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PubMed1997

A user-centred design approach for introducing computer-based process information systems.

There has been an increasing tendency to use computer-based process information systems as the main interface through which operators interact with complex industrial systems. Although the new technology has produced greater hardware reliability and maintainability, the corresponding potential benefits for operability have not always been achieved. Automation has introduced new forms of design and operating errors. One of the major reasons for this problem has been the lack of human factors advice and user participation early in the design process. This paper discusses a user-centred design approach to increase operability and user acceptance of new technologies and working practices. Application of this approach in the context of a chemical plant indicates its promise, but also highlights the difficulties involved in gaining user participation and management commitment.

Chemical Industry↗
PubMed1998

HIV encephalitis, proviral load and dementia in drug users and homosexuals with AIDS. Effect of neocortical involvement.

In this consecutive autopsy study, the pathological evidence of HIV encephalitis, which included the presence of giant cells and/or HIV p24 immunopositivity, was found more frequently in drug users (25 of 45; 56%) than in homosexual men (6 of 35; 17%) with AIDS (P < 0.01). Productive infection, as shown by HIV p24 positivity, was found in frontal lobe white matter in 29 of the 31 HIV encephalitis cases, but was also present in grey matter in 50% of the HIV encephalitis cases. Immunopositivity was confined to microglia, monocytes and most but not all giant cells. HIV-1 proviral load was determined by quantitative PCR in 65 of the 80 cases (separately in grey and white matter in 49 of these), and correlated well with the presence of HIV encephalitis (P < 0.001). Twenty-five patients with AIDS (13 male homosexuals, 12 drug users) showed no HIV encephalitis, opportunistic infection or cerebral lymphoma, while 18 (2 male homosexuals, 16 drug users) showed pure HIV encephalitis. Cognitive function had been assessed prospectively in this cohort and graded as normal or mildly, moderately or severely impaired. Because opportunistic infections and lymphomas of the brain may also lead to dementia, patients found to have these conditions at autopsy were excluded from the final analysis of the cases with dementia, so that the precise correlation between cognitive impairment and pure HIV encephalitis could be determined in this cohort without possible confounding variables. Fourteen of 18 patients with pure HIV encephalitis had shown cognitive impairment. Severe dementia correlated better with pure HIV encephalitis in cases in which grey matter involvement was present (7 out of 9) than in those in which only white matter was involved (2 out of 9) (P < 0.05), although milder degrees of cognitive impairment had been present in a further 5 HIV encephalitis cases. No correlation was found between zidovudine therapy and the degree of cognitive impairment. Systemic and cerebral opportunistic infections and lymphoma showed a negative association with HIV encephalitis, being more common in homosexuals than in drug users, despite comparable CD4 counts in the two groups. These findings suggest that neocortical productive HIV infection is a significant factor in AIDS-related dementia, although this may reflect merely a higher overall viral burden in the brain.

AIDS Dementia Complex↗
PubMed2001

Presence and usability in shared space virtual conferencing: a participatory design study.

The use of teleconferencing as an alternative to taking part in expensive or impractical traditional meetings is becoming more and more popular. However, there are limitations to both audio and video conferencing, such as lack of presence and involvement. These can potentially be avoided by the use of virtual shared space conferencing. This paper describes a three-phase study intended to investigate the issues of presence and usability with respect to this alternative form of conferencing. The first phase involved informal tests to establish a suitable starting point for the second phase, which employed a participatory design methodology whereby users of a prototype system contributed to its development toward an optimally usable and well-featured design, both for the meeting environment and for the user interface to it. The third phase involved further user trials to assess and refine the conclusions indicated by the second phase. The results of the study indicate a number of requirements for optimal design of shared space conferencing systems. These requirements include (1) the need to be selective about the degree of realism in different aspects of the system, (2) the importance of view control and avatar animation in support of talker identification, (3) the desire of users for flexibility and freedom with regard to turn-taking and gesture control, and (4) the benefits of symbolic acting when certain important considerations for its implementation are respected. Finally, the results also show that, following a short period of user habituation, shared space conferencing can induce a strong sense of involvement and presence for users.

Communication↗
PubMed1972

Measurement of journal availability in a biomedical library.

During a twelve-day period in October and November 1971, users of the Woodward Biomedical Library were asked to report each time they failed to find a needed journal issue or volume in the library. They reported 370 cases of failure. In 100 of these cases (27%) the journal was not held by the library or had not yet been received; in 66 (18%) it was in some stage of the binding process; in 64 (17%) it was in circulation; in 34 (9%) it was in use in the library; and in 41 (11%) user error was involved. The 64 journals required while in circulation constituted 4.7% of a total of 1,373 journals circulated during the period. Indications are that circulation may not be as great a problem as users have supposed and that more attention should be given to other user problems with journals.

