Limitations to current methods to estimate cause of death: a validation study of a verbal autopsy model

Background: Accurate information on causes of death (CoD) is essential to estimate burden of disease, track global progress, prioritize cost-effective interventions, and inform policies to reduce mortality. In low-income settings, where a significant proportion of deaths take place at home or in poorly-resourced peripheral health facilities, data on CoD often relies on verbal autopsies (VAs). Validations of VAs have been performed against clinical diagnosis, but never before against an acceptable gold standard: the complete diagnostic autopsy (CDA). Methods: We have validated a computer-coded verbal autopsy method –the InterVA- using individual and population metrics to determine CoD against the CDA, in 316 deceased patients of different age groups who died in a tertiary-level hospital in Maputo, Mozambique between 2013 and 2015. Results: We found a low agreement of the model across all age groups at the individual (kappa statistic ranging from -0.030 to 0.232, lowest in stillbirths and highest in adults) and population levels (chance-corrected cause-specific mortality fraction accuracy ranging from -1.00 to 0.62, lowest in stillbirths, highest in children). The sensitivity in identifying infectious diseases was low (0% for tuberculosis, diarrhea, and disseminated infections, 32% for HIV-related infections, 33% for malaria and 36% for pneumonia). Of maternal deaths, 26 were assigned to eclampsia but only four patients actually died of eclampsia. Conclusions: These findings do not lead to building confidence in current estimates of CoD. They also call to the need to implement autopsy methods where they may be feasible, and to improve the quality and performance of current VA techniques.

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Limitations to current methods to estimate cause of death: a validation study of a verbal autopsy model

Gates Open Research ◽

10.12688/gatesopenres.13132.1 ◽

2020 ◽

Vol 4 ◽

pp. 55

Author(s):

Clara Menéndez ◽

Llorenç Quintó ◽

Paola Castillo ◽

Carla Carrilho ◽

Mamudo R. Ismail ◽

...

Keyword(s):

Low Income ◽

Verbal Autopsy ◽

Age Groups ◽

Significant Proportion ◽

Kappa Statistic ◽

Cost Effective ◽

Accurate Information ◽

Effective Interventions ◽

And Performance ◽

The Individual

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Cultivating Resilience During the COVID-19 Pandemic: A Socioecological Perspective

Annual Review of Psychology ◽

10.1146/annurev-psych-030221-031857 ◽

2021 ◽

Vol 73 (1) ◽

Author(s):

Ning Zhang ◽

Shujuan Yang ◽

Peng Jia

Keyword(s):

Cost Effective ◽

Future Research ◽

Annual Review ◽

Publication Date ◽

Physical And Mental Health ◽

Pandemic Preparedness ◽

Predicting Factors ◽

Effective Interventions ◽

Interdisciplinary Framework ◽

The Individual

The coronavirus disease 2019 (COVID-19) pandemic poses wide-ranging impacts on the physical and mental health of people around the world, increasing attention from both researchers and practitioners on the topic of resilience. In this article, we review previous research on resilience from the past several decades, focusing on how to cultivate resilience during emerging situations such as the COVID-19 pandemic at the individual, organizational, community, and national levels from a socioecological perspective. Although previous research has greatly enriched our understanding of the conceptualization, predicting factors, processes, and consequences of resilience from a variety of disciplines and levels, future research is needed to gain a deeper and comprehensive understanding of resilience, including developing an integrative and interdisciplinary framework for cultivating resilience, developing an understanding of resilience from a life span perspective, and developing scalable and cost-effective interventions for enhancing resilience and improving pandemic preparedness. Expected final online publication date for the Annual Review of Psychology, Volume 73 is January 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

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Rubber Recycling

Rubber Chemistry and Technology ◽

10.5254/1.3547678 ◽

2002 ◽

Vol 75 (3) ◽

pp. 429-474 ◽

Cited By ~ 97

Author(s):

Marvin Myhre ◽

Duncan A. MacKillop

Keyword(s):

