10 research outputs found

    Chiefs’ endorsements and voter behavior

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    Traditional leaders can influence electoral outcomes. We designed an experiment to investigate why public endorsements by chiefs affect voters – and which types of voters they influence. Chiefs have incentives to prefer politicians who will promote local development, and can use endorsements to sway elections accordingly. We argue that voters often interpret chiefs’ endorsements as a signal of candidate quality. To assess this argument, we exposed voters to real endorsements made by chiefs during Ghana’s 2020 presidential election. We show that endorsements impact the vote choice of undecided voters. Consistent with a signaling mechanism, respondents exposed to chiefs’ rationale for endorsing a candidate were no more likely to vote for the endorsed candidate than those who only heard chiefs’ approval of a candidate. Further, treated respondents hold higher evaluations of the endorsed candidate on multiple dimensions of candidate quality. Our results suggest that chiefs influence voters through a non-coercive mechanism, which has positive implications for accountability

    Drug-resistant genotypes and multi-clonality in Plasmodium falciparum analysed by direct genome sequencing from peripheral blood of malaria patients.

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    Naturally acquired blood-stage infections of the malaria parasite Plasmodium falciparum typically harbour multiple haploid clones. The apparent number of clones observed in any single infection depends on the diversity of the polymorphic markers used for the analysis, and the relative abundance of rare clones, which frequently fail to be detected among PCR products derived from numerically dominant clones. However, minority clones are of clinical interest as they may harbour genes conferring drug resistance, leading to enhanced survival after treatment and the possibility of subsequent therapeutic failure. We deployed new generation sequencing to derive genome data for five non-propagated parasite isolates taken directly from 4 different patients treated for clinical malaria in a UK hospital. Analysis of depth of coverage and length of sequence intervals between paired reads identified both previously described and novel gene deletions and amplifications. Full-length sequence data was extracted for 6 loci considered to be under selection by antimalarial drugs, and both known and previously unknown amino acid substitutions were identified. Full mitochondrial genomes were extracted from the sequencing data for each isolate, and these are compared against a panel of polymorphic sites derived from published or unpublished but publicly available data. Finally, genome-wide analysis of clone multiplicity was performed, and the number of infecting parasite clones estimated for each isolate. Each patient harboured at least 3 clones of P. falciparum by this analysis, consistent with results obtained with conventional PCR analysis of polymorphic merozoite antigen loci. We conclude that genome sequencing of peripheral blood P. falciparum taken directly from malaria patients provides high quality data useful for drug resistance studies, genomic structural analyses and population genetics, and also robustly represents clonal multiplicity

    Pre-Analysis Plans: An Early Stocktaking

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    Do pre-analysis plans hamper publication?

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    Scholars assert that pre-analysis plans (PAPs) generate boring, lab-report style papers and thus hamper publication. We test this claim by comparing the publication rates of experimental NBER working papers with and without PAPs. We find that articles with PAPs are slightly less likely to be published. However, conditional on being published, PAP-generated papers are significantly more likely to land in top-five journals. Also, PAP-based journal articles generate more citations. Our findings suggest that the alleged trade-off between career concerns and the scientific credibility that comes from registering and adhering to a PAP is less stark than is sometimes alleged

    Pre-analysis plans: an early stocktaking

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    Pre-analysis plans (PAPs) have been championed as a solution to the problem of research credibility, but without any evidence that PAPs actually bolster the credibility of research. We analyze a representative sample of 195 PAPs registered on the Evidence in Governance and Politics (EGAP) and American Economic Association (AEA) registration platforms to assess whether PAPs registered in the early days of pre-registration (2011–2016) were sufficiently clear, precise, and comprehensive to achieve their objective of preventing “fishing” and reducing the scope for post-hoc adjustment of research hypotheses. We also analyze a subset of ninety-three PAPs from projects that resulted in publicly available papers to ascertain how faithfully they adhere to their preregistered specifications and hypotheses. We find significant variation in the extent to which PAPs registered during this period accomplished the goals they were designed to achieve. We discuss these findings in light of both the costs and benefits of preregistration, showing how our results speak to the various arguments that have been made in support of and against PAPs. We also highlight the norms and institutions that will need to be strengthened to augment the power of PAPs to improve research credibility and to create incentives for researchers to invest in both producing and policing them

    Vaccination Utilization and Subnational Inequities during the COVID-19 Pandemic: An Interrupted Time-Series Analysis of Administrative Data across 12 Low- and Middle-Income Countries