British Columbia↗
PubMed2001

Conceptual database modeling: a method for enabling end users (radiologists) to understand and develop their information management applications.

As medical technology advances at a rapid pace, clinicians become further and further removed from the design of their own technological tools. This is particularly evident with information management. For radiologists, clinical histories, patient reports, and other pertinent information require sophisticated tools for data handling. However, as databases grow more powerful and sophisticated, systems require the expertise of programmers and information technology personnel. The radiologist, the clinician end-user, must maintain involvement in the development of system tools to insure effective information management. Conceptual database modeling is a design method that serves to bridge the gap between the technological aspects of information management and its clinical applications. Conceptual database modeling involves developing information systems in simple language so that anyone can have input into the overall design. This presentation describes conceptual database modeling, using object role modeling, as a means by which end-users (clinicians) may participate in database development.

Database Management Systems↗
PubMed1996

Information services of the European Bioinformatics Institute.

The scope of the EBI is focused on providing better services to the scientific community. Technological advancements in the hardware area provide EBI with means of producing data much faster than before, and with greater accuracy since there is now a better technical ability to produce more exhaustive searches through larger indices. Hand in hand with the technological developments, research and development work is continuing on better indexing systems and more efficient ways of establishing and maintaining the future databases. The existing links of communication between EBI and the user community are exploited to study the needs of the scientific community, to provide better services, and to enhance the quality of databases by interpreting user feedback and updates. A very important goal is to enhance the awareness of the scientific (and, maybe even more, the nonscientific) public of the importance of the modern field of bioinformatics and to introduce special meetings and courses, in which more specific subjects will be studied in depth. Another aspect of this goal is to help in constructing special bioinformatics programs in university faculties. In such programs, in contrast to the existing layout, students will pursue studies in a combined environment that provides basic training in biology and in computation. Currently, one of the main problems in the field is that scientists are either biologists, who are self-educated in the field of computers and programming, or computer scientists without sufficient knowledge of biology. It is hoped that a combined program will provide a high level of education in both fields of interest at the appropriate ratios. Building an efficient and friendly interface between the EBI and the user community is the basis for any future development. This aim is achieved by using the most modern server systems while continuously researching newer and better systems and interfaces. This task can never be complete without involvement of the user community by providing feedback to any of EBI's services. A better bioinformatics community is a necessity for any future development of the biological research aiming at a better society.

Amino Acid Sequence↗
PubMed2006

Concurrent use of alcohol and cocaine: differences in patterns of use and problems among users of crack cocaine and cocaine powder.

AIM: To investigate differences in alcohol and drug consumption behaviours and related problems among users of cocaine powder versus crack cocaine. METHODS: The sample of concurrent users of alcohol and cocaine (n = 102) was recruited from clinical and community (non-clinical) settings in London. Those recruited in the community were contacted by means of snowball sampling methods. Data were collected by means of face-to-face structured interviews. RESULTS: Heavy drinking was common. There were differences in alcohol consumption between users of cocaine powder and crack cocaine. Cocaine powder users reported more frequent heavy drinking than crack users. Heavy drinking often involved drinking excessive amounts over prolonged periods. Crack cocaine users reported more serious problems associated with cocaine, other illicit drugs, psychological and physical health problems, and acquisitive crime. CONCLUSIONS: Frequent heavy drinking represents a serious risk to the health of many cocaine users. The differences in alcohol consumption patterns confirm the importance of distinguishing between use of cocaine powder and crack cocaine. Few of the sample had received treatment for cocaine or alcohol problems. Healthcare professionals working in primary care or accident and emergency settings may need to be trained to detect, assess, and respond to concurrent alcohol and cocaine problems.

Adult↗
PubMedDate not supplied

The transition from hospital to long-term institutional care.

The focus of this article is user and carer involvement in the transition of older people from acute hospital to continuing institutional long-term care. The policy context and research of relevant studies are reviewed. Findings from an action research project currently in progress further elucidate the concerns of older users and carers.

Aged↗
PubMed2005

An agent-based system for re-annotation of genomes.

Genome annotation projects can produce incorrect results if they are based on obsolete data or inappropriate models. We have developed an automatic re-annotation system that uses agents to perform repetitive tasks and reports the results to the user. These tasks involve BLAST searches on biological databases (GenBank) and the use of detection tools (Genemark and Glimmer) to identify new open reading frames. Several agents execute these tools and combine their results to produce a list of open reading frames that is sent back to the user. Our goal was to reduce the manual work, executing most tasks automatically by computational tools. A prototype was implemented and validated using Mycoplasma pneumoniae and Haemophilus influenzae original annotated genomes. The results reported by the system identify most of new features present in the re-annotated versions of these genomes.

