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CompStat emerged in the mid 1990s and quickly came to be seen as a major innovation in American policing. By the turn of the century it had received national awards from Harvard University and former Vice President Gore, and was featured prominently along with William Bratton (the police administrator who created the program) in the national news media. Its originators and proponents gave CompStat credit for impressive reductions in crime and improvements in neighborhood quality of life in a number of cities that had adopted the program (Silverman, 1996; Remnick, 1997; Gurwitt, 1998; Bratton, 1999). And while CompStat was first introduced only in 1994 in New York City, police departments around the country had begun to adopt it or variations of it by the first decade of the new century (Law Enforcement News, 1997; Maas, 1998; McDonald, 1998; Weisburd et al., 2003; Willis, Mastrofski & Kochel, 2010a). Indeed, in a Police Foundation survey conducted only six years after CompStat emerged on the scene in New York City, more than a third of American police agencies with 100 or more sworn officers claimed to have implemented a CompStat-like program (Weisburd et al., 2001). By 2006, Willis, Mastrofski, and Kochel (2010b) reported that about 60 percent of large police agencies had adopted CompStat, and a Police Executive Research Forum membership survey in 2011 reported that 85 percent of 166 responding member agencies reported having adopted or plans to adopt CompStat (Bureau of Justice Assistance & Police Executive Research Forum, 2013). Drawing on this survey and the comments of police leaders, researchers, and others attending a conference on CompStat in 2013, a report on the meeting offered a uniformly positive assessment of CompStat’s performance to date, as well as its future potential: “Regardless of how it develops in the future, it is clear that Compstat has become an integral part of policing in the United States by helping agencies become more productive, agile, and effective” (BJA & PERF, 2013: 30).
The aim of this systematic review is to evaluate the impact of personal protective equipment (PPE) on medical device use during public health emergency responses. We conducted a systematic literature search of peer-reviewed journals in PubMed, Web of Science, and EBSCO databases. Twenty-nine of 92 articles published between 1984 and 2015 met the inclusion criteria for the review. Although many medical device use impacts were reported, they predominantly fell into 3 categories: airway management, drug administration, and diagnostics and monitoring. Chemical, biological, radiological, and nuclear (CBRN)-PPE increased completion times for emergency clinical procedures by as much as 130% and first attempt failure rates by 35% (anesthetist) versus 55% (non-anesthetist). Effects of CBRN-PPE use depend on device, CBRN-PPE level, and clinician experience and training. Continuous clinical training of responders in CBRN-PPE and device modifications can improve safety and effectiveness of medical device use during public health emergency response.
Current coverage of mental healthcare in low- and middle-income countries is very limited, not only in terms of access to services but also in terms of financial protection of individuals in need of care and treatment.
To identify the challenges, opportunities and strategies for more equitable and sustainable mental health financing in six sub-Saharan African and South Asian countries, namely Ethiopia, India, Nepal, Nigeria, South Africa and Uganda.
In the context of a mental health systems research project (Emerald), a multi-methods approach was implemented consisting of three steps: a quantitative and narrative assessment of each country's disease burden profile, health system and macro-fiscal situation; in-depth interviews with expert stakeholders; and a policy analysis of sustainable financing options.
Key challenges identified for sustainable mental health financing include the low level of funding accorded to mental health services, widespread inequalities in access and poverty, although opportunities exist in the form of new political interest in mental health and ongoing reforms to national insurance schemes. Inclusion of mental health within planned or nascent national health insurance schemes was identified as a key strategy for moving towards more equitable and sustainable mental health financing in all six countries.
Including mental health in ongoing national health insurance reforms represent the most important strategic opportunity in the six participating countries to secure enhanced service provision and financial protection for individuals and households affected by mental disorders and psychosocial disabilities.
Declaration of interest
D.C. is a staff member of the World Health Organization.
Historic period Plains biographic art provides narratives of the deeds and actions of Indigenous peoples of the region. The Crow (Apsáalooke) are one such people with a rich record of biographic drawings in rock art and portable works. However, chronological and stylistic links between these two media have long been thought out of reach, even though such links are essential if the abundant Historic period rock art is to be fully incorporated into discussions of Apsáalooke history and their connection better ascertained to documented historical and ethnohistorical events and trends. Indeed, the lack of such a framework locks away a vast wealth of history in these hundreds of rock art pictures. In this article we present a statistical framework for comparing better-dated Crow portable artworks with their rock art equivalents. We are able to place rock art imagery from five sites into a relatively fine-grained chronological order, which permits a better understanding of changing patterns in Crow stylistic imagery. This permits a direct association with changing historical circumstances and facilitates a better understanding of the link between social history and the changing patterns seen in these artworks. Moreover, in one case, our analysis provides archaeological confirmation of Crow ethnohistory.
