Acute Human Immunodeficiency Virus ( Hiv ) Infection

Acute Human Immunodeficiency Virus ( Hiv ) Infection
Acute Human Immunodeficiency Virus (HIV) infection is the small period of time after a person has
been exposed to HIV and before they have seroconverted. Seroconversion is the process in which
the body starts to create antibodies to fight the HIV virus (Pietrangelo, 2013). During this period of
time, which is usually a few days, the virus replicates rapidly. The rapid replication results in
extremely high amounts of HIV in the blood because the body has not had time to respond to the
infection. As the viral load increases more CD4 white cells are destroyed. CD4 cells are a
responsible in protecting the body from infection. When these cells are destroyed they no longer are
able to adequately activate the body 's immune system. (AIDS.GOV). ... Show more content on
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Signs/symptoms of Acute HIV Infection Including H&P
Not all patients with HIV will have signs or symptoms during the acute infection phase. If a patient
is having symptoms they can often times think that they have the flu. Acute HIV infection
symptoms can show up 2–4 weeks after exposure and last from a few days to several weeks
(Cherney, 2014). If they are exhibiting symptoms they may present as having a fever, swollen lymph
nodes, skin rashes, myalgia, diarrhea, oral ulcers or thrush, and fatigue. Lab results may also show
leukopenia, thrombocytopenia, or an elevation in transaminase (DHHS, 2015). Differential
diagnoses include the flu or Epstein– Barr Virus since these also present with similar symptoms.
A thorough health history must be taken with patients before an exam in order to identify risk
behavior. Important things to ask about are sexual history, partners and possible exposures, any drug
use (especially intravenously), and any current STI's (HRSA, 2014). Upon physical exam things to
look for or may see with an acute HIV infection would be ecchymosis, purpura, petechiae, Kaposi
sarcoma, lymphadenopathy, oral candidiasis, or hepatosplenomegaly (Aberg et al., 2014).
Cultural Implications The numbers of new HIV infections per year has remained relatively the same
since the 1990's (CDC, 2015). Out of
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Hiv Viral Suppression Of More Than 200 Copies / Ml Of...
Although a HIV viral suppression of less than 200 copies/mL of blood is not the gold standard at
most sites. the rate is measured via the same definition across HHS agencies and programs. This
includes HRSA and its HAB (2015) under which the RWHAP Part C falls, the Centers for Disease
Control and Prevention, and CMS through "Medicaid, Medicare Physician Quality Reporting
System, Physician Feedback/Quality and Resource Use Reports, [and a] Physician Value–Based
Payment Modifier" (National Quality Forum [NQF], n.d.). All 360 RWHAP Part C sites report their
HIV viral suppression rates using the endorsed NQF (2013) indicator described in table one below.
The indicator was initially endorsed by the NQF as a paper measure. The HRSA ... Show more
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287). Therefore, nurse practitioners should be ever mindul of root causes. Below are possible root
causes for unsuppresed HIV viral loads by patient, provider, and system.
Patients:
May be depressed and unmotivated to take a pill a day; later experiencing pill fatigue. The
depression and lack of motivation can come from the stigma the patient feels, unstable housing, fear
of disclosure, taking medication every day, and death.
May not like taking pills, even once a day, as it is a reminder of the virus that patients choose to
block. Patients, especially youth, may feel friends and family will disassociate from them if they
find out they are taking antiretrovirals out of fear or hatred.
May experience unwanted side effects they were not aware may occur because they were to afraid to
ask the provider about the medication side effects and interference with other medications; not really
wanting to know or not wanting to dissapoint persons they perceive to hold positions of power.
May forget to take their medications because they are depressed because of homeless, using drugs to
hide the pain, lack self–confidence, or working several jobs to pay the bills.
Providers:
May not be building rapport with their patients because they didn't learn emotional intelligence; may
themselves feel

The Oraquick In-Home HIV Test System
testing programs. The Home Access HIV–1 Test System is a home kit that implicates a person's
finger being pricked for a sample of their blood, after the blood is sent to the lab for testing the
results would be available on the next available business day. If the results are positive the lab is
required to do follow up testing on the blood sample to confirm if the initial HIV result was
accurate. The second type of at home HIV testing is the OraQuick In–Home HIV Test, which is used
with a swab stick and tube to keep the sample and testing solution. The test is used by passing a
cotton swab attached to the stick on the side of the person's cheek to get an analysis of their oral
fluids. Results generally take twenty minutes to be ready. Any time ... Show more content on
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Thanks to better preventative measures and understanding of the infection, the life expectancy of
people living with HIV is now longer then ever. There is a better quality of life for people who are
infected because of the medications and treatment processes. In the article "Changing Trends in
Complications and Mortality Rates Among US Youth and Young adults With HIV Infection in the
Era of Combination Antiretroviral Therapy" ,Mirani ,Williams and Chernoff create an awareness of
complications and mortality rates in youth who have HIV in correlation with the decrease of using
Combination Antiretroviral Therapy (CART). The key question the authors are addressing is if the
HIV infection and long–term CART create new challenges for the infected youth. The main
prediction that the authors had throughout the study was that there would be underlying issues with
chronic infection and age related problems. The data was conducted between 2001 and 2007, 1201.
The study compared death of an HIV infected youth with pregnancy complications. What was found
was that the young and young adult survivors are now dealing with problems way worse which are
associated with HIV, a more chronic HIV which causes long term complications, such as poor bone
health. The authors also observed that there were very high rates of genital tract infections, which
are abnormal and can vastly increase rate of

English 302 Knowledge Report
ENGLISH 302 M29 & M30 – ADVANCED COMPOSITION
Kellie Gray
Spring 2017, Online
Project One: Knowledge Report
Nationally Specific Attitudes of Dental Students towards HIV–Infected Patients by Hossein Taheri
Introduction This study began with a perusal of the American Dental Association's website, ADA
Library and Archives index. Numerous articles on the subject of dentistry and HIV popped up, and I
followed their tracking of the need for research in the area. I engage, both socially and academically,
an international student body and the subject of HIV comes up often with a range of reactions,
particularly from the dental students who are becoming aware that it is an issue with which they
must become familiar.
Knowledge sharing in the field of ... Show more content on Helpwriting.net ...
Those White students who had a greater number of sexual partners, and those White students with
more positive HIV testing attitudes "were significant predictors of HIV testing among White
students" (2016). The study found that the older the student and personal sexual history were also
significant predictors of HIV testing for both groups. "There were no significant differences between
groups in number of sexual partners or self–reports in history of sexual experience (oral, vaginal, or
anal)" (2016). The study concluded that racial differences were a significant factor in predicting
attitudes towards HIV–infected

Essay on The Controversy Over HIV/AIDS Disclosure Law
Abstract
Forty million people worldwide are infected with the HIV virus. About six percent of them will not
inform their intimate partners about their health condition. Many efforts that have been made over
the past decade towards establishing a HIV/AIDS law, have finally paid off. The act of disclosing
the virus was written in 1990. It caused quite a stir among the citizens of the United States. Many
people concluded that there were holes in the disclosure law concerning HIV/AIDS because it
lacked complete thought. Some felt that if HIV positive people had to tell others about their
condition, they would be more susceptible to discrimination and rejection. Essentially, it was a law
that ended a few problems and then led to a massive ... Show more content on Helpwriting.net ...
The California Department of Health Services had written a section of their California HIV/AIDS
Law titled, "Exposing Another Person to HIV". The fact that the infected individual has to be aware
of their HIV status and inform his/her partner is very blunt and straight forward; although, the third
part of the law dealing with the intent to purposely infect a healthy individual
HIV/AIDS Disclosure Law 2 remains obscure. In most situations it is difficult to know exactly what
the suspect was thinking at the moment. This leads to an inconclusive verdict. A similar example
was seen in the case of Kanengele–Yondjo in 2003. He was accused of spreading the HIV disease to
two females without telling them that he was HIV positive. Rather than fifty years in jail, he was
sentenced to fourteen years. The reason why the sentence was shorter than planned was because it
was difficult to prove he had intentionally spread the disease, considering that he slept with several
other women who did not get infected. (Wallace, 2004) Either way, there is no legislation which
specifically makes knowing the possibility of spreading the disease, without the intention to do so, a
crime. The purpose of the current law is for the health and safety of society, but the absence of
minute details is a potential weapon that has caused an argument among people who are infected
and those who are not. (Wallace, 2004)
The HIV/AIDS Law also causes some controversial issues with today's

