Many people in different parts of the United States are affected by the problem of HIV/AIDS. This condition has been observed to catalyze numerous implications such as reduced productivity and social problems. The condition is also known to affect every age group, gender, and community. However, some groups such as minorities, lesbians, gays, and young women appear to be affected the most by this illness. When an effective evaluation or epidemiological analysis is completed successfully, it can be easier to understand the prevalence of the disease and implement appropriate preventative measures. This evaluation epidemiology paper, therefore, focuses on the problem of HIV/AIDS in the state of Florida. The paper also describes the nature of the existing surveillance methods and presents a descriptive epidemiology analysis of the disease. The document concludes by presenting three evidence-based plans that will be implemented to deal with this health condition in Miami, Florida.
HIV/AIDS Background
Mutevedzi and Newell (2014) define acquired immunodeficiency syndrome (AIDS) as a chronic condition that threatens human life. It is caused by a virus known as the human immunodeficiency virus (HIV). This virus damages the immune system, thereby making it hard for the body to fight different opportunistic illnesses. Researchers indicate that the signs and symptoms of the disease occur after the immune system is incapable of fighting different opportunistic microbes (Mutevedzi & Newell, 2014). This disease has continued to amaze many scholars and medical experts. Some analysts acknowledge that the disease might have originated in Congo in the 1920s (Mutevedzi & Newell, 2014). However, the condition remains unknown for several decades until in the 1980s when more people developed AIDS across the globe. Scientific breakthroughs have led to the production of medicines known as antiretroviral drugs (ARVs) that make it easier for patients to lead healthy lives.
This condition presents a wide range of symptoms that should be taken seriously. Schackman et al. (2015) indicate that around 40-60 percent of people will develop flu-like symptoms within a month after being infected with the virus. Some of these symptoms include mouth ulcers, sore throat, muscle aches, fatigue, rashes, fever, and chills (Frieden, Foti, & Mermin, 2015). After infection, patients go through a period known as clinical latency. This phase can last more than ten years. During this stage, many people infect others since they are usually unaware of their health statuses. This phase is followed by the AIDS stage (Huang et al., 2015). People who fail to get ARVs will progress to the stage within 10-15 years. The common symptoms during the phase include weight loss, tiredness, pneumonia, diarrhea, depression, memory loss, dementia, and sores in the mouth or genitals.
According to the Centers for Disease Control and Prevention (CDC), around 1.22 million Americans are affected by this illness. Around 38,000 new infections were reported in 2017 (“HIV in the United States,” n.d.). Most of the affected patients are usually unaware of their health statuses (“HIV in the United States,” n.d.). Statistics indicate that over 18,000 deaths are caused by HIV every year in the country. In Florida, it is estimated that around 104,000 people are living with HIV/AIDS (“Florida highlights,” n.d.). Minority groups such as Latinos, African Americans, and homosexuals are affected the most by the condition. Over 5,000 new infections were reported in 2015 (see Table 1). Around 2,000 HIV-related deaths occur every year in this state (Huang et al., 2015). In Miami, the number of citizens living with the disease is around 26,000. The total number of new infections recorded annually is around 1,400-1,450 (“Florida highlights,” n.d.). Statistics indicate that an average of 360 deaths associated with HIV occur annually in this county.
Table 1. A Table of HIV Prevalence Rates.
| Prevalence Indicator | Nationwide (US) | State (Florida) | County (Miami) |
| People living with HIV/AIDS | 1.218 million | 104,000 | 26,000 |
| New infections (Annually) | 38,000 | 5,000 | 1,400-1,450 |
| Deaths (2016) | 18,000 | 2,000 | 360 |
Surveillance Methods and Mandated Reporting
The Centers for Disease Control and Prevention (CDC) supported the establishment of the National Notifiable Disease Surveillance System (NNDSS) to promote the surveillance and reporting of different diseases such as HIV/AIDS. The system recommends that every state should report certain diseases to CDC (Frieden et al., 2015). CDC then analyzes the collected information and shares it with different agencies such as the World Health Organization (WHO). The analyzed data is also shared with local and state departments for health.
Additionally, information is transmitted to physicians and practitioners efficiently. The complexity of this condition explains why HIV/AIDS is one of the conditions targeted for federal funding. CDC collects adequate and timely using indicators such as the prevalence of HIV/AIDS, existing prevention measures, opportunistic diseases, and risk factors (Powers, Kretzschmar, Miller, & Cohen, 2014). This mandated reporting model ensures that timely and adequate information is available to different healthcare providers. The ultimate goal is to ensure the challenge of HIV/AIDS is addressed successfully.
