Description:
Abstract Background In 2016, we conducted a systematic review to assess the feasibility of treatment monitoring for people living with HIV (PLHIV) receiving antiretroviral therapy (ART) in low and middle-income countries (LMICs), in line with the 90-90-90 treatment target. By 2020, global estimates suggest the 90-90-90 target, particularly the last 90, remains unattainable in many LMICs. This study aims to review the progress and identify needs for public health interventions to improve viral load monitoring and viral suppression for PLHIV in LMICs. Methods A literature search was conducted using an update of the initial search strategy developed for the 2016 review. Electronic databases (Medline and PubMed) were searched to identify relevant literature published in English between Dec 2015 and August 2021. The primary outcome was initial viral load (VL) monitoring (the proportion of PLHIV on ART and eligible for VL monitoring who received a VL test). Secondary outcomes included follow-up VL monitoring (the proportion of PLHIV who received a follow-up VL after an initial elevated VL test), confirmation of treatment failure (the proportion of PLHIV who had two consecutive elevated VL results) and switching treatment regimen rates (the proportion of PLHIV who switched treatment regimen after confirmation of treatment failure). Results The search strategy identified 1984 non-duplicate records, of which 34 studies were included in the review. Marked variations in initial VL monitoring coverage were reported across study settings/countries (range: 12–93% median: 74% IQR: 46–82%) and study populations (adults (range: 25–96%, median: 67% IQR: 50–84%), children, adolescents/young people (range: 2–94%, median: 72% IQR: 47–85%), and pregnant women (range: 32–82%, median: 57% IQR: 43–71%)). Community-based models reported higher VL monitoring (median: 85%, IQR: 82-88%) compared to decentralised care at primary health facility (median: 64%, IRQ: 48-82%). Suboptimal uptake of follow-up VL monitoring and low regimen switching rates were observed. Conclusions Substantial gaps in VL coverage across study settings and study populations were evident, with limited data availability outside of sub-Saharan Africa. Further research is needed to fill the data gaps. Development and implementation of innovative, community-based interventions are required to improve VL monitoring and address the “failure cascade” in PLHIV on ART who fail to achieve viral suppression.
Description:
Abstract Background In 2016, we conducted a systematic review to assess the feasibility of treatment monitoring for people living with HIV (PLHIV) receiving antiretroviral therapy (ART) in low and middle-income countries (LMICs), in line with the 90-90-90 treatment target. By 2020, global estimates suggest the 90-90-90 target, particularly the last 90, remains unattainable in many LMICs. This study aims to review the progress and identify needs for public health interventions to improve viral load monitoring and viral suppression for PLHIV in LMICs. Methods A literature search was conducted using an update of the initial search strategy developed for the 2016 review. Electronic databases (Medline and PubMed) were searched to identify relevant literature published in English between Dec 2015 and August 2021. The primary outcome was initial viral load (VL) monitoring (the proportion of PLHIV on ART and eligible for VL monitoring who received a VL test). Secondary outcomes included follow-up VL monitoring (the proportion of PLHIV who received a follow-up VL after an initial elevated VL test), confirmation of treatment failure (the proportion of PLHIV who had two consecutive elevated VL results) and switching treatment regimen rates (the proportion of PLHIV who switched treatment regimen after confirmation of treatment failure). Results The search strategy identified 1984 non-duplicate records, of which 34 studies were included in the review. Marked variations in initial VL monitoring coverage were reported across study settings/countries (range: 12–93% median: 74% IQR: 46–82%) and study populations (adults (range: 25–96%, median: 67% IQR: 50–84%), children, adolescents/young people (range: 2–94%, median: 72% IQR: 47–85%), and pregnant women (range: 32–82%, median: 57% IQR: 43–71%)). Community-based models reported higher VL monitoring (median: 85%, IQR: 82-88%) compared to decentralised care at primary health facility (median: 64%, IRQ: 48-82%). Suboptimal uptake of follow-up VL monitoring and low regimen switching rates were observed. Conclusions Substantial gaps in VL coverage across study settings and study populations were evident, with limited data availability outside of sub-Saharan Africa. Further research is needed to fill the data gaps. Development and implementation of innovative, community-based interventions are required to improve VL monitoring and address the “failure cascade” in PLHIV on ART who fail to achieve viral suppression.