Hiv Essay
Imagine a world where an innocent child is given HIV due to mother to child transmission. Imagine
a world where a father cannot play football on an autumn's afternoon with his son because he
constantly feels a lack of energy. Imagine a world where for months straight one has a reoccurring
yeast infection. And lastly, imagine a world where one cannot remember one's very own mother's
name due to short term memory loss. Unfortunately, there is no need to imagine for all of the above
are actual possibilities when living with Human Immunodeficiency Virus. What is HIV? According
to www.aids.gov Human Immunodeficiency Virus is "a lot like other viruses, including those that
cause the flu or the common cold. But there is an important ... Show more content on
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In the survey, questions were asked about the participant's financial income, practice of safe sex and
were given HIV tests. The results showed that "HIV was detected in 2.4 percent of the people who
were living below the federal poverty line, which in 2007 was an annual income of roughly $10,000
or less for an individual. The 2.4 percent translates to roughly 1 in 42 people" which is substantially
higher than the national average, which is "0.45 percent, or 1 in 222 people." Therefore, it is safe to
say socioeconomic status increases one's risk of contracting Human Immunodeficiency Virus.
Unlike other diseases there is not a cure for HIV therefore possessing HIV prompts many issues.
The primary issue that is parallel to socioeconomic disadvantaged communities regarding HIV is the
lack of finances to get tested for HIV and other STDs. According to costhelper.com on average a test
of 7 to 10 STDs including HIV can range from $300 to $400. Prices as such make getting tested
very difficult and nearly impossible for those living under the poverty line. In a community where
healthcare insurance and medical treatment cannot be afforded the spread of such disease through
sexual partners or through mother–to–child transmission is increased dramatically due to late
detection of the disease because of lack of finances.
HIV prevention in socioeconomic disadvantaged discourse communities struck my interest.
Personally I believe that healthcare is not a luxury or a

Effects Of Reduction Of HIV
Reduction of HIV through PrEP on African American MSM
Introduction Sexual Transmitted Infections' (STI) are a significant health problem worldwide despite
being neglected from the stigma and taboo associated with it. There are over 25 diseases that can be
transmitted through sexual activity. Many STIs are unnoticeable as a result of the symptoms being
asymptomatic and the stigma that is attached to getting an STI would discourage an individual from
getting treatment. These infections could lead to a range of symptoms from painless ulcer to
stillbirth and ultimately leading to death. Populations who are at high risk of getting an STI are
minorities, youth and adolescence, women, and sex workers. Amongst the 25 diseases includes the
Human ... Show more content on Helpwriting.net ...
Some factors that could lead to an increase risk in exposure to HIV are the already high prevalence
of HIV, lack of knowledge of HIV status, discrimination, and substance abuse.
Description of selected STI
Human immunodeficiency Virus (HIV) is one of the most common STI seen in the world today [1].
HIV is a virus. HIV virus spreads across body fluids and it attacks the immune system such as CD4
cells or more commonly known as T–cells. There are three stages of HIV infection and it can only
be detected if an individual get tested. If HIV is left untreated, it would weaken the immune system,
resulting in an inability for our body to fight against other infections and diseases [2]. HIV disease is
a major health issue worldwide with 36.7 million people living with HIV [3]. In 2014, the total
number of people living with HIV in the United States is 955,081 and the rate is 299 per 100,000
population. The prevalence of this disease in the United States at the end of 2014, is around 1.1
million people above the age of 13. In 2014, the incidence of HIV infections in the United States
were 37,600 [4]. In 2015, the highest number of highest diagnoses is 17,670 cases in the African
American race [5]. In the United States, HIV mainly spreads by having sex or by sharing syringes
with a person who is already infected with HIV [6].It is important to intervene HIV in

What Additional Confirmatory Tests Should Be Done?
1. If HIV–seropositivity is detected, what additional confirmatory tests should be done? List 3 tests
and describe their principle.
Western blotting – In Western blotting first, the macromolecules have to be separated via gel
electrophoresis. The molecules now separated by electrophoresis are blotted onto either a
nitrocellulose or a polyvinylidene difluoride (PVDF) membrane (a second matrix). To inhibit the
binding of nonspecific antibodies to the membrane surface it is subsequently blocked. Then a
complex is formed (a probe) from the protein that was transferred and an enzyme linked with an
antibody. The enzyme is supplied a substrate then the 2 together should create a product e.g.
chromogenic precipitate that can be detected. Detection methods with most sensitivity use
chemiluminescent substrate because light is a by–product of the reaction between the substrate and
the enzyme. The output of the light can be measured using a CCD camera or on the other hand,
antibodies that have been tagged with fluorescents that are detected with a fluorescence imaging
system can be used (Thermo–Fisher Scientific 2015).
Real–time PCR – In RT PCR fluorescent markers are added to the components of the PCR to help
monitor the reaction in real–time. During the reaction, the fluorescent markers exhibit a signal that
is relative to the quantity of DNA or RNA that is amplified. Probes or primers (are sequence–
specific) that can bind with DNA are fluorescently labelled and used in RT PCR.

Hiv / Aids And Aids
Introduction
The African continent represents 12% of the worlds population, but Sub–Saharan Africa
disproportionately represents nearly 70% of the worlds HIV cases (1). Within that, it has been
estimated that there are 6.1 million people living with HIV/AIDS in South Africa, which is the
highest number from any country in the world (2), and represents 17% of the global burden of HIV
infection (3).
HAART has been the mainstay of treatment for HIV in industrialised countries since the 1990's (4).
Since its widespread introduction, it has changed the course of the epidemic dramatically and
improved survival and quality of life of people living with HIV/AIDS (5). HAART consists of three
different antiretroviral drugs, given in combination.
In 2013 the World Health Organisation (WHO) released its updated guidelines for the use of
HAART in HIV/AIDS (Appendix 1), providing recommendations for policy and decision makers
for more widespread use of HAART (6). These guidelines also raised the recommended threshold
for initiation of HAART from CD4<350cells/mm3 to CD4<500cells/mm3 in asymptomatic patients
(6), with a note that priority for starting treatment still remained with individuals with lower CD4
counts (<350cells/mm3). Despite this continuing expansion of HAART eligibility, uptake remains
low in many places, with only 54% of those eligible for HAART with a CD4<350cells/mm3
receiving it worldwide (7).
Low and middle–income countries, like South Africa, are faced with the

