Antiretroviral therapy (ART) adherence among people living with HIV/AIDS (PLHIV) in the north of Vietnam : a multi-method approach

The antiretroviral therapy (ART) program for People Living with HIV/AIDS (PLHIV) in Vietnam has been scaled up rapidly in recent years (from 50 clients in 2003 to almost 38,000 in 2009). ART success is highly dependent on the ability of the patients to fully adhere to the prescribed treatment regimen. Despite the remarkable extension of ART programs in Vietnam, HIV/AIDS program managers still have little reliable data on levels of ART adherence and factors that might promote or reduce adherence. Several previous studies in Vietnam estimated extremely high levels of ART adherence among their samples, although there are reasons to question the veracity of the conclusion that adherence is nearly perfect. Further, no study has quantitatively assessed the factors influencing ART adherence. In order to reduce these gaps, this study was designed to include several phases and used a multi-method approach to examine levels of ART non-adherence and its relationship to a range of demographic, clinical, social and psychological factors. The study began with an exploratory qualitative phase employing four focus group discussions and 30 in-depth interviews with PLHIV, peer educators, carers and health care providers (HCPs). Survey interviews were completed with 615 PLHIV in five rural and urban out-patient clinics in northern Vietnam using an Audio Computer Assisted Self-Interview (ACASI) and clinical records extraction. The survey instrument was carefully developed through a systematic procedure to ensure its reliability and validity. Cultural appropriateness was considered in the design and implementation of both the qualitative study and the cross sectional survey. The qualitative study uncovered several contrary perceptions between health care providers and HIV/AIDS patients regarding the true levels of ART adherence. Health care providers often stated that most of their patients closely adhered to their regimens, while PLHIV and their peers reported that “it is not easy” to do so. The quantitative survey findings supported the PLHIV and their peers’ point of view in the qualitative study, because non-adherence to ART was relatively common among the study sample. Using the ACASI technique, the estimated prevalence of onemonth non-adherence measured by the Visual Analogue Scale (VAS) was 24.9% and the prevalence of four-day not-on-time-adherence using the modified Adult AIDS Clinical Trials Group (AACTG) instrument was 29%. Observed agreement between the two measures was 84% and kappa coefficient was 0.60 (SE=0.04 and p<0.0001). The good agreement between the two measures in the current study is consistent with those found in previous research and provides evidence of cross-validation of the estimated adherence levels. The qualitative study was also valuable in suggesting important variables for the survey conceptual framework and instrument development. The survey confirmed significant correlations between two measures of ART adherence (i.e. dose adherence and time adherence) and many factors identified in the qualitative study, but failed to find evidence of significant correlations of some other factors and ART adherence. Non-adherence to ART was significantly associated with untreated depression, heavy alcohol use, illicit drug use, experiences with medication side-effects, chance health locus of control, low quality of information from HCPs, low satisfaction with received support and poor social connectedness. No multivariate association was observed between ART adherence and age, gender, education, duration of ART, the use of adherence aids, disclosure of ART, patients’ ability to initiate communication with HCPs or distance between clinic and patients’ residence. This is the largest study yet reported in Asia to examine non-adherence to ART and its possible determinants. The evidence strongly supports recent calls from other developing nations for HIV/AIDS services to provide screening, counseling and treatment for patients with depressive symptoms, heavy use of alcohol and substance use. Counseling should also address fatalistic beliefs about chance or luck determining health outcomes. The data suggest that adherence could be enhanced by regularly providing information on ART and assisting patients to maintain social connectedness with their family and the community. This study highlights the benefits of using a multi-method approach in examining complex barriers and facilitators of medication adherence. It also demonstrated the utility of the ACASI interview method to enhance open disclosure by people living with HIV/AIDS and thus, increase the veracity of self-reported data.

