Community knowledge variation, bed-net coverage, the role of a district health care system and their implications for malaria control in Southern Malawi

This paper presents data on the pattern of knowledge of caregivers, bed-net coverage and the role of a rural district healthcare system, and their implications for malaria transmission, treatment, prevention and control in Chikhwawa, southern Malawi, using multi-level logistic regression modelling with Bayesian estimation. The majority of caregivers could identify the main symptoms of malaria, that the mosquito was the vector, and that insecticide-treated nets (ITN) could be used to cover beds as an effective preventative measure, although cost was a prohibitive factor. Use of bed nets displayed significant variation between communities. Groups that were more knowledgeable on malaria prevention and symptoms included young mothers, people who had attended school, wealthy individuals, those residing closest to government hospitals and health posts, and communities that had access to a health surveillance assistant (HSA). HSAs should be trained on malaria intervention programmes, and tasked with the responsibility of working with village health committees to develop community-based malaria intervention programmes. These programmes should include appropriate and affordable household improvement methods, identification of high-risk groups, distribution of ITNs and the incorporation of larval control measures, to reduce exposure to the vector and parasite. This would reduce the transmission and prevalence of malaria at community level

Projection of Diabetes Population Size and Associated Economic Burden through 2030 in Iran : Evidence from Micro-Simulation Markov Model and Bayesian Meta-Analysis

Acknowledgments The authors would like to thank kindly all advisors and colleagues, for their valuable technical support. We would like to thank you Ms Laura Marie Dysart for editing the paper.Peer reviewedPublisher PD

Dynamic real-time risk analytics of uncontrollable states in complex internet of things systems, cyber risk at the edge

The Internet of Things (IoT) triggers new types of cyber risks. Therefore, the integration of new IoT devices and services requires a self-assessment of IoT cyber security posture. By security posture this article refers to the cybersecurity strength of an organisation to predict, prevent and respond to cyberthreats. At present, there is a gap in the state of the art, because there are no self-assessment methods for quantifying IoT cyber risk posture. To address this gap, an empirical analysis is performed of 12 cyber risk assessment approaches. The results and the main findings from the analysis is presented as the current and a target risk state for IoT systems, followed by conclusions and recommendations on a transformation roadmap, describing how IoT systems can achieve the target state with a new goal-oriented dependency model. By target state, we refer to the cyber security target that matches the generic security requirements of an organisation. The research paper studies and adapts four alternatives for IoT risk assessment and identifies the goal-oriented dependency modelling as a dominant approach among the risk assessment models studied. The new goal-oriented dependency model in this article enables the assessment of uncontrollable risk states in complex IoT systems and can be used for a quantitative self-assessment of IoT cyber risk posture

Cloud Storage and Bioinformatics in a private cloud deployment: Lessons for Data Intensive research

This paper describes service portability for a private cloud deployment, including a detailed case study about Cloud Storage and bioinformatics services developed as part of the Cloud Computing Adoption Framework (CCAF). Our Cloud Storage design and deployment is based on Storage Area Network (SAN) technologies, details of which include functionalities, technical implementation, architecture and user support. Experiments for data services (backup automation, data recovery and data migration) are performed and results confirm backup automation is completed swiftly and is reliable for data-intensive research. The data recovery result confirms that execution time is in proportion to quantity of recovered data, but the failure rate increases in an exponential manner. The data migration result confirms execution time is in proportion to disk volume of migrated data, but again the failure rate increases in an exponential manner. In addition, benefits of CCAF are illustrated using several bioinformatics examples such as tumour modelling, brain imaging, insulin molecules and simulations for medical training. Our Cloud Storage solution described here offers cost reduction, time-saving and user friendliness

What are GPs' preferences for financial and non-financial incentives in cancer screening? Evidence for breast, cervical, and colorectal cancers

We benefited for this research from grants provided by the French National Institute for Cancer (INCa) (INCA_7014). We would like to thank Dr Diane Skatun, Mary Kilonzo, and the three anonymous reviewers for their useful comments on the paper.Peer reviewedPostprin

What guidance are researchers given on how to present network meta-analyses to end-users such as policymakers and clinicians? A systematic review

© 2014 Sullivan et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Introduction: Network meta-analyses (NMAs) are complex methodological approaches that may be challenging for non-technical end-users, such as policymakers and clinicians, to understand. Consideration should be given to identifying optimal approaches to presenting NMAs that help clarify analyses. It is unclear what guidance researchers currently have on how to present and tailor NMAs to different end-users. Methods: A systematic review of NMA guidelines was conducted to identify guidance on how to present NMAs. Electronic databases and supplementary sources were searched for NMA guidelines. Presentation format details related to sample formats, target audiences, data sources, analysis methods and results were extracted and frequencies tabulated. Guideline quality was assessed following criteria developed for clinical practice guidelines. Results: Seven guidelines were included. Current guidelines focus on how to conduct NMAs but provide limited guidance to researchers on how to best present analyses to different end-users. None of the guidelines provided reporting templates. Few guidelines provided advice on tailoring presentations to different end-users, such as policymakers. Available guidance on presentation formats focused on evidence networks, characteristics of individual trials, comparisons between direct and indirect estimates and assumptions of heterogeneity and/or inconsistency. Some guidelines also provided examples of figures and tables that could be used to present information. Conclusions: Limited guidance exists for researchers on how best to present NMAs in an accessible format, especially for non-technical end-users such as policymakers and clinicians. NMA guidelines may require further integration with end-users' needs, when NMAs are used to support healthcare policy and practice decisions. Developing presentation formats that enhance understanding and accessibility of NMAs could also enhance the transparency and legitimacy of decisions informed by NMAs.The Canadian Institute of Health Research (CIHR) Drug Safety and Effectiveness Network (Funding reference number – 116573)

Randomised controlled trials of complex interventions and large-scale transformation of services

Complex interventions and large-scale transformations of services are necessary to meet the health-care challenges of the 21st century. However, the evaluation of these types of interventions is challenging and requires methodological development. Innovations such as cluster randomised controlled trials, stepped-wedge designs, and non-randomised evaluations provide options to meet the needs of decision-makers. Adoption of theory and logic models can help clarify causal assumptions, and process evaluation can assist in understanding delivery in context. Issues of implementation must also be considered throughout intervention design and evaluation to ensure that results can be scaled for population benefit. Relevance requires evaluations conducted under real-world conditions, which in turn requires a pragmatic attitude to design. The increasing complexity of interventions and evaluations threatens the ability of researchers to meet the needs of decision-makers for rapid results. Improvements in efficiency are thus crucial, with electronic health records offering significant potential

Using a Bayesian change-point statistical model with autoregressive terms to study the monthly number of dispensed asthma medications by public health services

In this paper, it is proposed a Bayesian analysis of a time series in the presence of a random change-point and autoregressive terms. The development of this model was motivated by a data set related to the monthly number of asthma medications dispensed by the public health services of Ribeirão Preto, Southeast Brazil, from 1999 to 2011. A pronounced increase trend has been observed from 1999 to a specific change-point, with a posterior decrease until the end of the series. In order to obtain estimates for the parameters of interest, a Bayesian Markov Chain Monte Carlo (MCMC) simulation procedure using the Gibbs sampler algorithm was developed. The Bayesian model with autoregressive terms of order 1 fits well to the data, allowing to estimate the change-point at July 2007, and probably reflecting the results of the new health policies and previously adopted programs directed toward patients with asthma. The results imply that the present model is useful to analyse the monthly number of dispensed asthma medications and it can be used to describe a broad range of epidemiological time series data where a change-point is present.Peer Reviewe