Environmental Concern ◽

Significant Proportion ◽

Road Construction ◽

Cost Effective ◽

Crumb Rubber ◽

Alkaline Solutions ◽

Scrap Tire ◽

Rubber Recycling ◽

Scrap Tire Rubber ◽

And Performance

Abstract For both environmental and economic reasons, there is a continuing broad based interest in recycling of scrap rubber and development of recycling technologies. The use of post- industrial scrap is established as a systematic business. However, the disposal and reuse of scrap tires remains a serious environmental concern and a business opportunity. The method for reclaiming rubber utilizing aqueous alkaline solutions has been abandoned in North America because of environmental pollution hazards. The focus of more recent research is to apply processes that do not generate disposal hazards and that might be carried out directly in the product manufacturer's factory. The major process at the present time is to utilize the scrap rubber as a very finely ground crumb. Crumb is produced either by ambient temperature mechanical grinding or by cryogenic shattering. In general, the crumb rubber is combined with virgin elastomer compounds to reduce cost. However, there is some loss in physical properties and performance. This factor has motivated the search for cost effective in-situ regeneration or devulcanization of the scrap rubber to provide superior properties. Some progress has been achieved utilizing mechanical shear, heat and other energy input, and a combination of chemicals such as oils, accelerators, amines, etc. to reduce the concentration of sulfur crosslinks in the vulcanized rubber. The major application of scrap rubber, particularly as crumb, is outside the conventional rubber industry. More than half of the scrap is burned for its fuel value for generation of electricity and as a component in cement production. The utilization in extension of asphalt in road construction is now recognized to provide superior road performance and reduced cost. The simple use of crumb rubber as a component in artificial turf is developing into a significant industry. Rubber crumb is now widely utilized in rubber products such as mats, floor tiles, carpet undercushion, etc., where the crumb is rebonded using polyurethane or latex adhesives. Other applications, such as in landfill, concrete, thermoplastic blends, pyrolysis to generate carbon black and chemicals, are discussed. The tire industry does utilize a significant proportion of fine crumb rubber in tire compounds. This is likely to not increase much due to the concern about tire performance and safety. However, there is a serious interest by tire manufacturers to increase the use of scrap tire rubber, if the recycled rubber could be regenerated to improve compatibility and performance in tire compounds.

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Identifying Children with Developmental Coordination Disorder via Parental Questionnaires. Spanish Reference Norms for the DCDDaily-Q-ES and Correlation with the DCDQ-ES

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17020555 ◽

2020 ◽

Vol 17 (2) ◽

pp. 555 ◽

Cited By ~ 5

Author(s):

Rebeca Montes-Montes ◽

Laura Delgado-Lobete ◽

Javier Pereira ◽

Marina M. Schoemaker ◽

Sergio Santos-del-Riego ◽

...

Keyword(s):

Correlation Coefficient ◽

Developmental Coordination Disorder ◽

Intraclass Correlation ◽

Age Groups ◽

Relevant Information ◽

School Aged Children ◽

Effective Interventions ◽

Cutoff Scores ◽

And Performance ◽

Coordination Disorder

Developmental Coordination Disorder (DCD) is one of the most prevalent neurodevelopmental disorders in school-aged children, with major consequences in psychosocial and physical health. Adequate identification of this disorder is necessary to prompt effective interventions. The aims of this study were to develop the Spanish adjusted reference norms for the DCDDaily-Q and to test the correlation and agreement between the Spanish versions of the DCDDaily-Q (DCDDaily-Q-ES) and the Developmental Coordination Disorder Questionnaire (DCDQ-ES), two reliable instruments to assess motor performance and DCD. Clinically relevant percentiles were calculated for the DCDDaily-Q-ES using a representative sample of Spanish children aged 5 to 10 years (n = 356; M = 7.3 years, SD = 1.8; boys = 50%). Pearson’s correlation coefficient and intraclass correlation coefficient (ICC) were used to determine correlation and agreement between questionnaires, respectively. A moderate and significant correlation and agreement between DCDDaily-Q-ES and DCDQ-ES was found (r = 0.406; ICC = 0.381; p < 0.001). Differences in daily participation and performance were found between age groups, but not between boys and girls. Spanish age-adjusted percentiles and cutoff scores for DCDDaily-Q-ES are provided. This study offers further validation and relevant information regarding assessment of DCD and has practical implications for clinical practice and research.

