Impact of using different blood donor subpopulations and models on the estimation of transfusion transmission residual risk of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus in Zimbabwe
Mapako T.,University of Groningen |
Janssen M.P.,University Utrecht |
Mvere D.A.,Planning |
Emmanuel J.C.,Planning |
And 4 more authors.
Transfusion | Year: 2016
BACKGROUND Various models for estimating the residual risk (RR) of transmission of infections by blood transfusion have been published mainly based on data from high-income countries. However, to obtain the data required for such an assessment remains challenging for most developing settings. The National Blood Service Zimbabwe (NBSZ) adapted a published incidence-window period (IWP) model, which has less demanding data requirements. In this study we assess the impact of various definitions of blood donor subpopulations and models on RR estimates. We compared the outcomes of two published models and an adapted NBSZ model. STUDY DESIGN AND METHODS The Schreiber IWP model (Model 1), an amended version (Model 2), and an adapted NBSZ model (Model 3) were applied. Variably the three models include prevalence, incidence, preseroconversion intervals, mean lifetime risk, and person-years at risk. Annual mean RR estimates and 95% confidence intervals for each of the three models for human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) were determined using NBSZ blood donor data from 2002 through 2011. RESULTS The annual mean RR estimates for Models 1 through 3 were 1 in 6542, 5805, and 6418, respectively for HIV; 1 in 1978, 2027, and 1628 for HBV; and 1 in 9588, 15,126, and 7750, for HCV. CONCLUSIONS The adapted NBSZ model provided comparable results to the published methods and these highlight the high occurrence of HBV in Zimbabwe. The adapted NBSZ model could be used as an alternative to estimate RRs when in settings where two repeat donations are not available. © 2016 AABB.
Agency: European Commission | Branch: H2020 | Program: ERA-NET-Cofund | Phase: SC5-02-2015 | Award Amount: 78.28M | Year: 2016
Within the European Research Area (ERA), the ERA4CS Consortium is aiming to boost, research for Climate Services (CS), including climate adaptation, mitigation and disaster risk management, allowing regions, cities and key economic sectors to develop opportunities and strengthen Europes leadership. CS are seen by this consortium as driven by user demands to provide knowledge to face impacts of climate variability and change, as well as guidance both to researchers and decisionmakers in policy and business. ERA4CS will focus on the development of a climate information translation layer bridging user communities and climate system sciences. It implies the development of tools, methods, standards and quality control for reliable, qualified and tailored information required by the various field actors for smart decisions. ERA4CS will boost the JPI Climate initiative by mobilizing more countries, within EU Member States and Associated Countries, by involving both the research performing organizations (RPOs) and the research funding organizations (RFOs), the distinct national climate services and the various disciplines of academia, including Social Sciences and Humanities. ERA4CS will launch a joint transnational co-funded call, with over 16 countries and up to 75M, with two complementary topics: (i) a cash topic, supported by 12 RFOs, on co-development for user needs and action-oriented projects; (ii) an in-kind topic, supported by 28 RPOs, on institutional integration of the research components of national CS. Finally, ERA4CS additional activities will initiate a strong partnership between JPI Climate and others key European and international initiatives (as Copernicus, KIC-Climate, JPIs, WMO/GFCS, Future Earth, Belmont Forum) in order to work towards a common vision and a multiyear implementation strategy, including better co-alignment of national programs and activities up to 2020 and beyond.
PubMed | Community Health science Unit, Ministry of Health, Evaluation and Research, University of Zambia and 3 more.
