Representation of dark skin tones in foundational nursing textbooks: An image analysis

PURPOSE

This study aimed to analyze and quantify the representation of dark skin tones (DST) images/graphics across fifteen foundational and clinical nursing textbooks to understand the degree of portrayed diversity in current nursing texts.

BACKGROUND

The United States (U.S.) population is becoming more ethnically and racially diverse. There is a scarcity of nursing literature, studies, and educational materials on the assessment and early recognition of common skin assessment in patients with dark skin tones (DST). The underrepresentation of people with DST images in didactic material suggests that omissions of these images in educational resources may introduce bias in health care provider education and practice.

METHODS

Fifteen popular foundational and clinical nursing textbooks were selected and analyzed. All the photo images and drawn graphics in these textbooks were coded according to Fitzpatrick's skin phototype (FSP) scale, which categorizes skin tone as (a) "Light" or Fitzpatrick scale I or II, (b) "Medium" or Fitzpatrick scale III or IV, and (c) "Dark" or Fitzpatrick scale V or VI. The training was provided for data collectors before analysis to ascertain good inter-rater reliability (Cohen's kappa = 0.960 for light skin tone, Cohen's kappa = 0.899 for medium skin tone, and Cohen's kappa = 0.913 for dark skin tone).

RESULTS

Analysis of 14,192 photo images and drawn graphics depicting skin tone was completed across 15 foundational and clinical nursing textbooks. 12.3 % of photo images and 2.4 % of drawn graphics depicted dark skin tones, compared to 60.9 % of photo images and 82.8 % of drawn graphics that displayed light skin tones in these textbooks.

CONCLUSIONS

Nursing textbooks overrepresent light skin tones and underrepresent dark skin tones. While the approximate racial distribution of the U.S. population is 59.3 % non-Hispanic-White, 13.6 % Black/African American, and 26.6 % Person of Color, the images and graphics of skin tones represented 68 % light, 15 % medium, and 9.4 % dark.

RELEVANCE TO CLINICAL PRACTICE

All healthcare providers are expected and required to deliver competent clinical care to an increasingly diverse population. For teaching-learning, more visual representations of DST and comparative images between what to expect in dark, medium, and light skin tones can help improve knowledge deficits and increase health equity.

Robo-vision! 3D mesh generation of a scene for a robot for planar and non-planar complex objects

This paper presents a novel architecture to generate a world model in terms of mesh from a continuous image stream with depth information extracted from a robot's ego-vision camera. We propose two algorithms for planar and non-planar mesh generation. A Cartesian grid-based mesh fitting algorithm is proposed for mesh generation of planar objects. For mesh generation of non-planar objects, we propose a Self Organization Map based algorithm. The proposed algorithm better approaches the boundary and overall shape of the objects compared to State-Of-the-Art (SOA). Extensive experiments done on three public datasets show that our method surpasses SOA both qualitatively and quantitatively.

Determining the impact of augmented reality graphic spatial location and motion on driver behaviors

While researchers have explored benefits of adding augmented reality graphics to vehicle displays, the impact of graphic characteristics have not been well researched. In this paper, we consider the impact of augmented reality graphic spatial location and motion, as well as turn direction, traffic presence, and gender, on participant driving and glance behavior and preferences. Twenty-two participants navigated through a simulated environment while using four different graphics. We employed a novel glance allocation analysis to differentiate information likely gathered with each glace with more granularity. Fixed graphics generally resulted in less visual attention and more time scanning for hazards than animated graphics. Finally, the screen-fixed graphic was preferred by participants over all world-relative graphics, suggesting that graphic spatially integration into the world may not always be necessary in visually complex urban environments like those considered in this study.

A graph for every analysis: Mapping visuals onto common analyses using flexplot

For decades, statisticians and methodologists have insisted researchers utilize graphical analysis much more heavily. Despite cogent and passionate recommendations, there has been no graphical revolution. Instead, researchers rely heavily on misleading graphics that violate visual processing heuristics. Perhaps the main reason for the persistence of deceptive graphics is software; most software familiar to psychological researchers suffer from poor defaults and limited capabilities. Also, visualization is ancillary to statistical analysis, providing an incentive to not produce graphics at all. In this paper, we argue that every statistical analysis must have an accompanying graphic, and we introduce the point-and-click software Flexplot, available both in JASP and Jamovi. We then present the theoretical framework that guides Flexplot, as well as show how to perform the most common statistical analyses in psychological literature.

