Defining retention and attrition in pre-antiretroviral HIV care: proposals based on experience in Africa

This repository item contains a single issue of the Health and Development Discussion Papers, an informal working paper series that began publishing in 2002 by the Boston University Center for Global Health and Development. It is intended to help the Center and individual authors to disseminate work that is being prepared for journal publication or that is not appropriate for journal publication but might still have value to readers.Fewer than 33% of those testing HIV-positive in sub-Saharan Africa are continuously retained in pre-antiretroviral therapy (ART) HIV care until ART initiation. Existing evidence is difficult to synthesize, however, due to unclear and inconsistent definitions of terms. We developed practical, standardized definitions for reporting retention for the three stages of pre-ART care: Stage 1, testing HIV-positive to initial ART eligibility assessment; Stage 2, initial assessment to ART eligibility; and Stage 3, ART eligibility to ART initiation. For each stage, negative outcomes include death, loss, or not being retained. Stage 1 retention is defined as the proportion of patients who complete initial ART eligibility assessment within 3 months of HIV testing, with reporting of cohort outcomes at 3 and 12 months after HIV testing. Patients who end Stage 1 eligible for ART move directly to Stage 3. Stage 2 retention is defined as the proportion of patients who either complete all possible ART eligibility re-assessments within 6 months of the site’s standard visit schedule or had an assessment within 1 year of the time reported to and were not ART eligible at the last assessment. Retention should be reported at 12-month intervals. Stage 3 retention is defined as the proportion of patients eligible for ART who initiate ART (i.e.ARVs dispensed) within 3 months of determining ART eligibility, with reporting at 3 months after eligibility and 3 monthly intervals thereafter. If pre-ART retention is to improve, consistent terminology is needed for collecting data, measuring and reporting outcomes, and comparing results across programs and countries. The definitions we propose offer a strategy for improving the consistency and comparability of future reports

Adult Obesity in Sanpete County, Utah

Goal Statement: To reduce the rates of adult obesity in Sanpete County, Utah. Significant Findings: Adult obesity in Sanpete County, Utah, has been steadily rising since 2004 (County Health Rankings and Roadmaps, n.d.). Risk factors such as poor diet and lack of physical activity contribute to obesity prevalence. Protective factors are linked to healthy family practices and community support, such as access to healthy foods and recreation. Social cognitive theory is a proven and effective preventative intervention for this population, particularly regarding positive changes in dietary and lifestyle habits (National Cancer Institute, 2005). The Hispanic population in this area is at higher risk due to cultural practices and perspectives, and efforts at prevention should be diversity conscious and culturally relevant. Advocacy measures should include working with institutions to educate and provide resources on obesity. Working with church leaders and employers will create awareness and generate adjustment of cultural norms and practices that contribute to obesity. Lastly, fostering partnerships between individuals, community leaders, and elected officials will help shape public policy to mitigate obesity rates. Objectives/Strategies/Interventions/Next Steps: Lobby local governments to build recreational trails for walking, jogging, and biking within city limits. Work to create partnerships between individuals, businesses, and community leaders to facilitate availability and access to healthy foods. Provide support for local health care centers to dispense resources and educational materials warning of obesity risks and consequences. This could include routine BMI screening and weight management counseling. Engage with local church leaders and employers to encourage healthier eating habits within the scope of their respective influence. Implement the evidence-based prevention program Faithful Families Eating Smart and Moving More (FFESMM) to unite church and community leaders in educating and promoting healthier lifestyle practices

THE MINISTRY OF THE SPIRIT, PROPHETIC WITNESS: A THEOLOGICAL MODEL FOR PROPHETS

Much of Christianity today neglects the role of the prophet. Christians who do acknowledge prophetic ministry commonly limit the impact of prophecy. Pentecostals, who embrace the role, often do not have a full biblical understanding of what a prophet is and what a prophet is to do. The project first builds a theological framework for the function of prophets and prophecy within the ecclesial community. From the theological framework, a model of the prophethood of believers is developed to encourage prophetic ministry that is inclusive, exercises discernment, and is faithful to the witness of Jesus Christ. The prophetic model is implemented in the lives of believers as they interact with the biblical story and the testimonies of prophetic believers. The prophet is distinguished first by a face-to-face relationship with YHWH. The prophet then serves as a witness of YHWH and ministers by speaking and actuating the word of God. In an intimate encounter, a prophet hears from God, receives a word to be shared with God\u27s people, then acts. However, it is not just the prophet who is to act. The prophet\u27s work is to move all of God\u27s people to act. The study investigates prophetic ministry in proto-Pentecostals of the nineteenth century, the classic Pentecostals of the early twentieth century, and the classic, charismatic, and independent Pentecostals from the 1970s to the 2020s. Field research from 2018-2020 focused on a sample of American Christians’ theology of prophets and prophecy. The Ministry of the Spirit, Prophetic Witnesses encourages sons and daughters to live as prophetic witnesses in the community. The identity of prophetic witnesses is not found in a charismatic gift or office; they are defined by the Risen Lord Jesus Christ and empowered by the Holy Spirit to prophesy. This prophetic ministry model could help contemporary believers develop discernment to engage the culture and confront the day\u27s voices in the power of the Holy Spirit

