Interventions that train parents to share picture books with children are seen as a strategy for supporting child language development. We conducted meta‐analyses using robust variance estimation ...modeling on results from 19 RCTs (Ntotal = 2,594; Mchildage = 1–6 years). Overall, book‐sharing interventions had a small sized effect on both expressive language (d = 0.41) and receptive language (d = 0.26). They had a large effect on caregiver book‐sharing competence (d = 1.01). The impact of the intervention on child language was moderated by intervention dosage, with lower dosage associated with a minimal impact. Child age and caregiver education level were unrelated to child outcome. This review and meta‐analysis confirms the promise of book‐sharing interventions for enhancing and accelerating child language development.
Attention to women's and girls' menstrual needs is critical for global health and gender equality. The importance of this neglected experience has been elucidated by a growing body of qualitative ...research, which we systematically reviewed and synthesised.
We undertook systematic searching to identify qualitative studies of women's and girls' experiences of menstruation in low- and middle-income countries (LMICs). Of 6,892 citations screened, 76 studies reported in 87 citations were included. Studies captured the experiences of over 6,000 participants from 35 countries. This included 45 studies from sub-Saharan Africa (with the greatest number of studies from Kenya n = 7, Uganda n = 6, and Ethiopia n = 5), 21 from South Asia (including India n = 12 and Nepal n = 5), 8 from East Asia and the Pacific, 5 from Latin America and the Caribbean, 5 from the Middle East and North Africa, and 1 study from Europe and Central Asia. Through synthesis, we identified overarching themes and their relationships to develop a directional model of menstrual experience. This model maps distal and proximal antecedents of menstrual experience through to the impacts of this experience on health and well-being. The sociocultural context, including menstrual stigma and gender norms, influenced experiences by limiting knowledge about menstruation, limiting social support, and shaping internalised and externally enforced behavioural expectations. Resource limitations underlay inadequate physical infrastructure to support menstruation, as well as an economic environment restricting access to affordable menstrual materials. Menstrual experience included multiple themes: menstrual practices, perceptions of practices and environments, confidence, shame and distress, and containment of bleeding and odour. These components of experience were interlinked and contributed to negative impacts on women's and girls' lives. Impacts included harms to physical and psychological health as well as education and social engagement. Our review is limited by the available studies. Study quality was varied, with 18 studies rated as high, 35 medium, and 23 low trustworthiness. Sampling and analysis tended to be untrustworthy in lower-quality studies. Studies focused on the experiences of adolescent girls were most strongly represented, and we achieved early saturation for this group. Reflecting the focus of menstrual health research globally, there was an absence of studies focused on adult women and those from certain geographical areas.
Through synthesis of extant qualitative studies of menstrual experience, we highlight consistent challenges and developed an integrated model of menstrual experience. This model hypothesises directional pathways that could be tested by future studies and may serve as a framework for program and policy development by highlighting critical antecedents and pathways through which interventions could improve women's and girls' health and well-being.
The review protocol registration is PROSPERO: CRD42018089581.
Background
Programs to support parents are the recommended strategy to reduce disruptive child behavior problems. Efforts have been made to demonstrate which program components (i.e., clusters of ...techniques taught) increase program effects, but these methods fail to account for the fact that components rarely operate in isolation. We examine how combinations of components cluster together to form program types and use network meta‐analysis to estimate the relative effects of these program types.
Methods
We updated an existing systematic review of parenting programs for disruptive child behavior and identified 197 randomized trials. We modeled clusters of components in each trial arm and chose the best‐fitting model. We subsequently took 20 draws from the probability distribution of the latent class for each arm, entered each draw into a network meta‐analysis model and combined findings using Rubin’s rules. Combined estimates were bootstrapped to rank the clusters. We estimated main models and separate models for prevention and treatment settings.
