scholarly journals Measuring self-reliance among refugee and internally displaced households: the development of an index in humanitarian settings

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Ilana Seff ◽  
Kellie Leeson ◽  
Lindsay Stark
Keyword(s):  
Internal Consistency ◽  
A Priori ◽  
Sensitivity Analyses ◽  
Internally Displaced ◽  
Humanitarian Settings ◽  
Self Reliance ◽  
Food Education ◽  
Inclusive Approach ◽  
Good Score ◽  
Over Time

Abstract Background Humanitarian practitioners have recently expanded their focus from the provision of assistance only to working to ensure refugees and internally displaced peoples (IDPs) can develop sustained ‘self-reliance’. However, few tools measure self-reliance, and even fewer capture non-financial dimensions of self-reliance or measure the construct within refugee and IDP populations. To help address these gaps in measurement and provide organizations with a tool to track households’ self-reliance over time, the Self-Reliance Index (SRI) was developed. The index component of the tool comprises 12 domains of self-reliance, including housing, food, education, healthcare, health status, safety, employment, financial resources, assistance, debt, and savings, and social capital. This paper presents the methodology used to evaluate the tool’s internal consistency and scoring validity, shares the corresponding findings, and offers a practical approach for developing a culturally relevant and robust tool for humanitarian settings. Results Data were collected from 57 and 59 refugee households in Nairobi, Kenya, and Palenque, Mexico, respectively; repeat follow-up interviews were held with 34 and 33 households in Kenya and Mexico after a period of 3 months. Cronbach’s alpha was found to be 0.66 in Kenya and 0.64 in Mexico, both of which met the a priori minimum threshold for internal consistency of 0.6. A data-driven process was used to inform the design of the scoring rubric for the SRI, prioritizing the tool’s validity such that the final score would signal useful information about a household’s overall level of self-reliance while also keeping the process as straightforward for users as possible. Final descriptive statistics and score distributions, considered alongside organizational knowledge of sample households and sensitivity analyses, suggest good score validity. Conclusions The SRI aims to serve as an important step in measuring the complex subject of self-reliance in a comprehensive way and over time. Results suggest that, with some contextualizing for each setting, the universal tool offers a measurement approach that is feasible, reliable, and valid. By encouraging relevant stakeholders to more holistically conceptualize and measure self-reliance, the SRI also aims to promote a more cross-sector, all-inclusive approach to programming.

scholarly journals P34 Characteristics, diagnosis and management of Cushing’s disease - A systematic review and meta-analysis

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Chan Hee Koh ◽  
Danyal Z Khan ◽  
Ronneil Digpal ◽  
Hugo Layard Horsfall ◽  
Hani J Marcus ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Cushing’S Disease ◽  
Meta Analysis ◽  
A Priori ◽  
Pituitary Surgery ◽  
Serum Cortisol ◽  
Cushing's Disease ◽  
Diagnosis And Management ◽  
Over Time

Abstract Introduction The clinical practice and research in the diagnosis and management of Cushing’s disease remains heterogeneous and challenging to this day. We sought to establish the characteristics of Cushing’s disease, and the trends in diagnosis, management and reporting in this field. Methods Searches of PubMed and Embase were conducted. Study protocol was registered a-priori. Random-effects analyses were conducted to establish numerical estimates. Results Our screening returned 159 papers. The average age of adult patients with Cushing’s disease was 39.3, and 13.6 for children. The male:female ratio was 1:3. 8% of patients had undergone previous transsphenoidal resection. The ratio of macroadenomas: microadenomas:imaging-undetectable adenomas was 18:53:29. The most commonly reported preoperative biochemical investigations were serum cortisol (average 26.4µg/dL) and ACTH (77.5pg/dL). Postoperative cortisol was most frequently used to define remission (74.8%), most commonly with threshold of 5µg/dL (44.8%). Average remission rates were 77.8% with recurrence rate of 13.9%. Median follow-up was 38 months. Majority of papers reported age (81.9%) and sex (79.4%). Only 56.6% reported whether their patients had previous pituitary surgery. 45.3% reported whether their adenomas were macroadenoma, microadenoma or undetectable. Only 24.1% reported preoperative cortisol, and this did not improve over time. 60.4% reported numerical thresholds for cortisol in defining remission, and this improved significantly over time (p = 0.004). Visual inspection of bubbleplots showed increasing preference for threshold of 5µg/dL. 70.4% reported the length of follow up. Conclusion We quantified the characteristics of Cushing’s disease, and analysed the trends in investigation and reporting. This review may help to inform future efforts in forming guidelines for research and clinical practice.

