Significant Difference In Usage Research Articles

Significant differences in usage of antibiotics in three Chinese cities measured by wastewater-based epidemiology

Antibiotic use, particularly inappropriate use by irrational prescribing or over-the-counter purchases, is of great concern for China as it facilitates the spread of antibiotic resistances. In this study, we applied wastewater-based epidemiology (WBE) to monitor the total consumption of eight common antibiotics in three cities in northern, eastern and southern China. Wastewater samples were successively collected from 17 wastewater treatment plants including weekdays and weekends spanning four seasons between 2019 and 2021. The concentration of antibiotics and their corresponding metabolites showed a significant correlation, confirming the measured antibiotics were actually consumed. Different seasonal trends in antibiotic use were found among the cities. It was more prevalent in the winter in the northern city Beijing, with the high antibiotic consumption attributed to peak influenza occurrence in the city. This is clear evidence of irrational prescription of antibiotics since it's known that antibiotics do little to treat influenza. In terms of overall consumption, Foshan is significantly lower, thanks to warmer climate and higher use of herbal tea as a prevention measure. WBE estimates of antibiotic consumption were relatively comparable with other data sources, with azithromycin as the top antibiotic measured here. The studied cities had higher WBE estimated antibiotics consumption than results of previous studies in the literature. Monitoring antibiotic use in different areas and periods through WBE in combination with complementary information, can better inform appropriate antibiotic guideline policies in various regions and nations.

A Comparative Study on Visual Attention, Verbal Engagement and Parental Behaviors During Shared Book Reading Using Scripted and Unscripted Story Books for Children with Autism Spectrum Disorder

Purpose: Shared book reading is nowadays considered as an important early language stimulation technique in the field of speech language pathology which encourages parent-child bonding and creates a conducive environment for language development. The parent-child interaction is important for a child with Autism Spectrum Disorder. This interaction along with adequate and contingent parental responses fosters early language development in children. Language-related parent behaviors promote children’s oral language skills by not only exposing the child to book-related vocabulary (e.g., labeling pictures, explaining word meanings, and linking words to everyday events), but also through explicit teaching of meaning-related skills related to the overall structure of the story (i.e., story grammar). Print-related SBR behaviors draw the child’s attention to print-related features of the book, for example, letter names and sounds.Methods: To better understand the relationship between children’s visual attention, verbal engagement and parent shared book reading behaviors during shared book reading tasks, this study included 10 preschoolers on the Autism Spectrum and their parents sharing an unfamiliar storybook including which are scripted and unscripted. Videos of the shared book reading interactions were transcribed and coded for visual attention, verbal engagement and parent behaviors using observational coding schemes. The frequency of visual attention, verbal engagement and parental SBR behaviors were compared between the scripted and unscripted story books using statistical tests-Wilcoxon signed rank test and Fisher’s Exact test.Results: Result reveals that there was no statistically significant difference between frequency of visual attention during unscripted story books and scripted books. Parental behaviors parameters pertaining to shared book reading were analyzed and found a significant difference in usage of book language is greater for scripted story books compared to unscripted books.Conclusions: The key findings shows the type of book (scripted or unscripted) have a significant impact and its contribution to the intervention of children with Autism Spectrum Disorder. Parental SBR behaviors can in turn contribute to the development of childhood language and preliteracy skills.

P032 Prospective Crossover Trial of Positional and Continuous Positive Airway Pressure Therapy (PaCT) for the Treatment of Mild-to-Moderate Positional Obstructive Sleep Apnoea

Abstract Introduction Positional obstructive sleep apnoea (pOSA), defined by a supine-to-non-supine AHI ratio ≥2, is a phenotype present in a significant subset of patients with sleep-disordered breathing. CPAP has been the gold standard for OSA treatment since its first description in clinical use, although various practical and patient factors may preclude its use. Positional therapy (PT) provides an alternative for pOSA – shown to be effective in restricting supine sleep, thereby reducing the frequency of events and improving outcomes. Methods Prospective, single-centre crossover trial of consecutive, treatment-naïve participants with symptomatic, mild-to-moderate pOSA on diagnostic polysomnogram. Eligible participants were randomised to undergo paired treatment CPAP and PT polysomnography to assess efficacy. Participants thereafter received a two-month trial of each, according to randomisation. Adherence, symptom, quality of life (QoL) measures, and patient preference were assessed. Results 53 participants completed treatment and follow-up. Mean age was 55.1±12.7 years. 30 participants were male (56.6%). Median BMI was 30.1kg/m2 (27–34). Median baseline AHI was 14.4 (9.9–20.2). Median baseline Epworth Sleepiness Scale (ESS) was 12 (10–14) and improved after treatment with positional [8 (6–11); p=0.001] and CPAP [8 (6-11); p<0.001] therapies. There was no difference in ESS reduction between treatment groups (p=0.691). There was no significant difference in usage between therapies (p=0.877). QoL measures were also assessed. Discussion In this cohort with symptomatic mild-to-moderate pOSA, treatment with both PT and CPAP resulted in comparable, clinically significant symptomatic improvement with similar usage. Our findings suggest either therapy can be considered effective in appropriately selected patients.

