Fife House

Abstract BackgroundPeople living with HIV are living longer, and can experience physical, mental and social health challenges associated with aging and multimorbidity. Rehabilitation is well positioned to address disability and maximize healthy aging. An international collaborative network, called the Canada-International HIV and Rehabilitation Research Collaborative (CIHRRC), works to guide this emerging field.In this article, we report findings from CIHRRC’s aim to identify emerging research priorities in HIV, aging and rehabilitation from the perspectives of people living with HIV, clinicians, researchers, representatives from community organizations and policy stakeholders.MethodsWe conducted a multi-stakeholder mixed-method international consultation with people living with HIV, researchers, clinicians and representatives of community-based organizations to identify research priorities in HIV, aging and rehabilitation. Stakeholders identified research priorities during a one-day International Forumcomprised of presentations and facilitated discussion. We collated and analyzed data using content analytical techniques, resulting in a framework of research priorities.ResultsSixty-nine stakeholders from countries including Canada (n=62;90%), the United Kingdom (n=5;7%), United States (n=1;1%) and Australia (n=1;1%) attended the International Forum on HIV, Aging and Rehabilitation. Stakeholders represented community-based organizations (n=20;29%), academic institutions (n=18;26%), community or institutional healthcare organizations (n=11;16%), research or knowledge production organizations (n=10;14%), and organizations representing government or industry (n=10;14%). TheFramework of Research Priorities in HIV, Aging and Rehabilitationincludes seven research priorities: 1) nature, extent and impact of disability, concurrent health conditions and chronic inflammation with HIV; 2) prevalence, severity and impact of frailty; 3) community and social participation aging with HIV; 4) strategies for chronic disease management and healthy aging with HIV; 5) facilitators and barriers to access to and engagement in, rehabilitation; 6) effectiveness of rehabilitation interventions for healthy aging with HIV; and 7) advancing development and use of patient reported outcome measures in HIV and aging. The Framework highlights methodological considerations to approach the priorities and the importance of knowledge translation and exchange to apply research knowledge into practice, programs and policy.ConclusionsThese priorities offer a foundation for collaboration among international and multidisciplinary teams to advance the field of HIV, aging and rehabilitation in order to promote healthy aging with HIV.

Although lack of housing is linked with adverse health outcomes, little is known about the impacts of the qualitative aspects of housing on health. This study examined the association between structural elements of housing, housing affordability, housing satisfaction and health-related quality of life over a 1-year period. Participants were 509 individuals living with HIV in Ontario, Canada. Regression analyses were conducted to examine relationships between housing variables and physical and mental health-related quality of life. We found significant cross-sectional associations between housing and neighborhood variables—including place of residence, housing affordability, housing stability, and satisfaction with material, meaningful and spatial dimensions of housing—and both physical and mental health-related quality of life. Our analyses also revealed longitudinal associations between housing and neighborhood variables and health-related quality of life. Interventions that enhance housing affordability and housing satisfaction may help improve health-related quality of life of people living with HIV.

The words “Actual” and “Potential” in the title of this book are particularly apt when applied to discussions of the development of Public Authority Information Systems in Britain. With few exceptions the technical “potential” for creating Information Systems has far exceeded “actual” development achieved. The Rural Land Use Information Systems (RLUIS) project, initiated in the Fife Region of Scotland (Figure 1), provides an interesting case study of the “political” and administrative problems, in addition to the technical difficulties, which may be encountered.