Background The degree to which children and young people are infected by and transmit the SARS-CoV-2 virus is unclear. Clinical series and testing cohorts based upon screening of symptomatic cases provide biased estimates of susceptibility in children. The role of children and young people in transmission of SARS-CoV-2 is dependent on susceptibility, symptoms, viral load, social contact patterns and behaviour. Methods We undertook a rapid systematic review of contact-tracing studies and population-screening studies to address the question What is the susceptibility to and transmission of SARS-CoV-2 by children and adolescents compared with adults? We searched PubMed and medRxiv on 16 May 2020 and identified 6327 studies, with additional studies identified through handsearching of cited references (2) and professional contacts (4). We assessed quality, summarized findings and undertook a random effects meta-analysis of contact-tracing studies. Results 18 studies met inclusion criteria; 9 contact-tracing, 8 population-screening and 1 systematic-review. Meta-analysis of contact tracing studies showed that the pooled odds ratio of being an infected contact in children compared with adults for all contact tracing studies was 0.44 (0.29, 0.69) with substantial heterogeneity (63%). Findings from a systematic review of household clusters of COVID-19 found 3/31 (10%) were due to a child index case and a population-based school contact tracing study found minimal transmission by child or teacher index cases. Findings from population-screening studies were heterogenous and not suitable for meta-analysis. Large studies from Iceland, the Netherlands and Spain and an Italian municipal study showed markedly lower SARS-CoV-2 prevalence amongst children and young people, however studies from Stockholm, England and municipalities in Switzerland and Germany showed showed no difference in infection prevalence between adults and children. Conclusions There is preliminary evidence that children and young people have lower susceptibility to SARS-CoV-2, with a 56% lower odds of being an infected contact. There is weak evidence that children and young people play a lesser role in transmission of SARS-CoV-2 at a population level. Our study provides no information on the infectivity of children.

Introduction: Adolescents and young people comprise a growing proportion of new HIV infections globally, yet current approaches do not effectively engage this group, and adolescent HIV-related outcomes are the poorest among all age groups. Providing psychosocial interventions incorporating psychological, social, and/or behavioural approaches offer a potential pathway to improve engagement in care and health and behavioural outcomes among adolescents and young people living with HIV (AYPLHIV). Methods: A systematic search of all peer-reviewed papers published between January 2000 and July 2020 was conducted through four electronic databases (Cochrane Library, PsycINFO, PubMed and Scopus). We included randomized controlled trials evaluating psychosocial interventions aimed at improving engagement in care and health and behavioural outcomes of AYPLHIV aged 10 to 24 years. Results and discussion: Thirty relevant studies were identified. Studies took place in the United States (n = 18, 60%), sub-Saharan Africa (Nigeria, South Africa, Uganda, Zambia, Zimbabwe) and Southeast Asia (Thailand). Outcomes of interest included adherence to antiretroviral therapy (ART), ART knowledge, viral load data, sexual risk behaviours, sexual risk knowledge, retention in care and linkage to care. Overall, psychosocial interventions for AYPLHIV showed important, small-tomoderate effects on adherence to ART (SMD = 0.3907, 95% CI: 0.1059 to 0.6754, 21 studies, n = 2647) and viral load (SMD = À0.2607, 95% CI À04518 to À0.0696, 12 studies, n = 1566). The psychosocial interventions reviewed did not demonstrate significant impacts on retention in care (n = 8), sexual risk behaviours and knowledge (n = 13), viral suppression (n = 4), undetectable viral load (n = 5) or linkage to care (n = 1) among AYPLHIV. No studies measured transition to adult services. Effective interventions employed various approaches, including digital and lay health worker delivery, which hold promise for scaling interventions in the context of COVID-19. Conclusions: This review highlights the potential of psychosocial interventions in improving health outcomes in AYPLHIV. However, more research needs to be conducted on interventions that can effectively reduce sexual risk behaviours of AYPL-HIV, as well as those that can strengthen engagement in care. Further investment is needed to ensure that these interventions are cost-effective, sustainable and resilient in the face of resource constraints and global challenges such as the COVID-19 pandemic.

Background Adolescent HIV and pregnancy rates in Southern Africa are amongst the highest in the world. Despite decades of sexual and reproductive health (SRH) programming targeting adolescents, recent trends suggest there is a continued need for interventions targeting condom use for this age group. Methods This review synthesises evidence from qualitative studies that describe the determinants of condom use among adolescents in Southern Africa. We conducted systematic searches in four databases. Data were extracted, appraised for quality and analysed using a ‘best-fit’ framework synthesis approach. Results We coded deductively findings from 23 original studies using an a priori framework and subsequently conducted thematic analysis. Synthesised findings produced six key themes relating to: 1) pervasive unequal gender norms and restrictive masculinities favouring male sexual decision-making and stigmatising condom use in committed relationships; 2) other social norms reflecting negative constructions of adolescent sexuality and non-traditional family planning; 3) economic and political barriers including poverty and a lack of policy support for condom use; 4) service-level barriers including a lack of youth-friendly SRH services and comprehensive sex education in schools; 5) interpersonal barriers and facilitators including unequal power dynamics in sexual partnerships, peer influences and encouraging condoning condom use, and inadequate communication about SRH from parents/caregivers; and 6) negative attitudes and beliefs about condoms and condom use among adolescents. A conceptual model was generated to describe determinants of condom use, illustrating individual-, interpersonal- and structural-level barriers and facilitating factors. Conclusion SRH programming targeting barriers and facilitators of condom use at multiple levels is recommended in Southern Africa. We present a multilevel integrated model of barriers and facilitators to guide adolescent SRH decision-making, programme planning and evaluation. Given the existence of multilevel barriers and facilitators, interventions should, likewise, take a multilevel approach that incorporates locally relevant understanding of the individual-, interpersonal- and structural-level barriers and facilitators to condom use among adolescents in the region.

