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No one had acted before. No one wanted to speak, and besides, what language would be used? None of them knew the play, but they had heard of Luo-ka (Lorca). None of them had any experience of portr...

Some recent performances have addressed events that created ‘human no-go zones’ such as Chernobyl (CEZ), Fukushima (FEZ) and the Korean DMZ. In the wake of the destruction that results in the absence of humans, non-human residents begin the process of recuperation, and the ‘no-go zones’ become inadvertent sanctuaries for wild and abandoned domestic animals. Each of the following productions takes a different view of what occurs when both the norms of nature and the practices of human societies and economies are profoundly disrupted. In addition, one play has depicted a community exercising a new restraint to establish an intentional ‘no-go zone’ to ensure its own survival. When confronted with catastrophes that threaten the existence of all life, as well as the surprising possibilities of renewal, dramatists employ heightened poetic diction and resort to mythical precedents in the attempt to capture the immensity of both the event and its aftermath.

In 2015, the Unfolding Kafka Festival was initiated by Thai dancer/choreographer Jitti Chompee, exploring the writings of Franz Kafka as a source of creativity for performers in Thailand and the Southeast Asian region. Three of the presented artworks focus on the concept of metamorphosis, and the body’s interaction with the environments it both creates and inhabits. Inspired by Isabelle Schad’s dance Der Bau (The Burrow), Chompee and visual artist/scenographer Yoko Seyama created Silence of the Insects, which adopted the cicada as a model of bodily transformation. Together, the two dances and the installation form an assemblage that can be considered under the rubric of Una Chaudhuri’s concept of a ‘theatre of species’. Catherine Diamond is Professor of Theatre and Environmental Literature at Soochow University in Taiwan, and is the director/playwright of the Kinnari Ecological Theatre Project, creating new plays addressing environmental issues in Southeast Asia.

Manila Zoo is the third part of Jocson’s Happy-land series, which satirizes several aspects of Disney’s global empire of manufactured happiness. See PDF ] When the dancers resumed their animal avatars in the second half, they prefaced their actions within more concrete political contexts by saying that this is how animals sound when: the nation’s healthcare system is due to run out of money by next year because of corruption at the top;the new anti-terrorism bill is being initiated to target political opposition;Filipinos are becoming foreigners in their own land because it is being sold to Chinese property developers;the lack of local employment is driving Filipinos overseas not only as domestic and factory labor, but also as performers at Hong Kong Disneyland. Departing from Happyland’s critique of Disney to address the confinement of the pandemic, Manila Zoo made only a brief reference to Disney at the end, when Ariel from The Little Mermaid (1989) sings of surrendering her voice to the sea witch Ursula in exchange for human legs that will allow her to go on land and pursue her prince.

In 2019, Artist Inc. and the Kinnari Ecological Theatre Project presented Snow White and the Apple’s Revenge at the Likhandula Festival in Los Banos, the Philippines. Adapting the original ...

In this article Catherine Diamond examines the flows of transcultural hybridity occurring in dance between Spanish flamencos, Japanese exponents of flamenco, and Indian dancers interacting with flamenco within their classical dance forms. Japan and India represent two distinct Asian reactions to the phenomenon of global flamenco: the Japanese have adopted it wholesale and compete with the Spanish on their own ground; the Indians claim that as the Roma (gypsy) people originated in India, the country is also the home of flamenco. Despite their differing attitudes, flamenco dance offers women in both cultures a pathway toward participating in an internal androgyny, a wider spectrum of gender representation than either the Asian traditional dance or contemporary Asian society normally allows. Catherine Diamond is a professor of theatre and environmental literature. She is Director of the Kinnari Ecological Theatre Project in Southeast Asia, and the director/choreographer of Red Shoes Dance Theatre in Taiwan.

