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.

Is there an App for that? : social media uses for road safety

The use of social media has increased dramatically in recent years in the areas of public health and injury prevention, with many organisations creating online and social media content. Despite the adoption of such media by modern society, research relating to the design and evaluation of social media for the promotion of health issues is very much in its infancy. A timely review of the available evidence in relation to the use of social media campaigns from both the road safety and broader public health context will be undertaken. In particular, this paper will address the questions of what social media should be developed, how it should be evaluated, as well as what should be the key measures of success and to what extent do these measures relate to practically significant outcomes, such as behaviour change. Much like more traditional media campaigns, social media may be best regarded as another approach within the array of potential approaches that a health advertising researcher or practitioner may utilise. With younger demographics becoming less likely to engage with more traditional advertising mediums relative to their preference for social media, social media‟s most important role in the road safety advertising context may be to offer the means of delivering road safety messages to high risk, younger road users.

Young children’s beliefs about including others in their play: Social and moral reasoning about inclusion and exclusion

Previous research has emphasised the importance of active citizenship in the early years for the development of a tolerant and cohesive Australian society. This paper presents findings related to young children’s beliefs about exclusion based on gender and race. The findings draw from a larger study exploring the development of children’s moral and social values and teachers’ beliefs and practices related to teaching for moral development, in the early years of school in Australia. This current study examined reasoning about exclusion in early childhood with children aged 5-8 years. One hundred children from seven schools (Preparatory to Grade 3) answered questions relating to two scenarios in which the children had to make a decision about whether to include others of different gender or race in their play. The majority of children believed that others should be included in their play, regardless of their gender or race. When asked to explain, the children primarily gave reasons related to moral concern and fairness. Children were then asked whether they would continue to include or exclude if their friends (social consensus) or teachers (authority) suggested otherwise. The majority of children maintained their beliefs when beliefs to the contrary were voiced by their peers and teachers. The implications of these responses are discussed.

Moral and social development : teachers’ knowledge of learning and teaching strategies in the early years

The intention of the analysis in this paper was to determine, from interviews with eleven early years’ teachers, what knowledge guided their teaching of moral behaviour. Six of the teachers defined moral behaviour in terms of social conventions only. Children’s learning was attributed by five of the teachers to incidental/contextual issues. Nine of the teachers used discussion of issues, in various contexts, as a way of teaching about social and moral issues. The majority of the teachers (n=7) gave the source of their knowledge of pedagogy as practical as opposed to theoretically informed. There was no clear relationship between their definitions, understanding of children’s learning, pedagogy or source of knowledge. Most of the teachers were using discussion, negotiation and reflection to develop the children’s moral and social behaviour. This is probably effective; however, it suggests a strong need for teaching of moral development to be given more prominence and addressed directly in in-service courses so that teachers are clear about their intentions and the most effective ways of achieving them.

The association between playgroup participation, learning competence and social-emotional wellbeing for children aged 4-5 years in Australia

Data from Growing Up in Australia: The Longitudinal Study of Australian Children is used to examine the associations between playgroup participation and the outcomes for children aged 4 to 5 years. Controlling for a range of socio-economic and family characteristics, playgroup participation across the ages of 0-3 years was used to predict learning competence and social-emotional functioning outcomes at age 4-5 years. For learning competence, both boys and girls from disadvantaged families scored 3-4% higher if they attended playgroup when aged 0-1 and 2-3 years compared to boys and girls from disadvantaged families who did not attend playgroup. For social and emotional functioning, girls from disadvantaged families who attended playgroup when they were aged 0-1 and 2-3 years scored nearly 5% higher than those who did not attend. Demographic characteristics also showed that disadvantaged families were the families least likely to access these services. Despite data limitations, this study provides evidence that continued participation in playgroups is associated with better outcomes for children from disadvantaged families.

Practices for teaching moral values in the early years : a call for a pedagogy of participation

Schools have long been seen as institutions for preparing children for life, both academically and as moral agents in society. In order to become capable, moral citizens, children need to be provided with opportunities to learn moral values. However, little is known about how teachers enact social and moral values programs in the classroom. The aim of this paper is to investigate the practices that Australian early years teachers describe as important for teaching moral values. To investigate early years teachers’ understandings of moral pedagogy, 379 Australian teachers with experience teaching children in the early years were invited to participate in an on-line survey. This paper focuses on responses provided to an open-ended question relating to teaching practices for moral values. The responses were analysed using an interpretive methodology. The results indicate that the most prominent approaches to teaching moral values described by this group of Australian early years teachers were engaging children in moral activities. This was closely followed by teaching practices for transmitting moral values. Engaging children in building meaning and participatory learning for moral values were least often described.

