Health policymakers in many countries are looking at ways of increasing health care coverage by scaling up the deployment of community health workers. In this commentary, we describe the rationale for the UK to learn from Brazil’s scaled-up Community Health Worker primary care strategy, starting with a pilot project in North Wales.
BackgroundThe detailed analysis of an outbreak database has been undertaken to examine the role of contact tracing in controlling an outbreak of possible avian influenza in humans. The outbreak, initiating from the purchase of infected domestic poultry, occurred in North Wales during May and June 2007. During this outbreak, extensive contact tracing was carried out. Following contact tracing, cases and contacts believed to be at risk of infection were given treatment/prophylaxis.MethodsWe analyse the database of cases and their contacts identified for the purposes of contact tracing in relation to both the contact tracing burden and effectiveness. We investigate the distribution of numbers of contacts identified, and use network structure to explore the speed with which treatment/prophylaxis was made available and to estimate the risk of transmission in different settings.ResultsFourteen cases of suspected H7N2 influenza A in humans were associated with a confirmed outbreak among poultry in May-June 2007. The contact tracing dataset consisted of 254 individuals (cases and contacts, of both poultry and humans) who were linked through a network of social contacts. Of these, 102 individuals were given treatment or prophylaxis. Considerable differences between individuals' contact patterns were observed. Home and workplace encounters were more likely to result in transmission than encounters in other settings. After an initial delay, while the outbreak proceeded undetected, contact tracing rapidly caught up with the cases and was effective in reducing the time between onset of symptoms and treatment/prophylaxis.ConclusionsContact tracing was used to link together the individuals involved in this outbreak in a social network, allowing the identification of the most likely paths of transmission and the risks of different types of interactions to be assessed. The outbreak highlights the substantial time and cost involved in contact tracing, even for an outbreak affecting few individuals. However, when sufficient resources are available, contact tracing enables cases to be identified before they result in further transmission and thus possibly assists in preventing an outbreak of a novel virus.
An increasing number of citizens change and adapt their party preferences during the electoral campaign. We analyze which short-term factors explain intra-campaign changes in voting preferences, focusing on the visibility and tone of news media reporting and party canvassing. Our analyses rely on an integrative data approach, linking data from media content analysis to public opinion data. This enables us to investigate the relative impact of news media reporting as well as party communication. Inherently, we overcome previously identified methodological problems in the study of communication effects on voting behavior. Our findings reveal that campaigns matter: Especially interpersonal party canvassing increases voters’ likelihood to change their voting preferences in favor of the respective party, whereas media effects are limited to quality news outlets and depend on individual voters’ party ambivalence.
This research analyzes the effectiveness of the list experiment and crosswise model in measuring self-plagiarism and data manipulation. Both methods were implemented in a large-scale survey of academics on social norms and academic misconduct. As the results lend little confidence about the effectiveness of the methods, researchers are best advised to avoid them or, at best, to handle them with care.
This article provides a meta-analysis of studies using the crosswise model (CM) in estimating the prevalence of sensitive characteristics in different samples and populations. On a data set of 141 items published in 33 either articles or books, we compare the difference (Δ) between estimates based on the CM and a direct question (DQ). The overall effect size of Δ is 4.88; 95% CI [4.56, 5.21]. The results of a meta-regression indicate that Δ is smaller when general populations and nonprobability samples are considered. The population effect suggests an education effect: Differences between the CM and DQ estimates are more likely to occur when highly educated populations, such as students, are studied. Our findings raise concerns to what extent the CM is able to improve estimates of sensitive behavior in general population samples.
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