Invited discussant comments during the UCL-Penn Global COVID Study webinar ‘Alone Together: Loneliness Research and Social Health Innovation in Lockdown and Beyond’

The coronavirus (Covid-19) pandemic has influenced people’s social relationships around the world in surprising ways. It has also underscored the importance of and accelerated innovation in solutions for social isolation and loneliness. This commentary offers takeaways from emerging research findings and a wide lens on the societal movement underway to create more socially connected communities

Younger adults with severe physical disabilities in the Capital Region

In Spring, 1994 the Gerontology Research Centre at Simon Fraser University was commissioned to undertake a project that would provide the Health Planning Division of the Capital Regional District of British Columbia (CRD) with information that would facilitate strategic planning for younger adults with severe physical disabilities. The specific goals of the project were to: 1) define the pertinent characteristics of persons aged 19-55 with severe physical disabilities living in the CRD, including: their socio-demographic characteristics (age and gender distribution, education, marital status, housing and living arrangement, sources of income); health and functional status (diagnosis, level of performance of Activities of Daily Living and Instrumental Activities of Daily Living); and available social supports; 2) ascertain consumer preferences (clients and their families) as to the type and location of housing and support services they require; 3) critically review existing health and social service programs in the CRD and province, and policies targeted to/encompassing younger adults with severe physical disabilities, with respect to their ability to respond to the identified consumer preferences; 4) recommend the type and level of resources required to meet consumer preferences. To fulfill the commission, the following activities were undertaken: Phase 1. Literature Review - An extensive electronic literature search and review was conducted. Unpublished material obtained from the Ministry of Health and other contacts was also reviewed (see: Gutman, G.M. (1995). Characteristics, service needs and service preferences of younger adults with severe physical disabilities: Literature review. Vancouver, BC: Gerontology Research Centre, Simon Fraser University. OAI: http://ir.lib.sfu.ca/handle/1892/11440). Phase 2. Profile of Continuing Care Clients - Assuming that most younger adults with severe physical disabilities living in the CRD were known to the Continuing Care Division of the Ministry of Health, a client profile was constructed using information from 153 clients\u27 LTC-1 forms, the Division\u27s standard assessment form (see Chapter 2 of this report for findings)

Violence Prevention in Middle School: A Preliminary Study

Violence in schools continues reflecting violence within society. There is a growing need for violence prevention programs within the schools that provide students with the skills needed to cope with interpersonal and relationship is-sues effectively. This study was conducted at a middle school and there were 345 middle school students (6th to 8th grade) who participated in the study. The students participated in a violence prevention program. In this study, the researchers used a pre-test/post-test design and the results indicated that there were some changes in attitudes towards violence that occurred after the intervention

Utilization of the Social Determinants of Mental Health Framework with Older Adults for Assessment, Case Conceptualization, and Treatment Planning

This conceptual paper will aid counselors and mental health professionals in obtaining insight to utilizing a Social Determinants of Mental Health Framework with older adult clients. Further, the article incorporates the Multicultural and Social Justice Counseling Competencies to further contextualize the therapeutic alliance. The authors utilize the Social Determinants of Mental Health Framework to frame counseling assessment, case conceptualization, and treatment planning to improve the mental health outcomes of older adults. The article utilizes a specific case example to assess, conceptualize, and plan treatment for an older adult client contextualized in their environment

A multilab study of bilingual infants: Exploring the preference for infant-directed speech

From the earliest months of life, infants prefer listening to and learn better from infant-directed speech (IDS) than adult-directed speech (ADS). Yet, IDS differs within communities, across languages, and across cultures, both in form and in prevalence. This large-scale, multi-site study used the diversity of bilingual infant experiences to explore the impact of different types of linguistic experience on infants’ IDS preference. As part of the multi-lab ManyBabies project, we compared lab-matched samples of 333 bilingual and 385 monolingual infants’ preference for North-American English IDS (cf. ManyBabies Consortium, in press (MB1)), tested in 17 labs in 7 countries. Those infants were tested in two age groups: 6–9 months (the younger sample) and 12–15 months (the older sample). We found that bilingual and monolingual infants both preferred IDS to ADS, and did not differ in terms of the overall magnitude of this preference. However, amongst bilingual infants who were acquiring North-American English (NAE) as a native language, greater exposure to NAE was associated with a stronger IDS preference, extending the previous finding from MB1 that monolinguals learning NAE as a native language showed a stronger preference than infants unexposed to NAE. Together, our findings indicate that IDS preference likely makes a similar contribution to monolingual and bilingual development, and that infants are exquisitely sensitive to the nature and frequency of different types of language input in their early environments

Associated risk factors of STIs and multiple sexual relationships among youths in Malawi

Having unprotected sex with multiple sexual partners (MSP) is the greatest risk factor for human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs) among youths. Young people with MSPs are less likely to use a condom and the greater the risk for STIs. This study examines the associated risk factors of STIs and multiple sexual partnerships among youths aged 15–24 years. The Malawi Demographic Health Survey 2010 data was used. Out of a sample of 2,987 males and 9,559 females aged 15–24 years, 2,026 males and 6,470 females were considered in the study. Chi square test and logistic regression techniques were performed. Analysis was performed using Statistical Package for Social Sciences (SPSS) version 22.Article writing fellowships were received from the Research Development Office, University of the Western Cape, 7535 Bellville, Cape Town, South Africa.Web of Scienc