Background Hierarchy and leadership are essential within any multidisciplinary team. However, team leaders can make mistakes irrespective of seniority. It is essential that everyone within the team feels confident in raising concerns to ensure patient safety. This can be particularly challenging for new staff joining established healthcare teams. We aimed to improve the confidence of new children’s nursing staff in raising concerns by introducing teaching on a structured method for raising concerns into their induction simulation session. Summary of education programme New nurses undertook a simulated clinical scenario in which the doctor was deliberately hesitant and reluctant to administer appropriate emergency treatment. Teaching was then provided on the PACE approach for raising concerns. Each nurse then participated again in a similar scenario. Each of the 23 participants completed pre and post questionnaires. Summary of results There was no difference in participants’ confidence between challenging a nurse or doctor (3.4/5) prior to training. Following the initial scenario the nurses reported feeling ‘frustrated’ and ‘scared’. After the session they stated that their confidence in challenging nurses and doctors had increased to 4.3/5 and 4.2/5 respectively. Free text comments included: ‘Hearing from doctors that they would rather be challenged was reassuring.’ ‘Improved my confidence to speak up when querying a decision’ Conclusions/Discussion Nursing staff reported improved confidence in their ability to raise concerns. This can only serve to improve patient safety. We believe that similar training would also benefit new medical staff. Consequentially, we plan to incorporate PACE training into all future medical and nursing induction programmes.

Without knowing anything of the contentious history between Sulawesi's Chinese and Indonesian Moslem communities, Taiwanese director Peng Ya-ling went to Makassar to conduct a reconciliation workshop. As director of Uhan Shii Theatre, Peng creates performances from oral histories she collects in interviews. She applied this technique in Indonesia, first having to overcome deep-seated suspicion from both sides. The Moslem Indonesian actors performed symbolic re-enactments of the Chinese settlers’ stories for a mixed audience from both communities, thus effecting a moment of racial harmony.

Two poems.

The socialist People’s Democratic Republic of Laos (Lao PDR) has some of the largest intact forests in Southeast Asia, yet these are being quickly depleted by illegal logging, slash-and-burn farmin...

HIV-related stigma remains a persistent global health concern among people living with HIV/AIDS (PLWA) in developing nations. The literature is lacking in studies about healthcare students' perceptions of PLWA. This study is the first effort to understand stigmatizing attitudes toward HIV-positive patients by healthcare students in Mwanza, Tanzania, not just those who will be directly treating patients but also those who will be indirectly involved through nonclinical roles, such as handling patient specimens and private health information. A total of 208 students were drawn from Clinical Medicine, Laboratory Sciences, Health Records and Information Management, and Community Health classes at the Tandabui Institute of Health Sciences and Technology for a voluntary survey that assessed stigmatizing beliefs toward PLWA. Students generally obtained high scores on the overall survey instrument, pointing to low stigmatizing beliefs toward PLWA and an overall willingness to treat PLWA with the same standard of care as other patients. However, there are gaps in knowledge that exist among students, such as a comprehensive understanding of all routes of HIV infection. The study also suggests that students who interact with patients as part of their training are less likely to exhibit stigmatizing beliefs toward PLWA. A comprehensive course in HIV infection, one that includes classroom sessions focused on the epidemiology and routes of transmission as well as clinical opportunities to directly interact with PLWA-perhaps through teaching sessions led by PLWA-may allow for significant reductions in stigma toward such patients and improve clinical outcomes for PLWA around the world.

Since 2011, Myanmar's military government has been shifting toward civilian leadership, and in the 2015 elections the National League for Democracy led by Aung San Suu Kyi won a decisive victory, though she was not able to assume the role of prime minister. This indicates that there are still many steps in the process toward guaranteeing civil liberties for all Myanmar citizens. Theatre, music, dance, and performance art during the past four years reveal both the eager hopefulness for more freedoms and the fears of sectarian violence as the impoverished country emerges from more than fifty years of exploitative misrule. Relaxation of laws governing public assembly and expression has encouraged cross-cultural collaboration, productions by minority religions, deeper probing of social injustices, new interest in Shakespearean plays, greater outreach to remote populations, and the establishment of new international festivals. Myanmar is undergoing an artistic as well as sociopolitical transition, and performing artists are challenged to be both reflective and guiding forces to meet the needs of the great diversity of its peoples.

