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Background The menstrual cycle is a critical indicator of women's health. Early prolonged secondary amenorrhea increases risks for morbidity and mortality. Menstrual cycle research in women with HIV is inconsistent and often lacks an adequate comparison sample. We aimed to determine whether women with HIV have a higher lifetime prevalence of amenorrhea and whether this is independently associated with HIV and/or other biopsychosocial variables. Methods With data from 2 established HIV cohorts, participants assigned female at birth were eligible if aged ≥16 years, not pregnant/lactating, and without anorexia/bulimia nervosa history. Amenorrhea was defined by self-reported history of (1) no menstrual flow for ≥12 months postmenarche not due to pregnancy/lactation, medications, or surgery or (2) early menopause or premature ovarian insufficiency. Multivariable logistic regression models explored biopsychosocial covariates of amenorrhea. Results Overall, 317 women with HIV (median age, 47.5 years [IQR, 39.2–56.4]) and 420 women without HIV (46.2 [32.6–57.2]) were included. Lifetime amenorrhea was significantly more prevalent among women with HIV than women without HIV (24.0% vs 13.3%). In the multivariable analysis, independent covariates of amenorrhea included HIV (adjusted odds ratio, 1.70 [95% CI, 1.10–2.64]), older age (1.01 [1.00–1.04]), White ethnicity (1.92 [1.24–3.03]), substance use history (6.41 [3.75–11.1]), and current food insecurity (2.03 [1.13–3.61]). Conclusions Nearly one-quarter of women with HIV have experienced amenorrhea, and this is associated with modifiable risk factors, including substance use and food insecurity. Care providers should regularly assess women's menstrual health and advocate for actionable sociostructural change to mitigate risks. [ABSTRACT FROM AUTHOR]

Background: Women living with HIV commonly experience low areal bone mineral density (BMD), but whether this is affected by low ovarian hormonal states (prolonged amenorrhea or menopause) is unknown. We compared rates of BMD loss between women living with HIV and HIV-negative control women and investigated its association with low ovarian hormonal states. Setting: Women living with HIV were enrolled from Vancouver Canada and controls from 9 Canadian sites. Methods: This longitudinal analysis included age-matched women living with HIV in the Children and Women: AntiRetrovirals and Markers of Aging cohort and controls in the population-based Canadian Multicentre Osteoporosis Study. Rate of change/year in BMD at the total hip and lumbar spine (L1-L4) between 3 and 5 years was compared between groups, adjusting for sociodemographic and clinical variables. Results: Ninety-two women living with HIV (median [interquartile range] age: 49.5 [41.6-54.1] years and body mass index: 24.1 [20.7-30.8] kg/m²) and 278 controls (age: 49.0 [43.0-55.0] years and body mass index: 25.8 [22.9-30.6] kg/m²) were included. Total hip BMD loss was associated with HIV (β: -0.003 [95% CI: -0.006 to -0.0001] g/cm²/yr), menopause (β: -0.007 [-0.01 to -0.005] g/cm²/yr), and smoking (β: -0.003 [-0.006 to -0.0002] g/cm²/yr); BMD gain was linked with higher body mass index (β: 0.0002 [0.0007-0.0004] g/cm²/yr). Menopause was associated with losing L1-L4 BMD (β: -0.01 [-0.01 to -0.006] g/cm²/yr). Amenorrhea was not associated with BMD loss. Conclusions: HIV and menopause negatively influenced total hip BMD. These data suggest women living with HIV require hip BMD monitoring as they age. [ABSTRACT FROM AUTHOR]

This review examines Anne Katrine Kamstrupp's article "The wow-effect in science teacher education; technology; sociomateriality." In the discussion below we explore three key areas of her ethnographic research. First, we reconsider Kamstrupp's article through the lens of technology as a pedagogical choice and philosophy. This is followed by our discussion of aspects of her study within the context of a basic understanding that entry-level pre-service teachers need to fully understand both the process of learning and scientific principles as these are important foundational factors in determining whether or not the wow-effect will occur as expected. Finally, our review team presents multiple areas in Kamstrupp's article as potential points for further elaboration. [Forum response to Kamstrupp, A. (2015). "The Wow-Effect in Science Teacher Education; Ttechnology; Sociomateriality" (EJ1121619).]

Digital games have become popular for engaging students in a range of learning goals, both in the classroom and the after-school space. In this article, I discuss a specific genre of video game, the massively multiplayer online role-playing game (MMO), which has been identified as a dynamic environment for encountering 21st-century workplace skills (King, 2012). Rather than advocating for bringing MMOs directly into the classroom to deliver content, I focus on designing after-school programs. Starting with a description of the MMO, I define the game space as a digital platform where an array of interest-driven learning takes place. Then, based upon a 2-year, game-based after-school program for teenage boys, the Casual Learning Lab was designed (Steinkuehler & King, 2009). Finally, I offer suggestions for program design highlighting the importance of involving teachers as co-learners, and structuring reflection activities to assist participants in connecting gaming activities to 21st-century skills.

A theoretical model is advanced that demonstrates that, if teacher and student attendance generate a shared good, then teacher and student attendance will be mutually reinforcing. Using data from the Northwest Frontier Province of Pakistan, empirical evidence supporting that proposition is advanced. Controlling for the endogeneity of teacher and student attendance, the most powerful factor raising teacher attendance is the attendance of the children in the school, and the most important factor influencing child attendance is the presence of the teacher. The results suggest that one important avenue to be explored in developing policies to reduce teacher absenteeism is to focus on raising the attendance of children. (Contains 5 tables.)

Background: Patterns of vitamin D intake are relatively unexplored among women living with HIV, despite its importance for women's health. We compared vitamin D dietary and supplement intakes in women with HIV and population‐based national controls and investigated barriers to intake. Methods: In this case–control study, women with HIV in the Children and Women: AntiRetrovirals and Markers of Aging (CARMA) cohort were matched with Canadian Multicentre Osteoporosis Study (CaMos) controls. Participants were queried for vitamin D in dairy consumption, supplementation/dosage, and sociodemographic variables. We assessed barriers to supplementation and factors associated with dietary intake by regression modelling. Results: Ninety‐five women living with HIV were age‐matched to 284 controls. Women with HIV had lower income and bone mineral density and were more likely to smoke, take multiple medications and be non‐white. Vitamin D dietary intake was lower in women living with HIV versus controls [0.76 vs. 1.79 μg/day; adjusted odds ratio (aOR) for greater than or equal to median intake 0.29 (0.12–0.61), p = 0.002], but any supplementation was higher [62.2% vs. 44.7%; aOR = 3.44 (95% CI: 1.16–11.00), p = 0.03]. Total vitamin D intake was similar between groups. Smoking was associated with no supplementation; non‐white ethnicity and low income were related to lower dietary intake. Conclusions: Women living with HIV showed lower dietary vitamin D intake but higher supplementation rates, suggesting that care providers are promoting supplementation. Women living with HIV who smoke, have low incomes and are non‐white may particularly benefit from targeted efforts to improve vitamin D intake. [ABSTRACT FROM AUTHOR]

Presents a simple framework for (1) demonstrating how households determine schooling investments through choice and voice; and (2) considering effects of decentralization on household behaviors, given information problems. Some aspects of decentralization may increase efficiency; others may be neutral or decrease efficiency. Further research is needed. (MLH)