A Geospatial Analysis of CDC-funded HIV Prevention Programs for African Americans in the United States

Given the increase in HIV/AIDS infection rates among racial and ethnic minorities, particularly African Americans, this study was undertaken as part of a larger research effort to examine the distribution of HIV prevention services focusing on African American populations within the United States. Data were gathered via a national survey of community-based organizations (CBOs) funded by the Centers for Disease Control and Prevention (CDC). A geocoded national database was constructed to identify, locate, and map these HIV prevention programs. A total of 1,020 CBOs responded to the survey, yielding a response rate of 70.3%. These CBOs administered a total of 3,028 HIV prevention programs. Data describing intervention types and persons served, combined with the address and service area of responding CBOs, were integrated with census data (2000) and analyzed by using a geographic information system (GIS). The results of our national level analysis show that HIV prevention services for African Americans have fair coverage where African Americans comprise a substantial proportion of the population in urban areas in northeastern states, but that HIV prevention services for African Americans are inadequately distributed in the southeastern states. A local-level analysis was conducted for Alabama, where 68% of HIV/AIDS cases are among African Americans. Specific interventions such as street and community outreach, health communications, and public information are fairly well provided to African Americans in more urban cities in Alabama, however, individual- and group-level interventions have poor coverage in rural areas where a large percentage of African-Americans live. Overall, our study illustrates that the use of GIS adds value when used with other data sources to provide prevention services that are accessible to the populations most in need

Student Recital: Deborah Jordan, Soprano; Brett Gibbs, Piano; May 20, 1973

Centennial East Recital HallSunday EveningMay 20, 19737:00 p.m

The Treatment and Outcome of Patients With Soft Tissue Sarcomas and Synchronous Metastases

Introduction: There is a strong association between poor overall survival and a short disease-free interval for patients with soft tissue sarcomas (STS) and metastatic disease. Patients with STS and synchronous metastases should have a very dismal prognosis.The role of surgery in this subgroup of patients with STS has not been defined

Young people’s preferences for the use of emerging technologies for asymptomatic regular chlamydia testing and management: a discrete choice experiment in England

Objective To undertake a comprehensive assessment of the strength of preferences among young people for attributes of emerging technologies for testing and treatment of asymptomatic chlamydia. Design Discrete choice experiment (DCE) with sequential mixed methods design. A staged approach to selection of attributes/levels included two literature reviews, focus groups with young people aged 16–24 years (n=21), experts’ review (n=13) and narrative synthesis. Cognitive testing was undertaken to pilot and adapt the initial questionnaire. Online national panel was used for final DCE survey to maximise generalisability. Analysis of questionnaire responses used multinomial logit models and included validity checks. Setting England. Participants 1230 young people aged 16–24 from a national online panel (completion rate 73%). Outcome measures ORs for service attributes in relation to reference levels. Results The strongest attribute influencing preferences was chlamydia test accuracy (OR 3.24, 95% CI 3.13 to 3.36), followed by time to result (OR 1.81, 95% CI 1.71 to 1.91). Respondents showed a preference for remote chlamydia testing options (self-testing, self-sampling and postal testing) over attendance at a testing location. For accessing treatment following a positive test result, there was a general preference for online (OR 1.21, 95% CI 1.15 to 1.28) versus traditional general practitioner (OR 1.18, 95% CI 1.12 to 1.24) or pharmacy (OR 1.15, 95% CI 1.10 to 1.22) over clinic services. For accessing a healthcare professional and receipt of antibiotics, there was little difference in preferences between options. Conclusions Both test accuracy and very short intervals between testing and results were important factors for young people when deciding whether to undergo a routine test for asymptomatic chlamydia, with test accuracy being more important. These findings should assist technology developers, policymakers, commissioners and service providers to optimise technology adoption in service redesign, although use of an online panel may limit generalisability of findings to other populations

Expression of Thor does not increase desiccation resistance in Drosophila melanogaster

Using microarray analysis of Drosophila melanogaster, the Gibbs lab has identified several hundred candidate genes that may be involved in desiccation resistance. One of these genes is Thor, an important downstream target of the TOR/insulin signaling pathway. Preliminary results confirm that Thor plays a role in desiccation resistance. Further research will be needed to verify these results and understand the mechanism by which Thor increases desiccation resistance. This research will also serve as a proof-of-principle for testing microarray-derived hypotheses. A previous microarray analysis found evidence that down-regulation of protein synthesis might be a cellular response to desiccation through the up-regulation of Thor. When Drosophila melanogaster adult males are exposed to desiccation, Thor expression increases 6.5-fold. Thor codes for the D. melanogaster 4Ebinding protein (4E-BP), which inhibits translation by binding to the eukaryotic initiation factor 4E (eIF-4E). Thus, a reduction in protein synthesis might function to reduce energy expenditures during desiccation. To test whether THOR plays a role in the response to desiccation, we measured desiccation resistance in flies with altered Thor expression. We measured desiccation resistance in flies with Thor expression reduced through P-element mutagenesis (Thork13517 and Thor2) and RNA interference (RNAi). Using the GAL4/UAS system (Brand and Perrimon, 1993), desiccation resistance was also measured in flies with increased expression of wild-type Thor and constitutively-active Thor (4EBP( AA)). We found that Thor hypomorph mutant males (Thork13517) are desiccation sensitive. However, we found no difference in desiccation sensitivity between Thor null mutants (Thor2) and control flies (Thor1rv1). Knocking down expression of Thor with RNAi increased desiccation sensitivity. However, desiccation resistance did not increase in male flies that over-expressed Thor or a constitutively-active Thor (4E-BP(AA)) using the GAL4/UAS system. These mixed results do not support the hypothesis that Thor expression increases desiccation resistance

Unexpected prolonged presentation of influenza antigens promotes CD4 T cell memory generation

The kinetics of presentation of influenza virus–derived antigens (Ags), resulting in CD4 T cell effector and memory generation, remains undefined. Naive influenza-specific CD4 T cells were transferred into mice at various times after influenza infection to determine the duration and impact of virus-derived Ag presentation. Ag-specific T cell responses were generated even when the donor T cells were transferred 3–4 wk after viral clearance. Transfer of naive CD4 T cells during early phases of infection resulted in a robust expansion of highly differentiated effectors, which then contracted to a small number of memory T cells. Importantly, T cell transfer during later phases of infection resulted in a modest expansion of effectors with intermediate phenotypes, which were capable of persisting as memory with high efficiency. Thus, distinct stages of pathogen-derived Ag presentation may provide a mechanism by which T cell heterogeneity is generated and diverse memory subsets are maintained

Balancing act: exploring the tone of The Life Aquatic with Steve Zissou

This paper provides an analysis of The Life Aquatic in the context of debates around tone, irony, the Smart Film, the New Sincerity and the Quirky. It argues that Anderson is one of a small but significant number of filmmakers to escape from the indiscriminate irony of fin de sie`cle cinema, and finds The Life Aquatic Aquatic a particularly interesting film in which to explore such matters because of its ready artifice, strong elements of pastiche and measuredly preposterous excesses. Offering a critical analysis, the paper balances an engagement with some of the systemic elements of the film’s tone with the detailed organisation of tonal elements in particular sequences