Search

BackgroundPre-exposure prophylaxis (PrEP) is highly effective in the prevention of HIV acquisition, particularly for men who have sex with men (MSM). Questions remain on the benefits of PrEP and implementation strategies for those at occupational risk of HIV acquisition in sex work, as well as on methods to support adherence among young people who initiate PrEP. ObjectiveThe Combination Prevention Effectiveness study for young cisgender MSM and transgender women (TGW) aims to assess the effectiveness and cost-effectiveness of a combination intervention among HIV-uninfected young MSM and TGW engaged in sex work in Thailand. MethodsThis open-label, nonrandomized assessment compares the relative effectiveness of a combination prevention intervention with and without daily oral emtricitabine and tenofovir disoproxil fumarate (Truvada) PrEP with SMS-based adherence support. HIV-uninfected young MSM and TGW aged 18 to 26 years in Bangkok and Pattaya who self-report selling/exchanging sex at least once in the previous 12 months are recruited by convenience sampling and peer referral and are eligible regardless of their intent to initiate PrEP. At baseline, participants complete a standard assessment for PrEP eligibility and may initiate PrEP then or at any time during study participation. All participants complete a survey and HIV testing at baseline and every 3 months. Participants who initiate PrEP complete monthly pill pickups and may opt-in to SMS reminders. All participants are sent brief weekly SMS surveys to assess behavior with additional adherence questions for those who initiated PrEP. Adherence is defined as use of 4 or more pills within the last 7 days. The analytic plan uses a person-time approach to assess HIV incidence, comparing participant time on oral PrEP to participant time off oral PrEP for 12 to 24 months of follow-up, using a propensity score to control for confounders. Enrollment is based on the goal of observing 620 person-years (PY) on PrEP and 620 PY off PrEP. ResultsAs of February 2019, 445 participants (417 MSM and 28 TGW) have contributed approximately 168 PY with 95% (73/77) retention at 12 months. 74.2% (330/445) of enrolled participants initiated PrEP at baseline, contributing to 134 PY of PrEP adherence, 1 PY nonadherence, and 33 PY PrEP nonuse/noninitiation. Some social harms, predominantly related to unintentional participant disclosure of PrEP use and peer stigmatization of PrEP and HIV, have been identified. ConclusionsThe majority of cisgender MSM and TGW who exchange sex and participate in this study are interested in PrEP, report taking sufficient PrEP, and stay on PrEP, though additional efforts are needed to address community misinformation and stigma. This novel multilevel, open-label study design and person-time approach will allow evaluation of the effectiveness and cost-effectiveness of combination prevention intervention in the contexts of both organized sex work and exchanged sex. International Registered Report Identifier (IRRID)RR1-10.2196/15354

Ethics review processes are frequently perceived as extending from codes and protocols rooted in biomedical disciplines. As a result, many researchers in the humanities and social sciences (HASS) find these processes to be misaligned, if not outrightly obstructive to their research. This leads some scholars to advocate against HASS participation in institutional review processes as they currently stand, or in their entirety. While ethics review processes can present a challenge to HASS researchers, these are not insurmountable and, in fact, present opportunities for ethics review boards (ERBs) to mediate their practices to better attend to the concerns of the HASS disciplines. By highlighting the potential "value" of the ethics review process in recognising the nuances and specificity across different forms of research, this article explores the generative possibilities of greater collaboration between HASS researchers and ERBs. Remaining cognisant of the epistemic and methodological differences that mark different disciplinary formations in turn will benefit the ethical conduct of "all" researchers.

This paper critically examines articulations of relationality present in education policy texts that shape particular discursive representations of relationality between students, teachers and curriculum. The policy texts of Australian state and territory education departments are considered as a set of discursive statements to illustrate how concepts such as relationality are deployed in policy as floating signifiers. Without deep contextualisation, concepts like relationality are instead potentially co-opted and corrupted. We contend that through its uptake, relationality has become a handy catch-all in educational policy discourses, while remaining a sliding signifier, free from a more productive affective potentiality. Instead, we argue that relationality should be centred in education policymaking as part of a commitment to recentre teaching and learning at the heart of schooling through a more authentic, dialogic relational pedagogy.

A growing body of literature critical of ethics review boards has drawn attention to the processes used to determine the ethical merit of research. Citing criticism on the bureaucratic nature of ethics review processes, this literature provides a useful provocation for (re)considering how the ethics review might be enacted. Much of this criticism focuses on how ethics review boards "deliberate," with particular attention given to the lack of transparency and opportunities for researcher recourse that characterise ethics review processes. Centered specifically on the conduct of ethics review boards convened within university settings, this paper draws on these inherent criticisms to consider the ways that ethics review boards might enact more communicative and deliberative practices. Outlining a set of principles against which ethics review boards might establish strategies for engaging with researchers and research communities, this paper draws attention to how "Deliberative communication," "Engagement with researchers" and the "Distribution of responsibility" for the ethics review might be enacted in the day-to-day practice of the university human ethics review board. This paper develops these themes via a conceptual lens derived from Habermas' (The theory of communicative action. Volume 1: Reason and the rationalization of society, 1984) articulation of 'communicative action' and Fraser's (Social Text, 25(26), 56-80, 1990) consideration of 'strong publics' to cast consideration of the role that human ethics review boards might play in supporting university research cultures. "Deliberative communication," "Engagement with researchers" and the "Distribution of responsibility" provide useful conceptual prompts for considering how ethics review boards might undertake their work.