Examining Engagement and Usability in an Online Discussion Platform for Older Adults: Findings From Pilot Studies.

Social media may facilitate older adults' ability to engage socially and explore health information, but it can present difficulties for older adults. Therefore, it is important to explore older adults' experience of usability and user engagement. We conducted two rounds of pilot studies where we used Facebook to engage older adults. We performed a mixed-methods evaluation of user engagement and usability. A directed content analysis of qualitative data from the pilot studies was used to explore engagement and perceived usability, and the Mann-Whitney U test was used to examine differences in feature usage and engagement. We analyzed qualitative data from 13 participants. Qualitative data analysis yielded themes pertaining to three main domains: user engagement, usability, and usability related to aging-related changes. In terms of user engagement and usability, participants in both pilot studies reported positive feedback on felt involvement and endurability, and the second pilot group reported more positive comments regarding perceived usefulness compared with the first pilot group. There was no statistically significant difference in usage over the two studies. The findings of this study suggest opportunities to improve older adults' experience of online discussion platforms. Considering changes that improve perceived aesthetic appeal and focused attention will be helpful.

Older Individuals and Digital Healthcare Platforms: Usage Motivations and the Impact of Age on Postadoption Usage Patterns

Digital healthcare platforms have enabled patients to receive healthcare in ways that were impossible previously—for example, by providing a “safer” way to meet, as underscored by the Covid-19 pandemic. This article investigates whether older and younger primary care users display behavioral differences on digital healthcare platforms. The article adopts a mixed-method approach in which one-way ANOVA analysis on a sample of 152 000 patient journeys was combined with qualitative interview data. The findings highlight significant differences in usage between elderly and younger patients. The elderly spends more time during use—for example, during anamnesis, onboarding, and in queues. We also outline how the key antecedent factors that are most central to platform usage, such as perceived usefulness, perceived ease of use, digital maturity, and trust, play out in the elderly user context. The study contributes to the nascent literature on digital healthcare platforms and the postadoption usage of information and communication technologies by the elderly. The article also outlines research implications in the area of DHPs and mHealth for elderly users, and it discusses the practical implications for both platform owners and healthcare professionals, where platform design and information management are particularly important for elderly users.

Drivers’ usage of driving automation systems in different contexts: A survey in China, Germany, Spain and USA

AbstractThe purpose of the study was to investigate how drivers use assisted and automated driving systems (DAS), more specifically their usage of SAE Level 1 and Level 2 systems, in different situations. An online survey was distributed to 2500 respondents in China, Germany, Spain, and the USA. The final dataset consisted of 549 respondents, all non‐professional drivers, with access to a minimum of a Level 1 system. A subset, 159 in total, had access also to a Level 2 DAS. The survey included questions on the attitude towards, access to, and usage of Level 1 and Level 2 systems in nine different situations respectively. The data was analysed on an individual and a national level. A cluster analysis showed two main groups: frequent and non‐frequent users. On an individual level, the reported usage of Level 1 and Level 2 DAS respectively differed depending on traffic situation, weather and daylight conditions and driver state. Reports by respondents with access to both Level 1 and Level 2 systems did not reveal any statistically significant differences in usage between situations. The Spanish sample was the only one that showed a consistently different usage pattern compared to samples from China, Germany, and the USA.