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A Design Method for Optimizing Collector Systems for Small Solar Central Receivers

Journal of Solar Energy Engineering ◽

10.1115/1.3266187 ◽

1980 ◽

Vol 102 (4) ◽

pp. 240-247 ◽

Cited By ~ 2

Author(s):

R. B. Bannerot ◽

C. L. Laurence

Keyword(s):

Power Systems ◽

Design Method ◽

Cost Effective ◽

Field Configuration ◽

Circular Aperture ◽

Plant Design ◽

Central Receiver ◽

Receiver System ◽

And Performance ◽

The Individual

The design methodology for the determination of the optimal heliostat field designs is presented in detail for a small solar central receiver. The optimization process is reviewed. Cost and performance models are discussed. To illustrate the design process a representative small solar central receiver system is optimized. Cost factors were developed from current prices. The individual heliostat design and cost data were taken from the design of the ten megawatt-electric Barstow Pilot Plant design. A north field configuration, steel guyed tower and a tilted, circular aperture, cavity receiver were utilized. It is demonstrated that solar central receiver systems are more cost effective at higher power levels, above those considered here. But this fact has nothing to do with relative cost effectiveness of competing small, stand-alone, power systems.

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Auton'Al 60: Prevention program for the loss of autonomy of elderly in France

Proceedings of The Nutrition Society ◽

10.1017/s0029665120006278 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Laura Lavefve ◽

Julie Branchu ◽

Béatrice Breil ◽

Flore Depeint ◽

Philippe Pouillart ◽

...

Keyword(s):

Health Status ◽

Low Income ◽

Dietary Habits ◽

Social Activity ◽

Age Groups ◽

Multidimensional Approach ◽

Balanced Diet ◽

Loss Of Autonomy ◽

Individual Health Status ◽

The Individual

AbstractIntroductionThe loss of autonomy in elderly varies according to the individual health status, but also to the social and psychological environment. Multiple risk factors play a role, including limited access to a balanced diet, physical inactivity or a poor social network. Prevention programs must therefore be based on a multidimensional approach, but are rarely studied with regard to their effectiveness.Materials and methodsThe objective of the Auton'Al 60 program is to prevent the loss of autonomy related to diet, physical activity and mental health in elderly, aged 60 to 89, in the county of Oise, North of France. Between February and July 2018, 7 different prevention workshops were conducted in 5 geographical areas (urban and rural). A blog and a monthly newsletter have been created to limit the loss to follow- up. Evaluation was based on an in-depth interview at T0 inquiring about the level of autonomy, the dietary habits and the health status, as well as on 2 self-administered questionnaires during and at the end of the program. In addition, each workshop has been evaluated separately according to key indicators. Statistical analysis was performed using SPSS 17.Results69 workshops have been completed during 5 months. In total, 91 subjects (27.8% men - 71.9% women) participated in at least one workshop, with a mean age of 69.1 years (± 6.3). 72.6% of the subjects were present at 6 or 7 workshops, and 49.5% participated in all activities. A state of loss of autonomy was reported by 6.7% of the participants. 32.6% of the population were chronic-disease-free and 43.8% had a normal BMI (kg / m2). The prevalence of obesity was 15.7%. The program showed effectiveness to decrease the consumption of high-fat products in 52.9% as well as the consumption of sugary products in 60.9% of the participants. Furthermore, 23.2% of the subjects started a new social activity during the program. However, compared to other age groups observed fragility seemed to be particularly high in elderly aged from 66 to 69 years.ConclusionThe Auton'Al 60 program confirms the heterogeneity in the level of autonomy, health status and health behavior in elderly. The multidimensional approach has shown satisfactory effectiveness. Prevention strategies have been developed for isolated or low-income subjects and are under current evaluation.

