124 research outputs found

    On Characterizing the Data Access Complexity of Programs

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    Technology trends will cause data movement to account for the majority of energy expenditure and execution time on emerging computers. Therefore, computational complexity will no longer be a sufficient metric for comparing algorithms, and a fundamental characterization of data access complexity will be increasingly important. The problem of developing lower bounds for data access complexity has been modeled using the formalism of Hong & Kung's red/blue pebble game for computational directed acyclic graphs (CDAGs). However, previously developed approaches to lower bounds analysis for the red/blue pebble game are very limited in effectiveness when applied to CDAGs of real programs, with computations comprised of multiple sub-computations with differing DAG structure. We address this problem by developing an approach for effectively composing lower bounds based on graph decomposition. We also develop a static analysis algorithm to derive the asymptotic data-access lower bounds of programs, as a function of the problem size and cache size

    Women’s Management of Recurrent Bacterial Vaginosis and Experiences of Clinical Care: A Qualitative Study.

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    Background Few data are available on how women manage recurring bacterial vaginosis (BV) and their experiences of the clinical care of this condition. This study aimed to explore women’s recurrent BV management approaches and clinical care experiences, with a view to informing and improving the clinical management of BV. Methods A descriptive, social constructionist approach was chosen as the framework for the study. Thirty-five women of varying sexual orientation who had experienced recurrent BV in the past 5 years took part in semi-structured interviews. Results The majority of women reported frustration and dissatisfaction with current treatment regimens and low levels of satisfaction with the clinical management of BV. Overall, women disliked taking antibiotics regularly, commonly experienced adverse side effects from treatment and felt frustrated at having symptoms recur quite quickly after treatment. Issues in clinical care included inconsistency in advice, misdiagnosis and inappropriate diagnostic approaches and insensitive or dismissive attitudes. Women were more inclined to report positive clinical experiences with sexual health physicians than primary care providers. Women’s frustrations led most to try their own self-help remedies and lifestyle modifications in an attempt to treat symptoms and prevent recurrences, including well-known risk practices such as douching. Conclusion In the face of considerable uncertainty about the cause of BV, high rates of recurrence, unacceptable treatment options and often insensitive and inconsistent clinical management, women are trying their own self-help remedies and lifestyle modifications to prevent recurrences, often with little effect. Clinical management of BV could be improved through the use of standardised diagnostic approaches, increased sensitivity and understanding of the impact of BV, and the provision of evidence based advice about known BV related risk factors.Dr. Jade Bilardi is in receipt of a National Health and Medical Research Council Early Career Fellowship (No. 1013135)

    Fungsi Sosiologis Undang-undang Dasar Negara Republik Indonesia Tahun 1945 Dalam Memenuhi Hak-hak Masyarakat

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    Constitution is a binding social contract between government and citizen. Their relationships figure the rights of the society. These rightsbecome the tool of society to participate in making government policy, to control the governmentand to avoid the practice of absolutpower.Therefore, the 1945 Indonesian Constitution regulates the norms of rights of society. The functions of the rights are to up hold society justice as well as to create society welfare. The regulation of rights of society in Indonesian Constitution indicates itssociological function.It accommodates the right of society in its relationship between government and citizen

    Women’s Views and Experiences of the Triggers for Onset of Bacterial Vaginosis and Exacerbating Factors Associated with Recurrence

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    Background Bacterial vaginosis (BV) is the most common vaginal infection affecting women of childbearing age. While the aetiology and transmissibility of BV remain unclear, there is strong evidence to suggest an association between BV and sexual activity. This study explored women’s views and experiences of the triggers for BV onset and factors associated with recurrence. Methods A descriptive, social constructionist approach was chosen as the framework for the study. Thirty five women of varying sexual orientation who had experienced recurrent BV in the past five years took part in semi-structured interviews. Results The majority of women predominantly reported sexual contact triggered the onset of BV and sexual and non-sexual factors precipitated recurrence. Recurrence was most commonly referred to in terms of a ‘flare-up’ of symptoms. The majority of women did not think BV was a sexually transmitted infection however many reported being informed this by their clinician. Single women who attributed BV onset to sex with casual partners were most likely to display self-blame tendencies and to consider changing their future sexual behaviour. Women who have sex with women (WSW) were more inclined to believe their partner was responsible for the transmission of or reinfection with BV and seek partner treatment or change their sexual practices. Conclusion Findings from this study strongly suggest women believe that BV onset is associated with sexual activity, concurring with epidemiological data which increasingly suggest BV may be sexually transmitted. Exacerbating factors associated with recurrence were largely heterogeneous and may reflect the fact it is difficult to determine whether recurrence is due to persistent BV or a new infection in women. There was however evidence to suggest possible transmission and reinfection among WSW, reinforcing the need for new approaches to treatment and management strategies including male and female partner treatment trials.Dr. Jade Bilardi is in receipt of an NHMRC Early Career Fellowship No 1013135

