Impact of information presentation on interpretability of spatial hazard information: Lessons from a study in avalanche safety

Abstract. Avalanche warning services publish avalanche condition reports, often called avalanche bulletins, to help backcountry recreationists make informed risk management decisions about when and where to travel in avalanche terrain. To be successful, the information presented in bulletins must be properly understood and applied prior to entering avalanche terrain. However, few avalanche bulletin elements have been empirically tested for their efficacy in communicating hazard information. The objective of this study is to explicitly test the effectiveness of three different graphics representing the aspect and elevation of avalanche problems on users’ ability to apply the information. To address this question, we conducted an online survey that presented participants with one of three graphic renderings of avalanche problem information and asked them to rank a series of route options in order of their exposure to the described hazard. Following completion of route ranking tasks, users were presented with all three graphics and asked to rate how effective they thought the graphics were. Our analysis dataset included responses from 3,056 backcountry recreationists with a variety of backgrounds and avalanche safety training levels. Using a series of generalized linear mixed effects models, our analysis shows that a graphic format that combines the aspect and elevation information for each avalanche problem is the most effective graphic for helping users understand the avalanche hazard conditions because it resulted in higher success in picking the correct exposure ranking, faster completion times, and was rated by users to be the most effective. These results are consistent with existing research on the impact of graphics on cognitive load and can be applied by avalanche warning services to improve the communication of avalanche hazard to readers of their avalanche bulletins.

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Evaluation of efficacy and safety of pegfilgrastim when given less than two weeks from dose-dense chemotherapy regimens

Journal of Oncology Pharmacy Practice ◽

10.1177/1078155220948937 ◽

2020 ◽

pp. 107815522094893

Author(s):

Godsfavour O Umoru ◽

Hanna Zaghloul ◽

Cynthia El-Rahi ◽

Joe E Ensor

Keyword(s):

Fixed Effects ◽

Primary Prophylaxis ◽

Chemotherapy Cycle ◽

Linear Mixed Effects ◽

Chemotherapy Administration ◽

The Mean ◽

Generalized Linear Mixed Effects ◽

Dose Dense ◽

The Impact ◽

Change In Mean

Introduction In clinical practice, waiting 14 days between the administration of pegfilgrastim and subsequent chemotherapy cycle (as recommended by the prescribing information) is sometimes not feasible with multi-cycle dose-dense regimens. This study evaluated the practice related to the use of pegfilgrastim in oncology patients at a multi-hospital health system. Methods Patients who received pegfilgrastim as primary prophylaxis following dose-dense chemotherapy scheduled every 14 days were included. The primary endpoint was the impact of <14 elapsed days between pegfilgrastim administration and next chemotherapy cycle on the change in mean absolute neutrophil counts (ANC). A generalized linear mixed-effects model with fixed effects for pegfilgrastim delivery method, elapsed days between pegfilgrastim and chemotherapy (fixed categorical effect for 12, 13, 14 days), and ANC at subsequent cycle was fitted to the change in ANC between chemotherapy cycles. Results One hundred and sixty four patients with breast cancer who received pegfilgrastim support for dose dense doxorubicin and cyclophosphamide (ddAC) qualified for the model. The mean age was 52 ± 12 years. Eighty-eight percent received pegfilgrastim on-body injector while 13% received pegfilgrastim injection. The mean number of elapsed days between pegfilgrastim and subsequent chemotherapy was 13 ± 0.5 days. The method of pegfilgrastim delivery and elapsed days between pegfilgrastim and chemotherapy administration had no significant effect on the change in ANC (p = 0.8663 and p = 0.8434 respectively); however, patient’s age (p = 0.0125) had a significant effect on the change in ANC. Conclusion The study findings suggest safety and efficacy when chemotherapy is administered 12–14 days from pegfilgrastim.

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Travel and terrain advice statements in public avalanche bulletins: A quantitative analysis of who uses this information, what makes it useful, and how it can be improved for users

10.5194/nhess-2021-324 ◽

2021 ◽

Author(s):

Kathryn C. Fisher ◽

Pascal Haegeli ◽

Patrick Mair

Keyword(s):

