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Results for “user involvement”

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PubMed2003

Utilization of general practitioner services in New Zealand and its relationship with income, ethnicity and government subsidy.

The New Zealand primary care system involves user part-charges for general practitioner (GP) care. This study explores the relationship between the use of GP services in New Zealand and government subsidies, income and ethnicity. The study used the 1996/97 New Zealand Health Survey dataset, a nationally representative household survey of health status and health service utilization. Multivariate logistic regression models were used to estimate the likelihood of visiting the GP at least once in 12 months, and the likelihood of frequent visits (at least six visits in 12 months). Adjustment was made for health need (as indicated by global self-reported health status and a number of specific disease and health-related behaviour measures), together with a range of other relevant demographic and socio-economic variables. Following these adjustments, low-income groups and Mäori were found to be significantly less likely to visit the GP at least once in the year, but there were no significant differences across income or ethnic groups in the likelihood of frequent visits. These results suggest that the system of low-income targeted government subsidies reduces, but does not fully compensate for the barrier posed by doctors' fees. Moreover, there appear to be barriers for indigenous groups, in addition to income.

Adolescent↗

PubMed2002

An evolutionary approach to team working in primary care.

Recent government policy emphasizes that interventions to improve health should be shifted as far as possible towards addressing identified needs and that partnership working is a key part of this initiative. The needs of patients are central, and patients want consistency and continuity from nursing. However, their experiences are sometimes fragmented, as professionals often have a degree of protectiveness about roles between nursing disciplines. Our vision for primary care in Sunderland is to achieve collaborative, empowered team working with shared philosophies and goals to develop and deliver creative, effective services in primary care. The balance of power will be shifted to front-line teams supported by strong strategic and professional leadership. This article outlines how new models of practice are replacing routine patterns of work; health needs and user involvement is encouraged. The role of the facilitator and the tools developed to progress with this initiative are described, including a stage approach to team development, a benchmarking tool and achieved outcomes of team working through new service developments.

Clinical Competence↗

PubMed2003

Older people as health service consumers 4: disempowered or disinterested?

Giving patients a greater say in the NHS is prominent in all national service frameworks (NSFs) and is evident in the expert patient initiative (Department of Health (DH), 2001a). One group of users who may have difficulty in making their voice heard are the elderly. The national service framework for older people (DH, 2001b) promotes user involvement in an attempt to achieve fair and equitable access to services for this group of patients who, statistically, make the highest use of the NHS and could be classified as consumers. This article, the last in a series on this topic, discusses whether a sample of older people in a village community have a consumerist ethos in regard to health care, and whether they are prepared to act in this way. Suggestions are made for better facilitating older people's involvement in and use of services.

Aged↗

PubMed2002

Providing accessible services to minority ethnic deaf people: insights from a study in Alberta, Canada.

Evidence suggests that minority ethnic people in general and minority ethnic deaf people (MEDP) in particular face numerous formidable obstacles in their attempts to gain access to services in the community. Deaf people from minority ethnic groups who have no English and/or American Sign Language (ASL) skills have particular difficulty gaining access to services. The study therefore was concerned with identifying some of the special needs and difficulties of MEDP who are trying to gain access to services in multiethnic communities. Qualitative approaches were used in data gathering and analysis. The results indicated six areas of difficulty for MEDP in gaining access to services: (a) communication barriers, (b) a lack of recognition of the needs of MEDP, (c) inappropriate service delivery and a lack of information on available services, (d) insufficient cultural sensitivity on the part of service providers, (e) issues of user involvement, and (f) a lack of specific programs for MEDP.

Canada↗

PubMed1998

Anabolic steroid use by male and female middle school students.

