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In this chapter Paul Ward focuses particularly on the concept of re-enactment, arguing that it raises varied questions about the nature of performance, agency, point of view and temporality within animated documentary. Ward grounds his theoretical speculations and conceptual distinctions in close readings of two animated documentaries, Andersartig (2011) and The Children of the Holocaust (2014), both of which depict individual childhood memories of living in Nazi-era Germany. He concludes that works such as these encourage audiences and critics alike to understand and engage with animated documentary as a filmmaking mode able to portray intangible, often non-indexical (and therefore un-photographable) documentary phenomena.

The chapter examines the ways in which affect and emotion are channelled and challenged through animated documentary. Murray Smith (1995) usefully distinguishes between alignment and allegiance in his discussion of how viewers identify with what is on the screen when viewing fictional characters and scenes. But there are clearly different moral and ethical registers at play in how such feelings and alliances are mobilised in nonfiction. Once we start talking about how films make us feel, alongside how they try and persuade us to root for particular (real) people, or find their specific arguments convincing, we are also in the realm of rhetoric. But a further problem arises if we are watching something whilst knowing that elements of it are not real, that is, that there are certain fabrications involved: the long-standing debates about how dramatisation and re-enactment can be mingled with documentary are evidence of such a problem. I have discussed elsewhere (in the anthology Drawn From Life, forthcoming, 2017) the specific problems of thinking about animated documentary as a form of re-enactment, but there is a more fundamental way in which animation foregrounds its constructed nature. Various philosophers of literature, drama and film have discussed the ‘paradox of fiction’ – that viewers will respond emotionally and authentically to something or someone they know does not exist – but animated documentary is a special case of a ‘paradox of nonfiction’: an expressive act, directly connected to real events and people, but peculiarly attenuated by its constructedness. The idea of animated documentary as an expressive act is something I connect to a discussion of philosopher and linguist J. L. Austin’s concept of ‘illocutionary force’ in his ‘performative’ model of language. The illocutionary force of a speech act is concerned with effect and intention: it points to what something means and what you mean by saying it (in the way that you do). Animated documentary’s power, poetry and potential can therefore be understood by thinking about its illocutionary force – how it communicates and expresses certain things in certain ways. Central to the deeper understanding of animated documentary proposed by this chapter is an interrogation of how the emotional ‘charge’ of viewing something we know to be real-yet-fabricated is underpinned by a series of paradoxes that are built on belief, emotion and affect.

It is known that a Green's function-type condition may be used to derive rates for approximation by radial basis functions (RBFs). In this paper, we introduce a method for obtaining rates for approximation by functions which can be convolved with a finite Borel measure to form a Green's function. Following a description of the method, rates will be found for two classes of RBFs. Specifically, rates will be found for the Sobolev splines, which are Green's functions, and the perturbation technique will then be employed to determine rates for approximation by Wendland functions.

This chapter challenges what might be called a ‘local history paradigm’, whereby immigration to Britain and the decline of industry are linked and local history is considered to ‘end’ in the 1980s. It explores representations of past and present in Rotherham, and draws on examples of heritage projects undertaken there by people from minority ethnic communities. This chapter emerged from the experience of many of the participants living in and researching the town during the child sexual exploitation scandal. Nonetheless, while about Rotherham, its interpretation might be applicable to a variety of post-industrial towns and cities in northern England and elsewhere. The chapter also considers ways in which the heritage projects add to the local history narrative of the town.

This chapter addresses the question of how historical knowledge can help one to make sense of communities like Rotherham. It first considers what counts as ‘historical knowledge’, and examines the limitations of historiography in producing histories at a local level, where issues of class, gender, and ethnicity are played out in people's everyday lives. The chapter then explores how historians are expanding what counts for historical knowledge — in particular, the co-production of research, which can be defined as research with people rather than on people. It also provides some real-world examples of co-production in action. Finally, the chapter provides some arguments as to why historical knowledge matters.

This critical interpretive research synthesis is on the topic of adaptation and skill. After an initial identification of 1995 abstracts we identified and collated a database of 140 publications that explicitly reference expertise and adaptation. We found that empirical data on adaptive skill are sparse and the literature base is largely conceptual. We differentiate the adaptive nature of expertise from routine or every day skill, and we redress the balance between what constitutes expertise and when expertise matters. We present an overview of current models of expertise including a project that we completed for the UK Ministry of Defence on the nature of adaptive skill. We discuss implications for future training by presenting empirically based training principles designed to develop adaptive skill. We assert that adaptive skill is the conditio sine qua non of expertise and conclude with suggestions for further research.