Type: Comparative Study | Journal: PloS one | Year: 2014
Todays uncertain HIV funding landscape threatens to slow progress towards treatment goals. Understanding the costs of antiretroviral therapy (ART) will be essential for governments to make informed policy decisions about the pace of scale-up under the 2013 WHO HIV Treatment Guidelines, which increase the number of people eligible for treatment from 17.6 million to 28.6 million. The study presented here is one of the largest of its kind and the first to describe the facility-level cost of ART in a random sample of facilities in Ethiopia, Malawi, Rwanda, South Africa and Zambia.In 2010-2011, comprehensive data on one year of facility-level ART costs and patient outcomes were collected from 161 facilities, selected using stratified random sampling. Overall, facility-level ART costs were significantly lower than expected in four of the five countries, with a simple average of $208 per patient-year (ppy) across Ethiopia, Malawi, Rwanda and Zambia. Costs were higher in South Africa, at $682 ppy. This included medications, laboratory services, direct and indirect personnel, patient support, equipment and administrative services. Facilities demonstrated the ability to retain patients alive and on treatment at these costs, although outcomes for established patients (2-8% annual loss to follow-up or death) were better than outcomes for new patients in their first year of ART (77-95% alive and on treatment).This study illustrated that the facility-level costs of ART are lower than previously understood in these five countries. While limitations must be considered, and costs will vary across countries, this suggests that expanded treatment coverage may be affordable. Further research is needed to understand investment costs of treatment scale-up, non-facility costs and opportunities for more efficient resource allocation.
Sugden B.D.,Plum Creek Timber Company |
Ethridge R.,705 Spurgin Road |
Mathieus G.,Planning |
Heffernan P.E.W.,PAFTI Inc |
And 2 more authors.
Journal of Forestry | Year: 2012
Under the federal Clean Water Act, states have developed nonpoint source control programs for forestry that range from voluntary to regulatory approaches. Nationally, management of runoff from forest roads is currently under scrutiny by courts, the US Environmental Protection Agency, and Congress. This article describes Montana's "blended" program of voluntary forestry best management practices (BMP) for roads and upland practices, and a Streamside Management Zone Act, which regulates operations near streams. Biennial audits over the past 20 years have shown continuous improvement, with BMP implementation rates increasing from 78% in 1990 to 97% in 2010. Observed water quality impacts have declined from an average of eight per harvest site in 1990 to less than one in 2010. Activities and culture that have promoted an effective program include regular compliance monitoring, customized landowner and logger education programs, strong buy-in from the forestry community, and program coordination by a statewide stakeholder group. © 2012 Society of American Foresters.
Choi W.,University of California at Los Angeles |
Paulson S.E.,University of California at Los Angeles |
Casmassi J.,Planning |
Winer A.M.,University of California at Los Angeles
Atmospheric Environment | Year: 2013
Meteorology confounds the comparison of air quality data across time and space. This presents challenges, for example, to comparisons of pollutant concentration data obtained with mobile monitoring platforms on different days and/or locations within the same airshed. In part to address this challenge, we employed a classification and regression tree (CART) modeling approach that can serve as a useful and straightforward tool in such air quality studies, to determine the comparability of meteorological conditions between measurement days and locations as well as to compare primary pollutant concentrations corrected by meteorological conditions. Specifically, regression trees were developed to obtain representative concentrations of traffic-related primary air pollutants such as NOx and CO, based on meteorological conditions for 2007-2009 in the California South Coast Air Basin (SoCAB). The resulting regression trees showed strong correlations between the regression classifications developed for different pollutant metrics, such as daily CO and NOx maxima, as well as between monitoring sites. For the SoCAB, the most important meteorological parameters controlling primary pollutant concentrations were the mean surface wind speed, geopotential heights at 925 mbar, the upper air north-south pressure gradient, the daily minimum temperature, relative humidity at 1000 mbar, and vertical stability, in approximate order of importance. The value of developing a regression tree for a single season was also explored by performing CART analysis separately on summer data. Although seasonal classifications were similar to those developed from annual data, the standard deviations of the classification groups were somewhat reduced. © 2012 Elsevier Ltd.
Gianazza D.,Planning |
Gianazza D.,CNRS Toulouse Institute in Information Technology
Artificial Intelligence | Year: 2010
The aim of the research presented in this paper is to forecast air traffic controller workload and required airspace configuration changes with enough lead time and with a good degree of realism. For this purpose, tree search methods were combined with a neural network. The neural network takes relevant air traffic complexity metrics as input and provides a workload indication (high, normal, or low) for any given air traffic control (ATC) sector. It was trained on historical data, i.e. archived sector operations, considering that ATC sectors made up of several airspace modules are usually split into several smaller sectors when the workload is excessive, or merged with other sectors when the workload is low. The input metrics are computed from the sector geometry and from simulated or real aircraft trajectories. The tree search methods explore all possible combinations of elementary airspace modules in order to build an optimal airspace partition where the workload is balanced as well as possible across the ATC sectors. The results are compared both to the real airspace configurations and to the forecast made by flow management operators in a French en-route air traffic control centre. © 2010 Elsevier B.V. All rights reserved.
