Early Retention Research Articles

Efficacy of SMS to Improve Early Retention in HIV Care for PLWH in Lima

Efficacy of SMS to Improve Early Retention in HIV Care for PLWH in Lima

Food and Beverage Intake From 12 to 23 Months by WIC Status.

Dietary data from the 2011-2014 NHANES were used to estimate the percentage of children who were aged 12 to 23 months consuming selected food and beverage categories on any given day by age and WIC status (children who were on WIC, those who were eligible for but not receiving WIC benefits, and those who were not eligible for WIC). Consumption of food and beverage categories differed by WIC status. On a given day, a lower percentage of children who were eligible for but did not receive WIC benefits consumed vegetables (excluding white potatoes; 42.3%) and grains (76.5%) compared with children who were participating in WIC (vegetables [excluding white potatoes]: 60.4%; grains: 85.5%) and those who were not eligible for WIC benefits (vegetables [excluding white potatoes]: 58.1%; grains: 87.2%; P < .05). A lower percentage of both children who were eligible for but not receiving WIC benefits and those who were participating in WIC consumed fruits (57.6% and 70.6%, respectively) and snacks (45.9% and 48.5%, respectively) than those who were not eligible for WIC (fruits: 86.4%; snacks: 69.1%; P < .05). A lower percentage of children who were receiving WIC consumed dairy than children who were not eligible for WIC (91.7% and 97.2%, respectively; P < .05). A higher percentage of those who were receiving WIC consumed 100% juice (70.6%) than children who were eligible for but not receiving WIC (51.6%) and children who were not eligible for WIC (50.8%; P < .05). Improving early WIC participation and retention could positively impact some diet-related disparities among young children who are eligible for WIC.

Improving 3D NAND Flash Memory Lifetime by Tolerating Early Retention Loss and Process Variation

Improving 3D NAND Flash Memory Lifetime by Tolerating Early Retention Loss and Process Variation

High-fat feeding reprograms maternal energy metabolism and induces long-term postpartum obesity in mice.

BackgroundExcessive gestational weight gain (EGWG) closely associates with postpartum obesity. However, the causal role of EGWG in postpartum obesity has not been experimentally verified. The objective of this study was to determine whether and how EGWG causes long-term postpartum obesity.MethodsC57BL/6 mice were fed with high-fat diet during gestation (HFFDG) or control chow, then their body composition and energy metabolism were monitored after delivery.ResultsWe found that HFFDG significantly increased gestational weight gain. After delivery, adiposity of HFFDG-treated mice (Preg-HF) quickly recovered to the levels of controls. However, three months after parturition, Preg-HF mice started to gain significantly more body fat even with regular chow. The increase of body fat of Preg-HF mice was progressive with aging and by 9 months after delivery had increased 2-fold above the levels of controls. The expansion of white adipose tissue (WAT) of Preg-HF mice was manifested by hyperplasia in visceral fat and hypertrophy in subcutaneous fat. Preg-HF mice developed low energy expenditure and UCP1 expression in interscapular brown adipose tissue (iBAT) in later life. Although blood estrogen concentrations were similar between Preg-HF and control mice, a significant decrease in estrogen receptor α (ERα) expression and hypermethylation of the ERα promoter was detected in the fat of Preg-HF mice nine months after delivery. Interestingly, hypermethylation of ERα promoter and low ERα expression were only detected in adipocyte progenitor cells in both iBAT and WAT of Preg-HF mice at the end of gestation.ConclusionsThese results demonstrate that HFFDG causes long-term postpartum obesity independent of early postpartum fat retention. This study also suggests that HFFDG adversely programs long-term postpartum energy metabolism by epigenetically reducing estrogen signaling in both BAT and WAT.

