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At least 415 records · Page 23Linked to original sources
PubMed2006

Song recognition by children and adolescents with cochlear implants.

PURPOSE: To assess song recognition and pitch perception in prelingually deaf individuals with cochlear implants (CIs). METHOD: Fifteen hearing children (5-8 years) and 15 adults heard different versions of familiar popular songs-original (vocal + instrumental), original instrumental, and synthesized melody versions-and identified the song in a closed-set task (Experiment 1). Ten CI users (8-18 years) and age-matched hearing listeners performed the same task (Experiment 2). Ten CI users (8-19 years) and 10 hearing 8-years-olds were required to detect pitch changes in repeating-tone contexts (Experiment 3). Finally, 8 CI users (6-19 years) and 13 hearing 5-year-olds were required to detect subtle pitch changes in a more challenging melodic context (Experiment 4). RESULTS: CI users performed more poorly than hearing listeners in all conditions. They succeeded in identifying the original and instrumental versions of familiar recorded songs, and they evaluated them favorably, but they could not identify the melody versions. Although CI users could detect a 0.5-semitone change in the simple context, they failed to detect a 1-semitone change in the more difficult melodic context. CONCLUSION: Current implant processors provide insufficient spectral detail for some aspects of music perception, but they do not preclude young implant users' enjoyment of music.

Adolescent↗
PubMed1996

Lothian general practitioners, HIV infection and drug misuse: epidemiology, experience and confidence 1988-1993.

BACKGROUND: Lothian has a high prevalence rate of HIV infection associated particularly with injecting drug use in the mid-1980s. During the late 1980s a number of services were introduced to support general practitioners to care for drug users and people with HIV infection. AIM: To ascertain the practice distribution of patients with HIV infection and drug users, and the experience and confidence of Lothian GPs in a number of HIV and drug related tasks, and to see how these changed over a five year period after the introduction of support services. METHOD: Information about practice distribution of patients with HIV infection and drug users and information about GP experience and confidence was obtained from a survey of individual GPs in 1988. Two practice surveys in 1991 and 1993, using a chosen GP for each practice, gave information about practice distribution of people with HIV infection and drug users, while a second survey of individual GPs in 1993, concentrating on GP experience and confidence, acted as a follow up to the 1988 survey. RESULTS: GPs are in touch with an increasing number of people with symptomatic HIV infection. They are increasingly involved and confident in caring for drug users. Offering support and training to GPs appears to have encouraged their involvement. There are a significant number of people with HIV infection in Lothian who are not known to GPs or to hospital services. A combination of practice and individual GP surveys was found to provide the most reliable information. It is planned to repeat the practice survey in 1995.

Attitude of Health Personnel↗
PubMed2002

Complications associated with optical-access laparoscopic trocars.

OBJECTIVE: To investigate the number and type of serious complications associated with optical-access trocars reported by sources other than the medical literature. METHODS: Optical-access trocars, first introduced in 1994, were designed to decrease the risk of injury to intra-abdominal structures by allowing the surgeon to visualize abdominal wall layers during placement. To date, very few complications with their use have been reported in the medical literature. MEDLINE, the Food and Drug Administration's Medical Device Reporting, and the Manufacturer and User Facility Device Experience databases were searched for reports of complications occurring during the use of optical-access trocars for laparoscopic access. RESULTS: Only two serious complications resulting from the use of optical-access trocars (vena cava injuries) have been reported in the medical literature. However, 79 serious complications using these techniques have been cited in the Medical Device Reporting and Manufacturer and User Facility Device Experience databases since 1994. These include 37 major vascular injuries involving aorta, vena cava, or iliac vessels, 18 bowel perforations, 20 cases of significant bleeding from other sites, three liver lacerations, and one stomach perforation. Four of these complications resulted in patient deaths. CONCLUSION: Optical-access trocars may be associated with significant injuries despite having the ability to visualize tissue layers during insertion.

Aorta↗
PubMed2000

The virtual NMR spectrometer: a computer program for efficient simulation of NMR experiments involving pulsed field gradients.

