Sample size considerations in active-control non-inferiority trials with binary data based on the odds ratio

This paper presents an approximate closed form sample size formula for determining non-inferiority in active-control trials with binary data. We use the odds-ratio as the measure of the relative treatment effect, derive the sample size formula based on the score test and compare it with a second, well-known formula based on the Wald test. Both closed form formulae are compared with simulations based on the likelihood ratio test. Within the range of parameter values investigated, the score test closed form formula is reasonably accurate when non-inferiority margins are based on odds-ratios of about 0.5 or above and when the magnitude of the odds ratio under the alternative hypothesis lies between about 1 and 2.5. The accuracy generally decreases as the odds ratio under the alternative hypothesis moves upwards from 1. As the non-inferiority margin odds ratio decreases from 0.5, the score test closed form formula increasingly overestimates the sample size irrespective of the magnitude of the odds ratio under the alternative hypothesis. The Wald test closed form formula is also reasonably accurate in the cases where the score test closed form formula works well. Outside these scenarios, the Wald test closed form formula can either underestimate or overestimate the sample size, depending on the magnitude of the non-inferiority margin odds ratio and the odds ratio under the alternative hypothesis. Although neither approximation is accurate for all cases, both approaches lead to satisfactory sample size calculation for non-inferiority trials with binary data where the odds ratio is the parameter of interest.

Infection Control in design and construction work

Objective: To clarify how infection control requirements are represented, communicated, and understood in work interactions through the medical facility construction project life cycle. To assist project participants with effective infection control management by highlighting the nature of such requirements and presenting recommendations to aid practice. Background: A 4-year study regarding client requirement representation and use on National Health Service construction projects in the United Kingdom provided empirical evidence of infection control requirement communication and understanding through design and construction work interactions. Methods: An analysis of construction project resources (e.g., infection control regulations and room data sheets) was combined with semi-structured interviews with hospital client employees and design and construction professionals to provide valuable insights into the management of infection control issues. Results: Infection control requirements are representationally indistinct but also omnipresent through all phases of the construction project life cycle: Failure to recognize their nature, relevance, and significance can result in delays, stoppages, and redesign work. Construction project resources (e.g., regulatory guidance and room data sheets) can mask or obscure the meaning of infection control issues. Conclusions: A preemptive identification of issues combined with knowledge sharing activities among project stakeholders can enable infection control requirements to be properly understood and addressed. Such initiatives should also reference existing infection control regulatory guidance and advice.

Methods to assess the effectiveness of naturally ventilated classrooms in Gauteng, South Africa

There is a tendency to reduce ventilation rates and natural or hybrid ventilation systems to ensure the conservation of energy in school buildings. However, high indoor pollutant concentration, due to natural or hybrid ventilation systems may have a significant adverse impact on the health and academic performance of pupils and students. Reviewed evidence shows that this can be detrimental to health and wellbeing in schools because of the learner density within a small area, eventually indicating that CO2 concentrations can rise to very high levels (about 4000 ppm) in classrooms during occupancy periods. In South Africa’s naturally ventilated classrooms, it is not clear whether the environmental conditions are conducive for learning. In addition, natural ventilation will be minimized given the fact that in cold, wet or windy weather, doors and windows will commonly remain closed. Evidence from literature based studies indicates that the significance of ventilation techniques is not understood satisfactorily and additional information concerning naturally ventilated schools has to be provided for better design and policy formulation. To develop a thorough understanding of the environments in classrooms, many other parameters have to be considered as well, such as outdoor air quality, CO2 concentrations, temperature and relative humidity and safety issues that may be important drawbacks for naturally ventilated schools. The aim of this paper is to develop a conceptual understanding of methods that can be implemented to assess the effectiveness of naturally ventilated classrooms in Gauteng, South Africa. A theoretical concept with an embedded practical methodology have been proposed for the research programme to investigate the relationship between ventilation rates and learning in schools in Gauteng , a province in South Africa. It is important that existing and future school buildings must include adequate outdoor ventilation, control of moisture, and avoidance of indoor exposures to microbiologic and chemical substances considered likely to have adverse effects in South Africa. Adequate ventilation in classrooms is necessary to reduce and/or eradicate the transmission of indoor pollutants.

Knowledge and perception of Ghanaian cocoa farmers on mirid control and their willingness to use forecasting systems

Annual losses of cocoa in Ghana to mirids are significant. Therefore, accurate timing of insecticide application is critical to enhance yields. However, cocoa farmers often lack information on the expected mirid population for each season to enable them to optimise pesticide use. This study assessed farmers’ knowledge and perceptions of mirid control and their willingness to use forecasting systems informing them of expected mirid peaks and time of application of pesticides. A total of 280 farmers were interviewed in the Eastern and Ashanti regions of Ghana with a structured open and closed ended questionnaire. Most farmers (87%) considered mirids as the most important insect pest on cocoa with 47% of them attributing 30-40% annual crop loss to mirid damage. There was wide variation in the timing of insecticide application as a result of farmers using different sources of information to guide the start of application. The majority of farmers (56%) do not have access to information on the type, frequency and timing of insecticides to use. However, respondents who are members of farmer groups had better access to such information. Extension officers were the preferred channel for information transfer to farmers with 72% of farmers preferring them to other available methods of communication. Almost all the respondents (99%) saw the need for a comprehensive forecasting system to help farmers manage cocoa mirids. The importance of accurate timing for mirid control based on forecasted information to farmer groups and extension officers was discussed.

Argo real-time quality control intercomparison

The real-time quality control (RTQC) methods applied to Argo profiling float data by the United Kingdom (UK) Met Office, the United States (US) Fleet Numerical Meteorology and Oceanography Centre, the Australian Bureau of Meteorology and the Coriolis Centre are compared and contrasted. Data are taken from the period 2007 to 2011 inclusive and RTQC performance is assessed with respect to Argo delayed-mode quality control (DMQC). An intercomparison of RTQC techniques is performed using a common data set of profiles from 2010 and 2011. The RTQC systems are found to have similar power in identifying faulty Argo profiles but to vary widely in the number of good profiles incorrectly rejected. The efficacy of individual QC tests are inferred from the results of the intercomparison. Techniques to increase QC performance are discussed.

Optimising mirid control on cocoa farms through complementary monitoring systems

Mirids (Sahlbergella singularis and Distantiella theobroma) are the most important insect pests affecting cocoa production across West Africa. Understanding the population dynamics of mirids is key to their management, however, the current recommended hand-height assessment method is labour intensive. The objective of the study was to compare recently developed mirid sex pheromone trapping and visual hand-height assessment methods as monitoring tools on cocoa farms and to consider implications for a decision support system. Ten farms from the Eastern and Ashanti regions of Ghana were used for the study. Mirid numbers and damage were assessed fortnightly on twenty trees per farm, using both methods, from January 2012 to April 2013. The mirid population increased rapidly in June, reached a peak in September and began to decline in October. There was a significant linear relationship between numbers of mirids sampled to hand-height and mirid damage. High numbers of male mirids were recorded in pheromone traps between January and April 2012 after which there was a gradual decline. There was a significant inverse relationship between numbers of trapped adult mirids and mirids sampled to hand-height (predominantly nymphs). Higher temperatures and lower relative humidities in the first half of the year were associated with fewer mirids at hand-height but larger numbers of adult males were caught in pheromone traps. The study showed that relying solely on one method is not sufficient to provide accurate information on mirid population dynamics and a combination of the two methods is necessary.