in the Post-Ferguson Era: A Study of 44 U.S. Cities

2021 ◽  
pp. 088626052110283
Author(s):  
Tyler J Lane
Keyword(s):  
Meta Analysis ◽  
Interrupted Time Series ◽  
Homicide Rates ◽  
Aggravated Assault ◽  
Series Design ◽  
Percentage Points ◽  
Black Populations ◽  
Fbi Data ◽  
The Impact ◽  
Interrupted Time Series Design

This study investigated whether homicides increased after protested police-involved deaths, focusing on the period after Michael Brown’s death in Ferguson in August 2014. It also tests for effects of legal cynicism by comparing effects in homicide and aggravated assault on the assumption that reporting of the latter is discretionary and police abuses may make communities reluctant to notify police. Using FBI data from 44 U.S. cities, homicide and assault rates from 2011 to 2019 were analyzed using an interrupted time series design and combined in a meta-analysis to calculate pooled effects. A meta-regression tested effect moderators including external investigations and city/county sociodemographic characteristics. With a conservative threshold of p ≤ .01, 21 of the 44 cities experienced a significant increase and one had a significant decrease. The pooled effect was a 26.1% increase in the homicide (99% CI: 15.3% to 36.8%). Aggravated assaults increased above baseline, though the effect was 15.2 percentage points smaller (99% CI: –26.7 to –3.6) than the effect in homicides. When outcomes were measured as percent change, there were no significant effect moderators, but when measured as absolute change, homicides increased to a greater extent when the death was subject to external investigation and in cities with higher Black populations, poverty rates, and baseline homicide rates. The findings suggest that protested police-involved deaths led to an increase in homicides and other violence due to the distrust fomented within the very communities whom police are meant to protect.

Impact of Fare Policy Changes on Paratransit Travel Options: METROLift Case Study

2019 ◽  
Vol 2673 (8) ◽  
pp. 198-208
Author(s):  
Shuman Tan ◽  
Eun Sug Park ◽  
Jinuk Hwang
Keyword(s):  
Interrupted Time Series ◽  
Service Area ◽  
Policy Changes ◽  
Series Design ◽  
Taxi Service ◽  
Willingness To Use ◽  
The Impact ◽  
Interrupted Time Series Design ◽  
Analyze Data

The Metropolitan Transit Authority of Harris County’s METROLift program implemented several revised fare policies on travel options available to eligible riders at the end of 2015 and the beginning of 2016. Fares changed on the METROLift paratransit single ticket and passes. A premium fare for the expanded service area and a smartcard—Freedom Q Card—that allows free ride on METRO’s fixed-route services were introduced. This paper documents analyses to determine the impact of the revised METROLift fare policies on travel patterns and travel frequency of METROLift riders. The authors used a linear segmented regression analysis to analyze data from an interrupted time series design. The results suggest that the revised fare policies controlled the growth of percentage of riders who use METROLift paratransit service in total ADA-eligible riders, while improved the awareness and willingness to use supplementary paratransit travel options, especially the fixed-route service in the base service area and the subsidy taxi service in the expanded service area.

scholarly journals Scaling-up implementation in community hospitals: a multisite interrupted time series design of the Mobilization of Vulnerable Elders (MOVE) program in Alberta

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jayna Holroyd-Leduc ◽  
◽  
Charmalee Harris ◽  
Jemila S. Hamid ◽  
Joycelyne E. Ewusie ◽  
...  
Keyword(s):  
Time Series ◽  
Length Of Stay ◽  
Interrupted Time Series ◽  
Hospitalized Patients ◽  
Intervention Period ◽  
Community Hospitals ◽  
Series Design ◽  
Time Series Design ◽  
The Impact ◽  
Interrupted Time Series Design

Abstract Background As the population ages, older hospitalized patients are at increased risk for hospital-acquired morbidity. The Mobilization of Vulnerable Elders (MOVE) program is an evidence-informed early mobilization intervention that was previously evaluated in Ontario, Canada. The program was effective at improving mobilization rates and decreasing length of stay in academic hospitals. The aim of this study was to scale-up the program and conduct a replication study evaluating the impact of the evidence-informed mobilization intervention on various units in community hospitals within a different Canadian province. Methods The MOVE program was tailored to the local context at four community hospitals in Alberta, Canada. The study population was patients aged 65 years and older who were admitted to medicine, surgery, rehabilitation and intensive care units between July 2015 and July 2016. The primary outcome was patient mobilization measured by conducting visual audits twice a week, three times a day. The secondary outcomes included hospital length of stay obtained from hospital administrative data, and perceptions of the intervention assessed through a qualitative assessment. Using an interrupted time series design, the intervention was evaluated over three time periods (pre-intervention, during, and post-intervention). Results A total of 3601 patients [mean age 80.1 years (SD = 8.4 years)] were included in the overall analysis. There was a significant increase in mobilization at the end of the intervention period compared to pre-intervention, with 6% more patients out of bed (95% confidence interval (CI) 1, 11; p-value = 0.0173). A decreasing trend in median length of stay was observed, where patients on average stayed an estimated 3.59 fewer days (95%CI -15.06, 7.88) during the intervention compared to pre-intervention period. Conclusions MOVE is a low-cost, effective and adaptable intervention that improves mobilization in older hospitalized patients. This intervention has been replicated and scaled up across various units and hospital settings.

Designs of Empirical Evaluations of Nonexperimental Methods in Field Settings

2018 ◽  
Vol 42 (2) ◽  
pp. 176-213 ◽  
Author(s):  
Vivian C. Wong ◽  
Peter M. Steiner
Keyword(s):  
Interrupted Time Series ◽  
Target Population ◽  
Randomized Experiment ◽  
Difference In Differences ◽  
Study Approach ◽  
Advantages And Disadvantages ◽  
Threats To Validity ◽  
Series Design ◽  
Quasi Experimental ◽  
Interrupted Time Series Design

Over the last three decades, a research design has emerged to evaluate the performance of nonexperimental (NE) designs and design features in field settings. It is called the within-study comparison (WSC) approach or the design replication study. In the traditional WSC design, treatment effects from a randomized experiment are compared to those produced by an NE approach that shares the same target population. The nonexperiment may be a quasi-experimental design, such as a regression-discontinuity or an interrupted time-series design, or an observational study approach that includes matching methods, standard regression adjustments, and difference-in-differences methods. The goals of the WSC are to determine whether the nonexperiment can replicate results from a randomized experiment (which provides the causal benchmark estimate), and the contexts and conditions under which these methods work in practice. This article presents a coherent theory of the design and implementation of WSCs for evaluating NE methods. It introduces and identifies the multiple purposes of WSCs, required design components, common threats to validity, design variants, and causal estimands of interest in WSCs. It highlights two general approaches for empirical evaluations of methods in field settings, WSC designs with independent and dependent benchmark and NE arms. This article highlights advantages and disadvantages for each approach, and conditions and contexts under which each approach is optimal for addressing methodological questions.

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