A Practical Guide to Integrating Reproductive Health and HIV/AIDS into Grant Proposals to the Global Fund

Integrating RH and HIV can greatly contribute to mitigating the AIDS pandemic by reducing unintended pregnancy; preventing perinatal transmission; expanding to more target groups; reducing gender based violence; meeting the needs of people living with HIV and providing our youth with the knowledge and services they need. Whether to integrate, how to integrate and exactly what to integrate will depend on a country's epidemiological profile, policies and program structures.Experience with implementation of integration initiatives in countries around the world shows that scale up and sustainability requires attention to policy and program operations issues. This document, with links to a range of resources, will help CCMs, civil society organizations and others developing proposals for the Global Fund that contribute to preventing HIV and mitigating the effects of the AIDS pandemic through programs that link and integrate RH and HIV/AIDS

Writing and iPads in the Early Years: A Report for the Standing Conference on Teacher Education North and South

This chapter sets out the rationale for the project and also sets out the policy context for literacy and digital technology in both Northern Ireland and the Republic of Ireland. Writing in a digital age: Beard (2000) argues that the ability to write, along with reading, is acclaimed as one of the twin peaks of literacy and one of the central gains from education. Writing is both a powerful form of expression and a vehicle for learning. It affords the learner the ability to reflect, think, compose, rearrange and respond (Andrews and Smith, 2011). However, writing is a complex and effortful activity and many children lose interest and motivation when asked to engage in writing. In a recent survey by the National Literacy Trust of pupils aged 8 to 18, just over 50% of children and young people said they enjoyed writing either very much or quite a lot. However, that leaves the other 50% who only enjoy writing a bit or not at all (Clark and Teravainen, 2017). Fewer children are engaging in daily writing outside of class but when they do write, it is technology based formats which dominate this writing (Clark, 2016). So whilst schools maintain what Yelland et al. (2008) refer to as a ‘heritage curriculum’ where value is attached to print texts, children themselves are appropriating and using digital technology for their own purposes in their daily lives. Indeed, McTavish (2014, p320) suggests that ‘for young children born into this technological epoch, there may be no choice, it is simply a way of being’. Many curriculum documents recognise and affirm the importance of communicating meaning through both traditional and digital texts yet print literacy continues to be privileged in classrooms (McKee and Heydon (2015). Therefore, this contradiction in rhetoric and reality is making it very difficult for educators to integrate new literacies and technologies within their classrooms (Wohlwend, 2009). Furthermore, where there is an emphasis on high-stakes testing, expanded views of literacy, beyond print-centric literacy practices, are difficult to achieve (Loerts and Heydon, 2017). With this apparent gap in what policy is advocating and what is happening in classrooms, it is important to look briefly at policy in the two jurisdictions for this study, Northern Ireland and the Republic of Ireland to set the context for the study

Developing a social understanding of autism through the 'social model'.

The aim of this study is to design an innovative research methodology to engage young people with a label of 'autism', in the research process. Advancement in the creation of a new and innovative research methodology made it possible for 11 young people to communicate with the researcher about what was important to them as they went through adolescence. 'Barriers' to inclusion in the research process were challenged by developing, practical ways to de-code and translate complex communication systems through the design of a 'communication profile'. Engaging young people with a label of 'autism' in a way that enables them to lead and direct the research process is new and challenges traditional research assumptions. It also challenges traditional research methods used with people with a label of Teaming difficulties' and questions the validity of 'researcher led' narrative. Utilising a more democratic process of 'inclusive' research methodology led to the findings that young people with a label of 'autism' are disabled by 'barriers' within wider society rather than by their perceived 'impairments'. The disabling barriers evident from this research were physical barriers (in relation the physical environment); support barriers (in relation to interpersonal relationships and support); and information barriers (the way information causes disabling barriers if it is not presented in ways that enables understanding). The findings significantly challenged current and past theories of autism and questioned the 'truth' in the 'knowledge' ascertained from positivist research methodologies. Listening to the collective 'voice' of young people with a label of 'autism', urges a move away from a reductionist explanation of 'impairment', to embrace the wider holistic explanation of autism as 'disability'. To advance the continuation of participation in research, this research study calls for a 'paradigm shift' in research methodology, to move away from 'positivist' research methodologies to advancing an 'emancipatory disability research' agenda. This research also calls for the inclusion of people with a label of 'autism' to become engaged in the wider 'social model of disability' debate and to become included as part of the wider disabled people's movement