This paper considers the implications of the current landscape of education policy reform in Australian schooling. We argue that the decontextualisation of education policy enactments and the eschewing of concerns relevant at the local level of the school over the past two decades have prompted various reform agendas to fail. We contend that recognition of the deep contextualisation of schools is paramount in any attempt at renewal. Therefore, it is at the local school-level that reform agendas can and should be directed by the pedagogical and innovative work of educators. We focus on 'relational pedagogy' because it offers opportunities to enact school-wide reform and enhance the professional capacities of educators as pedagogical innovators. Contemporary education reform agendas are best situated and registered within school sites and relational pedagogy stands as a deeply contextualised provocation for enacting school renewal.

This paper provides a conceptualisation of relational pedagogy in which informality is proposed as a pedagogical modality to activate inclusive, socially just learning and teaching encounters. Findings from two ethnographic studies conducted in alternative learning contexts are examined, which demonstrated that informality was crucial to the formation of pedagogical 'activations' that marked the conduct of each learning context and the interactions between teachers, students and learning. The formation of close bonds between students and teachers extended to renegotiated associations with the practices of schooling and reformulated relationships with learning experienced by students and their teachers. It was at the 'interface' between students, teachers and learning that these activations of relationality materialised, in which informality was a central dynamic. From these findings, a set of propositions are generated to centre relational pedagogy as being key to the engagement of young people in meaningful education across schooling and other learning contexts.

This paper examines the function of 'expertise' in mediating the student-supervisor relationship in Higher Degree Research (HDR). Prevailing conceptualisations of expertise generally translate as "disciplinary acumen" and reference the supervisor's specialist disciplinary and methodological knowledge. Beyond establishing the disciplinary 'signatures' of a discipline, this expertise also confers 'symbolic capital' within the disciplinary field. This paper asks: 'What might it mean when supervisors "lack" such specific disciplinary knowledge in the supervision of HDR projects?' Drawing on theoretical foundations from Jacques Rancière and Paulo Freire, this paper considers how alternative ways of knowing and enacting scholarly inquiry might afford new terrains of practice within the HDR project, with the authors' recent experiences in supervising beyond their respective disciplinary expertise providing an illustration of this modality of supervision. This case example demonstrates how mutuality and the enactment of a dialogic supervisory approach might widen considerations of what 'counts' as expertise within HDR supervision. In setting out this conceptualisation, an ethic of mutual inquiry prefaced by Rancière's 'two wills' provides a means for activating a dynamic HDR candidature, the production of innovative research and the recognition of expertise beyond narrowly defined configurations of disciplinary acumen.

In this paper, we deploy the concept of aporia to consider the ways in which enactments of policy become ‘stuck’ as policy flows between national and sub-national education systems. We illustrate the overlapping political, governmental and bureaucratic spheres of influence that mediate how national school reform agendas are received and enacted by schooling systems. Our analysis is based on interviews with senior bureaucrats from an Australian non-government sector’s national and state peak bodies representing Queensland, New South Wales, Tasmania and the Northern Territory. Drawing on conceptualisations of aporia as an impasse and more deliberatively, Lather’s interpretation of aporia as ‘moments of possibility’, we argue that aporias created by bureaucratic barriers, government timelines, government evaluation processes and the placement of accountability measures over schooling prevents the meaningful enactment of policy within school settings. We argue that there is a need to consider the generative possibilities that exist within this situation of policy aporia, and demarcate where possibilities to move beyond ‘stuck’ policy might arise. [ABSTRACT FROM AUTHOR]

Young transgender women (YTGW) who sell or trade sex have among the highest HIV incidence rates in Thailand. Using qualitative methods, we assessed perceived acceptability, feasibility, and optimal design of a combination HIV prevention intervention including PrEP for YTGW. Key informant interviews were conducted during July 2016-July 2018 with 21 YTGW, aged 18-26 years, who sold sex and resided in Bangkok or Pattaya, Thailand. Grounded theory and content analysis were used for data analysis. Most YTGW interviewed reported high interest in HIV prevention research and believed participation in it supported sexual health. However, participants perceived HIV studies as complicated and time-consuming. Regarding PrEP, participants suggested more PrEP options beyond daily oral PrEP and expressed concerns related to perceived side effects of PrEP, including interaction with gender-affirming hormone therapy. Improving PrEP knowledge, being able to self-assess HIV risk, and reducing HIV/PrEP stigma could increase interest in research and PrEP uptake among YTGW. [ABSTRACT FROM AUTHOR]