A priori assessment of a smart-navigated unmanned aerial vehicle disaster cargo fleet

SIMULATION ◽  
2020 ◽  
Vol 96 (8) ◽  
pp. 641-653
Author(s):  
Jonathan Larson ◽  
Paul Isihara ◽  
Gabriel Flores ◽  
Edwin Townsend ◽  
Danilo R. Diedrichs ◽  
...  
Keyword(s):  
Disaster Response ◽  
Best Practice ◽  
A Priori ◽  
Geographic Distance ◽  
Field Tests ◽  
General Purpose ◽  
Assessment Model ◽  
Sensitivity Analyses ◽  
Modeling And Analysis ◽  
Cargo Delivery

The United Nations Office for the Coordination of Humanitarian Affairs has asserted that risks in deployment of unmanned aerial vehicles (UAVs) within disaster response must be reduced by careful development of best-practice standards before implementing such systems. With recent humanitarian field tests of cargo UAVs as indication that implementation may soon become reality, a priori assessment of a smart-navigated (autonomous) UAV disaster cargo fleet via simulation modeling and analysis is vital to the best-practice development process. Logistical problems with ground transport of relief supplies in Puerto Rico after Hurricane Maria (2017) pose a compelling use scenario for UAV disaster cargo delivery. In this context, we introduce a General Purpose Assessment Model (GPAM) that can estimate the potential effectiveness of a cargo UAV fleet for any given response region. We evaluate this model using the following standards: (i) realistic specifications; (ii) stable output for various realistic specifications; and (iii) support of humanitarian goals. To this end, we discuss data from humanitarian cargo delivery field tests and feedback from practitioners, perform sensitivity analyses, and demonstrate the advantage of using humanitarian rather than geographic distance in making fleet delivery assignments. We conclude with several major challenges faced by those who wish to implement smart-navigated UAV cargo fleets in disaster response, and the need for further GPAM development. This paper proposes the GPAM as a useful simulation tool to encourage and guide steps toward humanitarian use of UAVs for cargo delivery. The model’s flexibility can allow organizations to quickly and effectively determine how best to respond to disasters.

Psychometric Testing and Refinement of the Support Needs Inventory for Parents of Asthmatic Children

2004 ◽  
Vol 12 (3) ◽  
pp. 179-193
Author(s):  
Christine Toye ◽  
Linda J. Kristjanson ◽  
Mardhie E. Coleman ◽  
Hendrika Maltby ◽  
Glenda Jackson
Keyword(s):  
Factor Analysis ◽  
Internal Consistency ◽  
Psychometric Testing ◽  
Internal Consistency Reliability ◽  
Support Needs ◽  
Clinical Screening ◽  
Asthmatic Children ◽  
Children With Asthma ◽  
Undue Burden ◽  
Over Time

