Youth visions in a changing climate: Emerging lessons from using immersive and arts-based methods for strengthening community-engaged research with urban youth

Despite increasing efforts, youth perspectives remain largely excluded from decision- making processes concerning their future and the social-ecological challenges they are set to inherit. While youth are a critical and powerful force for social change, many youths in underserved communities have limited access to appropriate information on the root causes and consequences of environmental change, in addition to an array of other complex social injustices. To address this, we embarked on a participatory action research process which focused on democratising research, science and the arts by facilitating experiential, immersive learning opportunities with the intention of eventually co-producing artifacts (in the form of participatory murals) in public spaces to facilitate longer term engagement with human nature futures. This article outlines and shares reflections on our process and offers insights for future engagement activities that seek to mobilise youth imaginaries and agency. We found participants were better engaged when conversations were (1) facilitated by other participants; (2) were outdoors and centred on public art; and (3) were happening in parallel with a hands-on activity. This contrasted with asking interview-type questions, or asking participants to write down their answers, which felt more like a test than a conversation, minimising participation. Key learnings included: the need to co-develop knowledge around enhancing climate literacy that is based on local realities; that multiple capacities and hives of activity already exist in communities and need to be mobilised and not built; that creative visioning and futuring can help identify options for change; and that many youths are seeking creative, immersive and safe spaces for co-learning and connection. Initiatives that aim to engage diverse voices should therefore be well- resourced so as to carefully co-design processes that start by acknowledging contextual differences and capacities within those contexts, and co-create immersive dialogues, in order to move away from test-like engagements which perpetuate power imbalances and discourage participation

Mortality of treated HIV-1 positive individuals according to viral subtype in Europe and Canada: collaborative cohort analysis

Objectives:To estimate prognosis by viral subtype in HIV-1-infected individuals from start of antiretroviral therapy (ART) and after viral failure.Design:Collaborative analysis of data from eight European and three Canadian cohorts.Methods:Adults (N>20000) who started triple ART between 1996 and 2012 and had data on viral subtype were followed for mortality. We estimated crude and adjusted (for age, sex, regimen, CD4(+) cell count, and AIDS at baseline, period of starting ART, stratified by cohort, region of origin and risk group) mortality hazard ratios (MHR) by subtype. We estimated MHR subsequent to viral failure defined as two HIV-RNA measurements greater than 500 copies/ml after achieving viral suppression.Results:The most prevalent subtypes were B (15419; 74%), C (2091; 10%), CRF02AG (1057; 5%), A (873; 4%), CRF01AE (506; 2.4%), G (359; 1.7%), and D (232; 1.1%). Subtypes were strongly patterned by region of origin and risk group. During 104649 person-years of observation, 1172/20784 patients died. Compared with subtype B, mortality was higher for subtype A, but similar for all other subtypes. MHR for A versus B were 1.13 (95% confidence interval 0.85,1.50) when stratified by cohort, increased to 1.78 (1.27,2.51) on stratification by region and risk, and attenuated to 1.59 (1.14,2.23) on adjustment for covariates. MHR for A versus B was 2.65 (1.64,4.28) and 0.95 (0.57,1.57) for patients who started ART with CD4(+) cell count below, or more than, 100 cells/l, respectively. There was no difference in mortality between subtypes A, B and C after viral failure.Conclusion:Patients with subtype A had worse prognosis, an observation which may be confounded by socio-demographic factors. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved