What medicines do households keep in their cabinets? Understanding the possession and use of medicines at home and the role of health insurance in Nigeria

Background Globally, the possession of medicines stored at home is increasing. However, little is known about the determinants of possessing medicines, their usage according to clinical purpose, which we term ‘correct drug match’, and the role of health insurance. Methods This study uses data from a 2013 survey evaluating a health insurance program in Kwara State, Nigeria, which upgraded health facilities and subsidized insurance premiums. The final dataset includes 1,090 households and 4,641 individuals. Multilevel mixed-effects logistic regressions were conducted at both the individual level and at the level of the medicines kept in respondents’ homes to understand the determinants of medicine possession and correct drug match, respectively, and to investigate the effect of health insurance on both. Results A total of 9,266 medicines were classified with 61.2% correct match according to self-reported use, 11.9% incorrect match and 26.9% indeterminate. Most medicines (73.0%) were obtained from patent proprietary medicine vendors (PPMVs). At 36.6%, analgesics were the most common medicine held at home, while anti-malarial use had the highest correct match at 96.1%. Antihistamines, vitamins and minerals, expectorants, and antibiotics were most likely to have an incorrect match at respectively 35.8%, 33.6%, 31.9%, and 26.6%. Medicines were less likely to have a correct match when found with the uneducated and obtained from public facilities. Enrolment in the insurance program increased correct matches for specific medicines, notably antihypertensives and antibiotics (odds ratio: 25.15 and 3.60, respectively). Conclusion Since PPMVs serve as both the most popular and better channel compared to the public sector to obtain medicines, we recommend that policymakers strengthen their focus on these vendors to educate communities on medicine types and their correct use. Health insurance programs that provide affordable access to improved-quality health facilities represent another important avenue for reducing the burden of incorrect drug use. This appears increasingly important in view of the global rise in antimicrobial resistance.

Practical Solutions to Forensic Contextual Bias

In 2009, the National Research Council (NRC) globally criticized forensic science and, in particular, the potential for contextual bias to increase errors in forensic examination. Nevertheless, very few research-based solutions have been proposed and, of the current recommendations, none are consistently used in practice. Two experiments are presented here. Experiment 1 replicates and extends the Quigley-McBride and Wells (2018) study in which fingerprint lineups (the Filler-Control Procedure) were shown to neutralize the effect of contextual information on novice fingerprint evaluations. Experiment 2 demonstrates that restricting the use of evidence lineups to verification decisions would also be effective for reducing incorrect match decisions without straining resources. In both experiments, the filler-control procedure consistently reduced the effect of suggestive contextual information and protected innocent suspect prints from being mistakenly matched to crime samples. Interdisciplinary approaches are discussed as a way to help close the gap between research and forensic science practice.

Errors of Analysis in Distance Assessment: Effects of Vertical on Horizontal Components

(a) Participants indicated, for pairs of circles whose locations varied on the horizontal and vertical axes of a frontal plane, whether the horizontal distance between the circles exceeded a target horizontal distance. The error rate depended on the vertical as well as the horizontal distance between the circles. (b) Participants indicated, for pairs of circles that were varying horizontal (or vertical) distances and a constant vertical (or horizontal) distance apart in a frontal plane, whether the horizontal (or vertical) distance between them matched a target horizontal (or vertical) distance. Incorrect “match” responses were more likely if the horizontal (or vertical) distance between the circles was less than as opposed to greater than the target distance. The results suggest that distance judgments for pairs of stimuli varying on the horizontal and vertical axes are based on the overall distance between the stimuli, with the relevant axis given more weight than the irrelevant axis in assessment of the distance. The results do not support the view that that such distance judgments are based on the relevant distance between the stimuli, with the relevant and irrelevant axes being erroneously interchanged on some iterations of the assessment process.

INCORRECT MATCH DETECTION METHOD FOR ARCTIC SEA-ICE RECONSTRUCTION USING UAV IMAGES

Shapes and surface roughness, which are considered as key indicators in understanding Arctic sea-ice, can be measured from the digital surface model (DSM) of the target area. Unmanned aerial vehicle (UAV) flying at low altitudes enables theoretically accurate DSM generation. However, the characteristics of sea-ice with textureless surface and incessant motion make image matching difficult for DSM generation. In this paper, we propose a method for effectively detecting incorrect matches before correcting a sea-ice DSM derived from UAV images. The proposed method variably adjusts the size of search window to analyze the matching results of DSM generated and distinguishes incorrect matches. Experimental results showed that the sea-ice DSM produced large errors along the textureless surfaces, and that the incorrect matches could be effectively detected by the proposed method.

Feasibility study for identifying adverse events attributable to vaccination by record linkage

SUMMARYTo investigate the feasibility of using a record linkage method for identifying vaccine attributable adverse events, computerized hospital admissions and vaccination records from South East Kent district were linked and checked for accuracy. Records for 90% of children under 2 years of age admitted to hospital over a 2-year period were matched with vaccination records using a computer algorithm based on name, date of birth, sex, and post-code supplemented by visual inspection. Relative to this gold standard, matching on date of birth, sex and postcode alone had a sensitivity of 60% and an incorrect match rate of 0·2% after matches to more than one vaccine recipient were excluded. Manual checking of a sample of admissions showed that only 4% had been assigned incorrect International Classification of Disease (ICD) codes. Routine record linkage of ICD admission codes to vaccination records therefore yields data of good quality which may be used for surveillance purposes.

Application of a Search System and Vapor-Phase Library to Spectral Identification Problems

A recent major advance in the field of gas chromatography/Fourier transform infrared spectrometry is the availability of a search system and digitized vapor phase infrared library. This paper presents the results of the application of this search system to a real-world sample. Examples are shown of correct matches and an incorrect match. Overall, the search performs very well with good quality unknown spectra, but cannot differentiate between a spectrum and background. These results indicate that visual comparison of the unknown and standard are required for all but the most routine identifications.