Integration of HIV Care with Primary Health Care Services: Effect on Patient Satisfaction and Stigma in Rural Kenya.

HIV departments within Kenyan health facilities are usually better staffed and equipped than departments offering non-HIV services. Integration of HIV services into primary care may address this issue of skewed resource allocation. Between 2008 and 2010, we piloted a system of integrating HIV services into primary care in rural Kenya. Before integration, we conducted a survey among returning adults ≥18-year old attending the HIV clinic. We then integrated HIV and primary care services. Three and twelve months after integration, we administered the same questionnaires to a sample of returning adults attending the integrated clinic. Changes in patient responses were assessed using truncated linear regression and logistic regression. At 12 months after integration, respondents were more likely to be satisfied with reception services (adjusted odds ratio, aOR 2.71, 95% CI 1.32-5.56), HIV education (aOR 3.28, 95% CI 1.92-6.83), and wait time (aOR 1.97 95% CI 1.03-3.76). Men's comfort with receiving care at an integrated clinic did not change (aOR = 0.46 95% CI 0.06-3.86). Women were more likely to express discomfort after integration (aOR 3.37 95% CI 1.33-8.52). Integration of HIV services into primary care services was associated with significant increases in patient satisfaction in certain domains, with no negative effect on satisfaction

The SFA Economist Vol. 4 No. 2

https://scholarworks.sfasu.edu/economist/1007/thumbnail.jp

Native American Medicine

Openly licensed anthology focused on the theme of Native American medicine. Contains: Ethnobotany of the Ojibwe Indians by Huron H. Smith; The Botanical Lore of the California Indians by John Bruno Romero; The Sacred Formulas of the Cherokees by James Mooney; The Medicine-Men of the Apache by John Gregory Bourke; The Mide\u27wiwin or Grand Medicine Society of the Ojibwa by Walter James Hoffman

Testing Mode-Coupling Theory for a Supercooled Binary Lennard-Jones Mixture II: Intermediate Scattering Function and Dynamic Susceptibility

We have performed a molecular dynamics computer simulation of a supercooled binary Lennard-Jones system in order to compare the dynamical behavior of this system with the predictions of the idealized version of mode-coupling theory (MCT). By scaling the time $t$ by the temperature dependent $\alpha$-relaxation time $\tau(T)$, we find that in the $\alpha$-relaxation regime $F(q,t)$ and $F_s(q,t)$, the coherent and incoherent intermediate scattering functions, for different temperatures each follows a $q$-dependent master curve as a function of scaled time. We show that during the early part of the $\alpha$-relaxation, which is equivalent to the late part of the $\beta$-relaxation, these master curves are well approximated by the master curve predicted by MCT for the $\beta$-relaxation. This part is also fitted well by a power-law, the so-called von Schweidler law. We show that the effective exponent $b'$ of this power-law depends on the wave vector $q$ if $q$ is varied over a large range. The early part of the $\beta$-relaxation regime does not show the critical decay predicted by MCT. The $q$-dependence of the nonergodicity parameter for $F_{s}(q,t)$ and $F(q,t)$ are in qualitative agreement with MCT. On the time scale of the late $\alpha$-relaxation the correlation functions show a Kohlrausch-Williams-Watt behavior (KWW). The KWW exponent $\beta$ is significantly different from the effective von Schweidler exponent $b'$. At low temperatures the $\alpha$-relaxation time $\tau(T)$ shows a power-law behavior with a critical temperature that is the same as the one found previously for the diffusion constant [Phys. Rev. Lett. {\bf 73}, 1376 (1994)]. The critical exponent of this power-law and the von Schweidler exponent $b'$ fulfill the connection proposed by MCT between these two quantities. We also show that theComment: 28 Pages of REVTEX, Figures available from W. Ko

The Physics and Mathematics of the Second Law of Thermodynamics

The essential postulates of classical thermodynamics are formulated, from which the second law is deduced as the principle of increase of entropy in irreversible adiabatic processes that take one equilibrium state to another. The entropy constructed here is defined only for equilibrium states and no attempt is made to define it otherwise. Statistical mechanics does not enter these considerations. One of the main concepts that makes everything work is the comparison principle (which, in essence, states that given any two states of the same chemical composition at least one is adiabatically accessible from the other) and we show that it can be derived from some assumptions about the pressure and thermal equilibrium. Temperature is derived from entropy, but at the start not even the concept of `hotness' is assumed. Our formulation offers a certain clarity and rigor that goes beyond most textbook discussions of the second law.Comment: 93 pages, TeX, 8 eps figures. Updated, published version. A summary appears in Notices of the Amer. Math. Soc. 45 (1998) 571-581, math-ph/980500

