Factors associated with suboptimal adherence to antiretroviral therapy in Viet Nam: A cross-sectional study using audio computer-assisted self-interview (ACASI)

Background: Optimal adherence to antiretroviral therapy (ART) is necessary for people living with HIV/AIDS (PLHIV). There have been relatively few systematic analyses of factors that promote or inhibit adherence to antiretroviral therapy among PLHIV in Asia. This study assessed ART adherence and examined factors associated with suboptimal adherence in northern Viet Nam. Methods: Data from 615 PLHIV on ART in two urban and three rural outpatient clinics were collected by medical record extraction and from patient interviews using audio computer-assisted self-interview (ACASI). Results: The prevalence of suboptimal adherence was estimated to be 24.9% via a visual analogue scale (VAS) of past-month dose-missing and 29.1% using a modified Adult AIDS Clinical Trial Group scale for on-time dose-taking in the past 4 days. Factors significantly associated with the more conservative VAS score were: depression (p < 0.001), side-effect experiences (p < 0.001), heavy alcohol use (p = 0.001), chance health locus of control (p = 0.003), low perceived quality of information from care providers (p = 0.04) and low social connectedness (p = 0.03). Illicit drug use alone was not significantly associated with suboptimal adherence, but interacted with heavy alcohol use to reduce adherence (p < 0.001). Conclusions: This is the largest survey of ART adherence yet reported from Asia and the first in a developing country to use the ACASI method in this context. The evidence strongly indicates that ART services in Viet Nam should include screening and treatment for depression, linkage with alcohol and/or drug dependence treatment, and counselling to address the belief that chance or luck determines health outcomes.

Education higher degree research students writing for publication

Higher Degree Research (HDR) student publications are increasingly valued by students, by professional communities and by research institutions. Peer-reviewed publications form the HDR student writer's publication track record and increase competitiveness in employment and research funding opportunities. These publications also make the results of HDR student research available to the community in accessible formats. HDR student publications are also valued by universities because they provide evidence of institutional research activity within a field and attract a return on research performance. However, although publications are important to multiple stakeholders, many Education HDR students do not publish the results of their research. Hence, an investigation of Education HDR graduates who submitted work for publication during their candidacy was undertaken. This multiple, explanatory case study investigated six recent Education HDR graduates who had submitted work to peer-reviewed outlets during their candidacy. The conceptual framework supported an analysis of the development of Education HDR student writing using Alexander's (2003, 2004) Model of Domain Learning which focuses on expertise, and Lave and Wenger's (1991) situated learning within a community of practice. Within this framework, the study investigated how these graduates were able to submit or publish their research despite their relative lack of writing expertise. Case data were gathered through interviews and from graduate publication records. Contextual data were collected through graduate interviews, from Faculty and university documents, and through interviews with two Education HDR supervisors. Directed content analysis was applied to all data to ascertain the support available in the research training environment. Thematic analysis of graduate and supervisor interviews was then undertaken to reveal further information on training opportunities accessed by the HDR graduates. Pattern matching of all interview transcripts provided information on how the HDR graduates developed writing expertise. Finally, explanation building was used to determine causal links between the training accessed by the graduates and their writing expertise. The results demonstrated that Education HDR graduates developed publications and some level of expertise simultaneously within communities of practice. Students were largely supported by supervisors who played a critical role. They facilitated communities of practice and largely mediated HDR engagement in other training opportunities. However, supervisor support alone did not ensure that the HDR graduates developed writing expertise. Graduates who appeared to develop the most expertise, and produce a number of publications reported experiencing both a sustained period of engagement within one community of practice, and participation in multiple communities of practice. The implications for the MDL theory, as applied to academic writing, suggests that communities of practice can assist learners to progress from initial contact with a new domain of interest through to competence. The implications for research training include the suggestion that supervisors as potentially crucial supporters of HDR student writing for publication should themselves be active publishers. Also, Faculty or university sponsorship of communities of practice focussed on HDR student writing for publication could provide effective support for the development of HDR student writing expertise and potentially increase the number of their peer-reviewed publications.