Description:
During strenuous and/or extended exercise in hot environments, considerable body heat can be produced. If the heat produced is above the body's thermoregulatory capacities, or if these capacities are impeded, a rise in core body temperature (Tc) will occur. Infantry soldiers and Airfield Defence Guards within the Australian Defence Force (ADF) are often based in areas which expose them to high levels of thermal stress. Furthermore, they must perform physically demanding training and operations, often in full camouflage, and on occasions with a range of equipment including body armour, which further increases the risk of developing a heat illness during training tasks. The ADF is addressing this issue as part of the Defence Physical Employment Standards (DPES) project, which aims at developing new employment standards using tests that reflect job requirements, and in which soldiers and airmen will be required to complete a number of strenuous and/or extended physical tasks. Two high risk tasks involve marching for either 10 or 20 km at an average velocity of 6km/hr, wearing full camouflage and carrying a 45kg pack. A third high risk task, which simulates movement in urban terrain, is shorter in duration but higher in intensity, and involves wearing ballistic vest, helmet, and webbing. In order to enhance safety by decreasing the risk of heat injury associated with completing these three tasks, Tc is being monitored using telemetric pills. A subject who reaches a Tc of 39.5oC will be withdrawn from the task. Preliminary testing in reasonably mild environmental conditions (15-20oC WBGTO), resulted in steady increases in Tc throughout each task, though no subject's core temperature reached 39.5 in any of the tasks.
Description:
The Emotional Availability Scales (EAS) are the most widely reported observational assessment measure of parent-child relationships and has been of particular interest in understanding differences between samples of depressed and nondepressed mothers and their offspring. Despite its widespread use, psychometric validation of the factor structure in normative samples and the measurement of invariance within clinical samples has not been published. We evaluated the internal structure (dimensionality, reliability, convergent, and discriminant validity) of the EAS fourth edition using a nondepressed sample of 157 Australian women and their infants aged 6 months, including testing the measurement invariance of the EAS between the same nondepressed sample (n = 157), and a depressed group (n = 185) of mother-infant dyads, using MPlus. Participants were recruited from tertiary hospitals, and depression status was established using a diagnostic measure. Higher-order confirmatory factor analyses on the EAS' six dimensions supported a unidimensional factor solution in our data. Full measurement invariance was not demonstrated due to metric noninvariance of the maternal nonintrusiveness and child responsiveness dimensions. Full scalar invariance supported mean comparisons, and a medium effect of .78SD lower mean emotional availability for the depressed group was found Cohen's d = .63, 95% CI [.41, .85]. While arguments exist for the clinical utility of differentiating between multiple dimensions of emotional availability, the current findings do not support a multidimensional factor structure or full multigroup measurement invariance of the EAS. Similar psychometric investigations of the EAS in clinical and nonclinical samples are needed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Description:
Social media applications are increasingly being used by healthcare providers because of the numerous communication, information, and public relations benefits they offer. Despite the growing adoption of social media in healthcare settings, its specific uses and value propositions are not well understood. To ensure continuous improvement, social media performance must be measured. However, little is known about the tools, techniques and yardsticks used to measure social media performance in healthcare settings. This study adopts qualitative research methods to explore healthcare providers’ perspectives on the value of social media in healthcare settings. Australian healthcare providers, from organizations of different sizes and locations, who use social media, were interviewed and the transcripts thematically analysed. The results demonstrate the uses of social media in health care, as well as the steps and techniques in social media measurement. Based on the findings, it is clear that the ability of social media to support various activities in healthcare settings makes it valuable to healthcare providers. Drawing on Bakhtin’s ‘theories’ and Stevens’s theory of measurement, this study theorises on the value of social media and introduces a protocol for measuring social media performance in healthcare settings. As one of the first studies to apply Bakhtinian ideas to consumer health informatics, this study has the potential to pave a new approach to conceptualizing the role of social media, particularly in healthcare settings. By using Stevens’s theory of measurement to explore the yardsticks suitable for social media measurement, this study provides a more nuanced framework for measuring the value of social media in healthcare settings.
Description:
Social media applications are increasingly being used by healthcare providers because of the numerous communication, information, and public relations benefits they offer. Despite the growing adoption of social media in healthcare settings, its specific uses and value propositions are not well understood. To ensure continuous improvement, social media performance must be measured. However, little is known about the tools, techniques and yardsticks used to measure social media performance in healthcare settings. This study adopts qualitative research methods to explore healthcare providers’ perspectives on the value of social media in healthcare settings. Australian healthcare providers, from organizations of different sizes and locations, who use social media, were interviewed and the transcripts thematically analysed. The results demonstrate the uses of social media in health care, as well as the steps and techniques in social media measurement. Based on the findings, it is clear that the ability of social media to support various activities in healthcare settings makes it valuable to healthcare providers. Drawing on Bakhtin’s ‘theories’ and Stevens’s theory of measurement, this study theorises on the value of social media and introduces a protocol for measuring social media performance in healthcare settings. As one of the first studies to apply Bakhtinian ideas to consumer health informatics, this study has the potential to pave a new approach to conceptualizing the role of social media, particularly in healthcare settings. By using Stevens’s theory of measurement to explore the yardsticks suitable for social media measurement, this study provides a more nuanced framework for measuring the value of social media in healthcare settings.
