Discussion of Validation Issues in Signed and Spoken Assessments for Adult L2 Learners

The use of argument-based validity as a framework for discussion of validity issues in spoken and signed second language (L2) assessment reveals many areas of commonality. Common areas include the role of systematic test development practices in the validity argument, the complexity of rating issues, the need to define and assess a construct of functional communication of meaning, and the centrality of test use in the validity argument. Examining these areas of commonality in this chapter reveals the fundamental similarities in the basic validity issues faced in spoken and signed language assessment. This chapter is a joint discussion of key items related to validation issues related to signed and spoken language assessment that were discussed in Chapters 8.1 and 8.2.

A randomized controlled study of biochemical tests in primary care: interventions can reduce the number of tests but usage does not become more appropriate

Objectives The use of laboratory tests increases worldwide, and to some extent their use is likely to be inappropriate. Although primary care is responsible for a substantial proportion of requests, this sector is less extensively investigated than hospitals. Methods We tested the effect of six combinations of four interventions applied to 313 primary care clinics, using vitamin D as model test (253,762 vitamin D results). We evaluated the changes in test numbers in the six intervention groups compared to the control group, and whether interventions resulted in more homogenous test use within groups or affected the distribution of test results. All interventions included information on vitamin D testing guidelines. Four groups were exposed to a non-interruptive alert in the ordering IT-system and in two groups this was supplemented by an interruptive alert. Half of the groups received monthly feedback reports. Results Application of alerts, irrespective of the combination with feedback reports, resulted in significantly reduced test numbers (maximum −46%). Guidelines either alone or combined with feedback reports did not cause significant difference from the control group. The within-group requesting pattern changed significantly for only two of the groups. The distribution of low and normal vitamin D results within groups showed no signs of more appropriate use of the test in any of the groups. Conclusions Some of the interventions reduced the number of tests, but there were no indications of improved adherence to the guidelines. The interventions may have led to under-utilization of the test and thus should be used with care.

A Python Library for the Jupyteo IDE Earth Observation Processing Tool Enabling Interoperability with the QGIS System for Use in Data Science

This paper describes JupyQgis – a new Python library for Jupyteo IDE enabling interoperability with the QGIS system. Jupyteo is an online integrated development environment for earth observation data processing and is available on a cloud platform. It is targeted at remote sensing experts, scientists and users who can develop the Jupyter notebook by reusing embedded open-source tools, WPS interfaces and existing notebooks. In recent years, there has been an increasing popularity of data science methods that have become the focus of many organizations. Many scientific disciplines are facing a significant transformation due to data-driven solutions. This is especially true of geodesy, environmental sciences, and Earth sciences, where large data sets, such as Earth observation satellite data (EO data) and GIS data are used. The previous experience in using Jupyteo, both among the users of this platform and its creators, indicates the need to supplement its functionality with GIS analytical tools. This study analyzed the most efficient way to combine the functionality of the QGIS system with the functionality of the Jupyteo platform in one tool. It was found that the most suitable solution is to create a custom library providing an API for collaboration between both environments. The resulting library makes the work much easier and simplifies the source code of the created Python scripts. The functionality of the developed solution was illustrated with a test use case.

Acceptability of HIV oral self-test among truck drivers and youths: a qualitative investigation from Pune, Maharashtra

Background Ending AIDS by 2030 is a global target, to which India is a signatory. HIV-self-test (HIVST) coupled with counselling and AIDS-care, including antiretroviral therapy, has the potential to achieve this. However, national programs are at varying stages of acceptance of HIVST, as discussions around its introduction spark controversy and debates. HIV-self-test, as yet, is not part of the AIDS control program in India. Against this backdrop, we explored acceptability of an HIV oral self-test (HIVOST) among truckers and young men and women. Methods A qualitative investigation with 41 in-depth-interviews and 15 group discussions were conducted in the district of Pune, in the western state of Maharashtra, India. These interactions were built around a prototype HIVOST kit, helped in taking the discussions forward. The software N-vivo (version 11.0) was used to manage the volumes of data generated through the aforementioned process. The study was conducted during June through December, 2019. Results While the truckers belonged to the age bracket 21–67 year, the youths were in the age group 18–24 year. ‘Ease of doing HIVOST’ and ‘fear of needle pricks’ were the reasons behind acceptance around HIVOST by both the study groups. Truckers felt that HIVOST would encourage one to know one’s HIV status and seek help as appropriate. Accuracy of HIVOST result and disposal of the kits following use were concerns of a few. Most of the participants preferred saliva over blood as the specimen of choice. Instructions in local language reportedly would enable test-use by self. The truck drivers preferred undertaking HIVOST at the truckers-friendly ‘Khushi clinics’ or in the vehicle, while youths preferred the privacy of home. Some of the young men mis-perceived the utility of HIVOST by referring to doing a test on a partner immediately prior to sexual encounter. On the other hand, a few truckers had wrong information on HIV cure. Conclusions Overall, the study communities expressed their acceptance towards HIV-self-test. The National AIDS Control Program, India would benefit by drawing upon the findings of the current investigation. Existing myths and misconceptions around HIV test and treatment require program attention.

