AIDS prevention : sexual ethics and responsibility

Do people infected with the human immunodeficiency virus (HIV) have special responsibilities to their sexual partners? If so, what do these responsibilities involve? Merely raising these questions directly has tended, until recently, to disquiet many people involved in AIDS-prevention efforts

Changing the paradigm for HIV testing : the end of exceptionalism

The Centers for Disease Control and Prevention (CDC) is poised to issue new recommendations for testing for HIV in adults, adolescents, and pregnant women. Frustrated that more than 25 percent of Americans with HIV infection are unaware of their status and that almost 40 percent of those with newly diagnosed AIDS discover that they are infected less than a year before diagnosis, officials have proposed that HIV screening be routinely offered in all health care settings. The CDC already recommends routine testing among high-risk groups and in high-prevalence settings. The radical departure is the extension of routine testing to the entire population and the reconceptualization of the requirements for consent. Patients would be told that HIV testing was a routine part of care and given the opportunity to opt out. According to the CDC, specific signed consent would no longer be required, because “general consent for medical care is sufficient to encompass consent for HIV testing.

Tell It Slant: Sex, Disclosure, and HIV

Encounters with HIV can tell us much about how we as individuals communicate about and view our bodies and most intimate selves—how we view and approach truth, lies, sex, and trust. Better ways of handling issues of disclosure in conjunction with changed sexual practices can be crucial to thwarting the HIV pandemic. We interviewed in depth 59 HIV-infected and 18 uninfected gay, bisexual, and heterosexual men and women. Five strategies emerged for dealing with disclosure and safer sex. Clinicians and policymakers need to be as aware and sensitive as possible to the perspectives of men and women grappling with these issues

HIV Antibody Screening: An Ethical Framework for Evaluating Proposed Programs

The acquired immunodeficiency syndrome (AIDS) poses a compelling ethical challenge to medicine, science, public health, the legal system, and our political democracy. This report focuses on one aspect of that challenge: the use of blood tests to identify individuals who have been infected with the retrovirus human immunodeficiency virus (HIV). In this article, we follow the terminology recently proposed by the International Committee on the Taxonomy of Viruses; that is, we use the term human immunodeficiency virus. This replaces the more cumbersome dual terminology of human T-cell lymphotropic virus type III/lymphadenopathy-associated virus (HTLV-III/LAV). The issue is urgent: the tests are already in use and plans to implement them much more broadly are being proposed. The issue is also complex: at stake is a potential conflict between the community\u27s interests in stopping the spread of a devastating disease and in preserving important values of individual liberty and equal rights

Adaptive Learning in Weighted Network Games

This paper studies adaptive learning in the class of weighted network games. This class of games includes applications like research and development within interlinked firms, crime within social networks, the economics of pollution, and defense expenditures within allied nations. We show that for every weighted network game, the set of pure Nash equilibria is non-empty and, generically, finite. Pairs of players are shown to have jointly profitable deviations from interior Nash equilibria. If all interaction weights are either non-negative or non-positive, then Nash equilibria are Pareto inefficient. We show that quite general learning processes converge to a Nash equilibrium of a weighted network game if every player updates with some regularity

Flexible Office: Assignment of Office Space to Enhance Knowledge Work Productivity

Abstract: Even though knowledge management has been around for more than a decade, so far concrete instruments that can be systematically deployed are still rare. This paper presents an optimization solution targeted at flexible management of office space considering knowledge management criteria in order to enhance knowledge work productivity. The paper presents the Flexible Office conceptual model and optimization solution and discusses the theoretical foundation, assumptions and reasoning. A corresponding prototype was field-tested, successfully introduced, evaluated with the help of a series of interviews with users and improved according to their requirements. The paper also reflects on the organisational impact and lessons learned from field test and practical experience

The Cool Little Kids randomised controlled trial: Population-level early prevention for anxiety disorders

Background: The World Health Organization predicts that by 2030 internalising problems (e.g. depression and anxiety) will be second only to HIV/AIDS in international burden of disease. Internalising problems affect 1 in 7 school aged children, impacting on peer relations, school engagement, and later mental health, relationships and employment. The development of early childhood prevention for internalising problems is in its infancy. The current study follows two successful &lsquo;efficacy&rsquo; trials of a parenting group intervention to reduce internalising disorders in temperamentally inhibited preschool children. Cool Little Kids is a population-level randomised trial to determine the impacts of systematically screening preschoolers for inhibition then offering a parenting group intervention, on child internalising problems and economic costs at school entry.Methods/Design: This randomised trial will be conducted within the preschool service system, attended by more than 95% of Australian children in the year before starting school. In early 2011, preschool services in four local government areas in Melbourne, Australia, will distribute the screening tool. The &asymp;16% (n&asymp;500) with temperamental inhibition will enter the trial. Intervention parents will be offered Cool Little Kids, a 6-session group program in the local community, focusing on ways to develop their child&rsquo;s bravery skills by reducing overprotective parenting interactions. Outcomes one and two years post-baseline will comprise child internalising diagnoses and symptoms, parenting interactions, and parent wellbeing. An economic evaluation (costconsequences framework) will compare incremental differences in costs of the intervention versus control children to incremental differences in outcomes, from a societal perspective. Analyses will use the intention-to-treat principle, using logistic and linear regression models (binary and continuous outcomes respectively) to compare outcomes between the trial arms.Discussion: This trial addresses gaps for internalising problems identified in the 2004 World Health Organization Prevention of Mental Disorders report. If effective and cost-effective, the intervention could readily be applied at a population level. Governments consider mental health to be a priority, enhancing the likelihood that an effective early prevention program would be adopted in Australia and internationally.<br /