BACKGROUND: The prevalence of anabolic steroid use by high school and college students has been reported in the literature. However, rumors persist regarding the use of steroids by younger populations. OBJECTIVE: To assess the extent of steroid use by male and female middle school students and to explore their attitudes and perceptions about these drugs. Methods. A confidential self-report questionnaire was administered to 466 male and 499 female students between 9 and 13 years of age (mean +/- SD, 11.4 +/- 0.9 years) in 5th, 6th, and 7th grades from four public middle schools in Massachusetts. The number of students reporting steroid use and differences between users' and nonusers' underlying attitudes and perceptions about these drugs were evaluated. RESULTS: The response rate was 82% (965/1175 eligible). Results indicated that 2.7% of all middle school students reported using steroids; 2.6% were males and 2.8% were females. When steroid users were compared with nonusers, 47% versus 43% thought that steroids make muscles bigger; 58% versus 31% thought that steroids make muscles stronger; 31% versus 11% thought that steroids improve athletic performance; 23% versus 13% thought that steroids make one look better; 23% versus 9% knew someone their own age who currently took steroids; 38% versus 4% were asked by someone to take steroids; 54% versus 91% thought that steroids were bad for them; and 35% versus 2% indicated that they would take steroids in the future. Additional analyses determined steroid user involvement in sports and activities. CONCLUSION: The results of this study suggest that the problem of illicit steroid use extends to children and young adolescents and that a segment of this population is mindful of the potential physiologic effects of steroids. This information will be useful to pediatricians, sport authorities, and school teachers whose guidance will become increasingly more important as steroid educational interventions for male and female middle school students are developed.

Adolescent↗

PubMed1992

Ineffectiveness of AIDS education and HIV antibody testing in reducing high-risk behaviors among injection drug users.

The effectiveness of education in reducing high-risk human immunodeficiency virus (HIV) transmission behaviors was examined in 313 injection drug users. Involvement in high-risk behaviors was assessed via structured interview at study entry and 4 months following the intervention. Subjects were randomly assigned to (1) AIDS education, (2) AIDS education with optional HIV antibody testing, or (3) a wait list. The sample as a whole decreased its involvement in high-risk behaviors, but there were no significant differences as a function of experimental group assignment.

AIDS Serodiagnosis↗

PubMed1980

Evaluation of kerb negotiation in a prototype and standard model wheelchair.

This article outlines an evaluatory study of kerb negotiation in a conventional wheelchair and a prototype diamond configuration, lever articulated wheelchair. The kerb negotiation sequence in both models is presented with the results of tests involving users able to negotiate kerbs (N = 16); users unable to negotiate kerbs (N = 15); and non-wheelchair users (N = 20). Results indicate preferences for the prototype amongst the first group, particularly for kerb descent. Free rolling tests of the loaded wheelchairs over various terrains revealed that while the standard wheelchair invariably turned downhill the prototype was relatively insensitive to loss of direction on sideslopes. A significant number of subjects (P = 0.01, N = 20) found the articulated framework of the prototype reduced the difficulties of self propulsion over rough and cambered surfaces. The prototype was found to possess a smaller turning circle (103 cm to 122 cm) and a longer wheelbase (94.7 cm to 39.7 cm) than the standard model though overall dimensions were broadly comparable. The implications of the prototype wheelbase for manual, attendant and powered propulsion are considered.

Ergonomics↗

PubMed2003

Automated laboratory reporting of infectious diseases in a climate of bioterrorism.

While newly available electronic transmission methods can increase timeliness and completeness of infectious disease reports, limitations of this technology may unintentionally compromise detection of, and response to, bioterrorism and other outbreaks. We reviewed implementation experiences for five electronic laboratory systems and identified problems with data transmission, sensitivity, specificity, and user interpretation. The results suggest a need for backup transmission methods, validation, standards, preserving human judgment in the process, and provider and end-user involvement. As illustrated, challenges encountered in deployment of existing electronic laboratory reporting systems could guide further refinement and advances in infectious disease surveillance.

Bioterrorism↗

PubMed2006

Recreational Viagra Use and Sexual Risk among Drug Abusing Men.