Improving 3D NAND Flash Memory Lifetime by Tolerating Early Retention Loss and Process Variation

Compared to planar (i.e., two-dimensional) NAND flash memory, 3D NAND flash memory uses a new flash cell design, and vertically stacks dozens of silicon layers in a single chip. This allows 3D NAND flash memory to increase storage density using a much less aggressive manufacturing process technology than planar NAND flash memory. The circuit-level and structural changes in 3D NAND flash memory significantly alter how different error sources affect the reliability of the memory. In this paper, through experimental characterization of real, state-of-the-art 3D NAND flash memory chips, we find that 3D NAND flash memory exhibits three new error sources that were not previously observed in planar NAND flash memory: (1) layer-to-layer process variation, a new phenomenon specific to the 3D nature of the device, where the average error rate of each 3D-stacked layer in a chip is significantly different; (2) early retention loss, a new phenomenon where the number of errors due to charge leakage increases quickly within several hours after programming; and (3) retention interference, a new phenomenon where the rate at which charge leaks from a flash cell is dependent on the data value stored in the neighboring cell. Based on our experimental results, we develop new analytical models of layer-to-layer process variation and retention loss in 3D NAND flash memory. Motivated by our new findings and models, we develop four new techniques to mitigate process variation and early retention loss in 3D NAND flash memory. Our first technique, Layer Variation Aware Reading (LaVAR), reduces the effect of layer-to-layer process variation by fine-tuning the read reference voltage separately for each layer. Our second technique, Layer-Interleaved Redundant Array of Independent Disks (LI-RAID), uses information about layer-to-layer process variation to intelligently group pages under the RAID error recovery technique in a manner that reduces the likelihood that the recovery of a group fails significantly earlier than the recovery of other groups. Our third technique, Retention Model Aware Reading (ReMAR), reduces retention errors in 3D NAND flash memory by tracking the retention time of the data using our new retention model and adapting the read reference voltage to data age. Our fourth technique, Retention Interference Aware Neighbor-Cell Assisted Correction (ReNAC), adapts the read reference voltage to the amount of retention interference a page has experienced, in order to re-read the data after a read operation fails. These four techniques are complementary, and can be combined together to significantly improve flash memory reliability. Compared to a state-of-the-art baseline, our techniques, when combined, improve flash memory lifetime by 1.85×. Alternatively, if a NAND flash vendor wants to keep the lifetime of the 3D NAND flash memory device constant, our techniques reduce the storage overhead required to hold error correction information by 78.9%.

Early Predictors of Trajectories of Tobacco Use Level from Adolescence to Young Adulthood: A 16-Year Follow-Up of the TEMPO Cohort Study (1999–2015)

Purpose: Individual and family characteristics early on in life are associated with adolescent smoking; however, their role with regard to long-term tobacco smoking trajectories into young adulthood is not well-known, which is what we set out to study using data from a longitudinal community-based cohort. Methods: We used data from 2,025 youths in France (12–26 years at baseline, 16 years of follow-up), participating in the longitudinal TEMPO cohort study. First, we modeled smoking trajectories from adolescence onwards using Group-Based Trajectory Modeling, by using the declared consumption of cigarettes at different ages. Second, among trajectories of smokers, associations with individual and family characteristics in childhood and adolescence were studied using multinomial logistic regression. Results: We observed 5 smoking trajectories: non-smokers (62.3%), 3 groups of persistent smokers with different levels of tobacco use (low, intermediate, high), and a group characterized by high-level smoking followed by cessation. Among participants who were lifetime smokers (n = 763), the trajectory of tobacco use was associated with early substance use initiation, academic attainment, grade retention, and parental smoking. Early tobacco and cannabis use initiation predicted high-level tobacco use, whether it persisted (OR 2.29, 95% CI 1.23–4.28) or not (OR 2.99, 95% CI 1.59–5.63). Grade retention and parental smoking predicted persistent smoking of intermediate (respectively OR 1.53, 95% CI 1.03–1.92; OR 1.74, 95% CI 1.03–2.92) or high level use (respectively OR 1.74, 95% CI 1.07–2.85; OR 1.70, 95% CI 0.91–3.18). Poor academic attainment predicted all 3 smoking trajectories, especially persistent high-level smoking (no high school degree: OR 5.29, 95% CI 1.65–16.97, vocational degree: OR 1.94, 95% CI 0.99–3.80). Conclusions: Tobacco smoking trajectories from adolescence to adulthood are associated with early substance use initiation, parental smoking, and academic difficulties.