    Women’s Views and Experiences of the Triggers for Onset of Bacterial Vaginosis and Exacerbating Factors Associated with Recurrence

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    Background Bacterial vaginosis (BV) is the most common vaginal infection affecting women of childbearing age. While the aetiology and transmissibility of BV remain unclear, there is strong evidence to suggest an association between BV and sexual activity. This study explored women’s views and experiences of the triggers for BV onset and factors associated with recurrence. Methods A descriptive, social constructionist approach was chosen as the framework for the study. Thirty five women of varying sexual orientation who had experienced recurrent BV in the past five years took part in semi-structured interviews. Results The majority of women predominantly reported sexual contact triggered the onset of BV and sexual and non-sexual factors precipitated recurrence. Recurrence was most commonly referred to in terms of a ‘flare-up’ of symptoms. The majority of women did not think BV was a sexually transmitted infection however many reported being informed this by their clinician. Single women who attributed BV onset to sex with casual partners were most likely to display self-blame tendencies and to consider changing their future sexual behaviour. Women who have sex with women (WSW) were more inclined to believe their partner was responsible for the transmission of or reinfection with BV and seek partner treatment or change their sexual practices. Conclusion Findings from this study strongly suggest women believe that BV onset is associated with sexual activity, concurring with epidemiological data which increasingly suggest BV may be sexually transmitted. Exacerbating factors associated with recurrence were largely heterogeneous and may reflect the fact it is difficult to determine whether recurrence is due to persistent BV or a new infection in women. There was however evidence to suggest possible transmission and reinfection among WSW, reinforcing the need for new approaches to treatment and management strategies including male and female partner treatment trials.Dr. Jade Bilardi is in receipt of an NHMRC Early Career Fellowship No 1013135

    Efficacy of interventions to increase the uptake of chlamydia screening in primary care: a systematic review

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    <p>Abstract</p> <p>Background</p> <p>As most genital chlamydia infections are asymptomatic, screening is the main way to detect and cases for treatment. We undertook a systematic review of studies assessing the efficacy of interventions for increasing the uptake of chlamydia screening in primary care.</p> <p>Methods</p> <p>We reviewed studies which compared chlamydia screening in the presence and the absence of an intervention. The primary endpoints were screening rate or total tests.</p> <p>Results</p> <p>We identified 16 intervention strategies; 11 were randomised controlled trials and five observational studies, 10 targeted females only, five both males and females, and one males only. Of the 15 interventions among females, six were associated with significant increases in screening rates at the 0.05 level including a multifaceted quality improvement program that involved provision of a urine jar to patients at registration (44% in intervention clinics vs. 16% in the control clinic); linking screening to routine Pap smears (6.9% vs. 4.5%), computer alerts for doctors (12.2% vs. 10.6%); education workshops for clinic staff; internet-based continuing medical education (15.5% vs. 12.4%); and free sexual health consultations (16.8% vs. 13.2%). Of the six interventions targeting males, two found significant increases including the multifaceted quality improvement program in which urine jars were provided to patients at registration (45% vs. 15%); and the offering by doctors of a test to all presenting young male clients, prior to consultation (29 vs. 4%).</p> <p>Conclusions</p> <p>Interventions that promoted the universal offer of a chlamydia test in young people had the greatest impact on increasing screening in primary care.</p

    Representations of migrant and nation in selected works of Rohinton Mistry and Salman Rushdie

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    This thesis explores the representations of, and the relationship between, the migrant and the nation in selected works of the Bombay-born novelists Rohinton Mistry and Salman Rushdie. I explore each writer's engagement with contemporary debates surrounding the material, political, social and imaginative consequences of the crisis in secularism in India during the 1970s, 1980s and 1990s, and consider how this engagement is informed by their migrant positions beyond India's borders. A primary concern is the way in which Mistry's and Rushdie's representations of the nation, and of migrant and diasporic subjects, intersects with the representation of Bombay in their work. This thesis is divided into five chapters. The first two chapters concentrate on Mistry's fiction, the remaining three on Rushdie's work. Published between 1988 and 2002, the central novels examined are situated within debates regarding the founding principles of the Indian nation, and notions of Indianness, the rise of communalism in general and Hindu nationalism in particular, and the renaming of Bombay as Mumbai. My readings foreground the necessity of a close understanding of the historical and political transformations taking place within Bombay and India during the 1970s, 1980s and 1990s, but also during the 1950s and 1960s. I argue that Mistry's and Rushdie's work is informed by a deepening anxiety over these socio-political transformations, and over how reconfigurations of Indianness increasingly position minority communities, and migrant and diasporic subjects, outside of definitions of national identity. This anxiety extends into the negotiation of their own migrant positions. My reading of the differing representations of the migrant in Mistry's and Rushdie's work engages with ideas of accountability, political responsibility, and with notions of cosmopolitanism. In doing so, I question familiar assumptions regarding the migrant condition as one of predominantly empowering political agency. I argue that, while both authors emphasise the importance of the migrant sustaining a critical engagement with India's politics, they also foreground the anxious difficulties of doing so. This difficulty informs Mistry's and Rushdie's divergent negotiation of their own position as migrant writers, and I examine how their fiction is marked by an anxiety over the adequacy of writing as a mode of political engagement with the crisis in secularism and the parochialisation of Bombay, and as a means of negotiating the politics of migrancy.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