Computational Biology↗
PubMed2006

The development of an evaluation questionnaire for the Newcastle Crisis Assessment and Home Treatment Service: finding a way to include the voices of service users.

The views of users of services have traditionally been sought through the use of 'patient satisfaction' surveys. Because such surveys are often devised by service providers there are concerns that their use as evaluation tools may be flawed due to issues of power and passivity, and that they do not represent active involvement by service users in the feedback loop. The Newcastle Crisis Assessment and Treatment Service offers treatment at home to people in mental health crisis who would otherwise be admitted to hospital. This article reports on the process of inviting previous users of a home treatment service to give their views about what was most important to them about receiving the service. A participatory research approach combining a two-stage modified Delphi study and semi-structured interviews conducted by service user interviewers were employed to gather rich data to inform the construction of a service evaluation questionnaire. The questionnaire is now in routine use for every person who is in receipt of treatment at home. The feedback obtained from the questionnaire will be used to shape and refine the service provided by the team. As a 'live' document through use and feedback, the questionnaire will continue to evolve in order to retain its sensitivity and relevance.

Attitude to Health↗
PubMedDate not supplied

Clinical features, site of involvement, bacteriologic findings, and outcome of infective endocarditis in intravenous drug users.

BACKGROUND: Intravenous drug use is an increasingly common condition predisposing to infective endocarditis. Data on infective endocarditis in intravenous drug users are limited. OBJECTIVE: To determine the clinical features, bacteriologic findings, site of involvement, complications, and mortality associated with infective endocarditis in intravenous drug users. METHODS: Cohort study of intravenous drug users with native valve infective endocarditis. RESULTS: A total of 125 cases of infective endocarditis occurred in 114 patients (84 cases [67%] in men and 41 cases [32%] in women) with a mean (+/- SD) age of 37 +/- 7 years. The tricuspid valve was involved in 58 cases (46%), the mitral valve in 40 cases (32%), and the aortic valve in 24 cases (19%). The microorganisms identified included Staphylococcus in 82 cases (65.6%) and Streptococcus in 32 cases (25.6%). Twenty-three patients (18%) underwent surgery, and two (9%) of them died. One hundred two patients (82%) were treated medically, and nine (9%) of them died. Fifteen patients (63%) with aortic valve involvement vs 17 patients (17%) without aortic valve involvement underwent surgery or died without surgery (odds ratio, 8.24; 95% confidence interval, 3.1 to 21.8). Among the survivors, at least one major cardiovascular complication occurred in 79 cases (69.3%). CONCLUSIONS: Infective endocarditis in intravenous drug users affects the right and left sides of the heart with approximately equal frequency. At present, more than 90% of cases of infective endocarditis in intravenous drug users in Chicago are caused by staphylococci or streptococci. Involvement of the aortic valve is predictive of increased morbidity and mortality in intravenous drug users with infective endocarditis. With medical treatment, and surgery when medical treatment fails, intravenous drug users with infective endocarditis have an in-hospital survival rate of 91%.

Adult↗
PubMed2005

An outbreak of hepatitis A virus infection with a high case-fatality rate among injecting drug users.

BACKGROUND/AIMS: In 2002, the first reported outbreak of hepatitis A virus (HAV) infection involving mostly intravenous drug users (IDU) occurred in Italy. We attempted a thorough evaluation of the outbreak, including epidemiological, clinical and virological analyses. METHODS: We conducted an epidemiological investigation, including a case-control study, to identify the source and the modes of HAV transmission. Hepatitis B and C (HCV) viruses and human immunodeficiency virus (HIV) coinfections were clinically analysed. Sequence analysis of the VP1/2A junction of the HAV isolates was also performed. RESULTS: Of the 47 symptomatic cases, 35 were IDUs. The only associated risk factor was contact (not related to injecting practices) with a jaundiced person (odds ratio: 5.8; 95% confidence interval: 1.3-29.9). Of the cases, 58% were anti-HCV positive and 4.7% anti-HIV positive. Three individuals died of acute liver failure: 2 were HCV-coinfected alcohol abusers, with underlying liver cirrhosis; 1 was HCV/HIV-coinfected. HAV-RNA was found in 15 of the 24 tested patients: genotype IB (8 cases) and IIIA (7 cases) were detected. CONCLUSIONS: HAV was probably transmitted through the fecal-oral route, although parenteral transmission cannot be excluded. The high fatality rate was probably due to severe underlying liver damage. The occurrence of this outbreak highlights the need for routine HAV vaccination for IDUs.

Adolescent↗
PubMed2000

Cannabis users in the general Canadian population.

