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.

Social outcomes in the construction industry : the case of the Western Australia ‘Percent for Art’ policy

Social outcomes, in particular intangible social outcomes, are generally difficult to achieve in the construction industry due to the predominantly episodic, fragmented and heavily regulated nature of construction that presupposes a tendency towards mainstream construction processes and design. The Western Australian ‘Percent for Art’ policy is recognized for stimulating social outcomes, by creating richer and more aesthetically pleasing social environments through the incorporation of artwork into public buildings. A case study of four Percent for Art projects highlights the role of the Artwork Selection Committee in incorporating artwork into construction. A total of 20 semi-structured interviews were conducted with committee members and policy officers. Data analysis involved a combination of pattern coding and matrix categorization, and resulted in the identification of the committee’s three key elements of collaborative communication, democratic decision-making and project champions. The findings suggest these key elements foster the interaction, communication and relationships needed to facilitate feedback, enhance relationships, create cross-functional teams and lower project resistance, which are all necessary to overcome constraints to social outcomes in construction. The findings provide greater insight into the mechanisms for achieving social outcomes and a basis for future discussion about the processes for achieving social outcomes in the construction industry.

From the margin to the centre : towards an art strategy for the ethnic enclaves in the city

Sunnybank represents a distinctly Australian take on the classic ‘Chinatown’ – or indeed other ethic community enclaves such as ‘little Italy’, ‘little Bombay’, ‘little Athens’ and so on. In the Northern Hemisphere these tended to grow up in the dense working class neighbourhoods of industrial cities, especially in port cities like Liverpool, London, New York and San Francisco. The existing Chinatowns of Sydney and Melbourne, and to some extent Brisbane’s Fortitude Valley, are of this variety. In the late 1970s, with the growth of suburbanisation and the de-industrialisation and consequent dereliction of the ‘inner city’, these ethnic communities were one of the few signs of life in the city. Apart from the daily commute into the CBD, business with the city council or a trip to the big shopping streets these areas were one of the few reasons for visiting city centres stigmatised by urban decay and petty crime.

The art of re-industrialisation in Shanghai

This paper deals with the development of ‘art clusters’ and their relocation in the city of Shanghai. It first looks at the revival of the city’s old inner city industrial area (along banks of Suzhou River) through ‘organic’ or ‘alternative’ artist-led cultural production; second, it describes the impact on these activities of the industrial restructuring of the wider city, reliant on large-scale real estate development, business services and global finance; and finally, outlines the relocation of these arts (and related) cultural industries to dispersed CBD locations as a result of those spatial, industrial and policy changes.

Entrepreneurship : from denial to discovery in nonprofit art museums?

This research explores the function of entrepreneurship in nonprofit art museums. Traditionally, entrepreneurship literature features debates on customer orientation and innovation. This paper reviews a tension in entrepreneurship: the relationship between limited funding and the need to innovate in nonprofit art museums. The paper develops a construct by which to explain the structure of entrepreneurship in nonprofit art museums in Australia and New Zealand since 1975. From this discussion, different strategies and tensions are highlighted that nonprofit art museum directors have used. The dynamics are explored in ten large art museums and the managerial implications are developed.

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.

Art unions legislation in Queensland

In Queensland, the legislation governing the conduct of art unions such as bingo, raffles and lucky envelopes is the Art Unions Act 1992 (ΑAct≅). The Act is administered by the Queensland Office of Gaming Regulation (ΑQOGR≅) which is part of the Queensland Treasury portfolio. The Act and other legislation such as the Criminal Code, Vagrants Gaming and Other Offences Act, generally makes it unlawful for a person to conduct art unions unless they are authorised to do so. The Art Unions Act allows Αeligible≅ nonprofit associations such as charities, schools, sporting and community groups to raise funds for their stated objects. Art unions were legalised in the early part of this century primarily to assist charities and other approved associations to raise funds for worthwhile causes. This principle is continued in the 1992 Act. The Queensland art union industry had a turnover of over$190M in 1996/97 and our Queensland art unions continue to attract not just sales from Queensland residents but also interstate and overseas buyers. Art unions continue to be an attractive form of fundraising for many nonprofit associations.

Strategic aesthetics in advertising campaigns : implications for art direction education

For over half a century art directors within the advertising industry have been adapting to the changes occurring in media, culture and the corporate sector, toward enhancing professional performance and competitiveness. These professionals seldom offer explicit justification about the role images play in effective communication. It is uncertain how this situation affects advertising performance, because advertising has, nevertheless, evolved in parallel to this as an industry able to fabricate new opportunities for itself. However, uncertainties in the formalization of art direction knowledge restrict the possibilities of knowledge transfer in higher education. The theoretical knowledge supporting advertising art direction has been adapted spontaneously from disciplines that rarely focus on specific aspects related to the production of advertising content, like, for example: marketing communication, design, visual communication, or visual art. Meanwhile, in scholarly research, vast empirical knowledge has been generated about advertising images, but often with limited insight into production expertise. Because art direction is understood as an industry practice and not as an academic discipline, an art direction perspective in scholarly contributions is rare. Scholarly research that is relevant to art direction seldom offers viewpoints to help understand how it is that research outputs may specifically contribute to art direction practices. This thesis is dedicated to formally understanding the knowledge underlying art direction and using it to explore models for visual analysis and knowledge transfer in higher education. The first three chapters of this thesis offer, firstly, a review of practical and contextual aspects that help define art direction, as a profession and as a component in higher education; secondly, a discussion about visual knowledge; and thirdly, a literature review of theoretical and analytic aspects relevant to art direction knowledge. Drawing on these three chapters, this thesis establishes explicit structures to help in the development of an art direction curriculum in higher education programs. Following these chapters, this thesis explores a theoretical combination of the terms ‘aesthetics’ and ‘strategy’ as foundational notions for the study of art direction. The theoretical exploration of the term ‘strategic aesthetics’ unveils the potential for furthering knowledge in visual commercial practices in general. The empirical part of this research explores ways in which strategic aesthetics notions can extend to methodologies of visual analysis. Using a combination of content analysis and of structures of interpretive analysis offered in visual anthropology, this research discusses issues of methodological appropriation as it shifts aspects of conventional methodologies to take into consideration paradigms of research that are producer-centred. Sampled out of 2759 still ads from the online databases of Cannes Lions Festival, this study uses an instrumental case study of love-related advertising to facilitate the analysis of content. This part of the research helps understand the limitations and functionality of the theoretical and methodological framework explored in the thesis. In light of the findings and discussions produced throughout the thesis, this project aims to provide directions for higher education in relation to art direction and highlights potential pathways for further investigation of strategic aesthetics.