In 2002, Futerra, a British media company advocating sustainability, launched "The Seasons Alter," a four-minute video of Titania's "bad weather" speech. Played by two actresses, Titania chides the surly Oberon, chasing him around the sparse modernist set dominated by an enormous clock. He responds to her recital of environmental disasters stemming from their quarrel by placing the onus on her: "Do you amend it then: it lies in you." She then repeats her own last line more forcefully: "We are their parents and original." (1) Formerly, directors were wont to shorten this speech--the longest in the play--because its serious topicality broke the spell of comic fantasy. Futerra, by extracting its prescient relevance to the contemporary global warming crisis, thrust A Midsummer Night's Dream into the Anthropocene. (2) By posing their fault equally, however, Futerra obscures the ethicality of their respective positions. It places Titania's commitments to rectifying the weather patterns upon which farmers depend and nurturing her votaress's child on the same level as Oberon's whim, an expression of power invested in him by a patriarchal hierarchy. Their debate also puts the Fairy Queen's concern for the world's inhabitants in conflict with her maternal affection for one particular child. She is not allowed by Oberon to love both. By trickery, he obtains the changeling, quells her rebellion, and reabsorbs her into his hierarchal order. However, Titania's challenge to his rule lingers from the image of her loving command over the forest dwellers, a delicate dream of an alternative relationship, of a possible something else. Titania's importance in the play and the expansive expression of her values and desires demonstrates one woman's conflict between her loyalty to nature and to her husband/king. Three other female characters in classical dramas also face similar dilemmas of having to choose between their identities associated with forest life and their roles in patriarchal societies: Sakuntala in Kalidasa's eponymous fifth century Sanskrit play, Neang Seda (Sita) in the Reamker, the eighteenth century Cambodian version of the Sanskrit Ramayana, (3) and Shakespeare's Rosalind in As You Like It. All four are unusual in that they are aristocratic women who spend the duration of their respective dramas in forests. Ecofeminism Their conflicts reprise one of the major concerns of ecofeminism that examines the "important connections between the oppression of women and the destruction and misuse of nonhuman nature within male-dominated cultures." (4) This general formulation does not specify the important connections, but Karla Armbruster adds, "central to the ecofeminist agenda is the goal of individual, social, and ideological change--specifically, change that will improve the cultural standing of women and nature." (5) She implies that the hierarchy of dualisms that divide the world and valorize the male side, such as nature/female and culture/male, has to be dissolved to allow more nuanced interconnections. These artificial divisions, with their concomitant ramifying dyads, were imposed not only to simplify, dominate, and unify the multiplicity of life forms, but also to justify that domination as the natural order. The mutual exclusivity of dualisms has been harmful to both halves, and ecofeminism challenges the gendered essentializing of qualities. It critiques those expected of women that perpetuate the notion that they are somehow physically and emotionally closer to nature, in contradistinction to mind, reason, and the scientific method, and that this association invalidates their environmental knowledge and concern. "Inherent in ecofeminism," writes Barbara Gates, "is a belief in the interconnectedness of all living things. Since all life is nature, no part of it can be closer than another to 'nature.'" (6) At the same time, it must account for women's historical roles as nurturing caregivers and the current focus of agencies dedicated to poverty eradication by empowering poor women to protect their own environment. …

Background Young people living with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) (PLWA) are at risk for HIV stigma. Methods The HIV/AIDS Stigma Instrument for PLWA was administered to 36 young PLWA across six clinics in Bandung, Indonesia, to assess the fear of contagion (FC), verbal abuse (VA), social isolation (SI), workplace stigma (WS), health care neglect (HCN) and negative self-perception (NSP). Results The median scores for FC, VA, SI, WS and HCN were all 0 while the median score for NSP was 4. In the last 3 months approximately 45% of surveyed PLWA felt they did not deserve to live and 64% felt completely worthless. Conclusions While these results are preliminary, access to mental health services should be a priority in the clinics that provide antiretroviral therapies.

Since the Sunflower Movement of 2014, when thousands of Taiwanese students protested against a trade deal the Nationalist government had made with China, the issue of Taiwan's sovereignty has again been brought to the political fore. Home to twenty-three million people, not only is Taiwan beset by threats from China and isolated by international organizations, but in its rapid push to industrialize it also has incurred severe environmental degradation. Two contemporary theatre troupes incorporated the Sunflower demonstration's ‘pro-Taiwanese homeland’ agenda into their works about the environment. Addressing both the pollution of the countryside and the demise of rural communities, they idealized pastoral life and emphasized Taiwan's roots in agrarian culture. Sun Son's Mulian Rescues Mother Earth imagined a perfectly organized small agricultural community trying to sustain its success, and San Que Yi's Earth Project portrayed two examples of rural communities engaged in David-and-Goliath struggles against industrial pollution.

