Choosing between the BP and BN sequential strategies

Cost and burden of diagnostic testing may be reduced if fewer tests can be applied. Sequential testing involves selecting a sequence of tests, but only administering subsequent tests dependent on results of previous tests. This research provides guidance to choosing between single tests or the believe the positive (BP) and believe the negative (BN) sequential testing strategies, using accuracy (as measured by the Youden Index) as the primary determinant. Approximately 75% of the parameter combinations examined resulted in either BP or BN being recommended based on a higher accuracy at the optimal point. In about half of the scenarios BP was preferred, and the other half, BN, with the choice often a function of the value of the ratio of standard deviations of those without and with disease (b). Large values of b for the first test of the sequence tended to be associated with preference for BN as opposed to BP, while small values of b appear to favor BP. When there was no preference between sequences and/or single tests based on the Youden Index, cost of the sequence was considered. In this case, disease prevalence plays a large role in the selection of strategies, with lower values favoring BN and sometimes higher values favoring BP. The cost threshold for the sequential strategy to be preferred over a single, more accurate test, was often quite high. It appears that while sequential strategies most often increase diagnostic accuracy over a single test, sequential strategies are not always preferred.     

Effects of habitat fragment size and isolation on the density and genetics of urban red-backed salamanders (Plethodon cinereus)

Urban expansion is creating environmental stressors through land use change, habitat fragmentation, and habitat loss. These stressors, along with a host of others, are driving precipitous declines in vertebrate taxa around the world. Amphibians, often requiring a narrow range of environmental conditions, can be especially susceptible to the stressors of environmental change. Despite habitat loss and degradation, some amphibian species continue to persist in altered urban landscapes. The red-backed salamander (Plethodon cinereus) is one such- species and in this study, we assess how habitat patch size affects population density and genetic diversity of salamander populations in and around an urban center in Ohio, United States. Further, we examined patterns of genetic differentiation and landscape connectivity to understand gene flow between populations and tested for historic demographic bottleneck effects. Populations were sampled from 9 urban forest patches ranging in size from less than 1 ha to approximately 250 ha. There was no apparent effect of contiguous habitat patch size on salamander density nor genetic diversity, but we did observe significant genetic differentiation between 97% of pairwise population comparisons. The differentiation observed was not a result of overland distance or effective distance due to landscape resistance. There was evidence of historic bottlenecks at every site. These results suggest that density is driven by within-patch heterogeneity and that genetic diversity is affected by drivers other than patch size or contemporary population density. Our study demonstrates that red-backed salamanders can persist in wooded, urban parks, but that genetic diversity remains susceptible to demographic changes.

     

Parental perceptions of the Children In Need Of Treatment dental program

This paper discusses the collaborative partnership involving the Middlesex-London Public Health Research, Education and Development site, the Ontario Ministry of Health Promotion and Sport, then Chronic Disease Prevention and Health Promotion Branch, and an academic institution in the first-ever research of parental perceptions of the Children In Need Of Treatment. This paper provides an overview of the Children In Need Of Treatment program, reviews the results of the research (a mailed, self-administered survey with a systematic random sample of parents from three health units whose children received dental treatment that was paid by Children In Need Of Treatment in 2006), and its subsequent recommendations. How these recommendations affected program planning and policy are examined. In conclusion, parents were very satisfied with the treating dentist and the Children In Need Of Treatment program, and found Children In Need Of Treatment to be vital in addressing the health of their children by attending to their urgent dental needs.