This paper presents a software program, the Virtual NMR Spectrometer, for computer simulation of multichannel, multidimensional NMR experiments on user-defined spin systems. The program is capable of reproducing most features of the modern NMR experiment, including homo- and heteronuclear pulse sequences, phase cycling, pulsed field gradients, and shaped pulses. Two different approaches are implemented to simulate the effect of pulsed field gradients on coherence selection, an explicit calculation of all coherence transfer pathways, and an effective approximate method using integration over multiple positions in the sample. The applications of the Virtual NMR Spectrometer are illustrated using homonuclear COSY and DQF COSY experiments with gradient selection, heteronuclear HSQC, and TROSY. The program uses an intuitive graphical user interface, which resembles the appearance and operation of a real spectrometer. A translator is used to allow the user to design pulse sequences with the same programming language used in the actual experiment on a real spectrometer. The Virtual NMR Spectrometer is designed as a useful tool for developing new NMR experiments and for tuning and adjusting the experimental setup for existing ones prior to running costly NMR experiments, in order to reduce the setup time on a real spectrometer. It will also be a useful aid for learning the general principles of magnetic resonance and contemporary innovations in NMR pulse sequence design.

Algorithms↗
PubMed2006

Illicit drug users in Northern Ireland: perceptions and experiences of health and social care professionals.

Over the 30 years of conflict, Northern Ireland escaped the worst excesses of illegal drug trafficking and usage. This was in large part due to the 'policing' of local community crime by paramilitaries. However, since the first 'cease-fire' in 1994 the province has witnessed a dramatic and unprecedented rise in the availability of illicit drugs. This increased availability reflects rising consumption of these drugs in the province. The aim of this study was to explore the perceptions that a sample of health and social care professionals' hold of illicit drug users in Northern Ireland. A survey methodology was used. Community settings across Northern Ireland were accessed. Focus groups and face-to-face interviews were used as data collection methods. Thirty-five health and social care professionals took part in this study. Thirty-two took part in six focus groups; three respondents underwent one-to-one interview. The participating professionals reported to have little or no education or training in the care and treatment of illicit drug users. Some stated that they would reject the offer of education and training in this area to prevent contact with illicit drug users. Many displayed strongly negative views of this client group, often expressing a preference not to care for or treat these people, preferring all their care to be given by specialists in illicit drug treatment. These findings indicate that most of the health and social care professionals who took part in this study appear unprepared and unwilling to meet the challenge of caring for illicit drug users. The findings will be of interest to service providers within and outside the UK.

Attitude of Health Personnel↗
PubMedDate not supplied

Trocar-associated injuries and fatalities: an analysis of 1399 reports to the FDA.

Laparoscopic trocars, medical devices used to gain access into the abdominal cavity, are the most common device named in malpractice injury claims associated with laparoscopic procedures. As part of its ongoing adverse event reporting program, the U.S. Food and Drug Administration (FDA) requires manufacturers and user facilities to file a report whenever a device was or may have been a factor in a death or serious injury. The FDA collects data from these reports in its Manufacturer and User Facility Device Experience (MAUDE) database. This study presents an analysis of fatality and injury data on laparoscopic trocars found in MAUDE reports received from January 1, 1997, through June 30, 2002, including 31 fatal injury cases and 1353 reports on nonfatal injuries. Cholecystectomy was the procedure most frequently associated with both fatal and nonfatal trocar injuries. Most fatalities involved vascular injuries. All fatality reports that identified the trocar design involved either a shielded trocar (which has a retractable shield that covers the trocar blade before and after insertion to help protect abdominal and pelvic organs from inadvertent puncture) or an optical trocar (which allows laparoscopists to view the cutting tip as it penetrates the tissues). Narrative comments cited surgical technique, device problems, and patient characteristics as contributing factors. Among nonfatal injuries, a change in surgical management such as additional surgical procedure--primarily laparotomy--prolonged surgery, or aborted surgery was reported most frequently for vascular and hollow viscus injuries. Many reports did not identify the device model, surgical procedure, or event timing, limiting Food and Drug Administration (FDA) and manufacturer investigations into whether the device contributed to the event. The most common manufacturer conclusions indicated the trocar was not returned, and no conclusions could be drawn about the trocar's contribution to the event. Fatalities occur with procedures in which shielded trocars and optical trocars are used. Further study is needed to evaluate the high proportion of reports associated with laparoscopic cholecystectomy. Laparoscopists should retain for evaluation any devices implicated in patient injuries and should ensure that detailed information on adverse events is provided in adverse event reports to the FDA. The FDA's Manufacturer and User Facility Device Experience (MAUDE) database can be a valuable source for information on adverse outcomes associated with medical devices and, given an understanding of its limitation, provides researchers with a viable adjunct to published literature and litigation surveys for obtaining this information.