A social marketing approach to value creation in a Well-Women’s health service

Understanding consumer value is imperative in health care as the receipt of value drives the demand for health care services. While there is increasing research into health-care that adopts an economic approach to value, this paper investigates a non-financial exchange context and uses an experiential approach to value, guided by a social marketing approach to behaviour change. An experiential approach is deemed more appropriate for government health-care services that are free and for preventative rather than treatment purposes. Thus instead of using an illness-paradigm to view health services outcomes, we adopt a wellness paradigm. Using qualitative data gathered during 25 depth interviews the authors demonstrate how social marketing thinking has guided the identification of six themes that represent four dimensions of value (functional, emotional, social and altruistic) evident during the health care consumption process of a free government service.

Neo-planning: Location-based social media to engage Australia’s new digital locals

Community engagement with time poor and seemingly apathetic citizens continues to challenge local governments. Capturing the attention of a digitally literate community who are technology and socially savvy adds a new quality to this challenge. Community engagement is resource and time intensive, yet local governments have to manage on continually tightened budgets. The benefits of assisting citizens in taking ownership in making their community and city a better place to live in collaboration with planners and local governments are well established. This study investigates a new collaborative form of civic participation and engagement for urban planning that employs in-place digital augmentation. It enhances people’s experience of physical spaces with digital technologies that are directly accessible within that space, in particular through interaction with mobile phones and public displays. The study developed and deployed a system called Discussions in Space (DIS) in conjunction with a major urban planning project in Brisbane. Planners used the system to ask local residents planning-related questions via a public screen, and passers-by sent responses via SMS or Twitter onto the screen for others to read and reflect, hence encouraging in-situ, real-time, civic discourse. The low barrier of entry proved to be successful in engaging a wide range of residents who are generally not heard due to their lack of time or interest. The system also reflected positively on the local government for reaching out in this way. Challenges and implications of the short-texted and ephemeral nature of this medium were evaluated in two focus groups with urban planners. The paper concludes with an analysis of the planners’ feedback evaluating the merits of the data generated by the system to better engage with Australia’s new digital locals.

Political information choices in a media saturated environment : credibility or convenience?

This thesis examines the ways in which citizens find out about socio-political issues. The project set out to discover how audience characteristics such as scepticism towards the media, gratifications sought, need for cognition and political interest influence information selection. While most previous information choice studies have focused on how individuals select from a narrow range of media types, this thesis considered a much wider sweep of the information landscape. This approach was taken to obtain an understanding of information choices in a more authentic context - in everyday life, people are not simply restricted to one or two news sources. Rather, they may obtain political information from a vast range of information sources, including media sources (e.g. radio, television, newspapers) and sources from beyond the media (eg. interpersonal sources, public speaking events, social networking websites). Thus, the study included both media and non-news media information sources. Data collection for the project consisted of a written, postal survey. The survey was administered to a probability sample in the greater Brisbane region, which is the third largest city in Australia. Data was collected during March and April 2008, approximately four months after the 2007 Australian Federal Election. Hence, the study was conducted in a non-election context. 585 usable surveys were obtained. In addition to measuring the attitudinal characteristics listed above, respondents were surveyed as to which information sources (eg. television shows, radio stations, websites and festivals) they usually use to find out about socio-political issues. Multiple linear regression analysis was conducted to explore patterns of influence between the audience characteristics and information consumption patterns. The results of this analysis indicated an apparent difference between the way citizens use news media sources and the way they use information sources from beyond the news media. In essence, it appears that non-news media information sources are used very deliberately to seek socio-political information, while media sources are used in a less purposeful way. If media use in a non-election context, such as that of the present study, is not primarily concerned with deliberate information seeking, media use must instead have other primary purposes, with political information acquisition as either a secondary driver, or a by-product of that primary purpose. It appears, then, that political information consumption in a media-saturated society is more about routine ‘practices’ than it is about ‘information seeking’. The suggestion that media use is no longer primarily concerned with information seeking, but rather, is simply a behaviour which occurs within the broader set of everyday practices reflects Couldry’s (2004) media as practice paradigm. These findings highlight the need for more authentic and holistic contexts for media research. It is insufficient to consider information choices in isolation, or even from a wider range of information sources, such as that incorporated in the present study. Future media research must take greater account of the broader social contexts and practices in which media-oriented behaviours occur. The findings also call into question the previously assumed centrality of trust to information selection decisions. Citizens regularly use media they do not trust to find out about politics. If people are willing to use information sources they do not trust for democratically important topics such as politics, it is important that citizens possess the media literacy skills to effectively understand and evaluate the information they are presented with. Without the application of such media literacy skills, a steady diet of ‘fast food’ media may result in uninformed or misinformed voting decisions, which have implications for the effectiveness of democratic processes. This research has emphasized the need for further holistic and authentically contextualised media use research, to better understand how citizens use information sources to find out about important topics such as politics.