Effectiveness of a Total Meal Replacement Program (OPTIFAST Program) on Weight Loss: Results from the OPTIWIN Study

Objective: The aim of this study was to test the effectiveness of the OPTIFAST program (OP), a total meal replacement dietary intervention, compared with a food-based (FB) dietary plan for weight loss. Methods: Participants with BMI 30 to 55 kg/m2, age 18 to 70 years old, were randomized to OP or FB dietary and lifestyle interventions for 26 weeks, followed by a weight-maintenance phase. Outcomes were percent change in body weight (%WL) from baseline to weeks 26 and 52, associated changes in body composition (using dual energy x-ray absorptiometry), and adverse events. Primary analysis used repeated-measures multivariable linear mixed models to compare outcomes between groups in a modified intention-to-treat fashion (mITT). Results: A total of 273 participants (83% of randomized; 135 OP, 138 FB) made up the mITT population. Mean age was 47.1 ± 11.2 years; 82% were female and 71% non-Hispanic white. Baseline BMI was 38.8 ± 5.9 kg/m2. At 26 weeks, OP %WL was 12.4%±0.6% versus 6.0%±0.6% in FB (P <0.001). At 52 weeks, OP %WL was 10.5% ± 0.6% versus 5.5% ± 0.6% in FB (P < 0.001). Fat mass loss was greater for OP; lean mass loss was proportional to total weight loss. There was no difference in serious adverse event rates between groups. Conclusions: Compared with an FB approach, OP was more effective with greater sustained weight loss

Test of mode coupling theory for a supercooled liquid of diatomic molecules. II. q-dependent orientational correlators

Using molecular dynamics computer simulations we study the dynamics of a molecular liquid by means of a general class of time-dependent correlators S_{ll'}^m(q,t) which explicitly involve translational (TDOF) and orientational degrees of freedom (ODOF). The system is composed of rigid, linear molecules with Lennard- Jones interactions. The q-dependence of the static correlators S_{ll'}^m(q) strongly depend on l, l' and m. The time dependent correlators are calculated for l=l'. A thorough test of the predictions of mode coupling theory (MCT) is performed for S_{ll}^m(q,t) and its self part S_{ll}^{(s)m}(q,t), for l=1,..,6. We find a clear signature for the existence of a single temperature T_c, at which the dynamics changes significantly. The first scaling law of MCT, which involves the critical correlator G(t), holds for l>=2, but no critical law is observed. Since this is true for the same exponent parameter lambda as obtained for the TDOF, we obtain a consistent description of both, the TDOF and ODOF, with the exception of l=1. This different behavior for l \ne 1 and l=1 can also be seen from the corresponding susceptibilities (chi'')_{ll}^m(q,omega) which exhibit a minimum at about the same frequency omega_{min} for all q and all l \ne 1, in contrast to (chi'')_{11}^m(q,omega) for which omega'_{min} approx 10 omega_{min} . The asymptotic regime, for which the first scaling law holds, shrinks with increasing l. The second scaling law of MCT (time-temperature superposition principle) is reasonably fulfilled for l \ne 1 but not for l=1. Furthermore we show that the q- and (l,m)-dependence of the self part approximately factorizes, i.e. S_{ll}^{(s)m}(q,t) \cong C_l^{(s)}(t) F_s(q,t) for all m.Comment: 11 pages of RevTex, 16 figure

Manacled to Identity: Cosmopolitanism, Class, and ‘The Culture Concept’ in Stephen Crane

This article begins with a close reading of Stephen Crane’s short story ‘Manacled’ from 1900, which situates this rarely considered short work within the context of contemporary debates about realism. I then proceed to argue that many of the debates raised by the tale have an afterlife in our own era of American literary studies, which has frequently focused on questions of ‘identity’ and ‘culture’ in its reading of realism and naturalism to the exclusion of the importance of cosmopolitan discourses of diffusion and exchange across national borders. I then offer a brief reading of Crane’s novel George’s Mother, which follows Walter Benn Michaels in suggesting that the recent critical attention paid to particularities of cultural difference in American studies have come to conflate ideas of class and social position with ideas of culture in ways that have ultimately obscured the presence of genuine historical inequalities in US society. In order to challenge this critical commonplace, I situate Crane’s work within a history of transatlantic cosmopolitanism associated with the ideas of Franz Boas and Matthew Arnold to demonstrate the ways in which Crane’s narratives sought out an experience of the universal within their treatments of the particular