421 research outputs found
A preferred vision for administering elementary schools : a reflective essay
Administration is a word cluttered with connotative and denotative thoughts for each individual. When attached to the word education, it brings on another layer of detail and philosophical purpose. Obviously those of us involved in education have laid down the first belief that is essential to our jobs. That being the desire and the motivation to mold and educate our nation\u27s youth. We believe we will make a difference in children\u27s lives. An important and positive impact toward the education of our youth should and will remain the focus for administrators, for without children, we would have no purpose. However, that in and of itself is not enough for the administrator. He or she has a desire and demand to do more and be more. Those roles and beliefs are the object of this narrative
Verbal autopsy-assigned causes of death among adults being investigated for TB in South Africa
Aaron S. Karat - ORCID 0000-0001-9643-664X
https://orcid.org/0000-0001-9643-664XBackground: Adults being investigated for TB in South Africa experience high mortality, yet causes of death
(CoD) are not well defined. We determined CoD in this population using verbal autopsy (VA), and compared
HIV- and TB-associated CoD using physician-certified verbal autopsy (PCVA) and InterVA-4 software.Methods: All contactable consenting caregivers of participants who died during a trial comparing Xpert MTB/
RIF to smear microscopy were interviewed using the WHO VA tool. CoD were assigned using PCVA and
InterVA-4. Kappa statistic (K) and concordance correlation coefficient (CCC) were calculated for comparison.Results: Among 231 deaths, relatives of 137 deceased were interviewed. Of the 137 deceased 76 (55.4%)
were males, median age 41 years (IQR 33–50). PCVA assigned 70 (51.1%) TB immediate CoD (44 [62.8%] pulmonary TB; 26 [37.1%] extra-pulmonary TB); 21 (15.3%) HIV/AIDS-related; and 46 (33.5%) other CoD.
InterVA-4 assigned 48 (35.0%) TB deaths; 49 (35.7%) HIV/AIDS-related deaths; and 40 (29.1%) other CoD.
Agreement between PCVA and InterVA-4 CoD was slight at individual level (K=0.20; 95% CI 0.10–0.30) and
poor at population level (CCC 0.67; 95% CI 0.38–0.99).Conclusions: TB and HIV are leading CoD among adults being investigated for TB. PCVA and InterVA agreement at individual level was slight and poor at population level. VA methodology needs further development
where TB and HIV are common.This work was supported by Bill & Melinda Gates Foundation [Grant Number: OPP1034523] for funding the study.https://doi.org/10.1093/trstmh/trw058110pubpub
Vein fluorite U-Pb dating demonstrates post-6.2 ma rare-earth element mobilization associated with Rio Grande rifting
Blocking monoclonal antibodies specific for mouse IFN-α/β receptor subunit 1 (IFNAR-1) from mice immunized by in vivo hydrodynamic transfection
Performance of verbal autopsy methods in estimating HIV-associated mortality among adults in South Africa
Aaron S. Karat - ORCID 0000-0001-9643-664X
https://orcid.org/0000-0001-9643-664XIntroduction Verbal autopsy (VA) can be integrated into civil registration and vital statistics systems, but its accuracy in determining HIV-associated causes of death (CoD) is uncertain. We assessed the sensitivity and specificity of VA questions in determining HIV status and antiretroviral therapy (ART) initiation and compared HIV-associated mortality fractions assigned by different VA interpretation methods.Methods Using the WHO 2012 instrument with added ART
questions, VA was conducted for deaths among adults with
known HIV status (356 HIV positive and 103 HIV negative)
in South Africa. CoD were assigned using physiciancertified VA (PCVA) and computer-coded VA (CCVA)
methods and compared with documented HIV statusResults The sensitivity of VA questions in detecting HIV
status and ART initiation was 84.3% (95% CI 80 to 88) and
91.0% (95% CI 86 to 95); 283/356 (79.5%) HIV-positive
individuals were assigned HIV-associated CoD by PCVA,
166 (46.6%) by InterVA-4.03, 201 (56.5%) by InterVA-5,
and 80 (22.5%) and 289 (81.2%) by SmartVA-Analyze
V.1.1.1 and V.1.2.1. Agreement between PCVA and older
CCVA methods was poor (chance-corrected concordance
[CCC] <0; cause-specific mortality fraction [CSMF]
accuracy ≤56%) but better between PCVA and updated
methods (CCC 0.21–0.75; CSMF accuracy 65%–98%).
All methods were specific (specificity 87% to 96%) in
assigning HIV-associated CoD.Conclusion All CCVA interpretation methods
underestimated the HIV-associated mortality fraction
compared with PCVA; InterVA-5 and SmartVA-Analyze
V.1.2.1 performed better than earlier versions. Changes
to VA methods and classification systems are needed to
track progress towards targets for reducing HIV-associated
mortality,This study was funded by a grant from the Bill & Melinda Gates Foundation (OPP1083118).http://dx.doi.org/10.1136/bmjgh-2018-0008333pubpub
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