Fatigue Damage Monitoring for Mining Vehicles using Data Driven Models

The life and condition of a mine truck frame are related to how the machine is used. Damage from stress cycles is accumulated over time, and measurements throughout the life of the machine are needed to monitor the condition. This results in high demands on the durability of sensors, especially in a harsh mining application. To make a monitoring system cheap and robust, sensors already available on the vehicles are preferred rather than additional strain gauges. The main question in this work is whether the existing on-board sensors can give the required information to estimate stress signals and calculate accumulated damage of the frame. Model complexity requirements and sensors selection are also considered. A final question is whether the accumulated damage can be used for prognostics and to increase reliability. The investigation is performed using a large data set from two vehicles operating in real mine applications. Coherence analysis, ARX-models, and rain flow counting are techniques used. The results show that a low number of available on-board sensors like load cells, damper cylinder positions, and angle transducers can give enough information to recreate some of the stress signals measured. The models are also used to show significant differences in usage by different operators, and its effect on the accumulated damage.

Reflection of Demographic Background on Word Usage

AbstractThe availability of personal writings in electronic format provides researchers in the fields of linguistics, psychology, and computational linguistics with an unprecedented chance to study, on a large scale, the relationship between language use and the demographic background of writers, allowing us to better understand people across different demographics. In this article, we analyze the relation between language and demographics by developing cross-demographic word models to identify words with usage bias, or words that are used in significantly different ways by speakers of different demographics. Focusing on three demographic categories, namely, location, gender, and industry, we identify words with significant usage differences in each category and investigate various approaches of encoding a word’s usage, allowing us to identify language aspects that contribute to the differences. Our word models using topic-based features achieve at least 20% improvement in accuracy over the baseline for all demographic categories, even for scenarios with classification into 15 categories, illustrating the usefulness of topic-based features in identifying word usage differences. Further, we note that for location and industry, topics extracted from immediate context are the best predictors of word usages, hinting at the importance of word meaning and its grammatical function for these demographics, while for gender, topics obtained from longer contexts are better predictors for word usage.

Social Media and Academic Performance: A Survey Research of Senior Secondary School Students in Uyo, Nigeria

The study examined the effect of social media (SM) on the academic performance (AP) of senior secondary school (SSS) students in Uyo, Akwa Ibom State, Nigeria. Four objectives served as the study’s guiding principles, and these were followed by research questions and hypotheses. A descriptive survey research design was used for the investigation. Using a simple random sampling technique, 200 students were selected as a sample from four SSSs in Uyo, Akwa Ibom State, Nigeria. A four-point Likert scale survey was used to poll the participants. The study questions were analysed using descriptive statistics such as frequency counts and percentages, whereas the null hypotheses were tested using chi-square, t-test, and Pearson product-moment correlation. Findings revealed that a large percentage of students are addicted to SM, with no significant differences in usage between boys and girls. It was also found that there is a link between SM addiction and a student's AP. In order to prevent students from falling behind academically, it is suggested that SM be used for educational purposes, that social networking sites (SNSs) be launched with new pages developed to effect academic activities, and that teachers and parents monitor students’ use of these sites. This is recommended in an effort to balance students’ SM usage and their academic goals. The study will aid students in learning more about the impact of SM and networking sites on their AP. It will also provide students with useful information for research and studies, as well as objective perspectives and a sense of balance. Significantly, the study will assist parents in becoming more aware of the potential influence and effect of SM on their children.

Comparison of Dietary Supplements Consumption Between Female University and National Team Sports Athletes in Malaysia.

Dietary supplement consumption had already become well known among athletes especially those who were involved in team sports to enhance performances, health benefits, and nutritional strategies. This study aimed to determine the difference in dietary supplement consumption between the female university and national team sports athletes in Malaysia. The Dietary Supplement Questionnaire was used to compare the participants’ dietary supplements usage and it was distributed online via a Google Form. Results from this study showed there was no significant difference in the usage of individual vitamins/minerals. However, based on frequency, the usage of vitamin C was the most popular among these groups. Next, there was a significant difference in the usage of protein powder (t = -2.435, df = 61, p <0.018) and, creatine (t = -2.192, df = 61, p <0.032) between the female university and national athletes. After that, there was a significant difference in usage of other supplements and sports aid which was fish oil/omega 3 (t = -1.466, df = 61, p < 0.032). The national athletes showed higher consumption of dietary supplements compared to the university athletes due to their higher level of competition, energy requirement, and long-time of training.

