The Value of Information in Decision‐Analytic Modeling for Malaria Vector Control in East Africa

Decision analysis tools and mathematical modeling are increasingly emphasized in malaria control programs worldwide to improve resource allocation and address ongoing challenges with sustainability. However, such tools require substantial scientific evidence, which is costly to acquire. The value of information (VOI) has been proposed as a metric for gauging the value of reduced model uncertainty. We apply this concept to an evidenced‐based Malaria Decision Analysis Support Tool (MDAST) designed for application in East Africa. In developing MDAST, substantial gaps in the scientific evidence base were identified regarding insecticide resistance in malaria vector control and the effectiveness of alternative mosquito control approaches, including larviciding. We identify four entomological parameters in the model (two for insecticide resistance and two for larviciding) that involve high levels of uncertainty and to which outputs in MDAST are sensitive. We estimate and compare a VOI for combinations of these parameters in evaluating three policy alternatives relative to a status quo policy. We find having perfect information on the uncertain parameters could improve program net benefits by up to 5–21%, with the highest VOI associated with jointly eliminating uncertainty about reproductive speed of malaria‐transmitting mosquitoes and initial efficacy of larviciding at reducing the emergence of new adult mosquitoes. Future research on parameter uncertainty in decision analysis of malaria control policy should investigate the VOI with respect to other aspects of malaria transmission (such as antimalarial resistance), the costs of reducing uncertainty in these parameters, and the extent to which imperfect information about these parameters can improve payoffs.     

Using the Inverse Maximum Ratio-Λ as a Technique to Quantify Surface Uniformity

Techniques used in variability assessment are subsequently used to draw conclusions regarding the “spread”/uniformity of data curves. Due to the limitations of these techniques, they are not adequate for circumstances where data manifest with multiple peaks. Examples of these manifestations (in three-dimensional space) include under-foot pressure distributions recorded for different types of footwear (Becerro-de-Bengoa-Vallejo et al., 2014 Biau, D.J. (2011). In brief: Standard deviation and standard error. Clinical Orthopaedics and Related Research 469(9):2661–2664.[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]; Cibulka et al., 1994 Cibulka, M.T., Sinacore, D.R., Mueller, M.J. (1994). Shin splints and forefoot contact running: A case report. Journal of Orthopaedic &; Sports Physical Therapy 20(2):98–102.[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]; Davies et al., 2003 Davies, M.B., Betts, R.P., Scott, I.R. (2003). Optical plantar pressure analysis following internal fixation for displaced intra-articular os calcis fractures. Foot &; Ankle International 24(11):851–856.[PubMed], [Web of Science ®] , [Google Scholar]), surface textures and interfaces designed to impact friction, and and and molecular surface structures such as viral epitopes (Torras and Garcia-Valls, 2004 Torras, C., Garcia-Valls, R. (2004). Quantification of membrane morphology by interpretation of scanning electron microscopy images. Journal of Membrane Science 233(1–2):119–127.[Crossref], [Web of Science ®] , [Google Scholar]; Pacejka, 1997; Fustaffson, 1997). This article proposes a technique for generating a single variable – Λ that will quantify the uniformity of such surfaces. We define and validate this technique using several mathematical and graphical models.     

Effects of a single-lesson tobacco prevention curriculum on knowledge, skill identification and smoking intention

One in five students report experimenting with tobacco before the age of 13 and most prevention efforts take place in the school setting. This study measures the effect of a single-lesson tobacco prevention curriculum, conducted by a health education center, focusing on knowledge of tobacco, ability to identify refusal techniques, and intent not to smoke. Data were collected, via electronic keypads, from students visiting a non-school, health education center in Michigan (n = 704 intervention and 85 comparison). Contingency table Chi-squared tests and t-tests demonstrated that a single lesson can improve general knowledge and ability to identify appropriate refusal techniques. Improvement in intent not to smoke was not significant because both groups had very high intent prior to implementation. Similar to results from other programs, multivariate logistic regression of gender, general knowledge, and skill identification revealed that only the skill variable was associated with intent not to smoke at pretest. Recommendations are given for further research and for designing more effective curricula or programs.     

Mindfulness: an intervention for anxiety in schizophrenia

Despite evidence that individuals with schizophrenia spectrum disorders experience significant and persistent symptoms of anxiety, there are few reports of the use of empirically supported treatments for anxiety in this population. This article describes how we have tried to adapt mindfulness interventions to help individuals with schizophrenia who experience significant anxiety symptoms. Although mindfulness has been widely used to help individuals without psychosis, to our knowledge, this is the first study adapting it to help those with schizophrenia manage worry and stress. We provide an overview of the intervention and use an individual example to describe how our treatment development group responded. We also explore directions for future research of mindfulness interventions for schizophrenia.     

Income Inequality across the Rural-Urban Continuum in the United States, 1970–2016*

The growth in macro-level income inequality in the United States is well established, but less is known about patterns of inequality at subnational scales and how they vary between and within rural and urban localities. Using data from the Decennial Census and American Community Survey, we produce estimates of within-county income inequality from 1970 to 2016 and analyze differences in inequality levels, the persistence of high (low) inequality, and populations' exposure to high (low) inequality across the rural-urban continuum. We find that income inequality has historically been higher in non-metropolitan than metropolitan counties, but inequality levels converged by 2016 due to growing inequality in metropolitan counties. Additionally, levels of inequality were generally persistent within counties over time, except that counties characterized by low inequality in 1970 were unlikely to remain as such in 2016. Third, non-trivial shares of the metropolitan population resided in low-inequality contexts in 1970, but virtually none of the U.S. population resided in such places by 2016. Residence in high-inequality counties is normative in rural and urban America. This statistical analysis provides an updated portrait of income inequality across the rural-urban continuum, and should spur additional research on stratification in rural America during an era of growing inequality.     

Reconciling care and justice in contesting social harm through performance and arts practice with looked after children and care leavers

The proportion of young people taken into the care of the state has increased recently and there is evidence that this social group suffer negative long‐term outcomes that might be conceptualised by the emergent criminological category of ‘social harm’. Debates in social work around an ethics of care and justice offer different ways of thinking about responding to social harm. This paper reports findings from an innovative arts‐based intervention with Looked After Children and young people and concludes that holding these competing value sets in creative tension is central to the success of the programme in helping young people to cope with and contest social harm.     

Parent Psychological Distress: A Moderator of Behavioral Health Intervention Outcomes among Justice‐Involved Adolescents

We examined whether pre‐existing parent psychological distress moderated juvenile offenders’ substance use, sexual risk, and mental health outcomes in a randomized trial. Forty‐seven parent–adolescent dyads received either Family‐based Affect Management Intervention (FAMI) for adolescent substance use and HIV prevention or adolescent‐only Health Promotion Intervention (HPI). Parents’ self‐reported distress at baseline significantly moderated adolescents’ self‐reported marijuana use and alcohol use but not other outcomes at 3 months postintervention, producing crossover interactions. FAMI outperformed HPI when parents reported high‐level distress, whereas HPI outperformed FAMI when parents reported low‐level distress. This finding that the relative efficacy of interventions depends on the severity of parent psychological distress could inform efforts to match substance‐using, justice‐involved adolescents with the intervention most likely to benefit them.