In a national survey conducted in 1994, 29.3% of all respondents reported that they had used cannabis at least once, 7.3% reported using at least once during the year of the survey, and 2.0% reported using cannabis at least once a week during the year of survey. Nonusers and those with different patterns of cannabis use could be distinguished by age; gender; the use of alcohol, tobacco, and other drugs; and involvement with drug users. Frequent cannabis use at the time of the survey was associated with "heavy" drinking and drinking problems, drinking and driving, driving within 2 hours of using cannabis, and the use of other drugs, especially among young males. The association between regular cannabis use, "heavy" drinking, and other risk behaviors poses challenges to prevention and harm-reduction initiatives.

Adolescent↗
PubMed2000

[Two years follow-up of a heroin users cohort treated with high dosage buprenorphine. Results of the SPESUB study (pharmacoepidemiologic follow-up of general practice Subutex)].

BACKGROUND: Since February 1996, French GPs are allowed to prescribe high dosage buprenorphine for maintenance treatment of major opioid drug addiction. A prospective cohort of major opioid addicts was initiated in order to assess patient outcomes: follow-up, retention rate in treatment, drug use, intravenous injection and social situation evolution. METHODS: Each GP, known to be involved in drug user management, had to include the first 10 opioid drug addict patients to whom he prescribed high dosage buprenorphine, with a maximum inclusion period of 3 months. Patients were followed up for two years and a regular standardized information was collected (usual data on drug users and prescription modalities). RESULTS: Between May and July 1996, 919 patients (664 men and 255 women, mean age: 30 years) were included by 101 GPs. They had a long and serious history of drug addiction, important parallel consumption of cocaine, codeine and other illicit drugs and psychiatric problems (28% of definite problems and 45% of probable) and frequent hepatic conditions (hepatitis B: 23%, hepatitis C: 21%). Two years later, 55% of patients were still followed-up by the same GP and an additional 12% were followed by another GP or in a health care service (hospitalized or receiving methadone in a specialized centre). 13% were not followed, but GPs were able to describe their situation. 8% had been included by GPs who had dropped the study. Finally, 12% of patients were lost to follow-up. Among the 508 patients still followed-up by the same GP after 2 years, the substitution treatment rate was 84%. The dosage bracket had widened (inclusion: mean dosage=7.8 mg +/-4.5, minimum=0.8, maximum=28, median=8; after 2 years: mean=7.6 mg +/-5.4, minimum=0.4, maximum=28, median=8) and the duration of the prescription and dispensing had increased. Declaration of heroin intake in the previous month had fell from 40% to 11% and declaration of drug intake from 53% to 20%. Social situation had improved on average (housing conditions and work). There were 12 seroconversions for hepatitis B, 21 for hepatitis C and 4 for HIV. 14% of patients had declared intravenous injection of high dosage buprenorphine in the previous month. CONCLUSION: After two years of follow-up, 55% of patients were still followed-up by the same GP and an additional 12% was followed by another GP or in a health care service. Among patients still followed up by the same GP, a reduction of drug related harm (seroconversions for hepatitis B, hepatitis C and HIV) was observed.

Adult↗
PubMed2005

Association testing with Mendel.

This report presents an overview of association testing strategies from a user's perspective, with particular attention to the capabilities of the computer program Mendel. Association testing is driven by the nature of the study sample, the nature of the disease trait, and the kind of markers employed. The practicing statistician must also choose whether to conduct parametric or nonparametric tests. Because of the complexities involved, Mendel offers users several analysis options. The different options are tied together by shared input and output conventions and a shared language for defining models. Mendel also features new statistics and theory found in no other genetics software. The most important innovations include: association testing by penetrance estimation, expansion of matched-pair designs to permutation unit designs, and a rigorous implementation of the measured genotype approach for quantitative trait loci. This report explains how Mendel imputes allele counts and conducts both asymptotic and permutation tests in the measured genotype framework.

Analysis of Variance↗
PubMed1991

Speech perception abilities of children with cochlear implants, tactile aids, or hearing aids.

The purpose of this experiment was first, to compare the performance of three matched groups of experimental subjects who used either a single-channel cochlear implant, a multichannel cochlear implant, or a two-channel vibrotactile aid on a battery of speech perception measures, and second, to compare the performance of subjects with residual hearing who used hearing aids to that of the three groups of experimental subjects. The results revealed that the subjects using hearing aids achieved the highest scores on all measures. The performance of the group of multichannel implant users was significantly higher than that of the single-channel implant users on tests involving discrimination of speech features, categorization of stress patterns, closed-set identification of familiar words, and identification of common phrases with and without visual cues. The performance of the subjects using 3M/House and Tactaid II devices was similar on all tests except those requiring integration of auditory or tactile cues and visual cues, on which the 3M/House device users achieved significantly higher scores than did the Tactaid II device users.

Adolescent↗