Evaluation of the HIV Infant Tracking System (HITSystem) to optimise quality and efficiency of early infant diagnosis: a cluster-randomised trial in Kenya

The HIV Infant Tracking System (HITSystem) is a web-based intervention linking providers of early infant diagnosis, laboratory technicians, and mothers and infants to improve outcomes for HIV-exposed infants. We aimed to evaluate the efficacy of the HITSystem on key outcomes of early infant diagnosis. We did a cluster-randomised trial at six hospitals in Kenya, which were matched on geographic region, resource level, and volume of patients (high, medium, and low). We randomly allocated hospitals within a matched pair to either the HITSystem (intervention; n=3) or standard of care (control; n=3). A random number generator was used to assign clusters. Investigators were unaware of the randomisation process. Eligible participants were mothers aged 18 years or older with an infant younger than 24 weeks presenting for their first early infant diagnosis appointment. The primary outcome was complete early infant diagnosis retention, which was defined as receipt of all indicated age-specific interventions until 18 months post partum (for HIV-negative infants) or antiretroviral therapy initiation (for HIV-positive infants). Analysis was per protocol in all randomised pairs judged eligible, excluding infant deaths and those who moved or were transferred to another health facility. Modified intention-to-treat sensitivity analyses judged all infant deaths and transfers as incomplete early infant diagnosis retention. Separate multivariable logistic regression analyses were done with intervention group, hospital volume, and significant covariates as fixed effects. This trial is registered with ClinicalTrials.gov, number NCT02072603; the trial has been completed. Between Feb 16, 2014, and Dec 31, 2015, 895 mother-infant pairs were enrolled. Of these, 87 were judged ineligible for analysis, 26 infants died, and 92 pairs moved or were transferred to another health facility. Thus, data from 690 mother-infant pairs were analysed, of whom 392 were allocated to the HITSystem and 298 to standard of care. Mother-infant pairs were followed up to Sept 30, 2017. Infants diagnosed as HIV-positive were followed up for a median of 2·1 months (IQR 1·6-4·8) and HIV-negative infants were followed up for a median of 17·0 months (IQR 16·6-17·6). Infants enrolled in the HITSystem were significantly more likely to receive complete early infant diagnosis services compared with those assigned standard of care (334 of 392 [85%] vs 180 of 298 [60%]; adjusted odds ratio [OR] 3·7, 95% CI 2·5-5·5; p<0·0001). No intervention effect was recorded at high-volume hospitals, but strong effects were seen at medium-volume and low-volume hospitals. Modified intention-to-treat analyses for complete early infant diagnosis were also significant (334 of 474 [70%] vs 180 of 334 [54%]; adjusted OR 2·0, 95% CI 1·4-2·7; p<0·0001). No adverse events related to study participation were reported. The HITSystem intervention is effective and feasible to implement in low-resource settings. The HITSystem algorithms have been modified to include HIV testing at birth, and an adapted HITSystem 2.0 version is supporting HIV-positive pregnant women to prevent perinatal transmission and optimise maternal and infant outcomes. National Institute of Child Health and Human Development.

Rethinking Early Elementary Grade Retention: Examining Long-Term Academic and Psychosocial Outcomes

Grade retention, the practice of requiring a student to remain in the same grade the following year, disproportionately affects students with sociodemographic risk and facing academic challenges. Each year, the United States spends $20 billion on retention and two million children are retained. Extant studies examining early elementary grade retention generally focus on short-term effects and academic outcomes; little is known about long-term effects on academic and psychosocial outcomes in the middle grades. The current study uses propensity score methods and a national data set to estimate the effect of first- or second-grade retention on academic achievement and psychosocial outcomes six or seven years later. By comparing students who were retained to students who were similar on observed characteristics but otherwise promoted, we generate causal estimates that show a statistically significant negative effect of retention on reading achievement. Significant and robust effects were not consistently detected for other academic or psychosocial outcomes. As grade retention is a widely used educational intervention, implications for its effectiveness from a policy and practice perspective are discussed.