    Incentive payments to general practitioners aimed at increasing opportunistic testing of young women for chlamydia: a pilot cluster randomised controlled trial

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    <p>Abstract</p> <p>Background</p> <p>Financial incentives have been used for many years internationally to improve quality of care in general practice. The aim of this pilot study was to determine if offering general practitioners (GP) a small incentive payment per test would increase chlamydia testing in women aged 16 to 24 years, attending general practice.</p> <p>Methods</p> <p>General practice clinics (n = 12) across Victoria, Australia, were cluster randomized to receive either a $AUD5 payment per chlamydia test or no payment for testing 16 to 24 year old women for chlamydia. Data were collected on the number of chlamydia tests and patient consultations undertaken by each GP over two time periods: 12 month pre-trial and 6 month trial period. The impact of the intervention was assessed using a mixed effects logistic regression model, accommodating for clustering at GP level.</p> <p>Results</p> <p>Testing increased from 6.2% (95% CI: 4.2, 8.4) to 8.8% (95% CI: 4.8, 13.0) (p = 0.1) in the control group and from 11.5% (95% CI: 4.6, 18.5) to 13.4% (95% CI: 9.5, 17.5) (p = 0.4) in the intervention group. Overall, the intervention did not result in a significant increase in chlamydia testing in general practice. The odds ratio for an increase in testing in the intervention group compared to the control group was 0.9 (95% CI: 0.6, 1.2). Major barriers to increased chlamydia testing reported by GPs included a lack of time, difficulty in remembering to offer testing and a lack of patient awareness around testing.</p> <p>Conclusions</p> <p>A small financial incentive alone did not increase chlamydia testing among young women attending general practice. It is possible small incentive payments in conjunction with reminder and feedback systems may be effective, as may higher financial incentive payments. Further research is required to determine if financial incentives can increase testing in Australian general practice, the type and level of financial scheme required and whether incentives needs to be part of a multi-faceted package.</p> <p>Trial Registration</p> <p>Australian New Zealand Clinical Trial Registry ACTRN12608000499381.</p

    Better than nothing? Patient-delivered partner therapy and partner notification for chlamydia: the views of Australian general practitioners

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    <p>Abstract</p> <p>Background</p> <p>Genital chlamydia is the most commonly notified sexually transmissible infection (STI) in Australia and worldwide and can have serious reproductive health outcomes. Partner notification, testing and treatment are important facets of chlamydia control. Traditional methods of partner notification are not reaching enough partners to effectively control transmission of chlamydia. Patient-delivered partner therapy (PDPT) has been shown to improve the treatment of sexual partners. In Australia, General Practitioners (GPs) are responsible for the bulk of chlamydia testing, diagnosis, treatment and follow up. This study aimed to determine the views and practices of Australian general practitioners (GPs) in relation to partner notification and PDPT for chlamydia and explored GPs' perceptions of their patients' barriers to notifying partners of a chlamydia diagnosis.</p> <p>Methods</p> <p>In-depth, semi-structured telephone interviews were conducted with 40 general practitioners (GPs) from rural, regional and urban Australia from November 2006 to March 2007. Topics covered: GPs' current practice and views about partner notification, perceived barriers and useful supports, previous use of and views regarding PDPT.</p> <p>Transcripts were imported into NVivo7 and subjected to thematic analysis. Data saturation was reached after 32 interviews had been completed.</p> <p>Results</p> <p>Perceived barriers to patients telling partners (patient referral) included: stigma; age and cultural background; casual or long-term relationship, ongoing relationship or not. Barriers to GPs undertaking partner notification (provider referral) included: lack of time and staff; lack of contact details; uncertainty about the legality of contacting partners and whether this constitutes breach of patient confidentiality; and feeling both personally uncomfortable and inadequately trained to contact someone who is not their patient. GPs were divided on the use of PDPT - many felt concerned that it is not best clinical practice but many also felt that it is better than nothing.</p> <p>GPs identified the following factors which they considered would facilitate partner notification: clear clinical guidelines; a legal framework around partner notification; a formal chlamydia screening program; financial incentives; education and practical support for health professionals, and raising awareness of chlamydia in the community, in particular amongst young people.</p> <p>Conclusions</p> <p>GPs reported some partners do not seek medical treatment even after they are notified of being a sexual contact of a patient with chlamydia. More routine use of PDPT may help address this issue however GPs in this study had negative attitudes to the use of PDPT. Appropriate guidelines and legislation may make the use of PDPT more acceptable to Australian GPs.</p
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