ENGINEER: Evaluation and analysis of the project impact

An evaluation report analysing the impact of the EU funded ENGINEER project, intended to design and implement materials to promote engineering in primary schools across Europe through science and technology. The report examines impact on teaching and learning in schools and science and technology centres in ten EU countries

Association Between Pregnancy at Enrollment into HIV Care and Loss to Care Among Women in the Democratic Republic of Congo, 2006-2013

BACKGROUND: Loss to care is high among asymptomatic HIV-infected women initiated on antiretroviral therapy (ART) during pregnancy or in the postpartum period. However, whether pregnancy itself plays a role in the high loss to care rate is uncertain. We compared loss to care over seven years between pregnant and non-pregnant women at enrollment into HIV care in the Democratic Republic of Congo (DRC). METHODS: We conducted a retrospective analysis of all ART-naive women aged 15-45 initiating HIV care at two large clinics in Kinshasa, DRC, from 2007-2013. Pregnancy status was recorded at care enrollment. Patients were classified as having no follow-up if they did not return to care after the initial enrollment visit. Among those with at least one follow-up visit after enrollment, we classified patients as lost to care if more than 365 days had passed since their last clinic visit. We used logistic regression to model the association between pregnancy status and no follow-up, and Cox proportional hazards regression to model the association between pregnancy status and time to loss to care. RESULTS: Of 2175 women included in the analysis, 1497 (68.8%) were pregnant at enrollment. Compared to non-pregnant women, pregnant women were less likely to be over 35 years of age (19.1% vs. 31.9%,

Speech perception from monaural and binaural information

Two experiments explored the concept of the binaural spectrogram [Culling and Colburn, J. Acoust. Soc. Am. 107, 517-527 (2000)] and its relationship to monaurally derived information. In each experiment, speech was added to noise at an adverse signal-to-noise ratio in the NoS pi binaural configuration. The resulting monaural and binaural cues were analyzed within an array of spectro-temporal bins and then these cues were resynthesized by modulating the intensity and/or interaural correlation of freshly generated noise. Experiment 1 measured the intelligibility of the resynthesized stimuli and compared them with the original NoSo and NoS pi stimuli at a fixed signal-to-noise ratio. While NoS pi stimuli were approximately equal to 50% intelligible, each cue in isolation produced similar (very low) intelligibility to the NoSo condition. The resynthesized combination produced approximately equal to 25% intelligibility. Modulation of interaural correlation below 1.2 kHz and of amplitude above 1.2 kHz was not as effective as their combination across all frequencies. Experiment 2 measured three-point psychometric functions in which the signal-to-noise ratio of the original NoS pi stimulus was increased in 3-dB steps from the level used in experiment 1. Modulation of interaural correlation alone proved to have a flat psychometric function. The functions for NoS pi and for combined monaural and binaural cues appeared similar in slope, but shifted horizontally. The results indicate that for sentence materials, neither fluctuations in interaural correlation nor in monaural intensity are sufficient to support speech recognition at signal-to-noise ratios where 50% intelligibility is achieved in the NoS pi configuration; listeners appear to synergistically combine monaural and binaural information in this task, to some extent within the same frequency region

Conditional Cash Transfers Improve Retention in PMTCT Services by Mitigating the Negative Effect of Not Having Money to Come to the Clinic

To elucidate the mechanisms by which a cash incentive intervention increases retention in prevention of mother-to-child transmission (PMTCT) services

Conditional Cash Transfers to Increase Retention in PMTCT Care, Antiretroviral Adherence, and Postpartum Virological Suppression: A Randomized Controlled Trial

Novel strategies are needed to increase retention in prevention of mother-to-child HIV transmission (PMTCT) services. We have recently shown that small, incremental cash transfers conditional on attending clinic resulted in increased retention along the PMTCT cascade. However, whether women who receive incentives to attend clinic visits are as adherent to antiretrovirals (ARV) as those who do not was unknown

Characteristics of HIV-Infected Children at Enrollment into Care and at Antiretroviral Therapy Initiation in Central Africa

Background Despite the World Health Organization (WHO) regularly updating guidelines to recommend earlier initiation of antiretroviral therapy (ART) in children, timely enrollment into care and initiation of ART in sub-Saharan Africa in children lags behind that of adults. The impact of implementing increasingly less restrictive ART guidelines on ART initiation in Central Africa has not been described. Materials and Methods Data are from the Central Africa International Epidemiologic Databases to Evaluate AIDS (IeDEA) pediatric cohort of 3,426 children (0±15 years) entering HIV care at 15 sites in Burundi, DRC, and Rwanda. Measures include CD4 count, WHO clinical stage, age, and weight-for-age Z score (WAZ), each at enrollment into HIV care and at ART initiation. Changes in the medians or proportions of each measure by year of enrollment and year of ART initiation were assessed to capture potential impacts of changing ART guidelines. Results Median age at care enrollment decreased from 77.2 months in 2004±05 to 30.3 months in 2012±13. The median age at ART initiation (n = 2058) decreased from 83.0 months in 2004±05 to 66.9 months in 2012±13. The proportion of children 24 months of age at enrollment increased from 12.7% in 2004±05 to 46.7% in 2012±13, and from 9.6% in 2004±05 to 24.2% in 2012±13 for ART initiation. The median CD4 count at enrollment into care increased from 563 (IQR: 275, 901) in 2004±05 to 660 (IQR: 339, 1071) cells/μl in 2012±13, and the median CD4 count at ART initiation increased from 310 (IQR:167, 600) in 2004±05 to 589 (IQR: 315, 1113) cells/μl in 2012±13. From 2004±05 to 2012±13, median WAZ improved from -2 (IQR: -3.4, -1.1) to -1 (IQR: -2.5, -0.2) at enrollment in care and from -2 (IQR: -3.8, -1.6) to -1 (IQR: -2.6, -0.4) at ART initiation. Discussion and Conclusion Although HIV-infected children 24 months of age accounted for half of all children enrolling in care in our cohort during 2012±13, they represented less than a quarter of all those who were initiated on ART during the same period. Further research is needed to identify barriers to timely diagnosis, linkage to care, and initiation of ART among children with HIV infection