Computer-assisted measurements of coronal knee joint laxity in vitro are related to low-stress behavior rather than structural properties of the collateral ligaments

The relationship between coronal knee laxity and the restraining properties of the collateral ligaments remains unknown. This study investigated correlations between the structural properties of the collateral ligaments and stress angles used in computer-assisted total knee arthroplasty (TKA), measured with an optically based navigation system. Ten fresh-frozen cadaveric knees (mean age: 81 ± 11 years) were dissected to leave the menisci, cruciate ligaments, posterior joint capsule and collateral ligaments. The resected femur and tibia were rigidly secured within a test system which permitted kinematic registration of the knee using a commercially available image-free navigation system. Frontal plane knee alignment and varus-valgus stress angles were acquired. The force applied during varus-valgus testing was quantified. Medial and lateral bone-collateral ligament-bone specimens were then prepared, mounted within a uni-axial materials testing machine, and extended to failure. Force and displacement data were used to calculate the principal structural properties of the ligaments. The mean varus laxity was 4 ± 1° and the mean valgus laxity was 4 ± 2°. The corresponding mean manual force applied was 10 ± 3 N and 11 ± 4 N, respectively. While measures of knee laxity were independent of the ultimate tensile strength and stiffness of the collateral ligaments, there was a significant correlation between the force applied during stress testing and the instantaneous stiffness of the medial (r = 0.91, p = 0.001) and lateral (r = 0.68, p = 0.04) collateral ligaments. These findings suggest that clinicians may perceive a rate of change of ligament stiffness as the end-point during assessment of collateral knee laxity.

Computer-assisted sampling of acoustic data for more efficient determination of bird species richness

Bird species richness survey is one of the most intriguing ecological topics for evaluating environmental health. Here, bird species richness denotes the number of unique bird species in a particular area. Factors affecting the investigation of bird species richness include weather, observation bias, and most importantly, the prohibitive costs of conducting surveys at large spatiotemporal scales. Thanks to advances in recording techniques, these problems have been alleviated by deploying sensors for acoustic data collection. Although automated detection techniques have been introduced to identify various bird species, the innate complexity of bird vocalizations, the background noise present in the recording and the escalating volumes of acoustic data pose a challenging task on determination of bird species richness. In this paper we proposed a two-step computer-assisted sampling approach for determining bird species richness in one-day acoustic data. First, a classification model is built based on acoustic indices for filtering out minutes that contain few bird species. Then the classified bird minutes are ordered by an acoustic index and the redundant temporal minutes are removed from the ranked minute sequence. The experimental results show that our method is more efficient in directing experts for determination of bird species compared with the previous methods.

Datorstödda studier i hälso- och socialvård : MuPSiNet-projektet

The aim of the study was to explore why the MuPSiNet project - a computer and network supported learning environment for the field of health care and social work - did not develop as expected. To grasp the problem some hypotheses were formulated. The hypotheses regarded the teachers' skills in and attitudes towards computing and their attitudes towards constructivist study methods. An online survey containing 48 items was performed. The survey targeted all the teachers within the field of health care and social work in the country, and it produced 461 responses that were analysed against the hypotheses. The reliability of the variables was tested using the Cronbach alpha coefficient and t-tests. Poor basic computing skills among the teachers combined with a vulnerable technical solution, and inadequate project management combined with lack of administrative models for transforming economic resources into manpower were the factors that turned out to play a decisive role in the project. Other important findings were that the teachers had rather poor skills and knowledge in computing, computer safety and computer supported instruction, and that these skills were significantly poorer among female teachers who were in majority in the sample. The fraction of teachers who were familiar with software for electronic patient records (EPR) was low. The attitudes towards constructivist teaching methods were positive, and further education seemed to utterly increase the teachers' readiness to use alternative teaching methods. The most important conclusions were the following: In order to integrate EPR software as a natural tool in teaching planning and documenting health care, it is crucial that the teachers have sufficient basic skills in computing and that more teachers have personal experience of using EPR software. In order for computer supported teaching to become accepted it is necessary to arrange with extensive further education for the teachers presently working, and for that further education to succeed it should be backed up locally among other things by sufficient support in matters concerning computer supported teaching. The attitudes towards computing showed significant gender differences. Based on the findings it is suggested that basic skills in computing should also include an awareness of data safety in relation to work in different kinds of computer networks, and that projects of this kind should be built up around a proper project organisation with sufficient resources. Suggestions concerning curricular development and further education are also presented. Conclusions concerning the research method were that reminders have a better effect, and that respondents tend to answer open-ended questions more verbosely in electronically distributed online surveys compared to traditional surveys. A method of utilising randomized passwords to guarantee respondent anonymity while maintaining sample control is presented. Keywords: computer-assisted learning, computer-assisted instruction, health care, social work, vocational education, computerized patient record, online survey

A Perspective on Computer Assisted Assessment Techniques for Short Free-Text Answers

Computer Assisted Assessment (CAA) has been existing for several years now. While some forms of CAA do not require sophisticated text understanding (e.g., multiple choice questions), there are also student answers that consist of free text and require analysis of text in the answer. Research towards the latter till date has concentrated on two main sub-tasks: (i) grading of essays, which is done mainly by checking the style, correctness of grammar, and coherence of the essay and (ii) assessment of short free-text answers. In this paper, we present a structured view of relevant research in automated assessment techniques for short free-text answers. We review papers spanning the last 15 years of research with emphasis on recent papers. Our main objectives are two folds. First we present the survey in a structured way by segregating information on dataset, problem formulation, techniques, and evaluation measures. Second we present a discussion on some of the potential future directions in this domain which we hope would be helpful for researchers.