A Dental Communication Board as an Oral Care Tool for Children with Autism Spectrum Disorder

Children with autism spectrum disorder (ASD) sometimes display an inability for information sharing through functional verbal communication. This may interfere with professional oral care. These children tend to process visual information more efficiently than auditory information. Picture schedules can briefly suffice as visual cues serving a vital function in helping children with ASD to function in a particular setting such as an oral care environment. A visual communication implement such as a dental communication board was developed in this study to allow for a facilitated communication process between the patient with ASD and the oral care professional. This study entailed two main phases, namely the selection of symbols for the construction of a dental communication board and the small scale testing of the board in a clinical setting. This study incorporated a combination of a quantitative non-experimental descriptive survey combined with a concurrent mixed method survey design which retrieved data for both close-ended and open-ended questions from the same respondent. A quantitative survey questionnaire at a structured dental seminar presentation was employed for the first phase, and a combination of a quantitative and qualitative questionnaire was employed for the second phase of this study. Documented responses were collated and analyzed using frequency and thematic analysis. The most frequently selected symbols were retrieved after a frequency analysis and displayed on a color coded background to distinguish the various categories on the dental communication board. The thematic analysis resulted in the emergence of three main themes, namely the strengths of the board; weakness of the board and suggestions. This study anticipates the incorporation of a dental communication board as a visual mode using graphic symbols to augment expressive and receptive language in an oral care environment to facilitate professional oral care for children with ASD.

The Basics of Ventilator Waveforms

Purpose of Review

Knowledge of ventilator waveforms is important for clinicians working with children requiring mechanical ventilation. This review covers the basics of how to interpret and use data from ventilator waveforms in the pediatric intensive care unit.

Recent Findings

Patient-ventilator asynchrony (PVA) is a common finding in pediatric patients and observed in approximately one-third of ventilator breaths. PVA is associated with worse outcomes including increased length of mechanical ventilation, increased length of stay, and increased mortality. Identification of PVA is possible with a thorough knowledge of ventilator waveforms.

Summary

Ventilator waveforms are graphical descriptions of how a breath is delivered to a patient. These include three scalars (flow versus time, volume versus time, and pressure versus time) and two loops (pressure-volume and flow-volume). Thorough understanding of both scalars and loops, and their characteristic appearances, is essential to being able to evaluate a patient’s respiratory mechanics and interaction with the ventilator.

Advantages of visualisations to evaluate and communicate adverse event information in randomised controlled trials

BACKGROUND

Randomised controlled trials (RCTs) provide valuable information and inform the development of harm profiles of new treatments. Harms are typically assessed through the collection of adverse events (AEs). Despite AEs being routine outcomes collected in trials, analysis and reporting of AEs in journal articles are continually shown to be suboptimal. One key challenge is the large volume of AEs, which can make evaluation and communication problematic. Prominent practice is to report frequency tables of AEs by arm. Visual displays offer an effective solution to assess and communicate complex information; however, they are rarely used and there is a lack of practical guidance on what and how to visually display complex AE data.

METHODS

In this article, we demonstrate the use of two plots identified to be beneficial for wide use in RCTs, since both can display multiple AEs and are suitable to display point estimates for binary, count, or time-to-event AE data: the volcano and dot plots. We compare and contrast the use of data visualisations against traditional frequency table reporting, using published AE information in two placebo-controlled trials, of remdesivir for COVID-19 and GDNF for Parkinson disease. We introduce statistical programmes for implementation in Stata.

RESULTS/CASE STUDY

Visualisations of AEs in the COVID-19 trial communicated a risk profile for remdesivir which differed from the main message in the published authors' conclusion. In the Parkinson's disease trial of GDNF, the visualisation provided immediate communication of harm signals, which had otherwise been contained within lengthy descriptive text and tables. Asymmetry in the volcano plot helped flag extreme events that were less obvious from review of the frequency table and dot plot. The dot plot allowed a more comprehensive representation by means of a more detailed summary.

CONCLUSIONS

Visualisations can better support investigators to assimilate large volumes of data and enable improved informal between-arm comparisons compared to tables. We endorse increased uptake for use in trial publications. Care in construction of visual displays needs to be taken as there can be potential to overemphasise treatment effects in some circumstances.

A new digital approach to SNP encoding for DNA identification

Identification of individuals has become an urgent problem for mankind. In the last three decades, STR-based DNA identification has actively evolved along with traditional biometric methods. Nonetheless, single-nucleotide polymorphisms (SNPs) are now of great interest and a number of relevant SNP panels have been proposed for DNA identification. Here, a simple approach to SNP data digitization that can provide assigning a unique genetic identification number (GIN) to each person is proposed. The key points of this approach are as follows: 1) SNP data are digitized as whole 4-bit boxes in the most convenient binary format, where character "1" (YES) is assigned to revealed nucleotides, and character "0" (NO) to missing nucleotides after SNP-typing; 2) all SNPs should be considered tetra-allelic. Calculations showed that a 72-plex SNP panel is enough to provide the population with unique GINs, which can be represented in digital (binary or hexadecimal) or graphic (linear or two-dimensional) formats. Simple software for SNP data processing and GINs creation in any format was written. It is likely that the national and global GIN databases will facilitate the solution of problems related to identification of individuals or human biological materials. The proposed approach may be extended to other living organisms as well.