The accompanying paper on vaccine distrust in France raises the ongoing and thorny issue of trust and distrust in childhood vaccinations, although this time from the perspective of doctors.1 The authors interviewed 16 French doctors who regularly treated adolescents and had experience of talking with adolescents and their parents about the human papillomavirus (HPV) vaccination. HPV vaccination rates are particularly low in France, and the authors set out to explore some of the reasons from the perspectives of doctors. One of the over-riding themes from the interviews was a distrust in the HPV vaccination, not in and of itself, but the stakeholders who had a part to play in vaccinations. They questioned their own knowledge of HPV vaccinations and ability to talk with adolescents about sexuality, distrusted the pharmaceutical industry to provide impartial information and were not fully convinced of the benefit-to-risk ratio of the HPV vaccination. All in all, these various levels of questioning and unease led to a general distrust in the HPV vaccination, leading to a situation whereby ‘the doctor becomes an involuntary instrument of the anti-vaccination discourse’.1 The key purpose of this Editorial is to explore the sometimes murky and impenetrable world of sociological theory, as applied to trust. It draws on my and colleagues’ publications on parental trust in childhood vaccinations in Australia, which provide neat synopses of different sociological ideas.2–5 The times when we were simply, even blindly, expected to trust people because they were in positions of power has gone. This is not to say that people in power should not be trusted, but simply that people are expected to question such authority, access other sources of information and perform the role of the ‘informed citizen’. Across many countries and cultures, this unquestioning of power has been somewhat eroded and, in …

Aim This paper explores how food regulators respond to food incidents and the barriers and enablers associated with doing so. Methods Twenty-six semi-structured interviews lasting between 30 and 60 minutes were undertaken with Australian food regulators. Regulators worked across food policy development, implementation, enforcement and standards setting. These interviews ascertained food regulators' views on food safety and responses to real and hypothetical food incidents. Data were analysed using thematic analysis. Results Food regulators reported that working together with other food regulators is an important part of effective food regulation and response to food incidents. Strategies for working together included clarifying expectations and developing formal documents such as a memorandum of understanding. However, challenges in working together were reported, including different risk thresholds, different political agendas and a lack of clarity on regulators' roles. Conclusions A focus on partnerships and good communication between food regulators is likely to facilitate effective management of food incidents, and maximise the chances that food incidents do not lead to increased consumer morbidity and mortality as a result of a poor response to a food incident.

Hypertension is a major cause of premature death in China. Understanding risk factors including behavioural and predisposing factors may help to prevent development of hypertension and control the extent of premature mortality. In this case-control design conducted in Hunan province, 416 hypertensive subjects were matched with an equal number of normotensive persons from nearly 9,000 volunteers. A self-report questionnaire was employed to collect demographic and lifestyle information, and fasting serum biomarkers related to lipid profile, renal function, glucose level and uric acid were assessed. When age and sex were stratified, serum biomarkers such as blood urea nitrogen and triglycerides showed a significant difference for hypertension, while lifestyle behaviours including university degree, alcohol use, Body Mass Index and psychological stress (job and married life) were also associated with hypertension. After adjusting for covariate confounding factors, only elevated triglyceride levels were strongly linked to high blood pressure, odds ratio = 1.55, 95 per cent confidence level = 1.16–2.06. To control high blood pressure, hypertriglyceridemia should be included in hypertension treatment and followed up to assess the substantial risk of cardiovascular diseases.

During skill execution, performers have been shown to attend to different aspects of movement, the external effects of one’s action, or to other environmental information. A variety of psychological mechanisms have been proposed to account for the differential outcomes when adopting each attentional strategy. However, there is limited information about the extent to which different attentional foci change the workload demands of task performance. To examine this, the current study administered the NASA-Task Load Index following a simulated shooting dual-task. Participants performed the primary shooting task alone (control), and also with a secondary task that directed attention toward an aspect of skill execution (skill-focused) and an unrelated environmental stimulus (extraneous focus). Primary and secondary task performances were significantly greater in the extraneous focus compared to the skill-focused dual-task. Also, workload was significantly lower during the extraneous focus compared to the skill-focused dual-task condition. Further analyses revealed that workload significantly mediated the effects of skill level on performance during the skill-focused and extraneous focus dual-tasks and various subscales of workload (i.e., temporal demand) contributed unique amounts of variance to this relationship. A discussion of the relationship between attention, workload and its subcomponents, skill level, and performance is presented.

This column aims to motivate research and technology development activities intended to achieve accelerated expertise via mentoring. There is a need for methods for identifying who might become good mentors, and systematic procedures for mentoring in the work setting. The authors propose developing "intelligent mentoring systems." These would require a significant expansion of the horizons for intelligent tutoring systems. The authors describe the characteristics of good mentors, which would specify the required capabilities for intelligent mentoring systems. They also offer some suggestions for the use of intelligent systems technologies in mentoring.