Descriptive Epidemiology Analysis
Studies indicate that the number of persons affected by HIV/AIDS has been declining since 2013 (Schackman et al., 2015). This outcome has been achieved due to the number of preventative measures, awareness programs, testing initiatives, and educational campaigns implemented to deal with the condition. Individuals are encouraged to be diagnosed frequently in order to protect themselves from HIV/AIDS.
However, statistics show conclusively that there are some groups that are affected the most by HIV/AIDS. For example, homosexuals account for around 67 percent of all new HIV diagnoses in the United States (Huang et al., 2015). Additionally, Latinos and African Americans are affected disproportionately by this condition. For instance, around 12 percent of all citizens are African Americans. However, 44 percent of all Americans infected with this condition come from this ethnic background. This means that the racial group records the highest rate of HIV diagnosis in comparison with the other ethnicities (Frieden et al., 2015). Similarly, Latinos account for 25 percent of HIV infections in the country despite representing 18 percent of the country’s population (“HIV in the United States,” n.d.).
The financial burden of HIV is extremely high in the United States (“HIV in the United States,” n.d.). It is estimated that the government will spend over 12.1 billion dollars to support the health needs of persons with HIV/AIDS in 2018 (“HIV in the United States,” n.d.). If more people were diagnosed and provided with appropriate medication, the government would save over 1 billion US dollars (Frieden et al., 2015). Additionally, it would be possible to reduce the financial burden associated with opportunistic conditions such as tuberculosis and flu. Most of the affected persons will be unable to engage in economic activities, thereby affecting the nation’s gross domestic product (GDP). In terms of social costs, the disease disorients the structures of different communities, affects social welfare programs, and forces specialists to focus on the needs of the targeted patients. Consequently, the costs have led to numerous problems such as poverty and increased number of orphans.
HIV/AIDS Diagnosis
In the United States, HIV testing and diagnosis is an area that has received much attention from different stakeholders. Testing is usually completed using an algorithm composed of two unique methods. The first one is known as ELISA while the second is called Western blot (Powers et al., 2014). These two methods are usually combined in order to produce accurate results. The use of the two methods has become the standard for diagnosing HIV/AIDs in the country. The first method (enzyme-linked immunosorbent assay) entails the use of color change and antibodies to identify the presence of a specific substance. Western blot is a powerful analytical technique that detects proteins in a given tissue homogenate extract or sample.
The Western blot technique is embraced because it has a high positive productive cost. The technique is used as a confirmatory method for testing HIV. This is the case because it tests proteins from infected cells, thereby increasing the level of accuracy. The cost for this method varies from one region to another depending on the implemented HIV prevention programs. In some states, the tests are free in an effort to deal with this epidemic (Schackman et al., 2015). There are several guidelines used to dictate the manner in which this testing method is carried out. For instance, individuals undergoing the test must be supported using existing ethical principles. For instance, they should be counseled and empowered after testing positive (Huang et al., 2015). The informed consent of the individual is crucial before undertaking the test. This means that the test should be conducted on individuals who have already made the needed decision. Finally, the issue of confidentiality must be taken seriously by health practitioners during the process.
Plan to Address this Epidemiological Condition
After finishing school, I am planning to work as a family nurse practitioner (FNP). This role will make it easier for me to meet the health needs of many patients affected by different conditions. One of these diseases is HIV/AIDS. I have settled on it because it continues to claim many lives (Powers et al., 2014). In order to address this disease, powerful measures and strategies will be needed in my county of Miami.
The first plan entails the use of powerful educational campaigns informing more people about the prevalence, signs and symptoms, and challenges associated with the condition. Such campaigns will target individuals aged between 16 and 35 years of age. This age bracket has been recording a high rate of new HIV infections (Frieden et al., 2015). The plan will encourage more individuals to engage in the best practices or behaviors and support one another. Those with the condition will also be empowered to take ARVs. I will measure the outcomes of the plan using a powerful strategy. This means that the number of beneficiaries from the program will be recorded periodically.
The second plan will focus on different families in the county. It will be appropriate to work and liaise with different families from the Latino and African American racial groups. These races appear to be affected the most by the condition. Family members will be informed about the best ways to protect themselves from the illness (Frieden et al., 2015). More patients will be guided to seek medical care. Every individual will also be encouraged to get tested. The success of this plan will be determined by the number of people who will get tested and those who will begin to use ARV drugs. The outcome will inform the major strategies to be implemented in the future to deal with this disease.
