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PubMed1991

MEDLINE end-user survey: the University of Florida experience.

The University of Florida Health Science Center Library (UF-HSCL) surveyed MEDLINE end-user activities of the faculty from the six colleges which the UF-HSCL serves. A questionnaire was developed and sent to all faculty members. The Basic SAS program was used to analyze the collected data. This survey was intended to identify the users, the reasons for faculty members not being end users, the purpose for searching MEDLINE, the information retrieval methods, the level of end-user satisfaction, and the librarian's role in information retrieval activities. Many findings from this survey were in agreement with those of the 1988 study by the National Library of Medicine.

Attitude to Computers↗

PubMedDate not supplied

Hypermedia-assisted instruction: authoring with learning guidelines.

The use of computers in nursing education has evolved from elementary drill and practice tutorials to challenging presentations. Hypermedia technology has emerged as a powerful method of instruction that allows the user to experience new concepts, gain cognitive skill, and encounter realistic clinical situations in a no-harm environment. Hypermedia incorporates sound, video, graphics, text, and interaction. This article describes the process used to develop a CD-ROM for adult cardiovascular nursing that can be used as an interactive instructional program. A description of the use of Gagne's instructional design theory is incorporated as a framework to guide the project. Educators possess knowledge expertise and must become involved in the design of new teaching methodologies. If instructional design principles are followed when using authoring software, learners are motivated with real, challenging, life-like, nonthreatening scenarios to expand their critical-thinking and decision-making skills.

Anatomy↗

PubMed2003

Racial differences in discrimination experiences and responses among minority substance users.

OBJECTIVES: Discrimination is associated with both mental and physical health, and may be a particularly important determinant of health among marginalized groups. This study assessed differences in discrimination experiences and responses to discrimination between Black and Latino active substance users in New York City. METHODS: 500 Black and 419 Latino active substance users were recruited through outreach workers, service agencies, and word of mouth. We collected data about different types of discrimination experienced (eg, discrimination due to race, gender, substance use), the domains in which it occurred (eg, at work, with police), and participants' responses to unfair treatment. RESULTS: Discrimination due to drug use was the most commonly reported type of discrimination among both Blacks and Latinos. Black respondents were more likely than Latinos to report discrimination due to their drug use (79% to 70%), race (39% to 23%), poverty (38% to 26%), gender (18% to 9%), and sexual orientation (38% to 6%). However, among those reporting discrimination due to drug use, Latinos experienced more rejection from family (81% to 70%), friends (73% to 60%), police (86% to 79%), employers (72% to 56%), and medical care professionals (29% to 18%). Black respondents were more likely to respond actively to discrimination, whereas Latino respondents were more likely to internalize experiences. CONCLUSIONS: Substantial differences exist in discrimination experiences and responses to discrimination between Black and Latino substance users. These differences may help explain racial and ethnic differences in health among marginalized populations, and identify avenues for effective, targeted intervention.

Adult↗

PubMed2006

Revision cochlear implantation for facial nerve stimulation in otosclerosis.

OBJECTIVE: To find if patients experiencing postsurgical facial nerve stimulation caused by underlying disease process (ie, otosclerosis) can improve their hearing performance with their cochlear implant by reimplantation and by an optimal programming strategy. DESIGN: Retrospective analysis. SETTING: Academic tertiary referral center. PATIENTS: Two cochlear otosclerosis patients with resistant facial nerve stimulation (FNS). Both patients were initially implanted with Nucleus 22 devices (Cochlear Corporation, Englewood, Colo) and they developed FNS after a period of use. Owing to the decreasing number of active electrodes, concurrent decreases in speech understanding occurred. INTERVENTIONS: Various programming approaches were used to address the FNS. Both subjects ultimately received Nucleus 24 devices. One was reimplanted in the same ear, and the other was implanted in the opposite ear. Both have been followed up for 8 months following the reimplantation. MAIN OUTCOME MEASURES: Cochlear implant programming levels, cochlear implant performance, and facial nerve stimulation. RESULTS: The FNS was managed for more than 3 years through optimized programming. However, the FNS progressed until performance dropped below acceptable levels. Reimplantation was believed to be the only option for improvement. After reimplantation and programming, both subjects showed immediate improvement in speech discrimination. One user increased his consonant-nucleus-consonant word score from 12% preoperatively to 42%, and the other's performance increased from 0% to 86%. CONCLUSIONS: Our results suggest that having more programming options with newer devices is critical in otosclerotic or ossified users who experience FNS. Also, reimplantation may be a useful tool to improve performance.

Cochlear Implantation↗

PubMed1999

Effect of four computer keyboards in computer users with upper extremity musculoskeletal disorders.