Library and information science education 2.0 : guiding principles and models of best practice ALTC Fellowship Report

This ALTC Teaching Fellowship aimed to establish Guiding Principles for Library and Information Science Education 2.0. The aim was achieved by (i) identifying the current and anticipated skills and knowledge required by successful library and information science (LIS) professionals in the age of web 2.0 (and beyond), (ii) establishing the current state of LIS education in Australia in supporting the development of librarian 2.0, and in doing so, identify models of best practice. The fellowship has contributed to curriculum renewal in the LIS profession. It has helped to ensure that LIS education in Australia continues to meet the changing skills and knowledge requirements of the profession it supports. It has also provided a vehicle through which LIS professionals and LIS educators may find opportunities for greater collaboration and more open communication. This will help bridge the gap between LIS theory and practice and will foster more authentic engagement between LIS education and other parts of the LIS industry in the education of the next generation of professionals. Through this fellowship the LIS discipline has become a role model for other disciplines who will be facing similar issues in the coming years. Eighty-one members of the Australian LIS profession participated in a series of focus groups exploring the current and anticipated skills and knowledge needed by the LIS professional in the web 2.0 world and beyond. Whilst each focus group tended to draw on specific themes of interest to that particular group of people, there was a great deal of common ground. Eight key themes emerged: technology, learning and education, research or evidence-based practice, communication, collaboration and team work, user focus, business savvy and personal traits. It was acknowledged that the need for successful LIS professionals to possess transferable skills and interpersonal attributes was not new. It was noted however that the speed with which things are changing in the web 2.0 world was having a significant impact and that this faster pace is placing a new and unexpected emphasis on the transferable skills and knowledge. It was also acknowledged that all librarians need to possess these skills, knowledge and attributes and not just the one or two role models who lead the way. The most interesting finding however was that web 2.0, library 2.0 and librarian 2.0 represented a ‘watershed’ for the LIS profession. Almost all the focus groups spoke about how they are seeing and experiencing a culture change in the profession. Librarian 2.0 requires a ‘different mindset or attitude’. The Levels of Perspective model by Daniel Kim provides one lens by which to view this finding. The focus group findings suggest that we are witnessing a re-awaking of the Australian LIS profession as it begins to move towards the higher levels of Kim’s model (ie mental models, vision). Thirty-six LIS educators participated in telephone interviews aimed at exploring the current state of LIS education in supporting the development of librarian 2.0. Skills and knowledge of LIS professionals in a web 2.0 world that were identified and discussed by the LIS educators mirrored those highlighted in the focus group discussions with LIS professionals. Similarly it was noted that librarian 2.0 needed a focus less on skills and knowledge and more on attitude. However, whilst LIS professionals felt that there was a paradigm shift within the profession. LIS educators did not speak with one voice on this matter with quite a number of the educators suggesting that this might be ‘overstating it a bit’. This study provides evidence for “disparate viewpoints” (Hallam, 2007) between LIS educators and LIS professionals that can have a significant implications for the future of not just LIS professional education specifically but for the profession generally. Library and information science education 2.0: guiding principles and models of best practice 1 Inviting the LIS academics to discuss how their teaching and learning activities support the development of librarian 2.0 was a core part of the interviews conducted. The strategies used and the challenges faced by LIS educators in developing their teaching and learning approaches to support the formation of librarian 2.0 are identified and discussed. A core part of the fellowship was the identification of best practice examples on how LIS educators were developing librarian 2.0. Twelve best practice examples were identified. Each educator was recorded discussing his or her approach to teaching and learning. Videos of these interviews are available via the Fellowship blog at .The LIS educators involved in making the videos felt uncomfortable with the term ‘best practice’. Many acknowledged that there simply seeking to do the best by their students and that there was always room for improvement. For this reason these videos are offered as examples of “great practice”. The videos are a tool for other educators to use, regardless of discipline, in developing their teaching and learning approaches to supporting web 2.0 professionals. It has been argued that the main purpose of professional education is transformation (Dall’ Alba, 2009; Dall’Alba & Barnacle, 2007). As such professional education should focus not just on skills and knowledge acquisition but also on helping students to develop ways of being the professionals in question (ie LIS professionals, teachers, lawyers, engineers).The aim of this fellowship was to establish Guidelines for Library and Information Science Education 2.0 it has however become apparent that at this point in time it is not yet possible to fulfil this aim. The fellowship has clearly identified skills and knowledge needed by the LIS professional in web 2.0 world (and beyond). It has also identified examples of ‘great practice’ by LIS educators as they endeavour to develop LIS professionals who will be successful in a web 20 world. The fellowship however has also shown that the LIS profession is currently undergoing significant attitudinal and conceptual change. Consequently, before a philosophy of LIS education 2.0 can be expressed, the Australian LIS profession must first explore and articulate what it means to be an LIS professional in the 21st century (ie a world of web 2.0 and beyond). In short, the LIS profession in Australia must take stock not of “what we know and can do” but on “who we are becoming” (Dall’Alba, 2009, p 34).