Evaluation of graphic messages to promote human papillomavirus vaccination among young adults: A statewide cross-sectional survey

Young adults in the United States 18-26 years of age are eligible for human papillomavirus (HPV) vaccination, yet they rarely attend preventive healthcare visits. In contrast, they have a high prevalence of social media use, which could be leveraged to provide healthcare recommendations. Since graphics attract users, the study's primary objective was to determine the most appealing graphic to promote HPV vaccination to young adults. A cross-sectional survey was conducted at the Minnesota State Fair. Participants 18-26 years of age completed a 36-item survey including information on demographics, HPV vaccination status, eHealth literacy, and assessed the appeal of 8 Instagram graphic mock-ups promoting HPV vaccination to prevent cancer. The graphics represented 4 categories: 1) infographics; 2) disease photos; 3) young adult cancer patient photos; 4) humorous graphics. A total of 1037 eligible young adults participated in the study. Median age was 22 years. A majority were women (63%), white (82%), educated (79% post-secondary education or greater), or privately insured (85%). Although 61% reported receiving at least one dose of HPV vaccine, only 48% reported receiving all three recommended doses. Participants were slightly more drawn to posts with humorous graphics or infographics than disease or patient photos (pairwise p-values <0.0001). There were small but statistically significant differences in response to graphics by gender, race, HPV vaccination status, and eHealth literacy. In conclusion, graphic types tested in this study showed only small differences in response, suggesting that factors other than graphic type need to be explored to improve appeal of HPV vaccine promotional messaging.

Communicating infectious disease prevalence through graphics: Results from an international survey

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The impact of graphics to inform the general public on health knowledge is unknown.

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Heat maps were evaluated as superior to dot maps or picto-trendlines.

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Heat maps are a viable option to widely disseminate information about infectious diseases.

Background

Graphics are increasingly used to represent the spread of infectious diseases (e.g., influenza, Zika, Ebola); however, the impact of using graphics to adequately inform the general population is unknown.

Objective

To examine whether three ways of visually presenting data (heat map, dot map, or picto-trendline)—all depicting the same information regarding the spread of a hypothetical outbreak of influenza—influence intent to vaccinate, risk perception, and knowledge.

Design

Survey with participants randomized to receive a simulated news article accompanied by one of the three graphics that communicated prevalence of influenza and number of influenza-related deaths.

Setting

International online survey.

Participants

16,510 adults living in 11 countries selected using stratified random sampling based on age and gender.

Measurements

After reading the article and viewing the presented graphic, participants completed a survey that measured interest in vaccination, perceived risk of contracting disease, knowledge gained, interest in additional information about the disease, and perception of the graphic.

Results

Heat maps and picto-trendlines were evaluated more positively than dot maps. Heat maps were more effective than picto-trendlines and no different from dot maps at increasing interest in vaccination, perceived risk of contracting disease, and interest in additional information about the disease. Heat maps and picto-trendlines were more successful at conveying knowledge than dot maps. Overall, heat maps were the only graphic to be superior in every outcome.

Limitations

Results are based on a hypothetical scenario.

Conclusion

Heat maps are a viable option to promote interest in and concern about infectious diseases.

[Descriptive statistics]

Descriptive statistics is the branch of statistics that gives recommendations on how to summarize clearly and simply research data in tables, figures, charts, or graphs. Before performing a descriptive analysis it is paramount to summarize its goal or goals, and to identify the measurement scales of the different variables recorded in the study. Tables or charts aim to provide timely information on the results of an investigation. The graphs show trends and can be histograms, pie charts, "box and whiskers" plots, line graphs, or scatter plots. Images serve as examples to reinforce concepts or facts. The choice of a chart, graph, or image must be based on the study objectives. Usually it is not recommended to use more than seven in an article, also depending on its length.

