Comparing Graphical Formats for Feedback of Clinical Practice Data

2017 ◽  
Vol 56 (01) ◽  
pp. 28-36 ◽  
Author(s):  
Florence Saillour-Glénisson ◽  
Karine Nouette-Gaulain ◽  
Vianney Jouhet ◽  
Louis-Rachid Salmi ◽  
Aurélie Petit-Monéger
Keyword(s):  
Clinical Practice ◽  
Primary Outcome ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Postoperative Nausea And Vomiting ◽  
Cross Sectional Study ◽  
Motivation To Change ◽  
Cross Sectional ◽  
Factors Associated ◽  
The Difference

Summary Objectives: Although graphical formats used to feedback clinical practice data may have an important impact, the most effective formats remain unknown. Using prevention of postoperative nausea and vomiting by anesthesiologists as an application, the objective of this study was to assess which graphical formats for feedback of clinical practice data are the most incentive to change practice. Methods: We conducted a multicenter cross-sectional study among anesthesiologists randomized in two groups between March andJune 2014. Each anesthesiologist assessed 15 graphical formats displaying an indicator of either prescription conformity or prescription effectiveness. Graphical formats varied by: type of graph (bar charts, linear sliders, or pictographs), presence or not of a target to reach, presence or not of a contrast between a hypothetical physician and his/her team, direction of the difference between the physician and his/her team, and restitution or not of the quality indicator evolution over the previous six months. The primary outcome was a numerical scale score expressing the anesthesiologists’ motivation to change his/her practice (ranging from 1 to 10 points). A linear mixed model was fitted to explain variation in motivation. Results: Sixty-six anesthesiologists assessed the conformity indicator and 67 assessed the effectiveness indicator. Factors associated with an increased motivation to change practice were: (i) presence of a clearly defined target to reach (conformity: β = 0.24 points, p = 0.0046; effectiveness: β = 1.11 points, p < 0.0001); (ii) contrast between the physician and his/her team (conformity: β = 0.38 points, p < 0.0001; effectiveness: β = 0.33 points, p = 0.0021); (iii) better results for the team than for the physician (conformity: β = 0.65 points, p < 0.0001; effectiveness β = 1.16 points, p < 0.0001). For the effectiveness indicator, anesthesiologists were more motivated to change practice with bar charts (β = 0.24 points, p = 0.0447) and pictographs (β = 0.45 points, p = 0.0001) than with linear sliders. Conclusions: Graphs associated with a defined target to reach should be preferred to deliver feedback, especially bar graphs or pictographs for indicators which are more complex to represent such as effectiveness indicators. Anesthesiologists are also more motivated to change practice when graphs report contrasted data between the physician and his/her team and a lower conformity or effectiveness for the physician than for his/her team.

Factors Associated with the Local Increase of Skin Temperature, ‘Hotspot,’ of Callus in Diabetic Foot: A Cross-Sectional Study

2021 ◽  
pp. 193229682110111
Author(s):  
Qi Qin ◽  
Makoto Oe ◽  
Yumiko Ohashi ◽  
Yuko Shimojima ◽  
Mikie Imafuku ◽  
...  
Keyword(s):  
Skin Temperature ◽  
Diabetic Foot ◽  
Plantar Pressure ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Local Skin ◽  
Factors Associated

Background: Increased local skin temperature (hotspot) on a callus site as detected by thermography is a well-known precursor of diabetic foot ulcers. This study aimed to determine the factors associated with callus hotspots in order to predict the risk of callus hotspots and then provide information for specific interventions. Methods: In this cross-sectional study, 1,007 patients’ data from a diabetic foot prevention clinic between April 2008 and March 2020 were used. Data regarding patients’ characteristics, foot calluses, and callus hotspots were collected and analyzed. Callus and callus hotspot were confirmed from foot photos and thermographs, respectively. A callus hotspot was defined as a relative increase in temperature compared to the skin surrounding the callus on the thermograph. Plantar pressure was measured with a pressure distribution measurement system. A generalized linear mixed model was used to identify the factors associated with callus hotspots. Results: Among the 2,014 feet, 28.5% had calluses, and 18.5% of feet with calluses had callus hotspots. The factors associated with callus hotspots were number of calluses (Adjusted odds ratio (aOR): 1.540, P = .003), static forefoot peak plantar pressure (SFPPP) (aOR: 1.008, P = .001), and body mass index (aOR: 0.912, P = .029). Conclusions: Patients with a higher SFPPP were more likely to have callus hotspots suggesting that SFPPP might contribute to callus inflammation. SFPPP has the potential to be a useful predictor of callus hotspots in people with diabetes and at the same time provide information for off-loading interventions to prevent callus hotspots.