Effect of Early Grade Retention on School Completion: A Prospective Study.

This 14 year prospective study investigated the effect of retention in grades 1-5 on high school completion (diploma, GED, or drop out). Participants were 734 (52.7% males) ethnically diverse, academically at-risk students recruited from Texas schools into the study when they were in first grade (mean age = 6.57). Propensity score weighting successfully equated the 256 retained students and the 478 students continuously promoted students on 65 covariates assessed in grade 1. At the end of 14 years, 477 had earned a diploma, 21 had obtained a GED, 110 had dropped out, and 126 were missing school completion status. Using multinomial logistic regression with high school graduation as the reference outcome, retention led to a significant increase in the likelihood of dropping out of high school (odds ratio = 2.61), above students' propensity to be retained and additional covariates. The contrast between graduation and GED outcomes was not significant. A significant Retention X Ethnicity X Gender interaction was obtained: The negative effect of retention was strongest for African American and Hispanic girls. Even though grade retention in the elementary grades does not harm students in terms of their academic achievement or educational motivation at the transition to high school, retention increases the odds that a student will drop out of school before obtaining a high school diploma.

RETAIN early career teacher retention programme: evaluating the role of research informed continuing professional development for a high quality, sustainable 21st century teaching profession

ABSTRACTTeacher recruitment and retention is an international challenge. In England the government have reported that more teachers leave before retirement age than five years ago, 30% within five years and schools are finding it difficult to fill posts with quality teachers . This paper evaluates the contribution of the research-informed RETAIN Early Career Teacher (ECT) Continuing Professional Development (CPD) Programme for developing and retaining quality teachers. RETAIN was a yearlong CPD pilot for Early Career Teachers (ECTs) in primary schools in Cornwall, UK (a region with high levels of socio-economic disadvantage). The programme design was informed by research and based on factors shown to support the retention of ECTs. It was contextualised using the precept that teachers should be active researchers, influencing curriculum development as ‘reflective practitioners’, focussed with a Professional Learning Community lens and theorised within a social constructivist frame. In addition, RETAIN utilised robust evidence-informed practice approaches to support teacher development in schools with persistently disadvantaged pupils. The programme was independently evaluated using multiple-methods over the course of the programme to generate data. The theory-based evaluation suggests that the contribution of this intervention to the field is the specific combination of development; taught workshops, coaching and collaborative professional learning, which improved the self-efficacy, confidence and quality of teaching of ECTs in differing but complementary ways. All ECTs who completed the programme have been retained in teaching and all have achieved a leadership role in their school. We argue that these outcomes are of international significance and the promise of the programme can be utilised for developing and retaining high quality teachers in other countries.

Discovery of Fuling Shale Gas Field and its prospects

A series of breakthroughs have been made in the understanding, evaluation, and exploration of shale gas from discovery, environmental protection to efficient exploration in the discovering of Fuling Gas Field. By revealing the positive correlation between organic carbon content and siliceous mineral content of shale deposited in deep shelf, dynamic preservation mechanism of “early retention and late deformation,” it is clarified that the shales deposited in deep shelf are the most favorable for shale gas generation, storage and fracturing. The preserving conditions determine the levels of shale gas accumulation, thus the evaluation concept of taking the quality of the shale as the base and the preserving conditions as key is proposed, the evaluation system for strategic selection of favorable zones is established for marine shale gas exploration in Southern China. Moreover, the “sweet point” seismic forecasting technologies for marine shale gas, the “six properties” logging technologies for evaluating shale gas layers, the technologies for quick and efficient drilling of horizontal well groups, and the fracturing technologies for composite fractures for horizontal wells are invented. The paper discussed the exploration prospect of shale gas in the shales of Wufeng-Longmaxi Formation in great depth in Sichuan Basin, shale gas exploration in the outer region of the south, and continental shale gas exploration in China.

