HIV-AIDS and social care

As the number of those with HIV-AIDS increases, an important concern is to understand the pattern and range of social care needs and how best these can be met. This paper relates to the report of a two-year project, funded jointly by the Department of Health (DH) and the Scottish Education Department (SED), and based at the Universities of Hull and York. The Hull-York study investigated, in brief, the range of HIV-AIDS generated demands for formal and informal social care; the nature of the delivery, management and coordination of that care; the development by Social Services Departments (SSDs) in England and Wales and Social Work Departments (SWDs) in Scotland of their patterns of provision; and the direct and indirect costs of social care for those with HIV-AIDS. The focus of this paper is the relationship between the demand for and the provision of social care for people with HIV-AIDS. Identification of the demand for social care and support services by people with HIV or AIDS provides the basis for assessing the appropriateness of HIV-AIDS service supply of local authorities and the voluntary sector. This paper outlines a supply framework that can be used to examine actual service provision and innovative practices in HIV-AIDS service supply and the resources required to meet service demands. Other aspects of the research will be explored in subsequent publications.HIV, AIDS, market

Brane Localization and Stabilization via Regional Physics

Extra-dimensional scenarios have become widespread among particle and gravitational theories of physics to address several outstanding problems, including cosmic acceleration, the weak hierarchy problem, and the quantization of gravity. In general, the topology and geometry of the full spacetime manifold will be non-trivial, even if our ordinary dimensions have the topology of their covering space. Most compact manifolds are inhomogeneous, even if they admit a homogeneous geometry, and it will be physically relevant where in the extra-dimensions one is located. In this letter, we explore the use of both local and global effects in a braneworld scenario to naturally provide position-dependent forces that determine and stabilize the location of a single brane. For illustrative purposes, we consider the 2-dimensional hyperbolic horn and the Euclidean cone as toy models of the extra-dimensional manifold, and add a brane wrapped around one of the two spatial dimensions. We calculate the total energy due to brane tension and bending (extrinsic curvature) as well as that due to the Casimir energy of a bulk scalar satisfying a Dirchlet boundary condition on the brane. From the competition of at least two of these effects there can exist a stable minimum of the effective potential for the brane location. However, on more generic spaces (on which more symmetries are broken) any one of these effects may be sufficient to stabilize the brane. We discuss this as an example of physics that is neither local nor global, but regional.Comment: 4 pages, 2 figures. PRL submitte

An interdisciplinary framework for measuring and supporting adherence in HIV prevention trials of ARV‐based vaginal rings

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138229/1/jia29158.pd

Accounts from developers of generic health state utility instruments explain why they produce different QALYs: a qualitative study

Purpose and setting: Despite the label generic health state utility instruments (HSUIs), empirical evidence shows that different HSUIs generate different estimates of Health-Related Quality of Life (HRQoL) in the same person. Once a HSUI is used to generate a QALY, the difference between HSUIs is often ignored, and decision-makers act as if \u27a QALY is a QALY is a QALY\u27. Complementing evidence that different generic HSUIs produce different empirical values, this study addresses an important gap by exploring how HSUIs differ, and processes that produced this difference. 15 developers of six generic HSUIs used for estimating the QOL component of QALYs: Quality of Well-Being (QWB) scale; 15 Dimension instrument (15D); Health Utilities Index (HUI); EuroQol EQ-5D; Short Form-6 Dimension (SF-6D), and the Assessment of Quality of Life (AQoL) were interviewed in 2012-2013. Principal findings: We identified key factors involved in shaping each instrument, and the rationale for similarities and differences across measures. While HSUIs have a common purpose, they are distinctly discrete constructs. Developers recalled complex developmental processes, grounded in unique histories, and these backgrounds help to explain different pathways taken at key decision points during the HSUI development. The basis for the HSUIs was commonly not equivalent conceptually: differently valued concepts and goals drove instrument design and development, according to each HSUI\u27s defined purpose. Developers drew from different sources of knowledge to develop their measure depending on their conceptualisation of HRQoL. Major conclusions/contribution to knowledge: We generated and analysed first-hand accounts of the development of the HSUIs to provide insight, beyond face value, about how and why such instruments differ. Findings enhance our understanding of why the six instruments developed the way they did, from the perspective of key developers of those instruments. Importantly, we provide additional, original explanation for why a QALY is not a QALY is not a QALY

Cosmological solutions of massive gravity on de Sitter

In the framework of the recently proposed models of massive gravity, defined with respect to a de Sitter reference metric, we obtain new homogeneous and isotropic solutions for arbitrary cosmological matter and arbitrary spatial curvature. These solutions can be classified into three branches. In the first two, the massive gravity terms behave like a cosmological constant. In the third branch, the massive gravity effects can be described by a time evolving effective fluid with rather remarkable features, including the property to behave as a cosmological constant at late time.Comment: 6 pages, 1 figure; discussion extended, a few references added, improved analysis in Section

Real-time target alignment system for high-power high-repetition rate laser operations using a five degree-of-freedom hybrid mechanism

This paper presents a real-time position control solution for the targets used in the high-repetition rate laser operations of large-scale high-power laser facilities. The design of the control system is based on an Abbe-compliant, in-process position measurement system of targets, employing a plane mirror interferometer and a five degree-of-freedom hybrid mechanism. An error model has been developed to characterise the position feedback information of the target in a high-repetition rate process to determine the effects of the non-collocation of the interferometer's measurement point and target on the control system's performance-a challenge for the real-time position control of targets. The behaviour of the control system is investigated with the error model and experimental data. It was found that the controller's position compensation scheme can be ineffective due to erroneous position feedback for the non-linear position information representing the non-collocated measurement point and the actual target. To solve the problem, an angular compensation technique is proposed for high-accuracy, real-time position and orientation control of the targets for high-repetition rate processes. The findings of this paper are valid for wider precision applications, e.g. motion control systems requiring highly accurate end-effector position control

Curvature perturbations from ekpyrotic collapse with multiple fields

A scale-invariant spectrum of isocurvature perturbations is generated during collapse in the ekpyrotic scaling solution in models where multiple fields have steep negative exponential potentials. The scale invariance of the spectrum is realized by a tachyonic instability in the isocurvature field. This instability drives the scaling solution to the late time attractor that is the old ekpyrotic collapse dominated by a single field. We show that the transition from the scaling solution to the single field dominated ekpyrotic collapse automatically converts the initial isocurvature perturbations about the scaling solution to comoving curvature perturbations about the late-time attractor. The final amplitude of the comoving curvature perturbation is determined by the Hubble scale at the transition.Comment: 15 pages, 3 figures, a reference added, to be published in CQG, a remark on the comoving density perturbation correcte