An Analysis of the Different Payment Systems of Digital Banking

Digital banking is a new concept and it uses different payment systems. The study is conducted to analyze the different payment systems of digital banking. For that purpose, the researchers selected BHIM, NEFT, NCTE, credit cards, and debit cards. The secondary data used for the study is collected from the reports of RBI, journals, and articles. Based on the hypothesis here used a t-test for the analysis and also used tables and charts. The study found that more transactions are carried through NEFT than IMPS. It was also discovered that there is no significant difference in usage of debit cards and credit cards and the usage of BHIM is showing an increasing trend. The study suggested that the applications like BHIM should be developed based on the opinion and convenience of common people, reduce the charge of IMPS and IMPS should provide services both online and offline.

A comparison of continuous positive airway pressure initiation techniques in the treatment of obstructive sleep apnoea/hypopnoea syndrome in adults

Introduction: This project assesses the differences between CPAP usage, a year after initiation, when patients were introduced to therapy via inpatient respiratory studies, outpatient auto-titration studies or a combination of the two. Methods: The retrospective review of 98 CPAP patients’ usage data was collected and statistically analysed using ANOVA tests, Chi-squared and Kruskal Wallace testing. Results: The findings showed a small clinically significant difference but no statistically significant differences in usage across the three groups (p>0.05). Combining initiation techniques improved yearly CPAP usage by up to 365 hours. The difference between RESP and APAP average usage was 90 hours a year. No statistically significant difference in usage between the three groups was seen. The APAP pathway is the most cost-effective and significantly reduces the time taken to get on to CPAP treatment. Demographic variables are not found to predict nightly usage. All patients increased in weight over the year. Conclusion: The results demonstrate higher levels of usage when combining initiation techniques, indicating initiation with high levels of interaction with healthcare professionals is beneficial. Significant weight gain across all groups poses the moral question of whether CPAP should be issued prior to initial weight loss attempts.

Family planning methods and fertility preferences according to HIV status among women in Cameroon.

We investigated whether HIV-positive women differ from HIV-negative women in their fertility, fertility intentions, and use of family planning (FP) among 16,202 women who received services through the Cameroon Baptist Convention Health Services' Women's Health Program from 2015 to 2017. The 13% of women who were HIV-positive had similar rates of modern FP usage and unmet need compared to HIV-negative women (26% versus 29% for modern FP usage, and 20% versus 21% for unmet need). However, HIV-positive women were more likely to be satisfied with their FP method (aOR = 1.70, p < .001). There were no significant differences in usage by HIV status for most FP methods, but HIV-positive women were more likely to use condoms (aOR = 1.85, p < .01) and less likely to use IUDs (aOR = 0.77, p < .05). HIV-positive women had fewer living children and also desired fewer children (both associations significant at p < .001 in multivariate linear regression). These findings highlight low FP usage and high unmet need among all women, and the need for integrated HIV and FP services for HIV-positive women, particularly aimed at increasing use of more reliable FP methods in addition to condoms.

Prevalence of antidepressant use and unmedicated depression in pregnant New Zealand women.

Throughout pregnancy, women are at an increased risk of depression, with prevalence estimates between 6.5% and 18%. Global prevalence of antenatal antidepressant use is considerably lower at 3%. The present study determined the proportion of women taking antidepressants across pregnancy in New Zealand. We investigated whether variation exists across age bands, area-level deprivation and ethnicities, and identified how many women experienced unmedicated depression. Antenatal data (n = 6822) consisted of primarily third-trimester interviews conducted with mothers participating in Growing Up in New Zealand, a longitudinal study investigating child development. Women were asked about their antidepressant intake during pregnancy and assessed on antenatal depression symptoms using the Edinburgh Postnatal Depression Scale. Antidepressant use data were also compared to population-level data from Statistics New Zealand's Integrated Data Infrastructure. Antidepressant prevalence across pregnancy was 3.2%, with a 2.7% prevalence in trimester one and 2.6% following the first trimester. There was no significant difference in usage within age bands and area-level deprivation quintiles. Ethnicity-specific data revealed that Pasifika and Asian ethnicities had the lowest antidepressant use, and New Zealand Europeans the highest. The rate of unmedicated depression, where women met the Edinburgh Postnatal Depression Scale criteria for significant depressive symptoms but did not receive antidepressants during pregnancy, was 11.8%, indicating that antenatal depression treatment may be inadequate. Greater rates of unmedicated depression were seen for younger women (⩽24 years), those living in high deprivation areas and mothers of Pasifika, Asian and Māori ethnicities. Antenatal antidepressant use in New Zealand follows global prevalence estimates and highlights possible undertreatment of antenatal depression in New Zealand. Future research including other treatment types (e.g. behavioural therapy) is needed to evaluate whether undertreatment occurs across all treatment options.