Effect of charge trap layer thickness on the charge spreading behavior within a few seconds in 3D charge trap flash memory

Charge spreading behavior within a few seconds, referred to as early retention, was comprehensively investigated in 24 word-line stacked tube-type 3D NAND flash memory. We thoroughly explored the charge spreading behavior from the perspectives of both electron and hole spreading in 3D NAND flash memory with different charge trap layer thicknesses at various programming and erasing levels for solid and checkerboard patterns to provide guidelines for minimizing and optimizing the charge spreading.

Correction to: AIDS Patient Care and STDs 2018;32:306-313; DOI: 10.1089/apc.2018.0028.

[This corrects the article DOI: 10.1089/apc.2018.0028.].

Abstract 018: High Stillbirth Rate and Altered Maternal Renal Function and Water Balance are Associated With Spontaneous Gestational Hypertension in Nonhuman Primates

Gestational hypertension (GH) is new-onset hypertension specific to pregnancy (PG) that may precede preeclampsia (PE). While the specific etiology of PE is unclear, defective fluid and electrolyte balances have been implicated. The African Green Monkey (AGM; Chlorocebus aethiops sabaeus ) is a novel model of spontaneous GH with pathophysiological consequences of PE. Systolic blood pressure (SBP; forearm plethysmography) was measured in AGMs pre-PG, during each trimester, and postpartum (PP). Gestational age was estimated by fetal lengths at 7 weeks/trimester (21 week gestation). Animals were characterized as normotensive (NT; SBP &lt; 120 mmHg in PG and PP) or gestational hypertensive (GH; SBP ≥ 140 mmHg during PG). SBP was unchanged in NT PG (pre-PG 110 ± 5 mmHg; 1 st trimester 101± 6 mmHg; 3 rd 107 ± 7 mmHg; n = 27). In GH AGMs, SBP increased in the 3 rd trimester from 115 ± 6 mmHg (1 st ) and 117 ± 25 mmHg (2 nd ) to 152 ± 7 mmHg (3 rd ; p&lt;0.05; n = 16). Plasma osmolality did not change during PG for NT AGMs but declined in GH (NT pre-PG 305 ± 5 mOsm/kg; PG 299 ± 5 mOsm/kg; n = 6; GH pre-PG 313 ± 6; PG 293 ± 4 mOsm/kg; p&lt;0.05 ANOVA; n = 15). Maternal body weight increased in GH by the 1 st trimester, while NT body weight did not change until the 3 rd trimester (NT pre-PG 3.8 ± 0.2 kg; 1 st trimester 3.8 ± 0.3 kg; 3 rd 4.4 ± 0.2 kg; GH pre-PG 3.7 ± 0.1 kg; 1 st trimester 4.4 ± 0.2 kg; 3 rd 4.7 ± 0.1 kg; p&lt;0.05). Protein excretion was unchanged in NT AGMs but increased with GH compared to pre-PG and NT PG (NT pre-PG 365 ± 45 mg/day; 3 rd trimester 466 ± 84 mg/day; GH pre-PG 346 ± 138 mg/day; 3 rd trimester 702 ± 69 mg/day; p&lt;0.05). Third trimester estimated GFR (eGFR) did not change in NT AGMs but declined in GH (NT 5.0 ± 0.7 ml/min vs GH 2.5 ± 0.5 ml/min; p&lt;0.05). Infants from GH pregnancies were smaller (NT 327.4 ± 13.7 g, n = 5, vs GH 290.0 ± 8.5 g n = 15; p&lt;0.05) and GH increased fetal stillbirth rate to 40% (6/15). Thus, GH in AGMs has early PG water retention, decreased plasma osmolality and excess weight gain preceding GH. GH AGMs have smaller infants and increased stillbirth rates, showing fetal growth restriction. Elevated SBP during GH may lead to renal dysfunction, proteinuria and reduced eGFR. Thus, the AGM is a novel, translational model of hypertensive pregnancy disorders for the study of acute and long-term effects on fetal development.