Results
A five‐class solution fit the data best: (1) behavior management; (2) behavior management with parental self‐management; (3) behavior management with psychoeducation and relationship enhancement; (4) maximal component loading and (5) no/minimal component loading (i.e. control). In the main model and in treatment settings, all four program types were effective compared to no/minimal components. In prevention settings, only behavior management and behavior management with parental self‐management were effective compared to no/minimal components. Probabilistic ranking showed that overall and in treatment settings, behavior management had the largest chance, and in prevention settings, behavior management with self‐management had the largest chance, of being most effective compared to no/minimal components.
Conclusions
Programs with more focused content seem more likely to yield stronger effects, and different foci may be needed in treatment versus prevention settings. Next steps include identifying individual family differences in optimal program content.
Until a vaccine is developed, a test, trace and isolate strategy is the most effective method of controlling the COVID-19 outbreak. Contact tracing and case isolation are common methods for ...controlling infectious disease outbreaks. However, the effectiveness of any contact tracing system rests on public engagement. Numerous factors may influence an individual's willingness to engage with a contact tracing system. Understanding these factors has become urgent during the COVID-19 pandemic.
To identify facilitators and barriers to uptake of, and engagement with, contact tracing during infectious disease outbreaks.
A rapid systematic review was conducted to identify papers based on primary research, written in English, and that assessed facilitators, barriers, and other factors associated with the uptake of, and engagement with, a contact tracing system.
Four themes were identified as facilitators to the uptake of, and engagement with, contact tracing: collective responsibility; personal benefit; co-production of contact tracing systems; and the perception of the system as efficient, rigorous and reliable. Five themes were identified as barriers to the uptake of, and engagement with, contact tracing: privacy concerns; mistrust and/or apprehension; unmet need for more information and support; fear of stigmatization; and mode-specific challenges.
By focusing on the factors that have been identified, contact tracing services are more likely to get people to engage with them, identify more potentially ill contacts, and reduce transmission.
The degree to which children and adolescents are infected by and transmit severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is unclear. The role of children and adolescents in transmission ...of SARS-CoV-2 is dependent on susceptibility, symptoms, viral load, social contact patterns, and behavior.
To systematically review the susceptibility to and transmission of SARS-CoV-2 among children and adolescents compared with adults.
PubMed and medRxiv were searched from database inception to July 28, 2020, and a total of 13 926 studies were identified, with additional studies identified through hand searching of cited references and professional contacts.
Studies that provided data on the prevalence of SARS-CoV-2 in children and adolescents (younger than 20 years) compared with adults (20 years and older) derived from contact tracing or population screening were included. Single-household studies were excluded.
PRISMA guidelines for abstracting data were followed, which was performed independently by 2 reviewers. Quality was assessed using a critical appraisal checklist for prevalence studies. Random-effects meta-analysis was undertaken.
Secondary infection rate (contact-tracing studies) or prevalence or seroprevalence (population screening studies) among children and adolescents compared with adults.
A total of 32 studies comprising 41 640 children and adolescents and 268 945 adults met inclusion criteria, including 18 contact-tracing studies and 14 population screening studies. The pooled odds ratio of being an infected contact in children compared with adults was 0.56 (95% CI, 0.37-0.85), with substantial heterogeneity (I2 = 94.6%). Three school-based contact-tracing studies found minimal transmission from child or teacher index cases. Findings from population screening studies were heterogenous and were not suitable for meta-analysis. Most studies were consistent with lower seroprevalence in children compared with adults, although seroprevalence in adolescents appeared similar to adults.
In this meta-analysis, there is preliminary evidence that children and adolescents have lower susceptibility to SARS-CoV-2, with an odds ratio of 0.56 for being an infected contact compared with adults. There is weak evidence that children and adolescents play a lesser role than adults in transmission of SARS-CoV-2 at a population level. This study provides no information on the infectivity of children.
Analyze the measurement invariance and the factor structure of the Patient Health Questionnaire-9 (PHQ-9) in the Peruvian population.
Secondary data analysis performed using cross-sectional data from ...the Health Questionnaire of the Demographic and Health Survey in Peru. Variables of interest were the PHQ-9 and demographic characteristics (sex, age group, level of education, socioeconomic status, marital status, and area of residence). Factor structure was evaluated by standard confirmatory factor analysis (CFA), and measurement invariance by multi-group CFA, using standard goodness-of-fit indices criteria for interpreting results from both CFAs. Analysis of the internal consistency (α and ω) was also pursued.