Simianification is the practice of humans inhabiting the simian body on stage. Because Asians have lived with monkeys and apes, several Asian theatre traditions have long legacies of representing monkeys on stage. In Europe and North America, where non-human primates did not exist, they are not a familiar feature in performance until nineteenth-century music hall and circus and twentieth-century film and television. In some recent performances in Asia dancers and actors have expanded their understanding of monkey roles by incorporating scientific discoveries, modern movement techniques, and global pop culture. On the British and American stage, actors experiment to ‘impersonate’ the humanized ape bodily and mentally, without the aid of the disguises and prosthetics usual in film. These performers ‘embody’ the philosophical inquiry of what it means to ‘be monkey’ by inhabiting a monkey’s body while still performing ‘art’ for a human audience. Catherine Diamond, a Contributing Editor to NTQ, is a professor of theatre and environmental literature at Soochow University, Taiwan. She is also the director of the Kinnari Ecological Theatre Project in Southeast Asia.

Ecodramaturgy is a new concept that foregrounds ecological relationships in theatrical creation and presentation. Some Southeast Asian theatres have taken initial steps to explore this new area, but it is still thematically marginalized even though the region’s natural spaces are under severe threat. This essay attempts to explain why nature and environmental issues are largely absent from the contemporary urban stage. It describes various productions in the region that have addressed nonhuman subjects, as well as analyzing others that have not adopted this approach but suggest the potential to do so. It discusses how modernity—in both its scientific discoveries and its globalized marketing—offers new challenges and opportunities for ecodramaturgical development.

Community schools link students, families, and communities to educate children and strengthen neighborhoods. They have become a popular model for education in many US cities in part because they build on community assets and address multiple determinants of educational disadvantage. Since community schools seek to have an impact on populations, not just the children enrolled, they provide an opportunity to improve community health. Community schools influence the health and education of neighborhood residents though three pathways: building trust, establishing norms, and linking people to networks and services. Through such services as school-based health centers, nutrition education, family mental health counseling, violence prevention, and sexuality education, these schools build on the multiple reciprocal relationships between health and education. By developing closer ties between community schools and neighborhood health programs, public health professionals can help to mobilize a powerful new resource for reducing the health and educational inequalities that now characterize US cities. We suggest an agenda for research, practice, and policy that can build the evidence needed to guide such a strategy.

Author(s): Karris, Maile Y; Jain, Sonia; Bowman, Vi Q; Rieg, Gunter; Goicoechea, Miguel; Dube, Michael P; Kerkar, Shubha; Kemper, Carol; Diamond, Catherine; Sun, Xiaoying; Daar, Eric S; Haubrich, Richard H; Morris, Sheldon; California Collaborative Treatment Group (CCTG) 589 Study Team

The pro-inflammatory cytokine interleukin (IL)-1β is an important mediator of the inflammatory response. In order to perform its role in the inflammatory cascade, IL-1β must be secreted from the cell, yet it lacks a signal peptide that is required for conventional secretion, and the exact mechanism of release remains undefined. Conventional biochemical methods have limited the investigation into the processes involved in IL-1β secretion to population dynamics, yet heterogeneity between cells has been observed at a single-cell level. Here, greater sensitivity is achieved with the use of a newly developed vector that codes for a fluorescently labelled version of IL-1β. Combining this with real-time single-cell confocal microscopy using the methods described here, we have developed an effective protocol for investigating the mechanisms of IL-1β secretion and the testing of the hypothesis that IL-1β secretion requires membrane permeabilisation.

Health literacy research has concentrated on adults; there has been inadequate research on youth health literacy and the effect it may have on health outcomes. Low-income, minority populations have low levels of health literacy and are at higher risk of illness and disease. Building Wellness™ is a youth health literacy curriculum targeting low-income youth from 3rd grade to 8th grade in order to prepare the youth to be active, educated participants in their healthcare. Lessons focus on asthma, obesity and overweight, accidental injury, and drug and alcohol use. Curriculum development was based on qualitative and quantitative assessment of the target population. The preliminary findings from the pilot project show an increase in knowledge, improved healthy behaviors, and enthusiasm from participants and facilitators. The development of the pilot project is described, with a suggestion for future development of youth health literacy assessment tools.

