scholarly journals Identification and Estimation of Undetected COVID-19 Cases Using Testing Data from Iceland

2020 ◽  
Author(s):  
Karl M. Aspelund ◽  
Michael Droste ◽  
James H. Stock ◽  
Christopher D. Walker
Keyword(s):  
Partial Identification ◽  
Risk Of Infection ◽  
Main Approach ◽  
Eligibility Criteria ◽  
Screening Programs ◽  
Public Data ◽  
Testing Data ◽  
Identification Techniques ◽  
International Testing ◽  
Random Screening

AbstractIn the early stages of the COVID-19 pandemic, international testing efforts tended to target individuals whose symptoms and/or jobs placed them at a high presumed risk of infection. Testing regimes of this sort potentially result in a high proportion of cases going undetected. Quantifying this parameter, which we refer to as the undetected rate, is an important contribution to the analysis of the spread of the SARS-CoV-2 virus. We show that partial identification techniques can credibly deal with the data problems that common COVID-19 testing programs induce (i.e. excluding quarantined individuals from testing and low participation in random screening programs). We use public data from two Icelandic testing regimes during the first month of the outbreak and estimate an identified interval for the undetected rate. Our main approach estimates that the undetected rate was between 89% and 93% before the medical system broadened its eligibility criteria and between 80% and 90% after.

Psychological Aspects of Cancer Screening

2019 ◽  
Author(s):  
Christian von Wagner ◽  
Wouter Verstraete ◽  
Sandro Stoffel
Keyword(s):  
Cancer Screening ◽  
Behavioral Science ◽  
Informed Choice ◽  
Universal Coverage ◽  
Target Population ◽  
Sociodemographic Factors ◽  
Opportunity Costs ◽  
Eligibility Criteria ◽  
Screening Programs ◽  
Patient Reported

Cancer screening aims to detect cancer before the appearance of symptoms. Applying a proactive and systematic approach, cancer screening programs invite every person in the target population automatically. Many countries have established guidelines that define criteria and principles on whether to implement screening programs for specific conditions. Despite the universal coverage of these programs, inequalities have been observed in their uptake based on various sociodemographic factors: gender, age, ethnicity, socioeconomic status (SES), educational level, and marital status. Behavioral science provides key performance indicators of these programs. Psychological factors such as perceived benefits (e.g., ability of the program to diagnose early or even prevent cancer) and barriers (e.g., opportunity costs relating to test attendance or completion), as well as people’s cancer and screening-related beliefs and perceptions of their own susceptibility to cancer, play a crucial role in cancer screening uptake. Furthermore, there is increasing awareness among professional bodies for the need to balance the public health benefits against individual costs, including financial and opportunity costs associated with participation and potential longer-term harms, such as receiving a cancer diagnosis that would never have caused any symptoms or problems). These recent developments have led to stronger emphasis on monitoring patient-reported experiences and ensuring that participation is based on informed choice. In addition, some of these issues have also been addressed by more fundamental changes to the screening paradigm such as more personalized approaches (using additional genetic and epigenetic information) to establishing eligibility criteria. The acceptability of using this information and its implication to offer more or less intensive screening and developing effective ways to understand the ability of the program to communicate this information are key challenges for the clinical, research and policy making community.

scholarly journals Epidemiology of COVID-19 in Northern Ireland, 26 February 2020–26 April 2020

2021 ◽  
Vol 149 ◽  
Author(s):  
J. Pett ◽  
P. McAleavey ◽  
P. McGurnaghan ◽  
R. Spiers ◽  
M. O'Doherty ◽  
...  
Keyword(s):  
Northern Ireland ◽  
Contact Tracing ◽  
Risk Of Infection ◽  
Household Contacts ◽  
Household Transmission ◽  
Effective Interventions ◽  
Incidence And Mortality ◽  
Testing Data ◽  
The Republic ◽  
The Uk