Eighty computer users with musculoskeletal disorders participated in a 6-month, randomized, placebo-controlled trial evaluating the effects of four computer keyboards on clinical findings, pain severity, functional hand status, and comfort. The alternative geometry keyboards tested were: the Apple Adjustable Keyboard [kb1], Comfort Keyboard System [kb2], Microsoft Natural Keyboard [kb3], and placebo. Compared to placebo, kb3 and to a lesser extent kb1 groups demonstrated an improving trend in pain severity and hand function following 6 months of keyboard use. However, there was no corresponding consistent improvement in clinical findings in the alternative geometry keyboard groups compared to the placebo group. Overall, there was a significant correlation between improvement of pain severity and greater satisfaction with the keyboards. These results provide evidence that keyboard users may experience a reduction in hand pain after several months of use of some alternative geometry keyboards.

Adult↗

PubMed1990

Construction of gene libraries for each human chromosome.

We describe the construction of two complete sets of small insert, complete digest DNA libraries for each of the 24 human chromosomal types by the National Laboratory Gene Library Project. Flow sorting was used to purify the chromosomes which provided the DNA for cloning. One set of libraries was cloned into the HindIII site of the lambda vector Charon 21A, and the other set was cloned into the EcoRI site of the same vector. Characterization information from both in-house experiments and user feedback is presented. These chromosome-specific libraries are available to the general scientific community from a repository at the American Type Culture Collection, Rockville, MD. The second phase of the project, the construction of large insert, partial digest libraries in both lambda and cosmid vectors, is underway.

Cell Fractionation↗

PubMed1987

Laser therapy of tumor stenoses in the upper gastrointestinal tract: an international inquiry.

The results of an international inquiry on palliative laser therapy of malignant inoperable stenoses in the upper gastrointestinal tract are reported. The results of the treatment of a total of 1,359 patients were collected. The data from laser users with experience in more than 50 treated patients (n = 1,184) were analyzed; 68.9% of the tumor stenoses were located in the esophagus, and 55.7% were not passable with the endoscope. The initial treatment was successful in 83.0% and the complication rate was 4.1% (49 of 1,184 patients). The mortality rate was 1.0% (12 of 1,184 patients).

Constriction, Pathologic↗

PubMed1993

Improved performance 4 hours after cocaine.

Cocaine (2 mg/kg) was given orally to 13 healthy volunteers and physiologic, subjective, attentional and performance effects were measured over a period of 4 h. Posner's reaction time paradigm measured the effects of cocaine on performance and on attention to visual cues. Cocaine increased heart rate, systolic blood pressure and pupil diameter and reduced skin temperature. Physiologic effects, subjective rating of intoxication, and cocaine levels in saliva peaked at approximately 75 min and returned to precocaine levels within 3 h. In contrast, a reaction time measure of performance speed on the visual attention task showed improvement for 4 h after cocaine. A measure of covert attention in the cocaine condition failed to show the improvement which occurred in the placebo condition. Less fatigue was reported 4 h after cocaine than after placebo. Cocaine users may experience the drug's stimulant effects considerably longer than the euphoriant effects.

Adult↗

PubMed2004

Spatial working memory in heavy cannabis users: a functional magnetic resonance imaging study.

RATIONALE: Many neuropsychological studies have documented deficits in working memory among recent heavy cannabis users. However, little is known about the effects of cannabis on brain activity. OBJECTIVE: We assessed brain function among recent heavy cannabis users while they performed a working memory task. METHODS: Functional magnetic resonance imaging was used to examine brain activity in 12 long-term heavy cannabis users, 6-36 h after last use, and in 10 control subjects while they performed a spatial working memory task. Regional brain activation was analyzed and compared using statistical parametric mapping techniques. RESULTS: Compared with controls, cannabis users exhibited increased activation of brain regions typically used for spatial working memory tasks (such as prefrontal cortex and anterior cingulate). Users also recruited additional regions not typically used for spatial working memory (such as regions in the basal ganglia). These findings remained essentially unchanged when re-analyzed using subjects' ages as a covariate. Brain activation showed little or no significant correlation with subjects' years of education, verbal IQ, lifetime episodes of cannabis use, or urinary cannabinoid levels at the time of scanning. CONCLUSIONS: Recent cannabis users displayed greater and more widespread brain activation than normal subjects when attempting to perform a spatial working memory task. This observation suggests that recent cannabis users may experience subtle neurophysiological deficits, and that they compensate for these deficits by "working harder"-calling upon additional brain regions to meet the demands of the task.

Adult↗

PubMed2006

[Digital slide training portal. Training slides available on the Internet from the German division of the IAP].