Communication Skills Training (CST) is a proven aid to help oncologists achieve high quality patient-centered communication. No research studies have provided clear guidelines for developing the content of CST. The aim of this work is to describe a method of developing such content and evaluation of effectiveness of CST training workshops (based on this method) in a real world medical education setting at Memorial Sloan-Kettering Cancer Center. Using a set of seven sequenced steps, we have developed a curriculum for training oncology fellows in several communication challenges. Oncology fellows (n = 45) participated in CST workshops. A coding system was applied to each participant's consultation video-recordings pre and post training. Participants completed evaluations of their confidence and self efficacy in communication skill usage. The training increased the fellows' overall level of skill usage (t44= − 2.426, p

Objective: The objective of this paper is to report the implementation and assessment of the Comskil Training Curriculum at Memorial Sloan-Kettering Cancer Center. Method: Twenty-eight attending physicians and surgeons participated in communication skills training modules as part of a train-the-trainer program. Doctors were video recorded in clinical consultations with patients two times before training and two times after training, resulting in 112 video recordings for analysis. Recordings were coded using the Comskil Coding System. Results: Communication skills related to two of the six major skill sets, Establishing the Consultation Framework and Checking, increased following training. Limited changes emerged in three skill sets, while one skill set, Shared Decision Making, did not change. Doctors who attended more training modules had higher levels of change. Female participants demonstrated three skills more frequently than males post-training. Conclusions: The intervention produced significant communication skills uptake in a group of experienced attending clinicians, mediated by the amount of training. Future research should focus on the dose of training necessary to achieve skills uptake and the effect of skills training on patient outcomes. Copyright © 2009 John Wiley & Sons, Ltd.

Because Myanmar's poverty and isolation somewhat protect its traditional performing arts from the competition of global influences, many of them flourish. The repressive military regime has appropriated the former court patronage of music and dance to assert its legitimacy. However, verbal arts such as literature, satire, spoken drama, and film are severely hampered by government censorship and lack of funding. Despite these obstacles, Burmese performers and their audiences demonstrate an amazing resilience: banned and formerly imprisoned performers continue to take to the stage, and audiences flock to see them.

For its size, Singapore hosts an exceptional amount of theatrical activity, emanating both from within the city state and from its role as sponsor of regional international workshops and productions. Its English-speaking dramatists are in the forefront of staging original plays about the foibles of Singaporean society and serving as mediators among South-east Asian theatre practitioners. While troupes depend on government funding and must obtain government permits to perform, most have opted to take an alternative position to the government's narrative of the Singapore success story. This has created an uneasy relationship that undermines the strength of the theatre's social-political critique and encourages self-censorship. In the following essay, Catherine Diamond examines the psychologically cramped conditions within which current Singaporean dramatists operate through a comparison of monodramas. Catherine Diamond is a professor of theatre at Soochow University in Taiwan, and a frequent contributor to NTQ. She is currently directing a flamenco dance-drama adaptation of The House of Bernarda Alba.

Balinese performing arts have had remarkable fluidity in their gender presentation, in which female impersonators have predominated. Over the past twenty-five years, however, women have been making inroads in the presentation of female characters, then androgynous characters, and now even some of the more crude male characters. Gamelan wanita, the all-women ensembles that were once a novelty, are now commonplace throughout the island and they are aspiring to ever higher levels of musicality. All-female troupes are performing formerly all-male genres such wayang wong, kecak, and topeng. Solo performers are both exploring the increasingly porous boundaries between masculine and feminine representations and probing the etiology of gender inequality.

Background Plasma concentrations of tenofovir increase when the drug is coadministered with some ritonavir-boosted protease inhibitors (PI/r). We hypothesized that tenofovir disoproxil fumarate (TDF)-treated patients taking PI/r-based regimens would have a greater decline in renal function than patients receiving nonnucleoside reverse-transcriptase inhibitor (NNRTI)-based therapy. Methods We compared the estimated decline in renal function among 146 human immunodeficiency virus type 1 (HIV-1)-infected patients receiving a TDF+PI/r- (n = 51), TDF+NNRTI- (n = 29), or non-TDF-containing (n = 66) regimen. Plasma tenofovir concentrations were measured at study week 2, and rates of creatinine clearance (CrCl) were estimated using the Cockcroft-Gault (C-G) and Modification of Diet in Renal Disease (MDRD) equations. Mixed-effects models were used to analyze regimen type and tenofovir concentration as predictors of change in CrCl from baseline to weeks 24 and 48. Results Decreases in C-G estimates of CrCl were not significantly different among the 3 groups during the first 24 weeks of therapy. However, in adjusted analyses, patients receiving TDF+PI/r had a greater rate of decline in CrCl than did the TDF+NNRTI group (for C-G, -13.9 vs. -6.2 mL/min/year [P = .03]; for MDRD, -14.7 vs. -4.5 mL/min/1.73 m(2)/year [P = .02]). Among TDF-treated patients, tenofovir plasma concentration was not associated with CrCl over time. Conclusions Treatment with TDF and PI/r was associated with greater declines in renal function over 48 weeks compared with TDF+NNRTI-based regimens.

