scholarly journals Facility and Regional Factors Associated With the New Adoption of Electronic Medical Records in Japan: Nationwide Longitudinal Observational Study (Preprint)

2019 ◽  
Author(s):  
Hideaki Kawaguchi ◽  
Soichi Koike ◽  
Kazuhiko Ohe
Keyword(s):  
Longitudinal Data ◽  
Logistic Models ◽  
Credible Interval ◽  
Fiscal Year ◽  
Multinomial Logistic Model ◽  
Factors Associated ◽  
Bayesian Credible Interval ◽  
Emr Adoption ◽  
Regional Factors ◽  
Over Time

BACKGROUND The rate of adoption of electronic medical record (EMR) systems has increased internationally, and new EMR adoption is currently a major topic in Japan. However, no study has performed a detailed analysis of longitudinal data to evaluate the changes in the EMR adoption status over time. OBJECTIVE This study aimed to evaluate the changes in the EMR adoption status over time in hospitals and clinics in Japan and to examine the facility and regional factors associated with these changes. METHODS Secondary longitudinal data were created by matching data in fiscal year (FY) 2011 and FY 2014 using reference numbers. EMR adoption status was defined as “EMR adoption,” “specified adoption schedule,” or “no adoption schedule.” Data were obtained for hospitals (n=4410) and clinics (n=67,329) that had no adoption schedule in FY 2011 and for hospitals (n=1068) and clinics (n=3132) with a specified adoption schedule in FY 2011. The EMR adoption statuses of medical institutions in FY 2014 were also examined. A multinomial logistic model was used to investigate the associations between EMR adoption status in FY 2014 and facility and regional factors in FY 2011. Considering the regional variations of these models, multilevel analyses with second levels were conducted. These models were constructed separately for hospitals and clinics, resulting in four multinomial logistic models. The odds ratio (OR) and 95% Bayesian credible interval (CI) were estimated for each variable. RESULTS A total of 6.9% of hospitals and 14.82% of clinics with no EMR adoption schedules in FY 2011 had adopted EMR by FY 2014, while 10.49% of hospitals and 33.65% of clinics with specified adoption schedules in FY 2011 had cancelled the scheduled adoption by FY 2014. For hospitals with no adoption schedules in FY 2011, EMR adoption/scheduled adoption was associated with practice size characteristics, such as number of outpatients (from quantile 4 to quantile 1: OR 1.67, 95% CI 1.005-2.84 and OR 2.40, 95% CI 1.80-3.21, respectively), and number of doctors (from quantile 4 to quantile 1: OR 4.20, 95% CI 2.39-7.31 and OR 2.02, 95% CI 1.52-2.64, respectively). For clinics with specified EMR adoption schedules in FY 2011, the factors negatively associated with EMR adoption/cancellation of scheduled EMR adoption were the presence of beds (quantile 4 to quantile 1: OR 0.57, 95% CI 0.45-0.72 and OR 0.74, 95% CI 0.58-0.96, respectively) and having a private establisher (quantile 4 to quantile 1: OR 0.27, 95% CI 0.13-0.55 and OR 0.43, 95% CI 0.19-0.91, respectively). No regional factors were significantly associated with the EMR adoption status of hospitals with no EMR adoption schedules; population density was positively associated with EMR adoption in clinics with no EMR adoption schedule (quantile 4 to quantile 1: OR 1.49, 95% CI 1.32-1.69). CONCLUSIONS Different approaches are needed to promote new adoption of EMR systems in hospitals as compared to clinics. It is important to induce decision making in small- and medium-sized hospitals, and regional postdecision technical support is important to avoid cancellation of scheduled EMR adoption in clinics.

scholarly journals Transition of Poverty in Pakistan: Evidence from the Longitudinal Data

2004 ◽  
Vol 43 (4II) ◽  
pp. 895-909 ◽  
Author(s):  
Rashida Haq
Keyword(s):  
Developing Countries ◽  
Nutritional Status ◽  
Longitudinal Data ◽  
Living Conditions ◽  
School Enrolment ◽  
Household Level ◽  
Factors Associated ◽  
Dynamic Perspective ◽  
Over Time

Interest in the dynamics of income and consumption at the household level has increased in the developing countries as measures of living conditions at a point in time are not necessarily a good indicator of its stability over time. For many purposes it is important to adopt a dynamic perspective, distinguishing between extremely, chronically or transitory poor. In Pakistan studies of poverty at a point in time provide very valuable information about its nature, characteristics and distribution. However, given the fluctuations in many dimensions of poverty such as school enrolment, nutritional status and income, these studies are unable to capture the dynamics of this phenomenon, making it impossible to analyse the factors associated with the poverty transition, i.e., movement into and out of poverty.

