Community health worker interventions to promote psychosocial outcomes among people living with HIV—A systematic review

Background Community health worker (CHW) interventions are a successful strategy to promote health among HIV-negative and persons living with HIV (PLWH). Psychosocial factors are critical dimensions of HIV/AIDS care contributing to prognosis of the disease, yet it is unclear how CHW interventions improve psychosocial outcomes in PLWH. The purpose of this study was to critically appraise the types, scope, and nature of CHW interventions designed to address psychosocial outcomes in PLWH. Methods We performed database searches—PubMed, EMBASE, CINAHL, and Cochrane—to identify randomized controlled trials published in English before April 2017. Fourteen articles met the eligibility criteria. Results Half of the studies were conducted in the United States. Social cognitive theory was used more than once in nine theory-guided studies. CHW interventions were largely focused on reducing depression (n = 6) or stigma related to HIV (n = 4), or promoting quality of life (n = 4), social support (n = 4), and self-efficacy (n = 4). Didactic methods and role-playing were used to train CHWs. CHWs played multiple roles in delivering intervention, including a counselor and a supporter (n = 10), educator (n = 5), or a navigator (n = 3). CHW intervention fidelity was assessed in 4 studies. Five studies found positive changes in six psychosocial outcomes including quality of life (2 of 4) and self-efficacy (2 of 4). CHW interventions had no effect on social support in 2 of 4 studies, and stigma in 3 of 4 studies. None of the CHW interventions were successful in reducing depressive symptoms among PLWH. Conclusions Evidence partially supported the use of CHWs in promoting psychosocial outcomes in PLWH. Future CHW intervention should be expanded in scope to address key psychosocial determinants of HIV/AIDS outcomes such as health literacy. Further, fidelity measures should be incorporated into intervention delivery

THE POWER OF STRUCTURED DESIGNS AND MIXED MODELS IN A REAL WORLD EXPERIMENT

Justifications usually given for adopting an automated system pertain to a reduction in labor and an improvement in quality control. A manufacturer of a prototype instrument that automated some of the steps for culturing bacteria wanted to compare the automated system to the manual system. The manufacturer wanted to compare the two systems in 1) Total time needed to isolate the target bacteria, 2) Ability to isolate the target bacteria, 3) Amount of interference from background (non-target) bacterial growth, and 1) Extent of cross (sample to sample) contamination. This paper presents the experimental design used to make these comparisons and how the design helped discover some surprising results about laboratory quality control. The experiment presented illustrates the importance of a good experimental design, the power of current statistical tools, and that a thorough and appropriate analysis of a data set requires side-by-side good detective work by both statistician and client

Impact assessment of the biological control of the cassava mealybug, Phenacoccus manihoti Matile-Ferrero (Hemiptera: Pseudococcidae), by the introduced parasitoid Epidinocarsis lopezi (De Santis) (Hymenoptera: Encyrtidae)

The impact of Phenacoccus manihoti Matile-Ferrero on growth and tuber yield of cassava, and the results of its biological control by the exotic parasitoid Epidinocarsis lopezi (De Santis) were investigated in a survey of 60 farmers' fields in Ghana and Ivory Coast over an area of 180 000 km2 of the savana and forest ecosystems. Twenty-nine variables associated with plant growth, agronomic and environmental factors, and insect populations were recorded. Densities of P. manihoti were closely correlated with stunting of the cassava shoot tips and, less so, with the rate of stunting early in the growing season. With increasing mealybug infestations, average harvest indices declined and populations of E. lopezi and of indigenous coccinellids increased, but parasitoids were found at lower host levels than were predators. The length of time E. lopezi had been present in an area was the most important factor influencing mealybug densities. Thus, P. manihoti populations were significantly lower where E. lopezi had been present for more than half the planting season than in areas where E. lopezi was lacking or had been only recently introduced. A significant proportion of the farmers in the savanna zone, where P. manihoti populations were much higher than in the forest zone, had observed this decline due to E. lopezi. Tuber yield losses due to P. manihoti in the absence of E. lopezi were tentatively estimated at 463 g/plant in the savanna zone. No significant effect was found in the forest region. When E. lopezi was present, average P. manihoti damage scores were reduced significantly, both in the savanna and forest regions. The increase in yields was 228g/plant or about 2.48 t/ha in the savanna regio

Can the internet reduce the loneliness of 50+ living alone?

Published online: 12 May 2020Living alone has been indicated as a key variable to explain loneliness in older adults. In contemporary society, where technology has become one of the main means of communication and personal interaction, has the internet influenced the relationship between living alone and loneliness? This paper aims to answer this research question by using a sample of 64,297 individuals who were surveyed in SHARE project wave 6 – in European countries with different welfare regimes (Portugal, Greece, Italy and Spain, Denmark, Sweden, Austria, Belgium, France, Germany, Switzerland, Luxemburg, Poland, Czech Republic; Slovenia, Estonia, and Croatia). The results of the regression analysis evidence the moderating role of the internet on the relationship between living alone and feelings of loneliness in individuals aged 50 and over, so that the impact of living alone on loneliness is diminished for internet users as compared to their peers who do not use the internet. The results therefore reinforce the importance of policies aimed at fostering e-inclusion as a way of reducing the loneliness of older adultsThis work was supported by European Commission; Fundação para a Ciência e a Tecnologia; U.S National Institute on Aging; Fundação Calouste Gulbenkian; German Ministry of Education and Researc

Synthesis and Fabrication of Nanocomposite Fibers of Collagen-Cellulose Nanocrystals by Coelectrocompaction

An electrochemical process has been used to compact cellulose nanocrystals (CNC) and access aligned micron-sized CNC fibers. Placing a current across aqueous solutions of carboxylic acid functionalized CNCs (<i>t</i>-CNC–COOH) or carboxylic acid/primary amine functionalized CNCs (<i>t</i>-CNC–COOH-NH₂) creates a pH gradient between the electrodes, which results in the migration and concentration of the CNC fibers at their isoelectric point. By matching the carboxylic acid/amine ratio of CNCs and collagen (ca. 30:70 carboxylic acid:amine ratio), it is possible to coelectrocompact both nanofibers and access aligned nanocomposite fibers. <i>t</i>-CNC–COOH-NH₂/collagen fibers showed a maximum increase in mechanical properties at 5 wt % of <i>t</i>-CNC–COOH-NH₂. Compared to collagen/CNC films which have no alignment in the plane of the films, the tensile properties of the aligned fibers show a significant enhancement in the wet mechanical properties (40 MPa vs 230 MPa) for the 5 wt % of <i>t</i>-CNC–COOH-NH₂/collagen films and fiber, respectively