This study refined the Support Needs Inventory for Parents of Asthmatic Children (SNIPAC) (Coleman, Maltby, Kristjanson, & Robinson, 2001) to produce a more parsimonious tool to assess the importance and meet the support needs of parents of children with asthma. The original tool was completed by 145 parents of 199 children with asthma, and 74 of these also provided test-retest responses. Internal consistency reliability, construct validity, and stability over time were assessed and refinements were made. Internal consistency reliability of the revised 20-item tool ranged from .77 to .95 for the three subscales of the Parent’s Priority Scale (PPS), and .92 for the full PPS. Cronbach’s alphas ranged from .74 to .90 for the three subscales of the Parent’s Fulfillment Scale (PFS) and was .91 for the full scale. Factor analysis results of the PPS were compatible with the tool’s conceptual framework. The revised 20-item tool demonstrated adequate psychometric properties in most areas. This tool may be used for research or clinical screening without imposing undue burden on parents. Further work is required to establish the tool’s stability over time.

Changes in the contents of corporate codes of ethics: an institutional interpretation

2015 ◽  
Vol 27 (4) ◽  
pp. 369-388 ◽  
Author(s):  
Jang B. Singh
Keyword(s):  
Design Methodology ◽  
Management Practices ◽  
A Priori ◽  
Codes Of Ethics ◽  
Legal Authority ◽  
Valuable Contribution ◽  
Content Type ◽  
Innovative Management ◽  
Study Population ◽  
Over Time

Purpose – The purpose of this paper was to examine changes in the contents of Canadian corporate codes of ethics over a period of two decades from an institutionalization perspective. Design/methodology/approach – The paper tracks changes in the contents of the codes of large Canadian corporations longitudinally by analyzing their contents at two points over two decades, in 1992 and 2012. In particular, the paper tests three hypotheses related to the institutionalization of codes. Findings – It was found that the codes have become more prescriptive, they are more concerned with social responsibility and are more likely to identify their moral and legal authority. Overall, the findings support an institutional interpretation of the observed changes. Research limitations/implications – While large corporations are critical in establishing new and innovative management practices, their selection as the study population limits the generalizabilty of the findings. Another limitation of this paper is that it used an a priori determined set of items to analyze the contents of the codes and while this was needed to facilitate the comparison across time, it also meant that some important items were not clearly identified. Originality/value – Codes of ethics are the foundation of ethics programs in corporations and their contents could be critical in the development of a culture of ethics in corporations. This paper makes a valuable contribution to research on business ethics by analyzing the codes of ethics of the largest corporations in Canada at two points over two decades. The need to track changes in corporate codes of ethics over time has been advocated by several researchers, but longitudinal studies in this area are rare.

scholarly journals Measles Outbreak in Complex Emergency: Estimating Vaccine Effectiveness and Evaluation of the Vaccination Campaign in Borno State, Nigeria, 2019

2020 ◽  
Author(s):  
Anne Eudes Jean Baptiste ◽  
John Wagai ◽  
Richard Ray Luce ◽  
Balcha Girma Masresha ◽  
Don Klinkenberg ◽  
...  
Keyword(s):  
Vaccination Campaign ◽  
Screening Method ◽  
Population Level ◽  
Vaccine Effectiveness ◽  
Sensitivity Analyses ◽  
Outbreak Response ◽  
Internally Displaced ◽  
Complex Emergency ◽  
Campaign Coverage ◽  
Measles Outbreaks

Abstract Background: From January to May 2019, large measles outbreaks affected Nigeria. Borno state was the most affected, recording 15,237 suspected cases with the state capital of Maiduguri having 1,125 cases investigated and line-listed by March 2019. In Borno state, 22 of the 27 Local Government Areas (LGAs or Districts), including 37 internally displaced persons (IDPs) camps were affected. In response to the situation, an outbreak response immunization (ORI) campaign was conducted in the 13 most affected LGAs. In addition to conventional vaccination teams, special teams were deployed in security compromised areas, areas with migrants, and for nomadic and IDPs. Here we describe the outbreak and the ORI campaign. We also assess the measles-containing vaccine (MCV) coverage and vaccine effectiveness (VE) in order to quantify the population-level impactMethods: We reviewed the ORI activities, and conducted an analysis of the surveillance and the outbreak investigation reports. We assessed VE of MCV by applying the screening-method. Sensitivity analyses were also conducted to assess the effect of final classification of cases on the VE of MCV. The MCV coverage was assessed by a post-campaign coverage survey (PCCS) after completion of the ORI through a quantitative survey in the 12 LGAs that were accessible. . Results: Of the total 15,237 reported measles cases, 2,002 cases were line-listed and investigated, and 737 were confirmed for measles by week 9 of 2019. Of the investigated cases 67.3% (n = 1,348) were between 9 and 59 months of age. Among the 737 confirmed cases, only 9% (n = 64) stated being vaccinated with at least 1 dose of MCV. The overall VE for MCV was 98.4 (95%CI: 97.8 – 98.8). No significant differences were observed in the VE estimates of lab-confirmed and epi-linked cases when compared to the original estimates. The aggregated weighted vaccination coverage was 85.7% (95% CI: 79.6 – 90.1).Conclusion: The experience in Borno demonstrates that adequate VE can be obtained in conflict-affected areas. In complex emergency affected by measles outbreaks, health authorities may consider integration with other health strategies and the engagement of security personnel as part of the ORI activities.

scholarly journals Fibromyalgia Impact Reduction Using Online Personal Health Informatics: Longitudinal Observational Study

10.2196/15819 ◽  
2020 ◽  
Vol 22 (4) ◽  
pp. e15819
Author(s):  
William Collinge ◽  
Robert Soltysik ◽  
Paul Yarnold
Keyword(s):  
Health Informatics ◽  
A Priori ◽  
Management Strategies ◽  
Personal Health ◽  
Single Subject ◽  
Cumulative Number ◽  
Impact Reduction ◽  
Health Diary ◽  
Over Time

Background Personal health informatics have the potential to help patients discover personalized health management strategies that influence outcomes. Fibromyalgia (FM) is a complex chronic illness requiring individualized strategies that may be informed by analysis of personal health informatics data. An online health diary program with dynamic feedback was developed to assist patients with FM in identifying symptom management strategies that predict their personal outcomes, and found reduced symptom levels associated with program use. Objective The aim of this study was to determine longitudinal associations between program use and functional impact of FM as measured by scores on a standardized assessment instrument, the Fibromyalgia Impact Questionnaire (FIQ). Methods Participants were self-identified as diagnosed with FM and recruited via online FM advocacy websites. Participants used an online health diary program (“SMARTLog”) to report symptom ratings, behaviors, and management strategies used. Based on single-subject analysis of the accumulated data over time, individualized recommendations (“SMARTProfile”) were then provided by the automated feedback program. Indices of program use comprised of cumulative numbers of SMARTLogs completed and SMARTProfiles received. Participants included in this analysis met a priori criteria of sufficient program use to generate SMARTProfiles (ie, ≥22 SMARTLogs completed). Users completed the FIQ at baseline and again each subsequent month of program use as follow-up data for analysis. Kendall tau-b, a nonparametric statistic that measures both the strength and direction of an ordinal association between two repeated measured variables, was computed between all included FIQ scores and both indices of program use for each subject at the time of each completed FIQ. Results A total of 76 users met the a priori use criteria. The mean baseline FIQ score was 61.6 (SD 14.7). There were 342 FIQ scores generated for longitudinal analysis via Kendall tau-b. Statistically significant inverse associations were found over time between FIQ scores and (1) the cumulative number of SMARTLogs completed (tau-b=–0.135, P<.001); and (2) the cumulative number of SMARTProfiles received (tau-b=–0.133, P<.001). Users who completed 61 or more SMARTLogs had mean follow-up scores of 49.9 (n=25, 33% of the sample), an 18.9% drop in FM impact. Users who generated 11 or more new SMARTProfiles had mean follow-up scores of 51.8 (n=23, 30% of the sample), a 15.9% drop. Conclusions Significant inverse associations were found between FIQ scores and both indices of program use, with FIQ scores declining as use increased. Based on established criteria for rating FM severity, the top one-third of users in terms of use had clinically significant reductions from “severe” to “moderate” FM impact. These findings underscore the value of self-management interventions with low burden, high usability, and high perceived relevance to the user. Trial Registration ClinicalTrials.gov NCT02515552; https://clinicaltrials.gov/ct2/show/NCT02515552

scholarly journals Back beliefs among elderly seeking health care due to back pain; psychometric properties of the Norwegian version of the back beliefs questionnaire