Aim This systematic review identifies, appraises and synthesizes the evidence on the provision of fundamental nursing care to hospitalized patients with a highly infectious virus and the effectiveness of adaptations to overcome barriers to care. Design Systematic review. Data Sources In July 2020, we searched Medline, PsycINFO (OvidSP), CINAHL (EBSCOhost), BNI (ProQuest), WHO COVID‐19 Database ( https://search.bvsalud.org/ ) MedRxiv ( https://www.medrxiv.org/ ), bioRxiv ( https://www.biorxiv.org/ ) and also Google Scholar, TRIP database and NICE Evidence, forwards citation searching and reference checking of included papers, from 2016 onwards. Review Methods We included quantitative and qualitative research reporting (i) the views, perceptions and experiences of patients who have received fundamental nursing care whilst in hospital with COVID‐19, MERS, SARS, H1N1 or EVD or (ii) the views, perceptions and experiences of professional nurses and non‐professionally registered care workers who have provided that care. We included review articles, commentaries, protocols and guidance documents. One reviewer performed data extraction and quality appraisal and was checked by another person. Results Of 3086 references, we included 64 articles; 19 empirical research and 45 review articles, commentaries, protocols and guidance documents spanning five pandemics. Four main themes (and 11 sub‐themes) were identified. Barriers to delivering fundamental care were wearing personal protective equipment, adequate staffing, infection control procedures and emotional challenges of care. These barriers were addressed by multiple adaptations to communication, organization of care, staff support and leadership. Conclusion To prepare for continuation of the COVID‐19 pandemic and future pandemics, evaluative studies of adaptations to fundamental healthcare delivery must be prioritized to enable evidence‐based care to be provided in future. Impact Our review identifies the barriers nurses experience in providing fundamental care during a pandemic, highlights potential adaptations that address barriers and ensure positive healthcare experiences and draws attention to the need for evaluative research on fundamental care practices during pandemics.

This Campbell systematic review examines the evidence on the effectiveness of the Tools of the Mind curriculum in promoting children?s self‐regulation and academic skills, in order to inform its implementation in schools. The participants included students of all ages, gender, ethnicity, special education status, language‐learning status, and socio‐economic status. The review summarizes findings from 14 records across six studies conducted in the USA. The Tools curriculum significantly improved children?s math skills relative to comparison curricula, but the effect size was small. There are also shortcomings in the quality of evidence. Although the average effect sizes for self‐regulation and literacy favored tools compared to other approaches, the effect was not statistically significant. The evidence from the small number of included studies is mostly consistent with the evidence observed for other similar programs, but again the evidence is weak. The results for the outcome measures were not statistically significant. Plain language summary The Tools of the Mind curriculum improves self‐regulation and academic skills in early childhoodThe Tools of the Mind early childhood curriculum appear to improve children's self‐regulation and academic skills. The assessment of the tools curriculum is hampered by a lack of rigorous evidence and more research is necessary to corroborate this finding. What did the review study?Tools of the Mind (Tools) is an early childhood education curriculum, which involves structured make‐believe play scenarios and a series of other curricular activities.Tools aims to promote and improve children's self‐regulation and academic skills by having a dual focus on self‐regulation and other social‐emotional skills in educational contexts. This review examines the evidence on the effectiveness of Tools in promoting children's self‐regulation and academic skills, in order to inform its implementation in schools. What studies are included?Included studies had to have used randomized controlled trials or quasi‐experimental studies and reported on one or more quantitative effect sizes regarding tools’ effectiveness in self‐regulatory or academic domains.A total of 14 records across six studies were included in the review. The participants included students of all ages, gender, ethnicity, special education status, language learning status, and socio‐economic status. The studies included measured at least one of four primary outcomes and did not measure any secondary outcome. Studies that compared Tools with a business‐as‐usual or another intervention were included in the review.All included studies were conducted in the USA. What are the main results of the review?The Tools curriculum significantly improved children's math skills relative to comparison curricula, but the effect size was small. There are also shortcomings in the quality of evidence.Although the average effect sizes for self‐regulation and literacy favored tools compared to other approaches, the effect was not statistically significan...