Purpose – The purpose of this paper is to report how food regulators communicate with consumers about food safety and how they believe consumers understand their role in relation to food safety. The implications of this on the role of food regulators are considered. Design/methodology/approach – In total, 42 food regulators from Australia, New Zealand and the UK participated in a semi-structured interview about their response to food incidents and issues of food regulation more generally. Data were analysed thematically. Findings – Food regulators have a key role in communicating information to consumers about food safety and food incidents. This is done in two main ways: proactive and reactive communication. The majority of regulators said that consumers do not have a good understanding of what food regulation involves and there were varied views on whether or not this is important. Practical implications – Both reactive and proactive communication with consumers are important, however there are clear benefits in food regulators communicating proactively with consumers, including a greater understanding of the regulators’ role. Regulators should be supported to communicate proactively where possible. Originality/value – There is a lack of information about how food regulators communicate with consumers about food safety and how food regulators perceive consumers to understand food regulation. It is this gap that forms the basis of this paper.

This essay argues that understanding people’s lives, emotions and intellectual reasoning is crucial to exploring national identity and that ‘the co-production of historical knowledge’ provides an approach or methodology that allows for a deeper comprehension of people’s self-identities by encouraging a diverse range of people to participate in the research process. We argue that many academic historians have maintained an intellectual detachment between university history and public and community history, to the detriment of furthering historical knowledge. We argue for a blurring of the boundaries between university and communities in exploring modern British history, and especially the history of national identities. It includes extracts of writing from community partners and a brief photographic essay of projects related to exploring identities.

Introduction: Violence among technical college students is a significant issue in Thailand, South East Asia, and yet few interventions are available for use with this group. In this study the outcomes of a culturally appropriate intervention, mindfulness meditation (MM), on anger and violent behavior are reported. The MM intervention was delivered over three consecutive weeks to technical college students (n = 40) and the effects compared to a comparison group (n = 56) who attend classes as usual. Methods: Both the intervention and comparison group completed a series of validated self-report measures on aggressive and violent behavior perpetration and victimization on three occasions (pre-intervention, 1 month and 3 month post-intervention). Results: Program participants reported lower levels of anger expression at one month follow-up, but there were no observed group × time interactions for self-reported violent behavior. Rates of victimization changed over time, with one interaction effect observed for reports of being threatened. Conclusions: MM may have the potential to improve emotional self-control, but is likely to only impact on violent behavior when this is anger mediated Refereed/Peer-reviewed

Smokers of all ages can benefit by quitting, but many smokers continue to smoke. Older Greek-Australian smokers, one of the largest ethnic groups in Australia, have higher rates of smoking than other groups of older Australians. This qualitative study aimed to explore older Greek-Australians’ views about socio-cultural influences on their smoking. A snowball sampling technique was used to identify twenty Greek–Australian smokers (12 males and eight females), aged ≥ 50 years. They were recruited through the Greek Orthodox Community Center of South Australia (GOCSA). Qualitative data were collected using semi-structured face-to-face interviews. The audio-taped interviews were translated and transcribed, and then analysed using content analysis. Results suggested that smoking was considered as the “norm” by older Greek-Australian smokers. There were four groups embedded in the participants’ social networks that were reported to be important in relation to either encouraging smoking or, smoking abstinence. These support groups included: family members, friends, the Greek community, and physicians. Smokers’ family members (brothers) and friends were identified as facilitators of smoking whereas non-smoker family members (children and spouses) were reported as providing barriers to smoking. Different approaches were used by supporter groups to assist smokers to quit smoking—both planned and unplanned. Knowledge, planning of social and cultural supports, and addressing barriers to smoking cessation are a important part of health planning for older Greek-Australians. Social norms, including those arising from social interactions, and predisposing traits can influence smoking behaviour. Addressing the specific barriers to smoking cessation of older Greek-Australians is critical to addressing the risk for chronic disease in this group. Refereed/Peer-reviewed

This paper examines the spatio-temporal disjuncture between ‘the future’ in public health obesity initiatives and the embodied reality of eating. Drawing upon ethnographic fieldwork in a disadvantaged community in South Australia (August 2012–July 2014), we argue that the future oriented discourses of managing risk employed in obesity prevention programs have limited relevance to the immediacy of poverty, contingencies and survival that mark people's day to day lives. Extending Bourdieu's position that temporality is a central feature of practice, we develop the concept of short horizons to offer a theoretical framework to articulate the tensions between public health imperatives of healthy eating, and local ‘tastes of necessity’. Research undertaken at the time of Australia's largest obesity prevention program (OPAL) demonstrates that pre-emptive and risk-based approaches to health can fail to resonate when the future is not within easy reach. Considering the lack of evidence for success of obesity prevention programs, over-reliance on appeals to ‘the future’ may be a major challenge to the design, operationalisation and success of interventions. Attention to local rather than future horizons reveals a range of innovative strategies around everyday food and eating practices, and these capabilities need to be understood and supported in the delivery of obesity interventions. We argue, therefore, that public health initiatives should be located in the dynamics of a living present, tailored to the particular, localised spatio-temporal perspectives and material circumstances in which people live.