Real Time Pcr Detection Of Hiv Viral Load
Real–time PCR detection of HIV viral load
Introduction:
HIV, the Human Immunodeficiency Virus is a lentivirus which is responsible for HIV infection and
eventually causes AIDS.
It's assumed that the virus has been in existence since 1930 but it's still unclear that how the virus
came into existence. There are two kinds of HIV virus, HIV–1 which causes more severe disease
and the source of transmission is a chimpanzee species Pan troglodytes whereas HIV–2 is
transmitted by Cercocebus atys, a monkey found in West Africa (Norris, 2011).
HIV binds to the CD4+ T cells because it needs CD4+ receptor to penetrate into cells. The virus
transcribes its RNA into cDNA and then integrates its DNA into the host DNA and replicates further.
It uses the DNA of CD4+ T lymphocytes and eventually ends up destroying them (Roberts, 2008).
Once it weakens the immune system, the body becomes vulnerable to various diseases and is
exposed to life threatening diseases known as opportunistic infections. A population of over 35
million people have HIV/AIDS and Sub Saharan Africa constitutes half of the population
(AMERICAN CANCER SOCIETY, 2014). Figure 1. A statistical map showing the number of
people infected with HIV/AIDS (Who.int, 2013).
The HIV Infection progresses through a number of stages. As shown in Figure 2. The acute infection
stage is associated with a rapid increase of the viral copies up to several millions per ml with a slow
decline in the CD4+ T cells. During the first few weeks

HIV and AIDS Worldwide
Worldwide, HIV/AIDS poses an enormous challenge on the survival of mankind. HIV is the leading
cause of mortality among women of reproductive age worldwide and is a major contributor to
maternal, infant and child morbidity and mortality (1). 33.4 million People are estimated to be living
with HIV worldwide; 15.7 million are women and 2 million are children younger than 15 years of
age (1). With an adult prevalence of 5.2% in 2008, sub–Saharan Africa (SSA) has been the most
severely HIV stricken region, accounting for 71% of all new infections in adults and children, and
about 90% of new infections among children worldwide (2). In 2009 the prevalence of HIV in
Ethiopia was estimated at 2.3% with differentials: urban (7.7%), rural (0.9%), male (1.8%), and
female (2.8%)(3). The number of people living with HIV/AIDS was 1,116,216 of which 84,189
were pregnant women, 72,945 were children under 15years and annual HIV positive births were
14,140(3). In the absence of any intervention of mother to child transmission of HIV(i.e. exclusive
breast feeding and use of antiretroviral drugs), the risk of a baby acquiring the virus from an infected
mother ranges from 15% to 25% in industrialized countries, and 25% to 35% in developing
countries. HIV transmission rate and time of transmission is estimated to be 5% to 10% during
pregnancy, 10% to 15% during delivery, and 5% to 20% during breast feeding (4–5). In 2009, 53%
of HIV–infected pregnant women worldwide received antiretroviral (ARV)

Evaluation Of The Clinical Leadership And Management Review
According to the Clinical Leadership & Management Review, (2008) healthcare spending is
currently taking up 16.2 percent of our nation's economy. According to the Centers for Medicare and
Medicaid Services, cost is expected to rise to twenty percent by 2015. Nearly, seventy percent of
medical decisions are based on laboratory tests, yet the costs of lab tests account for only four
percent of the total in health care costs. Annual sales for clinical laboratory testing in the U.S. in
2001 were thirty–five billion, and are expected to grow at four percent annually (Johnson, 2008).
Upon looking at annual global growth rate, laboratory testing is projected to increase by 5.5 percent
(Johnson, 2008). As a result, laboratories as a business plays a significant role, on how health care
dollars are spent. Additionally, laboratories offer a tremendous service for a reasonable price by
providing quality, state–of–the–art services and fair reimbursement that is essential. Plan for
Investigation The complexity in billing is especially costly for clinical laboratories that bill for high
volume, and relatively low–cost procedures. It significantly increases billing and administrative
costs, reducing profit (Johnson, 2008). It is important in this kind of environment to manage denial
of payment promptly and efficiently to enhance revenue and reduce compliance risk. Decreasing
reimbursements and increasing complexity of costs characterize many healthcare services provided
in the United

Construction Of A Data Warehouse
The process of where a data warehouse is fed with extracted source data is largely known as ETL
(Extraction, Transforming and Loading). ETL is a critical process in the construction of a data
warehouse project.
The three stages of the ETL process comply of:
 Extraction: Data is identified and extracted from one or more external different sources, including
applications and database systems.
 Transform: Data is transformed in the aim of ensuring consistency and satisfying business
requirements.
 Loading: Data is loaded into the resultant data warehouse.
There are many challenges involved with fulfilling a dependable ETL process. Some of these relate
to:
 Data volumes – as there are huge amounts of data available presently, ... Show more content on
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Throughout extraction, the desired data is identified and extracted from the source system and is
made available for additional processing. The data can be extracted from numerous different
sources. In most cases, the data sources are internal however sometimes they are external. The
ultimate aim is to retrieve all the essential data from the source system with as little resources as
possible. The size of the data extracted can range from kilobytes to gigabytes.
For extraction within the ETL to be positive and effective, it is essential that there is a high
understanding of the data's layout. The data should also be backed up in another location.
Sometimes, it isn't possible to identify the exact subsection of interest, as a result a larger amount of
data than needed has to be extracted. Consequently, the identification part of extract is carried out
further down the line within the ETL process. Depending on the competence of the system,
transformations can take place during the extraction stage of ETL.
The difficulty of the extraction step is dependent on how alike or unalike the source systems are and
the type of source data. Good documentation along with excellent maintenance and the use of
similar technology within a system should result in fairly simple extraction process. On the other
hand, poor documentation and incompetent maintenance using different formats of data and
technologies will result in

The Effects Of Viral Load On Hiv Essay
On November 10, 2016, a new report was released to the public about a special type of microchip
that can test the amount of viral load of HIV in less than 30 minutes. This test can be completely self
administered. The user can check the viral load amount in the bloodstream by placing a drop of their
blood on the microchip, which looks similar to that of a USB drive. This microchip is then inserted
into a computer, tablet, or other handheld device. The results can be achieved in less than 30
minutes, and many users had an answer in about 21 minutes with 95% accuracy. The current method
requires sending blood to a laboratory and can take at least three days, if not longer, to detect the
viral load present. This microchip can help to monitor those patients who are receiving treatment,
but do not have access to local clinics. Researchers hope that this device can specifically help in
Sub–Saharan Africa and other rural areas which may not have easy access to testing facilities nearby
(Imperial College London: 2016). This new microchip received a lot of publicity for a few major
reasons. While it is not currently commercially available, it provided a "proof of concept" for a
point–of–care method for the detection of the viral load of HIV present. This is the first report of an
on–chip detection of RNA via microchip. While there are a few similar products that are close to
market or in development, they all require lab equipment and a desktop instrument to find results,
whereas

The Prevalence Of Hiv Among Women
C.2. Study Population/Design {this paragraph need to be reduced by 3 lines} This study is a
prospective, special exposure cohort study. The study population will include HIV seropositive
pregnant women, postpartum women within 6 weeks after delivery (due to the fact that most HIV–
infected pregnant women do not usually come back for postpartum visits after delivery), and infants
of seropositive pregnant women till 6 months old in Gambia. The study will be conducted in three
years. The prevalence of HIV among women in Gambia is higher (7.6 per 1000) than other West
African countries (3.1 per 1000). Our eligibility criteria include reproductive ages of women from
15–45 years old, HIV seropositive pregnant women, and participants from the three regions of
Brikama, Janjanbureh, and Basse In Gambia (unicef, 2013). We intend recruiting 224~250
participants, based on the sample size calculation below (to accommodate potential losses to follow
ups), nationwide in urban hospital clinics from the largest antenatal centers in Gambia (Please send
me the correct link [2]). An informed consent will be obtained and signed by participants.
Afterwards, a detailed questionnaire about their demographic variables, physical examination
findings, HIV staging, and mode of delivery, breastfeeding and laboratory tests will be performed
(Lambert et al., 1997). The specimen will be collected and stored, and the women will be seen on
subsequent antenatal or postnatal visits for follow up. The selection