Objective: To improve the utility of therapeutic drug monitoring (TDM) by defining the proportion of patients with and predictors of above or below target protease inhibitor (PI) or nonnucleoside reverse transcriptase inhibitor (NNRTI) concentrations. Methods: This 48-week, multicenter, open-label clinical trial randomized patients to TDM versus standard of care (SOC). Serial pharmacokinetics, including a week-2 3-sample sparse collection, and expert committee TDM recommendations were given to TDM-arm patients' providers. Results: Seventy-four (39%) of 190 patients had week-2 concentrations outside of targets and 122 (64%) of 190 had nontarget exposure at least once over 48 weeks. Providers accepted 75% of TDM recommendations. Among patients with below-target concentrations, more TDM-arm than SOC-arm patients achieved targets (65% vs. 45%; P = 0.09). Increased body weight and efavirenz or lopinavir/ritonavir use were significant predictors of nontarget concentrations. Patients at target and patients who achieved targets after TDM-directed dose modifications trended toward greater viral load reductions at week 48 than patients with below-target exposures (HIV RNA reductions: 2.4, 2.3, and 1.9 log 10 copies/mL, respectively; P = 0.09). Conclusions: Most patients had nontarget PI and/or NNRTI concentrations over 48 weeks. TDM recommendations were well accepted and improved exposure. Patients below TDM targets trended toward worse virologic response.

A large proportion of Thai films and of traditional and modern dramas are based on significant figures whose lives helped shape the trajectory of Thai history, but who are in the end overwhelmed by events. Some works are produced with obvious propaganda intent, reflecting the efforts of cultural reconstruction and historical reinterpretation. This paper suggests that the plays under discussion follow an epic and episodic form, depicting the full scope of the protagonist's life rather than focusing on a single dramatic event or examining a tragic destiny. This structure resembles the paradigmatic epic underwriting Thai royalty, the Ramakien, even while the role and nature of the king is being newly exemplified in annual spectacles.

OBJECTIVE: We sought to determine the accuracy of cancer registry data regarding the human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) status of patients with non-Hodgkin's lymphoma (NHL). METHODS: We used the population-based San Diego/Orange County cancer registry to identify 392 patients with HIV-related NHL diagnosed 1994-1999. After matching for age, sex, race, period of NHL diagnosis, and hospital type, we were able to find 324 corresponding patients among the remaining 4,863 NHL patients diagnosed 1994-1999 (who did not have HIV infection according to cancer registry records). We sought to review these patients' charts at 41 hospitals with 15 separate institutional review boards to determine if the HIV serostatus from the cancer registry was correct. We performed a forward conditional multivariate logistic regression to determine characteristics associated with a false positive HIV status. RESULTS: The false positive rate was 8% while the false negative rate was 3%. The positive predictive value was 93% while the negative predictive value was 97%. Compared to correctly identified patients, false positives were more likely to be > or =50 years old, female, and treated with chemotherapy and less likely to be single with high grade or extranodal disease. CONCLUSION: Using cancer registry data to identify AIDS-related NHL is a valid research practice.

