Case 1 : Vanishing Volunteers: The Use of Implementation Research to Improve Support for Community Drug Distributors in Cote d\u27Ivoire

To be implemented successfully, most large-scale public health interventions, such as mass drug administration (MDA) campaigns for the elimination of lymphatic filariasis, require a large extent of human health resources. For several reasons, health workers and volunteer community drug distributors (CDDs) sometimes feel overwhelmed and unsupported in their work, which can cause them to give up their essential roles. In lower middle-income countries such as Côte d’Ivoire, where volunteers tasked with the distribution of antifilarial medications are already in short supply, losing valuable human health resources can ultimately cause MDA programs to fail. As such, it is crucial for implementers to recognize and address any issues with their health intervention plan that may lead to increased attrition among their workforce. Dr. Emmanuel Koffi, one of the neglected tropical disease program managers at Côte d’Ivoire’s Ministry of Health and Public Hygiene, recognizes that research is needed to investigate the factors contributing to increased stress and attrition rates among his volunteer CDDs. The steps that he should take to conduct an effective research project, however, remain uncertain. After reaching out to Dr. Myriam Kouamé at the University of Abidjan, Emmanuel has decided that applying an implementation research strategy may be best for this project. Having little experience with this type of research, he has enlisted Myriam’s assistance to develop a research plan that will help him identify how he can better support his volunteers. Emmanuel knows that time is short—the 2020 deadline to eliminate lymphatic filariasis in Côte d’Ivoire is fast approaching, and he must act quickly to ensure that the CDDs are well supported if they are to achieve this elimination goal

Improving coverage and compliance in mass drug administration for the elimination of LF in two 'Endgame' districts in Indonesia using micronarrative surveys

Author Summary This research describes the process used to assist two districts endemic for lymphatic filariasis (LF) in Indonesia to better understand the reasons why their LF elimination programs have had suboptimal results. A novel survey design was used to collect stories about people's direct experiences with mass drug administration (MDA) for LF. These questionnaires also explored the reasons community members took or did not take the LF drugs. Following MDA in 2013, two baseline surveys in endemic communities provided insight into the district MDA programs. Together with district health officials, feasible recommendations were provided before the next MDA round in 2014. Uptake of these recommendations by the districts was high, although no additional funding was made available for programmatic changes. As a result, both districts reported significant improvements in their MDA coverage and compliance rates after the endline surveys were completed in 2015. This demonstrated the utility of the survey tool and process to impact change and improvement in MDA programs

Observation of implicit complexity by non confluence

We propose to consider non confluence with respect to implicit complexity. We come back to some well known classes of first-order functional program, for which we have a characterization of their intentional properties, namely the class of cons-free programs, the class of programs with an interpretation, and the class of programs with a quasi-interpretation together with a termination proof by the product path ordering. They all correspond to PTIME. We prove that adding non confluence to the rules leads to respectively PTIME, NPTIME and PSPACE. Our thesis is that the separation of the classes is actually a witness of the intentional properties of the initial classes of programs

A Note on the Transaction Backout Problem

The transaction backout problem arises in the area of distributed databases. Suppose failures partition a data-redundant distributed database, and each partition continues to function as if it were the entire database. When the database is reconnected, the transactions executed by different partitions may not be serializable, and hence it may be necessary to back out some of the transactions. The transaction backout problem is to remove the smallest set of transactions that will leave the remaining ones serializable. The general problem is NP-complete, and in this paper we show that the special case of a fixed-size database can be solved in polynomial time by dynamic programming

The Complexity of Optimization Problems

Many important problems in computer science, such as CLIQUE, COLORING, and TRAVELLING SALESPERSON, arise naturally as optimization problems. Typically one considers these problems as decision procedures, which are often in NP, and one shows intractibility by showing them NP-complete. We generalize the notion of an NP problem, in a manner analogous to Valiant's class #P, by considering the optimization version of the problem itself, and we show that this idea yields a natural class of problems that we call OptP. This class allows us to make finer distinctions on the complexity of optimization problems than is possible in NP. For example, assuming P $\neq$ NP, we can show that TRAVELLING SALESPERSON is strictly harder than CLIQUE and CLIQUE is strictly harder than BIN PACKING. We then relate OptP to the class of functions computable in polynomial time with an oracle for NP, by showing that every $P^{SAT}$ function decomposes into an OptP function followed by a polynomial-time computation. This allows us to clear up a misconception on the role of uniqueness for the problem of UNIQUELY OPTIMAL TRAVELLING SALESPERSON as considered by Papadimitriou is the 1982 FOCS conference

Monadic Spectra and Regular Sets

Abstract not available

The Complexity of Optimization Problems

Many important problems in computer science, such as CLIQUE, COLORING, and TRAVELLING SALESPERSON, arise naturally as optimization problems. Typically one considers these problems as decision procedures, which are often in NP, and one shows intractibility by showing them NP-complete. We generalize the notion of an NP problem, in a manner analogous to Valiant's class #P, by considering the optimization version of the problem itself, and we show that this idea yields a natural class of problems that we call OptP. This class allows us to make finer distinctions on the complexity of optimization problems than is possible in NP. For example, assuming P $\neq$ NP, we can show that TRAVELLING SALESPERSON is strictly harder than CLIQUE and CLIQUE is strictly harder than BIN PACKING. We then relate OptP to the class of functions computable in polynomial time with an oracle for NP, by showing that every $P^{SAT}$ function decomposes into an OptP function followed by a polynomial-time computation. This allows us to clear up a misconception on the role of uniqueness for the problem of UNIQUELY OPTIMAL TRAVELLING SALESPERSON as considered by Papadimitriou is the 1982 FOCS conference

The Complexity of Optimization Problems

We study computational complexity theory and define a class of optimization problems called OptP (Optimization Polynomial Time), and we show that TRAVELLING SALESPERSON, KNAPSACK and 0-1 INTEGER LINEAR PROGRAMMING are complete for OptP. OptP is a natural generalization of NP (Nondeterministic Polynomial Time), but while NP only considers problems at the level of their yes/no question, the value of an OptP function is the optimal value of the problem. This approach enables us to show a deeper level of structure in these problems than is possible in NP

Assessing knowledge about lymphatic filariasis and the implementation of mass drug administration amongst drug deliverers in three districts/cities of Indonesia

Abstract Background This research assesses knowledge amongst drug deliverers about the implementation of mass drug administration (MDA) for lymphatic filariasis (LF) in Agam District (West Sumatera Province), the City of Depok (West Java Province) and the City of Batam (Kepulauan Riau Province), Indonesia. Methods A cross-sectional survey was conducted from January to March 2015 at these three sites. Respondents were identified using purposive sampling (i.e. cadre, health worker or community representatives). A total of 318 questionnaires were accepted for analysis. Three outcomes were assessed: knowledge about LF; knowledge about MDA implementation; and was informed about MDA coverage. Logistic regression analyses were employed to examine factors associated with these three outcomes. Results Less than half of respondents were charactersised as having a high level of LF knowledge and less than half a high level of knowledge about MDA. The odds of having a high level of knowledge of LF was significantly lower in Batam City than Agam District, yet higher amongst health workers than cadres. Deliverers living in urban areas reported more feedback on MDA outcomes than in the rural district. Health workers received more feedback than cadres (P < 0.001). Deliverers perceived the difference between coverage (drug receipt) and compliance (drug ingestion) in the community. Conclusions There are variations in knowledge about LF and MDA as well as feedback across drug deliverers in MDA across geographical areas. Adaptation of the MDA guidelines, supportive supervision, increasing the availability of supporting materials and directly-observed therapy might be beneficial to improve coverage and compliance in all areas