The third approach is to collaborate with health centers, hospitals, and clinics in the community. The rationale for this model is that such facilities will be equipped with adequate posters and manuals that can be distributed to every patient. This move will ensure that the greatest number of citizens is informed about the prevalence of this condition (Powers et al., 2014). The plan will be successful if more people have access to the provided posters. Additionally, every health institution will be encouraged to counsel and encourage more people to be tested. This move will ensure the challenge of HIV/AIDS is addressed successfully in Miami, Florida.
Conclusion
Although the number of persons infected with HIV/AIDS has declined significantly within the past five years, the condition continues to affect the lives of many Americans. It is also notable that more people are unaware of their HIV statuses. This gap makes it impossible for different health departments to implement evidence-based strategies to deal with the health problem. The use of different testing methods such as Western blot and ELISA should, therefore, be embraced in every community. The tests should be completed in accordance with the outlined ethical principles. Finally, nurse practitioners should be on the frontline to implement evidence-based campaigns, support different educational programs, and collaborate with health professionals to guide more people to protect themselves from the condition.
References
Florida highlights. (n.d.). Web.
Frieden, T. R., Foti, K. E., & Mermin, J. (2015). Applying public health principles to the HIV epidemic – How are we doing? The New England Journal of Medicine, 373(23), 2281-2287.
HIV in the United States: At a glance. (n.d.). Web.
Huang, M., Ye, L., Liang, B., Ning, C., Roth, W. W., Jiang, J., … Bond, V. C. (2015). Characterizing the HIV/AIDS epidemic in the United States and China. International Journal of Environmental Research and Public Health, 13(3), 1-9. Web.
Mutevedzi, P. C., & Newell, M. (2014). The changing face of the HIV epidemic in sub-Saharan Africa. Tropical Medicine and International Health, 19(9), 1015-1028. Web.
Powers, K. A., Kretzschmar, M. E., Miller, W. C., & Cohen, M. S. (2014). Impact of early-stage HIV transmission on treatment as prevention. PNAS, 111(45), 15867-15868.
Schackman, B. R., Fleishman, J. A., Su, A. E., Berkowitz, B. K., Moore, R. D., Walensky, R. P., … Losina, E. (2015). The lifetime medical cost savings from preventing HIV in the United States. Medical Care, 53(4), 293-301. Web.
The Battle Of The Sexes In The Miller’s Tale
Introduction
The Miller’s Tale is a humorous story about an old rich carpenter, his wife and two clerks. The latter two keeps seducing the carpenter’s wife in order to get her to bed. Among the various themes in this story is cuckoldry. The term cuckoldry refers to a man whose wife is unfaithful. This is a word derived from the cuckoo bird. The word can also refer to a man who gains sexual satisfaction by having his wife sleep with another man. The story tells how a woman in the medieval times could use her sexual appeal to deceive many people.
Thesis
Cuckoldry, fear of infidelity, battle of the sexes and mortality are some of the major themes that are central to and are found throughout the Miller’s Tale.
The Miller’s Tale: Cuckoldry and Fear of Infidelity
The old carpenter had married an 18 year old woman whom he really loved. He was very jealous and kept her caged for fear of her wild ways, a consequence of which he would be made a cuckold (Chaucer 142). They lived with a young clerk who had a passion for astrology and people would consult him regarding whether it will rain or not.
Cuckoldry is visible when John, the carpenter, withstands his wife’s adultery despite his knowing of it. When Absolon comes to sing with his guitar outside the carpenter’s house, all he asks his wife is whether she can hear Absolon sing instead of chasing him away. This is clear when he says “………he syngeth in his voys gentil and small” (Chaucer 256). According to the story, this does not happen once but takes place several times. Absolon even goes to the extent of sending her gifts in form of spiced wine and cakes. Chaucer says “he sententh hyre pyment, meeth and spiced ale” (line 270). We are not told anything about the protestations of the husband against such habits. Absolon keeps tries to woo Allison for a long time.
The cuckold here is not just John the carpenter but also Absolon because he is aware of the fact that Allison is married. She also makes it clear to him that she loves Nickolas, the clerk (Chaucer 144). Despite the fact that John knows Absolon is trying to woo his wife, he still neglects her and goes to Osenay. This is despite the fact that we are told he would have protected his wife with his life. This shows just how much John neglected his wife leaving her to do whatever she likes even if it meant falling for Absolon’s charms.
