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Four recent developments highlight that people continue to face significant legal and administrative barriers to using marijuana for medical purposes--despite the existence of the Marihuana Medical Access Regulations (MMAR), enacted by the federal government, as a result of court rulings, to enable people who require marijuana for medical purposes to exercise their constitutional right to such medicine.
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A study based on a convenience sample of 177 couples who each used 11 condoms found that 103 condoms (5.3%) broke before or during intercourse and 67 condoms (3.5%) slipped off during sex. Couples who had not used a condom in the past year were almost twice as likely to experience condom failure as were couples who had used at least one during that period (p < .001). Of the couples who had used a condom in the previous year, the failure rate among those who reported at least one condom break during that period was more than twice the failure rate among those who reported no breaks (p < .001). Among couples who had used condoms in the past year without breaking any, those who did not live with their partner and those who had a high school education or less were at increased risk of condom failure (adjusted odds ratios of 3.2 and 2.7, respectively).
Service users should be involved in drawing up their care programme. In practice, however, the meetings can be intimidating, and professionals may even disregard issues which the user has specifically requested to be included in the programme. PETER PHILLIPS highlights users' concerns and criticisms of the care programme approach.
OBJECTIVE: To assess the experience of public service users in a time-limited psychotherapeutic group dynamic intervention. METHODS: Eleven patients were randomly selected from a group of 52 who had participated in an efficacy study and were interviewed in-depth. Their account was submitted to content analysis, according to the Grounded Theory methodology. RESULTS: In general, patients accepted well and positively evaluated the psychotherapy intervention. The main findings were the importance of patient's interaction with the group participants, and their therapeutic course after the intervention, when most of them carried on with psychotherapy. CONCLUSIONS: The psychotherapeutic intervention was well accepted among the patients, had a favorable outcome and stimulated them to proceed with psychotherapy.
New and emerging media technologies have the potential to induce a variety of experiences in users. In this paper, it is argued that the inducement of experience presupposes that users are absorbed in the illusion created by these media. Looking to another successful visual medium, film, this paper borrows from the techniques used in "shaping experience" to hold spectators' attention in the illusion of film, and identifies what breaks the illusion/experience for spectators. This paper focuses on one medium, virtual reality (VR), and advocates a transparent or "invisible style" of interaction. We argue that transparency keeps users in the "flow" of their activities and consequently enhances experience in users. Breakdown in activities breaks the experience and subsequently provides opportunities to identify and analyze potential causes of usability problems. Adopting activity theory, we devise a model of interaction with VR--through consciousness and activity--and introduce the concept of breakdown in illusion. From this, a model of effective interaction with VR is devised and the occurrence of breakdown in interaction and illusion is identified along a continuum of engagement. Evaluation guidelines for the design of experience are proposed and applied to usability problems detected in an empirical study of a head-mounted display (HMD) VR system. This study shows that the guidelines are effective in the evaluation of VR. Finally, we look at the potential experiences that may be induced in users and propose a way to evaluate user experience in virtual environments (VEs) and other new and emerging media.
A questionnaire was used to survey the methaqualone experiences of college student users, and psychological test data from these users and a control group of non-users were compared. On differential pattern found was that methaqualone users have experimented with a wider variety of psychoactive drugs than have non-users. However, the two groups were essentially indistinguishable on the psychological test variables assessed. A preliminary modal profile of the college student methaqualone abuser and abuse experience was generated.
The purpose of this study was to analyse end user computing strategy and experiences in promoting nursing informatics in Taiwan. In February 2004, an 8-day NI technology training campaign was held in Taipei for 60 clinical nurses. Excel VBA was used as the tool to teach the clinical nurses, who had never written any programs, but were very interested in informatics. Three projects were determined after detailed discussion and evaluation of clinical needs and technical feasibility between the nurses and the technical support team, which was composed of one experienced informatics professor and one clinical NI assistant. A qualitative analysis was used to interview the three pairs of programming clinical nurses and their direct supervisors with a structured but open questionnaire. Representative concepts were categorized from the data until all were categorized. The concepts were organized under three categories: the purposes, the benefits and the challenges of system development. According to this study, end user computing strategy with Excel VBA was successful so far.