Background: The changing pattern in the doctor-patient relationship is becoming more of a challenge for health care providers. For a healthy and effective doctor-patient relation, trust and communication is considered to play a vital role. Aim: This literature review was conducted with the aim to gather the knowledge and concepts pertaining to communication and trust in a doctor-patient relationship and how they influence patient satisfaction and perceived quality of health care services. Method: Various electronic databases including PubMed, Hinari, Cochrane, Scopus and Google Scholar were used to search for the articles. Related article titles were selected which was narrowed down to abstract of interested articles and the final 17 selected full articles were reviewed. Results: All the articles reviewed showed that both trust and communication were positively related to patient satisfaction and perceived quality of health care services in-terms of better compliance with medication and following medical advice; both in developed and developing country. Though, the determinants of trust differed slightly between rural and urban setting. Apart from the doctor’s communication skills, level of interpersonal treatment and knowledge about the patient, respect for the doctors and treatment assurance lead to better trust as well in rural setting. Patient -centered communication with two-way conversation using open-ended questions leads to better communication. Collaborative decision-making leads to better management and better chances of compliance with treatment. Conclusion: The current evidence suggests that patient-centered approach with effective communications skills and trust leads to better management and improved patient satisfaction. This is associated to better adherence to the treatment, better health outcomes and better perceived quality of healthcare services.

To address the classic interior tomography problem where projections at each view extend only to the shadow of a circular region completely interior to the subject being scanned, previously we showed that the exact recovery of two- and three-dimensional piecewise smooth images is guaranteed using a one-dimensional generalized total variation seminorm penalty which allows a much faster reconstruction. To further accelerate the algorithm up to a level for clinical use, this paper proposes a novel multiscale reconstruction method by exploiting the Bedrosian identity of the Hilbert transform. More specifically, we show that the high frequency parts of the one-dimensional signals can be quickly recovered analytically with the Hilbert transform because of the Bedrosian identity. This implies that computationally expensive iterative reconstruction need only be applied to low resolution images in the downsampled domain, which significantly reduces the computational burden. Moreover, even for incomplete trajectories such as circular cone-beam geometry, we demonstrate that the proposed multiscale interior tomography approach can be combined with a novel spectral blending method in order to mitigate cone-beam artifacts from missing frequency regions. We show the efficacy of the proposed multiscale algorithm using circular fan-beam, helical cone-beam data, and circular cone-beam geometry. With a graphics processing unit implementation, we demonstrate that the speed of the algorithm can be significantly accelerated up to the level for clinical use for various acquisition geometries.

Objectives: \ud Three main goals were addressed in this research. First, we tested the claims of two cognitive mechanisms that have been proposed to explain expert performance. This was done during assessment and intervention phases of decision making. Second, we tested the validity of an online test of perceptual-cognitive skill in soccer: The Online Assessment of Strategic Skill In Soccer (OASSIS). Third, we compared the OASSIS to other predictors of skill in soccer.\ud \ud Design: \ud Over the course of a three-part experiment, participants completed an updated version of the option-generation paradigm employed by Ward, Ericsson, and Williams (2013), the OASSIS, and a battery of other cognitive tests. Performance on these tests was used to inform theory and validate the OASSIS as an applied tool for domain professionals.\ud \ud Method: \ud NCAA Division 1 and recreational-level soccer players completed a battery of tests, both using paper/pencil (see Ward et al., 2013) and online.\ud \ud Results:\ud Support for Long Term Working Memory theory (LTWM; see Ericsson & Kintsch, 1995) was observed during both phases of decision making, though the prescriptions of the Take-The-First heuristic (see Johnson & Raab, 2003) tend to hold, particularly within intervention phase. When used to predict skill-group membership, the OASSIS accounted for more variance than other domain-general tests of cognition. Furthermore, scores on the OASSIS correlated with other measures of perceptual-cognitive skill in soccer and the process-level predictions made by LTWM.\ud \ud Conclusions:\ud Updates to our theoretical understanding of expert performance are provided and the validity of the OASSIS is demonstrated.

Vehicles are currently being developed and sold with increasing levels of connectivity and automation. As with all networked computing devices, increased connectivity often results in a heightened risk of a cyber security attack. Furthermore, increased automation exacerbates any risk by increasing the opportunities for the adversary to implement a successful attack. In this paper, a large volume of publicly accessible literature is reviewed and compartmentalized based on the vulnerabilities identified and mitigation techniques developed. This review highlighted that the majority of studies are reactive and vulnerabilities are often discovered by friendly adversaries (white-hat hackers). Many gaps in the knowledge base were identified. Priority should be given to address these knowledge gaps to minimize future cyber security risks in the connected and autonomous vehicle sector.

In the nineteenth century, a new icon was added to the British national gallery. The distinctive costume of the Yeomen Warders, known as Beefeaters, and their highly visible role at the Tower of London made them colourful symbols of the nation. This chapter examines nineteenth century as an epoch of crisis to which the monarchy responded by creating a narrative of historical continuity based on loyalty to the Crown and constitution. The Beefeaters at the Tower played an important part in this response. In the United Kingdom, made up of at least four nations, the Beefeaters needed to prove themselves to be national symbols able to cope with the complexities of being British.

