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Acquired immune deficiency syndrome predictions for England and Wales (1992-97): sensitivity analysis, information, decision.

Some implications of the use of the back-calculation method for estimating future trends in HIV infections and AIDS incidence in England and Wales are explored. "This paper explores in...detail some aspects of the latest projections which have only been hinted at in the report published by the Public Health Laboratory Service in 1993. The value of additional information on the HIV epidemic in discriminating between different, otherwise equally plausible, scenarios is demonstrated. The role of the backcalculation approach in determining whether, and how, the incubation distribution has been affected by increased uptake of pre-AIDS prophylaxis and treatment is discussed."

Acquired Immunodeficiency Syndrome↗

Men's and women's use of intimate partner violence in clinical samples: toward a gender-sensitive analysis.

Early research with nationally representative samples suggested that women reported initiating violence as often as men. Such research has been criticized as focusing only on participation rates, and not assessing gender differences in impact, context, and motivation for using partner violence. Furthermore, research with nationally representative samples has been largely a-theoretical and may lack relevance to those working with clinical samples. Research with clinical populations has begun to address gender similarity and differences in the commission and experience of partner violence. The present article reviews research on men's and women's partner violence using a model for examining such gender differences that incorporates key elements of partner violence, including initiation of the overall pattern of partner violence, proportional initiation rates of violent episodes, physical and mental health impacts of partner violence, behavioral and emotional responses to partner-initiated violence, motivations for using partner violence, and fearfulness of partner-initiated violence. The review concludes that, within and across clinical samples, women are disproportionately victimized by partner violence compared to men. Implications for research, clinical programs, and policy development are discussed.

Fear↗

Highly sensitive analysis of gangliosides in human cerebrospinal fluid with neurological diseases.

We have developed a new method for detection and determination of ganglio-series gangliosides by TLC/enzyme-immunostaining. By using this method, even 1 pmole of the gangliosides in cerebrospinal fluid (CSF) from gangliosidoses and other neurological patients could be measured quantitatively. The accumulation of the gangliosides in CSF was demonstrated from patients with gangliosidoses, thus, the diagnosis could be confirmed antemortem.

Antibodies↗

A theoretical basis for clinically relevant proficiency testing evaluation limits. Sensitivity analysis of the effect of inherent test variability on acceptable method error.

The types and performance characteristics of the present rules for acceptance and rejection of quantitative results by proficiency testing agencies are reviewed. The rates of false acceptance and rejection by peer group evaluation are high when compared with explicit medical usefulness criteria. Accuracy-based target values and fixed limits provide the technologic basis for process control of interlaboratory accuracy, and their efficacy contrasts with that of peer limits. However, uniform criteria for result accuracy are also required. A clinical statistical model predicting the effect of method error on clinical diagnostic accuracy is proposed. A criterion is proposed for result accuracy defined in terms of uniform clinical benefit. The criterion specifies a fixed error limit for each type of application of a medical test that is appropriate for the inherent variability of the test application. Recent College of American Pathologists Survey experience with clinical fixed limits for allowable analytic error calculated by the model is presented.

Diagnostic Tests, Routine↗

A new, rapid, high-sensitivity analysis of amino acids in food type samples.

A new approach to the analysis of free amino acids and amino acids from hydrolyzed foods is described. The method is based on reaction of the free amino acids with phenylisothiocyanate to form stable derivatives which are subsequently separated by liquid chromatography. Sample preparation procedures are described and results are compared with conventional ion exchange results. Reproducibility of the new method has been determined on a typical food type sample.

Amino Acids↗

A sensitivity analysis of repeat migration attrition in the study of migrant adjustment: the case of Bangkok.

Studies of migrant adjustment often conclude that results apply only to remaining migrants. This paper examines the potential bias in using the difference between remaining migrants and natives as a measure of migrant adjustment. The results document that differences between remaining migrants and natives contain bias caused by attrition due to repeat migration. Such bias is small, however, and is unlikely to change migrant-native comparisons. Unless one is concerned with details of differences between migrants and natives, it is unnecessary to be concerned about migration attrition bias in drawing conclusions from the observed differences.

Adult↗

Analysis on sensitivity and landscape ecological spatial structure of site resources.

This article establishes a set of indicators and standards for landscape ecological sensitivity analysis of site resources by using the theories and approaches of landscape ecology. It uses landscape diversity index (H), evenness (E), natural degree (N), contrast degree (C) to study spatial structure and landscape heterogeneity of site resources and thus provides a qualitative-quantitative evaluation method for land planning and management of small, medium scale areas. The analysis of Yantian District, Shenzhen of China showed that Wutong Mountain belonged to high landscape ecological sensitivity area, Sanzhoutian Reservoir and Shangping Reservoir were medium landscape sensitivity and high ecological sensitivity area; Dameisha and Xiaomeisha belonged to medium sensitivity area caused by the decline of natural ecological areas. Shatoujiao, Yantian Pier belonged to low sensitivity area but urban landscape ecological development had reshaped and influenced their landscape ecological roles in a great extent. Suggestions on planning, protection goals and development intensity of each site or district were raised.

China↗

Cost utility analysis of radiographic screening for an orbital foreign body before MR imaging.

BACKGROUND AND PURPOSE: Our purpose was to evaluate the cost-effectiveness of clinical versus radiographic screening for an orbital foreign body before MR imaging. METHODS: Costs of screening were determined on the basis of published reports, disability rating guides, and a practice survey. Base case estimates were derived from published guidelines. A single-state change model was constructed using social cost as the unit of analysis. Sensitivity analysis was performed for each variable. The benefit of screening was avoidance of immediate, permanent, nonameliorable, unilateral blindness. RESULTS: Using base case estimates and a discount rate of zero, we calculated the cost of the current guideline as $328,580 per quality-adjusted life-year saved. Sensitivity analysis identified screening cost as a critical variable. Discount rates and effectiveness of foreign body removal also were found to be important factors. Probability of injury and prevalence of foreign body may impact the analysis. CONCLUSION: Clinical screening before radiography increases the cost-effectiveness of foreign body screening by an order of magnitude, assuming base case ocular foreign body removal rates. Asking the patient "Did a doctor get it all out?" serves this purpose. Occupational history by itself is not sufficient to mandate radiographic orbital screening. Current practice guidelines for foreign body screening should be altered.

Adult↗