Graphical display of histopathology data from toxicology studies for drug discovery and development: An industry perspective

Histopathology data comprise a critical component of pharmaceutical toxicology studies and are typically presented as finding incidence counts and severity scores per organ, and tabulated on multiple pages which can be challenging for review and aggregation of results. However, the SEND (Standard for Exchange of Nonclinical Data) standard provides a means for collecting and managing histopathology data in a uniform fashion which can allow informatics systems to archive, display and analyze data in novel ways. Various software applications have become available to convert histopathology data into graphical displays for analyses. A subgroup of the FDA-PhUSE Nonclinical Working Group conducted intra-industry surveys regarding the use of graphical displays of histopathology data. Visual cues, use-cases, the value of cross-domain and cross-study visualizations, and limitations were topics for discussion in the context of the surveys. The subgroup came to the following conclusions. Graphical displays appear advantageous as a communication tool to both pathologists and non-pathologists, and provide an efficient means for communicating pathology findings to project teams. Graphics can support hypothesis-generation which could include cross-domain interactive visualizations and/-or aggregating large datasets from multiple studies to observe and/or display patterns and trends. Incorporation of the SEND standard will provide a platform by which visualization tools will be able to aggregate, select and display information from complex and disparate datasets.

3D graphics, virtual reality, and motion-onset visual evoked potentials in neurogaming

A brain-computer interface (BCI) offers movement-free control of a computer application and is achieved by reading and translating the cortical activity of the brain into semantic control signals. Motion-onset visual evoked potentials (mVEP) are neural potentials employed in BCIs and occur when motion-related stimuli are attended visually. mVEP dynamics are correlated with the position and timing of the moving stimuli. To investigate the feasibility of utilizing the mVEP paradigm with video games of various graphical complexities including those of commercial quality, we conducted three studies over four separate sessions comparing the performance of classifying five mVEP responses with variations in graphical complexity and style, in-game distractions, and display parameters surrounding mVEP stimuli. To investigate the feasibility of utilizing contemporary presentation modalities in neurogaming, one of the studies compared mVEP classification performance when stimuli were presented using the oculus rift virtual reality headset. Results from 31 independent subjects were analyzed offline. The results show classification performances ranging up to 90% with variations in conditions in graphical complexity having limited effect on mVEP performance; thus, demonstrating the feasibility of using the mVEP paradigm within BCI-based neurogaming.

Words or graphics to present a Discrete Choice Experiment: Does it matter?

OBJECTIVE

To test whether presenting attribute levels in words or graphics generates different results with respect to attribute level interpretation, relative importance and participation probabilities.

METHODS

Parents of 959 newborns completed a DCE questionnaire that contained two versions of the same nine choice tasks in which the attribute levels were presented in words or graphics. Five attributes related to the decision of parents to vaccinate their newborn against rotavirus were included. Mixed-logit models were conducted to estimate the relative importance of the attribute levels.

RESULTS

Respondents who started with the choice tasks in words produced the most consistent answer patterns. All respondents significantly preferred words to graphics. Part-worth utilities and the relative importance of the attribute levels differed based on the words and graphics data, resulting in different probabilities to participate in vaccination.

CONCLUSIONS

Words were preferred over graphics, resulted in higher choice consistency, and showed more valid attribute level estimates. Graphics did not improve respondents' understanding of the attribute levels.

PRACTICE IMPLICATIONS

Future research on the use of either words or graphics is recommended in order to establish guidelines on how to develop a valid presentation method for attribute levels in the choice tasks of a DCE.

Real-time pulmonary graphics

Real-time pulmonary graphics now enable clinicians to view lung mechanics and patient-ventilator interactions on a breath-to-breath basis. Displays of pressure, volume, and flow waveforms, pressure-volume and flow-volume loops, and trend screens enable clinicians to customize ventilator settings based on the underlying pathophysiology and responses of the individual patient. This article reviews the basic concepts of pulmonary graphics and demonstrates how they contribute to our understanding of respiratory physiology and the management of neonatal respiratory failure.

Luscus: molecular viewer and editor for MOLCAS

The novel program for graphical display and editing of molecular systems, luscus, is described. The program allows fast and easy building and/or editing different molecular structures, up to several thousands of atoms large. Luscus is able to visualise dipole moments, normal modes, molecular orbitals, electron densities and electrostatic potentials. In addition, simple geometrical objects can be rendered in order to reveal a geometrical feature or a physical quantity. The program is developed as a graphical interface for the MOLCAS program package, however its adaptive nature makes possible to use luscus with other computational program packages and chemical formats. All data files are opened via simple plug-ins which makes easy to implement a new file format in luscus. The easiness of editing molecular geometries makes luscus suitable for teaching students chemical concepts and molecular modelling. Graphical AbstractScreenshot of luscus program showing molecular orbital.

Super educators

When Cathy Young wants to explain attention deficit hyperactivity disorder (ADHD) to the children she works with, she gives them a Medikidz guide called What's up with Astra? ' Five comic book heroes are on hand to explain health and medical conditions to young adolescents and their parents.