Description:
Mental time travel is an adaptive capacity that enables humans to engage in deliberate, prudent action on the basis of remembering past episodes (episodic memory) and simulating future scenarios (episodic foresight). This capacity has become a popular and rapidly growing topic of interdisciplinary research. Perhaps the most influential and frequently tested neuroscientific hypothesis in this domain is that the hippocampus is a hub in a critical neural network for mental time travel, support for which is now commonly assumed by most researchers in the area. In light of.recent findings revealing limitations with existing measures of episodic foresight, we critically evaluate the available evidence for this hypothesis and find that it is inconclusive. We suggest that this is due in significant part to the exclusive and widespread reliance on noisy verbal measures and discuss this case as an example of a more general issue pertaining to the measurement of episodic foresight. Accordingly, we suggest that an essential focus of future research should concern the development of objective measures that capture capacity differences by requiring people to put foresight not just into words, but into action. (C) 2019 Elsevier Ltd. All rights reserved.
Description:
Business relationships and activities will be mapped to establish the functional characteristics of the fine art industry cluster of which the National Gallery of Victoria (NGV) has long been the dominant figure. Many of the core activities of the NGV have been severely disrupted between 1999 and 2003 due to refurbishment. This circumstance has made it possible to examine and determine the effects of dislocation of the dominant member on the way a cluster functions. This research will provide information on how fine arts businesses, including some that are competitors, interrelate, and how and to what extent a previously dominant member can reinstate its position after a period of dislocation. This research project employs a longitudinal design so that cluster functioning and level of innovation can be compared before, during, and after disruption of the NGV’s core activities. This circumstance provides a unique opportunity to identify groups of firms with similar innovation patterns and consequent strategic types (personality), test conflicting expectations arising from alliance capitalism and market capitalism models and to examine the assumption that the strategic type (personality) of the cluster, to which a firm belongs, has a bearing on the innovative status of the cluster and its consequent adaptability to change in turbulent environments.
Description:
Business relationships and activities will be mapped to establish the functional characteristics of the fine art industry cluster of which the National Gallery of Victoria (NGV) has long been the dominant figure. Many of the core activities of the NGV have been severely disrupted between 1999 and 2003 due to refurbishment. This circumstance has made it possible to examine and determine the effects of dislocation of the dominant member on the way a cluster functions. This research will provide information on how fine arts businesses, including some that are competitors, interrelate, and how and to what extent a previously dominant member can reinstate its position after a period of dislocation. This research project employs a longitudinal design so that cluster functioning and level of innovation can be compared before, during, and after disruption of the NGV’s core activities. This circumstance provides a unique opportunity to identify groups of firms with similar innovation patterns and consequent strategic types (personality), test conflicting expectations arising from alliance capitalism and market capitalism models and to examine the assumption that the strategic type (personality) of the cluster, to which a firm belongs, has a bearing on the innovative status of the cluster and its consequent adaptability to change in turbulent environments.
Description:
There is an established relationship between depression and sexual functioning in women. However, there is limited research examining the relationship between perinatal depression and sexual functioning. This study draws on the Mercy Pregnancy and Emotional Wellbeing Study and reports on 211 women recruited in early pregnancy and followed to 12 months postpartum. Women were assessed for depression using the Structured Clinical Interview for the DSM-IV, repeated measurement of depressive symptoms using the Edinburgh Postnatal Depression Scale and sexual functioning using the Female Sexual Functioning Inventory. Data were also collected on antidepressant use, mode of delivery, history of childhood trauma, breastfeeding and partner support. Women showed a decline in sexual functioning over pregnancy and the first 6 months postpartum, which recovered by 12 months. For women with depression, sexual functioning was lower throughout pregnancy and continued to be lower at 6 months postpartum than those without depression. Ongoing depressive symptoms at 12 months were also associated with lower sexual functioning. Sexual functioning was not predicted by mode of delivery, antidepressant use or childhood trauma. Breastfeeding predicted lower sexual functioning only at 6 months. Higher partner support predicted higher female sexual functioning. Pregnancy and the postpartum are a time of reduced sexual functioning for women however, women with depression are more likely to have lower levels of sexual functioning and this was not predicted by antidepressant use. In women with perinatal depression, consideration of the impact on sexual functioning should be an integral part of care.