How HIV/AIDS scale-up has impacted on non- HIV priority services in Zambia

Background: Much of the debate as to whether or not the scaling up of HIV service delivery in Africa benefits non-HIV priority services has focused on the use of nationally aggregated data. This paper analyses and presents routine health facility record data to show trend correlations across priority services. Methods: Review of district office and health facility client records for 39 health facilities in three districts of Zambia, covering four consecutive years (2004-07). Intra-facility analyses were conducted, service and coverage trends assessed and rank correlations between services measured to compare service trends within facilities. Results: VCT, ART and PMTCT client numbers and coverage levels increased rapidly. There were some strong positive correlations in trends within facilities between reproductive health services (family planning and antenatal care) and ART and PMTCT, with Spearman rank correlations ranging from 0.33 to 0.83. Childhood immunisation coverage also increased. Stock-outs of important drugs for non-HIV priority services were significantly more frequent than were stock-outs of antiretroviral drugs. Conclusions: The analysis shows scale-up in reproductive health service numbers in the same facilities where HIV services were scaling up. While district childhood immunisations increased overall, this did not necessarily occur in facility catchment areas where HIV service scale-up occurred. The paper demonstrates an approach for comparing correlation trends across different services, using routine health facility information. Larger samples and explanatory studies are needed to understand the client, facility and health systems factors that contribute to positive and negative synergies between priority services

Integrating Prevention of Mother-to-Child HIV Transmission Programs to Improve Uptake: A Systematic Review

BACKGROUND: We performed a systematic review to assess the effect of integrated perinatal prevention of mother-to-child transmission of HIV interventions compared to non- or partially integrated services on the uptake in low- and middle-income countries. METHODS: We searched for experimental, quasi-experimental and controlled observational studies in any language from 21 databases and grey literature sources. RESULTS: Out of 28 654 citations retrieved, five studies met our inclusion criteria. A cluster randomized controlled trial reported higher probability of nevirapine uptake at the labor wards implementing HIV testing and structured nevirapine adherence assessment (RRR 1.37, bootstrapped 95% CI, 1.04-1.77). A stepped wedge design study showed marked improvement in antiretroviral therapy (ART) enrolment (44.4% versus 25.3%, p<0.001) and initiation (32.9% versus 14.4%, p<0.001) in integrated care, but the median gestational age of ART initiation (27.1 versus 27.7 weeks, p = 0.4), ART duration (10.8 versus 10.0 weeks, p = 0.3) or 90 days ART retention (87.8% versus 91.3%, p = 0.3) did not differ significantly. A cohort study reported no significant difference either in the ART coverage (55% versus 48% versus 47%, p = 0.29) or eight weeks of ART duration before the delivery (50% versus 42% versus 52%; p = 0.96) between integrated, proximal and distal partially integrated care. Two before and after studies assessed the impact of integration on HIV testing uptake in antenatal care. The first study reported that significantly more women received information on PMTCT (92% versus 77%, p<0.001), were tested (76% versus 62%, p<0.001) and learned their HIV status (66% versus 55%, p<0.001) after integration. The second study also reported significant increase in HIV testing uptake after integration (98.8% versus 52.6%, p<0.001). CONCLUSION: Limited, non-generalizable evidence supports the effectiveness of integrated PMTCT programs. More research measuring coverage and other relevant outcomes is urgently needed to inform the design of services delivering PMTCT programs

Comparing two service delivery models for the prevention of mother-to-child transmission (PMTCT) of HIV during transition from single-dose nevirapine to multi-drug antiretroviral regimens

<p>Abstract</p> <p>Background</p> <p>Mother-to-child transmission (MTCT) of HIV has been eliminated from the developed world with the introduction of multi-drug antiretroviral (md-ARV) regimens for the prevention of MTCT (PMTCT); but remains the major cause of HIV infection among sub-Saharan African children. This study compares two service delivery models of PMTCT interventions and documents the lessons learned and the challenges encountered during the transition from single-dose nevirapine (sd-nvp) to md-ARV regimens in a resource-limited setting.</p> <p>Methods</p> <p>Program data collected from 32 clinical sites was used to describe trends and compare the performance (uptake of HIV testing, CD4 screening and ARV regimens initiated during pregnancy) of sites providing PMTCT as a stand-alone service (<it>stand-alone site</it>) versus sites providing PMTCT as well as antiretroviral therapy (ART) (<it>full package site</it>). CD4 cell count screening, enrolment into ART services and the initiation of md-ARV regimens during pregnancy, including dual (zidovudine [AZT] +sd-nvp) prophylaxis and highly active antiretroviral therapy (HAART) were analysed.</p> <p>Results</p> <p>From July 2006 to December 2008, 1,622 pregnant women tested HIV positive (HIV+) during antenatal care (ANC). CD4 cell count screening during pregnancy increased from 60% to 70%, and the initiation of md-ARV regimens increased from 35.5% to 97% during this period. In 2008, women attending ANC at <it>full package </it>sites were 30% more likely to undergo CD4 cell count assessment during pregnancy than women attending <it>stand-alone </it>sites (relative risk (RR) = 1.3; 95% confidence interval (CI): 1.1-1.4). Enrolment of HIV+ pregnant women in ART services was almost twice as likely at <it>full package </it>sites than at <it>stand-alone </it>sites (RR = 1.9; 95% CI: 1.5-2.3). However, no significant differences were detected between the two models of care in providing md-ARV (RR = 0.9; 95% CI: 0.9-1.0).</p> <p>Conclusions</p> <p>All sites successfully transitioned from sd-nvp to md-ARV regimens for PMTCT. <it>Full package </it>sites offer the most efficient model for providing immunological assessment and enrolment into care and treatment of HIV+ pregnant women. Strengthening the capacity of <it>stand-alone </it>PMTCT sites to achieve the same objectives is paramount.</p