Until recently, the Viagra connection to HIV was anchored in older adults. However, CDC investigation showed stability in 50+ HIV diagnoses on the heels of upward trends in risk indicators among men who have sex with men (MSM) and substance abusing populations. Signs have increasingly pointed to recreational drug use among younger populations, to which Viagra is being added to the mix. Currently, the field is still locating the substance abuse, sexual risk and age-related dimensions of Viagra misuse. Recent studies identify it primarily as substance abuse, but the majority reports a combination of risky sex and risky drug use. At the very least, Viagra appears related to the enhancement of sexual experience or performance, even when it is used to compensate for erectile dysfunction caused by other drugs-either illicit or prescribed (e.g., antidepressants and highly active antiretroviral therapy or HAART). The populations studied, however, frequently have limited the generalizability of findings. This report analyzes the relationship among Viagra, Club Drugs and HIV sexual risk behavior in drug using men with a sample diverse in sexual orientation and demographic scope. Participants were 640 males recruited from three HIV prevention programs in Los Angeles County. Mean age was 43.97 years, ranging from 18.7 to 70.3 with almost 25% over 50. Sexual orientation was 79% heterosexual, 8% bisexual and 12% gay. Racial composition was 45% white, 35% black and 19% Hispanic. NIDA's Risk Behavior Assessment and a Club Drug/Viagra addendum were used to collect socio-demographic, substance use and sexual risk data. Multiple logistic regression models were constructed along with chi-square tests of association and some t-tests. White race was a major risk factor. No age effect was found. MSM were more likely to use Viagra. Insertive anal sex was a significant co-factor among heterosexual Viagra users involved in transactional sex with women. In the overall sample and the subsets of heterosexual, MSM, younger and older men, predictive models all identified club or designer drugs as significant co-factors in the use of Viagra. Different patterns of drug co-factors were observed for each subset. We detected consistent positive associations between the use of Viagra and the use of amphetamines immediately before or during sex. Viagra use has moved into a new generational context and now complicates the sexual risk and intervention equations for all men, particularly MSM as well as more hidden subgroups.

Journal Article↗

PubMedDate not supplied

Work-based learning: challenges and opportunities.

This article discusses some of the challenges and opportunities arising from the development and implementation of an innovative work-based open and distance learning programme available exclusively to healthcare assistants working in general health and mental health practice. The programme is based on a partnership between the sponsoring organisation and the Open University. The focus is on the development of standards of proficiency, service user involvement, partnership working, skills development and the pedagogic implications of a work-based learning format.

Adult↗

PubMed2003

Prostate boundary detection from ultrasonographic images.

OBJECTIVE: Prostate diseases are very common in adult and elderly men, and prostate boundary detection from ultrasonographic images plays a key role in prostate disease diagnosis and treatment. However, because of the poor quality of ultrasonographic images, prostate boundary detection still remains a challenging task. Currently, this task is performed manually, which is arduous and heavily user dependent. To improve the efficiency by automating the boundary detection process, numerous methods have been proposed. We present a review of these methods, aiming to find a good solution that could efficiently detect the prostate boundary on ultrasonographic images. METHODS: A full description of various methods is beyond the scope of this article; instead, we focus on providing an introduction to the different methods with a discussion of their advantages and disadvantages. Moreover, verification methods for estimating the accuracies of the algorithms reported in the literature are discussed as well. RESULTS: From the investigation, we summarize several key issues that might be confronted and project possible future research. CONCLUSIONS: Those model-based methods that minimize user involvement but allow for interactive guidance of experts will likely be most immediately successful.

Aged↗

PubMed1991

Best kept secrets ... Source Data Systems, Inc. (SDS).

The SDS/MEDNET system is a cost-effective option for small- to medium-size hospitals (up to 400 beds). The parameter-driven system lets users control operations with only occasional SDS assistance. A full application set, available for modular selection to reduce upfront costs while facilitating steady growth and protecting client investment, is adaptable to multi-facility environments. The industry-standard, Intel-based multi-user processors, network communications and protocols assure high efficiency, low-cost solutions independent of any one hardware vendor. Sustained growth in both client base and product offerings point to a high level of responsiveness and healthcare industry commitment. Corporate emphasis on user involvement and open systems integration assures clients of leading-edge capabilities. SDS/MEDNET will be a strong contender in selected marketing environments.

Computer Communication Networks↗

PubMed1992

Selecting an information system without an RFP.

Rapid advances in computer hardware and software have not been accompanied by improvements in the process of acquiring these systems. Reginald P. Gibson, Steven Berger, and Vincent G. Ciotti explain how the traditional request for proposal approach increases administrative costs. A simpler request for price quotation approach enables hospitals to conserve time and money, while involving user departments when acquiring a new installation.

Competitive Bidding↗

PubMed1997

Evolution of a regional health-care information system--the design phase.