Creative industries in China : art, design and media

Creative industries in China provides a fresh account of China’s emerging commercial cultural sector. The author shows how developments in Chinese art, design and media industries are reflected in policy, in market activity, and grassroots participation. Never has the attraction of being a media producer, an artist, or a designer in China been so enticing. National and regional governments offer financial incentives; consumption of cultural goods and services have increased; creative workers from Europe, North America and Asia are moving to Chinese cities; culture is increasingly positioned as a pillar industry. But what does this mean for our understanding of Chinese society? Can culture be industrialised following the low-cost model of China’s manufacturing economy. Is the national government really committed to social liberalisation? This engaging book is a valuable resource for students and scholars interested in social change in China. It draws on leading Chinese scholarship together with insights from global media studies, economic geography and cultural studies.

Reading images : the book club in the art gallery

This paper seeks to document and understand one instance of community-university engagement: that of an on-going book club organised in conjunction with public art exhibitions. The curator of the Queensland University of Technology (QUT) Art Museum invited the authors, three postgraduate research students in the faculty of Creative Writing and Literary Studies at QUT, to facilitate an informal book club. The purpose of the book club was to generate discussion, through engagement with fiction, around the themes and ideas explored in the Art Museum’s exhibitions. For example, during the William Robinson exhibition, which presented evocative images of the environment around Brisbane, Queensland, the book club explored texts that symbolically represented aspects of the Australian landscape in a variety of modes and guises. This paper emerges as a result of the authors’ observations during, and reflections on, their experiences facilitating the book club. It responds to the research question, how can we create a best practice model to engage readers through open-ended, reciprocal discussion of fiction, while at the same time encouraging interactions in the gallery space? To provide an overview of reading practices in book clubs, we rely on Jenny Hartley’s seminal text on the subject, The Reading Groups Book (2002). Although the book club was open to all members of the community, the participants were generally women. Elizabeth Long, in Book Clubs: Woman and the Uses of Reading in the Everyday (2003), offers a comprehensive account of women’s interactions as they engage in a reading community. Long (2003, 2) observes that an image of the solitary reader governs our understanding of reading. Long challenges this notion, arguing that reading is profoundly social (ibid), and, as women read and talk in book clubs, ‘they are supporting each other in a collective working-out of their relationship to a particular historical movement and the particular social conditions that characterise it’ (Long 2003, 22). Despite the book club’s capacity to act as a forum for analytical discussion, DeNel Rehberg Sedo (2010, 2) argues that there are barriers to interaction in such a space, including that members require a level of cultural capital and literacy before they feel comfortable to participate. How then can we seek to make book clubs more inclusive, and encourage readers to discuss and question outside of their comfort zone? How can we support interactions with texts and images? In this paper, we draw on pragmatic and self-reflective practice methods to document and evaluate the development of the book club model designed to facilitate engagement. We discuss how we selected texts, negotiating the dual needs of relevance to the exhibition and engagement with, and appeal to, the community. We reflect on developing questions and material prior to the book club to encourage interaction, and describe how we developed a flexible approach to question-asking and facilitating discussion. We conclude by reflecting on the outcomes of and improvements to the model.

Catherine or Kate, the royal name dilemma : humour and performance in collaborative art practice

The traditional model of visual arts practice is one that privileges highly individuated reflection and research on studio based, predominately material outcomes. This archetypal approach to thinking about cultural production tends to overlook all of the conceptual and contextual collaborations that take place, both informally and formally in the process of making artworks. The aim of this practice-led research project is to creatively and critically explore the potential for actively engaging in a collaborative process for making artworks. It will focus on this approach to research and making through performance and video based works made in conjunction with Kate Woodcroft. Through doing this it aims to explore the possibilities for thinking and working beyond singular, materially based practices and develop new understandings for this as a model for generating new and unexpected creative outcomes. Key departure points for this discussion include; tertiary performance, conceptual art, and humour.

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.

An interview with Jacques Rancière : on medium-specificity and discipline crossovers in modern art

Jacques Rancière's work on aesthetics has received a great deal of attention in recent years. Given his work has enormous range – covering art and literature, political theory, historiography, pedagogy and worker's history – Andrew McNamara and Toni Ross (UNSW) explore his wider critical ambitions in this interview, while showing how it leads to alternative insights into aesthetics. Rancière sets aside the core suppositions linking the medium to aesthetic judgment, which has informed many definitions of modernism. Rancière is emphatic in freeing aesthetic judgment from issues of medium-specificity. He argues that the idea of autonomy associated with medium-specificity – or 'truth to the medium' – was 'a very late one' in modernism, and that post-medium trends were already evident in early modernism. While not stressing a simple continuity between early modernism and contemporary art, Ranciere nonetheless emphasizes the on-going ethical and political ramifications of maintaining an a-disciplinary stance.