Theories used to develop or evaluate social prescribing in studies: a scoping review

This scoping review aims to provide an overview of how theories were used in the development or evaluation of social prescribing (SP) intervention studies.This scoping review aims to provide an overview of how theories were used in the development or evaluation of social prescribing (SP) intervention studies

HIV self-testing services for female sex workers, Malawi and Zimbabwe

OBJECTIVE: To present findings from implementation and scale-up of human immunodeficiency virus (HIV) self-testing programmes for female sex workers in Malawi and Zimbabwe, 2013-2018. METHODS: In Zimbabwe, we carried out formative research to assess the acceptability and accuracy of HIV self-testing. During implementation we evaluated sex workers' preferences for, and feasibility of, distribution of test kits before the programme was scaled-up. In Malawi, we conducted a rapid ethnographic assessment to explore the context and needs of female sex workers and resources available, leading to a workshop to define the distribution approach for test kits. Once distribution was implemented, we conducted a process evaluation and established a system for monitoring social harm. FINDINGS: In Zimbabwe, female sex workers were able to accurately self-test. The preference study helped to refine systems for national scale-up through existing services for female sex workers. The qualitative data helped to identify additional distribution strategies and mediate potential social harm to women. In Malawi, peer distribution of test kits was the preferred strategy. We identified some incidents of social harm among peer distributors and female sex workers, as well as supply-side barriers to implementation which hindered uptake of testing. CONCLUSION: Involving female sex workers in planning and ongoing implementation of HIV self-testing is essential, along with strategies to mitigate potential harm. Optimal strategies for distribution and post-test support are context-specific and need to consider existing support for female sex workers and levels of trust and cohesion within their communities

Lack of specialist nidicoles as a characteristic of mite assemblages inhabiting nests of the ground-nesting wood warbler, Phylloscopus sibilatrix (Aves: Passeriformes)

Bird and mammal nests provide microhabitats that support a range of other species, including invertebrates. However, the variation between communities of nest-dwelling invertebrates in different nests is poorly understood. The major aim of this study was to analyze the assemblage structure of mites from the suborder Uropodina (Acari: Mesostigmata) and from superfamily Crotonioidea (Acari: Oribatida) inhabiting nests of the wood warbler, Phylloscopus sibilatrix (Aves: Passeriformes), located on a forest floor in Białowieża Forest, in eastern Poland. We also assessed the correlation between the nest material used by the birds with the assemblage structure of Uropodina mites, and compared the results with published studies of the nests of other birds and a mammal (common mole, Talpa europaea), and also with communities of mites inhabiting the soil. The field research was conducted in the strict nature reserve of the Białowieża National Park, a near-primeval European temperate forest. In 2019, immediately after the breeding period, 69 wood warbler nests and 439 soil samples were collected. Analyses revealed assemblages of Uropodina mites inhabiting the nests that consisted of 14 species, mostly common soil species. Only five species of oribatid mites from superfamily Crotonioidea were present in the nest material. Analyzed nests had a high percentage of tree leaves and grass blades, whereas moss was the least frequent component of the nest material. The Uropodina mites were more abundant in the nests that had greater amounts of grass blades, but similar relationships were insignificant for the nests with varying amounts of tree leaves or moss. The assemblages of Uropodina mites inhabiting wood warbler nests were very similar to those found in soil and nests of the common mole, but they lacked typical nest-dwelling species of Uropodina (i.e., specialized nidicoles)

The long-term impact of the MEMA kwa Vijana adolescent sexual and reproductive health intervention: effect of dose and time since intervention exposure.

BACKGROUND: Despite recent decreases in HIV incidence in many sub-Saharan African countries, there is little evidence that specific behavioural interventions have led to a reduction in HIV among young people. Further and wider-scale decreases in HIV require better understanding of when behaviour change occurs and why. The MEMA kwa Vijana adolescent sexual and reproductive health intervention has been implemented in rural Mwanza, Tanzania since 1999. A long-term evaluation in 2007/8 found that the intervention improved knowledge, attitudes to sex and some reported risk behaviours, but not HIV or HSV2 prevalence. The aim of this paper was to assess the differential impact of the intervention according to gender, age, marital status, number of years of exposure and time since last exposure to the intervention. METHODS: In 2007, a cross-sectional survey was conducted in the 20 trial communities among 13,814 young people (15-30 yrs) who had attended intervention or comparison schools between 1999 and 2002. Outcomes for which the intervention had an impact in 2001 or 2007 were included in this subgroup analysis. Data were analysed using cluster-level methods for stratified cluster-randomised trials, using interaction tests to determine if intervention impact differed by subgroup. RESULTS: Taking into account multiplicity of testing, concurrence with a priori hypotheses and consistency within the results no strong effect-modifiers emerged. Impact on pregnancy knowledge and reported attitudes to sex increased with years of exposure to high-quality intervention. CONCLUSIONS: The desirable long-term impact of the MEMA kwa Vijana intervention did not vary greatly according to the subgroups examined. This suggests that the intervention can have an impact on a broad cross-section of young people in rural Mwanza. TRIAL REGISTRATION: ClinicalTrials.gov NCT00248469

