Theological Creative Nonfiction: Christian Literature for Christian Life

Since the Christian worldview is composed of more than theoretical truth, Christian literature should reflect these other aspects, such as how that truth is applied in the lives of the saints. Furthermore, the praxis element of worldview is reflected in literature more naturally in narrative genres than in more expository writings like systematic theology. Narrative genres mirror the complex, temporal way a person lives his life, and because of this are able to show how objective truth is applied in subjective situations. For this reason, Christians need contemporary writing that reflects the process of everyday Christian living to offer a model for growth and encouragement. Several authors have written books that can be classified as theological creative Nonfiction. They share the goal of encouraging the saints in everyday circumstances of faith as well as the methodology of drawing from the author’s own life and experience and are examples of the same model of theological writing that directly reflects and informs praxis

Evaluation [of] the effectiveness of a cognitive approach for teaching domestic chores to adolescents and adults with autism [abstract]

Individuals with autism often have difficulty transitioning into adulthood due decreased executive functioning. One important skill which assists in the transition into adulthood is the ability tocomplete various domestic chores. These tasks often require executive functioning skills such as initiation, planning and organization, and problem solving which individuals with autism often have difficulty with. Currently, there is limited research on effective teaching techniques for supporting individuals with autism in the acquisition of skills needed for independent living. This study aims to determine if the Cognitive Orientation to daily Occupational Performance (CO-OP) is an effective intervention approach for improving problem solving skills

Economic evaluation of interventions delivered by primary care providers to improve neurodevelopment in children aged under 5 years: protocol for a scoping review

Background: Frequently cited benefit-cost ratios suggest that interventions to improve neurodevelopment have high economic returns when implemented during pregnancy and early childhood. However, there are many challenges when primary care providers implement these interventions at scale, and it is unclear how many research studies or programmes have examined cost-effectiveness and which methods were used. There are no current scoping or systematic reviews which have assessed economic evaluations of interventions delivered by primary care providers to improve child neurodevelopment. Methods/design: The aim of this review is to describe the economic evaluations of interventions delivered by primary care providers to improve neurodevelopment in children aged 0–4 years. Specific subgroup analyses will include income level of country (high, middle and low); population type (universal vs targeted); time period when intervention was implemented (antenatal vs infancy [0–11 months] vs early childhood [12–59 months]); and setting (research study vs programmes evaluation at scale). All study designs will be included. The primary outcomes of interest are cost per neurodevelopmental or cognitive health gain in children aged 0–4 years. All measures of cost, neurodevelopment or cognitive function that have been previously validated as an appropriate test in this domain will be included. Databases such as MEDLINE (OVID), PsycINFO (OVID), EMBASE (OVID), CINAHL, Cochrane Library (including CENTRAL, DARE, HTA and NHS EED), Paediatric Economic Database Evaluation (PEDE) and WHO databases and reference lists of papers will be searched for relevant articles. Five phases will be followed: identifying the research question, identifying relevant studies, study selection, charting data and collating, summarising and reporting results. We will present cost and effectiveness data descriptively. Discussion: This review appears to be the first to be conducted in this area. The findings will be an important resource for future systematic reviews on interventions that have a cost component. This information will be valuable for policy makers and programmers who work in public health or primary care settings

Modelling clinical goals: a corpus of examples and a tentative ontology

Knowledge of clinical goals and the means to achieve them are either not represented in most current guideline representation systems or are encoded procedurally (e.g. as clinical algorithms, condition-action rules). There would be a number of major benefits if guideline enactment systems could reason explicitly about clinical objectives (e.g. whether a goal has been successfully achieved or not, whether it is consistent with prevailing conditions, or how the system should adapt to circumstances where a recommended action has failed to achieve the intended result). Our own guideline specification language, PROforma, includes a simple goal construct to address this need, but the interpretation is unsatisfactory in current enactment engines, and goals have yet to be included in the language semantics. This paper discusses some of the challenges involved in developing an explicit, declarative formalism for goals. As part of this, we report on a study we have undertaken which has identified over 200 goals in the routine management of breast cancer, and outline a tentative formal structure for this corpus

September 11: Perspectives From the Field of Philanthropy -- Volume Three

Assesses the philanthropic sector's response to September 11 through interviews with leaders in the field. Provides lessons learned in the government-philanthropic relief effort, highlighting unresolved public policy issues. Includes recommendations

Prevalence of Transmitted Antiretroviral Drug Resistance Differs Between Acutely and Chronically HIV-Infected Patients

The associations of acute HIV infection (AHI) and other predictors with transmitted drug resistance (TDR) prevalence were assessed in a cohort of HIV-infected, antiretroviral-naïve patients. AHI was defined as being seronegative with detectable HIV RNA. Binomial regression was used to estimate prevalence ratios and 95% confidence intervals (CIs) for associations with TDR. Among 43 AHI patients, TDR prevalence was 20.9%, while prevalence was 8.6% among 677 chronically-infected patients. AHI was associated with 1.9 times the prevalence of TDR (95% CI: 1.0, 3.6) in multivariable analysis. AHI patients may represent a vanguard group that portends increasing TDR in the future