Abstract This paper describes the epidemiology of coronavirus disease 2019 (COVID-19) in Northern Ireland (NI) between 26 February 2020 and 26 April 2020, and analyses enhanced surveillance and contact tracing data collected between 26 February 2020 and 13 March 2020 to estimate secondary attack rates (SAR) and relative risk of infection among different categories of contacts of individuals with laboratory confirmed severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection. Our results show that during the study period COVID-19 cumulative incidence and mortality was lower in NI than the rest of the UK. Incidence and mortality were also lower than in the Republic of Ireland (ROI), although these observed differences are difficult to interpret given considerable differences in testing and surveillance between the two nations. SAR among household contacts was 15.9% (95% CI 6.6%–30.1%), over 6 times higher than the SAR among ‘high-risk’ contacts at 2.5% (95% CI 0.9%–5.4%). The results from logistic regression analysis of testing data on contacts of laboratory-confirmed cases show that household contacts had 11.0 times higher odds (aOR: 11.0, 95% CI 1.7–70.03, P-value: 0.011) of testing positive for SARS-CoV-2 compared to other categories of contacts. These results demonstrate the importance of the household as a locus of SARS-CoV-2 transmission, and the urgency of identifying effective interventions to reduce household transmission.

scholarly journals Examining the Short-Term Natural History of Developmental Dysplasia of the Hip in Infancy: A Systematic Review

2021 ◽  
Author(s):  
Bryn O. Zomar ◽  
Kishore Mulpuri ◽  
Emily K. Schaeffer
Keyword(s):  
Natural History ◽  
Included Study ◽  
Developmental Dysplasia ◽  
Eligibility Criteria ◽  
Level Of Evidence ◽  
Screening Programs ◽  
Clinical Instability ◽  
Reported Study ◽  
History Of ◽  
Dysplasia Of The Hip

Abstract Background This study was an update on the AAOS clinical practice guideline’s analysis of the natural history of developmental dysplasia of the hip (DDH). The objective was to delineate the natural history of clinical instability or radiologic abnormalities of the hip in infants by identifying the proportion of cases that resolved without treatment compared to cases that progressed and/or required treatment. Methods We performed a literature search of PUBMED to identify studies which evaluated the natural history of DDH. We used the same search strategy as that utilized in the previous AAOS guidelines, updated to include articles published between September 2013 and May 2021. We assessed the quality of included articles using the Oxford Centre for Evidence-Based Medicine level of evidence and reported study demographics and outcomes using summary statistics. Results Twenty-four articles met our eligibility criteria. Most included studies were retrospective (14/24), investigated either the incidence of DDH (8/24) or assessed screening programs (7/24). The most prevalent study population followed were Graf 2A hips (7/24). Most studies were low quality with level of evidence 3 (13/24) or 4 (7/24). Sample sizes ranged from 9 to 3251. Twenty studies reported the number of cases resolved over the follow-up period with a mean rate of 84.3% (95% confidence interval 76.1, 92.6). Conclusion We found most mild-to-moderate DDH can resolve without treatment in early infancy, especially in physiologically immature (Graf 2A) hips. More high-quality evidence is needed to properly assess the natural history of DDH as only one included study was a randomized trial.

Economic interest groups and policy analysis in France

2018 ◽  
Author(s):  
Guillaume Courty ◽  
Marc Milet
Keyword(s):  
Policy Analysis ◽  
Interest Groups ◽  
Presidential Election ◽  
Analytical Framework ◽  
Economic Interest ◽  
Main Approach ◽  
Public Action ◽  
Public Data ◽  
Economic Interest Groups ◽  
Exhaustive List

The research on policy analysis undertaken by French economic interest groups is only marginally addressed in the existing literature. This chapter takes a closer look at this subject and propose a broader analytical framework based on three pillars: the study of selected main sectorial and inter sectorial representative organizations, the monitoring of policy analysis in the development of several significant pieces of legislation, and an exhaustive list of documents issued by these organizations in the electoral context (the 2012 French presidential election). First, the terms of policy analysis are introduced, including actors, their shapes and their objects. Second, it questions the main approach that consists of analyzing policy by checking main economic indicators and reacting to public decisions. Finally, economic actors are identified as agents of public action when they participate in the distribution of public data to their members and their industry.