Risk Management ◽

Online Survey ◽

The United States ◽

Management Approach ◽

Awareness Training ◽

Mixed Effect ◽

Management Plans ◽

User Groups ◽

Avalanche Warning ◽

Warning Services

Abstract. Recreationists are responsible for developing their own risk management plans for travelling in avalanche terrain. In order to provide guidance for recreationists on mitigating exposure to avalanche hazard, many avalanche warning services include explicit travel and terrain advice (TTA) statements in their daily avalanche bulletins where forecasters offer guidance about what specific terrain to avoid and what to favour under the existing hazard conditions. However, the use and effectiveness of this advice has never been tested to ensure it meets the needs of recreationists developing their risk management approach for backcountry winter travel. We conducted an online survey in Canada and the United States to determine which user groups are paying attention to the TTA in avalanche bulletins, what makes these statements useful, and if modifications to the phrasing of the statements would improve their usefulness for users. Our analysis reveals that the core audience of the TTA is users with introductory level avalanche awareness training who integrate slope-scale terrain considerations into their avalanche safety decisions. Using a series of ordinal mixed effect models, we show that reducing the jargon used in the advice helped users with no or only introductory level avalanche awareness training understand the advice significantly better and providing additional context for the advice made the advice more useful for them. These results provide avalanche warning services with critical perspectives and recommendations for improving their TTA so that they can better support recreationists who are at earlier stages of developing their avalanche risk management approach and therefore need the support the most.

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Do Inpatient Antimicrobial Stewardship Programs help us in the Battle against Antimicrobial Resistance?

Clinical Infectious Diseases ◽

10.1093/cid/ciaa1004 ◽

2020 ◽

Author(s):

Sara Y Tartof ◽

Lie Hong Chen ◽

Yun Tian ◽

Rong Wei ◽

Theresa Im ◽

...

Keyword(s):

Mixed Effects ◽

Unintended Consequences ◽

Mixed Effects Models ◽

Defined Daily Dose ◽

Drug Resistant ◽

Linear Mixed Effects Models ◽

Linear Mixed Effects ◽

Days Of Therapy ◽

Generalized Linear Mixed Effects ◽

The Impact

Abstract Background Antibiotic stewardship programs (ASPs) have demonstrated success at reducing costs, yet there is limited quality evidence of their effectiveness to reduce infections of high-profile drug-resistant organisms. Methods This retrospective cohort study included all Kaiser Permanente Southern California (KPSC) members hospitalized in 9 KPSC hospitals aged ≥18 years from January 1, 2008 to December 31, 2016. We measured the impact of staggered ASP implementation on consumption of 18 ASP-targeted antibiotics using generalized linear mixed effects models. We used multivariable generalized linear mixed effects models to estimate the adjusted effect of ASP on rates of infection with drug-resistant organisms. Analyses were adjusted for confounding by time, cluster effects, and patient-level and hospital-level characteristics. Results We included 765,111 hospitalizations (288,257 pre-ASP, 476,854 post-ASP). By defined daily dose, we found a 6.1% (-7.5% - -4.7%) overall decrease in use of antibiotics post-ASP, and by days of therapy, we detected a 4.3% (-5.4% - -3.1%) decrease in overall use of antibiotics. The number of prescriptions increased post-ASP (1.04 [1.03–1.05]). In adjusted analyses, we detected an overall increase of VRE infection following ASP (1.37 [1.10-1.69]). We did not detect a change in the rates of ESBL, CRE and MDR Pseudomonas aeruginosa following ASP. Conclusions ASPs with successful reductions in consumption of targeted antibiotics may not see changes in infection rates with antibiotic-resistant organisms in the 2 to 6 years post-implementation. There are likely differing timescales for reversion to susceptibility across organisms and antibiotics, and unintended consequences from compensatory prescribing may occur.

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Effects of Quarantine Due to the COVID-19 on Sleep Duration and Quality in Algerians

Acta Facultatis Educationis Physicae Universitatis Comenianae ◽

10.2478/afepuc-2020-0015 ◽

2020 ◽

Vol 60 (2) ◽

pp. 182-193

Author(s):

Kacem Abdelhadi ◽

Houar Abdelatif ◽

Zerf Mohamed ◽

Bengoua Ali

Keyword(s):

Statistical Analysis ◽

Sleep Quality ◽

Sleep Duration ◽

Online Survey ◽

Public Awareness ◽

Italian Version ◽

Sleep Timing ◽

Algerian Population ◽

Significant Change ◽

The Impact

SummaryThis study tests the impact of COVID-19 on sleep of Algerian population before and during the COVID-19 quarantine by an estimated online survey, adapted from the PSQI Italian version. Including 1210 participants (age between 18-60 years old). The statistical analysis was carried out using SPSS version 22.0 software. Our results showed a significant change in sleeping quality during quarantine, the sleep timing markedly changed, we also noticed additional use of sleeping medications. Algerian scientists recommend to build public awareness and to provide necessary information regarding Algerian sleep quality, especially for Algerian adults.

