Association of HIV Testing, Educational Attainment, and Age Among Black and Non-Black Men

Human Immunodeficiency Virus (HIV) infection can lead to a chronic condition, Acquired Immunodeficiency Syndrome (AIDS), but can be well managed with a combination of medications, treatments, and remedies.1 The emergence of HIV in the United States in 1981 created an atmosphere unlike any other at that time. Overtime, the science community has worked diligently to combat this disease through research, practice, and intervention. Although many efforts have been put forth over the past thirty years, millions of Americans still remain infected with HIV.2 Among those who are infected with HIV/AIDS we see disproportionate rates among specific races and gender. Research shows that nearly 75% of all HIV/AIDS cases in the United States are among men, more specifically Black men who have sex with men (MSM).2 Additionally, we see a disproportionate amount of Black and African American individuals becoming infected with HIV year after year.3 African Americans represent around 12% of the national population, but represent nearly 45% of all new HIV infections across the United States.3 In 2010, the U.S. government issued the first National Strategy for HIV/AIDS in the United States. Several approaches to the reduction of HIV are discussed in the strategic plan, including the recommendation of those at risk of infection to be tested annually and know their status.2 The Centers for Disease Control and Prevention (CDC) recommends that everyone between the ages of 13 and 64 get tested at least once as part of a routine healthcare check up from their regular provider.4 Unfortunately, nearly one in five people in the United States who have HIV do not know they are infected. These people unknowingly contribute to the spread of HIV.4 Unfortunately, many issues still remain with HIV vaccine research.5 According to researchers, there are many biological HIV and Education 3 components to the virus that make it extremely difficult to vaccinate against HIV, but are hopeful that there will be a vaccine in the future.5 Since a vaccination for HIV is unlikely in the near future, HIV testing remains a critical part of preventative sexual health.2,4,5 Education plays a significant role in the adherence to an overall healthy lifestyle. Researchers often take into account an individual’s education level and how education impacts one’s risk for contracting disease. Researchers have shown that low literacy has a strong tie to multiple adverse health outcomes.6 Applying this idea about health behavior outcomes and education level to HIV testing is more difficult, however. Increasing HIV testing in individuals remains a mutli-factorial issue. Stigma, education, and age all play a part in increasing the rates of testing each year.2.4 The information from the U.S. National HIV/AIDS Strategy as well as the recommendations from the CDC allow us to assume that obtaining a test for HIV is a preventative and healthy choice 2,4 Applying this idea of education and health outcomes to HIV testing, one would anticipate that the higher level of education one has then the more likely one would be to obtain a test for HIV as well as other sexually transmitted diseases. The study attempted to answer if an individual’s educational attainment and age impact the obtainment of HIV testing services. We hypothesized that individuals with higher education levels and age would be more likely to obtain HIV testing services. Although there are multiple studies that have previously explored the association of HIV testing rates and general educational attainment among women, there is a lack of research in this specific area on men in the United States. Exploring the literature allows you to perceive an obvious gap in this area. Previous studies are limited to studying HIV and Education 4 women in foreign nations, but it is important to note that each study echoes the hypothesis for this study of men in the United States. One study of a group of women in Kenya, Zambia and Zimbabwe revealed that there was an increase of HIV testing rates among women who had higher levels of education.7 An additional study, taking place in Northeast China, revealed that there was an increase in willingness to accept HIV testing, however, multiple factors influenced one’s willingness—including age, location, and education.8 This study will explore the association of HIV testing, educational attainment, and age among Black and Non-Black men ages of 15 and 44 using nationally representative data from the National Survey of Family Growth between year 2006 and 2010 (Figure 1)