Coping with longitudinal data in research on developmental psychopathology

2006 ◽  
Vol 30 (1) ◽  
pp. 20-25 ◽  
Author(s):  
David A. Cole
Keyword(s):  
Data Collection ◽  
Longitudinal Data ◽  
Developmental Psychopathology ◽  
Careful Consideration ◽  
Two Dimensions ◽  
The Other ◽  
Outcome Variable ◽  
The Third ◽  
Data Analytic ◽  
Over Time

Many outcome variables in developmental psychopathology research are highly stable over time. In conventional longitudinal data analytic approaches such as multiple regression, controlling for prior levels of the outcome variable often yields little (if any) reliable variance in the dependent variable for putative predictors to explain. Three strategies for coping with this problem are described. One involves focusing on developmental periods of transition, in which the outcome of interest may be less stable. A second is to give careful consideration to the amount of time allowed to elapse between waves of data collection. The third is to consider trait-state-occasion models that partition the outcome variable into two dimensions: one entirely stable and trait-like, the other less stable and subject to occasion-specific fluctuations.

scholarly journals Factors associated with professional identity formation within psychiatry residency training: A longitudinal study

2021 ◽  
Author(s):  
Qian Hui Chew ◽  
Yvonne Steinert ◽  
Kang Sim
Keyword(s):  
Professional Identity ◽  
Identity Formation ◽  
Psychiatry Residency ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Developmental Stages ◽  
Rate Of Change ◽  
Psychiatry Residents ◽  
Factors Associated ◽  
Over Time

Abstract Introduction Conceptual frameworks for professional identity (PI) formation highlight the importance of developmental stages and socialization as the learner progresses from legitimate peripheral to full participation. Based on extant literature and clinical impressions, the authors aimed to explore factors associated with PI formation in psychiatry residents over time, and hypothesized that time in training, seniority status, and duration of exposure to psychiatry prior to residency would be associated with PI formation. Methods Eighty out of 96 psychiatry residents (response rate, 83.3%) from the National Psychiatry Residency Program in Singapore participated and rated their PI development using the Professional Self Identity Questionnaire (PSIQ) across four timepoints from January 2016–December 2019. The residents were classified as junior (first 3 years) or senior residents (years 4–5). Linear mixed model analyses were conducted, with time in training, seniority status (junior versus senior residents), duration of psychiatry postings prior to residency, and their interaction as associated factors with PI over time. Results Time in training, seniority, and duration of psychiatry postings before residency (all p < 0.01) were significantly associated with higher PSIQ scores at baseline. Over time, although all residents had increases in PSIQ scores, this rate of change did not differ significantly between junior and senior residents. Discussion Exposure to psychiatry postings before residency, time in learning, and seniority are factors which influence PI development in residents. This has implications for psychiatry residency selection and training, adequate clinical exposure during training rotations, and continual support for new and senior residents to foster PI formation over time.

Neighborhood Firearm Victimization Rates and Social Capital Over Time

2015 ◽  
Vol 30 (1) ◽  
pp. 81-96 ◽  
Author(s):  
Justin C. Medina
Keyword(s):  
Social Capital ◽  
Longitudinal Data ◽  
Theoretical Framework ◽  
Policy Planning ◽  
Regression Analyses ◽  
Neighborhood Social Capital ◽  
The Relationship ◽  
The U.S ◽  
Over Time ◽  
Victimization Rates

Distribution of firearm victimization is not equal within cities. Victimization can persistently concentrate in a small number of neighborhoods, while others experience very little violence. Theorists have pointed to one possible explanation as the ability of groups to control violence using social capital. Researchers have shown this association at the U.S. county, state, and national levels. Few studies, however, have examined the relationship between neighborhood social capital and violence over time. This study uses longitudinal data to ask whether neighborhood social capital both predicts and is influenced by firearm victimization over 3 years in Philadelphia. The results of several regression analyses suggest that trusting others and firearm victimization are inversely related over time. Implications for neighborhood policy planning and social capital as a theoretical framework are discussed.