The prevalence and causes of vision loss in Indigenous Australians: the National Indigenous Eye Health Survey

Aim: To determine the prevalence and causes of vision loss in Indigenous Australians. Design, setting and participants: A national, stratified, random cluster sample was drawn from 30 communities across Australia that each included about 300 Indigenous people of all ages. A sample of non-Indigenous adults aged 40 years was also tested at several remote sites for comparison. Participants were examined using a standardised protocol that included a questionnaire (self-administered or completed with the help of field staff), visual acuity (VA) testing on presentation and after correction, visual field testing, trachoma grading, and fundus and lens photography. The data were collected in 2008. Main outcome measures: VA; prevalence of low vision and blindness; causes of vision loss; rates of vision loss in Indigenous compared with non-Indigenous adults. Results: 1694Indigenouschildrenand1189Indigenousadultswereexamined, representing recruitment rates of 84% for children aged 5–15 years and 72% for adults aged 40 years. Rates of low vision (VA \u3c 6/12 to 6/60) were 1.5% (95% CI, 0.9%–2.1%) in children and 9.4% (95% CI, 7.8%–11.1%) in adults. Rates of blindness (VA \u3c 6/60) were 0.2% (95% CI, 0.04%–0.5%) in children and 1.9% (95% CI, 1.1%–2.6%) in adults. The principal cause of low vision in both adults and children was refractive error. The principal causes of blindness in adults were cataract, refractive error and optic atrophy. Relative risks (RRs) of vision loss and blindness in Indigenous adults compared with adults in the mainstream Australian population were 2.8 and 6.2, respectively. By contrast, RRs of vision loss and blindness in Indigenous children compared with mainstream children were 0.2 and 0.6, respectively. Conclusion: Many causes of vision loss in our sample were readily avoidable. Better allocation of services and resources is required to give all Australians equal access to eye health services

Pilot and feasibility study of serum chemokines as markers to distinguish prostatic disease in men with low total serum PSA

BACKGROUND The incidence and prevalence of both benign prostatic hypertrophy (BPH) and prostate cancer (PCa) increase with the aging process. Our laboratory recently showed that the chemokines CXCL5 and CXCL12, which normally function as inflammatory mediators, are secreted at higher levels by aging prostate stromal fibroblasts and elicit proliferative responses from both prostate stromal fibroblast and epithelial cells. Because both CXCL5 and CXCL12 are secreted molecules, we hypothesized that their levels in patient serum might serve as biomarkers to distinguish between BPH and PCa. METHODS Serum CXCL5 and CXCL12 levels were determined using sandwich ELISAs for 51 men demonstrating low serum PSA values of ≤10 ng/ml who underwent diagnostic needle biopsy for the detection of PCa. The bivariate relationship of circulating chemokine levels, age, and disease status in the prostate was tested using the Wilcoxon rank-sum test. Results Total serum CXCL12 levels were significantly higher for men who were biopsy positive compared to those who were biopsy negative for cancer and histological prostatitis ( P  = 0.050). Among men who were biopsy negative for PCa, total serum CXCL5 levels were inversely associated with prostate volume and were significantly higher in men with concomitant BPH and histological prostatitis compared to those without evidence of prostatic disease ( P  < 0.003). CONCLUSIONS The results of this pilot and feasibility study suggest that serum or plasma CXCL5 and CXCL12 levels may potentially distinguish between BPH and PCa among patients presenting with low serum PSA, and may be useful toward facilitating decisions to perform diagnostic needle biopsy in this patient population. Prostate 68: 442–452, 2008. © 2008 Wiley-Liss, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/57914/1/20717_ftp.pd

Developing and Implementing FBA-BIPs in Elementary Classrooms: A Conceptual Replication

