Evaluation of a savings-led family-based economic empowerment intervention for AIDS-affected adolescents in Uganda: A four-year follow-up on efficacy and cost-effectiveness

Background Children who have lost a parent to HIV/AIDS, known as AIDS orphans, face multiple stressors affecting their health and development. Family economic empowerment (FEE) interventions have the potential to improve these outcomes and mitigate the risks they face. We present efficacy and cost-effectiveness analyses of the Bridges study, a savings-led FEE intervention among AIDS-orphaned adolescents in Uganda at four-year follow-up. Methods Intent-to-treat analyses using multilevel models compared the effects of two savings-led treatment arms: Bridges (1:1 matched incentive) and BridgesPLUS (2:1 matched incentive) to a usual care control group on the following outcomes: self-rated health, sexual health, and mental health functioning. Total per-participant costs for each arm were calculated using the treatment-on-the-treated sample. Intervention effects and per-participant costs were used to calculate incremental cost-effectiveness ratios (ICERs). Findings Among 1,383 participants, 55% were female, 20% were double orphans. Mean age was 12 years at baseline. At 48-months, BridgesPLUS significantly improved self-rated health, (0.25, 95% CI 0.06, 0.43), HIV knowledge (0.21, 95% CI 0.01, 0.41), self-concept (0.26, 95% CI 0.09, 0.44), and self-efficacy (0.26, 95% CI 0.09, 0.43) and lowered hopelessness (-0.28, 95% CI -0.43, -0.12); whereas Bridges improved self-rated health (0.26, 95% CI 0.08, 0.43) and HIV knowledge (0.22, 95% CI 0.05, 0.39). ICERs ranged from $224 for hopelessness to$298 for HIV knowledge per 0.2 standard deviation change. Conclusions Most intervention effects were sustained in both treatment arms at two years post-intervention. Higher matching incentives yielded a significant and lasting effect on a greater number of outcomes among adolescents compared to lower matching incentives at a similar incremental cost per unit effect. These findings contribute to the evidence supporting the incorporation of FEE interventions within national social protection frameworks

Failure Forecasting of Aircraft Air-Conditioning/Cooling Pack with Field Data

This paper presents methods for modeling the failure of air-conditioning/cooling packs for a particular type of aircraft with field data. In many regards, field data are highly desirable for more accurate failure prediction by aircraft operators, because the data implicitly account for all actual usage and environmental stresses. It is not always possible to accurately anticipate or simulate these stresses in a laboratory or even in a field test. Field data, in a larger extent, are also important to the manufacturer, because the data identify product deficiencies and areas of improvement. In this study, the failure of the aircraft air-conditioning/cooling pack under a customer-use environment is first modeled at the component level by using the Weibull distribution and its extensions. These include the two-parameter Weibull model, three-parameter Weibull model, mixture model, and phased bi-Weibull model. The number of failures over time is estimated by a renewal process. The failure of the air-conditioning/cooling pack at the system level is then modeled by using the power law process model. The failure trend is tested by the Laplace test. The results give an insight into the reliability and quality of the air-conditioning/cooling pack under actual operating conditions. The models presented here can be used by aircraft operators for assessing system and component failures and customizing the maintenance programs recommended by the manufacturer

Failure Data Analysis for Aircraft Maintenance Planning

This paper presents an application of Weibull method for forecasting the failure rate of Boeing 737 Auxiliary power unit (APU) oil pumps. The Weibull method is extremely useful for maintenance planning. Using Weibull failure forecasting, a maintenance planner can make quantitative trades between scheduled and unscheduled maintenance or non-destructive inspection and replacement. The method also helps for determining the age at which an operating part in an aircraft system should be replaced with a new part. In this study, the failure rate of APU oil pump of Boeing 737 aircraft is modeled by using the Weibull technique. The results were in close agreement with the real data indicating the validity of the Weibull model in predicting failure rate of failure for APU oil pumps. In addition, the optimum replacement age of the pumps is also calculated for various cost ratios