Prenatal And Routine Postnatal Hiv Screening
I. Introduction Human Immunodeficiency Virus (HIV) diagnoses are increasing among women in
the United States; as a result there is an increase in newborns born with HIV via vertical
transmission, accounting for nearly all pediatric AIDS cases in the US. Between 1999 and 2000,
about 370 HIV infected infants were born, 40% of which were born to mothers who were unaware
of their HIV status before delivery. Without antiretroviral therapy or other forms of intervention,
25% of infected pregnant women will transmit the virus to their child during pregnancy, labor or
delivery, or after delivery. In recent years, systematic reviews and peer reviewed studies have
suggested that mandatory screening for HIV in pregnant women is a cost–effective ... Show more
The study found that with the prenatal screening program, requiring pregnant women be screened
for HIV, more women would be tested (about 1.1 million), identifying 527 HIV infected pregnant
women and prevent 150 mother–infant transmission of HIV annually. This program would increase
life years by 3,311 among newborns and cost an estimated $8,900 per life year gained, or $195,700
per case of HIV avoided. The new born screening program, requiring all newborn infants be
screened, would result in 3.9 million infants tested annually and would prevent 266 cases of
newborn HIV infection. This method would identify 1,061 HIV infected women who gave birth and
increase life years by 5,878. The annual cost of the program is an estimated $40.9 million, or $7,000
per life year gained, and $153,000 per prevented HIV cases. The benefits of the newborn screening
program decrease if pregnant women agree to participate in the prenatal program; however, it is
argued that newborn screening is a non–consensual method of screening pregnant women (Zaric, G.,
Bayoumi, A., Brandeau, M., & Owens, D. 2000). Similar to Zaric's study, Josephine A. Mauskopf
conducted a study on the impact of HIV treatment in pregnant women and their newborns. Cost was
defined and estimated as Zaric defined cost and the conclusions were

The Best Tool For Industry Practice
Forth Iteration: Identify and Recommend the best tool for Industry practice Planning Phase After
successful completion of third iteration author is planning to compare SSIS, Informatica power
center and Oracle warehouse builder ETL tools for comparing effectiveness and features as per
industry requirements in IT projects. For this I will interact with same IT consultants to know how
each ETL tool is different than other. Understanding importance of my action research, this time I
will conduct group discussion between author, Krimish Shah (Technology Lead at AstraZeneca),
Neha Chhabra (An ETL developer at Infosys) and Ananda Krishnan (Project specialist at Cognizant)
through skype. For that I will invite all experts and confirm timing based ... Show more content on
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Various alternatives to load huge amount of data without ETL tool Which type of skillset needed to
work in organization as an ETL developer? Author will explore from Microsoft, Informatica and
Oracle websites for more enhancements of the features. Spending quality time for this session will
help author to make flawless comparison on ETL tool. Action Phase The second phase aimed at
accomplishing activities outlined in the planning phase. Initially during this phase author did
research through Microsoft, Informatica and Oracle websites for the comparison perspective of
ETL. Based on research author noted below points before meeting and discussed with experts
regarding the comparison of ETL tool: Design, development and data governance support Run time
platform support Data transformation and data delivery capabilities Data sources and target
environment support Error handling workflow Pricing and License model Data validations
Configuration setting Handling run time alerts Author communicated with all experts and invites
them for the group discussion for their input on action research. All experts have confirmed their
timing and meeting was fixed for April 6th 2016. Session was continued for duration of an hour with
experts. All IT consultants have shared their views and opinion based on their industry experience
on ETL tools they are using. They have discussed about challenges, solutions, strong

The Benefits of Introducing at-Home Testing for HIV in...
The growth of HIV cases in Indonesia is one of the most rapid ones among the countries in Asia
(UNAIDS 2013). Indonesia's Ministry of Health estimates that more than 500.000 people in
Indonesia will become infected with HIV in 2014 unless there is an acceleration of HIV prevention
programs (UNICEF Indonesia 2012). In Indonesia, the testing of HIV currently is done in voluntary
counseling and testing (VCT) clinics in selected hospitals. The patients are required to visit the
clinic to do the testing and counseling. VCT has been shown to have a role in both HIV prevention
and as an entry point to treatment (UNAIDS 2000). This program has been one of the most
important parts of national strategic plan to prevent and control HIV in Indonesia ... Show more
Indeed, Wright and Katz (2006) announced that the amounts of suicide cases in the USA were not
increased after the approval of home testing kits by FDA in 1996. On the other hand, some people
feared that notification of negative result in home testing would diminish the chances to educate at
risk individuals to understand their risky behavior. Meanwhile, in VCT setting there are less
concerns about this problem because it has face–to–face counseling for patients with any results.
However, it is believed that direct counseling services currently provided in clinic based testing are
ineffective because they are too brief and inadequate (Harris 2005). Moreover, according to a study
that interviewed at–risk individuals, most of them supported the argument that current face–to face
counseling services were not necessarily optimal and also supported the introduction of new
counseling methods like brochures, magazine, and telephone counseling (Spielberg et al. as cited in
Whellams 2008). In fact, it has been demonstrated in a study by Frank et al. (1997) that pre– test and
post–test telephone counseling provided in anonymous HIV home collection kits offered a safe and
effective substitute to traditional VCT method.
Another drawback of at–home testing kit especially OraQuick In–Home Test is that it is not as
accurate as HIV blood tests currently used in the clinical setting. Its sensitivity is inferior to standard
HIV blood tests, especially the

A Report On The Rate Of A Effective And A Program
Subsequently, an independent review of the MP concluded the program both cost–effective and a
program that led to the aversion of "an estimated 2.0 to 2.3 HIV infections in the first year
(according to the epidemic scenario), 5.0 to 6.2 over 5 years, and 9.2 to 13.1 over 20 years" (Kahn,
Kegeles, Hays, & Beltzer, 2001, p. 1). Aversion is particularly important when considering "at least
one teenager or young adult in this country is infected with HIV every hour of every day" (amfAR,
5015, para. 1). Hence, the significance of early intervention. Presently, the MP is running in upwards
of 55 communities throughout the U.S. with a trial program underway in Beirut (Lebanese AIDS, S,
Arab Foundation for Freedom, University of California, S. F., ... Show more content on
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These gatherings focus on HIV vulnerability relative to individual factors, interpersonal factors,
cultural factors, community/structural factors, and biomedical factors (MP, 2016). Also, participants
work toward positive changes in behavior and fostering healthy communities that are gay–positive
and ethnic/racial–positive.
Mpowerment Project Analysis
The most recent evidence concludes MSM/YMSM "aged 13 to 24 accounted for an estimated 92%
of new HIV diagnoses among all men in their age group and 27% of new diagnoses among all gay
and bisexual men" (Centers for Disease Control and Prevention, 2016, para. 3). Thus, suggests
intervention in highly populated MSM/YMSM communities is vital to reversing this negative trend.
Early recognition of this trend caught the attention of Dr. Kegeles and Dr. Hays from the Center for
AIDS Prevention Studies, at the University of California, San Francisco. Together they developed
an "HIV prevention methodology that reformed the social environment of people at risk for
HIV/AIDS, as well as focused on individual and interpersonal–level issues that result in individual's
vulnerability to HIV" (Kegeles & Hayes, 1996, p. 1129). Subsequently, their collaboration led to the
PP known as the MP, which today, continues to serve this vulnerable population while at the same
time decreasing new incidences of HIV among MSM/YMSM.
Administrating Agency, Time,