Description:
Background: Many health care organizations use social media to support a variety of activities. To ensure continuous improvement in social media performance, health care organizations must measure their social media. Objective: The purpose of this study is to explore how health care organizations approach social media measurement and to elucidate the tools they employ. Methods: In this exploratory qualitative research, Australian health care organizations that use social media, varying in size and locality, were invited to participate in the study. Data were collected through semistructured interviews, and the transcripts were analyzed using thematic analysis. Results: The study identified health care organizations' approaches to social media measurement. While some measured their social media frequently, others used infrequent measurements, and a few did not measure theirs at all. Those that measured their social media used one or a combination of the following yardsticks: personal benchmarking, peer benchmarking, and metric benchmarking. The metrics tracked included one or more of the following: reach, engagement, and conversion rates. The tools employed to measure social media were either inbuilt or add-on analytics tools. Although many participants showed great interest in measuring their social media, they still had some unanswered questions. Conclusions: The lack of a consensus approach to measurement suggests that, unlike other industries, social media measurement in health care settings is at a nascent stage. There is a need to improve knowledge, sophistication, and integration of social media strategy through the application of theoretical and analytical knowledge to help resolve the current challenge of effective social media measurement. This study calls for social media training in health care organizations. Such training must focus on how to use relevant tools and how to measure their use effectively.
Description:
Understanding factors that motivate young athletes to continue participation in sport can help key stakeholders cultivate an environment that fosters long-term participation. This investigation sought to determine the performance and participation factors that influenced continued participation in junior cricket. Administration-level data were collected each annual season across a seven-year period by a community-level junior cricket association in Australia and analysed to identify the performance and participation-based predictors of player retention. All players were males aged <16 years. Players were categorised according to whether they remained in (or departed from) the association at the end of each playing season. A multivariate logistic regression model with a stepwise variable selection was employed to identify significant independent predictors of player retention. The number of innings batted and overs bowled were significant participation-related contributors to junior cricket player retention. Performance factors such as the number of wickets taken and the number of runs scored also significantly influenced player retention. Finally, team age group, the number of previous seasons played and age were also significant factors in player retention. This demonstrates that sufficient opportunity for children to participate in the game and expression of skills competence are key factors for retention in cricket.
Description:
Most people would agree that an objective measurement of skill in work is not possible. Many perceptions of what is skilled work privilege 'male' over 'female' occupations, and pre-1950 industrial and craft jobs over more recently-established and service sector jobs. Theories of social construction of skill centre around claim-making by interest groups, structural conditions that allow or prevent such claims, and the institutionalisation of those claims. As skill cannot be measured objectively, the social construction of skill takes on immense significance in defining what are worthy and non-worthy occupations, and the training that is available and valued within those occupations.
Description:
Most people would agree that an objective measurement of skill in work is not possible. Many perceptions of what is skilled work privilege 'male' over 'female' occupations, and pre-1950 industrial and craft jobs over more recently-established and service sector jobs. Theories of social construction of skill centre around claim-making by interest groups, structural conditions that allow or prevent such claims, and the institutionalisation of those claims. As skill cannot be measured objectively, the social construction of skill takes on immense significance in defining what are worthy and non-worthy occupations, and the training that is available and valued within those occupations.
Description:
In the current study we examined the psychometric properties of the Greek adaptation of the Social Phobic Inventory (SoPhI) (Moore & Gee, 2003). The questionnaire is a 21-item self-report measure that assesses social anxiety based on the criteria of the DSM-IV-TR and DSM-5. A total of 221 university students volunteered to complete the SoPhI. Exploratory Principal Components Analysis indicated the presence of a single factor explaining 38% of the variance. The internal reliability was strong (· = .92). These results provide evidence for the utility of this instrument to assess social anxiety in countries where Greek is spoken as well as for research involving cross-cultural comparisons. Future directions in research using this instrument are discussed.
Description:
•Novel concepts in zero-injection buses (ZIBs) are introduced.•The reliability of fragile areas monitoring from overvoltage viewpoint is enhanced.•PMUs/redundant measurements are optimally located based on overvoltage risk sensitivity of buses.•New security concepts are introduced to model channel failure, PMU loss, and branch outage.•In the case of branch outage, selective security criteria are considered so as to enhance security of network observability against cascading failures. In this paper, a new method is proposed for security-oriented, optimal placement of phasor measurement units (PMUs) incorporating efficient observability redundancy. In this way, novel concepts in zero-injection buses (ZIBs) are introduced. The proposed concepts regard aspects of the ZIBs effect that have not yet been studied thus, by applying this concept, maximum possible capacity of the ZIBs will be available for use. Therefore, the proposed method is capable of producing optimum possible results with tangibly higher ZIBs capacity usage and measurement redundancy levels than those reached in preceding works. In addition, the reliability of fragile areas monitoring from overvoltage viewpoint is enhanced. Considering the fact that complete synchronized network observability is undeniably significant for making control decision in critical conditions to avoid brownouts or blackouts, a novel practical framework is proposed based on backup observability concept in order to model branch outage in addition to PMU loss and channel failure. All proposed security models can be tested by practical, large-scale test systems such as Polish 2383- and 3375-bus. Also, in the case of branch outage, selective security criteria are considered so as to enhance security of network observability against cascading failures in electric power systems.