Identifying opportunities for timely diagnosis through patterns of primary care tests in patients with bladder and renal cancer: a longitudinal linked data study

Background: Understanding pre-diagnostic test use could reveal diagnostic windows where more timely evaluation for cancer may be indicated. Aim: To examine pre-diagnostic patterns of results of abnormal blood tests in bladder and renal cancer patients. Design and setting: Retrospective cohort study using primary care and cancer registry data on bladder and renal cancer patients diagnosed between 2012-2015 in England. Method: We examined the rates of patients with a first abnormal result in the year before diagnosis, for “generic” (full blood count components, inflammatory markers, calcium) and “organ-specific” blood tests (creatinine, liver function test components) which may lead to subsequent detection of incidental cancers. We used Poisson regression, to detect the month during which the cohort’s rate of each abnormal test started to increase from baseline, and examined the proportion of patients with a test found in the first half of the window, as these ‘early’ tests might represent opportunities where further evaluation could be initiated. Results: Data from 4,533 bladder and renal cancer patients were analysed. The monthly rate of patients with a first abnormal test increased towards the time of cancer diagnosis. Abnormalities of both generic and organ-specific tests started to increase from 6-8 months pre-diagnosis, with 25-40% of these patients having an abnormal test in the “early half” of the diagnostic window. Conclusion: Population-level signals of bladder and renal cancer can be observed in abnormalities in commonly performed primary care blood tests up to 8 months before diagnosis, indicating the potential for earlier diagnosis in some patients.

High-value laboratory testing for hospitalized COVID-19 patients: a review

We present here an evidence-based review of the utility, timing, and indications for laboratory test use in the domains of inflammation, cardiology, hematology, nephrology and co-infection for clinicians managing the care of hospitalized COVID-19 patients. Levels of IL-6, CRP, absolute lymphocyte count, neutrophils and neutrophil-to-lymphocyte ratio obtained upon admission may help predict the severity of COVID-19. Elevated lactate dehydrogenase, ferritin, aspartate aminotransferase, and ᴅ-dimer are associated with severe illness and mortality. Elevated cardiac troponin at hospital admission can alert clinicians to patients at risk for cardiac complications. Elevated proBNP may help distinguish a cardiac complication from noncardiac etiologies. Evaluation for co-infection is typically unnecessary in nonsevere cases but is essential in severe COVID-19, intensive care unit patients, and immunocompromised patients.

Laboratory Testing Patterns by Day of Hospital Stay for Medical and Surgical Hospitalizations

Introduction/Objective Studies of laboratory test utilization and costs by specific hospital day of stay (DOS) have yet to be widely published. Evaluation of laboratory test use by DOS would be helpful to better predict laboratory test reduction as hospital length of stay (LOS) is shortened, since testing on the final day of hospitalization is likely to differ from the average daily figures. Methods/Case Report Using an internal cost accounting database, we evaluated laboratory tests and costs by hospital DOS over one year (2017) at a large health system (N=133,139 hospital days). To evaluate changes over the first days of hospitalization, we set day 1 of hospitalization as a baseline and determined subsequent days as a percentage of day 1 figures. We also calculated laboratory variable cost as a percent of aggregate variable costs per DOS. We limited our analysis to the first week of hospitalization. We employed Medicare Severity Diagnosis Related Groups (MSDRG), used by the US Centers for Medicare and Medicaid Services (CMS), to aggregate hospital encounters into medical or surgical hospitalizations using MSDRG grouping methods. Results (if a Case Study enter NA) For medical inpatient stays, average laboratory tests (variable costs) were 10.8 ($74.11) on day 1, 7.7 ($38.53) on day 2, and 5.8 ($23.75) on day 3, with little change over the next four hospital DOS. Laboratory testing, as a percent of day 1 testing, for days 2-7 was: 70.7%, 53.4%, 54.3%, 54.5%, 55.1%, and 54.0%. Laboratory variable costs represented 7.8% of aggregate variable costs on hospital day 1 and declined sequentially over days 2-7: 5.6%, 4.3%, 3.9%, 3.8%, 3.8%, and 3.5%. For surgical hospitalizations, average laboratory tests (variable costs) were 18.2 ($130.02) on day 1, 11.9 ($57.38) on day 2, and 8.4 ($35.32) on day 3. As with medical stays, there was little change over the next four hospital DOS. Laboratory testing, as a percent of day 1 testing, for days 2-7 was: 65.6%, 46.1%, 44.6%, 46.3%, 45.9%, and 44.9%. Laboratory variable costs represented 3.2% of aggregate variable costs on hospital day 1 and remained essentially unchanged over the following days (range 3.3%-3.7%). Conclusion Laboratory variable costs are highest on the first day of hospitalization and decline over subsequent days to flatten by day 3.