scholarly journals Evaluating the Use of 90-90-90 for HIV Policy in the Asian Context

2021 ◽  
pp. 43-48
Author(s):  
Richard M. Grimes ◽  
Deanna E. Grimes
Keyword(s):  
Viral Suppression ◽  
Point Prevalence ◽  
Point Estimate ◽  
Asian Countries ◽  
True Prevalence ◽  
Point Estimates ◽  
Prevalence Estimates ◽  
Asian Context ◽  
Low Prevalence ◽  
The Impact

UNAIDS recommends the 90-90-90 policy for controlling HIV infection (identify 90% of HIV cases, provide care for 90% of these, and have 90% of the treated achieve viral suppression). 90-90-90 requires an accurate measurement of HIV prevalence, which is impossible to achieve. Prevalence must be estimated. Customarily, 90-90-90 prevalence estimates are based on point estimates at the midpoint of a credible range of high and low estimates. This paper examines the effect of the high and low estimates on 90-90-90. We examined the impact on policy goal based on 90% of the point estimate, if the true prevalence were the credible range’s high or low estimate. This was calculated for 14 Asian Countries (Afghanistan, Cambodia, Indonesia, Iran, Kazakhstan, Laos Malaysia, Myanmar, Nepal, Pakistan, Philippines Thailand, Uzbekistan, Viet Nam) that UNAIDS estimated point prevalence of prevalence greater than 10,000 persons. If the low estimate for the 14 countries was the true prevalence, 11 of the countries could not achieve 90% of the point estimate because the low prevalence was less than 90% of the point estimate. The other three countries, would have to identify 97.5% to 99.0% of infected persons to achieve 90% of the point prevalence. If the true prevalence is the high estimate, twelve of the countries would have identified only 76.8% to 84.9 of the true prevalence. Afghanistan (26.0%) and Iran (40.8%) would have identified far fewer persons than the point estimate goal. Therefore 90-90-90 should be considered to be non-evaluable and should not be used for policy making.

Investigating the glass ceiling phenomenon

2017 ◽  
Vol 6 (3) ◽  
pp. 297-313 ◽  
Author(s):  
Sharjeel Saleem ◽  
Asia Rafiq ◽  
Saquib Yusaf
Keyword(s):  
Glass Ceiling ◽  
Role Theory ◽  
Training And Development ◽  
Attitudes Toward Women ◽  
Ceiling Effect ◽  
Least Square ◽  
Asian Countries ◽  
Content Type ◽  
Asian Context ◽  
The Impact

Purpose The purpose of this paper is to identify hurdles in women’s rise up the organizational ladder through the epistemic concept of the glass ceiling phenomenon. The secondary aim is to determine how the glass ceiling effect results in women’s failure to secure equal representation in high-ranking executive positions in comparison to males. The study intends to come up with empirical evidences to advance plausible justifications and support for the organizations to manage their workforce with the sense of egalitarianism. Design/methodology/approach The questionnaire is administered to a sample of 210 respondents including CEOs, directors, managers, assistants, accountants, doctors and teachers from public and private sectors. The variables that influence the glass ceiling phenomenon are gender (female) represented on the board of directors (BODs), stereotypical behavior and training and development of females to measure the glass ceiling effect. Further, this influence is examined regarding the selection and promotion of the females as candidates, as well as female effectiveness at work. To verify the glass ceiling phenomenon, multiple linear regression analyses with the ordinary least square method are used. Findings Drawing on the perspective of the social role theory, the authors identify plausible causes of the glass ceiling phenomenon in the Asian context. The results show the presence of glass ceiling, particularly characterizing its effects on the selection and promotion of the female candidates and their effectiveness. The authors found that glass ceiling was negatively related to both female effectiveness and “selection and promotion.” It was also identified that research variables such as lesser women’s representation on the BODs, training and development and stereotypical attitude toward women promote glass ceiling. Research limitations/implications The larger sample and data collection from different cultures would have assured more generalizability. The glass ceiling is affected by numerous variables; other factors can also be explored. Practical implications Organizations must consider competitive females in their selection and promotion decision making. Asian countries, especially developing countries such as Pakistan, need to develop policies to encourage active participation of the female workforce in upper echelon. The equal employment policies will reduce the dependency ratio of females, consequently driving the country’s economic growth. Social implications Societies need to change their stereotype attitudes toward women and encourage them to use their potential to benefit societies by shattering glass ceilings that continue to place women at a disadvantage. Developing a social culture that advances women empowerment will contribute to social and infrastructure development in Asian countries. Originality/value This paper adds a thought-provoking attitude of organizations in South Asia, especially in Pakistani societies that play a role in creating a glass ceiling, more so to shatter it even in 2016. This study compels firms in Pakistan and other Asian regions to use unbiased practices by investigating the impact of glass ceiling on female effectiveness that has not previously been conducted in the Asian context. To the best of the authors’ knowledge, the study of glass ceiling in Pakistani context is first in the literature.