scholarly journals Misconceptions about COVID-19 among older Rohingya (forcefully displaced Myanmar nationals) adults in Bangladesh: findings from a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e050427
Author(s):  
Sabuj Kanti Mistry ◽  
A R M Mehrab Ali ◽  
Uday Narayan Yadav ◽  
Saruna Ghimire ◽  
Md. Belal Hossain ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Health Workers ◽  
Multiple Linear Regression Model ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Cross Sectional ◽  
Factors Associated ◽  
Cumulative Score ◽  
Low Health Literacy ◽  
Communication Frequency

ObjectivesDue to low health literacy and adverse situation in the camps, there are possibilities of misconceptions related to COVID-19 among the older Rohingya (forcefully displaced Myanmar nationals or FDMNs) adults in Bangladesh. The present research aimed to assess the level of misconceptions and the factors associated with it among the older FDMNs in Bangladesh.DesignCross-sectional.SettingA selected Rohingya camp situated in Cox’s Bazar, a southeastern district of Bangladesh.ParticipantsInformation was collected from 416 conveniently selected FDMNs who were aged 60 years and above.Primary and secondary outcome measuresThe primary outcome was misconceptions related to the spread, prevention and treatment of COVID-19. Information on 14 different locally relevant misconceptions was gathered, each was scored as one, and obtained a cumulative score, ranging from 0 to 14, with a higher score indicating a higher level of misconceptions. A multiple linear regression model explored the factors associated with misconceptions.ResultsThe participants had an average of five misconceptions. The most prevalent misconceptions were: everyone should wear personal protective equipment when outside (84.6%) and its prevention by nutritious food (62.5%) and drinking water (59.3%). Other notable misconceptions included the spread of COVID-19 through mosquito bites (42%) and its transmissions only to the non/less religious person (31.4%). In regression analyses, memory or concentration problems, communication frequency with social networks, pre-existing conditions and receiving information from health workers were significantly associated with higher COVID-19 misconceptions. These misconceptions were less likely among those overwhelmed by COVID-19, having COVID-19 diagnosed friends or family members and receiving information from friends and family.ConclusionsOverall, we found that misconceptions were prevalent among the older FDMNs in Bangladesh. The associations have important implications for programmes to prevent and manage COVID-19 in these settings. Health workers need to be adequately trained to provide clear communication and counter misconceptions.

scholarly journals The association of socio-demographic and environmental factors on childhood diarrhea in Cambodia

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 303
Author(s):  
Vong Pisey ◽  
Pannee Banchonhattakit
Keyword(s):  
Maternal Age ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Secondary Data ◽  
Cross Sectional Study ◽  
Health Concern ◽  
Childhood Diarrhea ◽  
Public Health Concern ◽  
Cross Sectional ◽  
One Year

Background: Diarrhea is still the leading cause of childhood death worldwide, as well as a major cause for concern in developing countries. This study was conducted to investigate the factors related to childhood diarrhea in Cambodia. Methods: A cross-sectional study of the secondary data from the Cambodia Demographic and Health Survey 2014 was conducted using the combination of household data and children’s data. A generalized linear mixed model was used to analyze the determinant factors of childhood diarrhea. Results: The surveys included 2,828 children, aged 12 to 35 months. The prevalence of diarrhea in the last 2 weeks was 16.44% (95% CI: 14.72%-18.31%). Factors with statistically significant associations with childhood diarrhea in Cambodia were: maternal  unemployment, compared with being in employment (AOR = 1.43; 95% CI: 1.14-1.78); the child being male (AOR = 1.25; 95%CI: 1.02-1.53); the presence of unimproved toilet facilities (AOR = 1.17; 95%CI: 1.05-1.31) compared with improved toilet facilities; and unhygienic disposal of children’s stools (AOR = 1.32; 95%CI: 1.06-1.64) compared with hygienic disposal of children’s stools when controlling for other covariates. Both maternal age (one year older; AOR = 0.85; 95%CI: 0.78– 0.93) and child age (one month older; AOR = 0.86; 95%CI: 0.78-0.94) had significant negative associations with the occurrence of childhood diarrhea. Conclusion: Childhood diarrhea remains a public health concern in Cambodia. The probability of diarrhea occurring is shown to be increased by maternal unemployment, the sex of the child being male, lack of provision of improved toilet facilities, and the unhygienic disposal of children’s stools; whereas increasing maternal age and child’s age were associated with a reduced chance of diarrhea occurring. On the basis of these results, we recommend provision of programs focusing on reducing diarrhea through the construction of improved toilet facilities and the promotion of behavior to improve hygiene, specifically targeting younger mothers.