J.H. Whitley, recently retired as Speaker of the House of Commons, was appointed to chair the Royal Commission on Labour in India in 1929. Whitley’s founding of the joint industrial councils was well known and he had some interest in imperial matters, as was unavoidable for British politicians in the early twentieth century. Whitley was a member of the Empire Parliamentary Association and as Speaker had welcomed parliamentarians from across the dominions and Empire to the Palace of Westminster. In this chapter, we explore Whitley’s relationship to India, and what the Royal Commission did in India including what its recommendations were. We argue that the Royal Commission was initiated in context of the rise of trade unionism, industrial unrest and especially the threat to Empire as Britain struggled to maintain its rule, while it also sought seriously to understand and improve conditions for the labouring poor in India. The research for this chapter and its accompanying exhibition at the Whitley conference in September 2016 has been an exercise in the co-production of historical research, in which we worked together as a group of university students and staff to undertake the primary and secondary research, with co-interpretation and co-writing drawing together from discussions in a series of workshops.

Background: Research conducted by Ward, Muller, Tsourtos, et al. (Soc Sci Med 72(7):1140-1148, 2011) has led to the development of the psycho-social interactive model of resilience, which reveals the interaction between individual resilience factors (i.e. coping, confidence and self esteem) and external resilience environments (i.e. employment, supportive family environments and health promoting policies) in facilitating the development of resilience. This present study explored the utility of this model of resilience for understanding how people self-manage type-2 diabetes. Methods: Data were collected via 14 semi-structured life-history interviews with women and men living with type-2 diabetes mellitus (T2DM). Participants varied according to socio-demographics (gender, age, education level, income) and were recruited based on their self-reported management (or lack thereof) of T2DM. Results: The inter-play of internal traits and external resources with additive and subtractive resilience strategies were consistent with the psycho-social interactive model of resilience. Self-management was influenced by life history. Differences in self-management and material disadvantage were also identified. Alongside increased disadvantage are higher levels of external barriers to self-management practices. Conclusions: This paper supports the concepts of additive and subtractive resilience strategies for use with diabetes populations; providing health professionals and policy makers with an increased understanding of how to recognize and foster patient resilience for the improvement of self-care, disease management and ultimately health outcomes. Refereed/Peer-reviewed

The aim of this paper is to explore the challenges and opportunities of designing and delivering Degree and Higher Level Apprenticeships (D&HLAs) at levels 4 - 7 from a multi-stakeholder perspective namely employers, Universities, independent training organisations and professional bodies. 27 face to face interviews were undertaken and thematic content analysis was used to analyse the data. The following three themes emerged from the data analysis: programme design; programme delivery; and graduate attributes. We conclude that whilst there are increasing numbers of trailblazer groups developing higher level standards, the uptake of apprenticeships at these levels remains relatively low. Although stakeholders support the principle of D&HLAs, we identify a number of challenges and opportunities facing those who seek to successful introduction these programmes. Our policy recommendations include the need for all stakeholders to work collaboratively to co-create a flexible system to support the validity and relevance of D&HLAs. This will include streamlining and mapping the variety of qualifications currently available in order to promote a platform for parity of both esteem and opportunity for those achieving degree qualifications through the apprenticeship route.

Introduction Late presentation for HIV care (LP) delays the achievements of the 90-90-90 UNAIDS target, a program in which Ethiopia has subscribed for. However, the prevalence, trend, outcomes and risk factors of LP among children and adults were not assessed very well in the nation. Methods 12 years retrospective cohort study was conducted using data extracted from an antiretroviral therapy (ART) clinic in Southwest Ethiopia. LP for children and adults was measured using CD4 lymphocyte counts and WHO clinical stages. We described the percentage of LP by mortality, discontinuation from ART and immunological failure to show outcomes of LP. The analysis of descriptive and inferential statistics (logistic regression) was undertaken. Missing data were handled using multiple imputations assuming missing at random (MAR) pattern. Results Of the 8172 patients enrolled for HIV care between June 2003 and March 2015, 5299 (64.8%) patients were on ART: 4900 (92.5%) were adults and 399 (7.5%) were children. The prevalence of LP was 57% in children and 66.7% in adults with an overall prevalence of 65.5%, and the 11 years analysis of LP showed upwards trends. 74% of died children, 50% of discontinued children, 57% of transferred out children and 45% of children with immunological failure were delayed presenters for HIV care. Similarly, 64.7% of died adults, 65.3% of discontinued adults, 68.1% of transferred out adults and 78.7% of adults who had immunological failure presented late for the care. Factors for LP among adults were: being female, being married, having IF, having Tb/HIV co-infection and having no history of HIV testing. No statistically significant predictor was found for LP among children. Conclusions The prevalence LP was significant and majority HIV infected children and adults who presented late for HIV care had discontinued, transferred out and immunological failure. To address this, strategies such as unmanned aerial systems for transporting laboratory specimens, programs such as home and community-based HIV testing, ‘opt out’ and self-testing are compulsory.