246-OR: Probing the Role of Alternative Splicing of IKZF1 in Risk for Type 1 Diabetes

Genome wide association studies have identified a region at chromosome 7p12.2, containing the IKZF1 gene, that is associated with type 1 diabetes (T1D). IKZF1 encodes Ikaros, a transcription factor and critical regulator of lymphocyte development and homeostasis. The IKZF1 gene includes 9 exons that produce at least 10 distinct transcripts. Exons 3-5 encode 4 zinc finger motifs that mediate DNA binding, while the last exon encodes 2 zinc fingers that allow homo- or heterodimerization. We examined the expression of IKZF1 using RNA-seq data from different lymphocyte populations. Individual coding exons of IKZF1, notably exons 3 and 5, displayed significant differences in usage between CD4+ T cells, CD8+ T cells and CD19+ B cells among T1D cases as well as between cases and controls in memory CD4+ T cells. This suggested that specific transcript isoforms of IKZF1 are differentially expressed in lymphocyte subtypes as well as in T1D. To explore the role of alternative splicing of IKZF1 in T1D, CRISPR/cas9 was used to generate Jurkat T cell lines with truncating mutations in either IKZF1 exon 3, exon 5 or both. Clones were isolated by serial dilution and characterized by PCR amplification and DNA sequencing. Twenty clones with different IKZF1 mutations were identified. Immunoblots revealed shifts in Ikaros protein isoform abundance consistent with the exon targeting in individual clones. Mutation of exons 3 or 5 resulted in the upregulation of 218 genes and the downregulation of 309 genes, as assayed by RNA-seq. Interrogation of ENCODE project data showed that most of these differentially expressed genes have an IKZF1 ChIP-seq peak within 1kb of the gene, consistent with their being targets of Ikaros regulation. These results suggest that the number of zinc finger domains in Ikaros, rather than their sequence or structure, modulates their impact. More broadly, the differential expression of IKZF1 transcripts distinguishes the transcriptomes of specific lymphocyte populations in both T1D cases and controls. Disclosure L. Pastor palomo: Employee; Spouse/Partner; Cox Business. J. R. B. Newman: None. M. A. Atkinson: None. P. J. Concannon: Stock/Shareholder; Self; Amgen Inc. Funding National Institutes of Health (R01DK116954, P01AI042288)

Economic outcomes of depression screening after acute coronary syndromes: The CODIACS-QoL randomized clinical trial

ObjectiveTo evaluate the cost-effectiveness of screening for depression in patients with acute coronary syndrome (ACS) and no history of depression. MethodsCost-effectiveness analysis of a randomized trial enrolling 1500 patients with ACS between 2013 and 2017. Patients were randomized to no screening, screening and notifying the primary care provider (PCP), and screening, notifying the PCP, and providing enhanced depression treatment. Outcomes measured were Healthcare utilization, costs, and incremental cost-effectiveness ratios. Results7.1% of patients screened positive for depressive symptoms. There was no significant difference in usage of mental health services, cardiovascular tests and procedures, and medications. Mean total costs in No Screen group ($7440), in Screen, Notify, and Treat group ($6745), and in Screen and Notify group ($6204). The difference was only significant in the Screen and Notify group versus the No Screen group (−$1236, 95% confidence interval -$2388 to -$96). Because mean QALYs were higher (+0.003 QALY in Screen and Notify; +0.004 QALYs in Screen, Notify, and Treat) and mean total costs were lower in both intervention groups, these interventions were cost-effective. There was substantial uncertainty because confidence intervals around cost differences were wide and QALY effects were small. ConclusionDepression screening strategies for patients with ACS may be modestly cost-effective.