Failure Data Analysis for Aircraft Maintenance Planning

This paper presents an application of Weibull method for forecasting the failure rate of Boeing 737 Auxiliary power unit (APU) oil pumps. The Weibull method is extremely useful for maintenance planning. Using Weibull failure forecasting, a maintenance planner can make quantitative trades between scheduled and unscheduled maintenance or non-destructive inspection and replacement. The method also helps for determining the age at which an operating part in an aircraft system should be replaced with a new part. In this study, the failure rate of APU oil pump of Boeing 737 aircraft is modeled by using the Weibull technique. The results were in close agreement with the real data indicating the validity of the Weibull model in predicting failure rate of failure for APU oil pumps. In addition, the optimum replacement age of the pumps is also calculated for various cost ratios

Failure Forecasting of Aircraft Air-Conditioning/Cooling Pack with Field Data

This paper presents methods for modeling the failure of air-conditioning/cooling packs for a particular type of aircraft with field data. In many regards, field data are highly desirable for more accurate failure prediction by aircraft operators, because the data implicitly account for all actual usage and environmental stresses. It is not always possible to accurately anticipate or simulate these stresses in a laboratory or even in a field test. Field data, in a larger extent, are also important to the manufacturer, because the data identify product deficiencies and areas of improvement. In this study, the failure of the aircraft air-conditioning/cooling pack under a customer-use environment is first modeled at the component level by using the Weibull distribution and its extensions. These include the two-parameter Weibull model, three-parameter Weibull model, mixture model, and phased bi-Weibull model. The number of failures over time is estimated by a renewal process. The failure of the air-conditioning/cooling pack at the system level is then modeled by using the power law process model. The failure trend is tested by the Laplace test. The results give an insight into the reliability and quality of the air-conditioning/cooling pack under actual operating conditions. The models presented here can be used by aircraft operators for assessing system and component failures and customizing the maintenance programs recommended by the manufacturer

Failure Data Analysis for Aircraft Maintenance Planning

This paper presents an application of Weibull method for forecasting the failure rate of Boeing 737 Auxiliary power unit (APU) oil pumps. The Weibull method is extremely useful for maintenance planning. Using Weibull failure forecasting, a maintenance planner can make quantitative trades between scheduled and unscheduled maintenance or non-destructive inspection and replacement. The method also helps for determining the age at which an operating part in an aircraft system should be replaced with a new part. In this study, the failure rate of APU oil pump of Boeing 737 aircraft is modeled by using the Weibull technique. The results were in close agreement with the real data indicating the validity of the Weibull model in predicting failure rate of failure for APU oil pumps. In addition, the optimum replacement age of the pumps is also calculated for various cost ratios

Neural network-based failure rate prediction for De Havilland Dash-8 tires

An artificial neural network (ANN) model for predicting the failure rate of De Havilland Dash-8 airplane tires utilizing the twolayered feed-forward back-propagation algorithm as a learning rule is developed. The inputs to the neural network are independent variables and the output is the failure rate of the tires. Six years of data are used for model building and validation. Model validation, which reflects the suitability of the model for future prediction is performed by comparing the predictions of the model with that of Weibull regression model. The results show that the failure rate predicted by the ANN is closer in agreement with the actual data than the failure rate predicted by the Weibull model

Failure-Rate Prediction for De Havilland Dash-8 Tires Employing Neural-Network Technique

An artificial neural-network model for predicting the failure rate of De Havilland Dash-8 airplane tires utilizing the two-layered feedforward back-propagation algorithm as a learning rule is developed. The inputs to the neural network are independent variables, and the output is the failure rate of the tires. Six years of data are used for model building and validation. Model validation, which reflects the suitability of the model for future prediction, is performed by comparing the predictions of the model with that of theWeibull regression model. The results show that the failure rate predicted by the artificial neural network more closely agrees with the actual data than the failure rate predicted by the Weibull model

I expected little, although I learned a lot : Perceived benefits of participating in HIV risk reduction sessions among women engaged in sex work in Uganda

