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PubMed2000

A concept for a research tool for experiments with cochlear implant users.

APEX, an acronym for computer Application for Psycho-Electrical eXperiments, is a user friendly tool used to conduct psychophysical experiments and to investigate new speech coding algorithms with cochlear implant users. Most common psychophysical experiments can be easily programmed and all stimuli can be easily created without any knowledge of computer programing. The pulsatile stimuli are composed off-line using custom-made MATLAB (Registered trademark of The Mathworks, Inc., http://www.mathworks.com) functions and are stored on hard disk or CD ROM. These functions convert either a speech signal into a pulse sequence or generate any sequence of pulses based on the parameters specified by the experimenter. The APEX personal computer (PC) software reads a text file which specifies the experiment and the stimuli, controls the experiment, delivers the stimuli to the subject through a digital signal processor (DSP) board, collects the responses via a computer mouse or a graphics tablet, and writes the results to the same file. At present, the APEX system is implemented for the LAURA (Registered trademark of Philips Hearing Implants) cochlear implant. However, the concept-and many parts of the system-is portable to any other device. Also, psycho-acoustical experiments can be conducted by presenting the stimuli acoustically through a sound card.

Cochlear Implants↗
PubMed1990

Monitoring HIV trends in injecting drug users: an Italian experience.

To examine the incidence and prevalence of HIV infection, we studied a large sample of intravenous drug users (IVDUs) attending a drug dependency unit in Rome over the period 1985-1989. The annual prevalence of HIV antibodies remained stable over the 5-year period. However, a seroconversion study conducted on 302 subjects consistently attending the same facility showed a continued occurrence of HIV seroconversion, although the incidence declined from 8.9 per 100 person-years in 1985-1987 to 5.3 per 100 person-years in 1987-1989. The cumulative incidence of HIV seropositivity, estimated by the Kaplan-Meier survival technique, was higher in female than in male IVDUs. The findings show that the use of both incidence and prevalence data to monitor the trend of HIV infection allows a better understanding of the current viral spread among IVDUs.

Adult↗
PubMed2003

Bringing emergency contraception over the counter: experiences of nonprescription users in France, Norway, Sweden and Portugal.

Emergency contraceptive pills are now available on a nonprescription basis in over 25 countries worldwide. In an effort to learn about women's experiences with this new means of emergency contraception (EC) service delivery, we conducted focus-group discussions with nonprescription EC users from France, Norway, Portugal and Sweden. Participants from these countries overwhelming supported pharmacy access to EC, explaining that pharmacy delivery facilitated rapid access to the method. Despite expressing mixed reviews of the counseling given by the providing pharmacists, participants reported that they knew how use the method safely and properly. Most indicated that the package insert was easy to understand and adequately answered the majority of their questions. Participants described the EC experience as a motivating factor that, in many cases, has led to more consistent use of regular contraceptive methods. These data are valuable to policy-makers and institutions interested in learning more about the safety and acceptability of nonprescription access to emergency contraceptive pills.

Access to Information↗
PubMed2005

Fixing the system? The experience of service users of the quasi-market in disability services in Australia.

A qualitative study involving semi-structured interviews with 31 people with disabilities and 32 carers in the state of Queensland, Australia, found that their experience of supportive service delivery had not improved despite reforms of the service delivery system driven by a version of the quasi-market model. Instead of delivering increased consumer choice and improved efficiency in service delivery, service users experienced inadequate service supply, service cutbacks, and an increased emphasis on cost subsidisation and assessment processes. Additionally, few consumers felt that individualised funding arrangements had personally delivered the benefits which the quasi-market model and associated policy paradigm had indicated that they should receive. For many consumers, the notion of consumer 'choice' around service provision was fictitious and they felt that any efficiency gains were at the agency level, largely at the consumers' cost. It is concluded that there appears to be no particular benefit to service users of quasi-market reforms, particularly in policy contexts where service delivery systems are historically under-funded.

Community Health Services↗
PubMed1994

Simplified user poll and experience report language (SUPER): implementation and application.