Impact of Health Insurance, ADAP, and Income on HIV Viral Suppression Among US Women in the Womenʼs Interagency HIV Study, 2006–2009

Implementation of the Affordable Care Act motivates assessment of health insurance and supplementary programs, such as the AIDS Drug Assistance Program (ADAP) on health outcomes of HIV-infected people in the United States. We assessed the effects of health insurance, ADAP, and income on HIV viral load suppression

Validation of a sports nutrition knowledge questionnaire for athletes in the United Kingdom and Ireland.

Sound general and sports nutrition knowledge in athletes is essential for making appropriate dietary choices. Assessment of nutrition knowledge enables evaluation and tailoring of nutrition education. However, few well-validated tools are available to assess nutrition knowledge in athletes. The objective of the present study was to establish the validity of the Platform to Evaluate Athlete Knowledge Sports - Nutrition Questionnaire (PEAKS-NQ) for use in the United Kingdom and Irish (UK-I) athletes. To confirm content validity, twenty-three sports nutritionists (SNs) from elite, UK-I sports institutes provided feedback on the PEAKS-NQ via a modified Delphi method. After minor changes, the UK-I version of the PEAKS-NQ was administered to UK-I SN from the British Dietetic Association Sport and Exercise Nutrition Register, and elite athletes (EA) training at elite sports institutes in the UK and Ireland. Independent samples -test and independent samples median tests were used to compare PEAKS-NQ total and subsection scores between EA and SN (to assess construct validity). Cronbach's alpha (good ≥ 0⋅7) was used to establish internal consistency. The SN achieved greater overall [SN ( 23) 92⋅3 (9⋅3) EA ( 154): 71⋅4 (10⋅0)%; < 0⋅001] and individual section scores ( < 0⋅001) except Section B, Identification of Food Groups ( = 0⋅07). Largest knowledge differences between SN and EA were in Section D, Applied Sports Nutrition [SN: 88⋅5 (8⋅9) EA: 56⋅7 (14⋅5)%; < 0⋅00]. Overall ES was large (2⋅1), with subsections ranging from 0⋅6 to 2⋅3. Cronbach's alpha was good (0⋅83). The PEAKS-NQ had good content and construct validity, supporting its use to assess nutrition knowledge of UK-I athletes

Conditional cash transfers and uptake of and retention in prevention of mother-to-child HIV transmission care: a randomised controlled trial

Novel strategies are needed to increase retention in and uptake of prevention of mother-to-child HIV transmission (PMTCT) services in sub-Saharan Africa

Tuberculosis in Pediatric Antiretroviral Therapy Programs in Low- and Middle-Income Countries: Diagnosis and Screening Practices

Background The global burden of childhood tuberculosis (TB) is estimated to be 0.5 million new cases per year. Human immunodeficiency virus (HIV)-infected children are at high risk for TB. Diagnosis of TB in HIV-infected children remains a major challenge. Methods We describe TB diagnosis and screening practices of pediatric antiretroviral treatment (ART) programs in Africa, Asia, the Caribbean, and Central and South America. We used web-based questionnaires to collect data on ART programs and patients seen from March to July 2012. Forty-three ART programs treating children in 23 countries participated in the study. Results Sputum microscopy and chest Radiograph were available at all programs, mycobacterial culture in 40 (93%) sites, gastric aspiration in 27 (63%), induced sputum in 23 (54%), and Xpert MTB/RIF in 16 (37%) sites. Screening practices to exclude active TB before starting ART included contact history in 41 sites (84%), symptom screening in 38 (88%), and chest Radiograph in 34 sites (79%). The use of diagnostic tools was examined among 146 children diagnosed with TB during the study period. Chest Radiograph was used in 125 (86%) children, sputum microscopy in 76 (52%), induced sputum microscopy in 38 (26%), gastric aspirate microscopy in 35 (24%), culture in 25 (17%), and Xpert MTB/RIF in 11 (8%) children. Conclusions Induced sputum and Xpert MTB/RIF were infrequently available to diagnose childhood TB, and screening was largely based on symptom identification. There is an urgent need to improve the capacity of ART programs in low- and middle-income countries to exclude and diagnose TB in HIV-infected childre