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    Background: During and after the SARS-CoV-2 (COVID-19) pandemic, many countries experienced declines in immunization that have not fully recovered to pre-pandemic levels. This study uses routine health facility immunization data to estimate variability between and within countries in post-pandemic immunization service recovery for BCG, DPT1, and DPT3. Methods: After adjusting for data reporting completeness and outliers, interrupted time series regression was used to estimate the expected immunization service volume for each subnational unit, using an interruption point of March 2020. We assessed and compared the percent deviation of observed immunizations from the expected service volume for March 2020 between and within countries. Results: Six countries experienced significant service volume declines for at least one vaccine as of October 2022. The shortfall in BCG service volume was ~6% (95% CI −1.2%, −9.8%) in Guinea and ~19% (95% CI −16%, 22%) in Liberia. Significant cumulative shortfalls in DPT1 service volume are observed in Afghanistan (−4%, 95% CI −1%, −7%), Ghana (−3%, 95% CI −1%, −5%), Haiti (−7%, 95% CI −1%, −12%), and Kenya (−3%, 95% CI −1%, −4%). Afghanistan has the highest percentage of subnational units reporting a shortfall of 5% or higher in DPT1 service volume (85% in 2021 Q1 and 79% in 2020 Q4), followed by Bangladesh (2020 Q1, 83%), Haiti (80% in 2020 Q2), and Ghana (2022 Q2, 75%). All subnational units in Bangladesh experienced a 5% or higher shortfall in DPT3 service volume in the second quarter of 2020. In Haiti, 80% of the subnational units experienced a 5% or higher reduction in DPT3 service volume in the second quarter of 2020 and the third quarter of 2022. Conclusions: At least one region in every country has a significantly lower-than-expected post-pandemic cumulative volume for at least one of the three vaccines. Subnational monitoring of immunization service volumes using disaggregated routine health facility information data should be conducted routinely to target the limited vaccination resources to subnational units with the highest inequities

    Adaptation of the Wound Healing Questionnaire universal-reporter outcome measure for use in global surgery trials (TALON-1 study): mixed-methods study and Rasch analysis

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    BackgroundThe Bluebelle Wound Healing Questionnaire (WHQ) is a universal-reporter outcome measure developed in the UK for remote detection of surgical-site infection after abdominal surgery. This study aimed to explore cross-cultural equivalence, acceptability, and content validity of the WHQ for use across low- and middle-income countries, and to make recommendations for its adaptation.MethodsThis was a mixed-methods study within a trial (SWAT) embedded in an international randomized trial, conducted according to best practice guidelines, and co-produced with community and patient partners (TALON-1). Structured interviews and focus groups were used to gather data regarding cross-cultural, cross-contextual equivalence of the individual items and scale, and conduct a translatability assessment. Translation was completed into five languages in accordance with Mapi recommendations. Next, data from a prospective cohort (SWAT) were interpreted using Rasch analysis to explore scaling and measurement properties of the WHQ. Finally, qualitative and quantitative data were triangulated using a modified, exploratory, instrumental design model.ResultsIn the qualitative phase, 10 structured interviews and six focus groups took place with a total of 47 investigators across six countries. Themes related to comprehension, response mapping, retrieval, and judgement were identified with rich cross-cultural insights. In the quantitative phase, an exploratory Rasch model was fitted to data from 537 patients (369 excluding extremes). Owing to the number of extreme (floor) values, the overall level of power was low. The single WHQ scale satisfied tests of unidimensionality, indicating validity of the ordinal total WHQ score. There was significant overall model misfit of five items (5, 9, 14, 15, 16) and local dependency in 11 item pairs. The person separation index was estimated as 0.48 suggesting weak discrimination between classes, whereas Cronbach's α was high at 0.86. Triangulation of qualitative data with the Rasch analysis supported recommendations for cross-cultural adaptation of the WHQ items 1 (redness), 3 (clear fluid), 7 (deep wound opening), 10 (pain), 11 (fever), 15 (antibiotics), 16 (debridement), 18 (drainage), and 19 (reoperation). Changes to three item response categories (1, not at all; 2, a little; 3, a lot) were adopted for symptom items 1 to 10, and two categories (0, no; 1, yes) for item 11 (fever).ConclusionThis study made recommendations for cross-cultural adaptation of the WHQ for use in global surgical research and practice, using co-produced mixed-methods data from three continents. Translations are now available for implementation into remote wound assessment pathways
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