Oseltamivir-Resistant Pandemic (H1N1) 2009 Virus, Mexico

During May 2009–April 2010, we analyzed 692 samples of pandemic (H1N1) 2009 virus from patients in Mexico. We detected the H275Y substitution of the neuraminidase gene in a specimen from an infant with pandemic (H1N1) 2009 who was treated with oseltamivir. This virus was susceptible to zanamivir and resistant to adamantanes and oseltamivir

Methamphetamine Use among Newly Diagnosed HIV-Positive Young Men in North Carolina, United States, from 2000 to 2005

Methamphetamine (MA) is a new arrival to the Southeastern United States (US). Incidence of HIV is also increasing regionally, but data are limited regarding any association between this trend and MA use. We examined behavioral data from North Carolina (NC) residents newly diagnosed with HIV, collected by the Department of Health between 2000-2005.Among 1,460 newly diagnosed HIV-positive young men, an increasing trend was seen from 2000-2005 in MA use (p = 0.01, total n = 20). In bivariate analyses, users of MA had significantly greater odds of reporting other substance use, including alcohol, powder or crack cocaine, marijuana, and methylenedioxymethamphetamine (MDMA, "ecstasy"). They were also more likely to have reported sexual activity while traveling outside NC; sex with anonymous partners; and previous HIV testing. In a predictive model, MA use had a negative association with nonwhite race, and strong positive associations with powder cocaine, "ecstasy," or intravenous drug use and being a university student.Similar to trends seen in more urban parts of the US, MA use among newly diagnosed, HIV-positive young men is increasing in NC. These data are among the first to demonstrate this relationship in a region with a burgeoning epidemic of MA use. Opportunities exist for MA-related HIV risk-reduction interventions whenever young men intersect the healthcare system

How should HIV resources be allocated? Lessons learnt from applying Optima HIV in 23 countries.

INTRODUCTION: With limited funds available, meeting global health targets requires countries to both mobilize and prioritize their health spending. Within this context, countries have recognized the importance of allocating funds for HIV as efficiently as possible to maximize impact. Over the past six years, the governments of 23 countries in Africa, Asia, Eastern Europe and Latin America have used the Optima HIV tool to estimate the optimal allocation of HIV resources. METHODS: Each study commenced with a request by the national government for technical assistance in conducting an HIV allocative efficiency study using Optima HIV. Each study team validated the required data, calibrated the Optima HIV epidemic model to produce HIV epidemic projections, agreed on cost functions for interventions, and used the model to calculate the optimal allocation of available funds to best address national strategic plan targets. From a review and analysis of these 23 country studies, we extract common themes around the optimal allocation of HIV funding in different epidemiological contexts. RESULTS AND DISCUSSION: The optimal distribution of HIV resources depends on the amount of funding available and the characteristics of each country's epidemic, response and targets. Universally, the modelling results indicated that scaling up treatment coverage is an efficient use of resources. There is scope for efficiency gains by targeting the HIV response towards the populations and geographical regions where HIV incidence is highest. Across a range of countries, the model results indicate that a more efficient allocation of HIV resources could reduce cumulative new HIV infections by an average of 18% over the years to 2020 and 25% over the years to 2030, along with an approximately 25% reduction in deaths for both timelines. However, in most countries this would still not be sufficient to meet the targets of the national strategic plan, with modelling results indicating that budget increases of up to 185% would be required. CONCLUSIONS: Greater epidemiological impact would be possible through better targeting of existing resources, but additional resources would still be required to meet targets. Allocative efficiency models have proven valuable in improving the HIV planning and budgeting process

Triple Combination Antiviral Drug (TCAD) Composed of Amantadine, Oseltamivir, and Ribavirin Impedes the Selection of Drug-Resistant Influenza A Virus

Widespread resistance among circulating influenza A strains to at least one of the anti-influenza drugs is a major public health concern. A triple combination antiviral drug (TCAD) regimen comprised of amantadine, oseltamivir, and ribavirin has been shown to have synergistic and broad spectrum activity against influenza A strains, including drug resistant strains. Here, we used mathematical modeling along with three different experimental approaches to understand the effects of single agents, double combinations, and the TCAD regimen on resistance in influenza in vitro, including: 1) serial passage at constant drug concentrations, 2) serial passage at escalating drug concentrations, and 3) evaluation of the contribution of each component of the TCAD regimen to the suppression of resistance. Consistent with the modeling which demonstrated that three drugs were required to suppress the emergence of resistance in influenza A, treatment with the TCAD regimen resulted in the sustained suppression of drug resistant viruses, whereas treatment with amantadine alone or the amantadine-oseltamivir double combination led to the rapid selection of resistant variants which comprised ∼100% of the population. Furthermore, the TCAD regimen imposed a high genetic barrier to resistance, requiring multiple mutations in order to escape the effects of all the drugs in the regimen. Finally, we demonstrate that each drug in the TCAD regimen made a significant contribution to the suppression of virus breakthrough and resistance at clinically achievable concentrations. Taken together, these data demonstrate that the TCAD regimen was superior to double combinations and single agents at suppressing resistance, and that three drugs at a minimum were required to impede the selection of drug resistant variants in influenza A virus. The use of mathematical modeling with multiple experimental designs and molecular readouts to evaluate and optimize combination drug regimens for the suppression of resistance may be broadly applicable to other infectious diseases