Early Retention in Care Neither Mediates Nor Modifies the Effect of Sex and Sexual Mode of HIV Acquisition on HIV Survival in the Americas.

Early retention in care, sex, and sexual mode of HIV acquisition has been associated with mortality risk among persons living with HIV (PLWH). We assessed whether early retention in care mediates or modifies the association between mortality and sex and sexual mode of HIV acquisition among PLWH on antiretroviral therapy (ART) in the Americas. ART-naïve, adult PLWH (≥18 years) enrolling at Caribbean, Central and South America network for HIV epidemiology (CCASAnet) and Vanderbilt Comprehensive Care Clinic sites 2000-2015, starting ART, and with ≥1 visit after ART-start were included. Early retention in care was defined as ≥2 HIV care visits/labs ≥90 days apart in the first year of ART. Cox models assessed the association between early retention in care, sex, and sexual mode of HIV acquisition [i.e., women, heterosexual men and men who have sex with men (MSM)], and mortality. Associations were estimated separately by site and pooled. Among 11,721 included PLWH (median follow-up, 4.3 years; interquartile range, 2.0-7.6), 647 died (rate = 10.9/1000 person-years) and 1985 were lost to follow-up (rate = 33.6/1000 person-years). After adjustment for confounders, early retention in care was associated with lower mortality during subsequent years (pooled hazard ratio = 0.47; 95% confidence interval = 0.39-0.57). MSM had lower and heterosexual men had comparable mortality risk to women; risks were similar when adjusting for early retention in care. Additionally, no evidence of an interaction between early retention in care and sex and sexual mode of HIV acquisition on mortality was observed (p > 0.05). Early retention in care substantially reduced mortality but does not mediate or modify the association between sex and sexual mode of HIV acquisition and mortality in our population.

Integrating depression management into HIV primary care in central Malawi: the implementation of a pilot capacity building program

BackgroundIn Malawi, early retention in HIV care remains challenging. Depression is strongly associated with reduced anti-retroviral therapy (ART) adherence and viral suppression. Appropriate depression care for people initiating ART is likely to be supportive of early and continued engagement in the HIV care continuum. This paper aims to provide an overview of a task-shifting program that integrates depression screening and treatment into HIV care and the strategy used to evaluate this program, describes the implementation process, and discusses key challenges and lessons learned in the first phase of program implementation.MethodsWe are implementing a program integrating depression screening and treatment into HIV care initiation at two clinics in Lilongwe District, Malawi. The program’s effect on patients’ depression and HIV outcomes will be evaluated using a multiple baseline pre-post study. In this manuscript, we draw from our experiences as program implementers and some of the quantitative data to describe the process of implementation and key lessons learned.ResultsWe successfully implemented the screening phase of this program at both clinics; 88.3 and 93.2% of newly diagnosed patients have been screened for depression at each clinic respectively. 25% of enrolled patients reported symptoms of mild-to-severe depression and only 6% reported symptoms of moderate-to-severe depression. Key lessons learned from the process show the importance of utilizing existing processes and infrastructure and focusing on iterative and collaborative learning. We continued to face challenges around establishing a sense of program ownership among providers, developing capacity to diagnose and manage depression, and ensuring the availability of appropriate medication. Our efforts to address these challenges provide insight into the technical and managerial support needed to prepare for, roll out, and sustain integrated models of mental health and HIV care.ConclusionsThis activity demonstrates how a depression screening program can successfully be integrated into HIV care within the public health system in Malawi. While this program focuses on integrating depression management into HIV care, most of the lessons learned could apply to integration of mental health into any non-psychiatric specialist setting.Trial registrationClinicalTrials.gov ID [NCT03555669]. Retrospectively registered on 13 June 2018.