Introduction Antiretroviral therapy (ART) discontinuation obscures achievements for the UNAIDS treatment targets 2 and 3. Nevertheless, the magnitude, trend and its risk factors are not explored contextually. We carried out historical data analysis to assess prevalence, trend and risk factors for ART discontinuation among adults in Southwest Ethiopia. Methods 12 years retrospective cohort analysis was performed with 4900 HIV-infected adults between 21 June 2003 and 15 March 2015 registered at the ART clinic at Jimma University Teaching Hospital. ART Discontinuation could be lost to follow-up, defaulting and/or stopping medication while remaining in care. 10 years trends for ART discontinuation was described using a line graph. We used binary logistic regression to identify factors that were correlated with ART discontinuation. To handle missing data, we applied multiple imputations assuming missing at random pattern. Results In total, 4900 adults enrolled on ART, of whom 1090 (22.4%) had discontinued, 954 (19.6%) had transferred out, 300 (6.2%) had died, and the remaining 2517 (51.8%) were alive and on ART between 2003 and 2015. The recent trend of ART discontinuation showed an upward direction reaching a peak in 2004 and 2005 with 10%. Being female (AOR=2.1, 95% CI: 1.7–2.8), having an immunological failure (AOR=2.3, 1.9–8.2), having tuberculosis/HIV co-infection (AOR=1.5, 1.1–2.1) and no previous history of HIV testing (AOR=1.8, 1.4–2.9) were the risk factors for ART discontinuation. Conclusion One of five adults had discontinued from ART, and the trend of ART discontinuation increased recently. Discontinued adults were more likely to be females, tuberculosis/HIV co-infected, with immunological failure and no history of HIV testing. Therefore, it is vital to implement effective programs such as community ART distribution and linkage-case-management to enhance ART linkage and retention.

Background Waiting times for hospital appointments, treatment and/or surgery have become a major political and health service problem, leading to national maximum waiting times and policies to reduce waiting times. Quantitative studies have documented waiting times for various types of surgery and longer waiting times in public vs private hospitals. However, very little qualitative research has explored patient experiences of waiting, how this compares between public and private hospitals, and the implications for trust in hospitals and healthcare professionals. The aim of this paper is to provide a deep understanding of the impact of waiting times on patient trust in public and private hospitals. Methods A qualitative study in South Australia, including 36 in-depth interviews (18 from public and 18 from private hospitals). Data collection occurred in 2012–13, and data were analysed using pre-coding, followed by conceptual and theoretical categorisation. Results Participants differentiated between experiences of ‘waiting for’ (e.g. for specialist appointments and surgery) and ‘waiting in’ (e.g. in emergency departments and outpatient clinics) public and private hospitals. Whilst ‘waiting for’ public hospitals was longer than private hospitals, this was often justified and accepted by public patients (e.g. due to reduced government funding), therefore it did not lead to distrust of public hospitals. Private patients had shorter ‘waiting for’ hospital services, increasing their trust in private hospitals and distrust of public hospitals. Public patients also recounted many experiences of longer ‘waiting in’ public hospitals, leading to frustration and anxiety, although they rarely blamed or distrusted the doctors or nurses, instead blaming an underfunded system and over-worked staff. Doctors and nurses were seen to be doing their best, and therefore trustworthy. Conclusion Although public patients experienced longer ‘waiting for’ and ‘waiting in’ public hospitals, it did not lead to widespread distrust in public hospitals or healthcare professionals. Private patients recounted largely positive stories of reduced ‘waiting for’ and ‘waiting in’ private hospitals, and generally distrusted public hospitals. The continuing trust by public patients in the face of negative experiences may be understood as a form of exchange trust norm, in which institutional trust is based on base-level expectations of consistency and minimum standards of care and safety. The institutional trust by private patients may be understood as a form of communal trust norm, whereby trust is based on the additional and higher-level expectations of flexibility, reduced waiting and more time with healthcare professionals.

Developing the evidence base for health promotion can be challenging because interventions often have to target competing determinants of health, including social, structural, environmental and political determinants; all of which are difficult to measure and thus evaluate. Drawing on a case study of food insecurity, which refers to inadequate access to food due to financial constraints, we illustrate the challenges faced by community-based organizations in collecting data to form an evidence base for the development and evaluation of collective programmes aimed at addressing food insecurity. Interviews were conducted with members of a multi-stakeholder coalition (n = 22 interviewees; n = 10 organizations) who collectively work to address food insecurity in their community through a range of community-based programmes and services. Member organizations also provided a list of measures currently used to inform programme and service development and evaluation. Data were collected in a city in Southern Ontario, Canada between May and September 2015. Participants identified four barriers to collecting data: Organizational needs and philosophies; concerns surrounding clientele wellbeing and dignity; issues of feasibility; and restrictive requirements imposed by funding bodies. Participants also discussed their previous successes in collecting meaningful data for identifying impact. Our results point to the challenge of generating data suitable for developing and evaluating programmes aimed at broader determinants of health, while maintaining the primary goal of meeting clients' needs. Documenting change at intermediate- and macro-levels would provide evidence for the collective effectiveness of current programmes and services offered. However, appropriate resources need to be invested to allow for scientific evaluation.