Hiv Prevention Is A Preventable Disease
Today, as we must know HIV is still spreading around the world and neither a vaccine nor a cure
exists. The prevention of the disease remains the main key of the strategy to stop the epidemic. The
most common mode of HIV transmission is sexual contact; therefore, HIV prevention is closely
linked to the sexual and reproductive health of men and women. Effective prevention programs
include interventions that promote sex abstinence, delay sexual initiation, maintain a mutually
faithful partner, limit sexual partners, use condoms consistently and correctly, and counsel and test
for HIV. The most effective combination of these interventions depends on the characteristics of
groups infected with HIV. Effective programs also consider the social, ... Show more content on
Helpwriting.net ...
(Avert, 2017)
(Avert, 2017) Comparing national data shows huge differences in efforts to slow the spread of new
infections. Some countries have achieved a 50% or higher reduction in new HIV infections in adults
over the past 10 years, while many have not made much progress. However, others are experiencing
fears of an increase in the number of HIV infections. (Avert, 2017)
(Avert, 2017)
Let take a look at the HIV statistic just in America in the same time. By 2015, 39,513 people are
diagnosed with HIV in the United States. The number of new HIV diagnoses has decreased by 19%
between 2005 and 2014.
Because HIV testing has remained stable or increased in recent years, this decline indicates a real
decline in new infections. . This reduction may be due to HIV prevention efforts. However, progress
has been uneven, and the diagnosis has increased in several groups. (CDC 2016)
Let take a look a the table below, it indicated the new HIV Diagnoses in the United States for the
Most–Affected Subpopulations, 2015
(CDC 2016)
The HIV impact across The United State: Table below (Kaiser Family, 2017)
Table 2: Top Ten States/Areas by Number and Rate of New HIV Diagnoses (Adults and
Adolescents), 2015
State New HIV Diagnoses, Number (%) State/Area New HIV Diagnoses, per 100,000

Florida 4,849 (12%) District of Columbia 66.1
California 4,720 (12%) Louisiana 29.2
Texas

Notes On The And Hiv Counselling
NACP and HIV counselling
NACP began in 1987, as an Indian health ministry initiated surveillance taskforce, after the first
Indian HIV case was reported. Since then, it has extended its role to provide HIV services (IAVI,
2005; Singh et al., 2005). In 1992, the Indian Health Ministry set up the National AIDS Control
Organisation (NACO) as a separate wing to implement and closely monitor various components of
the programme (Singh et al., 2005; NACO, 2015b). Services provided under this programme trickle
down to states and districts through their respective AIDS Control Societies supported by non–
governmental organisations (NGO). NACP was also responsible for targeted interventions aimed at
facilitating behavioural change in HRG communities ... Show more content on Helpwriting.net ...
An integrated counselling and training centre (ICTC) is a place where VCT services are provided to
the clients who are either referred or walk in voluntarily to the centre (NACO 2004). An ICTC links
the client with a range of services such as family planning, financial access, treatment and care,
legal support, community and peer support, employment services and even with spiritual support
centres (NACO, 2006). Being diagnosed HIV–positive and coming to terms with this knowledge
has profound emotional, social, behavioural, and medical implications (Bharat, 2011; NACO, 2004).
Counselling aims to support the HIV positive clients in understanding the disease; making them
aware of their rights; and empowering them to lead a healthy life (Avert, 2014b; NACO, 2004). In
India, most public health facilities have an ICTC, totalling 15,606 in number (Planning
Commission, 2011), along with several stand–alone, private and mobile ICTCs (NACO, 2004).
An HIV counselling session is required to follow certain guidelines and code of ethics. The HIV
counselling guidelines, laid down by WHO (2007), aim for a voluntary; non–coercive; confidential;
and cost–effective approach to provide information, education, and communication (IEC) to the
client, while the Unicef's code of ethics outlines the fundamental values of HIV counselling:
integrity and

Data Warehouse Components And Architecture
DATA WAREHOUSE COMPONENTS & ARCHITECTURE
Lecture Note # 02
The data in a data warehouse comes from operational systems of the organization as well as from
other external sources. These are collectively referred to as source systems. The data extracted from
source systems is stored in a area called data staging area, where the data is cleaned, transformed,
combined, deduplicated to prepare the data for us in the data warehouse. The data staging area is
generally a collection of machines where simple activities like sorting and sequential processing
takes place. The data staging area does not provide any query or presentation services. As soon as a
system provides query or presentation services, it is categorized as a presentation server. A
presentation server is the target machine on which the data is loaded from the data staging area
organized and stored for direct querying by end users, report writers and other applications. The
three different kinds of systems that are required for a data warehouse are:
1. Source Systems
2. Data Staging Area
3. Presentation servers
The data travels from source systems to presentation servers via the data staging area. The entire
process is popularly known as ETL (extract, transform, and load) or ETT (extract, transform, and
transfer). Oracle's ETL tool is called Oracle Warehouse Builder (OWB) and MS SQL Server's ETL
tool is called Data Transformation Services (DTS).
A typical architecture of a data warehouse is shown below:

1) I Would Like To Become An Hiv Peer Test Counselor Because
1) I would like to become an HIV Peer Test Counselor because I want to empower students with the
knowledge and agency to live healthy lives as they balance their sexual, emotional and physical
health. Taking an HIV test is an intimidating experience for many people, so I want to provide my
peers a warm, anonymous, and safe space where they can share their experiences while I help them
make informed decisions that reflect their cherished values and beliefs. This role will help me
increase my emotional intelligence and mindfulness of different people, making me a strong ally and
resource for a diverse group of people.
2) My volunteer work has positioned me as an active listener and educator. These skills are vital as
an HIV Peer Counselor ... Show more content on Helpwriting.net ...
One solution that the student and I both developed was to tutor them one on one after school while
also giving them snacks in the school library. We ironed out the details with the school librarian.
That way, the student would receive their math help while waiting for their parent in a dry,
comfortable space. This was a small, but crucial step that they formulated with my guidance, and I
think that they developed some independence in meeting their needs while also consulting with
someone that they trust. This is the type of independence that I think an HIV peer test counselor
must give their clients/peers. While you should educate, you must also give students room to voice
their concerns so that they can address them happily.
Volunteer Footwasher at CARe (Community Aid and Resources) Clinics: CARe is an on–campus
student organization at UCSC that assembles basic healthcare clinics in Santa Cruz, giving its
underserved, homeless clients compassion, decency, and respect. My role in CARe over the past
year has been running the foot washing station. While many of my peers in my dorms find foot
washing a weird task to undertake at the clinic, I feel that this task empowers CARe's clients with
dignity and compassion. As I wash and massage the calloused feet of people, I know that this
moment is an intimate experience that they have never had before. Homelessness makes them
faceless on the streets, but now they have

An Ambitious Treatment For The Aids Epidemic
In September of 2016, Sweden became officially recognized as the first country in the world to
achieve the UN's 90–90–90 goal. This goal means that 90% of people living with HIV will know
their HIV status, 90% of people will receive antiretroviral therapy, and 90% of people receiving
antiretroviral therapy will have viral suppression. These goals were enacted by the UNAIDS group
in 2014 and the 90–90–90 goal has a target year of 2020. UNAIDS is referring to this as "an
ambitious treatment target to help end the AIDS epidemic" (90–90–90 – An Ambitious Treatment).
It is ambitious, but it is clear that is goal is possible in at least a single country. The fact that Sweden
was able to reach the UNAIDS's goal within 2 years is incredible. While this goal was achievable in
Sweden, the possibility that another country can reach it in the exact same way that Sweden was
able to is not likely. Sweden has unique characteristics that have allowed it to attain this goal such as
small outbreak size, healthcare access and national guidelines (Carter). The data was nationally
collected to determine Sweden's progress in reaching the 90–90–90 goal. By the end of 2015,
Sweden had reached and surpassed the UN's goal. They had 90% of cases diagnosed, 99.8% of
people were linked to antiretroviral therapy and 95% of people taking antiretroviral for 6 months or
more had a viral load below 50 copies/ml (Carter). The use of antiretroviral therapy in many patients
who have HIV has reduced