Lexical and Discourse Analysis of Online Chat Dialog

One of the ultimate goals of natural language processing (NLP) systems is understanding the meaning of what is being transmitted, irrespective of the medium (e.g., written versus spoken) or the form (e.g., static documents versus dynamic dialogues). Although much work has been done in traditional language domains such as speech and static written text, little has yet been done in the newer communication domains enabled by the Internet, e.g., online chat and instant messaging. This is in part due to the fact that there are no annotated chat corpora available to the broader research community. The purpose of this research is to build a chat corpus, tagged with lexical (token part-of-speech labels), syntactic (post parse tree), and discourse (post classification) information. Such a corpus can then be used to develop more complex, statistical-based NLP applications that perform tasks such as author profiling, entity identification, and social network analysis

From Old Labour to New Labour: a comment on Rubinstein

In a critique of our book New Labour, David Rubinstein has argued that we exaggerate the degree of difference between Old and New Labour and underplay the similarities. In this article we agree with many of the continuities that Rubinstein outlines. However, we argue that he himself gives plenty of evidence in favour of our thesis that change has been marked in many policy areas. We argue that we give a good account of the wider social factors that he says accounts for such change. In this article we offer a restatement of the view that New Labour offers a `post-Thatcherite politics. New Labour breaks both with post-war social democracy and with Thatcherism

Improving the annual review of diabetic patients in primary care: an appreciative inquiry in the Cape Town District Health Services

Background: Diabetes in a common chronic disease in the Cape Town District Health Services and yet an audit of diabetic care demonstrated serious deficiencies in the quality of care. The Metro District Health Services (MDHS) decided to focus on improving the annual review of the diabetic patient. The MDHS provides primary care to the uninsured population of Cape Town through a network of 45 Community Health Centres (CHC). Methods: An appreciative inquiry was established amongst the staff responsible for diabetic care at the 15 CHCs that had newly appointed facility managers. The inquiry completed three cycles of action-reflection over a period of one year and included training in clinical skills as requested by the participants. At the end of the inquiry a consensus was reached on the learning of the group. Results: This consensus was expressed in the form of 11 key themes. CHCs that reported success with improving the annual review formed chronic care teams that met regularly to discuss their goals, roles and to plan improvements. These teams developed more structured and systematic approaches to care, which included the creation of special clubs, attention to the steps in patient flow and methods of summarising and accessing key information. These teams also appointed specific champions who would not rotate to other duties and who would provide continuity of leadership and organisation. These teams also supported continuity of relationships, clinical management and organisation of care. Teams involved the community and local non-profit organisations, particularly in the establishment of support groups that could disseminate medications and build health literacy and self-efficacy. Some teams emphasised the need to also care for the carers and to not just focus on workload and output indicators. More successful CHCs also grappled with balancing of the workload, quality of care and waiting times in a way that improved all three in an upward spiral. Patient satisfaction, staff satisfaction and clinical outcomes were seen as interlinked' There was a need to plan methods for empowering patients and build self-efficacy through a variety of facility- and community-based as well as individual- and group-orientated initiatives. Training in clinical skills was requested for foot and eye screening. Feedback was given to the MDHS on the need to improve referral pathways and access to preventative services such as dieticians, podiatrists and vascular surgery. Finally, the inquiry process itself together with the annual audit supported organisational learning and change at the facility level. Conclusion: Improving the annual review has more to do with the organisation of care than gaps in knowledge or skills that can be addressed through training. While such gaps do exist, as shown by the training around foot screening, the main focus was on issues of leadership, teamwork, systematic organisation, continuity, staff satisfaction, motivation and the balancing of quality care provided, quantity of care demanded and queuing required. The appreciative inquiry (Al) process supported decentralised organisational learning and, while key themes were shared, the specific solutions were localised

Improving the annual review of diabetic patients in primary care: an appreciative inquiry in the Cape Town District Health Services