In 1996 a program of the Soros Foundation was launched to study a regional health care inodel Main stake holders of health care financing and providing in three counties in South-Western Hungary found the idea appealing and the Soros Model Region Program was started. This paper outlines the activity of the second sub-project of the model region program: the development of a regional health care information system. The build-up of a data and knowledge base serving the differing needs of mentioned goals is based on international standards. Availability and user involvement is based on different media for presenting the information as printed publications, CD-ROM data bases and World Wide Web availability. A congruency and coherency principle is maintained by a unified data model used for different purposes and a planned unified communication protocol among all participants in the model region program. Studies regarding health care status, economics and financing on regional level show that a better fitting health care services profile and a more flexible resource management might be achieved based on the mentioned regionality principle.

Computer Systems↗

PubMed1985

Medication carts--are they all the same?

Purchase of unit dose medication carts is one of the major capital expenditures in the development and maintenance of a unit dose distribution system. Critical factors in this selection process are the considerations of product reliability and durability. To develop an assessment of user satisfaction with the various brands of unit dose carts, a national survey of 500 randomly selected hospital pharmacies was developed and mailed. The questionnaire requested information on types of carts used, satisfaction with cart performance, types of repairs needed, frequency of repairs, providers of cart repairs, and frequency of cart maintenance inspections. Two hundred seventy responses (54%) were available for evaluation. Eighty-five percent of cart users have five or more carts. Although 60% of respondents have carts greater than or equal to 4 years old, comparative satisfaction did not decrease as a function of increasing age of carts. There were 11 brands of unit dose carts reported by 214 responders. One hundred and three of these 214 responders (48.1%) used MacBick as compared with 36, 22, 18, and 35 users of Trans Aid, Lionville, Ferno Forge, and seven other brands, respectively. MacBick's users reported less equipment failure rate compared with the other brands, but this difference did not reach statistical significance (p less than 0.2 greater than 0.05). It was also determined that only 29% of hospitals routinely inspect carts to insure proper functioning. Since the most frequent type of equipment failure reported (up to 61% of users) involved cart locking mechanisms, drug security can be compromised without routine inspections.

Attitude of Health Personnel↗

PubMed1999

Service user movement. The customer is sometimes right.

Patients' groups and service user organisations have grown enormously in the past 20 years. The NHS is beginning to take the principle of patients managing their own conditions seriously. Sustained service user involvement in the planning of local services is still some way off.

Community Health Planning↗

PubMedDate not supplied

Developing a decision support system to meet nurse managers' information needs for effective resource management.

This article describes the development of a decision support system called CLASSICA, which assists nurse managers in financial management, resource allocation, activity planning, and quality control. CLASSICA integrates information about patient flow and activity, staffing, and the cost of nursing care at the nursing-unit level. The system provides assistance in planning activities, balancing the budget, and identifying barriers to unsatisfactory resource management. In addition, CLASSICA contains forecasting and simulation options to analyze the influence of factors that affect nursing costs. This article describes the system's development process steps to tailor it to the needs of nurse managers and their existing work practices. Nurse managers actively participated in defining their tasks and responsibilities; identified barriers and difficulties in managing these tasks; defined information needs, data input, and output and interface requirements; and identified expected benefits. Clear communication of project goals, strong user involvement, and purposeful benefit planning was used to achieve the goals for CLASSICA: (1) to provide essential information and decision support for effective financial management, resource allocation, activity planning, and staffing; (2) to improve nurse managers' competence in financial management and decision making; (3) to improve cost containment; and (4) to provide a helpful and easy to use tool for decision support.

Decision Support Systems, Management↗

PubMed1997

Community participation in determining the needs of users and carers of rural community care services. Highland Community Care Forum.

In this paper we present the methods and key outcomes of a community led needs assessment exercise. The needs assessment sought to enhance the development of rural community care services by ensuring the views of users and carers were secured and considered in joint planning processes. The research was developed by members of the North and West Sutherland Community Care Forum. A community profiling template was developed and employed in five parish areas of Sutherland. This was drawn from 45 interviews with key informants and 2 community workshops, In addition 54 users and carers were interviewed. The outcomes of the needs assessment exercise identified geographical and cultural factors which present difficulties in developing services as well as posing barriers to user involvement.

Community Health Services↗