Are They Really Lost? "True" Status and Reasons for Treatment Discontinuation among HIV Infected Patients on Antiretroviral Therapy Considered Lost to Follow Up in Urban Malawi

INTRODUCTION Patients who are lost to follow-up (LTFU) while on antiretroviral therapy (ART) pose challenges to the long-term success of ART programs. We describe the extent to which patients considered LTFU are misclassified as true disengagement from care when they are still alive on ART and explain reasons for ART discontinuation using our active tracing program to further improve ART retention programs and policies. METHODS We identified adult ART patients who missed clinic appointment by more than 3 weeks between January 2006 and December 2010, assuming that such patients would miss their doses of antiretroviral drugs. Patients considered LTFU who consented during ART registration were traced by phone or home visits; true ART status after tracing was documented. Reasons for ART discontinuation were also recorded for those who stopped ART. RESULTS Of the 4,560 suspected LTFU cases, 1,384 (30%) could not be traced. Of the 3,176 successfully traced patients, 952 (30%) were dead and 2,224 (70%) were alive, of which 2,183 (99.5%) started ART according to phone-based self-reports or physical verification during in-person interviews. Of those who started ART, 957 (44%) stopped ART and 1,226 (56%) reported still taking ART at the time of interview by sourcing drugs from another clinic, using alternative ART sources or making brief ART interruptions. Among 940 cases with reasons for ART discontinuations, failure to remember (17%), too weak/sick (12%), travel (46%), and lack of transport to the clinic (16%) were frequently cited; reasons differed by gender. CONCLUSION The LTFU category comprises sizeable proportions of patients still taking ART that may potentially bias retention estimates and misdirect resources at the clinic and national levels if not properly accounted for. Clinics should consider further decentralization efforts, increasing drug allocations for frequent travels, and improving communication on patient transfers between clinics to increase retention and adherence.

Information-centric communication in mobile and wireless networks

Information-centric networking (ICN) is a new communication paradigm that has been proposed to cope with drawbacks of host-based communication protocols, namely scalability and security. In this thesis, we base our work on Named Data Networking (NDN), which is a popular ICN architecture, and investigate NDN in the context of wireless and mobile ad hoc networks. In a first part, we focus on NDN efficiency (and potential improvements) in wireless environments by investigating NDN in wireless one-hop communication, i.e., without any routing protocols. A basic requirement to initiate informationcentric communication is the knowledge of existing and available content names. Therefore, we develop three opportunistic content discovery algorithms and evaluate them in diverse scenarios for different node densities and content distributions. After content names are known, requesters can retrieve content opportunistically from any neighbor node that provides the content. However, in case of short contact times to content sources, content retrieval may be disrupted. Therefore, we develop a requester application that keeps meta information of disrupted content retrievals and enables resume operations when a new content source has been found. Besides message efficiency, we also evaluate power consumption of information-centric broadcast and unicast communication. Based on our findings, we develop two mechanisms to increase efficiency of information-centric wireless one-hop communication. The first approach called Dynamic Unicast (DU) avoids broadcast communication whenever possible since broadcast transmissions result in more duplicate Data transmissions, lower data rates and higher energy consumption on mobile nodes, which are not interested in overheard Data, compared to unicast communication. Hence, DU uses broadcast communication only until a content source has been found and then retrieves content directly via unicast from the same source. The second approach called RC-NDN targets efficiency of wireless broadcast communication by reducing the number of duplicate Data transmissions. In particular, RC-NDN is a Data encoding scheme for content sources that increases diversity in wireless broadcast transmissions such that multiple concurrent requesters can profit from each others’ (overheard) message transmissions. If requesters and content sources are not in one-hop distance to each other, requests need to be forwarded via multi-hop routing. Therefore, in a second part of this thesis, we investigate information-centric wireless multi-hop communication. First, we consider multi-hop broadcast communication in the context of rather static community networks. We introduce the concept of preferred forwarders, which relay Interest messages slightly faster than non-preferred forwarders to reduce redundant duplicate message transmissions. While this approach works well in static networks, the performance may degrade in mobile networks if preferred forwarders may regularly move away. Thus, to enable routing in mobile ad hoc networks, we extend DU for multi-hop communication. Compared to one-hop communication, multi-hop DU requires efficient path update mechanisms (since multi-hop paths may expire quickly) and new forwarding strategies to maintain NDN benefits (request aggregation and caching) such that only a few messages need to be transmitted over the entire end-to-end path even in case of multiple concurrent requesters. To perform quick retransmission in case of collisions or other transmission errors, we implement and evaluate retransmission timers from related work and compare them to CCNTimer, which is a new algorithm that enables shorter content retrieval times in information-centric wireless multi-hop communication. Yet, in case of intermittent connectivity between requesters and content sources, multi-hop routing protocols may not work because they require continuous end-to-end paths. Therefore, we present agent-based content retrieval (ACR) for delay-tolerant networks. In ACR, requester nodes can delegate content retrieval to mobile agent nodes, which move closer to content sources, can retrieve content and return it to requesters. Thus, ACR exploits the mobility of agent nodes to retrieve content from remote locations. To enable delay-tolerant communication via agents, retrieved content needs to be stored persistently such that requesters can verify its authenticity via original publisher signatures. To achieve this, we develop a persistent caching concept that maintains received popular content in repositories and deletes unpopular content if free space is required. Since our persistent caching concept can complement regular short-term caching in the content store, it can also be used for network caching to store popular delay-tolerant content at edge routers (to reduce network traffic and improve network performance) while real-time traffic can still be maintained and served from the content store.