OBJECTIVE: User data and information about anatomy education were used to guide development of a learning environment that is efficient and effective. The research question focused on how to design instructional software suitable for the educational goals of different groups of users of the Visible Human data set. The ultimate goal of the study was to provide options for students and teachers to use different anatomy learning modules corresponding to key topics, for course work and professional training. DESIGN: The research used both qualitative and quantitative methods. It was driven by the belief that good instructional design must address learning context information and pedagogic content information. The data collection emphasized measurement of users' perspectives, experience, and demands in anatomy learning. MEASUREMENT: Users' requirements elicited from 12 focus groups were combined and rated by 11 researchers. Collective data were sorted and analyzed by use of multidimensional scaling and cluster analysis. RESULTS: A set of functions and features in high demand across all groups of users was suggested by the results. However, several subgroups of users shared distinct demands. The design of the learning modules will encompass both unified core components and user-specific applications. The design templates will allow sufficient flexibility for dynamic insertion of different learning applications for different users. CONCLUSION: This study describes how users' requirements, associated with users' learning experiences, were systematically collected and analyzed and then transformed into guidelines informing the iterative design of multiple learning modules. Information about learning challenges and processes was gathered to define essential anatomy teaching strategies. A prototype instrument to design and polish the Visible Human user interface system is currently being developed using ideas and feedback from users.
OBJECTIVE: To examine method-related experiences and acceptability of depot medroxyprogesterone acetate (DMPA) among women using this contraceptive for the first time. METHODS: Five hundred thirty-six women who received an injection of DMPA from any of seventeen clinical settings in southeast Texas, United States, were followed for 1 year. At each follow-up visit, patients were asked about their experiences with DMPA during the past 3 months and their plans to use this method in the future. RESULTS: Amenorrhea, irregular bleeding, and weight gain were the conditions reported most frequently. Reports of amenorrhea, weight gain, and acne or skin problems increased over time, but complaints of longer periods decreased (P < .001). Two pregnancies occurred during the study period. However, of these, one existed before the first injection. Depot medroxyprogesterone acetate's continuation rate at 1 year was 28.6%. Heavier and more frequent bleeding, increased cramping, amenorrhea, weight gain, headaches, depression, and nervousness were more frequent complaints of women who discontinued DMPA (P < .05), whereas lighter and less frequent bleeding were reported more often by those who continued to use this method (P <.05). Women who discontinued use of DMPA were more likely to be married and have a concern about injectable contraceptives than those who continued to use this method. CONCLUSION: Intolerable side effects and changes in menstrual pattern are the most frequently indicated reasons for discontinuing DMPA use. Our results suggest that DMPA's 1-year continuation rate may be lower than previously reported.
OBJECTIVE: To gain an understanding of the knowledge, perceptions and experiences of using contraceptive methods among Turkish withdrawal users. DESIGN: Population-based, cross-sectional and descriptive study using a questionnaire conducted face to face. SETTING: Women who live in the Number 6 primary health unit area in Manisa, Turkey. PARTICIPANTS: 276 women who used the 'withdrawal' method for contraception. MEASUREMENTS AND FINDINGS: Almost all women were aware of modern contraceptive methods. The condom, intrauterine contraceptive device (IUCD) and oral contraceptives were the most known methods. The most common reasons for using 'withdrawal' were that this method was reliable, husbands preferred it, it was healthier, easier to use or more convenient than other methods. CONCLUSION AND IMPLICATIONS FOR PRACTICE: It is important for midwives and nurses to recognise the effects of cultural beliefs on women's contraceptive use. Educational programmes should be individualised to meet the specific needs of women and their partners.
This experiment examined the effects of spectral resolution and fine spectral structure on recognition of spectrally asynchronous sentences by normal-hearing and cochlear implant listeners. Sentence recognition was measured in six normal-hearing subjects listening to either full-spectrum or noise-band processors and five Nucleus-22 cochlear implant listeners fitted with 4-channel continuous interleaved sampling (CIS) processors. For the full-spectrum processor, the speech signals were divided into either 4 or 16 channels. For the noise-band processor, after band-pass filtering into 4 or 16 channels, the envelope of each channel was extracted and used to modulate noise of the same bandwidth as the analysis band, thus eliminating the fine spectral structure available in the full-spectrum processor. For the 4-channel CIS processor, the amplitude envelopes extracted from four bands were transformed to electric currents by a power function and the resulting electric currents were used to modulate pulse trains delivered to four electrode pairs. For all processors, the output of each channel was time-shifted relative to other channels, varying the channel delay across channels from 0 to 240 ms (in 40-ms steps). Within each delay condition, all channels were desynchronized such that the cross-channel delays between adjacent channels were maximized, thereby avoiding local pockets of channel synchrony. Results show no significant difference between the 4- and 16-channel full-spectrum speech processor for normal-hearing listeners. Recognition scores dropped significantly only when the maximum delay reached 200 ms for the 4-channel processor and 240 ms for the 16-channel processor. When fine spectral structures were removed in the noise-band processor, sentence recognition dropped significantly when the maximum delay was 160 ms for the 16-channel noise-band processor and 40 ms for the 4-channel noise-band processor. There was no significant difference between implant listeners using the 4-channel CIS processor and normal-hearing listeners using the 4-channel noise-band processor. The results imply that when fine spectral structures are not available, as in the implant listener's case, increased spectral resolution is important for overcoming cross-channel asynchrony in speech signals.