Adolescent↗
PubMed1998

Developing user involvement in mental health services.

This paper describes the user consultation component of a corporate approach to the mental health needs assessment of a local population. The context of the paper is established by presenting the views of users and user representatives on current mental health services. This is followed by the development of participants' views of an 'ideal' mental health service within the boundaries of technical feasibility. Three focus groups were held with current service users, and one group with user representatives. The users have extensive experience of a range of mental health services. The findings suggest that user representatives tend to represent their own needs rather than those of users. It would also seem that service users are not a homogeneous group, different groups having different priorities. Overall, users' views of current services generally reflect previous studies, but the 'ideal' approach seems to broaden the discussion and identify an agenda for change. This agenda is framed within categories of service delivery, service providers, labelling, advocacy, future research, leaving services, involvement, co-ordination, information, choice and accessibility. There is no clear role specifically identified for mental health nurses by users, but many opportunities are highlighted. Exploration of the utility of co-operative inquiry between mental health nurses and service users is recommended.

Female↗
PubMed2005

"Rollin' on E": a qualitative analysis of ecstasy use among inner city adolescents and young adults.

Ecstasy use has spread beyond the rave and club scenes into other arenas of party culture, and from middle-class America to working-class and low-income neighborhoods of large cities. In order to explore ecstasy use among inner city adolescents and young adults, we conducted in-depth interviews with 23 poly-drug users who had used ecstasy, in Hartford, CT. Most users reported positive experiences while on the drug. Negative experiences were most often related to poly-drug mixing. However, heavy users (40+ times ever used) experienced negative aftereffects, which led them to decide to decrease or halt their use. Some participants discussed using ecstasy during sex, and irregular use of condoms. These findings point to the need for more in-depth research on MDMA use within inner city settings, with a particular focus on ethnic and cultural context, self-controlled drug use, poly-drug mixing, and sex risk behaviors.

Adolescent↗
PubMed1985

Preliminary experiences with WHO's ICIDH; a user's report.

A simple feasibility study of the ICIDH was conducted: 1148 patients were classified by their physician, the opinion of the physicians about the feasibility of the ICIDH was recorded, and finally 21 patients were classified twice to assess reliability. The results suggest that the I code is feasible for patients with locomotor disorders. The use of the D code presented several problems. It is very time-consuming and reliability of D code assignments seems to be low. The feasibility of the D code can probably be improved if the numerical framework is reshaped. The H code seems to allow for simple meaningful scorings, although we tended to use it as a substitute for the impractical D code, rather than as an indicator of handicap.

Persons with Disabilities↗
PubMed2004

Implant contraception in Singaporean women: one decade of experience in KK Women's and Children's Hospital.