Pokhrel D.R.,Planning |
Adil Godiwalla P.E.,Planning
Electronic Journal of Geotechnical Engineering | Year: 2012
Houston Airport System uses Advanced, Modern and Innovative pavement stabilization techniques, which are considered one of the most effective engineered technologies to prepare stable airfield pavement for the safe operation of heaviest and critical aircraft including B777 and Airbus A380. This technique allows pavement sub-grade to gain strength in a slow and controlled manner in order to reduce shrinkage crack and to produce long term "Autogenous Healing" Effect. Among such techniques, Lime fly ash stabilization is one of the most popular pozzolanic pavement sub-grade stabilization techniques adapted in almost every Runway and Taxiways projects at Houston Airport Systems. The objective of this paper is to evaluate the performance of stabilized soils through compaction and strength response behavior of Lime Fly-ash stabilized soil. Specimens were prepared in two groups for compaction and strength evaluation using different dose of stabilizer: 4% Lime + 8% Fly ash and 6% Lime + 8% Fly ash. The results showed improved compaction characteristics with stabilized soils. The results also indicated that the specimen with 6% Lime +8% Fly ash gave the highest compressive strength, in a range of 400 psi to 720 psi over the curing period of 90 days. Relationship between Plasticity Index (PI) of virgin soils and compressive strength of Lime Fly-ash stabilized soils are presented. The study was based on project specific research; Runway 4-22 at Hobby Airport, and the outcomes of this paper does not necessarily reflect any standard and specification. © 2012 ejge.
Planning | Date: 2016-12-06
Cappa C.,Statistics and Monitoring Section |
Child Abuse and Neglect | Year: 2011
Objectives: This article presents findings on caregivers' attitudes towards physical punishment of children from 34 household surveys conducted in low- and middle-income countries in 2005 and 2006. The article analyzes the variability in attitudes by background characteristics of the respondents to examine whether various factors at the individual and family levels correlate with the caregivers' beliefs in the need for violent discipline. The article also examines to what extent attitudes influence behaviors and compares groups of respondents to see how attitudes relate to disciplinary practices across caregivers of different socio-economic backgrounds. Methods: The analysis is based on nationally representative data from 33 MICS and 1 DHS surveys. Questions on child discipline were addressed to the mother (or primary caregiver) of one randomly selected child aged 2-14 years in each household. The questionnaire asked whether any member of the household had used various violent and non-violent disciplinary practices with that child during the past month. Additionally, the interviewers asked the respondent if she believed that, in order to bring up that child properly, physical punishment was necessary. The sample included 166,635 mothers/primary caregivers. Results: The analysis shows that, in most countries, the majority of mothers/primary caregivers did not think there was a need for physical punishment. Overall, characteristics such as household wealth and size, educational level and age, as well as place of residence were significantly associated with caregivers' attitudes. The analysis confirms that beliefs influence disciplinary practices to a large degree: in all the countries but two, children were significantly more likely to experience physical punishment if their mothers/primary caregivers thought such punishment was needed. However, large proportions of children were found to be subject to physical punishment even if their mothers/primary caregivers did not consider this method necessary. This discrepancy between attitudes and behaviors is observed, although to different extents, in all the countries and across groups of mothers/primary caregivers with different levels of education and wealth. Conclusions: The data presented in this article are among the few resources available to help develop a more global understanding of caregivers' motivation in using violent discipline across a multitude of low- and middle-income countries. As such, the analysis of these data provides important insights for the development of effective strategies that will promote positive parenting practices. However, further data collection and analysis are needed to fully understand the reasons why physical punishment is used - even when caregivers do not think such method is necessary - opening the door for an even sharper programmatic response to change the practice. © 2011 Elsevier Ltd.