Case Study Of ZALORA
Company information
ZALORA has be known as the largest online fashion evolution in Asia. ZALORA which based
online shopping that sold clothes in variety of style and suit both men and women also focus on
children fashions. Nowadays, there are many online shopping destination that can be choose by all
people and the most popular among others is ZALORA. ZALORA operated in many Asia Country
such as Malaysia, Singapore, Thailand, Vietnam, Hong Kong, Indonesia, Philippines, Brunei,
Australia and New Zealand. ZALORA not only favors by customer based on their cheap price,
quality product and made by popular designer but also be the first place in customer heart because
of customer are really satisfied with their services.
Groupon is a global e–commerce ... Show more content on Helpwriting.net ...
The PageSpeed Grade for Groupon website is 86% which is good enough but it is less than speed of
ZALORA website. So, chances that customers and prospects will abandoned Groupon website
higher than ZALORA website because people expect a fast user experience online, and when they
don't get it, they often bail. Next, the YSlow Grade of ZALORA also higher than Groupon website
even its not too good which bring the meaning that YSlow analyzes Groupon web pages is slow than
ZALORA web page and why they're slow based on Yahoo!'s rules for high performance web sites.
Then, page load for ZALORA website is 4.3 second which is faster than Groupon website which at
5.1 second. So that, ZALORA have higher ranking than Groupon because fast load times equal
higher rankings and higher rankings also lead to more traffic. The total page size of ZALORA also
less Groupon. The larger the the page size to download, the slower the experience. Website obesity
has become an epidemic and web developers are to blame. There are no excuses. Last but not least,
the total request of Groupon is higher than ZALORA which bring meaning that ZALORA have
higher speed because the number of HTTP requests required to render the page is lesser. In
conclusion, the website performance of ZALORA is better than Groupon

Understanding Couples Hiv Testing And Counselling Essay
Literature Review
1. Overview Couples HIV Testing and Counselling
HIV Testing and Counselling
HIV antibody tests were first issued by the World Health Organization in 1992 (WHO, 1997), since
then with frequent update of recommendations, HIV testing and counselling continue to be the
gateway to HIV prevention, essential treatments and cares (Fonner et al., 2012, WHO, 2012b).
However, globally not more than half (49%–58%) of people living with HIV knew their serostatus
(WHO, 2015b). To address this gap, a new global 90–90–90 target calls to reach at least 90% of
people living with the virus to know their HIV status by the year 2020 (UNAIDS, 2014).
To achieve the goal, both client and provider initiated service deliveries are implemented in various
countries to increase access for HIV testing and counselling. Despite these efforts, the uptake of
HIV testing and counselling vary across countries and different population groups (WHO, 2014).
Overall in high HIV prevalence settings, HIV test uptake by men is very low as compared to
women. The variability could be due to the fact that in most countries, HIV testing and counselling
services are conducted at reproductive health or antenatal care clinics (WHO, 2015a).
Couples HIV Testing and Counselling
In the last couple of decades, President's Emergency Plan for AIDS Relief (PEPFAR) support for
African countries has been tremendous to increase different models of outreach to prevent HIV
infection. Couples based HIV prevention

Using Quantitative Pcr For Hiv Viral Load Control
Results
An HIV GWAS SNP marks expression of a long non–coding RNA (lncRNA).
Human chromosome 3p21–22 harbors a cluster of chemokine receptor genes, several of which serve
as major or minor co–receptors of HIV–1 [1]. The genetic associations of CCR5 and CCR2 gene
polymorphisms with HIV–1 pathogenesis are well known [2–5], but any potential role of variation
in other regions of the cluster is largely unknown. An intergenic SNP (rs1015164 A/G) downstream
of the CCRL2 gene was shown to associate with HIV viral load control [6] and progression to AIDS
[7] in two independent cohorts of HIV–infected patients. Importantly, the SNP showed genome–
wide significant association with HIV outcomes in meta–analyses that collectively examined
genotyping data from 6,315 HIV–infected patients [8]. The SNP is in close genomic proximity to a
non–coding RNA gene RP–11–24F11.2 (Fig. S1). We were able to detect and quantify the
polyadenylated lncRNA transcript in the total RNA from peripheral blood lymphocytes (PBLs)
using quantitative PCR (qPCR). Specificity of the primers was confirmed by sequencing of the
amplicons. We designated this lncRNA as Lnc11.2. The rs1015164A allele, which associated with
higher viral loads (OR=1.4, p=3.3 ×10–5) [6] and more rapid disease progression (HR=1.4, p=8.6
×10–6) [7] correlated with higher expression levels of Lnc11.2 in PBLs (Fig. 1).
Characterization of the Lnc11.2 transcript Amplification of the 3'and 5'ends of the Lnc11.2 transcript
uncovered the

Three Types of Stigma Related to HIV
Goffman (1963) defined stigma as any condition, attribute, trait, or behavior that is deeply
discrediting and reduces the bearer from a whole and usual person to a tainted and discounted one. .
Stigma consist of an attributes that marks people as different leading to devaluation. Stigma is
socially constructed (Major & O'Brien, 2005) thus is dependent both on relationship and context. In
fact, Goffman (1963) emphasized using the "language of relationships" (p. 3) when considering
stigma. A subsequent framework proposed by Corrigan, Markowitz, and Watson (2004) expands the
social mechanisms of stigma by describing the structural determinants of stigma that arise from
economic, political, and historical sources.
Three types of stigma have been generally conceptualized in current HIV/AIDS psychosocial and
behavioral studies. These include: enacted stigma (overt acts of discrimination and hostility),
perceived stigma (subjective awareness of stigma), and internalized stigma (individual acceptance of
stigma as valid) (Steward et al., 2008). PLWH are stigmatized because their illness is socially
perceived as associated with deviant behavior; viewed as the responsibility of the individual; tainted
as to its immorality; perceived as contagious and threatening; associated with an undesirable and an
unaesthetic form of death; and not well understood by the lay community and viewed negatively by
healthcare providers (Alonzo & Reynolds, 1995).
2) The relation of stigma and

Questions On A Enterprise And Community Edition
Pentaho Pentaho, an organization founded in 2004, provides open source Business Intelligence (BI)
suite. They provide two kinds of editions, one is Enterprise edition and the other is Community
edition. The difference between an Enterprise and Community edition is that the Enterprise edition
has more features to offer to the users than the Community edition. Like all other ETL tools,
Pentaho also runs on Java. Here, the storage and transformation are done separately and are stored in
XML format. The Pentaho Business Analytics suite offers products which are helpful in data
integration (ETL), OLAP, reporting, dashboards, and data mining. These products can be classified
as Server applications, Desktop/client applications and Pentaho ... Show more content on
Helpwriting.net ...
It is used to perform data flow functions like reading, validating, refining, transforming, writing data
to data sources. Pan – It is used to run data transformations. Chef – It is used to create jobs which
automates the database update process in a complex way. Kitchen – It is used to execute jobs in a
batch mode. Carte – A web server which allows remote monitoring of the running ETL process
through a web browser. Encr – It is a command line tool for encrypting strings for storage.
Enterprise Edition (EE) Data Integration Server – Data Integration Engine, Security integration with
LDAP/Active Directory, Monitor/Scheduler, Content Management. Other than being used in the
data warehouses, Pentaho Data Integration tool can also be used for the following purposes:
Migrating data between applications or databases. Exporting data from databases to flat files.
Loading data massively into databases. Data cleansing. Integrating applications. The latest Pentaho
version available is v6.1, which brings the following mentioned enhancements: Improved system
performance monitoring. Data profiling enhancements. Updated Look and Feel for Pentaho Data
Integration. Easily add new plugins. Deliver data from multiple data sources. New Embedded
Analytics APIs for Analyzer. Data movement load balancing.