The majority of students with disabilities and behavioral challenges are taught in general education classrooms. Although these students may receive interventions resulting in positive behavioral changes, little is known about the collateral effects of implementing behavior intervention plans (BIP) on classroom peers with similar behavioral problems who are not receiving an intervention. The purpose of this study was to investigate the effects of functional behavioral assessments (FBAs) and BIPs for students with challenging behavior as well as their peers. We measured target student and peer academic engagement, as well as treatment integrity and social validity. As a result of the intervention, target students demonstrated increased academic engagement. In addition, results suggest that the FBA-BIPs had small effects on engagement for some peers

Rates, causes and predictors of all-cause and avoidable mortality in 163 686 children and young people with and without intellectual disabilities:A record linkage national cohort study

Objectives: To investigate mortality rates and associated factors, and avoidable mortality in children/young people with intellectual disabilities. Design: Retrospective cohort; individual record-linked data between Scotland’s 2011 Census and 9.5 years of National Records for Scotland death certification data. Setting: General community. Participants: Children and young people with intellectual disabilities living in Scotland aged 5–24 years, and an age-matched comparison group. Main outcome measures: Deaths up to 2020: age of death, age-standardised mortality ratios (age-SMRs); causes of death including cause-specific age-SMRs/sex-SMRs; and avoidable deaths. Results: Death occurred in 260/7247 (3.6%) children/young people with intellectual disabilities (crude mortality rate=388/100 000 person-years) and 528/156 439 (0.3%) children/young people without intellectual disabilities (crude mortality rate=36/100 000 person-years). SMRs for children/young people with versus those without intellectual disabilities were 10.7 for all causes (95% CI 9.47 to 12.1), 5.17 for avoidable death (95% CI 4.19 to 6.37), 2.3 for preventable death (95% CI 1.6 to 3.2) and 16.1 for treatable death (95% CI 12.5 to 20.8). SMRs were highest for children (27.4, 95% CI 20.6 to 36.3) aged 5–9 years, and lowest for young people (6.6, 95% CI 5.1 to 8.6) aged 20–24 years. SMRs were higher in more affluent neighbourhoods. Crude mortality incidences were higher for the children/young people with intellectual disabilities for most International Statistical Classification of Diseases and Related Health Problems, 10th Revision chapters. The most common underlying avoidable causes of mortality for children/young people with intellectual disabilities were epilepsy, aspiration/reflux/choking and respiratory infection, and for children/young people without intellectual disabilities were suicide, accidental drug-related deaths and car accidents. Conclusion: Children with intellectual disabilities had significantly higher rates of all-cause, avoidable, treatable and preventable mortality than their peers. The largest differences were for treatable mortality, particularly at ages 5–9 years. Interventions to improve healthcare to reduce treatable mortality should be a priority for children/young people with intellectual disabilities. Examples include improved epilepsy management and risk assessments, and coordinated multidisciplinary actions to reduce aspiration/reflux/choking and respiratory infection. This is necessary across all neighbourhoods

Low serum cortisol predicts early death following acute myocardial infarction

&lt;b&gt;Objective&lt;/b&gt;: Low serum cortisol concentrations have been associated with adverse prognosis in critical illness of diverse aetiology. We aimed to determine whether low serum cortisol concentrations are associated with adverse prognosis in patients with acute myocardial infarction. &lt;b&gt;Design&lt;/b&gt;: Nested case-control study. &lt;b&gt;Setting&lt;/b&gt;: Prospective cohort study of consecutive patients admitted with acute myocardial infarction to 9 Scottish hospitals. &lt;b&gt;Patients&lt;/b&gt;: 100 patients who survived 30 days (controls) and 100 patients who died within 30 days (cases). &lt;b&gt;Measurements and Main Results&lt;/b&gt;: Admission cortisol concentrations were lower in patients who died than those who survived (median 1,189 versus 1,355 nmol/L, p&#60;0.001). A cortisol concentration in the bottom quartile (&#60;1,136 nmol/L) was a strong predictor of death within 30 days, and remained so after adjustment for age and cardiac troponin concentration (adjusted OR 8.78, 95% CI 3.09-24.96, p&#60;0.001). &lt;b&gt;Conclusions&lt;/b&gt;: Patients who mount a lesser cortisol stress response to acute myocardial infarction have a poorer early prognosis