A voting mechanism for named entity translation in English-Chinese question answering

In this paper, we describe a voting mechanism for accurate named entity (NE) translation in English–Chinese question answering (QA). This mechanism involves translations from three different sources: machine translation,online encyclopaedia, and web documents. The translation with the highest number of votes is selected. We evaluated this approach using test collection, topics and assessment results from the NTCIR-8 evaluation forum. This mechanism achieved 95% accuracy in NEs translation and 0.3756 MAP in English–Chinese cross-lingual information retrieval of QA.

Multiculturalism, education for sustainable development (ESD) and the shifting discursive landscape of social inclusion

Australia has a long and sometimes turbulent relationship with the migrant Other. This paper examines a component of this relationship via the window of contemporary multicultural policy. The paper begins with an analysis of the political and social conditions that enabled a national and bipartisan policy of multiculturalism to emerge as formalised federal policy during the late 1960s and early 1970s. The paper re-problematises the influences that helped shape Australia's articulation of race and ethnicity and argues that multiculturalism, within a post-September 11 environment, can no longer be framed solely within its traditional framework of social justice. The paper positions education for sustainable development (ESD) as an emerging discursive field that provides educators with an alternative road map for critiquing Australia's fluid relationship with the migrant Other. By linking the tenets of multiculturalism with ESD, this paper suggests pre-service teacher educators are presented with a productive, and at the same time politically palatable, means for regaining pedagogical traction for a semi-dormant agenda of social inclusion.

Sources of stress experienced by occupational therapists and social workers in mental health settings

This study examined the sources of stress experienced by occupational therapists and social workers employed in Australian public mental health services and identified the demographic and work-related factors related to stress using a cross-sectional survey design. Participants provided demographic and work-related information and completed the Mental Health Professionals Stress Scale. The overall response rate to the survey was 76.6%, consisting of 196 occupational therapists and 108 social workers. Results indicated that lack of resources, relationships and conflicts with other professionals, workload, and professional self-doubt were correlated with increased stress. Working in case management was associated with stress caused by client-related difficulties, lack of resources, and professional self-doubt. The results of this study suggest that Australian occupational therapists and social workers experience stress, with social workers reporting slightly more overall stress than occupational therapists.

Applying a social justice framework to ensure good practice in monitoring student learning engagement

A current Australian Learning and Teaching Council (ALTC) funded action research project aims to provide a set of practical resources founded on a social justice framework, to guide good practice for monitoring student learning engagement (MSLE) in higher education. The project involves ten Australasian institutions, eight of which are engaged in various MSLE type projects. A draft framework, consisting of six social justice principles which emerged from the literature has been examined with reference to the eight institutional approaches for MSLE in conjunction with the personnel working on these initiatives during the first action research cycle. The cycle will examine the strategic and operational implications of the framework in each of the participating institutions. Cycle 2 will also build capacity to embed the principles within the institutional MSLE program and will identify and collect examples and resources that exemplify the principles in practice. The final cycle will seek to pilot the framework to guide new MSLE initiatives. In its entirety, the project will deliver significant resources to the sector in the form of a social justice framework for MSLE, guidelines and sector exemplars for MSLE. As well as increasing the awareness amongst staff around the criticality of transition to university (thereby preventing attrition) and the significance of the learning and teaching agenda in enhancing student engagement, the project will build leadership capacity within the participating institutions and provide a knowledge base and institutional capacity for the Australasian HE sector to deploy the deliverables that will safeguard student learning engagement At this early stage of the project the workshop session provides an opportunity to discuss and examine the draft set of social justice principles and to discuss their potential value for the participants’ institutional contexts. Specifically, the workshop will explore critical questions associated with the principles.