Mandatory Prenatal HIV Testing Essay
Mandatory Prenatal HIV Testing
This particular journal researches prenatal HIV testing as it relates to vertical transmission.
Randomized controlled studies involving HIV– positive pregnant women at various stages of
pregnancy were monitored and evaluated in an effort to find conclusive reasoning for prenatal
testing. Women of different income levels, educational and ethnic backgrounds were involved in
these studies.
The AIDS Clinical Trials Group Study 076 as well as following randomized controlled trials were
used in order to test whether prenatal testing was an effective means of preventing the vertical
transmission of the HIV virus. Quick and relatively simple tests were performed in order to first
determine whether ... Show more content on Helpwriting.net ...
Statistically, these methods of research produce findings that are typically more accurate than the
other various approaches to research. Likewise, the HIV test itself is basically a simple and for the
most part accurate means of determining whether a pregnant mother is HIV– positive. The tests
were administered to mothers that had already tested positive in order to further ensure the accuracy
of the study. In this way, it appears that much time and effort was put forth in order to find
conclusive reasoning either proving or disproving the theory that prenatal HIV testing should be
mandatory. On the other hand, in order to develop policies that would make prenatal screening
mandatory there are two sides to consider; pregnant women who are HIV– positive and pregnant
women who do not carry the virus. In this way, the study lacks in including women who must be
tested for seemingly no reason. It fails to mention if any undue hardships must be placed upon
women who are HIV– negative.
Because HIV can be a treatable disease the findings from this study are as most would expect them
to be. Early detection leads to an increased likelihood of preventing the viral transmission of the
disease. The findings themselves are quite impressive also. If at anytime the spread of a disease can
be decreased by nearly 50 % as long as it is detected and treated in a timely fashion, then it is easy
to assume that those measures would be

Benefits Of Mandatory HIV Testing
Mandatory HIV testing should be enforced, because for those who have the virus and do not know
that they have it, could possibly be spreading it to many of partners. If the government starts
enforcing this potential law, it would prevent many misfortunes and burdens. An article read, "It will
help people make informed choices. Some people are not honest enough to disclose their HIV
status" (Obemeyer). This quote explains that for those who do not have HIV, will not make informed
choices about intercourse. In fact, it will raise the formality of the subject and create better choices.
Mandatory HIV testing would overall lower virus ratings and prevent newborns and adults from
acquiring a virus.
"People living with HIV are thriving and can continue, because those citizens got tested early
enough to keep it under control"Increasing access to voluntary HIV testing". This article explains
further that everyone should be tested, and for those who have it can keep it under control and not
let it further escalate into something fatal. Mandatory HIV testing can prevent a good deal of
misunderstanding and it can also help prevent spreading diseases to other people. A very worried
discussion when talking about HIV is the health care workers. HIV transmission in healthcare
settings is what most are worried about; but although the the workers take a great risk working with
needles, sharps, and contact with the people, HIV testing is overall beneficial to the people, and with
correct

Defining Couples Hiv Testing And Counselling
1. Overview Couples HIV Testing and Counselling
HIV Testing and Counselling
HIV antibody tests were first issued by the World Health Organization in 1992 (WHO, 1997), since
then with frequent update of recommendation, and advancement in innovation (Rotheram–Borus et
al., 2000) HIV testing and counselling continue to be the gateway to HIV prevention, essential
treatment and care (Fonner et al., 2012, WHO, 2012b). Knowing one's HIV status used to be
considered as a death sentence. However, after having the right treatment peoples' view changed
into considering the status as a chronic condition (Bedingfield et al., 2014). Thus the development of
life–saving drugs for HIV/AIDS patients markedly shifted policies to encourage uptake of HIV
testing(WHO, 2012b). In spite of that, WHO/UNAIDS in 2014 reported that, globally not more than
half (49%–58%) of people living with HIV know their serostatus (WHO, 2015b, UNAIDS, 2014b).
To address this gap, in 2014 a new global 90–90–90 target introduced in called to reach at least 90%
of all people living with the virus to know their HIV status; 90% of all those diagnosed with HIV
infection to receive sustain antiretroviral therapy; and 90% of all those initiated the treatment to
have viral suppression by the year 2020 (UNAIDS, 2014a).
To achieve the diagnosis goal, both client and provider–initiated service deliveries are implemented
in various countries to increase access to HIV testing and counselling. Despite these efforts, the
uptake of

Symptoms And Treatment Of Acute Rheumatic Fever
A 12 year old boy presents to urgent care with knee swelling and pain. On review of the record, he
was seen and diagnosed with strep pharyngitis a month ago. On further questioning, mother admits
she was unable to fill his prescription for amoxicillin, but his throat symptoms resolved. History
reveals migratory arthritis, intermittent fevers up to 102oF. On physical exam, there are no oral
lesions, neck is supple and there is a soft diastolic murmur. His right knee has a small effusion.
Which of the following streptococcal complications has likely occured?
A: Acute rheumatic fever
The reason this is the answer is because acute rheumatic fever is a complication that can occur post
strep. In order to be diagnosed with rheumatic fever, a person must have a history of strep infection,
plus at least one of the major and 2 minor or two majors. The criteria is known as the Jones criteria.
The major symptoms are carditis, polyarthritis, chorea, erythema marginatum, and subcutaneous
nodules. The minor criteria include a fever, arthralgia, previous history of disease, acute phase
reactions, and prolonged QT interval.
https://www.uptodate.com/contents/acute–rheumatic–fever–clinical–manifestations–and–diagnosis?
source=search_result&search=rheumatic%20fever&selectedTitle=1~119#H3
B: Glomerulonephritis
C: Scarlet fever D: Septic arthritis
Septic arthritis is also known as infectious arthritis and is normally caused by a bacteria or fungus
that is caught in a larger joint, such as

Data Analysis And Data Processes
Data Transformation are often very complex and is the most costly section of the ETL process.
Transformations are often achieved outside the database using flat files, but mostly occurs within an
Oracle database. The transform step applies rules or functions to the extracted data. These rules or
functions will decide on the analysis of data and can involve transformations like the following:
Data Summations
Data Merging
Data Encoding
Data Splitting
Data Calculations
Creating Surrogate Keys
Data Aggregation
When transformed, the data is clean, accurate, consistent and ready for analysis by the data
warehouse users.
Data can be transformed in two ways:
Multistage Data Transformation
Pipelined Data Transformation
The most ... Show more content on Helpwriting.net ...
Most of the tasks are completed outside the database, for example step 1 to 4 as shown in figure 6
below and then is inserted into the warehouse table.
FIGURE 6: PIPELINED DATA TRANSFORMATION
2.2.2 Cleansing Data
Data cleansing is the process of removing incorrect, inappropriate and duplicate data. It can also be
called data cleaning or data scrubbing. Not cleansing the data will lead to inaccurate and unreliable
results. During the process of cleansing data, if dirty data is detected, it will have to be modified and
will therefore cause delays within the process. Dirty data can be caused by the following:
Members of an organization are poorly trained and will therefore enter data erroneously.
Inaccurate system configuration rules are applied.
Regular data updates are neglected.
Inconsistent or lack of validation rules.
Duplicates are not removed.
Data cleansing can be performed within single or multiple sets of data. Usually problems within
single data sets are due to misspellings when entering data of that they have left out missing
information when inputting. When problems occur within multiple data sets e.g. in a data

warehouse, the need to cleanse data increases greatly. This is because the data is more than likely to
have redundant data from different sources, and will therefore have to make sure all