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Alexander Tingulstad ◽  
Rikke Munk ◽  
Margreth Grotle ◽  
Ørjan Vigdal ◽  
Kjersti Storheim ◽  
...  
Keyword(s):  
Back Pain ◽  
Elderly Patients ◽  
Construct Validity ◽  
Psychometric Properties ◽  
Correlation Coefficient ◽  
Internal Consistency ◽  
A Priori ◽  
Minimal Detectable Change ◽  
Norwegian Version ◽  
Patient Reported

Abstract Background The Back Beliefs Questionnaire (BBQ) is a 14-item patient-reported questionnaire that measures attitudes and beliefs about the consequences of back pain. The BBQ has recently been translated into Norwegian, but its psychometric properties have not yet been tested. The aim of this study is to evaluate the reliability and construct validity of the BBQ when used on elderly patients with back pain. Method A prospective cohort study with a test-retest design among 116 elderly patients (> 55 years of age) seeking primary care for a new episode of back pain. Test-retest, standard error of measurement (SEM), minimal detectable change (MDC), internal consistency and construct validity by a priori hypotheses (Spearman’s- and Pearson correlation coefficient) were tested. Results A total of 116 patients, mean age (SD) 67.7 (8.3), were included and 63 patients responded to the test-retest assessment. The mean (SD) BBQ sum scores (range 9–45) were 29.8 (7.0) and 29.2 (6.7) for the test and retest respectively. The test-retest was acceptable with an intraclass correlation coefficient of 0.71 (95% CI, 0.54–0.82), SEM was 3.8 and MDC 10.5. Internal consistency with Cronbach’s alpha was good (0.82) and acceptable construct validity was supported by the confirmation of 75% of the a priori hypotheses. Conclusion The Norwegian version of the BBQ demonstrated acceptable test-retest reliability and good construct validity and can be used to assess pessimistic beliefs in elderly patients with back pain.

scholarly journals P295 VALIDation of the IBD-Disk instrument for assessing disability in inflammatory bowel diseases in a population-based cohort: The VALIDate study

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S299-S301
Author(s):  
C Le Berre ◽  
A Bourreille ◽  
M Flamant ◽  
G Bouguen ◽  
L Siproudhis ◽  
...  
Keyword(s):  
Internal Consistency ◽  
Inflammatory Bowel Diseases ◽  
Population Based ◽  
Large Cohort ◽  
Inactive Disease ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Physician Patient ◽  
Over Time

Abstract Background Inflammatory bowel diseases (IBD) are disabling disorders. The IBD-Disability Index (IBD-DI) was developed for quantifying disability in IBD patients but is difficult to use. The IBD-Disk is a shortened and visual adaptation of the IBD-DI. It has not been validated yet. The main objectives were to validate the IBD-Disk in a large cohort of IBD patients and to assess its variability over time. Methods From March 2018 to July 2019, IBD patients from three university-affiliated hospitals responded twice to both IBD-Disk and IBD-DI at 3–12 months intervals (NCT03590639). Validation included concurrent validity, reproducibility, internal consistency, and evaluation of IBD-Disk correlation with IBD activity. Variability was assessed by comparing scores between baseline and follow-up visits. Results A total of 559 patients (73% Crohn’s disease, 27% ulcerative colitis) were included and 389 were followed up (Table 1). There was a good correlation between IBD-Disk and IBD-DI scores (r = 0.75, p &lt; 0.001) (Figure 1). The IBD-Disk was significantly higher in patients with active disease according to Physician/Patient Global Assessment (Figure 2), clinical scores (Figure 3), and biomarkers levels, compared with patients with inactive disease. Reproducibility was excellent (intra-class correlation coefficient = 0.90), as well as internal consistency (Cronbach’s α = 0.89). The IBD-Disk score significantly decreased in patients becoming inactive over time. Conclusion This is the first study to validate the IBD-Disk in a large cohort of IBD patients, demonstrating that it is a valid and reliable tool for quantifying disability in clinical practice. Further studies are warranted to assess its correlation with endoscopic activity, to explore its responsiveness to change, and to evaluate the factors associated with disability.