Biological computing is generally organized as standalone implementation on a PC-type computer or on a central facility (e.g. a university computer center). Services provided by central facilities need to be tailored to the user community. Unless very work-intensive individual contacts are used, the feedback must be collected with generalized tools, such as questionnaires distributed in the form of a newsletter. We have developed a method to have such polls automated and tailored, as well as having multiple-choice questions combined with branching after fundamental questions. As the evaluation of the results needs to know the questions asked, we have also included a method to process the answers and give detailed tables on the answers. SUPER was applied in a poll to query the academic usership in Switzerland on the usage of molecular biology databases.

Biology↗
PubMed1994

Simplified user poll and experience report language (SUPER): implementation and application.

Biological computing is generally organized as stand-alone implementation on a PC-type computer or on a central facility (e.g. a university computer center). Services provided by central facilities need to be tailored to the user community. Unless very work-intensive individual contacts are used, the feedback must be collected with generalized tools, such as questionnaires distributed in the form of a newsletter. We have developed a method to have such polls automated and tailored, as well as having multiple-choice questions combined with branching after fundamental questions. As the evaluation of the results needs to know the questions asked, we have also included a method to process the answers and give detailed tables on the answers. SUPER was applied in a poll to query the academic usership in Switzerland on the usage of molecular biology databases.

Evaluation Studies as Topic↗
PubMed1990

AIDS education and prevention programs for intravenous drug users: the California experience.

The state of California, pursuant to 1985 legislation, established the California AIDS Program (CAP) within the state Office of AIDS. As part of this program, the Office of AIDS contracts with public and private agencies to provide AIDS education to specific target groups throughout the state. Intravenous drug users (IVDUs) constitute one of the target populations singled out for special attention by the state. This article, based on a statewide evaluation, describes the AIDS education programs for IVDUs funded by the Office of AIDS. The types of educational interventions used are presented, both for IVDUs in treatment and those not in treatment. The unique problems in reaching this target population are also discussed. The article concludes that the state is making a good effort to reach IVDUs, but that further educational and evaluative efforts are needed. Specifically, the individual educational programs must move beyond the transmission and evaluation of cognitive knowledge about AIDS to an assessment of the attitudes that impede behavior change.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Recreational MDMA use in Sydney: a profile of 'Ecstacy' users and their experiences with the drug.

'Ecstasy' (3,4-methylenedioxymethamphetamine or MDMA) is a recreational drug that is gaining popularity world wide. There is a paucity of research regarding the ways in which Ecstasy is used and the nature of its effects. A 'snowball' peer network technique was used to recruit 100 users who completed anonymous questionnaires. The research revealed that Ecstasy is primarily used by infrequent recreational drug users for 'fun' at dance parties and social gatherings. The primary reported effects of Ecstasy were a 'positive mood state' and feelings of intimacy and closeness to others. The secondary effects of Ecstasy were the stimulant effects of energy and activation, and the psychedelic effects of insight and perceptual and sensual enhancement. Ecstasy was reported to share the properties of both amphetamines and hallucinogens in the nature of its side effects and residual effects which were no more severe than those of the latter two classes of drug. It appeared Ecstasy was not conductive to regular and frequent use, because tolerance was reported to develop to the positive effects of Ecstasy, while negative effects increased with use. Although few problems associated with the recreational use of Ecstasy have surfaced to date, animal research has shown it to be neurotoxic to serotonergic nerve terminals. Caution must be observed until further research can determine the level of hazard in humans.

3,4-Methylenedioxyamphetamine↗
PubMed2000

Fitting hearing aids to first-time users.

Clinical experience indicates that first-time hearing aid users prefer less gain and lower maximum output levels than experienced users. This hypothesis was tested on 20 subjects being fitted with their first aids. The study was double blinded by using a programmable hearing aid, set to either the standard setting according to the manufacturer's software or to reduced gain and maximum output. Half of the subjects started with one hearing aid and half with the other, changing to the other hearing aid after 3 days trial with each setting. At the end of the study, subjects stated preference in specified situations and overall. No significant differences in APHAB, sound quality, estimated communication ability or perceived loudness scores were seen for the two settings. Nine subjects preferred the standard setting, seven the reduced setting and four were undecided. No correlation could be found between preference and audiological variables.

Acoustic Stimulation↗
PubMed2002

Experience and meaning of user involvement: some explorations from a community mental health project.

