Circular labour migration networks and HIV in Malawi.

Doctor of Philosophy in Development Studies. University of KwaZulu-Natal, Durban 2015.Circular labour migration is a livelihood strategy for many Malawians regardless that migrant workers and their sexual partners are well known groups to be at risk of HIV infection. Many of these migrant workers and their sexual partners are socially and sexually connected through kinship, friendship and sexuality. The aim of this research is to explore the role of social networks on HIV risk reduction strategies and transmission mechanisms among the migrant workers and their sexual partners. To explore the role of social networks on HIV risk reduction strategies and transmission mechanisms among the migrant workers and their sexual partners, this research makes use of empirical qualitative data. The data was collected through in-depth interviews, focus group discussions and conversational observations both at the migrant rural workplace of Kayelekera Uranium mine and one of the migrant sending rural village of Maganga in Malawi. Findings of this research show that HIV and AIDS information was discussed daily within the social networks of the migrant workers and their sexual partners. As a result, knowledge about HIV and AIDS was universal among the migrant workers and their sexual partners. However, most of these social network discussions about HIV and AIDS among the migrant workers and their sexual partners were along gender lines, in that the migrant men talked with their male colleagues while their sexual partners talked with their female friends. Despite the gendered nature of their social networks, their influences on discussions about HIV and AIDS for the migrant men were similar to those for their sexual partners. In their discussions, the migrant workers and their sexual partners attempted to formulate HIV risk reduction strategies. These HIV risk reduction strategies were socially framed to suit to the local social circumstances of the migrant workers and their sexual partners. Although similar, social network influences on risk perception for both the migrant workers and their sexual partners nevertheless reached quite different conclusions about appropriate HIV risk reduction strategies. Most of the migrant workers talked more about partner selection, partner reduction and remaining faithful. In their discussions, the rural regular sexual partners of the migrant workers focused on how to persuade their migrant partners to remain faithful. The differences in HIV risk reduction strategies between the migrant workers and their sexual partners could be that social influence plays a greater role in HIV and AIDS conversation networks. In this case, the more dense and homogeneous the HIV and AIDS conversation network is, the more normative the effects are, that is, the social influence. For the rural partners, their HIV and AIDS conversation partners were usually from the same local village. While for the migrant men, there was greater social integration from different geographical locations meeting at the workplace. All in all, the most important empirical result is that social networks of the migrant workers and their sexual partners have significant and substantial effects on HIV risk reduction strategies. Despite socially accepted strategies of HIV risk reduction, some of the migrant workers and their sexual partners indulged in risky sexual behaviour. Some of these migrant workers and their sexual partners were involved in, supported and encouraged multiple and concurrent sexual partnerships among their social networks of colleagues and friends. They even assisted each other in identifying potential sexual partners. With the influence of their social network colleagues, some of the migrant workers used condoms with some of their casual sexual partners especially at the workplace. However, none of the regular sexual partners of the migrant workers used condoms with their casual sexual partners in the migrant sending rural village. Also, the migrant workers themselves did not used condoms with their regular rural sexual partners. The prevailing social norm was that condoms were not acceptable in regular sexual partnerships. It is this sanctioned low level of protection within regular sexual partnerships that is likely to increase the risk of HIV transmission among the migrant workers and their regular sexual partners regardless of some noticeable efforts within their social networks to reduce HIV risk. Therefore, my findings confirm that social networks have a role both on HIV risk reduction strategies and transmission mechanisms among the migrant workers and their sexual partners. Thus, the consideration of the local social contexts within which the migrant workers and their sexual partners transact their daily life is paramount if HIV interventions are to work

Improving Underrepresented Minority Student Persistence in STEM.