Data from 30,449 study participants were analyzed, 56.7% were women, average age was 40.5 years (standard deviation (SD) = 16.3), 65.9% lived in urban areas, 74.6% were married, and had 9 years of education on average (SD = 4.6). From standard CFA, a one-dimensional model presented the best fit (CFI = 0.936; RMSEA = 0.089; SRMR = 0.039). From multi-group CFA, all progressively restricted models had ΔCFI<0.01 across almost all groups by demographic characteristics. PHQ-9 reliability was optimal (α = ω = 0.87).
The evidence presents support for the one-dimensional model and measurement invariance of the PHQ-9 measure, allowing for reliable comparisons between sex, age groups, education level, socioeconomic status, marital status, and residence area, and recommends its use within the Peruvian population.
Children's disruptive behavior problems place children at high risk for oppositional defiant disorder and conduct disorder, and carry a high burden for individuals and society. Policy makers and ...service providers aiming to reduce children's disruptive behavior problems must often choose between importing an intervention developed abroad or instead developing or using a "homegrown" (i.e., local) intervention. No comprehensive comparison of these interventions exists.
We performed a multilevel meta-regression of 129 randomized trials (374 effect sizes) of transported and homegrown parenting interventions. We identified trials by searching the included trials lists of systematic reviews, found through searches in 6 databases (e.g., MEDLINE, EMBASE). Trials that had not yet been reviewed were found by searching the same databases. Primary outcome was the mean difference in effectiveness between transported and homegrown interventions to reduce disruptive child behavior. We also compared this differential effectiveness for various intervention "brands" (e.g., Incredible Years and Triple P Positive Parenting Program) and geographical regions (e.g., North America and Europe).
Transported and homegrown interventions did not differ in their effectiveness to reduce disruptive child behavior (d = 0.10, not significant). Results were robust across intervention brands and geographical regions. Six trials on transported interventions in Hong Kong, Iran, and Panama suggest promising results for transporting interventions to "nonwestern" countries, whereas one trial in Indonesia does not.
Parenting interventions based on the same principles led to similar outcomes, whether transported or homegrown. This finding supports the selection of interventions based on their evidence base rather than on cultural specificity.
Illicit drug use before or during sex - known as sexualized drug use (colloquially 'chemsex' or 'party and play') - has evolved as novel psychoactive substances have entered the market in many parts ...of the world. Here, we review key conceptual issues in associations between illicit drug use and sexual risk-behaviour in MSM.
Although many studies have confirmed that MSM use drugs with greater prevalence than the general population, evidence is of variable quality and a sampling frame is difficult to establish. Moreover, psychosocial hypotheses linking drug use and sexual risk, including cognitive escape and sensation seeking, are unsatisfactory and generally ignore strategic use of drugs for sexual aims. Person-level associations between drug use history and both sexual risk behaviour and HIV infection tend to be consistent around the world, but evidence comparing encounters within subjects is generally unclear and out of date.
There is a need for interventions for harm reduction targeted at MSM that account specifically for the social and cultural contexts of sexualized drug use. Expanded attention to surveillance of emerging drug use trends can help clinicians in sexual health and infectious diseases best anticipate the needs of their service users.
Summary Massive slums have become major features of cities in many low-income and middle-income countries. Here, in the first in a Series of two papers, we discuss why slums are unhealthy places with ...especially high risks of infection and injury. We show that children are especially vulnerable, and that the combination of malnutrition and recurrent diarrhoea leads to stunted growth and longer-term effects on cognitive development. We find that the scientific literature on slum health is underdeveloped in comparison to urban health, and poverty and health. This shortcoming is important because health is affected by factors arising from the shared physical and social environment, which have effects beyond those of poverty alone. In the second paper we will consider what can be done to improve health and make recommendations for the development of slum health as a field of study.
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