We could also say that Nickolas is a cuckold as he knows that Allison is married. The man insists that he loves her regardless of the fact that he knows she is another man’s wife. He also mentions nothing to Absolon about his love for Allison. He does not ask him to leave her alone and in the end he pays for this by having his back branded by Absolon.
The fear of infidelity is evident throughout the tale. First, when the old carpenter marries a young beautiful bride, he is described as being overprotective and jealous. This is evident when Chaucer says “jalous he was, and heeld hire narwe in cage” (line 116). We are told that he is willing to guard her even with his own life. This is because she is young and wild and the carpenter is scared of her making a cuckold out of him or rather scared of her being adulterous. Cato always advised men to marry women of their own age stating that a young person is wild and unpredictable (Chaucer 160). This is a clear indication of the fear of infidelity. The society fears that if an old man married a young woman, then she would betray him by sleeping with other men. The author says “……but since he had fallen into the snare, he had to endure his problem like everyone else” (Chaucer 164).
The author says that Allison is as graceful as a weasel. A weasel is a sly animal and not a graceful one (Chaucer 159). This could be a satirical description by the author meant to be deciphered only by the readers.
When Allison is first approached by Nicholas, she rejects his advances and even threatens to accuse him of rape. She is scared of being adulterous and getting involved with Nicholas but the desires of her body overcome her and she gives in to Nicholas’ advances. She also asks him to be very secretive as her husband is a very jealous man. She tells him that “…unless we watch well, and keep private, I know very well I am dead” (Chaucer 164)
At this juncture, we should ask ourselves why Nicholas and Allison did not fornicate when the husband was away on business. This is a time when they had every opportunity. But they had to go all the way by planning and executing a plan where they would fool the carpenter just to have an opportunity to fornicate. Only one conclusion can be made from such a situation. This is the fear of infidelity in the community. Absolon (another man who loved Allison dearly) was denied of having her due to the fact that she stated very clearly that she was in love with another man (Chaucer & Richmond 279).
Mortality
Traditional mortality is brought about when death occurs under normal circumstances for example due to old age or sickness (Chaucer 160). Mortality at work is first seen when Nicholas asks Allison to be with him lest he dies. According to him, he has a deep desire to be with her such that if this need is not satisfied, he is as good as dead. Chaucer & Richmond writes “……and seyed, lemman love me al atones or I wol dyen or God save me” (line 172-173).
In the second instance, Allison tells Nickolas to be secretive lest her husband finds out and she “…………..(becomes) dead” (Chaucer 234). Here, death is symbolic in that it refers to what would happen if her jealous husband finds out that she is sleeping around with another man.
Allison and Nicholas had decided to pull a prank on the carpenter by pretending that he had an astrological premonition. In the prank, the carpenter thought that he was sick and the first utterance from his mouth was “God shield him from dying suddenly” (Chaucer 300).
Not only were the people religious, but mortality was also a revered topic and it was not seen as a good thing. The only thing the carpenter could have prayed for is life for Nicholas. There is an illustration of another student of astrology who had died after trying to understand what they called “God’s secrets” (Chaucer 160). There is belief in a supernatural being that punishes wrong doers by death and therefore death is seen as a punishment from God.
There is also a belief in evil creatures whose main aim is to finish off men through death. The servant exclaims “I protect you by the cross from elves and creatures” (Chaucer & Richmond 34). Elves and creatures are signs of evil and death while the cross is a sign of life. Chaucer writes “I crouche thee from elves and fro wightes, therwith the nyght spell seyed he anon rightes” (lines 373-374).
Nicholas tells the carpenter about his premonition and the carpenter laments the death of his wife. This is another indication of the fear of death. The carpenter even goes to the extent of building tabs and filling them with food to protect his wife against death from drowning. However, Nicholas tries to trick the carpenter to remain behind by telling him that Noah loved his wife so much that he would have left her the ship. He says “the sowre of Noe with his felawshipe er that he mighte gete his wyf to shipe ?” (Chaucer 431-432).
At one time, Allison goes to church and that is where she meets Absolon who falls madly in love with her (Chaucer 162). The fact that there is a church is an indication of the belief in life after death. The tale even refers to Allison as a good woman who goes to church when the author writes “to church this good woman went” (Chaucer 43). A supreme being was supposed to save mankind from all evil, including death.