Under the European Union’s Solvency II regulations, insurance firms are required to use a one-year VaR (Value at Risk) approach. This involves a one-year projection of the balance sheet and requires sufficient capital to be solvent in 99.5% of outcomes. The Solvency II Internal Model risk calibrations require annual changes in market indices/term structure for the estimation of risk distribution for each of the Internal Model risk drivers. This presents a significant challenge for calibrators in terms of:
Robustness of the calibration that is relevant to the current market regimes and at the same time able to represent the historically observed worst crisis;
Stability of the calibration model year on year with arrival of new information.
The above points need careful consideration to avoid credibility issues with the Solvency Capital Requirement (SCR) calculation, in that the results are subject to high levels of uncertainty.
For market risks, common industry practice to compensate for the limited number of historic annual data points is to use overlapping annual changes. Overlapping changes are dependent on each other, and this dependence can cause issues in estimation, statistical testing, and communication of uncertainty levels around risk calibrations.
This paper discusses the issues with the use of overlapping data when producing risk calibrations for an Internal Model. A comparison of the overlapping data approach with the alternative non-overlapping data approach is presented. A comparison is made of the bias and mean squared error of the first four cumulants under four different statistical models. For some statistical models it is found that overlapping data can be used with bias corrections to obtain similarly unbiased results as non-overlapping data, but with significantly lower mean squared errors. For more complex statistical models (e.g. GARCH) it is found that published bias corrections for non-overlapping and overlapping datasets do not result in unbiased cumulant estimates and/or lead to increased variance of the process.
In order to test the goodness of fit of probability distributions to the datasets, it is common to use statistical tests. Most of these tests do not function when using overlapping data, as overlapping data breach the independence assumption underlying most statistical tests. We present and test an adjustment to one of the statistical tests (the Kolmogorov Smirnov goodness-of-fit test) to allow for overlapping data.
Finally, we explore the methods of converting “high”-frequency (e.g. monthly data) to “low”-frequency data (e.g. annual data). This is an alternative methodology to using overlapping data, and the approach of fitting a statistical model to monthly data and then using the monthly model aggregated over 12 time steps to model annual returns is explored. There are a number of methods available for this approach. We explore two of the widely used approaches for aggregating the time series.
Jaswal & Akhtar provide several quotes ostensibly from people with autism but obtained via the discredited techniques of Facilitated Communication and the Rapid Prompting Method, and they do not acknowledge the use of these techniques. As a result, their argument is substantially less convincing than they assert, and the article lacks transparency.
This commentary highlights the observation that social motivation is usually an imprecisely specified construct. We suggest four social motivation conceptualizations across levels of analysis and explore where the target article situates among these. We then offer theoretical and practical guidance for operationalization and measurement of social motivation to support more comprehensive future research on this complex construct in the autism literature.
We present an unusual case of concordant ventriculoarterial connections, subpulmonary infundibulum, and parallel arterial trunks. This case was complicated by extreme pulmonary artery tortuosity and low arching aorta causing severe tracheal compression. We discuss the difficulty in prenatal diagnosis, necessity for advanced imaging postnatally, and associated airway complications.
A national need is to prepare for and respond to accidental or intentional disasters categorized as chemical, biological, radiological, nuclear, or explosive (CBRNE). These incidents require specific subject-matter expertise, yet have commonalities. We identify 7 core elements comprising CBRNE science that require integration for effective preparedness planning and public health and medical response and recovery. These core elements are (1) basic and clinical sciences, (2) modeling and systems management, (3) planning, (4) response and incident management, (5) recovery and resilience, (6) lessons learned, and (7) continuous improvement. A key feature is the ability of relevant subject matter experts to integrate information into response operations. We propose the CBRNE medical operations science support expert as a professional who (1) understands that CBRNE incidents require an integrated systems approach, (2) understands the key functions and contributions of CBRNE science practitioners, (3) helps direct strategic and tactical CBRNE planning and responses through first-hand experience, and (4) provides advice to senior decision-makers managing response activities. Recognition of both CBRNE science as a distinct competency and the establishment of the CBRNE medical operations science support expert informs the public of the enormous progress made, broadcasts opportunities for new talent, and enhances the sophistication and analytic expertise of senior managers planning for and responding to CBRNE incidents.
