15,605 research outputs found
Accuracy of assessment of eligibility for early medical abortion by community health workers in Ethiopia, India and South Africa
No full textTo assess the accuracy of assessment of eligibility for early medical abortion by community health workers using a simple checklist toolkit.; Diagnostic accuracy study.; Ethiopia, India and South Africa.; Two hundred seventeen women in Ethiopia, 258 in India and 236 in South Africa were enrolled into the study. A checklist toolkit to determine eligibility for early medical abortion was validated by comparing results of clinician and community health worker assessment of eligibility using the checklist toolkit with the reference standard exam.; Accuracy was over 90% and the negative likelihood ratio <0.1 at all three sites when used by clinician assessors. Positive likelihood ratios were 4.3 in Ethiopia, 5.8 in India and 6.3 in South Africa. When used by community health workers the overall accuracy of the toolkit was 92% in Ethiopia, 80% in India and 77% in South Africa negative likelihood ratios were 0.08 in Ethiopia, 0.25 in India and 0.22 in South Africa and positive likelihood ratios were 5.9 in Ethiopia and 2.0 in India and South Africa.; The checklist toolkit, as used by clinicians, was excellent at ruling out participants who were not eligible, and moderately effective at ruling in participants who were eligible for medical abortion. Results were promising when used by community health workers particularly in Ethiopia where they had more prior experience with use of diagnostic aids and longer professional training. The checklist toolkit assessments resulted in some participants being wrongly assessed as eligible for medical abortion which is an area of concern. Further research is needed to streamline the components of the tool, explore optimal duration and content of training for community health workers, and test feasibility and acceptability
Public law 96-317
No full textFlyer imploring recipients to write congressmen and embark on a letter writing campaign against reparations and redress.The Japanese American Relocation Collection is composed of ephemera related to the relocation program during World War II. Items include the official government report of Manzanar Relocation Center, a photo album, post-war activism materials related to preserving and remembering the camps, various clippings, and documents. The strength of this collection is found in its many perspectives on the controversial relocation program and how it has been presented since World War II
Evaluation of tuberculosis diagnostics: establishing an evidence base around the public health impact.
No full textThe limitations of existing tuberculosis diagnostic tools are significantly hampering tuberculosis control efforts, most noticeably in areas with high prevalence of human immunodeficiency virus (HIV) infection and antituberculosis drug resistance. However, renewed global interest in tuberculosis research has begun to bear fruit, with several new diagnostic technologies progressing through the development pipeline. There are significant challenges in building a sound evidence base to inform public health policies because most diagnostic research focuses on the accuracy of individual tests, with often significant limitations in the design, conduct, and reporting of diagnostic accuracy studies. Diagnostic accuracy studies may not be appropriate to guide public health policies, and clinical trials may increasingly be required to determine the incremental value and cost-effectiveness of new tools. The urgent need for new diagnostics should not distract from pursuing rigorous scientific evaluation focused on public health impact
Comparison of co-located laser and metal oxide continuous monitoring systems
No full textAccurate measurement of methane (CH4) concentrations on oil and gas sites is essential for accurate estimates of methane emission rates via inversion algorithms. Different types of continuous monitoring sensors are offered as commercial solutions, with varying accuracy. In this paper we compare data from co-located Metal Oxide (MOx) and Laser Spectroscopy (LS) sensors on a midstream oil and gas site, with the goal of quantifying the differences in raw concentration measurements between the two technologies. We first analyze the impact of meteorological variables on the difference between MOx and LS concentrations measurements taken at the same time and location, finding that temperatures from 30 to 70 degrees Fahrenheit and higher humidity contribute to larger concentration differences on average. Further, analysis of enhanced methane concentrations (likely from emissions on the site) recorded by both sets of sensors reveals that the LS sensors consistently record larger methane concentrations during these periods. This difference means that when using concentration measurements from both sensor technologies in inversion algorithms to estimate emission rates, using MOx sensor data would likely lead to underestimating emission rates, although we did not test this explicitly in this report
Assessing performance of Bayesian state-space models fit to Argos Satellite telemetry locations processed with Kalman Filtering
