Monitoring water and sanitation service levels over time: findings from WaterAid Malawi

Post-implementation monitoring surveys (PIMS) are part of WaterAid’s global monitoring requirements for assessing the current status of water and sanitation services installed 1, 3, 5 and 10 years previously. This Briefing Paper sets out a summary of findings and recommendations from a survey undertaken in Salima District during August 2013. Findings are discussed in relation to four service level indicators for water (quantity, quality, access and reliability) and for sanitation (design, use, quality and hand-washing). Two critical findings for water concern per capita consumption and significant variations in the performance of different pump types. For sanitation, two challenges relate to the distance between latrines and communal water points, and secondly sustaining hand-washing facilities

Improving water supply and sanitation programme effectiveness: lessons from WaterAid's outcome evaluation studies

Many low income countries are off-track to reach the Millennium Development Goals for water supply and sanitation. This paper develops a theoretical framework and methodology to improve the evaluation of water and sanitation programme outcomes, focusing on relevance, effectiveness and sustainability. The resulting set of evaluation questions are applied to seven independent evaluations of WaterAid's country programmes. Results are synthesised by assigning an ordinal ranking to the findings which are aggregated to assess overall outcome status that has validity at an organisational level, rather than just at country programme level. Strong areas of performance are partnership development, policy advocacy, equity and inclusion. Areas requiring attention are organisational learning, programme structure and government partner capacity for sustainability. The findings will be used to prioritise future programme management and are clustered into seven outcome areas that are of generic interest and significance to other organisations managing water supply and sanitation programmes

Positioning Singapore in the global economy: a study of political and economic processes.

This study seeks to understand the significance of political decision-making and economic processes in the establishment of Singapore as an Asian 'economic miracle'. Throughout the study, illustrative passages drawn from three case studies conducted in different sectors of the economy - the port, banking and the biomedical sciences — are used to throw light on matters such as the contribution of statutory boards and government-linked companies, privatisation, the role of foreign MNCs and direct investment, and the challenges facing local start-up companies. Singapore's linkages with the outside world are put in context through exploration of a theoretical framework comprising globalisation, regionalism and the world city concept. The treatment of these is questioning as well as descriptive, and also includes a substantial literature review. The main body of the thesis investigates five main factors that, in the author's view, influence the nature of Singapore's integration in the global economy. The first, often glossed over, is the enduring vulnerability of the city-state, both in economic and security terms. Second are the various means of state control of and intervention in, the economy. Third is the actual interface of Singapore and the global economy, and the approaches taken to the opportunities and dangers involved. The fourth and fifth factors — the growth of a knowledge-based economy and a refreshed and more urgent programme of regionalisation - represent the latest efforts to re-make the economy in order that Singapore remains competitive in a changing world. Following the conclusions to be drawn from the research project, the final chapter is given over to discussion about the future, highlighting the need for changes of mindset on the part of both government and governed, and closing with a proposal regarding the future direction of world-city research

Is failure to raise concerns about misconduct a breach of integrity? Researchers’ reflections on reporting misconduct

<p>This article describes and discusses the views of researchers on the significance of raising concerns about scientific misconduct in their work environment and the reasons or circumstances that might deter them from doing so. In this exploratory qualitative research study, we conducted in-depth interviews with 33 researchers working in life sciences and medicine. They represent three seniority levels and five universities across Switzerland. A large majority of respondents in this research study argued that failure to raise concerns about scientific misconduct compromises research integrity. This is an encouraging result demonstrating that researchers try to adhere to high ethical standards. However, further interaction with respondents highlighted that this correct ethical assessment does not lead researchers to take the consequent action of raising concerns. The factors that discourage researchers from raising concerns need to be addressed at the level of research groups, institutions, and by setting a positive precedent which helps them to believe in the system’s ability to investigate concerns raised in a timely and professional manner. Training of researchers in research integrity related issues will have limited utility unless it is coupled with the creation of research culture where raising concerns is a standard practice of scientific and research activities.</p

Trends in invasive bacterial diseases during the first 2 years of the COVID-19 pandemic- analyses of prospective surveillance data from 30 countries and territories in the IRIS Consortium

Background: The Invasive Respiratory Infection Surveillance (IRIS) Consortium was established to assess the impact of the COVID-19 pandemic on invasive diseases caused by Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis, and Streptococcus agalactiae. We aimed to analyse the incidence and distribution of these diseases during the first 2 years of the COVID-19 pandemic compared to the 2 years preceding the pandemic. Methods: For this prospective analysis, laboratories in 30 countries and territories representing five continents submitted surveillance data from Jan 1, 2018, to Jan 2, 2022, to private projects within databases in PubMLST. The impact of COVID-19 containment measures on the overall number of cases was analysed, and changes in disease distributions by patient age and serotype or group were examined. Interrupted time-series analyses were done to quantify the impact of pandemic response measures and their relaxation on disease rates, and autoregressive integrated moving average models were used to estimate effect sizes and forecast counterfactual trends by hemisphere. Findings: Overall, 116 841 cases were analysed: 76 481 in 2018-19, before the pandemic, and 40 360 in 2020-21, during the pandemic. During the pandemic there was a significant reduction in the risk of disease caused by S pneumoniae (risk ratio 0·47; 95% CI 0·40-0·55), H influenzae (0·51; 0·40-0·66) and N meningitidis (0·26; 0·21-0·31), while no significant changes were observed for S agalactiae (1·02; 0·75-1·40), which is not transmitted via the respiratory route. No major changes in the distribution of cases were observed when stratified by patient age or serotype or group. An estimated 36 289 (95% prediction interval 17 145-55 434) cases of invasive bacterial disease were averted during the first 2 years of the pandemic among IRIS-participating countries and territories. Interpretation: COVID-19 containment measures were associated with a sustained decrease in the incidence of invasive disease caused by S pneumoniae, H influenzae, and N meningitidis during the first 2 years of the pandemic, but cases began to increase in some countries towards the end of 2021 as pandemic restrictions were lifted. These IRIS data provide a better understanding of microbial transmission, will inform vaccine development and implementation, and can contribute to health-care service planning and provision of policies. Funding: Wellcome Trust, NIHR Oxford Biomedical Research Centre, Spanish Ministry of Science and Innovation, Korea Disease Control and Prevention Agency, Torsten Söderberg Foundation, Stockholm County Council, Swedish Research Council, German Federal Ministry of Health, Robert Koch Institute, Pfizer, Merck, and the Greek National Public Health Organization.</p