Adoption of HIV pre-exposure prophylaxis among women at high risk of HIV infection in Kenya

In 2017, Kenya became one of the first African countries to provide pre-exposure prophylaxis (PrEP) in its national HIV prevention plan. We sought to characterize factors associated with PrEP uptake and persistence among a cohort of women at risk of HIV infection during the early stages of PrEP scale-up in Kenya. HIV-negative women ≥18 years with ≥2 sexual partners in the past 4 weeks were recruited as part of an ongoing cluster randomized trial of an HIV self-testing intervention. PrEP use was assessed at baseline and at 6- and 12-month follow-up visits. Between June 2017 and August 2018, 2,086 were enrolled and had complete baseline data. 138 (6.6%) reported PrEP use during the first year of the study. Although PrEP use increased, persistence on PrEP was low, and less than half of individuals reported continuing PrEP at follow-up visits. In multivariate analyses, PrEP use was associated with recent STIs, having an HIV-positive primary partner, having regular transactional sex in the past 12 months, and being a female sex worker. In the early stages of PrEP scale-up in Kenya, uptake increased modestly among women with risk factors for HIV infection, but overall uptake and persistence was low

CheriRTOS: A Capability Model for Embedded Devices

Embedded systems are deployed ubiquitously among various sectors including automotive, medical, robotics and avionics. As these devices become increasingly connected, the attack surface also increases tremendously; new mechanisms must be deployed to defend against more sophisticated attacks while not violating resource constraints. In this paper we present CheriRTOS on CHERI-64, a hardware-software platform atop Capability Hardware Enhanced RISC Instructions (CHERI) for embedded systems. Our system provides efficient and scalable task isolation, fast and secure inter-task communication, fine-grained memory safety, and real-time guarantees, using hardware capabilities as the sole protection mechanism. We summarize state-of-the-art se- curity and memory safety for embedded systems for comparison with our platform, illustrating the superior substrate provided by CHERI’s capabilities. Finally, our evaluations show that a capability system can be implemented within the constraints of embedded systems

The HIV care cascade among female sex workers in Zimbabwe: results of a population-based survey from the Sisters Antiretroviral therapy Programme for Prevention of HIV, an Integrated Response (SAPPH-IRe) Trial.

: Female sex workers (FSW) in sub-Saharan Africa have a higher prevalence of HIV than other women of reproductive age. Social, legal, and structural barriers influence their access to care. Little is known about the HIV diagnosis and care cascade in most countries in Southern Africa. We aimed to describe the HIV diagnosis and care cascade among FSW in Zimbabwe. : We conducted cross-sectional respondent driven sampling (RDS) surveys of FSW in 14 sites across Zimbabwe as the baseline for a cluster-randomised controlled trial investigating a combination HIV prevention and care package. We administered a questionnaire, tested women for HIV and measured viral load. We report the mean, minimum, and maximum respondent-driven sampling-2 weighted site values. : The survey included 2722 women, approximately 200 per site. The mean HIV prevalence was 57.5% (42.8-79.2 site minimum and maximum). Of HIV-positive women, 64.0% (51.6-73.7) were aware of their status, 67.7% (53.4-84.1) of these reported taking antiretroviral therapy, and 77.8% (64.4-90.8) of these had a suppressed HIV viral load (&lt;1000 copies/mL). Among all HIV-positive women, 49.5% had a viral load &lt; 1000 copies/mL. : Although most HIV-positive women aware of their status are accessing antiretroviral therapy, 36.0% of HIV-positive women are unaware of their status and 29.3% of all FSW have an unsuppressed HIV viral load. Investigation and investment into models of testing, treatment, and care are necessary to reach UNAIDS targets for HIV elimination.<br/

Efficient tagged memory

We characterize the cache behavior of an in-memory tag table and demonstrate that an optimized implementation can typically achieve a near-zero memory traffic overhead. Both industry and academia have repeatedly demonstrated tagged memory as a key mechanism to enable enforcement of powerful security invariants, including capabilities pointer integrity, watchpoints, and information-flow tracking. A single-bit tag shadowspace is the most commonly proposed requirement, as one bit is the minimum metadata needed to distinguish between an untyped data word and any number of new hardware-enforced types. We survey various tag shadowspace approaches and identify their common requirements and positive features of their implementations. To avoid non-standard memory widths, we identify the most practical implementation for tag storage to be an in-memory table managed next to the DRAM controller. We characterize the caching performance of such a tag table and demonstrate a DRAM traffic overhead below 5\% for the vast majority of applications. We identify spatial locality on a page scale as the primary factor that enables surprisingly high table cache-ability. We then demonstrate tag-table compression for a set of common applications. A hierarchical structure with elegantly simple optimizations reduces DRAM traffic overhead to below 1\% for most applications. These insights and optimizations pave the way for commercial applications making use of single-bit tags stored in commodity memory