A Test of Computer-assisted Matching Using the North Pacific Humpback Whale, Megaptera novaeangliae, Tail Flukes Photograph Collection

Testing was conducted of a computer-assisted system for matching humpback whale tail flukes photographs. Trials with a 12,000-photographs database found no differences in match success between matching by computer and matching by comparing smaller catalogs ranging in size from 200 to 400 photographs. Tests with a 24,000-photographs database showed that, on average, the first match was found after examining about 130 photographs whether the photograph quality was excellent, good, or poor. Match success did not appear to be strongly related to whether the tail flukes had especially distinctive markings or pigment patterns (recognition quality). An advantage of computer-assisted matching is the ability to compare new photographs to the entire North Pacific collection, where no bias is introduced based on expectation of resightings within or between specific areas, or based on expectation of behavioral role (e.g. matching “known” females to “known” females).

Computer assisted peak recognition for polychlorinated dibenzo-p-dioxins (PCDD) and polychlorinated dibenzofurans (PCDF) in environmental samples

A software has been developed for the peak recognition of 136 polychlorinated dibenzo-p-dioxins (PCDD) and polychlorinated dibenzofurans (PCDF) after high resolution gas chromatography coupled with mass spectrometry (HRGC/HRMS). Based on the retention times of C-13 labelled 2,3,7,8-substituted PCDD/F internal standards, the retention times of all PCDD and PCDF can be calibrated automatically and accurately. Therefore, it is very convenient to identify the peaks by comparing the retention of samples and the calibrated retention times of their chromatograms. Hence, this approach is very significant because it is impossible to obtain always a standard chromatogram and PCDD/F analysis are very expensive and time consuming. The calibration results can be transferred to Excel for calculation. The approach is a first step to store costly and environmentally relevant data for future application.

Use of computer-assisted sperm analysis (CASA) to evaluate the quality of cryopreserved sperm in red seabream (Pagrus major)

In the present study, the quality of post-thaw sperm of red seabream Pagrus major frozen with 6-24% DMSO was investigated. The motility, average path velocity and fertilizing capacity of fresh and their corresponding post-thaw sperm were examined for evaluation of the post-thaw sperm motion characteristics and its association with fertilizing capacity. An analysis of sperm motility before and after cryopreservation has been performed using computer-assisted sperm analysis (CASA). For post-thaw sperm frozen with 12-21% DMSO, the percentages of motile sperm were not significantly (P > 0.05) changed 10 s after activation. Moreover, the main motility pattern and swimming velocity of the motile post-thaw sperm were not significantly (P > 0.05) changed and the progressive linear motion was still the dominant pattern. However, the total motility of post-thaw sperm (72.3 +/- 6.3%) 30 s after activation was (P < 0.05) lower than the corresponding fresh sperm (82.7 +/- 7.2%). Additionally, the fertilizing capacity of post-thaw sperm was investigated with a standardized sperm to egg ratio 500:1. There is a linear regression relationship between the percentage of motile post-thaw sperm and fertilizing capability. These data demonstrate that 12-21% DMSO can provide good protection to the sperm during the freezing-thawing process. (c) 2006 Elsevier B.V. All rights reserved.

Computer-assisted automatic peak recognition and result evaluation for analysis of chlorinated hydrocarbons in environmental samples

A data manipulation method has been developed for automatic peak recognition and result evaluation in the analysis of organic chlorinated hydrocarbons with dual-column gas chromatography. Based on the retention times of two internal standards, pentachlorotoluene and decachlorobiphenyl, the retention times of chlorinated hydrocarbons can be calibrated automatically and accurately. It is very convenient to identify the peaks by comparing the retention times of samples with the calibrated retention times calculated from the relative retention indices of standards. Meanwhile, with a suggested two-step evaluation method the evaluation coefficients and the suitable quantitative results of each component can be automatically achieved for practical samples in an analytical system using two columns with different polarities and two internal standards. (C) 2002 Elsevier Science B.V. All rights reserved.