scholarly journals Increases in Risky Drinking During the COVID-19 Pandemic Assessed via Longitudinal Cohort Design: Associations With Racial Tensions, Financial Distress, Psychological Distress and Virus-Related Fears

2021 ◽  
Author(s):  
William V Lechner ◽  
Natasha K Sidhu ◽  
Jackson T Jin ◽  
Ahmad A Kittaneh ◽  
Kimberly R Laurene ◽  
...  
Keyword(s):  
Psychological Distress ◽  
High Risk ◽  
Alcohol Use ◽  
Financial Distress ◽  
Daily Life ◽  
Drinking Patterns ◽  
Risky Drinking ◽  
Factors Associated ◽  
High Risk Drinking ◽  
Over Time

Abstract Background The COVID-19 pandemic has created disruptions to daily life resulting in wide-spread unemployment and psychological distress. Recent studies have reported high rates of alcohol use during this time; however, longitudinal data remain scarce and factors associated with increases in high-risk drinking observed over time are unknown. Aims The current study examined changes in high-risk drinking patterns across four 7-day observation periods, prior to and following a university wide campus closure. Additionally, factors associated with changes in alcohol use patterns were examined including financial distress, psychological distress, impact of racial tensions and virus-related fears. Method Students (N = 1001) in the Midwestern USA completed repeated assessments between March and June 2020. Each survey included a timeline follow-back measure of alcohol use. Pandemic-related distress spanning several factors was assessed at the final follow-up. Results Risky drinking patterns increased significantly over time. Overall, psychological distress and impact of racial tensions were associated with higher rates of risky drinking, whereas COVID-19-related fears were associated with lower rates. However, only financial-related distress was associated with an increase in risky drinking patterns over time. Conclusions Increased risky drinking patterns observed in the current study may signal problems that are likely to persist even after the direct impact of the COVID-19 pandemic on daily life ends. Individuals experiencing financial distress may represent a particularly high-risk group. Interventions targeting the cross-section of job loss, financial stress and problematic alcohol use will be important to identify.

scholarly journals Factors associated with 56-day non-return rate in dairy cattle

2011 ◽  
Vol 46 (6) ◽  
pp. 648-654 ◽  
Author(s):  
Ramiro Fouz ◽  
Fernando Gandoy ◽  
María Luisa Sanjuán ◽  
Eduardo Yus ◽  
Francisco Javier Diéguez
Keyword(s):  
Logistic Models ◽  
Herd Size ◽  
Return Rate ◽  
Dairy Herds ◽  
Model Parameters ◽  
North West ◽  
Factors Associated ◽  
Lactating Cows ◽  
Service Conception ◽  
Major Factors

The objective of this work was to identify factors associated with the 56-day non-return rate (56-NRR) in dairy herds in the Galician region, Spain, and to estimate it for individual Holstein bulls. The experiment was carried out in herds originated from North-West Spain, from September 2008 to August 2009. Data of the 76,440 first inseminations performed during this period were gathered. Candidate factors were tested for their association with the 56-NRR by using a logistic model (binomial). Afterwards, 37 sires with a minimum of 150 first performed inseminations were individually evaluated. Logistic models were also estimated for each bull, and predicted individual 56-NRR rate values were calculated as a solution for the model parameters. Logistic regression found four major factors associated with 56-NRR in lactating cows: age at insemination, days from calving to insemination, milk production level at the time of insemination, and herd size. First-service conception rate, when a particular sire was used, was higher for heifers (0.71) than for lactating cows (0.52). Non-return rates were highly variable among bulls. Asignificant part of the herd-level variation of 56-NRR of Holstein cattle seems attributable to the service sire. High correlation level between observed and predicted 56-NRR was found.

A longitudinal analysis of sociodemographic and health correlates of sexual health among HIV-infected men in the USA

Sexual Health ◽  
2009 ◽  
Vol 6 (4) ◽  
pp. 285 ◽  
Author(s):  
William L. Jeffries ◽  
Barbara A. Zsembik ◽  
Chuck W. Peek ◽  
Constance R. Uphold
Keyword(s):  
Life Satisfaction ◽  
Sexual Health ◽  
Sexual Activity ◽  
Erectile Function ◽  
Temporal Changes ◽  
Depression Symptoms ◽  
Factors Associated ◽  
Sex Drive ◽  
The Usa ◽  
Over Time