scholarly journals Obtaining prevalence estimates of COVID-19: A model to inform decision-making

2020 ◽  
Author(s):  
Ida Sahlu ◽  
Alexander B Whittaker
Keyword(s):  
Random Sampling ◽  
Geographic Area ◽  
Misclassification Error ◽  
Point Estimate ◽  
Prevalence Estimates ◽  
Error Bias ◽  
The Impact ◽  
Number Of Individuals ◽  
Case Data ◽  
Random Sampling Approach

Objectives: The primary aim was to evaluate whether randomly sampling and testing a set number of individuals for active or past COVID-19 while adjusting for misclassification error captures a simulated prevalence. The secondary aim was to quantify the impact of misclassification error bias on publicly reported case data in Maryland. Methods: Using a stratified random sampling approach, 50,000 individuals were selected from a simulated Maryland population to estimate the prevalence of active and past COVID-19. Data from the 2014-2018 and 2018 American Community Surveys were used. The simulated prevalence was 0.5% and 1.0% for active and past COVID-19, respectively. Bayesian models, informed by published validity estimates, were used to account for misclassification error when estimating the prevalence of active and past COVID-19. Results: Failure to account for misclassification error overestimated the simulated prevalence for active and past COVID-19. Adjustment for misclassification error decreased the point estimate for active and past COVID-19 prevalence by 55% and 29%, respectively. Adjustment for sampling method and misclassification error only captured the simulated past COVID-19 prevalence. The simulated active COVID-19 prevalence was only captured when set to 0.7% and above. Adjustment for misclassification error for publicly reported Maryland data increased the estimated average daily cases by 8%. Conclusions: Random sampling and testing of COVID-19 is needed but must be accompanied by adjustment for misclassification error to avoid over- or underestimating the prevalence. This approach bolsters disease control efforts. Implementing random testing for active COVID-19 may be best in a smaller geographic area with highly prevalent cases.

scholarly journals The impact of improved data quality on the prevalence estimates of anthropometric measures using DHS datasets in India

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Harsh Vivek Harkare ◽  
Daniel J. Corsi ◽  
Rockli Kim ◽  
Sebastian Vollmer ◽  
S. V. Subramanian
Keyword(s):  
Data Quality ◽  
Differential Impact ◽  
Anthropometric Measures ◽  
True Prevalence ◽  
Contentious Issue ◽  
Percentage Points ◽  
Prevalence Estimates ◽  
Quality Checks ◽  
The Impact ◽  
Data Quality Indicators

AbstractThe importance of data quality to correctly determine prevalence estimates of child anthropometric failures has been a contentious issue among policymakers and researchers. Our research objective was to ascertain the impact of improved DHS data quality on the prevalence estimates of stunting, wasting, and underweight. The study also looks for the drivers of data quality. Using five data quality indicators based on age, sex, anthropometric measurements, and normality distribution, we arrive at two datasets of differential data quality and their estimates of anthropometric failures. For this purpose, we use the 2005–2006 and 2015–2016 NFHS data covering 311,182 observations from India. The prevalence estimates of stunting and underweight were virtually unchanged after the application of quality checks. The estimate of wasting had fallen 2 percentage points, indicating an overestimation of the true prevalence. However, this differential impact on the estimate of wasting was driven by the flagging procedure’s sensitivity and was in accordance with empirical evidence from existing literature. We found DHS data quality to be of sufficiently high quality for the prevalence estimates of stunting and underweight, to not change significantly after further improving the data quality. The differential estimate of wasting is attributable to the sensitivity of the flagging procedure.

scholarly journals COVID-19 prevalence estimation by random sampling in population - Optimal sample pooling under varying assumptions about true prevalence

2020 ◽  
Author(s):  
Ola Brynildsrud
Keyword(s):  
Random Sampling ◽  
Large Fraction ◽  
Rt Pcr ◽  
Individual Level ◽  
True Prevalence ◽  
Prevalence Estimation ◽  
Prevalence Estimates ◽  
Sample Pooling ◽  
Many Sources ◽  
Low Prevalence