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Reliability of screening tests for health-related problems among low-income elderly

Cadernos de Saúde Pública ◽

10.1590/0102-311x00023114 ◽

2014 ◽

Vol 30 (12) ◽

pp. 2691-2696 ◽

Cited By ~ 2

Author(s):

Valéria Teresa Saraiva Lino ◽

Margareth Crisóstomo Portela ◽

Luiz Antônio Bastos Camacho ◽

Nádia Cristina Pinheiro Rodrigues

Keyword(s):

Elderly People ◽

Low Income ◽

Intraclass Correlation ◽

Kappa Statistic ◽

Screening Tests ◽

Continuous Variables ◽

Supporting the delivery of cost-effective interventions in primary health-care systems in low-income and middle-income countries: an overview of systematic reviews

The Lancet ◽

10.1016/s0140-6736(08)61403-8 ◽

2008 ◽

Vol 372 (9642) ◽

pp. 928-939 ◽

Cited By ~ 125

Author(s):

Simon Lewin ◽

John N Lavis ◽

Andrew D Oxman ◽

Gabriel Bastías ◽

Mickey Chopra ◽

...

Keyword(s):

Health Care ◽

Low Income ◽

Health Care Systems ◽

Cost Effective ◽

Middle Income ◽

Middle Income Countries ◽

Primary Health ◽

Effective Interventions ◽

Overview Of Systematic Reviews ◽

Care Systems

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Evaluation of United Nations-supported pilot projects for the prevention of mother-to-child transmission of HIV: Overview of findings

10.31899/hiv2003.1008 ◽

2003 ◽

Keyword(s):

Antenatal Care ◽

Low Cost ◽

Significant Proportion ◽

Cost Effective ◽

Hiv Infections ◽

Mother To Child Transmission ◽

Child Transmission ◽

Working Paper ◽

Effective Interventions ◽

Mother To Child

Worldwide about 800,000 children a year get HIV infections from their mothers—either during pregnancy, childbirth, or breastfeeding. Countries have the potential to prevent a large share of these infections through low-cost, effective interventions. UN agencies have taken the lead in helping developing countries mount programs for prevention of mother-to-child transmission (PMTCT). This working paper presents key findings from an evaluation of UN-supported pilot PMTCT projects in 11 countries: Botswana, Burundi, Cote d’Ivoire, Honduras, India, Kenya, Rwanda, Tanzania, Uganda, Zambia, and Zimbabwe. Key findings include feasibility and coverage, factors contributing to program coverage, program challenges, scaling up, the special case of low-prevalence countries, and recommendations. The pilot experience has shown that introducing PMTCT programs into antenatal care in a wide variety of settings is feasible and acceptable to a significant proportion of antenatal care clients who have a demand for HIV information, counseling, and testing. As they go to scale, PMTCT programs can learn from the pilot phase, during which hundreds of thousands of clients were successfully reached.

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Towards an adaptive decision-support system for Type I Diabetes treatment based on simulation and machine learning

Proceedings of the 8th International Workshop on Innovative Simulation for Healthcare (IWISH 2019) ◽

10.46354/i3m.2019.iwish.003 ◽

2019 ◽

Author(s):

Iván Castilla-Rodríguez ◽

Rafael Arnay ◽

José M. González-Cava ◽

Juan A. Méndez ◽

Amado Rivero-Santana ◽

...

Keyword(s):

Machine Learning ◽

Decision Support ◽

Decision Support System ◽

Support System ◽

Low Income ◽

Type I Diabetes ◽

Cost Effective ◽

Low Income Countries ◽

Type I ◽

Effective Interventions

"Diabetes is one of the most prevalent chronic diseases in the world, especially in middle- and low-income countries. Inter- and intra-patient variability greatly hinders the establishment of effective treatments by clinicians, even among those most experienced. This variability also prevents health administrations to establish adequate controls that guarantee the application of the most cost-effective interventions. In this work, we propose a decision support system that uses simulation and machine learning as tools to provide the clinician with information adapted to the patient on the best intervention for a patient in terms of effectiveness and cost-effectiveness."

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