Background: Sexual health among HIV-infected men primarily has been examined in cross-sectional designs. Few have used longitudinal data to measure sexual health change or factors associated with change. Moreover, studies of HIV-infected men disproportionately focus on sexual risk behaviours. The present paper examines temporal changes in sexual health based on measures of sexual activity, erectile function, sex drive, and sex life satisfaction. Methods: Data from a prospective cohort study of HIV-infected men (n = 197) in the USA were used. Sexual health measures were based on self-reported sexual activity, erectile function, sex drive, and sex life satisfaction at 12- and 24-month follow-ups. Transition matrices described 1-year sexual health changes. Logistic regression models determined sociodemographic and health-related factors associated with change. Results: Men reported considerable change in sexual health during the year-long observation interval. Among men who experienced change, younger age, cohabitation, and higher CD4 counts were associated with greater sexual activity over time. Men with more depression symptoms had lower erectile function over time, and higher education and higher income were protective against temporal declines in sex drive and satisfaction. Less disease comorbidity was associated with 1-year improvements in sex life satisfaction. Conclusions: Some men in our sample experienced sexual health change, but stability was common for most. Temporal changes in sexual health varied according to age, cohabitation, education, income, and physical and mental health covariates. The present paper highlights the benefits of longitudinal investigations and multidimensional definitions of sexual health.

Differential Aging: An Exploratory Approach Using Cluster Analysis

1984 ◽  
Vol 18 (2) ◽  
pp. 141-157 ◽  
Author(s):  
Graeme Ford ◽  
Rex Taylor
Keyword(s):  
Cluster Analysis ◽  
Longitudinal Data ◽  
Random Sample ◽  
Successful Aging ◽  
Elderly Population ◽  
Structural Data ◽  
Exploratory Approach ◽  
Aging Well ◽  
Well Elderly ◽  
Over Time

This article uses cluster analysis to identify different patterns of personal resources within a random sample of the well, elderly population. Ten such patterns or natural groupings are identified and their implications for coping and successful aging are discussed. It is apparent that there are a number of ways both of aging well and aging badly, and that these patterns cannot be predicted solely on the basis of structural data. The article poses a number of questions on the performance of cluster members over time and draws attention to the importance of longitudinal data.

scholarly journals Factors Associated with Acute Community-Acquired Pyelonephritis Caused by Extended-Spectrum β-Lactamase-Producing Escherichia coli

2021 ◽  
Vol 10 (21) ◽  
pp. 5192
Author(s):  
Mónica Romero Nieto ◽  
Sara Maestre Verdú ◽  
Vicente Gil ◽  
Carlos Pérez Barba ◽  
Jose Antonio Quesada Rico ◽  
...  
Keyword(s):  
Roc Curve ◽  
Goodness Of Fit ◽  
Logistic Models ◽  
Predictive Performance ◽  
Demographic Characteristics ◽  
E Coli ◽  
Factors Associated ◽  
Extended Spectrum ◽  
Male Sex ◽  
Tract Infections

This study aimed to identify the factors associated with the presence of extended-spectrum ß-lactamase-(ESBL) in patients with acute community-acquired pyelonephritis (APN) caused by Escherechia coli (E. coli), with a view of optimising empirical antibiotic therapy in this context. We performed a retrospective analysis of patients with community-acquired APN and confirmed E. coli infection, collecting data related to demographic characteristics, comorbidities, and treatment. The associations of these factors with the presence of ESBL were quantified by fitting multivariate logistic models. Goodness-of-fit and predictive performance were measured using the ROC curve. We included 367 patients of which 51 presented with ESBL, of whom 90.1% had uncomplicated APN, 56.1% were women aged ≤55 years, 33.5% had at least one mild comorbidity, and 12% had recently taken antibiotics. The prevalence of ESBL-producing E. coli was 13%. In the multivariate analysis, the factors independently associated with ESBL were male sex (OR 2.296; 95% CI 1.043–5.055), smoking (OR 4.846, 95% CI 2.376–9.882), hypertension (OR 3.342, 95% CI 1.423–7.852), urinary incontinence (OR 2.291, 95% CI 0.689–7.618) and recurrent urinary tract infections (OR 4.673, 95% CI 2.271–9.614). The area under the ROC curve was 0.802 (IC 95% 0.7307–0.8736), meaning our model can correctly classify an individual with ESBL-producing E. coli infection in 80.2% of cases.

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