Abstract Background: The number of confirmed COVID-19 cases divided by population size is used as a coarse measurement for the burden of disease in a population. However, this fraction depends heavily on the sampling intensity and the various test criteria used in different jurisdictions, and many sources indicate that a large fraction of cases tend to go undetected. Methods: Estimates of the true prevalence of COVID-19 in a population can be made by random sampling and pooling of RT-PCR tests. Here I use simulations to explore how experiment sample size and degrees of sample pooling impact precision of prevalence estimates and potential for minimizing the total number of tests required to get individual-level diagnostic results.Results: Sample pooling can greatly reduce the total number of tests required for prevalence estimation. In low-prevalence populations, it is theoretically possible to pool hundreds of samples with only marginal loss of precision. Even when the true prevalence is as high as 10% it can be appropriate to pool up to 15 samples. Sample pooling can be particularly beneficial when the test has imperfect specificity by providing more accurate estimates of the prevalence than an equal number of individual-level tests.Conclusion: Sample pooling should be considered in COVID-19 prevalence estimation efforts.

scholarly journals Comprehensive Overview of Sleep Disorders in Patients with Chronic Liver Disease

2021 ◽  
Vol 11 (2) ◽  
pp. 142
Author(s):  
Oana-Mihaela Plotogea ◽  
Madalina Ilie ◽  
Simona Bungau ◽  
Alexandru Laurentiu Chiotoroiu ◽  
Ana Maria Alexandra Stanescu ◽  
...  
Keyword(s):  
Sleep Disorders ◽  
Daily Practice ◽  
Chronic Liver ◽  
Asian Countries ◽  
Chronic Liver Diseases ◽  
Comprehensive Overview ◽  
The Usa ◽  
The Impact ◽  
Reliable Methods

The impact of sleep disorders (SDs) on patients with chronic liver diseases (CLD) is tremendous. SDs are frequently encountered among these patients and interfere with their quality of life. This review aims to present the data available so far about the prevalence, phenotypes, and proposed pathophysiological mechanisms of SDs in CLD. Moreover, we proposed to search the literature regarding the most reliable methods to assess SDs and the possible therapeutic options in patients with CLD. The main results of this review show that when it comes to prevalence, the percentages reported vary widely between studies performed among populations from the USA or Europe and those coming from Asian countries. Furthermore, it has been proven that SDs may also be present in the absence of neurocognitive disorders attributable to hepatic encephalopathy (HE), which contradicts traditional suppositions where SDs were considered part of the clinical scenario of HE. Currently, there are no specific recommendations or protocols to assess SDs in CLD patients and data about the therapeutic management are limited. Taking into consideration their impact, a protocol for diagnosing and managing SDs should be developed and included in the daily practice of hepatologists.

scholarly journals Prevalence of internalizing disorders, symptoms, and traits across age using advanced nonlinear models

2021 ◽  
pp. 1-10
Author(s):  
Hanna M. van Loo ◽  
Lian Beijers ◽  
Martijn Wieling ◽  
Trynke R. de Jong ◽  
Robert A. Schoevers ◽  
...  
Keyword(s):  
Internalizing Symptoms ◽  
Nonlinear Models ◽  
Generalized Additive Models ◽  
Population Sample ◽  
Internalizing Disorders ◽  
Relative Difference ◽  
Additive Models ◽  
Point Prevalence ◽  
Cross Sectional ◽  
The Impact

Abstract Background Most epidemiological studies show a decrease of internalizing disorders at older ages, but it is unclear how the prevalence exactly changes with age, and whether there are different patterns for internalizing symptoms and traits, and for men and women. This study investigates the impact of age and sex on the point prevalence across different mood and anxiety disorders, internalizing symptoms, and neuroticism. Methods We used cross-sectional data on 146 315 subjects, aged 18–80 years, from the Lifelines Cohort Study, a Dutch general population sample. Between 2012 and 2016, five current internalizing disorders – major depression, dysthymia, generalized anxiety disorder, social phobia, and panic disorder – were assessed according to DSM-IV criteria. Depressive symptoms, anxiety symptoms, neuroticism, and negative affect (NA) were also measured. Generalized additive models were used to identify nonlinear patterns across age, and to investigate sex differences. Results The point prevalence of internalizing disorders generally increased between the ages of 18 and 30 years, stabilized between 30 and 50, and decreased after age 50. The patterns of internalizing symptoms and traits were different. NA and neuroticism gradually decreased after age 18. Women reported more internalizing disorders than men, but the relative difference remained stable across age (relative risk ~1.7). Conclusions The point prevalence of internalizing disorders was typically highest between age 30 and 50, but there were differences between the disorders, which could indicate differences in etiology. The relative gap between the sexes remained similar across age, suggesting that changes in sex hormones around the menopause do not significantly influence women's risk of internalizing disorders.