A Preventive Approach for Consistent OWL 2 DL Ontology Versions

2019 ◽  
Vol 15 (1) ◽  
pp. 76-101
Author(s):  
Wassim Jaziri ◽  
Leila Bayoudhi ◽  
Najla Sassi
Keyword(s):  
A Priori ◽  
Ontology Engineering ◽  
A Posteriori ◽  
Engineering Process ◽  
Preventive Approach ◽  
Semantic Modelling ◽  
Prevention Approach ◽  
Over Time

Knowledge is continually changing over time. As such, semantic modelling knowledge formalisms, such as ontologies, must follow this evolution and change accordingly. However, ontology changes should never affect consistency. An ontology needs to remain in a consistent state along the whole ontology engineering process. In the literature, most of the approaches check/repair ontology inconsistencies in an a posteriori manner. This costs time and resources. In this article, an inconsistency prevention approach is proposed. It relies on OWL 2 DL change kits, which anticipate inconsistencies upon each change request. The proposed approach predicts potential inconsistencies, provides an a priori repair action, and applies the required changes. Consistency rules are defined and used to check logical inconsistencies, but also syntactical invalidities or style issues. A protégé extension is implemented to validate the proposal.

An approach for assessing suitability for forest management based on constraints of the physical environment at a regional scale

2015 ◽  
Vol 45 (5) ◽  
pp. 529-539 ◽  
Author(s):  
André Robitaille ◽  
Jean-Pierre Saucier ◽  
Michel Chabot ◽  
Damien Côté ◽  
Catherine Boudreault
Keyword(s):  
Forest Management ◽  
Physical Environment ◽  
A Priori ◽  
Regional Scale ◽  
Forest Growth ◽  
Sensitivity Analyses ◽  
Land Area ◽  
Forest Operations ◽  
Entire Study ◽  
Aeolian Deposits

Constraints of the physical environment affect forest growth and forest operations. At a local scale, these constraints are generally considered during forest operations. At regional or continental scales, they are often integrated to larger assessments of the potential for a given land unit to be managed. In this study, we propose an approach to analyze the integration of physical-environment constraints in forest management activities at the regional scale (482 000 km2). The land features that pose constraints to forest management (i.e., hydromorphic organic deposits, dead-ice moraines, washed till, glacial block fields, talus, and active aeolian deposits, slopes > 40%) were evaluated within 1114 land districts. To distinguish land districts that can be suitably managed from those where constraints are too important for sustainable timber production, we carried out a sensitivity analysis of physical constraints for the 1114 land districts. After analysis of two portions of the study area under management, a land district was considered suitable for management when more than 20% of its land area consists of features imposing few constraints or, for mountain-type relief districts, when more than 40% of the land area consists of features imposing few constraints. These cutoff values were defined by expert opinion, based on sensitivity analyses performed on the entire study area, on analyses of two different sectors with different types of constraints and on a strong understanding of the study area. Our results show that land districts where the physical environment posed significant constraints covered 7.5% of the study area (36 000 km2). This study shows that doing an a priori classification of land units based on permanent environmental features could facilitate the identification of areas that are not suitable for forest management activities.

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