The impact of communication and cultural diversity in utilizing dental services among Saudi Arabian students in U.S.A.

Objectives: The purpose of this study is to understand the perceived effects of patient-dental staff communication and cultural diversity on the utilization of dental services in the U.S. by Saudi Arabian students who live in the U.S. and enrolled into the King Abdullah Scholarship program. Methods: The study design was an analytical cross-sectional study. Data for this study was obtained from the Saudi Dental Servicers Utilization Survey, a voluntary internet survey available online for one month through Facebook. Ordered logistic regression analyses and multinomial logistic regression analyses were used to measure the relationships between patient-dental staff communication and cultural diversity on the utilization of dental services. Results: Eight hundred and forty-seven responses were analyzed for this study. Overall, the majority of Saudi students reported having excellent communication experience with dental providers in the U.S. More than 58% of respondents reported at least one regular dental visit last year. Factors that influenced the use of regular dental care were: dentist's explanation of treatment plan, response of dental staff to patient's needs, respectful and polite dental staff, dental staff kindness, availability of up-to-date equipment, and overall communication with dentist. However, the utilization of emergency dental care was not associated with any measurement of patient-dental provider communication. Overall future utilization of dental care is associated with all aspects of patient-dental staff communication measured in this survey. Furthermore, more utilization of regular dental care was related to respondent's perception of the importance of trustworthiness dental staff and the importance of a dentist's reputation was only marginally associated. Respondent's perception of dentist's reputation was associated with more use of emergency dental services. Respondents are more likely to anticipate using dental care in the future if they perceived trustworthiness dental staff, and the dentist's reputation as influencing factors to their usage of dental services. Conclusions: Patient-dental staff communication was partially associated with utilization of regular dental care, not associated with utilization of emergency dental care, and broadly associated with anticipated future utilization of dental care. In addition, trustworthy dental staff, and a dentist's reputation were considered to be strong influencing factors towards utilization of dental services.^

Parameter-based mechanism for unifying user interaction, applications and communication protocols

In the smart building control industry, creating a platform to integrate different communication protocols and ease the interaction between users and devices is becoming increasingly important. BATMP is a platform designed to achieve this goal. In this paper, the authors describe a novel mechanism for information exchange, which introduces a new concept, Parameter, and uses it as the common object among all the BATMP components: Gateway Manager, Technology Manager, Application Manager, Model Manager and Data Warehouse. Parameter is an object which represents a physical magnitude and contains the information about its presentation, available actions, access type, etc. Each component of BATMP has a copy of the parameters. In the Technology Manager, three drivers for different communication protocols, KNX, CoAP and Modbus, are implemented to convert devices into parameters. In the Gateway Manager, users can control the parameters directly or by defining a scenario. In the Application Manager, the applications can subscribe to parameters and decide the values of parameters by negotiating. Finally, a Negotiator is implemented in the Model Manager to notify other components about the changes taking place in any component. By applying this mechanism, BATMP ensures the simultaneous and concurrent communication among users, applications and devices.

The Virtual Interactive Relationship Between BIM Project Teams: Effective Communication to aid Collaboration in the Design Process

Building Information Modelling (BIM) provides a shared source of information about a built asset, which creates a collaborative virtual environment for project teams. Literature suggests that to collaborate efficiently, the relationship between the project team is based on sympathy, obligation, trust and rapport. Communication increases in importance when working collaboratively but effective communication can only be achieved when the stakeholders are willing to act, react, listen and share information. Case study research and interviews with Architecture, Engineering and Construction (AEC) industry experts suggest that synchronous face-to-face communication is project teams’ preferred method, allowing teams to socialise and build rapport, accelerating the creation of trust between the stakeholders. However, virtual unified communication platforms are a close second-preferred option for communication between the teams. Effective methods for virtual communication in professional practice, such as virtual collaboration environments (CVE), that build trust and achieve similar spontaneous responses as face-to-face communication, are necessary to face the global challenges and can be achieved with the right people, processes and technology. This research paper investigates current industry methods for virtual communication within BIM projects and explores the suitability of avatar interaction in a collaborative virtual environment as an alternative to face-to-face communication to enhance collaboration between design teams’ professional practice on a project. Hence, this paper presents comparisons between the effectiveness of these communication methods within construction design teams with results of further experiments conducted to test recommendations for more efficient methods for virtual communication to add value in the workplace between design teams.