A Research Study On Jane Doe Essay
Jane Doe is a 25–year–old Registered Nurse who has been working in the emergency department for
2 years. One night she was drawing blood on a HIV positive patient and upon disposing a butterfly
needle in to the appropriate sharps container, she had a needle stick injury due to the safety needle
not retracting into the sheath and was stuck deeply into one of her finger pads. She immediately
began to wash the injury with soap and water and squeezed out some of the blood contents, and
went to seek Post–Exposure Prophylaxis Treatment within 3 hours. Her initial baseline testing were
shown as negative
Jane was not showing any signs or symptoms of complication until about four months later. She
began to experience recurring headaches, fatigue, decreased appetite, and losing weight, fever and
complained of a sore throat with white patches developing. Her neck lymph nodes were also
showing signs of swelling. Her Physician immediately ordered an Enzyme–Linked Immunosorbent
(ELISA) test, Western Blot testing, CD4 T–cell count, Complete Blood Count (CBC), Erythrocyte
Sedimentation Rate (ESR), and a p24 Antigen test and was asked to come follow up when the
results where in.
________________________________________
ASSESSMENT
Upon Jane's follow up visit, she expresses her concern about her previous needle stick injury to the
nurse. She understands symptoms may take time to appear and is experiencing a lot of anxiety. She
states, "I was not that worried once I had intervened with PEP,

HIV Treatment Adherence Essay
Treatment adherence is critical for HIV positive individuals, but many find it challenging to
maintain. Sarita D. Boyd (2011) conducted a review of currently recommended treatment guidelines
for patients managing HIV infection, including adherence obstacles and benefits.
According to Boyd, HIV treatment should consist of antiretroviral therapy and routine health
monitoring, but many patients often defer treatment and fail to report for monitoring appointments.
Reasons for this failure to adhere to the treatment plan vary depending on the individual patient, and
the situation may be further complicated by differing medical opinions and lack of resources and
opportunity for the patient.
Antiretroviral therapy (ART) is the current standard for ... Show more content on Helpwriting.net ...
The cost of these drugs is a major obstacle to treatment adherence because they are expensive,
averaging $22,000.00 to $32,000.00 annually for consistent treatment (Boyd, 2011). Several
government programs cover initial HIV screening costs but not life–time care, so many patients only
take their medicines as their finances allow
(Boyd, 2011). This nonadherence leads to the development of drug resistance which increases
transmission potential and decreases treatment options (Boyd, 2011). Efavirenz is a fixed dose
ART combining tenofovir and emtricitabine (Boyd, 2011). It offers once daily dosing and is
currently the simplest and least expensive protocol available. Due to deferred treatment options, less
pills, once daily dosing, fewer side effects and improved drug potency, HIV patients are reporting
increased treatment adherence and better treatment success (Boyd, 2011). More efforts must be
made to insure treatment adherence throughout the entire life of the patient.
Another hindrance to early diagnosis and program adherence lies in the communication skills and
comfort levels of patient and physician. The article "HIV prevention efforts mired in patient denial,
physician discomfort" (2011) examines the attitudes of both patients

Transmission Of Human Immunodeficiency Virus ( Hiv )
Huge strides in the United States in controlling the rate of transmission of human immunodeficiency
virus (HIV) has been made resulting in a significant decrease of its incidence since the epidemic
advent. During the epidemic's height in the 1980s of the United States, the CDC estimated its
incidence at about 150,000 new infections per year. This figure plateaued and dropped significantly
during the 1990s due to introduction of highly effective antiviral treatments and due to a overall
public cultural shift with promotion of HIV education, HIV testing, and condom use, especially
among the LGBT community which was affected disproportionately by HIV infection. However,
during the 2000s, a small, growing trend of incidence rates was seen, ... Show more content on
Helpwriting.net ...
It was estimated that between the years of 2006 and 2009 alone, the number of new HIV infections
among all 13 to 24 year olds due to male–to–male sexual contact increased from 61% to 71%,
respectively. This has many implications for public health efforts because previously those most
affected by HIV infection were adult men who have sex with men (MSM). The current research and
work to reduce HIV is therefore mainly aimed at the MSM population, which may not translate to
curbing infection rates in YMSM. In fact, studies that have looked at individual risk factors (i.e.
unprotected anal intercourse, or UAI) seen in MSM populations as associated to increased risk of
HIV infection among YMSM have found large inconsistencies. Current theories in the literature
suggest that individual characteristics, social norms, and behavioral patterns within the YMSM
population are highly interrelated and evolving, and individually can not predict accurately who
among the YMSM population is at most risk. One particular compounding variable is the growing
use of technology. YMSM are using technology (i.e. GPS compatible smartphones) to seek sexual
partners which is largely changing their constructed social environment and relationship patterns.
Therefore, there is a call to use a more multivariate model of risks to better understand useful
preventative strategies to

The Is The Mobile Clinic Be Operated For Providing Hiv...
The mobile clinic will be operated for providing HIV testing and counseling service. Weekly
outreach events will be hosted on a total of 5 college campuses in Alameda County at UC Berkeley,
Cal State Hayward (East Bay), Chabot College, Laney College, and Mills College. The outreach on
the campuses provides awareness and educate college students regarding the HIV cause,
transmission, and prevention. The intervention proceeds over a 24–month period with participants
between the ages of 20–29 years old in Alameda County who are both HIV–positive and HIV–
negative. The 24–months intervention is broken down into 1–month, 3–months, 6–months, 12–
months, and 24 months. The first month includes interactive activities, watching short videos, peer
... Show more content on Helpwriting.net ...
Training of the staff will be before the implementation begins and there will be on–going
training/follow–up for every month throughout the program. Also, the mobile clinic outreach
services are continuous for the full 24–month period to provide HIV testing and counseling services
to the general population of college students.
Staffing Plan The personnel for this intervention will include a Project Manager/HIV–Prevention
Coordinator, two clinicians (health workers), three peer educators, two counselors, and a consultant.
The Coordinator/Project Manager, Alexis Wielunski, has a Masters of Public Health degree from
San Jose State University. She is well knowledgeable on HIV prevention methods and also works
full–time with San Francisco Department of Public Health. She has worked for the Berkeley Free
Clinic for over 3 years and is passionate about health promotion and prevention. The two clinicians
are nursing students from local universities, and they are expected to graduate as a registered nurse
in the next 6 months. The peer educators are young individuals, some are college students, and some
are not college students. These individuals are enthused and passionate about volunteering in their
community. Selection of the peer educators is from individuals that have a health or social science
background such as psychology majors, public health majors, and sociology majors. The

Hiv Testing Reflection
In August 2009, the VA policy for HIV testing was revised from "risk–based" testing to routine HIV
of all Veterans regardless of risk factors. Written informed consent was no longer needed, but verbal
consent was still required. Initially, this change in policy was not well received. Already
overburdened primary care physicians were complaining about workload issues and assumed that
routine testing would result in minimal yield. There were many misconceptions that even educated
health care providers believed. My job was to implement this new policy change and my vision was
to increase (at least double) the number of Veterans with a documented HIV test. As the agency lead
for HIV programs, this was a major challenge because the ... Show more content on Helpwriting.net
...
I helped create a large creative public health/social media campaign across the VA titled "Say Yes to
the Test" that focused on changing attitudes of Veterans toward routine HIV testing and increasing
acceptance of the test. Videos, posters, pins, and other written and visual messages were spread
throughout all the VA Medical Facilities – encouraging Veterans to ask their providers to be tested
for HIV. Additionally, VA expanded National HIV Testing Day to National HIV Testing Week to
encourage as many Veterans as possible to get tested. We utilized social media – facebook, twitter,
and others to get the message out to the Veterans. We also changed the language the providers used
to offer HIV tests to be inclusive of all routine screening. For example, I convinced providers to
change the approach to offering a test and incorporating it to their routine testing language by saying
– "VA is now recommending that all Veterans be screened for cholesterol, diabetes, and HIV –
would you like me to screen you for these things

Acute Human Immunodeficiency Virus ( Hiv ) Infection

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Acute Human Immunodeficiency Virus ( Hiv ) Infection