Background: Diabetes in a common chronic disease in the Cape Town District Health Services and yet an audit of diabetic care demonstrated serious deficiencies in the quality of care. The Metro District Health Services (MDHS) decided to focus on improving the annual review of the diabetic patient. The MDHS provides primary care to the uninsured population of Cape Town through a network of 45 Community Health Centres (CHC). Methods: An appreciative inquiry was established amongst the staff responsible for diabetic care at the 15 CHCs that had newly appointed facility managers. The inquiry completed three cycles of action-reflection over a period of one year and included training in clinical skills as requested by the participants. At the end of the inquiry a consensus was reached on the learning of the group. Results: This consensus was expressed in the form of 11 key themes. CHCs that reported success with improving the annual review formed chronic care teams that met regularly to discuss their goals, roles and to plan improvements. These teams developed more structured and systematic approaches to care, which included the creation of special clubs, attention to the steps in patient flow and methods of summarising and accessing key information. These teams also appointed specific champions who would not rotate to other duties and who would provide continuity of leadership and organisation. These teams also supported continuity of relationships, clinical management and organisation of care. Teams involved the community and local non-profit organisations, particularly in the establishment of support groups that could disseminate medications and build health literacy and self-efficacy. Some teams emphasised the need to also care for the carers and to not just focus on workload and output indicators. More successful CHCs also grappled with balancing of the workload, quality of care and waiting times in a way that improved all three in an upward spiral. Patient satisfaction, staff satisfaction and clinical outcomes were seen as interlinked' There was a need to plan methods for empowering patients and build self-efficacy through a variety of facility- and community-based as well as individual- and group-orientated initiatives. Training in clinical skills was requested for foot and eye screening. Feedback was given to the MDHS on the need to improve referral pathways and access to preventative services such as dieticians, podiatrists and vascular surgery. Finally, the inquiry process itself together with the annual audit supported organisational learning and change at the facility level. Conclusion: Improving the annual review has more to do with the organisation of care than gaps in knowledge or skills that can be addressed through training. While such gaps do exist, as shown by the training around foot screening, the main focus was on issues of leadership, teamwork, systematic organisation, continuity, staff satisfaction, motivation and the balancing of quality care provided, quantity of care demanded and queuing required. The appreciative inquiry (Al) process supported decentralised organisational learning and, while key themes were shared, the specific solutions were localised

Is the Bombali virus pathogenic in humans?

Motivation: The potential of the Bombali virus, a novel Ebolavirus, to cause disease in humans remains unknown. We have previously identified potential determinants of Ebolavirus pathogenicity in humans by analysing the amino acid positions that are differentially conserved (specificity 15 determining positions; SDPs) between human pathogenic Ebolaviruses and the non-pathogenic Reston virus. Here, we include the many Ebolavirus genome sequences that have since become available into our analysis and investigate the amino acid sequence of the Bombali virus proteins at the SDPs that discriminate between human pathogenic and non-human pathogenic Ebolaviruses. 20 Results: The use of 1408 Ebolavirus genomes (196 in the original analysis) resulted in a set of 166 SDPs (reduced from 180), 146 (88%) of which were retained from the original analysis. This indicates the robustness of our approach and refines the set of SDPs that distinguish human pathogenic Ebolaviruses from Reston virus. At SDPs, Bombali virus shared the majority of amino acids with the human pathogenic Ebolaviruses (63.25%). However, for two SDPs in VP24 (M136L, R139S) 25 that have been proposed to be critical for the lack of Reston virus human pathogenicity because they alter the VP24-karyopherin interaction, the Bombali virus amino acids match those of Reston virus. Thus, Bombali virus may not be pathogenic in humans. Supporting this, no Bombali virusassociated disease outbreaks have been reported, although Bombali virus was isolated from fruit bats cohabitating in close contact with humans, and anti-Ebolavirus antibodies that may indicate 30 contact with Bombali virus have been detected in humans

Comprehensive assessment of a peer mentor program for first-year students

College students who engage in first-year programs such as peer mentorship are correlated with higher achievement. Peer mentorship can also have a significant impact on students\u27 feelings of belonging to their campus community. This mixed-methods study will provide a comprehensive assessment of a Class Leader (CL) program. Data will include first-semester outcomes (i.e., first-term GPA; retention) for all students (N ~ 1850) and first-generation students as compared to non-participants, survey responses (n ~ 471) about students\u27 experiences with CLs and perceptions related to the program, and focus group data from students, CLs, and instructors at the end of the semester