Integrated care is an underpinning concept of contemporary health care policy proffered as a strategy to overcome the fragmentations in care encountered by people with complex care needs (Shaw et al. [2011] What is Integrated Care? An Overview of Integrated Care in the NHS). Cancer patients have potential to benefit from such policy, often having needs that extend beyond cancer. This paper seeks to understand how the concept of integrated care is used in the cancer literature. A search of leading databases was conducted for original research relating to integrated care or an integration intervention aiming to improve outcomes of cancer patients, and analysed using textual narrative synthesis. 38 papers were included, each with a focus on improving cancer-specific aspects of care enhancing the capabilities of the cancer multidisciplinary team. Of the eight studies involving integration between the cancer service and other care providers, all focused on utilising the external provider to deliver aspects of cancer care or placed them in a passive role, as survey participant, a recipient of cancer-related clinical information or as the comparator “usual care” arm. Within the cancer literature, integration is predominantly used to describe initiatives to improve cancer-related aspects of care. Less attention is given to integration initiatives that enhance coordination across levels of the healthcare system or service providers.

Background It is well acknowledged that antiretroviral therapy (ART) discontinuation hampers the progress towards achieving the UNAIDS treatment targets that aim to treat 90% of HIV diagnosed patients and achieve viral suppression for 90% of those on treatment. Nevertheless, the magnitude, trend and risk factors for ART discontinuation have not been explored extensively. We carried out a retrospective data analysis to assess prevalence, trend and risk factors for ART discontinuation among adults in Southwest Ethiopia. Methods 12 years retrospective cohort analysis was performed with 4900 HIV-infected adult patients between 21 June 2003 and 15 March 2015 registered at the ART clinic at Jimma University Teaching Hospital. ART discontinuation could be loss to follow-up, defaulting and/or stopping medication while remaining in care. Because data for 2003 and 2015 were incomplete, the 10 years data were used to describe trends for ART discontinuation using a line graph. We used binary logistic regression to identify factors that were correlated with ART discontinuation. To handle missing data, we applied multiple imputations assuming missing at random pattern. Results In total, 4900 adult patients enrolled on ART, of whom 1090 (22.3%) had discontinued, 954 (19.5%) had transferred out, 300 (6.1%) had died, 2517 (51.4%) were alive and on ART, and the remaining 39 (0.8%) had unknown outcome status. The trend of ART discontinuation showed an upward direction in the recent times and reached a peak, accounting for a magnitude of 10%, in 2004 and 2005. Being a female (AOR = 2.1, 95%CI: 1.7–2.8), having an immunological failure (AOR = 2.3, 1.9–8.2), having tuberculosis/HIV co-infection (AOR = 1.5, 1.1–2.1) and no previous history of HIV testing (AOR = 1.8, 1.4–2.9) were the risk factors for ART discontinuation. Conclusions One out of five adults had discontinued from ART, and the trend of ART discontinuation increased recently. Discontinued adults were more likely to be females, tuberculosis/HIV co-infected, with immunological failure and no history of HIV testing. Therefore, it is vital to implement effective programs such as community ART distribution and linkage-case-management to enhance ART linkage and retention.

Objective To explore the experiences and perceptions of health workers and implementers of task-shifting in rural health facilities in Upper East Region, Ghana. Methods Data was collected through field interviews. A total of sixty eight (68) in-depth interviews were conducted with health workers' in primary health care facilities (health centres); Four in-depth interviews with key persons involved in staff management was conducted to understand how task-shifting is organised including its strengths and challenges. The health workers interview guide was designed with the aim of getting data on official tasks of health workers, additional tasks assigned to them, how they perceive these tasks, and the challenges associated with the practice of task-shifting. Findings Task-shifting is a practice being used across the health facilities in the study area to help reduce the impact of insufficient health workers. Generally, health workers had a comprehensive training that supported the organisation of task-shifting. However, staff members' are sometimes engaged in tasks above their level of training and beyond their actual job descriptions. Adequate training is usually not provided before additional tasks are assigned to staff members. Whilst some health workers perceived the additional tasks they performed as an opportunity to learn new skills, others described these as stressful and overburdening. Conclusion Task-shifting has the potential to contribute to addressing the insufficient health workforce, and thereby improving health delivery system where the procedures are well defined and staff members work in a coordinated and organised manner. The provision of adequate training and supervision for health workers is important in order to improve their expertise before additional tasks are assigned to them so that the quality of care would not be compromised.

