The new bank capital adequacy standards

Bank capital ; Banks and banking

Understanding HIV care delays in the US South and the role of the social-level in HIV care engagement/retention: a qualitative study

Introduction: In a significant geographical shift in the distribution of HIV infection, the US South - comprising 17 states - now has the greatest number of adults and adolescents with HIV (PLHIV) in the nation. More than 60% of PLHIV are not in HIV care in Alabama and Mississippi, contrasted with a national figure of 25%. Poorer HIV outcomes raise concerns about HIV-related inequities for southern PLHIV, which warrant further study. This qualitative study sought to understand experiences of low-income PLHIV on the AIDS Drug Assistance Program in engagement and retention in continuous HIV care in two sites in Alabama. Methods: The study was designed using grounded theory. Semi-structured interviews with 25 PLHIV explored experiences with care linkage, reported factors and behaviors affecting engagement/retention in continuous HIV care, including socio-economic factors. To triangulate sources, 25 additional interviews were conducted with health and social service providers from the same clinics and AIDS Service Organizations where clients obtained services. Across the narratives, we used the HIV care continuum to map where care delays and drop out occurred. Using open coding, constant comparison and iterative data collection and analysis, we constructed a conceptual model illustrating how participants described their path to HIV care engagement and retention. Results: Most respondents reported delayed HIV care, describing concentric factors: psychological distress, fear, lack of information, substance use, incarceration, lack of food, transport and housing. Stark health system drop out occurred immediately after receipt of HIV test results, with ART initiation generally occurring when individuals became ill. Findings highlight these enablers to care: Alabama\u27s \u27social infrastructure\u27; \u27twinning\u27 medical with social services, \u27social enablers\u27 who actively link PLHIV to care; and \u27enabling spaces\u27 that break down PLHIV isolation, facilitating HIV care linkage/retention. Conclusions: Ryan White-funded programs, together with housing, food and psychological support were pre-conditions for participants\u27 entry and retention in HIV care. The path to achieving continuous HIV care for individuals at risk of lack of entry or delayed HIV care requires robust social-level responses, like in Alabama, that address physical and mental health of clients and directly engage the particular social and economic contexts and vulnerabilities of southern PLHIV

Social Actors Fight the Rising Tide of HIV in U.S. Southern Poor

The greatest number of persons living with HIV in the United States are now living in the South, and they face poorer health outcomes and increased AIDS-related deaths as compared to the rest of the country. The southern United States has a disproportionate share of low-income individuals, with many lacking access to health care and health insurance. Health facilities are also comparatively fewer and more difficult to reach than in other areas of the United States. The impacts of this already poor health infrastructure on low-income people living with HIV in the South can be life-threatening. This policy brief summarizes key findings and recommendations based on qualitative research carried out in 2012 by HIV researchers at the University of Massachusetts Boston

Interactions between the auditory and vibrotactile senses : a study of perceptual effects

Thesis (Ph. D.)--Harvard-MIT Division of Health Sciences and Technology, February 2010."September 2009." Cataloged from PDF version of thesis.Includes bibliographical references (p. 160-175).This project is an experimental study of perceptual interactions between auditory and tactile stimuli. These experiments present vibrotactile stimuli to the fingertip and auditory tones diotically in broadband noise. Our hypothesis states that if the auditory and tactile systems integrate, the performance of the two sensory stimuli presented simultaneously will be different from the performance of the individual sensory stimuli. The research consists of work in two major areas: (1) Studies of the detection of auditory and tactile sinusoidal stimuli at levels near the threshold of perception (masked thresholds for auditory stimuli and absolute thresholds for tactile stimuli); and (2) Studies of loudness matching employing various combinations of auditory and tactile stimuli presented at supra-threshold levels. Results were compared to three models of auditory-tactile integration. The objective detection studies explore the effects of three major variables on perceptual integration: (a) the starting phase of the auditory relative to the tactile stimulus; (b) the temporal synchrony of stimulation within each of the two modalities; and (c) the frequency of stimulation within each modality. Detection performance for combined auditory-tactile (A+T) presentations was measured using stimulus levels that yielded 63%-77%-correct unimodal performance in a 2-Interval, 2-Alternative Forced- Choice procedure. Results for combined vibrotactile and auditory detection indicated: (1) For synchronous presentation of 500-msec, 250 Hz sinusoidal stimuli, percent-correct scores in the combined A+T conditions were significantly higher than scores within each single modality;(cont.) (2) Scores in the A+T conditions were not affected by the relative phase of the 250 Hz auditory and tactile stimuli; (3) For asynchronous presentation of auditory and tactile 250 Hz stimuli, scores on the A+T conditions improved only when the tactile stimulus preceded the auditory stimulus (and not vice versa); and (4) The highest rates of detection in the combined-modality stimulus were obtained when stimulating frequencies in the two modalities were equal or closely spaced (and within the Pacinian range). The lack of phase effect suggests that integration operates on the envelopes rather than on temporal fine structure. The effects of asynchronous presentation imply a shorter time constant in the auditory compared to the tactile modality and are consistent with time constants deduced from single-modality masking experiments. The effects of frequency depend both on absolute frequency and on relative frequency of stimulation within each modality. In general, we found that an additive sensitivity model best explained detection performance when tones were presented synchronously and of the same frequency. In the second area of research, loudness matching was employed in a subjective study of the effects of frequency on auditory-tactile integration for stimuli presented at supra-threshold levels. These experiments, which were derived from previous auditory studies demonstrating the dependence of loudness on critical-band spacing of tonal signals, employed various combinations of auditory and tactile stimuli that were presented at equally loud levels in isolation.(cont.) Loudness matches were obtained for auditory-only (A+A) and auditory-tactile (A+T) stimuli that were both close as well as farther apart in frequency. The results show that the matched loudness of an auditory pure tone is greater when the frequencies of combined stimuli (both A+A and A+T) are farther apart in frequency than when they are close in frequency. These results are consistent with the results found in the previous experiment exploring the frequency relationships at near-threshold levels, as well as with results in the psychoacoustic literature, and suggest that the auditory and tactile systems are interacting in a frequency-specific manner similar to the interactions of purely auditory stimuli. The research conducted here demonstrates objective and subjective perceptual effects that support the mounting anatomical and physiological evidence for interactions between the auditory and tactual sensory systems.by E. Courtenay Wilson.Ph.D