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Psychological Impacts of COVID-19 During the First Nationwide Lockdown in Vietnam: Web-Based, Cross-Sectional Survey Study (Preprint)

10.2196/preprints.24776 ◽

2020 ◽

Author(s):

Khanh Ngoc Cong Duong ◽

Tien Nguyen Le Bao ◽

Phuong Thi Lan Nguyen ◽

Thanh Vo Van ◽

Toi Phung Lam ◽

...

Keyword(s):

Psychological Distress ◽

General Population ◽

Psychological Health ◽

Online Survey ◽

Survey Study ◽

Limited Information ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Event Scale ◽

The Impact

BACKGROUND The first nationwide lockdown due to the COVID-19 pandemic was implemented in Vietnam from April 1 to 15, 2020. Nevertheless, there has been limited information on the impact of COVID-19 on the psychological health of the public. OBJECTIVE This study aimed to estimate the prevalence of psychological issues and identify the factors associated with the psychological impact of COVID-19 during the first nationwide lockdown among the general population in Vietnam. METHODS We employed a cross-sectional study design with convenience sampling. A self-administered, online survey was used to collect data and assess psychological distress, depression, anxiety, and stress of participants from April 10 to 15, 2020. The Impact of Event Scale-Revised (IES-R) and the Depression, Anxiety, and Stress Scale-21 (DASS-21) were utilized to assess psychological distress, depression, anxiety, and stress of participants during social distancing due to COVID-19. Associations across factors were explored using regression analysis. RESULTS A total of 1385 respondents completed the survey. Of this, 35.9% (n=497) experienced psychological distress, as well as depression (n=325, 23.5%), anxiety (n=195, 14.1%), and stress (n=309, 22.3%). Respondents who evaluated their physical health as average had a higher IES-R score (beta coefficient [B]=9.16, 95% CI 6.43 to 11.89), as well as higher depression (B=5.85, 95% CI 4.49 to 7.21), anxiety (B=3.64, 95% CI 2.64 to 4.63), and stress (B=5.19, 95% CI 3.83 to 6.56) scores for DASS-21 than those who rated their health as good or very good. Those who self-reported their health as bad or very bad experienced more severe depression (B=9.57, 95% CI 4.54 to 14.59), anxiety (B=7.24, 95% CI 3.55 to 10.9), and stress (B=10.60, 95% CI 5.56 to 15.65). Unemployment was more likely to be associated with depression (B=3.34, 95% CI 1.68 to 5.01) and stress (B=2.34, 95% CI 0.84 to 3.85). Regarding worries about COVID-19, more than half (n=755, 54.5%) expressed concern for their children aged <18 years, which increased their IES-R score (B=7.81, 95% CI 4.98 to 10.64) and DASS-21 stress score (B=1.75, 95% CI 0.27 to 3.24). The majority of respondents (n=1335, 96.4%) were confident about their doctor’s expertise in terms of COVID-19 diagnosis and treatment, which was positively associated with less distress caused by the outbreak (B=–7.84, 95% CI –14.58 to –1.11). CONCLUSIONS The findings highlight the effect of COVID-19 on mental health during the nationwide lockdown among the general population in Vietnam. The study provides useful evidence for policy decision makers to develop and implement interventions to mitigate these impacts. CLINICALTRIAL

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Are public health measures and individualised care compatible in the face of a pandemic? A national observational study of bereaved relatives’ experiences during the COVID-19 pandemic

Palliative Medicine ◽

10.1177/02692163211019885 ◽

2021 ◽

pp. 026921632110198

Author(s):

Catriona R Mayland ◽

Rosemary Hughes ◽

Steven Lane ◽

Tamsin McGlinchey ◽

Warren Donnellan ◽

...

