Browsing by Subject "Detection"

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    Constraints and invariance in target detection
    (2000) Nicolls, Frederick
    The concept of invariance in hypothesis testing is discussed for purposes of target detection. Invariant tests are proposed and analysed in two contexts. The first involves the use of cyclic permutation invariance as a solution to detecting targets with unknown location in noise. An invariance condition is used to eliminate the target location parameter, and a uniformly most powerful test developed for the reduced data. The test is compared with conventional solutions, and shown to be more powerfu. The difference however is slight, justifying the simpler formulations. This conclusion continues to hold even when additional unknown noise parameters are introduced.
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    Health systems strengthening interventions for perinatal common mental disorders and experiences of domestic violence in Cape Town, South Africa: protocol for a pilot implementation study
    (2022-05-07) Abrahams, Zulfa; Schneider, Marguerite; Honikman, Simone; Olckers, Patti; Boisits, Sonet; Seward, Nadine; Lund, Crick
    Background During the perinatal period, common mental disorders (CMDs) such as depression and anxiety are highly prevalent, especially in low-resource settings, and are associated with domestic violence, poverty, and food insecurity. Perinatal CMDs have been associated with several adverse maternal and child outcomes. While the Department of Health in South Africa provides healthcare workers with the tools to detect psychological distress and experiences of domestic violence, few healthcare workers routinely screen pregnant women at clinic visits, citing discomfort with mental health issues and the lack of standardised referral pathways as the key barriers. The aim of this study is to select and evaluate a set of health systems strengthening (HSS) interventions aimed at improving the care and outcomes for perinatal women with CMDs and experiences of domestic violence, attending public healthcare facilities in Cape Town. Methods This study consists of a pre-implementation, development, and implementation phase. Contextual barriers identified during the pre-implementation phase included poor patient knowledge and health-seeking behaviour, high levels of stigma, and poor detection, referral, and treatment rates. Implementation science determinant frameworks were applied to findings from the pre-implementation phase to identify determinants and gaps in delivering high-quality evidence-informed care. A participatory Theory of Change workshop was used to design a HSS programme, consisting of awareness raising, detection, referral, and treatment. HSS interventions selected to support the delivery of the HSS programme includes training, health promotion, change to the healthcare environment, task-sharing, audit and feedback, and performance monitoring. The implementation phase will be used to assess several implementation and clinical outcomes associated with the delivery of the HSS programme, which will be piloted at three healthcare facilities. Qualitative and quantitative methods will be used to evaluate the implementation and clinical outcomes. Discussion This pilot implementation study will inform us about a range of implementation and clinical outcome measures that are relevant for assessing HSS interventions for perinatal women with depression, anxiety, or experiences of domestic violence in low-resource settings. Lessons learnt from the pilot study will be incorporated into the design of a cluster randomised control trial for which further funding will be sought.