No full textArgos recently implemented a new algorithm to calculate locations of satellite-tracked animals that uses a Kalman filter (KF). The KF algorithm is reported to increase the number and accuracy of estimated positions over the traditional Least Squares (LS) algorithm, with potential advantages to the application of state-space methods to model animal movement data. We tested the performance of two Bayesian state-space models (SSMs) fitted to satellite tracking data processed with KF algorithm. Tracks from 7 harbour seals (Phoca vitulina) tagged with ARGOS satellite transmitters equipped with Fastloc GPS loggers were used to calculate the error of locations estimated from SSMs fitted to KF and LS data, by comparing those to “true” GPS locations. Data on 6 fin whales (Balaenoptera physalus) were used to investigate consistency in movement parameters, location and behavioural states estimated by switching state-space models (SSSM) fitted to data derived from KF and LS methods. The model fit to KF locations improved the accuracy of seal trips by 27% over the LS model. 82% of locations predicted from the KF model and 73% of locations from the LS model were <5 km from the corresponding interpolated GPS position. Uncertainty in KF model estimates (5.6±5.6 km) was nearly half that of LS estimates (11.6±8.4 km). Accuracy of KF and LS modelled locations was sensitive to precision but not to observation frequency or temporal resolution of raw Argos data. On average, 88% of whale locations estimated by KF models fell within the 95% probability ellipse of paired locations from LS models. Precision of KF locations for whales was generally higher. Whales’ behavioural mode inferred by KF models matched the classification from LS models in 94% of the cases. State-space models fit to KF data can improve spatial accuracy of location estimates over LS models and produce equally reliable behavioural estimates.Peer reviewe
The accuracy of human population maps for public health application
No full textObjectivesHuman population totals are used for generating burden of disease estimates at global, continental and national scales to help guide priority setting in international health financing. These exercises should be aware of the accuracy of the demographic information used.MethodsThe analysis presented in this paper tests the accuracy of five large-area, public-domain human population distribution data maps against high spatial resolution population census data enumerated in Kenya in 1999. We illustrate the epidemiological significance, by assessing the impact of using these different human population surfaces in determining populations at risk of various levels of climate suitability for malaria transmission. We also describe how areal weighting, pycnophylactic interpolation and accessibility potential interpolation techniques can be used to generate novel human population distribution surfaces from local census information and evaluate to what accuracy this can be achieved.ResultsWe demonstrate which human population distribution surface performed best and which population interpolation techniques generated the most accurate bespoke distributions. Despite various levels of modelling complexity, the accuracy achieved by the different surfaces was primarily determined by the spatial resolution of the input population data. The simplest technique of areal weighting performed best. Conclusions Differences in estimates of populations at risk of malaria in Kenya of over 1 million persons can be generated by the choice of surface, highlighting the importance of these considerations in deriving per capita health metrics in public health. Despite focussing on Kenya the results of these analyses have general application and are discussed in this wider context
Yugoslav Public Opinion 1998
No full textElectoral behaviour, questions on the political system and attitudes towards political parties and media.
Topics: Availability in the household concerning radio, television, video recorder, phone, computer, automobile, access to E-mail; radio stations and TV stations listen to/watched in the past month and time of listening/watching; radio programs and TV programs listen to/watching; daily newspapers and magazines read in the past month and frequency/contents of reading; sources of information on politics; most trustworthy source of information; political, psychological and moral censorship; state control; objectivity of state and private media; media and majority´s opinion; distrust in party media; journalists and bribery; accuracy of rumours; national vs. local media; political differences between state and local media; broadcasting foreign programs on domestic stations; objectivity of media which receive foreign/state help; public media and openness towards parties; interest in politics; discussions about politics; most useful source for political decisions and for voting; feelings in 12 months; direction of development in Yugoslavia, Serbia, Montenegro; solution for Kosovo and Metohija; civilian casualties in the Kosovo; close person fighting in Kosovo; international community in Kosovo and Metohija; opinion about other nationalities; territorial and social belonging; voting in the Federal Elections (Sunday question); satisfaction with the election of S. Milosevic, M. Milutinovic, M. Djukanovic, M. Bulatovic and elections in Montenegro; expectations from social revolt; contribution to positive changes; selling public companies to strangers; trust in institutions; most trusted institution and politician; relations of Serbian and Montenegrin authorities; most appreciated foreign politician; survival of B&H as an independent state; conditions for lifting sanctions; delivery of indicted to The Hague Tribunal; role of opposition; best leader of the united opposition; cooperation of SPS, YUL, and SRP; cooperation of Serbian opposition and Montenegrin Coalition; results of protests in 1996/1997; voting in local elections in Serbia and Montenegro (Sunday question); future of the country in a year; most important problem; most competent party in Serbia/Montenegro.
Demography: Gender, age; education; occupation; employment status; running a private business; going abroad (respondent, family members); household income; financial situation; nationality; religiousness.Wahlverhalten, Fragen zum politischen System, Einstellungen zu politischen Parteien und Medienfragen.