Digital divide in the major regions of the world and the possibility of convergence

PurposeThe purpose of this paper is to investigate the nature of the inequalities in the usage of the internet and inequalities in the growth rate in the usage of the internet, and thus ascertain the possibility of convergence of the digital divide between the major regions of the world.Design/methodology/approachThe design was a longitudinal study of the usage of internet and growth rate in the usage of the internet in the different regions of the world for the period 2009–2019. The quantitative research method was used. Simple percentages and F-test were used in data analysis.FindingsThe usage of internet in Asia and Europe is higher than all the other regions in the world but there is no significant difference in usage between the other regions. The results further showed that some of the digitally disadvantaged regions had higher growth rates in the usage of the internet and these digitally disadvantage states are not disadvantaged in access to smartphones and the emerging 5G technology, thus suggesting the possibility of imminent convergence in access to the internet given the increasing usage of smartphones for the internet subscription.Research limitations/implicationsThe focus on internet usage in the major regions of the world without recourse to the variability of the usage and growth rate of internet usage within the regions. The dearth of the empirical literature on quantitative research on the research problem was another constraint. Finally, restriction in available statistics on digital divide constrained the use of 2009–2019 as the periodic scope of the study.Practical implicationsInclusion of ICT in the school curricula of the component states to acquaint them with information and communication technology (ICT) usage at an early stage, as well as provision of the enabling environment for business to thrive and through a national culture that will encourage businesses to be vibrant, and thus lay a foundation for future convergence.Social implicationsEnhancement in employment opportunities through the increased investment in the ICT facilities and the subsequent reduction in social vices.Originality/valueUse of secondary data through a longitudinal design to categorically indicate the differences between the different regions of the world in terms of internet usage, as well as the empirical determination of the discrepancies between the growth rates in the access to internet and usage of internet by different regions of the world, especially as regard some of the digitally disadvantaged regions having higher growth rates in the usage of the internet than the perceived digitally advantaged regions.

Abstract 15212: Long-term Outcomes Between Genders Are Similar Despite Gender Disparities in High-intensity Statin Use in a Contemporary Cohort of Patients Diagnosed With Nonobstructive Coronary Artery Disease by Invasive Coronary Angiography

Introduction: In current practice, high intensity statins are prescribed for patients diagnosed with CAD. However, studies have shown that women are commonly undertreated with statins. We compared long-term outcomes and medication usage patterns related to gender in a contemporary cohort of patients who underwent invasive coronary angiography (ICA) for index evaluation of suspected CAD for an abnormal stress test, stable or unstable angina, following an NSTEMI, or as part of their evaluation for heart failure. Methods: A cohort of 850 consecutive patients who underwent ICA for suspected CAD was classified as having normal/near-normal coronary arteries (≤20% stenosis, n=264), nonobstructive CAD (21-49% stenosis, n=114), or obstructive CAD (≥50% stenosis, n=472). We prospectively determined outcomes (cardiac death, nonfatal MI, and late revascularization) via Kaplan-Meier analysis in these 3 groups. We also obtained baseline and follow up data on statin use, and compared usage in the 3 groups related to gender by Chi-square analysis. Results: Baseline mean LDL values were 103 in men and 113 in women (p&lt;0.001). At a median follow up of 6.0 years, there was an increase in statin use (51.5% at baseline vs 85.0% at follow up in obstructive CAD group; 54.0% vs 67.3% for nonobstructive CAD group). There were no differences in aspirin, beta-blocker, or overall statin usage by gender across all groups (p&gt;0.05 for all medications). No difference in high intensity statin use (atorvastatin 40/80 mg or rosuvastatin 20/40 mg) was seen between genders in patients with obstructive CAD (61.4% of men vs 62.9% of women, p=0.78). Interestingly, there was a significant difference in usage of high intensity statins between genders in patients with nonobstructive CAD (63.9% of men vs 26.8% of women, p =0.001). Yet, outcomes were similar between genders across all stenosis groups (p&gt;0.05 for all groups). Conclusions: Our study shows that fewer women with nonobstructive CAD are treated with high intensity statins compared to their male cohorts. Despite this disparity in treatment, outcomes remained similar between genders. This discrepancy warrants the need for further study and could represent an area for optimization of medical therapy in female patients with nonobstructive CAD.

The use of the Panda-Nerve Block pain app in single-shot peripheral nerve block patients: a feasibility study.