scholarly journals The association of socio-demographic and environmental factors on childhood diarrhea in Cambodia

F1000Research ◽  
2021 ◽  
Vol 9 ◽  
pp. 303
Author(s):  
Vong Pisey ◽  
Pannee Banchonhattakit ◽  
Wongsa Laohasiriwong
Keyword(s):  
Maternal Age ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Secondary Data ◽  
Cross Sectional Study ◽  
Health Concern ◽  
Childhood Diarrhea ◽  
Public Health Concern ◽  
Cross Sectional ◽  
One Year

Background:Diarrhea is still the leading cause of childhood death worldwide, as well as a major cause for concern in developing countries. This study was conducted to investigate the factors related to childhood diarrhea in Cambodia. Methods:A cross-sectional study of the secondary data from the Cambodia Demographic and Health Survey 2014 was conducted using the combined dataset of household data and children’s data. A generalized linear mixed model was used to analyze the determinant factors of childhood diarrhea. Results:The surveys included 2,828 children, aged 12 to 35 months. The prevalence of diarrhea in the last 2 weeks was 16.44% (95% CI: 14.72%-18.31%). Factors with statistically significant associations with childhood diarrhea in Cambodia were: maternal unemployment, compared with being in employment (AOR = 1.43; 95% CI: 1.14-1.78); the child being male (AOR = 1.25; 95%CI: 1.02-1.53); the presence of unimproved toilet facilities (AOR = 1.17; 95%CI: 1.05-1.31) compared with improved toilet facilities; and unhygienic disposal of children’s stools (AOR = 1.32; 95%CI: 1.06-1.64) compared with hygienic disposal of children’s stools when controlling for other covariates. Both maternal age (one year older; AOR = 0.85; 95%CI: 0.78– 0.93) and child age (one month older; AOR = 0.86; 95%CI: 0.78-0.94) had significant negative associations with the occurrence of childhood diarrhea. Conclusion:Childhood diarrhea remains a public health concern in Cambodia. The probability of diarrhea occurring is shown to be increased by maternal unemployment, the sex of the child being male, lack of provision of improved toilet facilities, and the unhygienic disposal of children’s stools; whereas increasing maternal age and child’s age were associated with a reduced chance of diarrhea occurring. On the basis of these results, we recommend provision of programs focusing on reducing diarrhea through the construction of improved toilet facilities and the promotion of behavior to improve hygiene, specifically targeting younger mothers.

scholarly journals Linking Differences in Eating Behavior with Appetitive Hormones in Women

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 594-594
Author(s):  
Debra Kirsty Tacad ◽  
Christine Bowlus ◽  
Leslie Woodhouse ◽  
Sridevi Krishnan ◽  
Nancy Keim
Keyword(s):  
Mixed Model ◽  
Linear Mixed Model ◽  
Bimodal Distribution ◽  
Cross Sectional Study ◽  
Blood Collection ◽  
Response Curves ◽  
Chi Square ◽  
Cross Sectional ◽  
Glucose Levels ◽  
Time To Peak