Alternatively to sending glass slides via mail order, the German division of the IAP established a digital slide training portal on the Internet. Following the principle of virtual microscopy, histology slides were scanned completely in high resolution, stored on a server, and can be accessed over the Internet. The slide training portal can be used with current Internet browsers without additional plugins. Working on digital slides with the virtual microscope is easy but flexible. Loading a detail image using image streaming technologies takes about 500 ms with the German research network (DFN) and about 3 s with DSL. The digital slide training portal of the German IAP provides a clear choice and is always available for every member. Despite the little experience some users had with the Internet and diagnostics at the monitor, image quality and usability were rated as good.

Germany↗

PubMed1988

Intravenous cocaine: psychiatric effects, biological mechanisms.

Volunteer addicts were administered iv loading doses of cocaine, followed by 4-hr cocaine infusions that maintained steady-state conditions. The loading doses were followed by the "rush" and "high" subjective effects that users typically experience; cocaine infusions maintained the experience of drug "high", but not "rush". In a subsequent experiment, haloperidol pretreatment did not alter cocaine "rush" but partially attenuated cocaine "high." During cocaine infusions, we also noted suspicious and paranoid behavior, which were blindly rated by nurses. During one of the infusion conditions, the degree of suspiciousness observed was related to the amount of cocaine previously administered. Although cardiovascular responses to cocaine were marked, we found no alterations in plasma catecholamines following cocaine administrations. Baseline homovanillic acid (HVA) levels, however, were related to the degree of suspiciousness observed following cocaine dosing. The potential contributions of dopaminergic systems and physiological sensitization to the development of the psychiatric toxicity of cocaine are discussed.

Adult↗

PubMed1992

Impact of user fees on attendance at a referral centre for sexually transmitted diseases in Kenya.

We investigated the impact of a short-lived policy of charging fees to patients attending public-sector outpatient health facilities in Kenya by collecting data on attendance at Nairobi's Special Treatment Clinic for sexually transmitted diseases (STDs) before (23 months), during (9 months), and after (15 months) the user-charge period. During the user-charge period, the seasonally adjusted total mean monthly attendance of men decreased significantly to 40% (95% CI 36-45) of that before fees were levied. Attendance rose in the post-user-charge period, but reached only 64% (59-68) of the pre-user-charge level. For women, the adjusted total mean monthly attendance during the user-charge period was reduced significantly to 65% (55-77) of the pre-user-charge level. Mean monthly attendance by women rose in the post-user-charge period to 22% (9-37) above the pre-user-charge level. There was no evidence of an increase in attendance over the course of the user-charge period among either men or women. The introduction of user fees probably increased the number of untreated STDs in the population, with potentially serious long-term health implications. The user-fee experience in Kenya should be carefully evaluated before similar measures are introduced elsewhere.

Community Health Centers↗

PubMed1980

A survey of current phantom limb pain treatment in the United States.

A survey of phantom limb pain treatment methods currently used by Veterans Administration hospitals, medical schools, pain clinics, and pain specialists in the United States was carried out to determine which treatments are in use, their success rates as estimated by their users, and experience with unsuccessful treatment methods used by patients prior to referral to the respondent. The combined results of a recent literature search and this survey identified 68 treatment methods of which 50 were commented upon by the survey respondents as being in current use. Only a few treatment methods were even moderately successful when subjected to the criterion of low failure rates after one year. Non-surgical treatment methods were far more successful than surgical ones. A possible treatment regime based on optimizing moderately successful methods is proposed for further study.

Chronic Disease↗

PubMed2007

The pincer chopsticks: the investigation of a new utensil in pinching function.

The manipulation of chopsticks requires skillful motions of fingers. Therefore, it would be difficult to manipulate chopsticks for people with hand dysfunction. We designed a simple and convenient utensil, the pincer chopsticks, to simulate the pincers-pinching operation of traditional chopsticks. To compare the performance of the new device with that of traditional chopsticks and spoons, 32 volunteers applied these utensils to pick up four kinds of fool with either hand. For dominant hands, the manipulation time of both pincer and traditional chopsticks was shorter than that of spoons, while using pincer chopsticks with non-dominant hands revealed the best performance among the three experimental utensils for users without experience. In this study, the newly designed pincer chopsticks demonstrated advantages for operation and performance. It has the potential to benefit patients with impaired hands.

Adolescent↗

PubMed2006

Psychiatric disorders in inhalant users: results from The National Epidemiologic Survey on Alcohol and Related Conditions.

