Preventing HIV/AIDS in young people. A systematic review of the evidence from developing countries. Introduction and rationale.
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Adolescent↗
Biomedical subjects
Bruce Dick
Publications and source records attributed to Bruce Dick.
Review of the evidence for interventions to increase young people's use of health services in developing countries.
OBJECTIVE: This chapter reviews the evidence base for interventions that aim to increase young people's use of health services in developing countries. METHODS: We identified published and unpublished studies and reports from developing countries that provided information about interventions designed to increase young people's use of health services. The studies were classified into six different types based on whether they included some or all of the following characteristics: training for service providers and clinic staff; making efforts to improve the quality of the facilities; implementing community activities to generate demand and support for the services; and involving other sectors, notably schools and the media. The levels of evidence required to make decisions about policies and programmes were defined for each of these types. FINDINGS: Despite the lack of detailed descriptions of interventions in the studies and difficulties interpreting the data reported in the evaluations, the studies provided evidence of increased use of health services by young people for those types of interventions that included training for service providers, making improvements to clinic facilities and implementing activities in the community, with or without the involvement of other sectors. CONCLUSION: The evidence for the effectiveness of interventions to increase young people's use of health services was sufficient to recommend that interventions that include training for service providers, making improvements to clinics and using activities in the community should be widely implemented with careful monitoring of quality and coverage and that those that additionally involve other sectors should also be widely but cautiously implemented, provided they include a strong evaluation component. Operations research is also required to better understand the content of the interventions and their mechanisms of action.
Adolescent↗
Achieving the global goals on HIV among young people most at risk in developing countries: young sex workers, injecting drug users and men who have sex with men.
OBJECTIVE: To review evaluations of interventions in developing countries targeting three groups most at risk of becoming infected with HIV: young sex workers, young injecting drug users and young men who have sex with men. METHODS: A systematic literature review was undertaken to identify programmes in developing countries targeting young people in the three selected groups most at risk from HIV. We also identified programmes directed at young people in developed countries as well as programmes in developing countries that targeted these three population groups but that did not differentiate between young people and adults. FINDINGS: Young people 10 to 24 years of age represent a large proportion of the population most at risk of becoming infected with HIV in developing countries. Despite this fact, well documented evaluations of interventions that target these groups are scarce. However, there is evidence of effectiveness for programmes that are facility-based and use outreach to provide information and services to at-risk young people. CONCLUSION: There is growing evidence from developing countries of successful interventions that target groups most at risk from HIV, and these programmes should be widely implemented provided that they are carefully planned and monitored and have a strong evaluation component. However, there is an urgent need to disaggregate data by age in order to determine how effective these programmes are in reaching young people and to better understand the specific needs of at-risk young people as opposed to older age groups.
Adolescent↗
Dipole localization accuracy using grand-average EEG data sets.
OBJECTIVE: Dipole localization of grand-average event related potentials only give a tentative description of the estimated underlying neural sources. This study evaluates the differences in dipole solutions between individual and group-average data sets using a standard realistic head model. METHODS: Auditory evoked potentials were recorded from 14 right-handed healthy subjects using a 64 electrode montage. Inverse dipole solutions were obtained for each individual data set, as well as for all individual responses averaged together (grand-average). Differences in dipole solutions between individual and grand-average responses are reported. Simulations using a two dipole model with 15 different electrode sets are then used to investigate the effects of electrode misplacement and random noise on dipole localization. These effects are compared to those due to grand-averaging. RESULTS: The average differences in dipole locations between the individual and grand-averaged data sets were approximately 1.1 cm (SD=0.7 cm). This difference is larger than typical localization errors due to electrode misplacement and typical noise. CONCLUSIONS: Using a standard realistic head model, it is concluded that dipole solutions based on group-averaged EEG datasets are significantly different than those obtained using subject-specific data.
Adolescent↗
Assessing the effect of pain on demands for attentional resources using ERPs.
Event-related potentials were used as an adjunct to behavioral and self-report measures to examine the impact of pain in a short-term memory-scanning task. P3 amplitude was reduced and a frontal slow wave was increased during pain regardless of the number of items in memory. Results are discussed in terms of pain affecting an attention-switch mechanism.
Adolescent↗
Attentional functioning in fibromyalgia, rheumatoid arthritis, and musculoskeletal pain patients.
OBJECTIVES: To investigate whether chronic pain patients have deficits in attentional functioning compared with pain-free controls, and whether fibromyalgia patients have larger deficits in attentional functioning compared with rheumatoid arthritis and musculoskeletal pain patients. METHODS: Sixty patients (20 in each of 3 patient groups) and 20 pain-free controls completed measures assessing pain intensity, mood, pain-related disability, somatic awareness, and catastrophic thinking about pain. Attentional functioning was assessed using an age-standardized, ecologically valid test battery. Analyses were made of between-group differences. RESULTS: Sixty percent of patients had at least one score in the clinical range of neuropsychological impairment, independent of demography and mood. Fibromyalgia patients were more anxious and somatically aware than rheumatoid arthritis or musculoskeletal pain patients, but did not show larger attentional deficits than other patient groups. CONCLUSION: All 3 groups of chronic pain patients, regardless of diagnosis, had impaired cognitive functioning on an ecologically sensitive neuropsychological test of everyday attention.
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Temporal dynamics of reflexive attention shifts: a dual-stream rapid serial visual presentation exploration.
We combined a prototypical exogenous cuing procedure with rapid serial visual presentation (RSVP) to provide a precise characterization of the temporal dynamics of reflexive attention shifts. The novel paradigm thus created has several useful properties, most notably that the physical presentation of the target is neither an onset nor a unique event and that temporal precision is provided without the requirement for a speeded response. A biphasic pattern was observed, with early benefits followed by later costs (inhibition of return) at the cued location relative to the uncued location. The finding of inhibition of return in this paradigm disproves the assertion that inhibition of return is merely a reluctance to respond in the target's direction. It may be partly that, but encoding mechanisms linked to attention must also be involved.
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