Abstract Objectives Examine and compare the hormones related to satiety in women identified as 1) restrained + disinhibited eaters, 2) restrained, non-disinhibited eaters, or 3) unrestrained, non-disinhibited eaters. We hypothesized restrained eaters with disinhibition would have a different pattern of appetitive hormones involved in food intake regulation. Methods 178 women from a cross-sectional study completed the three factor eating questionnaire (TFEQ), and were classified as restrained + disinhibited eaters (RD, n = 38), restrained, non-disinhibited eaters (R, n = 52), or unrestrained, non-disinhibited eaters (LL, n = 88). Women fasted for 12 h prior to baseline blood collection, and postprandial blood was collected after a meal challenge at 30 min, 3 h, and 6 h. Data were evaluated for outliers and missingness, and transformed and imputed using multivariate normal imputation. Differences in glucose, insulin and ghrelin were analyzed using a linear mixed model comparing groups. Time to peak and nadir for glucose, insulin and ghrelin were calculated from response curves. Chi square tests of proportions were used to determine whether the distribution of participants in the three groups were different in their times to peak and nadir. Results There were no significant differences between groups in ghrelin or insulin concentrations over time. However, overall glucose levels in RD were significantly lower than R and LL groups (P = 0.05 and P = 0.03, respectively). Chi-squared tests indicated that a greater proportion of women in the RD group reached peak glucose at 3 h, compared to women in R and LL with peak glucose occurring at 30 min (P = 0.04). Glucose nadir displayed a bimodal distribution in R, with more women at baseline and 3 h compared to RD and LL (P = 0.05). Ghrelin nadir was reached at 3 h for more participants in RD and LL, but occurred later at 6 h in more participants in R (P = 0.04). Conclusions Dietary restraint and disinhibition are associated with circulating glucose and ghrelin concentrations; however, prospective research is needed to determine if there is a causal relationship. Funding Sources USDA CRIS 2032-51530-022, 2032-51530-025, and 2032-51530-026-00-D, and a grant from Arla Foods Inc.

scholarly journals Prevalence and Risk Factors Associated withS. haematobiumEgg Excretion during the Dry Season, Six Months following Mass Distribution of Praziquantel (PZQ) in 2017 in the Bafia Health Area, South West Region Cameroon: A Cross-Sectional Study

2019 ◽  
Vol 2019 ◽  
pp. 1-10
Author(s):  
Vicky Daonyle Ndassi ◽  
Judith Kuoh Anchang-Kimbi ◽  
Irene Ule Ngole Sumbele ◽  
Godlove Bunda Wepnje ◽  
Helen Kuokuo Kimbi
Keyword(s):  
Membrane Filtration ◽  
Infection Intensity ◽  
Cross Sectional Study ◽  
Dry Season ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Health Area ◽  
Contact Behaviour ◽  
The Difference

Background. A selective population mass drug administration of PZQ involving school-aged children was carried out in the Bafia Health Area in April 2017. This study investigated the prevalence, intensity, and factors associated withS. haematobiumegg excretion in this foci during the dry season, six months after the chemotherapy campaign.Methods. A cross-sectional study including 1001 consenting individuals (aged 3-62 years) was carried out in three localities (Ikata, Bafia, and Munyenge) in the Bafia Health Area between November 2017 and January 2018. Information on sociodemographic, stream usage, and contact behaviour was documented.Schistosoma haematobiumova in urine were detected using membrane filtration technique.Results. The prevalence ofS. haematobiumegg excretion was 8% with a higher level recorded in Munyenge (13.2%) than Ikata (7.5%) and Bafia (2.8%). The difference was significant (p < 0.001). Equally, Munyenge had the highest infection intensity (36.36 range: 2-200) when compared with Ikata (16.25 range: 2-57) and Bafia (8.0 range: 0-8). Although the age group (5–15 years) was significantly (p < 0.001) associated with more exposure to infested water, this group was less likely (OR: 0.42 95% CI: 0.19-0.91) associated withS. haematobiumegg excretion. The risk of egg excretion increased by 4.79 times (95% CI: 2.20-10.41) and 3.68 times (95% CI: 1.59-8.54) among residents in Munyenge and Ikata, respectively. Similarly, frequency to the stream (> thrice/day) was significantly higher (χ2= 58.73; p < 0.001) in Munyenge. Frequent contact (three visits/day) with stream correlated with highest odds of egg excretion (OR: 8.43 95% CI: 3.71-19.13).Conclusion. The prevalence ofS. haematobiumegg excretion was low during the dry season. This was most likely attributed to the preventive campaign with PZQ and may parallel low transmission potentials in infested waters during this period.

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