De-authoring or Authoring?: A plunge into the question of authorship and language in J.M. Coetzee's Foe

J. M. Coetzee's Foe is not only a post-colonial novel, but it is also a re-writing of a classic, and its main themes are language, authorship, power and identity. Moreover, Foe is narrated by a woman, while written by a male, Nobel prize winning South African author. The aim of my tesina is to focus on the question of authorship and the role of language in Foe. Without any claim to be exhaustive, in the first section I will examine some selected extracts of Coetzee's book, in order to provide an analysis of the novel. These quotations will mainly be its metalinguistic parts and will be analysed in the “theory” sections of my work, relying on literary theory and on previous works on the novel. Among others, I will cover themes such as the relationship between speech and writing, the connection between writing, history, and memory, the role of silence and alternative ways of communicating and the relationship between literary authority and truth. These arguments will be the foundation for my second section, in which I will attempt to shed a light on the importance of the novel from a linguistic point of view, but always keeping an eye on the implication that this has on authorship. While it is true that it is less politically-permeated than Coetzee's previous works, Foe is above all a “journey of discovery” in the world of language and authorship. In fact, it becomes a warning for any person immersed in the ocean of language since, while everyone naturally tends to trust speech and writing as the only medium through which one can get closer to the truth, authority never is a synonym of reliability, and language is a system of communication behind which structures of power, misconceptions, lies, and treacherous tides easily hide.

Transport and communication:

At head of title, no. 1- : Official statistics, commonwealth of Australia. Commonwealth Bureau of census and statistics, Melbourne.

Interagency coordination in drug research and regulation : hearings before the Subcommittee on Reorganization and International Organizations of the Committee on Government Operations, United States Senate, Eighty-seventh Congress, second session. Agency coordination study (pursuant to S. Res. 276, 87th Cong.). Review of cooperation on drug policies among Food and Drug Administration, National Institutes of Health, Veterans' Administration, and other agencies. ...

Pt. 4-5 titles vary: "Eighty-eighth Congress, first session. Agency Coordination Study (pursuant to S. Res. 27, 88th Cong., as amended). Review of cooperation on drug policies among (the) Food and Drug Administration, National Institutes of Health, Veterans' Administration, and other agencies.

Impact of social group processes and functional diversity on communication in networked organizations

This study examines the role of social group processes in perceptions of effective communication in Australian Cooperative Research Centres (CRCs). Communication professionals in 25 CRCs discussed the barriers and opportunities for communication in their diverse networked organizations. Thematic analysis of the transcripts highlighted the contribution of social group processes to both barriers and opportunities. Communication challenges implicated the social identity of organizational members, many of which were associated with distinct structural aspects of these organizations. Opportunities for communication frequently involved features that implicated social identity, including taking advantage of existing organizational or industry identities, preventing conflicting identities from becoming salient, and promoting a collective CRC identity.

"We do it, but they don't": Multiple categorizations and work team communication

The present study adopted an intergroup approach to information sharing and ratings of work team communication in a public hospital (N = 142) undergoing large-scale restructuring. Consistent with predictions, ratings of communication followed a double ingroup serving bias: while team members reported sending about the same levels of information to double ingroup members (same work team/same occupational group) as they did to partial ingroup members (same work team/different occupational group), they reported receiving less information from partial ingroup members than from double ingroup members and rated the communication that they received from partial ingroup members as less effective. We discuss the implication of these results for the management of information sharing and organizational communication.

Communication in investigative and legal contexts:integrated approaches from forensic psychology, linguistics and law enforcement

Communication in Forensic Contexts provides in-depth coverage of the complex area of communication in forensic situations. Drawing on expertise from forensic psychology, linguistics and law enforcement worldwide, the text bridges the gap between these fields in a definitive guide to best practice. • Offers best practice for understanding and improving communication in forensic contexts, including interviewing of victims, witnesses and suspects, discourse in courtrooms, and discourse via interpreters • Bridges the knowledge gaps between forensic psychology, forensic linguistics and law enforcement, with chapters written by teams bringing together expertise from each field • Published in collaboration with the International Investigative Interviewing Research Group, dedicated to furthering evidence-based practice and practice-based research amongst researchers and practitioners • International, cross-disciplinary team includes contributors from North America, Europe and Asia Pacific, and from psychology, linguistics and forensic practice