Trends in invasive bacterial diseases during the first 2 years of the COVID-19 pandemic- analyses of prospective surveillance data from 30 countries and territories in the IRIS Consortium

Background: The Invasive Respiratory Infection Surveillance (IRIS) Consortium was established to assess the impact of the COVID-19 pandemic on invasive diseases caused by Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis, and Streptococcus agalactiae. We aimed to analyse the incidence and distribution of these diseases during the first 2 years of the COVID-19 pandemic compared to the 2 years preceding the pandemic. Methods: For this prospective analysis, laboratories in 30 countries and territories representing five continents submitted surveillance data from Jan 1, 2018, to Jan 2, 2022, to private projects within databases in PubMLST. The impact of COVID-19 containment measures on the overall number of cases was analysed, and changes in disease distributions by patient age and serotype or group were examined. Interrupted time-series analyses were done to quantify the impact of pandemic response measures and their relaxation on disease rates, and autoregressive integrated moving average models were used to estimate effect sizes and forecast counterfactual trends by hemisphere. Findings: Overall, 116 841 cases were analysed: 76 481 in 2018-19, before the pandemic, and 40 360 in 2020-21, during the pandemic. During the pandemic there was a significant reduction in the risk of disease caused by S pneumoniae (risk ratio 0·47; 95% CI 0·40-0·55), H influenzae (0·51; 0·40-0·66) and N meningitidis (0·26; 0·21-0·31), while no significant changes were observed for S agalactiae (1·02; 0·75-1·40), which is not transmitted via the respiratory route. No major changes in the distribution of cases were observed when stratified by patient age or serotype or group. An estimated 36 289 (95% prediction interval 17 145-55 434) cases of invasive bacterial disease were averted during the first 2 years of the pandemic among IRIS-participating countries and territories. Interpretation: COVID-19 containment measures were associated with a sustained decrease in the incidence of invasive disease caused by S pneumoniae, H influenzae, and N meningitidis during the first 2 years of the pandemic, but cases began to increase in some countries towards the end of 2021 as pandemic restrictions were lifted. These IRIS data provide a better understanding of microbial transmission, will inform vaccine development and implementation, and can contribute to health-care service planning and provision of policies. Funding: Wellcome Trust, NIHR Oxford Biomedical Research Centre, Spanish Ministry of Science and Innovation, Korea Disease Control and Prevention Agency, Torsten Söderberg Foundation, Stockholm County Council, Swedish Research Council, German Federal Ministry of Health, Robert Koch Institute, Pfizer, Merck, and the Greek National Public Health Organization.</p

Scatter plots comparing results of FEC and a commercial cELISA (Bio X, Belgium) for <i>F</i>. <i>hepatica</i> infection in faecal samples that were collected from wild Scottish red deer between 2012 and 2014 (n = 353).

<p>Assays were carried out on samples that had been stored in two ways: (A) fresh (unfrozen) from the time of collection until time of testing (n = 146), and (B) frozen immediately after being collected from culled deer (n = 207). For the FEC test, results are recorded in eggs per gram of faeces (epg). For the cELISA, results are expressed in ELISA units (EU). Positive diagnosis by the cELISA was recorded for samples where results fell above a cut off derived using a positive reference standard.</p

FE and cELISA estimated prevalence of <i>F</i>. <i>hepatica</i> infection (percentage of specific cohorts infected by sex (male, m; female, f) and sample storage method).

<p>Cohorts were from nine wild red deer populations during two stalking seasons (2012–13 and 2013–14); cohort sample sizes are shown next to each point. See <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0162420#pone.0162420.s005" target="_blank">S2 Table</a> for details of sampling sites and seasons to which these data relate.</p

Cross-tabulated comparison between the diagnostic outcomes of a cELISA (BioX, Belgium), FE and post mortem whole liver examination for <i>F</i>. <i>hepatica</i> infection using faecal samples collected from wild Scottish red deer (n = 353), stored fresh and frozen.

<p>Cross-tabulated comparison between the diagnostic outcomes of a cELISA (BioX, Belgium), FE and post mortem whole liver examination for <i>F</i>. <i>hepatica</i> infection using faecal samples collected from wild Scottish red deer (n = 353), stored fresh and frozen.</p

Prevalence of <i>F</i>. <i>hepatica</i> in red deer in the Scottish Highlands (n = 959).

<p>Pie charts illustrate the proportions of infected and non-infected male and female deer in each estate. The size of each pie chart correlates with the number of samples collected on each estate. Overall differences in prevalence between estates are denoted by compact letter descriptors (calculated using Tukey Contrasts in the {glht} function in R), whereby estates that share at least one letter do not have significant differences (at the 5% level) in prevalence. See <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0162420#pone.0162420.s007" target="_blank">S4 Table</a> for prevalence stratified by sex and sampling seasons. Livestock presence (*) is noted for estates that contained sheep and/or cattle. All (*) denoted estates had hill sheep, and Applecross, Conaglen and Strathconon also had cattle.</p