Patients’ experiences and reported barriers to screening colonoscopy: A systematic review

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 1537-1537
Author(s):  
S. McLachlan ◽  
A. Clements ◽  
J. Austoker
Keyword(s):  
Bowel Preparation ◽  
Final Analysis ◽  
Screening Colonoscopy ◽  
Patient Acceptance ◽  
Qualitative Synthesis ◽  
Eligibility Criteria ◽  
Screening Programs ◽  
Inadequate Knowledge ◽  
Patient Reported ◽  
Primary Test

1537 Background: Colonoscopy is a component of most colorectal screening programs, as a primary test or as follow-up to an abnormal FOB test. Little is known about why some patients do not comply with colonoscopy after being referred. Methods: A search strategy using three themes of screening, colonoscopy, and patient acceptance was developed and used in MEDLINE, EMBASE and PSYCHinfo (1996–2008). Retrieved citations were assessed for eligibility by two reviewers using prespecified criteria. A qualitative synthesis was conducted. Results: From an initial 3,174 studies, 264 were identified as potentially eligible for review. After full text assessment, 64 studies met eligibility criteria and were included in the final analysis. Six studies examined the experience of a primary colonoscopy by eliciting patients’ views soon after they had the test. Fifty-six studies addressed patient-reported concerns and barriers to an anticipated primary colonoscopy. Most patients perceived the laxative bowel preparation to be the most burdensome part and the greatest barrier to colonoscopy. Other reported difficulties included anxiety and anticipation of pain. Feelings of embarrassment and vulnerability occurred, particularly in women, and also acted as barriers to adherence. Inadequate knowledge about screening was common and was identified as an obstacle to the uptake of screening colonoscopy as was fear of finding cancer. Physician endorsement, having a family history, knowing someone with cancer, and perceived accuracy of the test were incentives to having a colonoscopy. The most common reported practical barriers were inconvenience, transportation, scheduling, and cost. Only two studies focused on colonoscopy as a secondary procedure in the screening context. Similar procedural, personal, and practical concerns were reported by patients in this setting. Conclusions: Bowel preparation, lack of awareness of the importance of screening, and feelings of vulnerability in women are all significant barriers to colonoscopy in the screening context. These obstacles need to be addressed, and further research undertaken on barriers to second line colonoscopy. No significant financial relationships to disclose.

Coming Together Through Falling Apart

2019 ◽  
Vol 40 (2) ◽  
pp. 151-168
Author(s):  
Heather Churchill ◽  
Jeremy M. Ridenour
Keyword(s):  
Data Analysis ◽  
Qualitative Data ◽  
Structural Changes ◽  
Systematic Approach ◽  
Qualitative Approach ◽  
Psychological Assessments ◽  
Transference And Countertransference ◽  
Testing Data ◽  
Psychoanalytically Oriented Psychotherapy

Abstract. Assessing change during long-term psychotherapy can be a challenging and uncertain task. Psychological assessments can be a valuable tool and can offer a perspective from outside the therapy dyad, independent of the powerful and distorting influences of transference and countertransference. Subtle structural changes that may not yet have manifested behaviorally can also be assessed. However, it can be difficult to find a balance between a rigorous, systematic approach to data, while also allowing for the richness of the patient’s internal world to emerge. In this article, the authors discuss a primarily qualitative approach to the data and demonstrate the ways in which this kind of approach can deepen the understanding of the more subtle or complex changes a particular patient is undergoing while in treatment, as well as provide more detail about the nature of an individual’s internal world. The authors also outline several developmental frameworks that focus on the ways a patient constructs their reality and can guide the interpretation of qualitative data. The authors then analyze testing data from a patient in long-term psychoanalytically oriented psychotherapy in order to demonstrate an approach to data analysis and to show an example of how change can unfold over long-term treatments.

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