Themen: Radio, Fernseher, Videorekorder, Telefon, Computer, Auto im Haushalt verfügbar, E-mailzugang; rezipierte Radio- und Fernsehprogramme, Tageszeitungen und Magazine; Informationsquellen für politische Themen; vertrauenswürdigste Informationsquelle; politische, psychologische und moralische Zensur; Kontrolle durch den Staat; Objektivität der staatlichen und privaten Medien; Misstrauen in Medien der Parteien; Journalisten und Korruption; Gerüchte; nationale vs. lokale Medien; Übertragung ausländischer Programme auf einheimischen Kanälen; Objektivität der Medien mit ausländischer und staatlicher Unterstützung; öffentliche Medien und Aufgeschlossensein gegenüber Parteien; Diskussionen über Politik; nützlichste Quelle für politische Diskussionen und Wahlentscheidung; Gefühle der letzten 12 Monate; Entwicklungsrichtung Jugoslawiens, Serbien und Montenegros; Lösung für den Kosovo und Metohija; nahestehende Person, die im Kosovo kämpft; Stellung der internationalen Gemeinschaft im Kosovo; Haltung zu anderen Nationalitäten; territoriale und soziale Zugehörigkeit; Sonntagsfrage; Zufriedenheit mit Wahl von S. Milosevic, M. Milutinovic, M. Djukanovic, und M. Bulatovic; Wahlen in Montenegro; Verkauf öffentlicher Firmen an Ausländer; Vertrauen in Institutionen; vertrauenswürdigster Politiker; Beziehung von serbischen und montenegrinischen Behörden; Bosnien-Herzegowina als unabhängiger Staat; Bedingungen für die Lockerung der Sanktionen; Übergaben der Verurteilten an das Hager Tribunal; Rolle der Opposition; bester Führer der vereinten Opposition; Kooperation von SPS, YUL, und SRP; Kooperation der serbischen Opposition und der montenegrinischen Koalition; Resultate der Proteste von 1996/1997; Sonntagsfrage; Zukunft des Landes in einem Jahr; größtes Problem des Landes; kompetenteste Partei.
Demographie: Geschlecht; Alter; Bildung; Beruf; Beschäftigungsstatus; Absichten, sich selbständig zu machen; Abwanderung ins Ausland (Befragte, Familienmitglieder); Haushaltseinkommen; finanzielle Situation; Nationalität; Religiosität
Rapid, point-of-care antigen and molecular-based tests for diagnosis of SARS-CoV-2 infection
No full textBACKGROUND: Accurate rapid diagnostic tests for SARS-CoV-2 infection could contribute to clinical and public health strategies to manage the COVID-19 pandemic. Point-of-care antigen and molecular tests to detect current infection could increase access to testing and early confirmation of cases, and expediate clinical and public health management decisions that may reduce transmission. OBJECTIVES: To assess the diagnostic accuracy of point-of-care antigen and molecular-based tests for diagnosis of SARS-CoV-2 infection. We consider accuracy separately in symptomatic and asymptomatic population groups. SEARCH METHODS: Electronic searches of the Cochrane COVID-19 Study Register and the COVID-19 Living Evidence Database from the University of Bern (which includes daily updates from PubMed and Embase and preprints from medRxiv and bioRxiv) were undertaken on 30 Sept 2020. We checked repositories of COVID-19 publications and included independent evaluations from national reference laboratories, the Foundation for Innovative New Diagnostics and the Diagnostics Global Health website to 16 Nov 2020. We did not apply language restrictions. SELECTION CRITERIA: We included studies of people with either suspected SARS-CoV-2 infection, known SARS-CoV-2 infection or known absence of infection, or those who were being screened for infection. We included test accuracy studies of any design that evaluated commercially produced, rapid antigen or molecular tests suitable for a point-of-care setting (minimal equipment, sample preparation, and biosafety requirements, with results within two hours of sample collection). We included all reference standards that define the presence or absence of SARS-CoV-2 (including reverse transcription polymerase chain reaction (RT-PCR) tests and established diagnostic criteria). DATA COLLECTION AND ANALYSIS: Studies were screened independently in duplicate with disagreements resolved by discussion with a third author. Study characteristics were extracted by one author and checked by a second; extraction of study results and assessments of risk of bias and applicability (made using the QUADAS-2 tool) were undertaken independently in duplicate. We present sensitivity and specificity with 95% confidence intervals (CIs) for each test and pooled data using the bivariate model separately for antigen and molecular-based tests. We tabulated results by test manufacturer and compliance with manufacturer instructions for use and according to symptom status. MAIN RESULTS: Seventy-eight study cohorts were included (described in 64 study reports, including 20 pre-prints), reporting results for 24,087 samples (7,415 with confirmed SARS-CoV-2). Studies were mainly from Europe (n = 39) or North America (n = 20), and evaluated 16 antigen and five