The great possibility of alternative education programs rests in the affront to established conventions that these present for what counts as learning, engagement and the experience of schooling. This paper takes as its point of focus one specific, in-school alternative learning program, and considers the possibilities for student re-engagement that emerged via the repair and restoration of old bicycles. The discussion focusses particularly on the "informality" that presented within the day-to-day dynamics of the program and how the space provided in the program's workshop sessions offered the opportunity for students to re-configure their relationships with each other, their teachers and the larger practice of schooling. A discussion of both the potential "and" risk of a "pedagogy of informality" is posited in light of current discussions in the literature of alternative education in Australia.

This paper outlines a conceptual framework for enacting relational pedagogy. Commencing with a description of a relational ontology that can work to provide the foundation for engaged and participatory enactments of teaching and learning, the paper moves to consider the dynamics that support inclusive modes of education and the dimensions of relational pedagogical encounters. In particular, the pedagogical encounter is examined with a view to illuminating how the ontological and epistemological dynamics and dimensions of relational pedagogy open opportunities for inclusive and participatory modes of teaching and learning. In addition, the practical implications of pedagogical informality are considered, including the in-the-moment immediacy inherent to the relational encounter and concomitant enactments of the pedagogical exchange. In doing so, we argue for a relational pedagogy that widens the possibility for meaningful engagement with young people through pedagogical enactments that build upon the inter-relationality of teachers and students. [ABSTRACT FROM AUTHOR]

This paper charts the experiences of a group of young people and their involvement in a local government initiative to engage young people in public decision-making. Activated through a youth leaders' council that sought to influence and inform local government decision-making, the participating young people were given responsibility for enacting focus projects in collaboration with local government personnel. However, this method of simply bringing young people together with local government decision-makers did not automatically alter the way that decisions came to be made and ironically resulted in interactions that went some way to further reinforce existing perceptions of young people as incapable in situations of public administration. This paper reports on a case example detailing an interaction between the youth leaders and local government councillors, and will suggest that the experience of the young people involved in the youth leaders' council can be understood against a dynamic of 'constraint'.

Background: Quality assessments of gonococcal surveillance data are critical to improve data validity and to enhance the value of surveillance findings. Detecting data errors by systematic audits identifies areas for quality improvement. We designed and implemented an internal audit process to evaluate the accuracy and completeness of surveillance data for the Thailand Enhanced Gonococcal Antimicrobial Surveillance Programme (EGASP). Methods: We conducted a data quality audit of source records by comparison with the data stored in the EGASP database for five audit cycles from 2015–2021. Ten percent of culture-confirmed cases of Neisseria gonorrhoeae were randomly sampled along with any cases identified with elevated antimicrobial susceptibility testing results and cases with repeat infections. Incorrect and incomplete data were investigated, and corrective action and preventive actions (CAPA) were implemented. Accuracy was defined as the percentage of identical data in both the source records and the database. Completeness was defined as the percentage of non-missing data from either the source document or the database. Statistical analyses were performed using the t-test and the Fisher's exact test. Results: We sampled and reviewed 70, 162, 85, 68, and 46 EGASP records during the five audit cycles. Overall accuracy and completeness in the five audit cycles ranged from 93.6% to 99.4% and 95.0% to 99.9%, respectively. Overall, completeness was significantly higher than accuracy (p = 0.017). For each laboratory and clinical data element, concordance was >85% in all audit cycles except for two laboratory data elements in two audit cycles. These elements significantly improved following identification and CAPA implementation. Discussion: We found a high level of data accuracy and completeness in the five audit cycles. The implementation of the audit process identified areas for improvement. Systematic quality assessments of laboratory and clinical data ensure high quality EGASP surveillance data to monitor for antimicrobial resistant Neisseria gonorrhoeae in Thailand. [ABSTRACT FROM AUTHOR]

Research investigating elite schools has highlighted how students within these learning environments embody and naturalise their privilege through discourses of merit, hard work, and innate talent and skill. However, relatively little is known about how privilege, and its associated discourses, moves with students beyond the school gate and into adulthood. In this paper we present accounts from elite boys' school alumni to interrogate how they mediate representations of Self as morally 'good and sincere'. The active disavowal of the elite education experience, and deferral of culpability from the cultural practices of these institutions feature in these accounts. In particular, the paper explores the strategies used to reconcile aspects of the elite boys' school experience. We argue that these practices of disavowal and deferred culpability provide a degree of personal and professional mobility, from which the cultivation of a positive sense of self as a 'good' man emerges. [ABSTRACT FROM AUTHOR]