BACKGROUND: The global HIV burden remains a public health concern. Women engaged in sex work (WESW) are at higher risk of acquiring HIV compared to the general adult population. Uganda reports high rates of HIV prevalence among WESW. While WESW in Uganda have long been the subject of surveillance studies, they have not been targeted by theory-informed HIV prevention intervention approaches. In this study, we explored the perceived benefits of an evidence-based HIV risk reduction intervention that was implemented as part of a combination intervention tested in a clinical trial in Uganda. METHODS: As part of a larger randomized clinical trial, we conducted semi-structured in-depth interviews with 20 WESW selected using a stratified purposive sampling. All interviews were conducted in Luganda, language spoken in the study area, and audio-recorded. They were transcribed verbatim and translated to English. Thematic analysis was used to analyze the data. RESULTS: WESW\u27s narratives focused on: (1) condom use; (2) alcohol/drug consumption; (3) PrEP use; (4) handling customers; and (5) massaging customers. WESW agreed that male condom was one of the important learning points for them and planned to continue using them while female condoms were received with mixed reactions. Many women appreciated receiving information about the risks of consuming alcohol and drugs, and discussed how they reduced/ eliminated their consumption. PrEP information was appreciated though identified by fewer WESW. Handling a client was discussed as a helpful strategy for safer sex through improved ability to convince customers to use condoms or avoiding sex. Massaging was also beneficial to avoid penetrative sex, but similar to female condom, massaging also yielded mixed perceptions. CONCLUSION: WESW found the intervention beneficial and described ways in which it improved their ability to engage in safer sex and stay healthy. The fact that WESW identified other strategies beyond condom use as helpful underlines the importance of adopting a comprehensive approach to behavioral interventions targeting HIV prevention even when combined with other interventions. Additionally, WESW\u27s narratives suggest that incorporating the tenets of social cognitive theory and harm reduction approaches in HIV prevention among this population can result in risk behavior change

Economic Abuse and Care-seeking Practices for HIV and Financial Support Services in Women Employed by Sex Work: A Cross-Sectional Baseline Assessment of a Clinical Trial Cohort in Uganda

Economic hardship is a driver of entry into sex work, which is associated with high HIV risk. Yet, little is known about economic abuse in women employed by sex work (WESW) and its relationship to uptake of HIV prevention and financial support services. This study used cross-sectional baseline data from a multisite, longitudinal clinical trial that tests the efficacy of adding economic empowerment to traditional HIV risk reduction education on HIV incidence in 542 WESW. Mixed effects logistic and linear regressions were used to examine associations in reported economic abuse by demographic characteristics, sexual behaviors, HIV care-seeking, and financial care-seeking. Mean age was 31.4 years. Most WESW were unmarried (74%) and had less than primary school education (64%). 48% had savings, and 72% had debt. 93% reported at least one economic abuse incident. Common incidents included being forced to ask for money (80%), having financial information kept from them (61%), and being forced to disclose how money was spent (56%). WESW also reported partners/relatives spending money needed for bills (45%), not paying bills (38%), threatening them to quit their job(s) (38%), and using physical violence when earning income (24%). Married/partnered WESW (OR = 2.68, 95% CI:1.60–4.48), those with debt (OR = 1.70, 95% CI:1.04–2.77), and those with sex-work bosses (OR = 1.90, 95% CI:1.07–3.38) had higher economic abuse. Condomless sex (β = +4.43, p < .05) was higher among WESW experiencing economic abuse, who also had lower odds of initiating PrEP (OR = .39, 95% CI:.17–.89). WESW experiencing economic abuse were also more likely to ask for cash among relatives (OR = 2.36, 95% CI:1.13–4.94) or banks (OR = 2.12, 95% CI:1.11–4.03). The high prevalence of HIV and economic abuse in WESW underscores the importance of integrating financial empowerment in HIV risk reduction interventions for WESW, including education about economic abuse and strategies to address it. Programs focusing on violence against women should also consider economic barriers to accessing HIV prevention services