Control of Vancomycin-Resistant Enterococci at a Community Hospital: Efficacy of Patient and Staff Cohorting

1999 ◽  
Vol 20 (2) ◽  
pp. 106-109 ◽  
Author(s):  
Elise M. Jochimsen ◽  
Laurie Fish ◽  
Kelly Manning ◽  
Sally Young ◽  
Daniel A. Singer ◽  
...  
Keyword(s):  
Community Hospital ◽  
Point Prevalence ◽  
Control Measures ◽  
Prevalence Survey ◽  
Infection Control Measures ◽  
Contact Isolation ◽  
Point Prevalence Survey ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
The Impact

AbstractObjective:To evaluate the efficacy of patient and staff cohorting to control vancomycin-resistant enterococci (VRE) at an Indianapolis community hospital.Design:To interrupt transmission of VRE, a VRE point-prevalence survey of hospital inpatients was conducted, and VRE-infected or -colonized patients were cohorted on a single ward with dedicated nursing staff and patient-care equipment. To assess the impact of the intervention, staff compliance with contact isolation procedures was observed, and the VRE point-prevalence survey was repeated 2 months after the cohort ward was established.Results:Following the establishment of the cohort ward, VRE prevalence among all hospitalized inpatients decreased from 8.1% to 4.7% (25 positive cultures among 310 patients compared to 13 positive cultures among 276 patients,P=.14); VRE prevalence among patients whose VRE status was unknown before cultures were obtained decreased from 5.9% to 0.8% (18 positive cultures among 303 patients compared to 2 positive cultures among 262 patients,P=.002); and observed staff-patient interactions compliant with published isolation recommendations increased (5 [22%] of 23 interactions compared to 36 [88%] of 41 interactions,P<.0001).Conclusions:Our data suggest that, in hospitals with endemic VRE or continued VRE transmission despite implementation of contact isolation measures, establishing a VRE cohort ward may be a practical and effective method to improve compliance with infection control measures and thereby to control epidemic or endemic VRE transmission.

A descriptive study of stress fractures in competitive event horses in the UK

2004 ◽  
Vol 1 (4) ◽  
pp. 233-238
Author(s):  
Emma Hayton ◽  
Jennifer C Sneddon
Keyword(s):  
Stress Fracture ◽  
Descriptive Study ◽  
Stress Fractures ◽  
Anatomical Location ◽  
True Prevalence ◽  
Fracture Prevalence ◽  
The Uk ◽  
The Impact ◽  
Larger Sample ◽  
Age Category

AbstractThe impact of stress fractures on competitive event horses in the UK is completely unknown. Ninety-one replies to 450 questionnaires sent to competitive event riders across the UK indicated that 11 horses, representing 12% of the responders, had a confirmed stress fracture. As data on the total number of horses owned or ridden by the riders were not available, the true prevalence of stress fractures in this sample of horses could not be directly assessed. Within the bounds of this study, competitive level of the rider had a significant effect on stress fracture prevalence (X2(0.05, df. 2) = 24.74, P<0.05), as did years of eventing experience (X2(0.05, df. 1) = 27.80, P<0.01). Training regime was also influential (X2(0.05,df. 1) = 26.30, PX20.01). There was a predominance of fractures in geldings (X2(0.05, df. 1) = 24.45, P<0.03); however, geldings constituted 82% of reported cases. Thoroughbred cross horses had a significantly lower incidence of stress fractures than Thoroughbreds (X2(0.05, df. 1) = 20.82, P<0.01) but constituted only 18% of the sample. Horses in the oldest age category (9–12 years) had 6% of all stress fractures (X2(0.05, df. 2) = 24.54, P<0.1). All fractures occurred on the foreleg at the knee or below, with no significant effect of anatomical location. Seventy-three per cent of horses were not competing when diagnosed (X2(0.05, df. 1) = 22.27, P<0.1). These data indicate that useful preliminary data were yielded by the questionnaire and that further research with a larger sample size is justified.

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