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While the impact of Community Health Workers (CHWs) on home-based human immunodeficiency virus (HIV) care has been documented, barriers and recommendations have not been systematically reviewed. Following the reporting requirements of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we used an aggregative narrative synthesis approach to summarize the results of qualitative studies published between January 1, 2000, and November 6, 2020 in the following databases: PubMed, CINAHL, PsychINFO, Web of Science, and Google Scholar. In total, 17 studies met the selection criteria and were included in the analysis. They reported on a range of roles played by CHWs in HIV care, including education and health promotion; HIV-specific care (HIV testing services; screening for opportunistic infections and acute illness); medication delivery; tracing persons who had defaulted from care; and support (treatment support; referral; home-based care; and psychosocial support). Many different barriers to community-based HIV care were reported and centered on the following themes: Stigma and nondisclosure; inadequate support (lack of resources, inadequate training, inadequate funding, and inadequate monitoring); and health system challenges (patients' preference for more frequent visits and poor integration of CHWs in the wider health care system). Recommendations to mitigate these barriers included: addressing HIV-related stigma; introducing updated and relevant CHW training; strengthening the supervision of CHWs; coordinating care between the home and facilities; incorporating patient-centered mHealth approaches; and committing to the funding and resources needed for successful community-based care. In summary, CHWs are providing a variety of important community-based HIV services but face challenges with regards to training, resources, and supervision.

ObjectiveTo review and frequently update the available evidence on injury risk factors and epidemiology of injury in trail running.DesignLiving systematic review. Updated searches will be done every 6 months for a minimum period of 5 years.Data sourcesEight electronic databases were searched from inception to 18 March 2021.Eligibility criteriaStudies that investigated injury risk factors and/or reported the epidemiology of injury in trail running.ResultsNineteen eligible studies were included, of which 10 studies investigated injury risk factors among 2 785 participants. Significant intrinsic factors associated with injury are: more running experience, level A runner and higher total propensity to sports accident questionnaire (PAD-22) score. Previous history of cramping and postrace biomarkers of muscle damage is associated with cramping. Younger age and low skin phototypes are associated with sunburn. Significant extrinsic factors associated with injury are neglecting warm-up, no specialised running plan, training on asphalt, double training sessions per day and physical labour occupations. A slower race finishing time is associated with cramping, while more than 3 hours of training per day, shade as the primary mode of sun protection and being single are associated with sunburn. An injury incidence range 0.7–61.2 injuries/1000 hours of running and prevalence range 1.3% to 90% were reported. The lower limb was the most reported region of injury, specifically involving blisters of the foot/toe.ConclusionLimited studies investigated injury risk factors in trail running. Our review found eight intrinsic and nine extrinsic injury risk factors. This review highlighted areas for future research that may aid in designing injury risk management strategies for safer trail running participation.PROSPERO registration numberCRD42021240832.

________________________________________________________________________________ AbstractThe aim of the study was to determine if the breeding potential of 25-month old Bonsmara beef bulls could be predicted from production characteristics. Forty-one Bonsmara bulls were included in an on-farm performance test (also known as the Phase D growth test) for a period of 180 days. At an average age of 24.7 months the bulls were subjected to a libido test and overall breeding soundness evaluation (OBE). The bulls were categorised into independent breeding potential categories according to the scores they obtained for the measured reproductive traits. The categories included sperm morphology and motility. One-way ANOVA revealed that none of the production traits measured had a significant effect on the different breeding potential categories. A positive correlation (r = 0.33) was recorded between pre-weaning growth rate and percentage morphologically normal sperm, while a negative correlation (r = -0.36) was recorded between total acrosomal-and flagellar sperm defects and pre-weaning growth. A positive correlation was demonstrated between sperm motility and pre-weaning growth (r = 0.36), and a consequent negative correlation (r = -0.38) between the percentage aberrant sperm movement and pre-weaning growth. The correlation between the percentage morphologically normal sperm and percentage progressively moving sperm was r = 0.50, while the correlation between percentage morphologically normal sperm and aberrant and immotile sperm was r = 0.48 for both variables. The number of total defects correlated highly significantly with flagellar and acrosomal defects (r = 0.72 and r = 0.93, respectively) and correlated poorly with the total number of nuclear defects (r = 0.32). These results suggest that total sperm defects were mainly due to acrosomal and flagellar defects, rather than nuclear defects and as the percentage morphologically normal sperm decreased, the motility also decreased. High growth rates before weaning may have a positive effect, while high growth rates after weaning may have a negative effect on the breeding potential of a bull. None of the measured reproductive and production traits had a significant effect on libido score and thus, cannot be used to predict the libido of young extensively maintained bulls. ________________________________________________________________________________

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