4 research outputs found
The Testing Database as Pandemic Technology: Reflections on the COVID-19 Response in India
No full textThis article examines the COVID-19 response in India, viewing it as deeply enmeshed in the dynamics of the ‘database’ as an emerging technology of governmentality. Databases aim to translate entire populations into units of information abstracted from social identities and local specificities. In the context of the coronavirus pandemic, bureaucratic state systems attempt to manage and respond to the health crisis via databases collating testing data across the country. Problematising COVID-19 testing databases, we delve into the logic of database governance. We find that as a tool of governance the database falters in its attempts to compress complex identities and locations into de-contextualised units of information. As the complexity of lived reality interrupts the logic of databasing, state discourse on ‘unintended consequences’, ‘leakages’, ‘duplication’, and ‘reconciliation’ processes in the management of databases abounds and the ambivalence of databases becomes manifest in the COVID-19 response. In this article, we use secondary data to understand how testing databases intervene and interact with complex realities to establish bureaucratic order around a pandemic. We posit that COVID-19 testing databases should be understood as being embedded in emerging database governmentalities that supplant care of the population with the maintenance of databases
Wealth elites of Kolkata
No full textIn this paper, focusing on the city of Kolkata, we present a narrative concerning - a. The caste-class-ethnicity intersectionality with respect to wealth ownership; b. The sectoral dimension of wealth creation; and c. the spatial implications of the process of wealth accumulation. We study this with reference to the transition through various regimes of accumulation (pre-colonial, colonial, post-independence Nehruvian regime and post-independence neoliberal regime). We have collected data from multiple sources (including Hurun List, various secondary sources, primary data collection, and interviews). It is found that a relatively larger number of 1000 cr+ Primary Wealth Owners (PWO), as per the Hurun list, are involved in Metals and Mining sector activities, followed by sectors such as Textiles, Apparels & Accessories. PWOs from the Hurun list are diverse in terms of their wealth profile, sectoral involvement and also their social identities (e.g., community). The analysis of family background and educational attainment and affiliation, demonstrates how the location of birth tends to become critical both socially and economically. The ethnic, caste and religious dimensions of the accounting of wealth elites in Kolkata are unavoidable. The wealthy elite minority is overpopulated by the Marwaris. Bengalis are scarcely there. Religion wise this group is mainly Hindu dominated.University of the WitwatersrandSouthern Centre for Inequality Studies (SCIS)CM202
Diagnostic test accuracy of remote, multidomain cognitive assessment (telephone and video call) for dementia
No full textBackground:
Remote cognitive assessments are increasingly needed to assist in the detection of cognitive disorders, but the diagnostic accuracy of telephone‐ and video‐based cognitive screening remains unclear.
Objectives:
To assess the test accuracy of any multidomain cognitive test delivered remotely for the diagnosis of any form of dementia.
To assess for potential differences in cognitive test scoring when using a remote platform, and where a remote screener was compared to the equivalent face‐to‐face test.
Search methods:
We searched ALOIS, the Cochrane Dementia and Cognitive Improvement Group Specialized Register, CENTRAL, MEDLINE, Embase, PsycINFO, CINAHL, Web of Science, LILACS, and ClinicalTrials.gov (www.clinicaltrials.gov/) databases on 2 June 2021. We performed forward and backward searching of included citations.
Selection criteria:
We included cross‐sectional studies, where a remote, multidomain assessment was administered alongside a clinical diagnosis of dementia or equivalent face‐to‐face test.
Data collection and analysis:
Two review authors independently assessed risk of bias and extracted data; a third review author moderated disagreements. Our primary analysis was the accuracy of remote assessments against a clinical diagnosis of dementia. Where data were available, we reported test accuracy as sensitivity and specificity. We did not perform quantitative meta‐analysis as there were too few studies at individual test level.
For those studies comparing remote versus in‐person use of an equivalent screening test, if data allowed, we described correlations, reliability, differences in scores and the proportion classified as having cognitive impairment for each test.
Main results:
The review contains 31 studies (19 differing tests, 3075 participants), of which seven studies (six telephone, one video call, 756 participants) were relevant to our primary objective of describing test accuracy against a clinical diagnosis of dementia. All studies were at unclear or high risk of bias in at least one domain, but were low risk in applicability to the review question. Overall, sensitivity of remote tools varied with values between 26% and 100%, and specificity between 65% and 100%, with no clearly superior test.
Across the 24 papers comparing equivalent remote and in‐person tests (14 telephone, 10 video call), agreement between tests was good, but rarely perfect (correlation coefficient range: 0.48 to 0.98).
Authors' conclusions:
Despite the common and increasing use of remote cognitive assessment, supporting evidence on test accuracy is limited. Available data do not allow us to suggest a preferred test. Remote testing is complex, and this is reflected in the heterogeneity seen in tests used, their application, and their analysis. More research is needed to describe accuracy of contemporary approaches to remote cognitive assessment. While data comparing remote and in‐person use of a test were reassuring, thresholds and scoring rules derived from in‐person testing may not be applicable when the equivalent test is adapted for remote use