Members of the Joint Working Group on Improving Underrepresented Minorities (URMs) Persistence in Science, Technology, Engineering, and Mathematics (STEM)-convened by the National Institute of General Medical Sciences and the Howard Hughes Medical Institute-review current data and propose deliberation about why the academic "pathways" leak more for URM than white or Asian STEM students. They suggest expanding to include a stronger focus on the institutional barriers that need to be removed and the types of interventions that "lift" students' interests, commitment, and ability to persist in STEM fields. Using Kurt Lewin's planned approach to change, the committee describes five recommendations to increase URM persistence in STEM at the undergraduate level. These recommendations capitalize on known successes, recognize the need for accountability, and are framed to facilitate greater progress in the future. The impact of these recommendations rests upon enacting the first recommendation: to track successes and failures at the institutional level and collect data that help explain the existing trends

Evidence of individual differences in the long-term social, psychological, and cognitive consequences of child maltreatment

Background: The prevalence and consequences of child maltreatment are alarming, but evidence from studies with long follow-up intervals are limited. This study examined the long-term consequences of child maltreatment in relation to age of onset and follow-up interval. / Methods: The exposed group comprised 63 individuals (aged 13–34 years) with a first-time diagnosis of child maltreatment between 2001 and 2010, whereas the unexposed group comprised 63 individuals who were matched upon gender, age of onset, follow-up period, and poverty status at the index hospital admission but had no medical records of maltreatment in Hong Kong. The participants completed a set of questionnaires on executive functions and mental health and provided blood samples for measurement of IL-6 and IL-10 levels during a health assessment session. / Results: Compared with the unexposed group, the exposed group reported poorer maternal care during childhood (β = −4.64, p < 0.001) and had lower family support (β = −2.97, p = 0.010) and higher inflammatory responses (IL-6: β = 0.15, p = 0.001; IL-10: β = 0.11, p = 0.011) at follow-up. Additionally, the associations of childhood maltreatment exposure with family support and maternal care differed by age of onset and the length of time since exposure. / Conclusions: This matched cohort study highlights childhood maltreatment as a risk factor for systemic inflammation and an indicator of suboptimal social environment, both of which could persist over a long period of time

Associations between childhood maltreatment and psychiatric disorders: analysis from electronic health records in Hong Kong

There has been a lack of high-quality evidence concerning the association between childhood maltreatment and psychiatric diagnoses particularly for Axis II disorders. This study aimed to examine the association between childhood maltreatment exposure and Axis I and Axis II psychiatry disorders using electronic health records. In this study, the exposed group (n = 7473) comprised patients aged 0 to 19 years with a first-time record of maltreatment episode between January 1, 2001 and December 31, 2010, whereas the unexposed group (n = 26,834) comprised individuals of the same gender and age who were admitted into the same hospital in the same calendar year and month but had no records of maltreatment in the Hong Kong Clinical Data Analysis and Reporting System (CDARS). Data on their psychiatric diagnoses recorded from the date of admission to January 31, 2019 were extracted. A Cox proportional hazard regression model was fitted to estimate the hazard ratio (HR, plus 95% CIs) between childhood maltreatment exposure and psychiatric diagnoses, adjusting for age at index visit, sex, and government welfare recipient status. Results showed that childhood maltreatment exposure was significantly associated with subsequent diagnosis of conduct disorder/ oppositional defiant disorder (adjusted HR, 10.99 [95% CI 6.36, 19.01]), attention deficit hyperactivity disorder (ADHD) (7.28 [5.49, 9.65]), and personality disorders (5.36 [3.78, 7.59]). The risk of psychiatric disorders following childhood maltreatment did not vary by history of childhood sexual abuse, age at maltreatment exposure, and gender. Individuals with a history of childhood maltreatment are vulnerable to psychiatric disorders. Findings support the provision of integrated care within the primary health care setting to address the long-term medical and psychosocial needs of individuals with a history of childhood maltreatment

A selected bibliography on parameter optimization methods suitable for hybrid computation

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68333/2/10.1177_003754976700800610.pd

Association of early nutritional status With child development in the Asia Pacific region