Grounded Media: Expanding the Scope of Ecological Art Practices Within New Media Arts Culture

‘Grounded Media’ is a form of art practice focused around the understanding that our ecological crisis is also a cultural crisis, perpetuated by our sense of separation from the material and immaterial ecologies upon which we depend. This misunderstanding of relationships manifests not only as environmental breakdown, but also in the hemorrhaging of our social fabric. ‘Grounded Media’ is consistent with an approach to media art making that I name ‘ecosophical’ and ‘praxis-led’ – which seeks through a range of strategies, to draw attention to the integrity, diversity and efficacy of the biophysical, social and electronic environments of which we are an integral part. It undertakes this through particular choices of location, interaction design,participative strategies and performative direction. This form of working emerged out of the production of two major projects, Grounded Light [8] and Shifting Intimacies [9] and is evident in a recent prototypical wearable art project called In_Step [6]. The following analysis and reflections will assist in promoting new, sustainable roles for media artists who are similarly interested in attuning their practices.

Then I let you

In this video, a male voice recites a teenage love poem. Words flash on screen in time with the spoken words. Sometimes the two sets of words match, and sometimes they differ. This work examines processes of signification. It emphasizes disruption and disconnection as fundamental and generative operations in making meaning. Extending on post-structural and deconstructionist ideas, this work questions the relationship between written and spoken words. By actively disrupting the sincerity of a teenage love poem, it questions the sites and mechanisms of comprehension, poetry and signification.

Do you see what I mean? charting changing representations and receptions of the disabled body in contemporary and pop cultural performance

The meaning of the body emerges through acts of seeing, looking and staring in daily and dramatic performances. Acts that are, as Maike Bleeker argues1, bound up with the scopic rules, regimes and narratives that apply in specific cultures at specific times. In Western culture, the disabled body has been seen as a sign of defect, deficiency, fear, shame or stigma. Disabled artists – Mat Fraser, Bill Shannon, Aaron Williamson, Katherine Araniello, Liz Crow and Ju Gosling – have attempted, via performances that co-opt conventional images of the disabled body, to challenge dominant ways of representing and responding such bodies from within. In this paper, I consider what happens when non-disabled artists co-opt images of the disabled body to draw attention to, affirm, and even exoticise, eroticise or beautify, other modalities of or desires for difference. As Carrie Sandahl has noted2, the signs, symbols and somatic idiosyncrasies of the disabled body are, today, transported or translated into theatre, film and television as a metaphor or "master trope" for every body’s experience of difference. This happens in performance art (Guillermo Gomez-Pena’s use of a wheelchair in Chamber of Confessions), performance (Marie Chouinard's use of crutches, canes and walkers to represent dancers’ experience of becoming different or mutant during training in bODY rEMIX /gOLDBERG vARIATIONS), and pop culture (characters in wheelchairs in Glee or Oz). In this paper, I chart changing representations and receptions of the disabled body in such contexts. I use analysis of this cultural shift as a starting point for a re-consideration of questions about whether a face-toface encounter with a disabled body is in fact a privileged site for the emergence of a politics, and whether co-opting disability as a metaphor for a range of difference differences reduces its currency as a category around which a specific group might mobilise a politics.

New evaluation methodologies for public art programs in cultural instiutions

I put my abstract in for this conference back in March, based on some evaluation work I had been doing in 2010 with my colleague Professor Greg Hearn for the 3C Regional Writing NeoGreography Project. I had been swapping notes with a colleague from the Smithsonian’s Centre for Folklife and Cultural Heritage about their evaluation work, and stuck inside during the rains of January, I decided to apply for a Qld Smithsonian fellowship based on the quandary of evaluation-particular in public histories (oral histories) and digital storytelling. In July I was awarded the fellowship, so I have tweaked my presentation to talk about what we hope to do with this collaboration, to propel the importance placed on evaluation in public arts programs in Qld and beyond.