Keyword(s):

Public Health ◽

Family Support ◽

Online Survey ◽

Free Text ◽

Professional Networks ◽

Dying Patients ◽

The Face ◽

Individualised Care ◽

The Impact ◽

Informative Communication

Background: COVID-19 public health restrictions have affected end-of-life care experiences for dying patients and their families. Aim: To explore bereaved relatives’ experiences of quality of care and family support provided during the last days of life; to identify the impact of factors associated with perceived support. Design: A national, observational, open online survey was developed and disseminated via social media, public fora and professional networks (June–September 2020). Validated instruments and purposively designed questions assessed experiences. Analysis used descriptive statistics, logistic regression and thematic analysis of free-text responses. Participants: Individuals (⩾18 years) who had experienced the death of a relative/friend (all care settings) within the United Kingdome during the COVID-19 pandemic. Results: Respondents ( n = 278, mean 53.4 years) tended to be female ( n = 216, 78%); over half were ‘son/daughter’ (174, 62.6%) to the deceased. Deceased individuals (mean 81.6 years) most frequently died in their ‘usual place of care’ ( n = 192, 69.3%). Analysis established five conceptual themes affecting individualised care: (1) public health restrictions compounding the distress of ‘not knowing’; (2) disparate views about support from doctors and nurses; (3) challenges in communication and level of preparedness for the death; (4) delivery of compassionate care; (5) emotional needs and potential impact on grief. Male respondents (OR 2.9, p = 0.03) and those able to visit (OR 2.2, p = 0.04) were independently associated with good perceptions of family support. Conclusion: Despite public health restrictions, individualised care can be enabled by proactive, informative communication; recognising dying in a timely manner and facilitating the ability to be present before death.

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Impact of COVID-19 on multiple sclerosis care and management: Results from the European Committee for Treatment and Research in Multiple Sclerosis survey

Multiple Sclerosis Journal ◽

10.1177/13524585211005339 ◽

2021 ◽

pp. 135245852110053

Author(s):

Emilio Portaccio ◽

Mattia Fonderico ◽

Bernhard Hemmer ◽

Tobias Derfuss ◽

Bruno Stankoff ◽

...

Keyword(s):

Multiple Sclerosis ◽

Access To Care ◽

Online Survey ◽

Dimethyl Fumarate ◽

Standards Of Care ◽

Treatment Practices ◽

European Committee ◽

Disease Modifying Therapy ◽

Anti Cd20 ◽

The Impact

Background: The spread of Coronavirus disease-19 (COVID-19) poses unique challenges in the management of people with multiple sclerosis (PwMS). Objectives: To collect data about the impact of COVID-19 emergency on access to care for PwMS and on MS treatment practices. Methods: Between March and July 2020, the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) promoted an online survey covering patient access to care, management of relapses and visits, disease-modifying therapy (DMT) and experience with COVID-19. Results: Three-hundred and sixty neurologists from 52 countries (68% from Europe) completed the survey. 98% reported COVID-19-related restrictions. Telemedicine was adopted to overcome the limited access to care and was newly activated (73%) or widely implemented (17%). 70% reported changes in DMT management. Interferons and glatiramer were considered safe. Dimethyl fumarate, teriflunomide and fingolimod were considered safe except for patients developing lymphopenia. No modifications were considered for natalizumab in 64%, cladribine in 24%, anti-CD20 in 22% and alemtuzumab in 17%; 18% (for alemtuzumab and cladribine) and 43% (for anti-CD20) considered postponing treatment. Conclusion: The ECTRIMS survey highlighted the challenges in keeping standards of care in clinical practice. Telemedicine clearly needs to be implemented. Gathering data on DMT safety will remain crucial to inform treatment decisions.

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Experiences and impact of international medical volunteering: a multi-country mixed methods study

BMJ Open ◽

10.1136/bmjopen-2020-041599 ◽

2021 ◽

Vol 11 (3) ◽

pp. e041599 ◽

Cited By ~ 1

Author(s):

Mary McCauley ◽

Joanna Raven ◽

Nynke van den Broek

Keyword(s):