ObjectivesTo develop a computer-based system for modelling and interpreting plasma antiretroviral concentrations for therapeutic drug monitoring (TDM).MethodsData were extracted from a prospective TDM study of 199 HIV-infected patients (CCTG 578). Lopinavir (LPV) and efavirenz (EFV) pharmacokinetic (PK) parameters were modelled using a Bayesian method and interpreted by an expert committee of HIV specialists and pharmacologists who made TDM recommendations. These PK models and recommendations formed the knowledge base to develop an artificial intelligence (AI) system that could estimate drug exposure, interpret PK data and generate TDM recommendations. The modelled PK exposures and expert committee TDM recommendations were considered optimum and used to validate results obtained by the AI system.ResultsA group of patients, 67 on LPV, 46 on EFV and three on both drugs, were included in this analysis. Correlations were high for LPV and EFV estimated trough and 4 h post-dose concentrations between the AI estimates and modelled values (r>0.79 for all comparisons; PConclusionsThe AI system successfully estimated LPV and EFV trough concentrations and achieved good agreement with expert committee TDM recommendations for EFV- and LPV-treated patients.

In this article, we compared the characteristics of public and private accredited public health training programs. We analyzed the distinct opportunities and challenges that publicly funded schools of public health face in preparing the nation’s public health workforce. Using our experience in creating a new, collaborative public school of public health in the nation’s largest urban public university system, we described efforts to use our public status and mission to develop new approaches to educating a workforce that meets the health needs of our region and contributes to the goal of reducing health inequalities. Finally, we considered policies that could protect and strengthen the distinct contributions that public schools of public health make to improving population health and reducing health inequalities.

Highly active retroviral therapy (HAART) has been in widespread use in the United States since 1996. We sought to determine how the use of HAART influenced survival among patients with acquired immunodeficiency syndrome (AIDS) and primary central nervous system (CNS) non-Hodgkin's lymphoma (NHL). We used the population-based San Diego and Orange County cancer registry to identify 94 patients with both AIDS and CNS NHL diagnosed 1994-1999, of whom 31 were diagnosed 1996-1999. We performed Kaplan-Meier analyses to compare survival between patients who received HAART at NHL diagnosis or thereafter versus untreated patients and Cox proportional hazard models for adjusted survival. Among the patients diagnosed with NHL in 1996-1999, seven (23%) were taking HAART at the time of NHL diagnosis. Median survival was eight months for those who received HAART at the time of lymphoma diagnosis or after, versus one month for untreated patients. HAART, radiation therapy, and better performance status were associated with improved survival. We conclude that HAART prolongs survival in AIDS-related CNS NHL.

Objective: We conducted a randomized, multi-site, controlled trial of a cognitive-behavioral adherence intervention for patients initiating or changing an antiretroviral (ART) regimen. Design: A 3 x 2 factorial design was used with the primary randomization assigning patients (1 : 1 : 1) to one of two adherence interventions or usual care. Methods: The five-session adherence interventions consisted of cognitive-behavioral and motivational components, with or without a 2-week pre-treatment placebo practice trial. Intent-to-treat analysis used probability weights and regression tree analysis to account for missing data. Results: A total of 230 patients were randomized; 199 started ART, of whom 74% completed the 48-week study. Electronic monitored adherence outcomes between the two intervention groups did not differ significantly and were thus pooled in analyses. At week 4, 82% of intervention patients had taken at least 90% of their prescribed ART doses, compared with 65% of controls (P < 0.01); this group difference dropped to 12% at week 12 (72 versus 60%; P = 0.15) and 11 % at week 24 (66 versus 55%; P = 0.28). Mean adherence in the intervention group was significantly higher than the control group at week 24 (89 versus 81%; P < 0.05) only. There were no group differences with respect to HIV-1 RNA throughout the study. Conclusions: The effects of the cognitive-behavioral intervention on adherence were modest and transient, and no effects were observed on viral load or CD4 cell count. More robust effects may require a more intense intervention that combines ongoing adherence monitoring and individualized intervention 'dosage' that matches the need and performance of each patient.