With an increased interest in and policy commitment to involving service users in the planning and delivery of health service provision, there is a clear need to explore both the rhetoric and realities of what user involvement entails. In the present paper, by drawing upon an evaluation of a community-based exercise facility for people with mental health problems, the authors explore ways in which the reality of user involvement is subject to a range of configurations within health services. The paper describes a piece of qualitative research that was undertaken within a participatory framework to explore the nature of user involvement within the facility. The data have been analysed using a grounded theory approach to provide insights into: the organisational context in which user involvement takes place; factors which encourage meaningful participation on the part of service users; perceived barriers to user involvement; and issues of sustainability and continuity. This research approach has enabled the authors to explore the views and experiences of users, service providers and referral agencies in relation to the nature and potential for user involvement. The findings illustrate ways in which user involvement may take place under both flexible and formal arrangements across a variety of activities. The present paper provides an account of some of the meanings and experiences of what 'successful' user participation may involve and the conditions which underpin 'success'. The authors conclude that successful and meaningful user involvement should enable and support users to recognise their existing skills, and to develop new ones, at a pace that suits their particular circumstances and personal resources. This process may require adaptation not only by organisations, but also by service providers and non-involved users.

Community Mental Health Services↗
PubMedDate not supplied

Automated pharmacokinetic analysis: experiences of a user.

Two curve-stripping and three nonlinear regression computer programs currently in use for automated pharmacokinetic analysis were tested alone and in combination on their suitability to solve a number of pharmacokinetic problems. The five programs, NONLIN, NONLINEAR, CFT3, ESTRIP, and RUGFIT (all non-commercial and readily available from the particular authors), were compared on these features: reliability, robustness, user convenience, and availability on macro or micro computers. The results show that if reliability and robustness are considered only, a combination of the curve-stripping program ESTRIP with the nonlinear regression program CFT3 operates better than the other combinations. This combination is even more attractive if, in addition, user convenience and availability on micro computers are taken into account.

Computers↗
PubMed1993

Practical experience with graphical user interfaces and object-oriented design in the clinical laboratory.

The computing strategy in our laboratories evolved from research in Artificial Intelligence, and is based on powerful software tools running on high performance desktop computers with a graphical user interface. This allows most tasks to be regarded as design problems rather than implementation projects, and both rapid prototyping and an object-oriented approach to be employed during the in-house development and enhancement of the laboratory information systems. The practical application of this strategy is discussed, with particular reference to the system designer, the laboratory user and the laboratory customer. Routine operation covers five departments, and the systems are stable, flexible and well accepted by the users. Client-server computing, currently undergoing final trials, is seen as the key to further development, and this approach to Pathology computing has considerable potential for the future.

Clinical Laboratory Information Systems↗
PubMed2006

Experiences of service user and carer participation in health care education.

The agenda of involving service users and their carers more meaningfully in the development, delivery and evaluation of professional education in health is gaining in importance. The paper reports on a symposium which presented three diverse initiatives, established within a school of nursing and midwifery in the United Kingdom. These represent different approaches and attempts to engage service users and in some instances carers more fully in professional education aimed at developing mental health practitioners. Each is presented as achieving movement on a continuum of participation from service users as passive recipients to service users as collaborators and co-researchers. The paper concludes with a discussion of the lessons to be learnt which will hopefully stimulate service user involvement on a wider basis.

Attitude of Health Personnel↗
PubMed1998

Tinnitus in Cochlear Implant Users: The Freiburg Experience.

Cochlear implantation is a well-accepted method of aural rehabilitation in deaf or severely hearing-impaired adults and children. A majority of patients not only suffer from hearing impairment but from tinnitus. The high rate of preoperative tinnitus in adults (68.1%) stands in contrast to assumed lower rates in children. Unknown are such factors as how tinnitus develops in children, how they realize what tinnitus is, and whether the mechanism of development of tinnitus differs from that in adults, respectively. Electrical stimulation of the auditory pathway is followed by loss, or at least reduction, of tinnitus in most cases (75%). Also, the insertional trauma alone is able to stop tinnitus in some patients. Attention must be paid to the low risk of developing tinnitus postoperatively. No reports are available regarding tinnitus in children. Though younger children may not be able to report, some adolescent patients report preoperative or postoperative tinnitus (or both) that is reduced by electrical stimulation at the rates seen in adults. Further investigations are needed to define the mechanism of tinnitus development in children and to define optimal stimulation modes and rates for tinnitus reduction with best auditory performance.

Journal Article↗