OBJECTIVE: To examine the prevalence and correlates of mood, anxiety, and personality disorders among lifetime inhalant users. METHODS: Statistical analyses were based on data from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a nationally representative survey of adults in the United States. RESULTS: Inhalant users (N=664) had high lifetime prevalences of DSM-IV mood (48%), anxiety (36%), and personality (45%) disorders. Of all inhalant users, 70% met criteria for at least one lifetime mood, anxiety, or personality disorder and 38% experienced a mood or anxiety disorder in the past year. Prevalences of comorbid psychiatric disorders varied by gender. Compared with male inhalant users, female inhalant users had higher prevalences of lifetime dysthymia (24% versus 16%), any anxiety disorder (53% versus 30%), panic disorder without agoraphobia (25% versus 11%), and specific phobia (28% versus 14%), but a lower prevalence of antisocial personality disorder (22% versus 36%). Female inhalant users also were more likely than male inhalant users to meet criteria for three or more mood or anxiety disorders (15% versus 8%) in the past year. Among inhalant users with comorbid disorders, those who developed social or specific phobia typically experienced onset of these disorders prior to initiation of inhalant use; all other mood and anxiety disorders usually developed following the onset of inhalant use. Inhalant users who were women, poor, less educated, with early onset of inhalant use, family histories of psychopathology, and personal histories of substance abuse treatment had increased odds of psychiatric disorders. CONCLUSIONS: Psychiatric disorders are highly prevalent among inhalant users nationally and female inhalant users are more likely than male inhalant users to experience multiple psychiatric disorders. Inhalant use and its consequences among females warrant greater research attention.

Administration, Inhalation↗

PubMed2026

Surveilled subjectivation: narratives of drug policing among people who use prohibited drugs in Sweden.

In Sweden, possession and personal use of drugs are criminalized since 1988, resulting in police work being directed towards minor drug offenses. Despite this, police and other authorities are encouraged to protect the health and wellbeing of people who use prohibited drugs (PWUPD). Knowledge is scarce on how this drug policy plays out in practice. This study therefore analyzes interviews with 20 PWUPD who visited harm reduction services and interacted with policing agents in Stockholm, Sweden. The analysis is based on the participants' narratives of drug policing, and it concerns how they produced themselves as subjects through relations between materiality and discourse. We utilize the concept of surveilled subjectivation to elucidate what the participants could do, what they knew and who they could be or become under drug policing. Four themes were identified illustrating the link between discourse and materiality in PWUPD's surveilled subjectivation: "Material aspects of surveillance"; "Resisting the 'drug abuser' identity"; "Fighting power with power"; and "Crossing boundaries and becoming-other". The participants described nonstop efforts to prevent their bodies, activities, belongings and environments from being enfolded by drug law enforcement, which otherwise would fuel even more surveillance. They therefore disassociated themselves from the "drug abuser" identity, and managed encounters with policing agents by keeping a low profile or acting compliantly. While the study highlights the skills and knowledges the participants deployed to navigate omnipresent drug policing, we conclude that their production of autonomous and empowered subjectivities would be facilitated if possession and use of drugs were no longer criminalized.

Humans↗

PubMed2006

Remembering the basics: administrative technology and nursing care in a hospital emergency department.

This article discusses findings from qualitative research conducted with nurses in a hospital Emergency Department. It explores nurses' attitudes towards a patient care information system (PCIS) installed by hospital management in an effort to improve patient care through more effective "data sharing". Nurses' definitions of care are examined vis-à-vis their perceptions of administrative tasks and technologies like the PCIS. Efforts are made to link the system with wider patterns of administrative technology acquisition in health care and users' everyday/night experiences of using these technologies. The article also presents key themes from a literature review of recent case studies about information technology implementation in nursing. Results show that nurses choose to define care in a way that highlights relationship building and physical/emotional connectedness between nurse and patient. The article contends that nurses' refusal to incorporate technology-enabled "data sharing" into their definitions of care is indicative of efforts to make visible their caring work, often rendered invisible by the feminization of care. The article concludes by reaffirming the importance of 'remembering the basics', i.e., patient care is rooted in the skilled practice of individual caregivers, not in data sharing.

Canada↗

PubMed1998

Human factors for pleasure in product use.

Traditionally, human factors have tended to concentrate on making products 'usable'--focusing on utilitarian, functional product benefits. This paper reports an interview-based study looking at the issue of 'pleasure' in product use. The study was a 'first pass' at addressing the hedonic and experiential benefits and penalties associated with product use, and at identifying the properties of a product that influence how pleasurable or displeasurable it is to use. Feelings associated with using pleasurable products included security, confidence, pride, excitement and satisfaction. Displeasurable products, meanwhile, were associated with feelings that included annoyance, anxiety, contempt and frustration. The properties of products that were salient in terms of influencing the level of pleasure/displeasure with a product included features, usability, aesthetics, performance and reliability. Responses to questions investigating behavioural correlates to pleasure in product use suggested that pleasurable products were used more regularly and that future purchase choices would be affected by the level of pleasure in product use. It is concluded that the issue of pleasure in product use involves more than usability alone. As the user's representative in the product creation process, the human factors specialist should consider many other factors in order to ensure that the user's experience of product use is maximised.

Consumer Behavior↗