Toolkit for success: The Griffith Health suite of online student support resources. A Practice Report

In the current higher education climate, never has it been more imperative to promote early and ongoing student success and retention. Transition theory suggests that taking a coherent, scalable and holistic approach to supporting the student learning experience is the best way to scaffold and enable early success and persistence. Utilising this pedagogical approach, Griffith Health has designed and implemented a range of innovative, online resources to support the needs of undergraduate and postgraduate students as they transition across the student lifecycle. This ‘toolkit for success’ includes school-specific orientation websites, a targeted writing and referencing online guide, and a ‘one-stop-shop’ resource where students can quickly and easily connect with all of the support services and resources available across the University. Analytics data show the support resources are being very well accessed and utilised, with staff and student feedback also highlighting their effectiveness and value.

Effect of point-of-care early infant diagnosis on antiretroviral therapy initiation and retention of patients.

We measured the effect of point-of-care (POC) early infant HIV testing on antiretroviral therapy initiation rates and retention in care among infants in Mozambique. A cluster-randomized trial was conducted in 16 primary healthcare centres providing either on-site POC arm (n = 8) or referred laboratory [standard-of-care (SOC) arm; n = 8] infant HIV testing. The primary outcomes were the proportion of HIV-positive infants initiating antiretroviral therapy within 60 days of sample collection, and the proportion of HIV-positive infants who initiated antiretroviral therapy that were retained in care at 90 days of follow-up. The proportion of HIV-positive infants initiating antiretroviral therapy within 60 days of sample collection was 89.7% (157 of 175) for the POC arm and 12.8% (13 of 102) for the SOC arm [relative risk (RR)(adj) 7.34; P < 0.001]. The proportion of HIV-positive infants who initiated antiretroviral therapy that were retained in care at 90 days of follow-up was 61.6% (101 of 164) for the POC arm and 42.9% (21 of 49) for the SOC arm [RR(adj) 1.40; P < 0.027]. The median time from sample collection to antiretroviral therapy initiation was less than 1 day (interquartile range: 0-1) for the POC arm and 127 days (44-154; P < 0.001) for the SOC arm. POC infant HIV testing enabled clinics to more rapidly diagnose and provide treatment to HIV-infected infants. This reduced opportunities for pretreatment loss to follow-up and enabled a larger proportion of infants to receive test results and initiate antiretroviral therapy. The benefits of faster HIV diagnosis and antiretroviral treatment may also improve early retention in care.

EHealth and Prevention of Mother-to-Child Transmission of HIV.

The goal of this paper is to describe areas in prevention of mother-to-child transmission of HIV (PMTCT) programs that could benefit from ehealth and to summarize current evidence of ehealth effectiveness in PMTCT. PMTCT programs require maternal retention, adherence to antiretroviral treatment (ART), and return for infant diagnosis of HIV. eHealth systems for PMTCT could either be integrated within MCH ehealth systems or within HIV adherence ehealth systems. PMTCT ehealth messages need to balance maternal concerns about pregnancy, childbirth, and infant care with need for clinic retention and ART adherence for PMTCT. Health approaches currently being assessed for effects on PMTCT outcomes include SMS, phone reminders, and integration of laboratory results and health worker reminders. Randomized trials are ongoing to determine effect of PMTCT ehealth interventions on retention, adherence, viral suppression, and early infant diagnosis (EID). There is evidence that ehealth for PMTCT improves early retention and EID, while data on long-term outcomes are accruing. PMTCT ehealth interventions may be useful to enhance maternal retention and ART adherence and decrease risk of infant HIV infection. Ongoing clinical trials will be important to determine effectiveness of mhealth approaches in improving PMTCT outcomes.

Attrition, Retention, and Development of Early Career Teachers: Pan-Canadian Narratives

Our pan-Canadian research study examined the differential impact of teacher induction and mentorship programs on the early-career teachers’ retention. This article details the stories from our interview participants (N=36) in relation to what their lived experiences were during their first years of teaching and how they dealt with the requirements, expectations, and challenges. Their narratives were analyzed through the lenses of early career teacher attrition, retention, and development. Our findings showed that despite geographic, contextual and policy differences, there were striking similarities in teachers’ lived experiences and in the impact of these experiences on their decisions to stay or leave and predispositions towards personal and professional development as teachers.