BACKGROUND The authors sought to determine whether the availability of highly active antiretroviral therapy (HAART) coincided with changes in the epidemiology of acquired immunodeficiency syndrome (AIDS)-related non-Hodgkin lymphoma (NHL). METHODS Cancer registry data from 1988–2000 were linked with AIDS registry data from 1981 to July 2003 for San Diego County to identify 537 AIDS-NHL patients. By using the total number of patients with AIDS who were alive as of July 1 annually as the AIDS population denominator, the average annual incidence of NHL was estimated among patients with AIDS for the pre-HAART period (1988–1995) and post-HAART period (1996–2000). The chi-square test was used to compare proportions, and a Cox proportional hazards model was used to compare survival between the pre-HAART and post-HAART periods. RESULTS The incidence of NHL decreased from 29.6 per 1000 person-years pre-HAART to 6.5 per 1000 person-years post-HAART. The proportion of patients who had NHL of central nervous system (CNS) origin decreased from 28% pre-HAART to 17% post-HAART. Among patients with systemic NHL, 54% received chemotherapy pre-HAART, and 72% received chemotherapy post-HAART. The percentage of intermediate-grade NHL increased from 33% pre-HAART to 49% post-HAART, and the percentage of high-grade NHL decreased from 38% to 19%, respectively. A diagnosis of human immunodeficiency virus infection preceding the NHL diagnosis and Stage IV NHL were associated with worse survival, whereas a diagnosis of NHL in the post-HAART period and chemotherapy were associated with better survival. The median survival was 4 months pre-HAART and 9 months post-HAART. CONCLUSIONS Since the introduction of HAART, there has been a decrease in the incidence of systemic and CNS NHL among patients with AIDS. Among patients with systemic, AIDS-related NHL, there has been decreased high-grade histology, increased use of chemotherapy, and improved survival. Cancer 2006. © 2005 American Cancer Society.

The duality of female characterization in Thai theatre and film is exemplified by the character of Mae Naak. She is a ghost-woman whose love for her husband transcends death, but monastic Buddhism sees her as consumed by worldly attachment. This character, along with other famous traditional stage figures such as White Snake, Kaki, Sita (Sida), and Busba, is experiencing a change of interpretation in contemporary Thailand, especially as women have become prominent dramatists and have chosen to confront the "good-bad" woman dichotomy in Thai court, popular, and folk theatres. In contemporary productions such characters have been presented in a feminist light, which exposes the misogynistic structures leading to their predicaments. Dramatists such as playwright Daraka Wongsiri and actress-producer Patravadi Mejudhon explore the shifting perspective toward women's roles in modern Thai culture, influenced by both Bhuddist and Western ideals. The conflict within Mae Naak continues to be relevant to her contemporary counterparts, for though the duality may take on modern public-private dimensions, it remains unresolved and theatrically powerful.

Unlike most Southeast Asian theatres, Vietnam has created a sizeable corpus of scripted spoken dramas that continue to be popular in performance with urban audiences. Initially influenced by French classicism and Ibsenist realism, the Vietnamese spoken drama, kich noi, very quickly adapted to local social realities and survives by readily incorporating topical subjects. While keeping abreast of current social issues, the theatre nonetheless makes use of its multi-cultural heritage, and in any given modern performance one can see the layers of influence – traditional Sino-Vietnamese hat boi/tuong; Vietnamese cheo theatre, Cham dance, French realism, Soviet constructivism and socialist realism, and most recently, western performance art. The Vietnamese playwrights, set designers, directors, and actors have combined aspects of the realistic theatre with the conventions of their suppositional traditional theatre to come up with a hybrid that is uniquely Vietnamese. It is argued that these manifold layers should be regarded as a kind of palimpsest rather than just as pastiche.

Objective: We sought to determine if the introduction of highly active antiretroviral therapy (HAART) corresponded with changes in anal squamous cell cancer rates among men with AIDS Study: We linked cancer registry data from 1988-2000 and AIDS registry data from 1981-July/2003 for San Diego County. We defined 1991-1995 and 1996-2000 as the pre- and post-HAART periods, respectively. Results: The annual incidence of invasive anal cancer increased from zero per 100,000 men with AIDS aged 25 to 64 years (95% confidence interval [CI], 0-226) in 1991 to 224 per 100,000 (95% CI, 102-425) in the year 2000. Pre-HAART, the average annual incidence of invasive anal cancer was 49 per 100,000 men with AIDS aged 25 to 64 years (95% CI, 16-114) versus 144 per 100,000 (95% CI, 93-212) post-HAART. The relative risk of invasive anal cancer among men with AIDS compared with men without known HIV/AIDS was 98 (95% CI, 36-264) pre-HAART and 352 (95% CI, 186-669) post-HAART. The increased incidence of anal cancer among men with AIDS resulted in an increase in the overall rate of anal cancer among men in San Diego County. Conclusions: The rising incidence of anal cancer among men with AIDS may be related to increased longevity with HAART and the consequent increased time at risk for the development of malignancy and/or the result of greater use of cytologic screening.