EVALUATING THE EFFECTS OF WILDERNESS ON POPULATION AND EMPLOYMENT GROWTH IN THE ELEVEN WESTERN STATES

This paper examines the role of protected land on population and employment growth in the eleven Western States, which is an important issue in many counties that have high levels of federally owned land. A Carlino and Mills regional adjustment model is used to examine how these land management policies affect the local population and employment opportunities. This model assumes simultaneity in population and employment, so a two-stage least squares regression is used. The empirical evidence suggests that population is attracted to land with a conservation mandate, and that this population increases employment. There is also additional evidence that employment opportunities increase as a direct result of protected landscapes. In addition to these primary findings, population was attracted to a more diverse set of conservation land in the 1990s than the 1980s, but the positive effect of conservation land on employment decreased in the 1990s. Nonetheless, there is no evidence that any sector of employment is harmed by land management policies with a conservation mandate

Addressing LISA Science Analysis Challenges

The principal goal of the \emph{LISA Science Analysis Workshop} is to encourage the development and maturation of science analysis technology in preparation for LISA science operations. Exactly because LISA is a pathfinder for a new scientific discipline -- gravitational wave astronomy -- LISA data processing and science analysis methodologies are in their infancy and require considerable maturation if they are to be ready to take advantage of LISA data. Here we offer some thoughts, in anticipation of the LISA Science Analysis Workshop, on analysis research problems that demonstrate the capabilities of different proposed analysis methodologies and, simultaneously, help to push those techniques toward greater maturity. Particular emphasis is placed on formulating questions that can be turned into well-posed problems involving tests run on specific data sets, which can be shared among different groups to enable the comparison of techniques on a well-defined platform.Comment: 7 page

The Testbed for LISA Analysis Project

The Testbed for LISA Analysis (TLA) Project aims to facilitate the development, validation and comparison of different methods for LISA science data analysis, by the broad LISA Science Community, to meet the special challenges that LISA poses. It includes a well-defined Simulated LISA Data Product (SLDP), which provides a clean interface between the communities that have developed to model and to analyze the LISA science data stream; a web-based clearinghouse (at ) providing SLDP software libraries, relevant software, papers and other documentation, and a repository for SLDP data sets; a set of mailing lists for communication between and among LISA simulators and LISA science analysts; a problem tracking system for SLDP support; and a program of workshops to allow the burgeoning LISA science community to further refine the SLDP definition, define specific LISA science analysis challenges, and report their results. This note describes the TLA Project, the resources it provides immediately, its future plans, and invites the participation of the broader community in the furtherance of its goals.Comment: 5 pages, no figure

Finite-size critical scaling in Ising spin glasses in the mean-field regime

We study in Ising spin glasses the finite-size effects near the spin-glass transition in zero field and at the de Almeida-Thouless transition in a field by Monte Carlo methods and by analytical approximations. In zero field, the finite-size scaling function associated with the spin-glass susceptibility of the Sherrington-Kirkpatrick mean-field spin-glass model is of the same form as that of one-dimensional spin-glass models with power-law long-range interactions in the regime where they can be a proxy for the Edwards-Anderson short-range spin-glass model above the upper critical dimension. We also calculate a simple analytical approximation for the spin-glass susceptibility crossover function. The behavior of the spin-glass susceptibility near the de Almeida-Thouless transition line has also been studied, but here we have only been able to obtain analytically its behavior in the asymptotic limit above and below the transition. We have also simulated the one-dimensional system in a field in the non-mean-field regime to illustrate that when the Imry-Ma droplet length scale exceeds the system size one can then be erroneously lead to conclude that there is a de Almeida-Thouless transition even though it is absent.Comment: 10 pages, 7 figure