Peripheral nerve blocks (PNBs) provide excellent perioperative analgesia but can increase the risk of severe postoperative pain once the block wears off. Poor adherence to discharge instructions may increase this risk. Panda-Nerve Block(Panda) is an app that alerts the patient to assess their PNB, score their pain, and take scheduled pain medication. We assessed the usability and feasibility of Panda for assisting patients after receiving a PNB. Twenty-nine patients tested Panda in three rounds, for two to seven days, postoperatively to assess and manage their pain and PNB. Feedback was provided via phone interview and the Computer System Usability Questionnaire (CSUQ). Additionally, each user's usage log was analyzed for parameters such as alert response times. Feasibility was determined by alert responses that occurred before the next alert, with a goal of greater than 50%. User adherence was measured as percentage compliance with alerts within one hour; usability and user satisfaction were determined from the CSUQ and interviews. A median [interquartile range (IQR)] of 68 [34-93]% responded before the next alert during the first 48 hr of app use, and 83 [54-92]% responded before the next alert with 87 [75-96]% of these within one hour. There were no significant differences in usage between rounds. Ninety-three percent of patients reported Panda to be easy to use and helpful, and 79% of patients would use Panda again. Critical themes included changes to the layout and appearance, clarification of the language of the PNB check, and requests for dynamic adjustments to the medication schedule based on user responses. Panda-Nerve Block is a feasible method for PNB patients to manage postoperative pain with a high response rate. Future work should include providing two-way communication for patients and clinicians and assessing its effect on pain outcomes. www.clinicaltrials.gov (NCT03369392); registered 5 December 2017.

Interesting Patterns Found When Academic and Public Library Use by Foreign-born Students Is Assessed Using ‘Super-Diversity’ Variables

A Review of:&#x0D; Albarillo, F. (2018). Super-diversity and foreign-born students in academic libraries: A survey study. portal: Libraries and the Academy, 18(1), 59-91. https://doi.org/10.1353/pla.2018.0004&#x0D; Abstract&#x0D; Objective – To evaluate the relationship between academic and public library usage and various characteristics of foreign-born students.&#x0D; Design – Survey questionnaire.&#x0D; Setting – Medium-sized public liberal arts college in the northeastern United States.&#x0D; Subjects – 123 foreign-born students enrolled at the institution in fall 2014.&#x0D; Methods – The researcher emailed a five-part survey to participants who indicated on a screening survey that they were foreign-born students currently enrolled at the college. Of the participants emailed, 94 completed the survey. The survey used a super-diversity lens to assess academic and public library use by foreign-born students in relationship to multiple variables, including student status, race and ethnicity, immigration status, first-generation student status, gender, age, age of arrival in the United States (US), years living in the US, and ZIP Code (used to approximate median income based on the US Census Bureau’s 2014 American Community Survey). Respondents reported frequency of use on a Likert-type scale of 1=Never to 6=Always. The author adapted items from the In Library Use Survey Instrument (University of Washington Libraries, 2011). Usage types included: computer, Wi-Fi, staff assistance, electronic resources, physical resources, printing/scanning/photocopying, program attendance, and physical space. Independent sample t-tests were used to evaluate mean differences in reported library usage based on demographic variables. The author used Somers’ d statistical tests to explore the relationship between library use and age, age on arrival in the US, years lived in the US, and median income. The survey asked participants to describe both academic and public libraries in five words. To show term frequency, the author used word clouds as a visualization technique.&#x0D; Main Results – The study reported on the results of the library use survey section. Overall, foreign-born students used college libraries more frequently than public libraries. The author reported on findings that were statistically significant (p ≤ 0.5), focusing on those with mean differences ≥ 0.5. Key findings included: undergraduate students used public libraries and Wi-Fi/e-resources onsite at college libraries more often than graduate students; first-generation students gathered at the library with friends more frequently; no significant difference was reported in library resource use by gender; and non-white students used the college library more frequently as a study space and for printing. The author was surprised no significant differences in usage were found between participants with permanent vs. temporary immigration status. Somers’ d associations showed an inverse relationship between age and Wi-Fi use and age of arrival in the United States and likelihood of eating in the library. Overall, both library types were positively described in open-ended responses as places with social and academic value.&#x0D; Conclusion – The author suggested the concept of super-diversity equips librarians with a more inclusive approach to studying library user perspectives and behaviors. The author used survey data and the Association of College and Research Libraries (ACRL) Diversity Standards (2012) to highlight library service considerations for foreign-born students. Examples of suggested service improvements included supporting printing in Unicode non-English fonts, cultivating a diverse library staff, and providing culturally appropriate library orientations and outreach. The author recommended that more research with foreign-born students was needed to assess culturally appropriate areas for eating and socializing, unique information needs, and expectations and awareness of library services. The author suggested first-generation students’ use of the library for socializing and non-white students’ higher use of libraries for studying as two areas for further qualitative study. The author also suggested creating services and partnerships between public and academic libraries could support foreign-born students, even recommending cross-training of library staff.