Two experiments investigating the effects of auditory stimulation delivered via a Nucleus multichannel cochlear implant upon vowel production in adventitiously deafened adult speakers are reported. The first experiment contrasts vowel formant frequencies produced without auditory stimulation (implant processor OFF) to those produced with auditory stimulation (processor ON). Significant shifts in second formant frequencies were observed for intermediate vowels produced without auditory stimulation; however, no significant shifts were observed for the point vowels. Higher first formant frequencies occurred in five of eight vowels when the processor was turned ON versus OFF. A second experiment contrasted productions of the word "head" produced with a FULL map, OFF condition, and a SINGLE channel condition that restricted the amount of auditory information received by the subjects. This experiment revealed significant shifts in second formant frequencies between FULL map utterances and the other conditions. No significant differences in second formant frequencies were observed between SINGLE channel and OFF conditions. These data suggest auditory feedback information may be used to adjust the articulation of some speech sounds.
Complete software support has been developed for a direct memory access microprocessor system used to store and analyze diffraction data from striated muscle. These studies are based on the premise that the regularly alternating light and dark regions of the fiber behave like a phase grating to incident laser light. A knowledge of the position of a diffracted order can thus be used to determine striation spacing. Since these striations are directly associated with the force generating components of the muscle, diffraction data can provide insights into the mechanism of force generation in muscle. In our system, a charge-coupled device (CCD) is used to detect diffracted order, position, and intensity. In addition, a high speed muscle puller and tension transducer are used to characterize or alter the mechanical state of the muscle. The software has been designed to allow the inexperienced user to perform sophisticated diffraction experiments. The user may present several experimental parameters: magnitude and direction of puller movement; number of frames of data to be taken; and delay of puller or scan. This has been accomplished by interleaving DMA and control loop cycles. System performance indicates that the full 256 point analog output of the CCD can be digitized and stored in about 2 ms. The data can be transferred directly from the CCD to memory leaving the CPU free for experimental control or closed-loop processing.
OBJECTIVE: To review the key issues related to the design and implementation of an electronic health record (EHR) system in urban primary health care (PHC) practice in Cameroon. METHODOLOGY: The goal of the project was to assess EHR as a tool to improve providers' performance, quality and continuity of care, and the availability of data in PHC practice in Cameroon. A locally designed EHR system called MEDCAB was developed. The system was based on the International Classification for Primary Care (ICPC) and was designed taking into consideration the PHC practice environment in Cameroon. An original cohort of 14 users was involved in the experiment. RESULTS: Users generally showed good acceptance of the system. Monitoring the use of the system at the early stages of implementation was important to ensure immediate response to users' comments and requests. Some of the key issues identified during the development and implementation of the system were: user involvement, the choice of an appropriate terminology, pre-existing data collection culture and leadership issues. Some positive achievements brought about by the system included promotion of good medical practice and routine availability of consultation data. CONCLUSION: Strengthening the medical record in general, and the EHR in particular, could contribute to its position as a valuable source of information for healthcare delivery, public health and policy making in Cameroon. Challenges to adoption are huge and successful implementation for any specific setting will require a comprehensive modelling of the local medical practice, the choice of an appropriate terminology and a co-ordinated approach involving all stakeholders.
This study aimed to get to know some visible and hidden meanings in drugs users' experience. The interviews were associated with the Projective Technique (free and thematic drawing), based on which we analyzed the subjective content and what was expressed by the users. The results demonstrated the existence of family deterioration, stigma and prejudice.
Exchange of syringes and needles has for the last 3 years been offered to injecting drug users as part of an HIV prevention project in a small university town in south Sweden. The program at the local hospital has been visited by 979 drug users, of which 182 have participated on a more regular basis. The typical participant is a 30-year-old male who has injected amphetamine or heroin for at least 10 years. The seroprevalence for HIV among drug users in south Sweden has been maintained at approximately 1% in contrast to up to 60% in subpopulations from other Scandinavian regions with a comparable drug problem. No project participant has become HIV infected during the study period and a reduction in risk behavior has been noted among local drug injectors. The HIV prevention project has attracted many individuals with no previous contact with drug rehabilitation programs; for a number of drug users, the syringe exchange has served as an introduction to such treatment efforts.
This article describes an interactive prototyping model for development of four computer software modules for British youth on sexual issues. An iterative cycle of development, user review and feedback, and subsequent modification and retesting was used with approximately 150 young adults, with particular attention to presentation style, screen design, usability, relevance of material, enjoyment, and learning. The software was designed to be realistically accommodated in school settings, to be used as a reference tool by students working alone or in a group teaching situation. Feedback from youth and adults attests to the feasibility of development, implementation, and instructional usefulness. Interactive prototyping proved essential in the face of skepticism from teachers concerning young people's information needs and acceptance of a computerized educational approach.