Syndromic algorithms for detection of gambiense human african trypanosomiasis in South Sudan.

BACKGROUND: Active screening by mobile teams is considered the best method for detecting human African trypanosomiasis (HAT) caused by Trypanosoma brucei gambiense but the current funding context in many post-conflict countries limits this approach. As an alternative, non-specialist health care workers (HCWs) in peripheral health facilities could be trained to identify potential cases who need testing based on their symptoms. We explored the predictive value of syndromic referral algorithms to identify symptomatic cases of HAT among a treatment-seeking population in Nimule, South Sudan. METHODOLOGY/PRINCIPAL FINDINGS: Symptom data from 462 patients (27 cases) presenting for a HAT test via passive screening over a 7 month period were collected to construct and evaluate over 14,000 four item syndromic algorithms considered simple enough to be used by peripheral HCWs. For comparison, algorithms developed in other settings were also tested on our data, and a panel of expert HAT clinicians were asked to make referral decisions based on the symptom dataset. The best performing algorithms consisted of three core symptoms (sleep problems, neurological problems and weight loss), with or without a history of oedema, cervical adenopathy or proximity to livestock. They had a sensitivity of 88.9-92.6%, a negative predictive value of up to 98.8% and a positive predictive value in this context of 8.4-8.7%. In terms of sensitivity, these out-performed more complex algorithms identified in other studies, as well as the expert panel. The best-performing algorithm is predicted to identify about 9/10 treatment-seeking HAT cases, though only 1/10 patients referred would test positive. CONCLUSIONS/SIGNIFICANCE: In the absence of regular active screening, improving referrals of HAT patients through other means is essential. Systematic use of syndromic algorithms by peripheral HCWs has the potential to increase case detection and would increase their participation in HAT programmes. The algorithms proposed here, though promising, should be validated elsewhere.

Sense of coherence and job characteristics in predicting burnout in a South African sample

Orientation: Research that considers the effects of individual characteristics and job characteristics jointly in burnout is necessary, especially when one considers the possibility of curvilinear relationships between job characteristics and burnout. Research purpose: This study examines the contribution of sense of coherence (SOC) and job characteristics to predicting burnout by considering direct and moderating effects. Motivation for this study: Understanding the relationships of individual and job characteristics with burnout is necessary for preventing burnout. It also informs the design of interventions. Research design, approach and method: The participants were 632 working adults (57% female) in South Africa. The measures included the Job Content Questionnaire, the Sense of Coherence Questionnaire and the Maslach Burnout Inventory. The authors analysed the data using hierarchical multiple regression with the enter method. Main findings: Job characteristics and SOC show the expected direct effects on burnout. SOC has a direct negative effect on burnout. Job demands and supervisor social support show nonlinear relationships with burnout. SOC moderates the effect of demands on burnout and has a protective function so that the demands-burnout relationship differs for those with high and low SOC. Practical/managerial implications: The types of effects, the shape of the stressor-strain relationship and the different contributions of individual and job characteristics have implications for designing interventions. Contribution/value add: SOC functions differently when combined with demands, control and support. These different effects suggest that it is not merely the presence or absence of a job characteristic that is important for well-being outcomes but how people respond to its presence or absence.

African-Americans in Iowa, 2015

To recall and celebrate the positive contributions to our nation made by people of African descent, American historian Carter G. Woodson established Black History Week beginning on Feb. 12, 1926. In 1976, as part of the nation’s bicentennial, the week was expanded into Black History Month.

Report on the Governor’s Office of Drug Control Policy for the year ended June 30, 2014

Report on the Governor’s Office of Drug Control Policy for the year ended June 30, 2014

Forest owners' acceptance of incentive based policy instruments in forest biodiversity conservation : a choice experiment based approach

Abstract

African Americans in Iowa, 2007

Produced by the State Data Center of Iowa for the Iowa Commission on the Status of African-Americans. It is an annual snapshot of the demographic profile of the African American population in Iowa.

African Americans in Iowa, 2009

Produced by the State Data Center of Iowa for the Iowa Commission on the Status of African-Americans. It is an annual snapshot of the demographic profile of the African American population in Iowa.

African Americans in Iowa, 2010

Produced by the State Data Center of Iowa for the Iowa Commission on the Status of African-Americans. It is an annual snapshot of the demographic profile of the African American population in Iowa.

African Americans in Iowa, 2011

Produced by the State Data Center of Iowa for the Iowa Commission on the Status of African-Americans. It is an annual snapshot of the demographic profile of the African American population in Iowa.

African Americans in Iowa, 2012

Produced by the State Data Center of Iowa for the Iowa Commission on the Status of African-Americans. It is an annual snapshot of the demographic profile of the African American population in Iowa.

African Americans in Iowa, 2013

Produced by the State Data Center of Iowa for the Iowa Commission on the Status of African-Americans. It is an annual snapshot of the demographic profile of the African American population in Iowa.

African Americans in Iowa, 2014

Produced by the State Data Center of Iowa for the Iowa Commission on the Status of African-Americans. It is an annual snapshot of the demographic profile of the African American population in Iowa.