Catherine or Kate : the tertiary spaces of collaboration, performance and humour in contemporary art

The traditional model of visual arts practice is one that privileges highly individuated and predominantly material investigations and outcomes. This approach overlooks and devalues the formal and informal dialogues and collaborations that take place in the process of making art. This Masters research project considers how the experience of working in collaboration can generate a new model for thinking about practice-led methodologies in visual arts. It aims to do this by mapping out and elaborating on the processes and approaches to making that fellow Masters student Catherine Sagin and I have come to use in our alliance as ‘Fiona Mail’, ‘Catherine Sagin’ and ‘Catherine or Kate’ respectively. The fluidity of our collaborative moniker is one example of the way this project creatively explores and re-assesses the implications of collaboration. Drawing upon the contextual frames of conceptual art, performance art, and comedy this research looks at the significance of and possibilities for working as a collaborative duo.

Come together : forging publics in Brisbane's Gallery of Modern Art

The Gallery of Modern Art (GoMA) in Brisbane, Australia’s third largest city, recently staged ‘21st Century: Art of the First Decade’. The gallery spaces were replete with a commissioned slide by Carsten Höller, an installation of Rivane Neuenschwande’s I Wish Your Wish (2003), a table of white Legos, a room of purple balloons and other participatory or interactive artworks designed to engage multiple publics and encourage audience participation in a variety of ways. Many of the featured projects used day-to-day experiences and offered new conceptions about art practice and what they can elicit in their public – raise awareness about local issues, help audiences imagine different ways of negotiating their environs or experi-ence a museum in a new way. At times, the bottom floor galleries resembled a theme park – adults and children playing with Legos and using Höller’s slide. This article examines the benefits and limitations of such artistic interventions by relating the GoMA exhibition to Brisbane City Council’s campaign of ‘Together Brisbane’ (featuring images of Neunenschwande’s ribbons); a response to the devastation brought to the city and its surrounds in January 2011. During the Brisbane floods, GoMA’s basement was damaged, the museum closed and upon reopening, visitor numbers soared. In this context, GoMA’s use of engaged art practice – always verging on the ephemeral and ‘fun’ – has been used to project a wider notion of a collective urban public. What questions does this raise, not only regarding the cultural politics around the social and participatory ‘turn’ in art practice, but its use to address a much wider urban public in a moment of crisis.

Cutting on action : interference strategies in contemporary art practice

The domestication of creative software and hardware has been a significant factor in the recent proliferation of still and moving image creation. Booming numbers of amateur image-makers have the resources, skills and ambitions to create and distribute their work on a mass scale. At the same time, contemporary art seems increasingly dominated by ‘post-medium’ practices that adopt and adapt the representational techniques of mass culture, rather than overtly reject or oppose them. As a consequence of this network of forces, the field of image and video production is no longer the exclusive specialty of art and the mass media, and art may no longer be the most prominent watchdog of mass image culture. Intuitively and intentionally, contemporary artists are responding to these shifting conditions. From the position of a creative practitioner and researcher, this paper examines the strategies that contemporary artists use to engage with the changing relationships between image culture, lived experience and artistic practice. By examining the intersections between W.J.T. Mitchell’s detailed understanding of visual literacy and Jacques Derrida’s philosophical models of reading and writing, I identify ‘editing’ as a broad methodology that describes how practitioners creatively and critically engage with the field of still and moving images. My contention is that by emphasising the intersections of looking and making, ‘reading’ and ‘writing’, artists provide crucial jump cuts, pauses and distortions in the medley of our mediated experiences.

The power of art, the power of entertainment

The question of the relationship between culture and power continues to exercise researchers. In this paper I argue that it is useful to consider the differences between ‘art’ and ‘entertainment’ as systems of culture, each involving a distinct set of power relationships between producers and audiences. Art wants to change audiences; entertainment wants to be changed by audiences. From these different starting points a series of differences unfold in the power possessed by producers and audiences. Artists pride themselves in not involving the audience in the process of making art. By contrast, entertainment wants audiences to contribute to the making of texts. As to the question of who controls the range of what forms of culture are available, it seems that entertainment consumers – unlike art consumers – are ill-disciplined. Historical evidence demonstrates that if legal corporate providers do not offer the kinds of entertainment they want, they will turn to illegal sources. The different ways in which ‘art’ and ‘entertainment’ function as cultural systems suggest that we must rethink our positions on ‘media power’.