Filarial nematodes possess glutathione transferases (GSTs), ubiquitous enzymes with the potential to detoxify xenobiotic and endogenous substrates, and modulate the host immune system, which may aid worm infection establishment, maintenance and survival in the host. Here we have identified and characterized a σ class glycosylated GST (OoGST1), from the cattle-infective filarial nematode Onchocerca ochengi, which is homologous (99% amino acid identity) with an immunodominant GST and potential vaccine candidate from the human parasite, O. volvulus, (OvGST1b). Onchocerca ochengi native GSTs were purified using a two-step affinity chromatography approach, resolved by 2D and 1D SDS-PAGE and subjected to enzymic deglycosylation revealing the existence of at least four glycoforms. A combination of lectin-blotting and mass spectrometry (MS) analyses of the released N-glycans indicated that OoGST1 contained mainly oligomannose Man5GlcNAc2 structure, but also hybrid- and larger oligommanose-type glycans in a lower proportion. Furthermore, purified OoGST1 showed prostaglandin synthase activity as confirmed by Liquid Chromatography (LC)/MS following a coupled-enzyme assay. This is only the second reported and characterized glycosylated GST and our study highlights its potential role in host-parasite interactions and use in the study of human onchocerciasis.
Schizophrenia is associated with robust hippocampal volume deficits but subregion volume deficits, their associations with cognition, and contributing genes remain to be determined.
Hippocampal formation (HF) subregion volumes were obtained using FreeSurfer 6.0 from individuals with schizophrenia (n = 176, mean age ± s.d. = 39.0 ± 11.5, 132 males) and healthy volunteers (n = 173, mean age ± s.d. = 37.6 ± 11.3, 123 males) with similar mean age, gender, handedness, and race distributions. Relationships between the HF subregion volume with the largest between group difference, neuropsychological performance, and single-nucleotide polymorphisms were assessed.
This study found a significant group by region interaction on hippocampal subregion volumes. Compared to healthy volunteers, individuals with schizophrenia had significantly smaller dentate gyrus (DG) (Cohen's d = −0.57), Cornu Ammonis (CA) 4, molecular layer of the hippocampus, hippocampal tail, and CA 1 volumes, when statistically controlling for intracranial volume; DG (d = −0.43) and CA 4 volumes remained significantly smaller when statistically controlling for mean hippocampal volume. DG volume showed the largest between group difference and significant positive associations with visual memory and speed of processing in the overall sample. Genome-wide association analysis with DG volume as the quantitative phenotype identified rs56055643 (β = 10.8, p < 5 × 10−8, 95% CI 7.0–14.5) on chromosome 3 in high linkage disequilibrium with MOBP. Gene-based analyses identified associations between SLC25A38 and RPSA and DG volume.
This study suggests that DG dysfunction is fundamentally involved in schizophrenia pathophysiology, that it may contribute to cognitive abnormalities in schizophrenia, and that underlying biological mechanisms may involve contributions from MOBP, SLC25A38, and RPSA.
Porphyrins are vital pigments involved in biological energy transduction processes. Their abilities to absorb light, then convert it to energy, have raised the interest of using porphyrin nanoparticles as photosensitizers in photodynamic therapy. A recent study showed that self- assembled porphyrin-silica composite nanoparticles can selectively destroy tumor cells, but detection of the cellular uptake of porphyrin-silica composite nanoparticles was limited to imaging microscopy. Here we developed a novel method to rapidly identify porphyrin-silica composite nanoparticles using Atmospheric Solids Analysis Probe-Mass Spectrometry (ASAP-MS). ASAP-MS can directly analyze complex mixtures without the need for sample preparation. Porphyrin-silica composite nanoparticles were vaporized using heated nitrogen desolvation gas, and their thermo-profiles were examined to identify distinct mass- to-charge (M/Z) signatures. HeLa cells were incubated in growth media containing the nanoparticles, and after sufficient washing to remove residual nanoparticles, the cell suspension was loaded onto the end of ASAP glass capillary probe. Upon heating, HeLa cells were degraded and porphyrin-silica composite nanoparticles were released. Vaporized nanoparticles were ionized and detected by MS. The cellular uptake of porphyrin-silica composite nanoparticles was identified using this ASAP-MS method.
Very few practical frameworks exist to guide the formulation of recommendations at hospital-based health technology assessment (HTA) units. The objectives of our study were: (i) to identify decision criteria specific to the context of hospital-based health technologies and interventions, (ii) to estimate the extent to which the expert community agrees on the importance of the identified criteria, (iii) to incorporate the identified criteria into a decision-aid tool, and (iv) to illustrate the application of a prototype decision-aid tool.
Relevant decision criteria were identified using existing frameworks for HTA recommendations, our past experience, a literature search, and feedback from a survey of diverse stakeholders.
Based on the survey results, twenty-three decision criteria were incorporated into the final framework. We defined an approach that eschewed a scoring system, but instead relied on a visual means for arriving at a final recommendation, by juxtaposing the importance rating for each criterion against the results of the health technology assessment. For a technology to be approved, a majority of criteria considered important should also have received favorable findings.
We created a simple and practical decision-aid tool that incorporates all decision criteria relevant to a hospital-based HTA unit. With its ease of use and accessibility, our tool renders the subjective decision-making process more structured and transparent.