What are the essential components of HIV treatment and care services in low and middle-income countries: an overview by settings and levels of the health system?

OBJECTIVES: To review and summarize the essential components of HIV treatment and care services in low and middle-income countries (LMICs). METHODS: Literature review and reflection on programmatic experience. FINDINGS: There is increasing recognition that the essential 'package' of HIV care must include early identification of HIV-positive people in need of care, appropriate initial and continued counselling, assessment of HIV disease stage, treatment with HAART for those who need it, monitoring while on treatment for efficacy, adherence and side-effects, detection and management of other complications of HIV infection, provision of sexual and reproductive health services as well as careful record-keeping. The impressive scale-up of HIV treatment and care services has required decentralization of service provision linked to task-shifting. But the future holds even greater challenges, as the number of people in need of HIV care continues to rise at a time when many traditional donors and governments in the most-affected regions have reduced budgets. CONCLUSION: In the long-term, the increased demand for HIV-care services can only be satisfied through increased decentralisation to peripheral health units, with the role of each type of unit being appropriate to the human and material resources available to it.HIV-care services can also naturally integrate with the care of chronic noncommunicable diseases and with closely related services like mother and child health, and thus should promote a shift from vertical to integrated programming. Staff training and support around a set of evidence-based policies and guidelines and a reliable supply of essential medicines and supplies are further essential components for a successful programme

Heat flow in InAs/InP heterostructure nanowires

The transfer of heat between electrons and phonons plays a key role for thermal management in future nanowire-based devices, but only a few experimental measurements of electron-phonon (e-ph) coupling in nanowires are available. Here, we combine experimental temperature measurements on an InAs/InP heterostructure nanowire system with finite element modeling (FEM) to extract information on heat flow mediated by e-ph coupling. We find that the electron and phonon temperatures in our system are highly coupled even at temperatures as low as 2 K. Additionally, we find evidence that the usual power-law temperature dependence of electron-phonon coupling may not correctly describe the coupling in nanowires and show that this result is consistent with previous research on similar one-dimensional electron systems. We also compare the strength of the observed e-ph coupling to a theoretical analysis of e-ph interaction in InAs nanowires, which predicts a significantly weaker coupling strength than observed experimentally.Comment: 9 pages, 6 figure

Marketing innovative service solutions with inter-organizational service networks: opportunities and threats

--

Non-equilibrium dynamics of a system with Quantum Frustration

Using flow equations, equilibrium and non-equilibrium dynamics of a two-level system are investigated, which couples via non-commuting components to two independent oscillator baths. In equilibrium the two-level energy splitting is protected when the TLS is coupled symmetrically to both bath. A critical asymmetry angle separates the localized from the delocalized phase. On the other hand, real-time decoherence of a non-equilibrium initial state is for a generic initial state faster for a coupling to two baths than for a single bath.Comment: 22 pages, 9 figure

Characterization of hemodialysis membranes by inverse size exclusion chromatography

Inverse size exclusion chromatography (i-SEC) was used to characterize three different cellulosic hollow fiber hemodialysis membranes, i.e. low-flux cuprophan and hemophan and high-flux RC-HP400A. With the i-SEC technique the pore size distribution and porosity of a membrane can be determined and adsorption phenomena can be studied. The membranes showed clear differences in pore size and porosity, the high-flux RC-HP400A membrane has a larger pore size as well as a higher porosity. For all the membranes it was found that the elution curves were best described by a homoporous pore volume distribution. It appeared that the bound or non-freezing water in the membranes was at least partly accessible to solutes. The test molecules creatinine and vitamin B 12 both adsorbed to the cellulosic membranes. The adsorption behavior of creatinine was strongly dependent on the NaCl concentration present. The observations could be explained by assuming that cuprophan and RC-HP400A are negatively charged whereas hemophan is positively charged due to the modification with N,N-diethylaminoethyl ether. The net charge of the hemophan is smaller

Ausbildung zum Beratungslehrer

Schlechte Druckqualität

Non-Gaussianity Consistency Relation for Multi-field Inflation

While detection of the "local form" bispectrum of primordial perturbations would rule out all single-field inflation models, multi-field models would still be allowed. We show that multi-field models described by the $\delta N$ formalism obey an inequality between $f_{\rm NL}$ and one of the local-form {\it trispectrum} amplitudes, $\tau_{\rm NL}$, such that $\tau_{\rm NL}>\frac12(\frac65f_{\rm NL})^2$ with a possible logarithmic scale dependence, provided that 2-loop terms are small. Detection of a violation of this inequality would rule out most of multi-field models, challenging inflation as a mechanism for generating the primoridal perturbations.Comment: 5 pages. Accepted for publication in Physical Review Letter