At the end of this tale, everyone gets hurt as a result of their relationship with a woman. This means that the woman is the cause of death to all men. John fell and broke his arm, a fall that would have led to his death. Absolon had a phobia of being farted on (Chaucer 178) which Nicholas did and Nicholas ended up with branded buttocks. Allison was the only one who never got hurt.
Death is feared to the extent that the carpenter sends his servants away after being advised by Nicholas that he cannot save them (Chaucer 178). Sin is also seen as a cause of death in man. The tale states that “for it is God’s own wish that your wife may hang away from you, so that there is no sin between you” (Chaucer 178). It continues “thy wyf and thou moote hange fer atwynne for that bitwixe you shal be no syn” (Chaucer 482-483).
Conclusion
The author goes on to narrate how shaken the carpenter was after learning that he is about to lose his life. Allison also pretends to be shaken when her husband tells her of what he had learnt from Nicholas. This is to show how much death and life meant to the people in those days and time. The carpenter even wailed at the thought of losing his Allison. Cuckoldry, battle of the sexes and mortality are thus very evident in the text. If an old man married a beautiful woman during those times, he had the responsibility of keeping her away from other men. But he was bound to be careful when doing this just so that he does not offend his bride because he might lose her. Men fight against each other to gain the attention of a woman. Mortality was a sacred subject and human beings feared death. It clearly describes what people at that time believed could bring death and mortality.
Works Cited
Chaucer, Geoffrey & Richmond, K. The Canterbury Tales. Virginia: Hesperus Press, 2007.
Chaucer, Geoffrey. The Canterbury Tales: The Millers Tale. Oxford: Oxford University Press, 2008.
Professor-Student Communication Using Technology
Introduction
To begin with, it should be said that innovative technologies have become an essential part of modern life. Innovations have entered all the spheres of human life (education is not an exception) and have made it easier. No one dares to say that innovative technologies have created conditions which make human life more complicated. Still, there are cases when innovations harm people. Nevertheless, this is not a problem for discussion in this paper. The essay is directed at dwelling upon the problem of communication between professors and students and the role of innovative technologies in making this communication easier.
Blackboard
Studying at universities, many students face the problem of information search. The whole system of education in many countries is based on innovative technologies. Blackboard is special software which helps students and professors communicate. Being an application it gives professors an opportunity to provide pre-formatted templates for students to have an authorized access to the information. Studying at colleges, students are offered personal logins and passwords which help them enter the website and have an access to the information they need for studying at a particular course and learning at specific classes (About Bb, 2013).
This software makes communication between a teacher and students easier as students are already aware of teacher’s requirements and at the lessons teacher should not spend time on explaining extra information. It has been proven that even though face to face communication is better for many students, online communicating is considered as the most convenient one due to the possibility to contact a teacher without leaving home (Parsloe, Benton, Davis, and Strang-Wolf, 2010).
Registration
Registration at the university online databases is easy as in most cases students are offered a login and a password in their educational establishment. Otherwise, they are to register personally having presented the information which is familiar only for them. It is very important to register to the university database on time as at the very first stages of studying the information presented there may be very useful.
Registration may take place at any region. Students are not to be at the campus as the Internet makes it easier. Each step is usually perfectly structured and students just need to read attentively what is asked to do and to follow the procedure in accordance with the instruction. Online procedure of registration usually consists of two steps. The first step is personal introduction and the choice of login and password. The second stage is the process of personalization when the system defines whether this person can have an account in a particular system. Finally, after these two steps are completed, a student receives a message with the confirmation of an access and he/she can enter a website.
Conclusion
As it has already been mentioned innovative technologies make the access to the information easier and faster. Students do not necessarily go to college or to university to have a look at the template they need to use. Moreover, having faced a problem, students have always turn either to students of the same course or to a teacher through the direct system. Innovations help students get information they need faster and it improves the quality of their knowledge. It should be stated that information systems in different university may vary depending on the peculiarities of the inner policies, however, in most cases the purpose of the information systems and their functioning is the same.
Reference List
“About Bb,” Blackboard. Web.
Parsloe, Sarah, Benton, Amanda, Davis, Daniel and Nicholas Strang-Wolf. “Preferred Communication Channels between Students and Faculty Within Extra Class Interactions.” Presentation at the Annual Meeting of the International Communication Association, Suntec Singapore International Convention & Exhibition Centre, Suntec City, Singapore, 2010.