The Asymptotic Giant Branches of GCs: Selective Entry Only

The handful of available observations of AGB stars in Galactic Globular Clusters suggest that the GC AGB populations are dominated by cyanogen-weak stars. This contrasts strongly with the distributions in the RGB (and other) populations, which generally show a 50:50 bimodality in CN band strength. If it is true that the AGB populations show very different distributions then it presents a serious problem for low mass stellar evolution theory, since such a surface abundance change going from the RGB to AGB is not predicted by stellar models. However this is only a tentative conclusion, since it is based on very small AGB sample sizes. To test whether this problem really exists we have carried out an observational campaign specifically targeting AGB stars in GCs. We have obtained medium resolution spectra for about 250 AGB stars across 9 Galactic GCs using the multi-object spectrograph on the AAT (2df/AAOmega). We present some of the preliminary findings of the study for the second parameter trio of GCs: NGC 288, NGC 362 and NGC 1851. The results indeed show that there is a deficiency of stars with strong CN bands on the AGB. To confirm that this phenomenon is robust and not just confined to CN band strengths and their vagaries, we have made observations using FLAMES/VLT to measure elemental abundances for NGC 6752.We present some initial results from this study also. Our sodium abundance results show conclusively that only a subset of stars in GCs experience the AGB phase of evolution. This is the first direct, concrete confirmation of the phenomenon.Comment: 4 pages, to appear in conference proceedings of "Reading the book of globular clusters with the lens of stellar evolution", Rome, 26-28 November 201

Protocol for a randomized controlled trial examining multilevel prediction of response to behavioral activation and exposure-based therapy for generalized anxiety disorder.

BACKGROUND:Only 40-60% of patients with generalized anxiety disorder experience long-lasting improvement with gold standard psychosocial interventions. Identifying neurobehavioral factors that predict treatment success might provide specific targets for more individualized interventions, fostering more optimal outcomes and bringing us closer to the goal of "personalized medicine." Research suggests that reward and threat processing (approach/avoidance behavior) and cognitive control may be important for understanding anxiety and comorbid depressive disorders and may have relevance to treatment outcomes. This study was designed to determine whether approach-avoidance behaviors and associated neural responses moderate treatment response to exposure-based versus behavioral activation therapy for generalized anxiety disorder. METHODS/DESIGN:We are conducting a randomized controlled trial involving two 10-week group-based interventions: exposure-based therapy or behavioral activation therapy. These interventions focus on specific and unique aspects of threat and reward processing, respectively. Prior to and after treatment, participants are interviewed and undergo behavioral, biomarker, and neuroimaging assessments, with a focus on approach and avoidance processing and decision-making. Primary analyses will use mixed models to examine whether hypothesized approach, avoidance, and conflict arbitration behaviors and associated neural responses at baseline moderate symptom change with treatment, as assessed using the Generalized Anxiety Disorder-7 item scale. Exploratory analyses will examine additional potential treatment moderators and use data reduction and machine learning methods. DISCUSSION:This protocol provides a framework for how studies may be designed to move the field toward neuroscience-informed and personalized psychosocial treatments. The results of this trial will have implications for approach-avoidance processing in generalized anxiety disorder, relationships between levels of analysis (i.e., behavioral, neural), and predictors of behavioral therapy outcome. TRIAL REGISTRATION:The study was retrospectively registered within 21 days of first participant enrollment in accordance with FDAAA 801 with ClinicalTrials.gov, NCT02807480. Registered on June 21, 2016, before results

Weighted norm inequalities, off-diagonal estimates and elliptic operators. Part IV: Riesz transforms on manifolds and weights

This is the fourth article of our series. Here, we study weighted norm inequalities for the Riesz transform of the Laplace-Beltrami operator on Riemannian manifolds and of subelliptic sum of squares on Lie groups, under the doubling volume property and Gaussian upper bounds.Comment: 12 pages. Fourth of 4 papers. Important revision: improvement of main result by eliminating use of Poincar\'e inequalities replaced by the weaker Gaussian keat kernel bound