molecular assays. We considered risk of bias to be high in 29 (50%) studies because of participant selection; in 66 (85%) because of weaknesses in the reference standard for absence of infection; and in 29 (45%) for participant flow and timing. Studies of antigen tests were of a higher methodological quality compared to studies of molecular tests, particularly regarding the risk of bias for participant selection and the index test. Characteristics of participants in 35 (45%) studies differed from those in whom the test was intended to be used and the delivery of the index test in 39 (50%) studies differed from the way in which the test was intended to be used. Nearly all studies (97%) defined the presence or absence of SARS-CoV-2 based on a single RT-PCR result, and none included participants meeting case definitions for probable COVID-19. Antigen tests Forty-eight studies reported 58 evaluations of antigen tests. Estimates of sensitivity varied considerably between studies. There were differences between symptomatic (72.0%, 95% CI 63.7% to 79.0%; 37 evaluations; 15530 samples, 4410 cases) and asymptomatic participants (58.1%, 95% CI 40.2% to 74.1%; 12 evaluations; 1581 samples, 295 cases). Average sensitivity was higher in the first week after symptom onset (78.3%, 95% CI 71.1% to 84.1%; 26 evaluations; 5769 samples, 2320 cases) than in the second week of symptoms (51.0%, 95% CI 40.8% to 61.0%; 22 evaluations; 935 samples, 692 cases). Sensitivity was high in those with cycle threshold (Ct) values on PCR ≤25 (94.5%, 95% CI 91.0% to 96.7%; 36 evaluations; 2613 cases) compared to those with Ct values >25 (40.7%, 95% CI 31.8% to 50.3%; 36 evaluations; 2632 cases). Sensitivity varied between brands. Using data from instructions for use (IFU) compliant evaluations in symptomatic participants, summary sensitivities ranged from 34.1% (95% CI 29.7% to 38.8%; Coris Bioconcept) to 88.1% (95% CI 84.2% to 91.1%; SD Biosensor STANDARD Q). Average specificities were high in symptomatic and asymptomatic participants, and for most brands (overall summary specificity 99.6%, 95% CI 99.0% to 99.8%). At 5% prevalence using data for the most sensitive assays in symptomatic people (SD Biosensor STANDARD Q and Abbott Panbio), positive predictive values (PPVs) of 84% to 90% mean that between 1 in 10 and 1 in 6 positive results will be a false positive, and between 1 in 4 and 1 in 8 cases will be missed. At 0.5% prevalence applying the same tests in asymptomatic people would result in PPVs of 11% to 28% meaning that between 7 in 10 and 9 in 10 positive results will be false positives, and between 1 in 2 and 1 in 3 cases will be missed. No studies assessed the accuracy of repeated lateral flow testing or self-testing. Rapid molecular assays Thirty studies reported 33 evaluations of five different rapid molecular tests. Sensitivities varied according to test brand. Most of the data relate to the ID NOW and Xpert Xpress assays. Using data from evaluations following the manufacturer's instructions for use, the average sensitivity of ID NOW was 73.0% (95% CI 66.8% to 78.4%) and average specificity 99.7% (95% CI 98.7% to 99.9%; 4 evaluations; 812 samples, 222 cases). For Xpert Xpress, the average sensitivity was 100% (95% CI 88.1% to 100%) and average specificity 97.2% (95% CI 89.4% to 99.3%; 2 evaluations; 100 samples, 29 cases). Insufficient data were available to investigate the effect of symptom status or time after symptom onset. AUTHORS' CONCLUSIONS: Antigen tests vary in sensitivity. In people with signs and symptoms of COVID-19, sensitivities are highest in the first week of illness when viral loads are higher. The assays shown to meet appropriate criteria, such as WHO's priority target product profiles for COVID-19 diagnostics ('acceptable' sensitivity ≥ 80% and specificity ≥ 97%), can be considered as a replacement for laboratory-based RT-PCR when immediate decisions about patient care must be made, or where RT-PCR cannot be delivered in a timely manner. Positive predictive values suggest that confirmatory testing of those with positive results may be considered in low prevalence settings. Due to the variable sensitivity of antigen tests, people who test negative may still be infected. Evidence for testing in asymptomatic cohorts was limited. Test accuracy studies cannot adequately assess the ability of antigen tests to differentiate those who are infectious and require isolation from those who pose no risk, as there is no reference standard for infectiousness. A small number of molecular tests showed high accuracy and may be suitable alternatives to RT-PCR. However, further evaluations of the tests in settings as they are intended to be used are required to fully establish performance in practice. Several important studies in asymptomatic individuals have been reported since the close of our search and will be incorporated at the next update of this review. Comparative studies of antigen tests in their intended use settings and according to test operator (including self-testing) are required.sponsorship: Department for International Development, UKr Project number: 300342-104r National Institute for Health Research (NIHR), UKr NIHR Birmingham Biomedical Research Centre at the University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, UK (Department for International Development, UK|300342-104, National Institute for Health Research (NIHR), UK, NIHR Birmingham Biomedical Research Centre at the University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, UK, National Institute for Health Research|CDF-2016-09-018, National Institute for Health Research|PDF-2017-10-059)status: Publishe
