2,094 research outputs found
Routine Rapid HIV Screening in Six Community Health Centers Serving Populations at Risk
In 2006, to increase opportunities for patients to become aware of their HIV status, the Centers for Disease Control and Prevention released updated guidelines for routine, opt-out HIV screening of adults, adolescents, and pregnant women in healthcare settings. To date, there are few documented applications of these recommendations.
To measure the impact of application of the guidelines for routine screening in health centers serving communities disproportionately affected by HIV in the southeastern US.
A multi-site program implementation study, describing patients tested and not tested and assessing changes in testing frequency before and after new guidelines were implemented.
All patients aged 13 to 64 seen in participating health centers.
Routine rapid HIV screening in accord with CDC guidelines.
The frequency of testing before and after routine screening was in place and demographic differences in offering and receipt of testing.
Compared to approximately 3,000 patients in the year prior to implementation, 16,148 patients were offered testing with 10,769 tested. Of 39 rapid tests resulting in preliminary positives, 17 were newly detected infections. Among these patients, 12 of 14 receiving referrals were linked to HIV care. Nineteen were false positives. Younger patients, African Americans and Latinos were more likely to receive testing.
By integrating CDC-recommended guidelines and applying rapid test technology, health centers were able to provide new access to HIV testing. Variation across centers in offering and receiving tests may indicate that clinical training could enhance universal access
Reinforced reasoning in medicine
Some philosophers have argued that evidence of underlying mechanisms does not provide evidence for the effectiveness of a medical intervention. One such argument appeals to the unreliability of mechanistic reasoning. However, mechanistic reasoning is not the only way that evidence of mechanisms might provide evidence of effectiveness. A more reliable type of reasoning may be distinguished by appealing to recent work on evidential pluralism in the epistemology of medicine. A case study from virology provides an example of this soâcalled reinforced reasoning in medicine. It is argued that in this case study, the available evidence of underlying mechanisms did in fact play a role in providing evidence in favour of a medical intervention. This paper therefore adds a novel and recent case study to the literature in support of evidential pluralism in medicine
The Role of Demography and Markets in Determining Deforestation Rates Near Ranomafana National Park, Madagascar
The highland forests of Madagascar are home to some of the world's most unique and diverse flora and fauna and to some of its poorest people. This juxtaposition of poverty and biodiversity is continually reinforced by rapid population growth, which results in increasing pressure on the remaining forest habitat in the highland region, and the biodiversity therein. Here we derive a mathematical expression for the subsistence of households to assess the role of markets and household demography on deforestation near Ranomafana National Park. In villages closest to urban rice markets, households were likely to clear less land than our model predicted, presumably because they were purchasing food at market. This effect was offset by the large number of migrant households who cleared significantly more land between 1989â2003 than did residents throughout the region. Deforestation by migrant households typically occurred after a mean time lag of 9 years. Analyses suggest that while local conservation efforts in Madagascar have been successful at reducing the footprint of individual households, large-scale conservation must rely on policies that can reduce the establishment of new households in remaining forested areas
Cardy and Kerr
The Kerr/CFT correspondence employs the Cardy formula to compute the entropy
of the left moving CFT states. This computation, which correctly reproduces the
Bekenstein--Hawking entropy of the four-dimensional extremal Kerr black hole,
is performed in a regime where the temperature is of order unity rather than in
a high-temperature regime. We show that the comparison of the entropy of the
extreme Kerr black hole and the entropy in the CFT can be understood within the
Cardy regime by considering a D0-D6 system with the same entropic properties.Comment: 20 pages; LaTeX; JHEP format; v.2 references added, v.3 Section 4
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Reasoning with global assumptions in arithmetic modal logics
We establish a generic upper bound ExpTime for reasoning with global assumptions in coalgebraic modal logics. Unlike earlier results of this kind, we do not require a tractable set of tableau rules for the in- stance logics, so that the result applies to wider classes of logics. Examples are Presburger modal logic, which extends graded modal logic with linear inequalities over numbers of successors, and probabilistic modal logic with polynomial inequalities over probabilities. We establish the theoretical upper bound using a type elimination algorithm. We also provide a global caching algorithm that offers potential for practical reasoning
Magnetic vortex oscillator driven by dc spin-polarized current
Transfer of angular momentum from a spin-polarized current to a ferromagnet
provides an efficient means to control the dynamics of nanomagnets. A peculiar
consequence of this spin-torque, the ability to induce persistent oscillations
of a nanomagnet by applying a dc current, has previously been reported only for
spatially uniform nanomagnets. Here we demonstrate that a quintessentially
nonuniform magnetic structure, a magnetic vortex, isolated within a nanoscale
spin valve structure, can be excited into persistent microwave-frequency
oscillations by a spin-polarized dc current. Comparison to micromagnetic
simulations leads to identification of the oscillations with a precession of
the vortex core. The oscillations, which can be obtained in essentially zero
magnetic field, exhibit linewidths that can be narrower than 300 kHz, making
these highly compact spin-torque vortex oscillator devices potential candidates
for microwave signal-processing applications, and a powerful new tool for
fundamental studies of vortex dynamics in magnetic nanostructures.Comment: 14 pages, 4 figure
Empowerment and Parent Gain as Mediators and Moderators of Distress in Mothers of Children with Autism Spectrum Disorders
Mothers of children with Autism Spectrum Disorders (ASD) experience considerable amounts of distress and experiences of crisis. The Family Adjustment and Adaptation Response model provides a theory for understanding the experience of distress and family crisis in families, and the purpose of the present study was to examine experiences of distress in mothers of individuals with ASD using this framework. We specifically investigated how parent empowerment and positive gain are related to their experiences of distress, whether as mediators or as moderators of child aggression. Participants included 156 mothers of children with ASD ranging in age from 4 â 21 years. Mothers completed an online survey of demographics, problem behaviors, family empowerment, positive gain, and distress. We conducted path analyses of multiple mediation and moderation. Results indicated that greater child problem behavior was related to less parent empowerment, which was related to greater maternal distress, supporting empowerment as a partial mediator. At the same time, greater child aggression was not related to maternal distress in mothers who report high rates of positive gain, suggesting that parent gain functions as a moderator. The implications for how and when clinicians intervene with families of children with ASD are discussed
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