I-vector based speaker recognition using advanced channel compensation techniques

This paper investigates advanced channel compensation techniques for the purpose of improving i-vector speaker verification performance in the presence of high intersession variability using the NIST 2008 and 2010 SRE corpora. The performance of four channel compensation techniques: (a) weighted maximum margin criterion (WMMC), (b) source-normalized WMMC (SN-WMMC), (c) weighted linear discriminant analysis (WLDA), and; (d) source-normalized WLDA (SN-WLDA) have been investigated. We show that, by extracting the discriminatory information between pairs of speakers as well as capturing the source variation information in the development i-vector space, the SN-WLDA based cosine similarity scoring (CSS) i-vector system is shown to provide over 20% improvement in EER for NIST 2008 interview and microphone verification and over 10% improvement in EER for NIST 2008 telephone verification, when compared to SN-LDA based CSS i-vector system. Further, score-level fusion techniques are analyzed to combine the best channel compensation approaches, to provide over 8% improvement in DCF over the best single approach, (SN-WLDA), for NIST 2008 interview/ telephone enrolment-verification condition. Finally, we demonstrate that the improvements found in the context of CSS also generalize to state-of-the-art GPLDA with up to 14% relative improvement in EER for NIST SRE 2010 interview and microphone verification and over 7% relative improvement in EER for NIST SRE 2010 telephone verification.

Pieces of a city : the art of making speculative cities, bodies, & texts

This practice-led doctorate involved the development of a collection – a bricolage – of interwoven fragments of literary texts and visual imagery explor-ing questions of speculative fiction, urban space and embodiment. As a sup-plement to the creative work, I also developed an exegesis, using a combina-tion of theoretical and contextual analysis combined with critical reflections on my creative process and outputs. An emphasis on issues of creative practice and a sustained investigation into an aesthetics of fragmentation and assem-blage is organised around the concept and methodology of bricolage, the eve-ryday art of ‘making do’. The exegesis also addresses my interest in the city and urban forms of subjectivity and embodiment through the use of a range of theorists, including Michel de Certeau and Elizabeth Grosz.

The politics and poetics of coexistence : experiments at the intersection of art and environmental engineering

This research project explores how interdisciplinary art practices can provide ways for questioning and envisaging alternative modes of coexistence between humans and the non-humans who together, make up the environment. As a practiceled project, it combines a body of creative work (50%) and this exegesis (50%). My interdisciplinary artistic practice appropriates methods and processes from science and engineering and merges them into artistic contexts for critical and poetic ends. By blending pseudo-scientific experimentation with creative strategies like visual fiction, humour, absurd public performance and scripted audience participation, my work engages with a range of debates around ecology. This exegesis details the interplay between critical theory relating to these debates, the work of other creative practitioners and my own evolving artistic practice. Through utilising methods and processes drawn from my prior career in water engineering, I present an interdisciplinary synthesis that seeks to promote improved understandings of the causes and consequences of our ecological actions and inactions.

The paradox of autistic art

Certain autistic children whose linguistic ability is virtually nonexistent can draw natural scenes from memory with astonishing accuracy. In particular their drawings display convincing perspective. In contrast, normal children of the same preschool age group and even untrained adults draw primitive schematics or symbols of objects which they can verbally identify. These are usually conceptual outlines devoid of detail. It is argued that the difference between autistic child artists and normal individuals is that autistic artists make no assumptions about what is to be seen in their environment. They have not formed mental representations of what is significant and consequently perceive all details as equally important. Equivalently, they do not impose visual or linguistic schema -- a process necessary for rapid conceptualisation in a dynamic existence, especially when the information presented to the eye is incomplete.