Gender-specific profiles of adverse childhood experiences, past year mental and substance use disorders, and their associations among a national sample of adults in the United States

Purpose: This study examined profiles of adverse childhood experiences (ACEs) and mental and substance use disorders (MSUDs), and associations between distinct profiles of ACEs and MSUDs. Methods: Participants were adults (N = 34, 652) involved in the National Epidemiologic Survey on Alcohol and Related Conditions. Latent class analysis was used to examine both profiles of ten ACEs and ten past year MSUDs. Dual latent class analysis regression was used to examine associations between profiles of ACEs and MSUDs. Given gender differences in ACEs and MSUDs, analyses were conducted separately for females and males. Results: Four profiles of ACEs and three profiles of MSUDs were selected for both genders. The four profiles of ACEs were characterized by the following probabilities: high multiple ACEs, high parental substance abuse, high childhood physical abuse, and low ACEs. The three profiles of MSUDs were characterized by the following probabilities: high multiple MSUDs for females and low MSUDs except alcohol use disorders for males, moderate-to-high major depressive episode, and low MSUDs. When compared to the low ACEs and MSUDs profiles, members in the higher ACEs profiles had 3.71–89.75 times greater odds of also being members in the higher MSUDs profiles. However, more than one-third of members in the high multiple ACEs profiles were also in the low MSUDs profiles. Conclusions: Study findings suggest four profiles of the ACEs widely studied as part of the Adverse Childhood Experiences study and risk and resilience for recent MSUDs among men and women nationally affected by ACEs

Environmental monitoring of Mycobacterium bovis in badger feces and badger sett soil by real-time PCR, as confirmed by immunofluorescence, immunocapture, and cultivation

Real-time PCR was used to detect and quantify Mycobacterium bovis cells in naturally infected soil and badger faeces. Immunomagnetic capture, immunofluorescence and selective culture confirmed species identification and cell viability. These techniques will prove useful for monitoring M. bovis in the environment and for elucidating transmission routes between wildlife and cattle

Combining epidemiology with basic biology of sand flies, parasites, and hosts to inform leishmaniasis transmission dynamics and control.

Quantitation of the nonlinear heterogeneities in Leishmania parasites, sand fly vectors, and mammalian host relationships provides insights to better understand leishmanial transmission epidemiology towards improving its control. The parasite manipulates the sand fly via production of promastigote secretory gel (PSG), leading to the "blocked sand fly" phenotype, persistent feeding attempts, and feeding on multiple hosts. PSG is injected into the mammalian host with the parasite and promotes the establishment of infection. Animal models demonstrate that sand flies with the highest parasite loads and percent metacyclic promastigotes transmit more parasites with greater frequency, resulting in higher load infections that are more likely to be both symptomatic and efficient reservoirs. The existence of mammalian and sand fly "super-spreaders" provides a biological basis for the spatial and temporal clustering of clinical leishmanial disease. Sand fly blood-feeding behavior will determine the efficacies of indoor residual spraying, topical insecticides, and bed nets. Interventions need to have sufficient coverage to include transmission hot spots, especially in the absence of field tools to assess infectiousness. Interventions that reduce sand fly densities in the absence of elimination could have negative consequences, for example, by interfering with partial immunity conferred by exposure to sand fly saliva. A deeper understanding of both sand fly and host biology and behavior is essential to ensuring effectiveness of vector interventions

Empowering academics to be adaptive with eLearning technologies: An exploratory case study

© 2019. This paper describes an exploratory case study investigating the capacity of a multidisciplinary approach to academic development, to empower adaptive responses to ongoing technological change impacting on teaching practice. A quasi-experimental design with an intervention group (n = 22) and a comparative control group (n = 7) was adopted. Pre and post online questionnaires were administered to participants in both groups to evaluate attitudes and experiences relating to technology use in teaching and learning. The questionnaires were adapted from the Technology Acceptance Model. Qualitative measurement of the intervention group's experiences following the professional development was captured using semi-structured interviews, followed by two focus groups to confirm the interview findings. Results indicate that the professional development impacted positively on participants through significantly increased levels of confidence and perceived ease of use. Qualitative data indicated participants experienced cognitive, emotional, and/or practical changes during and/or following the professional development