Low Income ◽

Online Survey ◽

Positive Impact ◽

Healthcare Providers ◽

International Medical ◽

Middle Income ◽

Use Of Resources ◽

The Uk ◽

Medical Volunteers ◽

The Impact

ObjectiveTo assess the experience and impact of medical volunteers who facilitated training workshops for healthcare providers in maternal and newborn emergency care in 13 countries.SettingsBangladesh, Ghana, India, Kenya, Malawi, Namibia, Nigeria, Pakistan, Sierra Leone, South Africa, Tanzania, UK and Zimbabwe.ParticipantsMedical volunteers from the UK (n=162) and from low-income and middle-income countries (LMIC) (n=138).Outcome measuresExpectations, experience, views, personal and professional impact of the experience of volunteering on medical volunteers based in the UK and in LMIC.ResultsUK-based medical volunteers (n=38) were interviewed using focus group discussions (n=12) and key informant interviews (n=26). 262 volunteers (UK-based n=124 (47.3%), and LMIC-based n=138 (52.7%)) responded to the online survey (62% response rate), covering 506 volunteering episodes. UK-based medical volunteers were motivated by altruism, and perceived volunteering as a valuable opportunity to develop their skills in leadership, teaching and communication, skills reported to be transferable to their home workplace. Medical volunteers based in the UK and in LMIC (n=244) reported increased confidence (98%, n=239); improved teamwork (95%, n=232); strengthened leadership skills (90%, n=220); and reported that volunteering had a positive impact for the host country (96%, n=234) and healthcare providers trained (99%, n=241); formed sustainable partnerships (97%, n=237); promoted multidisciplinary team working (98%, n=239); and was a good use of resources (98%, n=239). Medical volunteers based in LMIC reported higher satisfaction scores than those from the UK with regards to impact on personal and professional development.ConclusionHealthcare providers from the UK and LMIC are highly motivated to volunteer to increase local healthcare providers’ knowledge and skills in low-resource settings. Further research is necessary to understand the experiences of local partners and communities regarding how the impact of international medical volunteering can be mutually beneficial and sustainable with measurable outcomes.

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The Impact of the COVID-19 Pandemic on the Working Conditions, Employment, Career Development and Well-Being of Refugee Researchers

Societies ◽

10.3390/soc11030071 ◽

2021 ◽

Vol 11 (3) ◽

pp. 71

Author(s):

Ourania Tzoraki ◽

Svetlana Dimitrova ◽

Marin Barzakov ◽

Saad Yaseen ◽

Vasilis Gavalas ◽

...

Keyword(s):

Online Survey ◽

Negative Impact ◽

Well Being ◽

Appropriate Technology ◽

Public Authorities ◽

Policy Makers ◽

Home Setting ◽

The Public ◽

Work From Home ◽

The Impact

The ongoing ‘refugee crisis’ of the past years has led to the migration of refugee researchers (RRs) to European countries. Due to the COVID-19 pandemic, RRs often had to work from home and/or to continue their social, cultural and economic integration process under new conditions. An online survey carried out to explore the impact of the pandemic on the refugee researchers showed that RRs found it difficult to adapt their everyday working life to the ‘home’ setting. The majority have had neither a suitable work environment at home nor the appropriate technology. Although they stated that they are rather pleased with the measures taken by the public authorities, they expressed concern about their vulnerability due to their precarious contracts and the bureaucratic asylum procedures, as the pandemic has had a negative impact on these major issues. The majority of RRs working in academia seem not to have been affected at all as far as their income is concerned, while the majority of those employed in other sectors became unemployed during the pandemic (58%). Recommendations are provided to the public authorities and policy makers to assist RRs to mitigate the consequences of the pandemic on their life.

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Changes in Consumers’ Food Practices during the COVID-19 Lockdown, Implications for Diet Quality and the Food System: A Cross-Continental Comparison

Nutrients ◽

10.3390/nu13010020 ◽

2020 ◽

Vol 13 (1) ◽

pp. 20

Author(s):

Blain Murphy ◽

Tony Benson ◽

Amanda McCloat ◽

Elaine Mooney ◽

Chris Elliott ◽

...

Keyword(s):

Diet Quality ◽

Food Systems ◽

Online Survey ◽

Food System ◽

Vegetable Intake ◽

Saturated Fat ◽

Physical And Mental Health ◽

Cross Sectional ◽

Food Practices ◽

The Impact

COVID-19 has led to dramatic societal changes. Differing movement restrictions across countries have affected changes in consumers’ food practices, with a potentially detrimental impact on their health and food systems. To investigate this, this research explored changes in consumers’ food practices during the initial COVID-19 phase and assessed the impact of location on these changes. A sample of 2360 adults from three continents (Island of Ireland (IOI), Great Britain (GB), United States (USA), and New Zealand (NZ)) were recruited for a cross-sectional online survey (May–June 2020). Participants completed questions in relation to their cooking and food practices, diet quality, and COVID-19 food-related practices. Significant changes in consumers’ food practices during the pandemic were seen within and between regions, with fewer cooking practices changes found in the USA. Food practices, which may put added pressure on the food system, such as bulk buying, were seen across all regions. To prevent this, organisational food practices, including planning ahead, should be emphasized. Additionally, while positive cooking-related practices and increases in fruit and vegetable intake were found, an increase in saturated fat intake was also seen. With the additional pressure on individuals’ physical and mental health, the essentiality of maintaining a balanced diet should be promoted.

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