The Art of Freestyle

"This book is intended to be instructional, inspirational and of interest to both novice and expert alike. The assumption is made that to even begin to playboat the paddler will already be an intermdiate white water boater familiar with basic strokes and boating skills. For the interested non paddler a glossary of terms is included. Part One gives an overview of the sport and lays the foundations of understanding on which the rest of the book builds, as well as exploring safety issues and exploring key concepts. Part Two describes and coaches the moves which are divided into intermediate and advanced standard. Part Three looks at how to train in order to hone your physical and mental skills and be 'the best you can be'. Never before has so much freestyle, rodeo and playboating information from so many great boaters been gathered together in one place. In a world dominated by the biggest, the fastest, the loudest...the most big headed, this book makes a stand. Whilst of course covering all the latest moves, the authors have not been frightened to start right back at basic concepts. Technical ability is nothing without knowledge, without planning and without stamina. This book tells you the secrets. Freestyle is a thinking person's sport. The authors, the contributors and the book's publisher have an unrivalled breadth of knowledge in this field, so let this book do some of the thinking for you. The full colour format and the emphasis on personal training and coaching make for a particularly easy read. When planning my preparation or training before a competition, I always try to evaluate its potential benefits in terms of how many places it will have helped me move up in the final results. As a general rule in life, any time spent off the water should be viewed with suspicion! However, use this time constructively and absorb the information in this book and you will reap your own rewards. The Art of Freestyle is a book genuinely written by paddlers for paddlers. It is often a hard task to get top athletes to part with their preferred training or competition techniques, but this book is full of such 'Top Tips'. This is not a book written just by its authors, but by a wealth of accomplished paddlers. It is this subtle combination that keeps the reader in the real world...believing in a move, not just imagining it. This is the real world...believe you can do it."--Playak Website

The art of being a fan : complicity and criticality in contemporary art and fandom

This practice-led research project aims to use contemporary art processes and concepts of fandom to construct a space for the critical and creative exploration of the relationship between them. Much of the discourse addressing the intersection of these spaces over the last three decades tends to treat art and fan studies as separate areas of critical and theoretical research. There has also been very little consideration of the critical interface that art practice and fandom share in their engagement with one another – or how the artist as fan might creatively exploit this relationship. Approaching these issues through a practice-led methodology that combines studio based explorations and traditional modes of research, the project aims to demonstrate how my 'fannish' engagements with popular culture can generate new responses to, and understandings of, the relationship between fandom, affect and visual art. The research acts as a performative and creative investigation of fandom as I document the complicit tendencies that arise out of my affective relationship with pop cultural artefacts. It does this through appropriating and reconfiguring content from film, television and print media, to create digital video installations aimed at engendering new experiences and critical interpretations of screen culture. This approach promotes new possibilities for creative engagements with art and popular culture, and these are framed through the lens of what I term the digital-bricoleur. The research will be primarily contextualised by examining other artists' practices as well as selected theoretical frameworks that traverse my investigative terrain. The key artists that are discussed include Douglas Gordon, Candice Brietz, Pierre Huyghe, Paul Pfieffer, and Jennifer and Kevin McCoy. The theoretical developments of the project are drawn from a pluralistic range of ideas ranging from Johanna Drucker's discussion of critical complicity in contemporary art, Matt Hills' discussion of subjectivity in fandom and academia, Nicolas Bourriaud's discussion of Postproduction art practices, and Jacques Rancière's ideas about aesthetics and politics. The methodology and artworks developed over the course of this project will also demonstrate how digital-bricolage leads to new understandings of the relationships between contemporary art and entertainment. The research aims to exploit these apparently contradictory positions to generate a productive site for rethinking the relationship between the creative and critical possibilities of art and fandom. The outcomes of the research consists of a body of artworks – 75% – that demonstrate new contributions to knowledge, and an exegetical component – 25% – that acts to reflect on, analyse and critically contextualise the practice-led findings.