Measuring Coverage in MNCH:A Validation Study Linking Population Survey Derived Coverage to Maternal, Newborn, and Child Health Care Records in Rural China
No full textBackground: Accurate data on coverage of key maternal, newborn, and child health (MNCH) interventions are crucial for monitoring progress toward the Millennium Development Goals 4 and 5. Coverage estimates are primarily obtained from routine population surveys through self-reporting, the validity of which is not well understood. We aimed to examine the validity of the coverage of selected MNCH interventions in Gongcheng County, China. Method and Findings: We conducted a validation study by comparing women's self-reported coverage of MNCH interventions relating to antenatal and postnatal care, mode of delivery, and child vaccinations in a community survey with their paper- and electronic-based health care records, treating the health care records as the reference standard. Of 936 women recruited, 914 (97.6%) completed the survey. Results show that self-reported coverage of these interventions had moderate to high sensitivity (0.57 [95% confidence interval (CI): 0.50-0.63] to 0.99 [95% CI: 0.98-1.00]) and low to high specificity (0 to 0.83 [95% CI: 0.80-0.86]). Despite varying overall validity, with the area under the receiver operating characteristic curve (AUC) ranging between 0.49 [95% CI: 0.39-0.57] and 0.90 [95% CI: 0.88-0.92], bias in the coverage estimates at the population level was small to moderate, with the test to actual positive (TAP) ratio ranging between 0.8 and 1.5 for 24 of the 28 indicators examined. Our ability to accurately estimate validity was affected by several caveats associated with the reference standard. Caution should be exercised when generalizing the results to other settings. Conclusions: The overall validity of self-reported coverage was moderate across selected MNCH indicators. However, at the population level, self-reported coverage appears to have small to moderate degree of bias. Accuracy of the coverage was particularly high for indicators with high recorded coverage or low recorded coverage but high specificity. The study provides insights into the accuracy of self-reports based on a population survey in low- and middle-income countries. Similar studies applying an improved reference standard are warranted in the future.</p
Public confidence in the New South Wales criminal justice system: 2012 update
No full textThis report assesses whether confidence in the New South Wales criminal justice system has changed since 2007, whether changes in knowledge and/or punitiveness underpin any changes in confidence, and whether confidence in police differs from confidence in the courts.
Method: Repeat cross-sectional survey of the NSW public (n=2,002 in 2007; n=2,001 in 2012). The survey measured confidence, levels of knowledge and public demand for harsher sentencing in both years. Logistic regression models estimated changes in confidence after accounting for changes in sample composition. In 2012, participants were also asked about confidence in the police and courts separately.
Results: Participants had high levels of confidence that the CJS respects the rights of the accused and treats them fairly but lower levels of confidence that the CJS brings people to justice, deals with cases promptly or meets the needs of victims. With the exception of confidence in respecting the rights of the accused, confidence was significantly higher in 2012 than in 2007. The 2012 respondents were also more knowledgeable about crime and justice and less punitive than the 2007 respondents. Respondents tended to have higher levels of confidence in the police than the courts.
Conclusion: Levels of confidence in the CJS have improved since 2007. Factors such as increased knowledge and decreases in punitiveness may have contributed to these increases. However the changes in all three measures could reflect other factors such as the effect of the media and public policy. While confidence in police is generally high, the public lack confidence in the expediency of the courts and in outcomes for victims
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