Importance: Stunting was used as a proxy for underdevelopment in early childhood in previous studies, but the associations between child development and other growth and body composition parameters were rarely studied. Objective: To estimate the association between malnutrition and early child development (ECD) at an individual level. Design, Setting, and Participants: This population-based, cross-sectional study used data from the East Asia Pacific Early Child Development Scales, a population-representative survey of children aged 3 to 5 years old, conducted in 2012 to 2014 in communities in Cambodia, China, Mongolia, Papua New Guinea, and Vanuatu. Data analysis was performed from November 2019 to April 2021. Exposures: Stunting (height-for-age [HFA] z score less than −2), wasting (weight-for-height z score less than −2), overweight (weight-for-height z score greater than 2), body mass index (BMI)–for-age z score, and body fat proportion based on existing growth standard and formula. Main Outcomes and Measures: ECD directly assessed using the validated East Asia–Pacific ECD Scales. Results: A total of 7108 children (3547 girls; mean [SD], age 4.48 [0.84] years) were included in this study. The prevalence of stunting was 27.1% (range across countries, 1.2%-55.0%), that of wasting was 13.7% (range, 5.4%-35.9%), and that of overweight was 15.9% (range, 2.2%-53.7%). Adjusted for country variations, age, sex, urbanicity, family socioeconomic status, and body fat proportion, ECD was linearly associated with HFA (β, 1.57; 95% CI, 1.35-1.80) and BMI-for-age (β, 0.64; 95% CI, 0.45-0.82). After adjustment for BMI and height, better ECD was associated with low body fat proportion (β, 0.93; 95% CI, 0.45-1.42). The association of HFA was more pronounced in Southeast Asia and the Pacific region than in East Asia, and the association of fat proportion was specific to children living in urban environments. Conclusions and Relevance: HFA, BMI-for-age, and body fat proportion were independently associated with ECD, and these findings suggest that future studies should consider using these parameters to estimate the prevalence of child underdevelopment; nutritional trials should examine to what extent the associations are causal

Age- and sex-specific physical fitness reference and association with body mass index in Hong Kong Chinese schoolchildren

There is lacking a population-based study on the fitness level of Hong Kong schoolchildren, and it seems that increasing childhood obesity prevalence has shifted the classification of healthy fitness, with ‘underfit’ as normal. This cross-sectional territory study aimed to develop an age- and sex-specific physical fitness reference using a representative sample of children aged 6–17 and to determine the associations with body mass index in schoolchildren. The study analyzed Hong Kong School Physical Fitness Award Scheme data covering grade 1 to grade 12 students’ physical fitness and anthropometric measurements from 2017 to 2018. This reference was established without the impact due to COVID-19. Four aspects of physical fitness tests were measured using a standardized protocol, including (i) upper limb muscle strength, (ii) one-minute sit-up, (iii) sit-and-reach, and (iv) endurance run tests. The generalized additive model for location, scale, and shape was used to construct the reference charts. A Mann–Whitney U test was used to compare the mean differences in age, weight, and height, and a Pearson’s chi-square test was used to examine the distributions of sex groups. A Kruskal–Wallis test was used to compare the group differences in BMI status, followed by the Dunn test for pairwise comparisons. A 5% level of significance was regarded as statistically significant. Data of 119,693 students before the COVID-19 pandemic were included in the analysis. The association between physical fitness level and BMI status varied depending on the test used, and there were significant differences in fitness test scores among BMI groups. The mean test scores of the obese group were lower in most of the tests for both boys and girls, except for handgrip strength. The underweight group outperformed the obese group in push-ups, one-minute sit-ups, and endurance run tests, but not in handgrip strength. In conclusion, a sex- and age-specific physical fitness reference value for Hong Kong Chinese children aged 6 to 17 years old is established, and this study demonstrated a nonlinear relationship between BMI status and physical fitness. The reference will help to identify children with poor physical fitness to offer support and guidance on exercise training. It also serves as a baseline for assessing the impact of the COVID-19 pandemic on Hong Kong students’ physical fitness