In this paper, we study the compressibility of random processes and fields, called generalized L\'evy processes, that are solutions of stochastic differential equations driven by $d$-dimensional periodic L\'evy white noises. Our results are based on the estimation of the Besov regularity of L\'evy white noises and generalized L\'evy processes. We show in particular that non-Gaussian generalized L\'evy processes are more compressible in a wavelet basis than the corresponding Gaussian processes, in the sense that their $n$-term approximation error decays faster. We quantify this compressibility in terms of the Blumenthal-Getoor index of the underlying L\'evy white noise., Comment: 23 pages

Evidence exists that suggests that women are vulnerable to negative HIV treatment outcomes worldwide. This study explored barriers to treatment outcomes of women in Jimma, Southwest Ethiopia. We interviewed 11 HIV patients, 9 health workers, 10 community advocates and 5 HIV program managers from 10 institutions using an in-depth interview guide designed to probe barriers to HIV care at individual, community, healthcare provider, and government policy levels. To systematically analyze the data, we applied a thematic framework analysis using NVivo. In total, 35 participants were involved in the study and provided the following interrelated barriers: (i) Availability&mdash, most women living in rural areas who accessed HIV cared less often than men, (ii) free antiretroviral therapy (ART) is expensive&mdash, most women who have low income and who live in urban areas sold ART drugs illegally to cover ART associated costs, (iii) fear of being seen by others&mdash, negative consequences of HIV related stigma was higher in women than men, (iv) the role of tradition&mdash, the dominance of patriarchy was found to be the primary barrier to women&rsquo, s HIV care and treatment outcomes. In conclusion, barriers related to culture or tradition constrain women&rsquo, s access to HIV care. Therefore, policies and strategies should focus on these contextual constrains.

Ethiopia&rsquo, s performance toward the UNAIDS 90-90-90 targets is low. The present study explored interventions to improve delayed HIV care presentation (first 90), poor retention (second 90) and clinical and immunological failure (third 90). We employed a qualitative approach using in-depth interviews with 10 HIV patients, nine health workers, 11 community advocates and five HIV program managers. Ethical approvals were obtained from Australia and Ethiopia. The following were suggested solutions to improve HIV care and treatment to meet the three 90s: (i) strengthening existing programs including collaboration with religious leaders, (ii) implementing new programs such as self-HIV testing, house-to-house HIV testing, community antiretroviral therapy (ART) distribution and teach-test-treat-link strategy, (iii) decentralizing and integrating services such as ART in health post and in private clinics, and integrating HIV care services with mental illness and other non-communicable diseases, and (iv) filling gaps in legislation in issues related with HIV status disclosure and traditional healing practices. In conclusion, the study suggested important solutions for improving delayed HIV care presentation, attrition, and clinical and immunological failure. A program such as the teach-test-treat-link strategy was found to be a cross-cutting intervention to enhance the three 90s. We recommend further nationwide research before implementing the interventions.

In this article we examine how and why the media construct food risks, from the perspective of ‘media actors’ (people involved in different types of media) using data from 30 interviews conducted in 2013 with media actors from Australia and the United Kingdom. In modern society, many risks are invisible and are brought to the attention of the public through representations in the mass media. This is particularly relevant for food safety, where the widening gap between producers and consumers in the developed world has increased the need for consumer trust in the food supply. We show the importance of newsworthiness in construction of media stories about food risk using Beck’s ideas on cosmopolitan risk to interpret the data. We note the ways in which the strategies that media actors use to construct stories about food risk amplify the risk posed potentially creating consumer anxiety about the safety of the food system. It is important for food regulators and public health professionals to be aware of this...

Introduction Colorectal cancer (CRC) has the second highest cancer mortality rate in Australia. The Australian National Bowel Cancer Screening Program (NBCSP) aims to increase early detection of CRC by offering free Faecal Occult Blood Testing (FOBT), although uptake is low for culturally and linguistically diverse (CALD) groups. Aim of paper To present data on trust and mistrust in the NBCSP by population groups with low uptake and thus to highlight areas in need of policy change. Methods A qualitative study was undertaken in South Australia, involving interviews with 94 people from four CALD groups: Greek, Iranian, Anglo-Australian, and Indigenous peoples. Results Our study highlights the complexities of institutional trust, which involves considerations of trust at interpersonal, local and national levels. In addition, trust and mistrust was found in more abstract systems such as the medical knowledge of doctors to diagnose or treat cancer or the scientific procedures in laboratories to test the FOBTs. The object of institutional (mis)trust differed between cultural groups – AngloAustralian and Iranian groups indicated a high level of trust in the government, whereas Indigenous participants were much less trusting. Conclusion The level and nature of trust in the screening process varied between the CALD groups. Addressing program misconceptions, clarifying the FOBT capabilities and involving medical services in collecting and transporting the samples may increase trust in the NBCSP. However, broader and more enduring mistrust in services and institutions may need to be dealt with in order to increase trust and participation.