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A personal narrative is presented which explores the author's experience of writing poem.

Investigates patterns of age mixing and gender mixing among children and adolescents at an ungraded school. Age mixing more frequent for 12-15-year-olds than for 8-11 or 16-19-year-olds and less frequent for conversations than for activities; Gender mixing less frequent for 8-11-year-olds than for other age groups and more frequent for conversations than for activities.

Discusses how group support builds the morale of patients with cancers of the head and neck. Activities of the group; Topics discussed within the group; Limitations of support groups.

Abstract: Background: The current algorithm for HIV diagnosis in the US involves screening with an immunoassay (IA) and supplemental testing with Western blot (WB) or immunofluorescence assay. Because of existence of more sensitive and specific FDA-approved assays that would also reduce the cost and turn-around time of testing compared to WB, several alternative algorithms have been evaluated. Recently, an alternative algorithm using a sensitive 3rd or 4th generation IA followed by an HIV-1 and HIV-2 discriminatory supplemental test on the initial IA-positive specimens was proposed. Concordant positive results indicate HIV-positive specimens and discordant results are resolved by nucleic acid amplification testing (NAAT). Objectives: To evaluate the sensitivity of assays during acute HIV infection and the performance of the current and an alternative algorithm using samples from HIV-1 seroconversion panels and persons with established HIV infections. Study design: To evaluate the algorithms in early infections, 26 HIV-1 seroconverters from the US were tested with three 3rd generation and one 4th generation IA, six rapid tests (RTs), one NAAT, and WB. Sensitivity and specificity of the algorithms were calculated by testing an additional 416 HIV-positive and 414 uninfected control samples with one 3rd generation and one 4th generation IA, four RTs, one NAAT, and WB. Results: The individual assays evaluated became positive 5 (RT) to 26 days (NAAT) before WB was positive. Among seroconverters, the alternative algorithm detected significantly more infections than the current algorithm (103–134 versus 56, p <0.0001). Furthermore, the use of a 4th generation IA instead of a 3rd generation assay as the screen resulted in significantly higher detection of acute infections (p <0.0001). In contrast, the algorithms performed equally among specimens from established HIV-1 infections. Conclusions: This study demonstrated improved sensitivity of the alternative algorithm for detecting acute HIV-1 infections, while maintaining the ability to accurately detect established HIV-1 infections. Early detection is important as individuals can be highly infectious during acute infection. In addition, the alternative algorithm should reduce turn-around time by using a RT as the supplemental test has the potential to increase the number of test results returned. [Copyright &y& Elsevier]

Objective: To monitor trends in HIV seroprevalence in the United States, HIV testing was included in the National Health and Nutrition Examination Survey (NHANES) conducted from 1999 to 2006., Methods: From 1999 to 2006, 11,928 participants aged 18–49 years were tested for HIV antibody. Prevalence estimates were weighted to account for over sampling and nonresponse., Results: There were 67 HIV antibody-reactive individuals for a seroprevalence of 0.5% [95% confidence interval (CI) 0.3–0.6]. In the only age subgroup directly comparable between surveys (18–39 years), HIV seroprevalence remained constant from NHANES III(1988–1994) to NHANES 1999–2002 and 2003–2006. In NHANES 1999–2006, non–Hispanic blacks had significantly higher HIV seroprevalence(2.0%, 95% CI 1.5–2.7) compared with individuals in all other race/ethnic groups combined. Seroprevalence was also higher in each race/ethnic group among men who have sex with men (9.4%95% CI 5.0–17.1), among persons who had detectable antibody to herpes simplex type-two (1.9% 95% CI 1.4–2.8), among those who had 50 or more lifetime sex partners (3.4%, 95% CI 1.7–6.7), and among those who never married (0.8%, 95% CI 0.5–1.3)., Conclusions: In this household-based population, seroprevalence did not significantly change from NHANES III to NHANES 1999–2006. Non–Hispanic blacks had significantly higher prevalence of infection compared with other race/ethnic groups. Male-to-male sex and the presence of HSV-2 antibody were the strongest predictors of HIV infection