INTRODUCTION: The aim of this study was to assess user acceptability and effectiveness of implant contraception in Singaporean women. METHODS: A prospective study was carried out on 553 patients who received Norplant implant in our hospital from 1 January 1992 to 31 December 2000, and followed-up till 15 July 2003. The patients' profile, side-effects, satisfaction and continuation rate of Norplant implant were studied. RESULTS: The mean age of the subjects was 29.4 (plus or minus 5.1) years. The mean parity was 2.1 (plus or minus 1) live births. More than one-half (55.2 percent) of the subjects had used other methods of contraception before. The main reason for them to switch to implant contraception was convenience (63.6 percent). Of the 516 users on follow-up, the common side-effects were menstrual irregularity (51 percent), secondary amenorrhoea (9.6 percent) and weight gain (15.7 percent). 29.3 percent of users did not experience any side-effect. There was only one contraceptive failure, which may be related to drug interaction. The Pearl Index was 0.054 per hundred women years. There was only one serious adverse event of a patient (0.2 percent) who developed severe hypertension requiring treatment. The continuation rate was 92.4 percent after one year, 80.8 percent after two years, 68.9 percent after three years and 58.5 percent after four years. The main reasons for early implant removal were side-effects and desire for future pregnancy. Re-insertion was carried out in 53.7 percent of users who had completed five years of Norplant contraception. CONCLUSION: This largest sub-dermal hormonal implant contraception study in multi-racial Singapore showed that Norplant contraception had a high degree of effectiveness with relatively high user satisfaction and continuation rate.

Adult↗
PubMed1989

Evaluation of a new work seat for industrial sewing operations: results of three field studies.

A newly developed work seat for industrial sewing operations was compared with a traditional sewing work seat to evaluate the effectiveness of design features. The new seat was designed with special seat-pan and backrest features to accommodate the musculoskeletal geometry of a low sit-stand posture. The seat-pan consisted of a pelvic support which supported the ischial tuberosities and areas behind them, and a thigh support which maintained the thighs at a 15 degrees downward angle, resulting in a 105 degrees trunk-thigh angle. The backrest consisted of a lumbar support which preserved lumbar lordosis and a thoracic support which supported the upper back during backward leaning. The traditional work seat was similar to an office chair (i e, a large horizontal seat-pan and a wide backrest) with the exception of having a higher than normal seat-height. This investigation consisted of three studies to compare the seats: (1) A user comfort and acceptance experiment which compared the initial psychophysical responses of 50 industrial sewers when introduced to the new seat; (2) a backrest usage experiment which compared the duration of backrest use among 10 industrial sewers; and (3) a follow-up experiment to evaluate chair preference after extended use of the new seat. The results of the user comfort and acceptance experiment found that the new work seat had greater comfort and user preference; the results of the backrest usage experiment found that the new seat had greater backrest use than the traditional seat; the results of the follow-up experiment found that the preference for the new seat was maintained over time and not due to a Hawthorne Effect.

Journal Article↗
PubMedDate not supplied

Effects of a decision support system on the diagnostic accuracy of users: a preliminary report.

OBJECTIVES: To assess the effects of incomplete data upon the output of a computerized diagnostic decision support system (DSS), to assess the effects of using the system upon the diagnostic opinions of users, and to explore if these effects vary as a function of clinical experience. DESIGN: Experimental pilot study. Four clusters of nine cases each were constructed and equated for case difficulty. Definitive findings were omitted from the case abstracts. Subjects were randomly assigned to one of four clusters and were trained on the DSS prior to use. SUBJECTS: The study involved 16 physicians at three levels of clinical experience (six general internists, four residents in internal medicine, and six fourth-year medical students), from three academic medical centers. PROCEDURE: Each subject worked up nine cases, first without and then with ILIAD consultation. They were asked to offer up to six potential diagnoses and to list up to three steps that should be the next items in the diagnostic workup. Effects of DSS consultation were measured by changes in the position of the correct diagnosis in the lists of differential diagnoses, pre- and post-consultation. RESULTS: The DSS lists of diagnostic possibilities contained the correct diagnosis in 38% of cases, about midway between the levels of accuracy of residents and attending general internists. In over 70% of cases, the DSS output had no effect on the position of the correct diagnosis in the subjects' lists. The system's diagnostic accuracy was unaffected by the clinical experience of the users.

Decision Making↗
PubMed2006

The experience of senior stroke survivors: factors in community participation among wheelchair users.

PURPOSE: This qualitative study investigated the lived experience of senior stroke survivors who used prescribed wheelchairs in their home and community. METHODS: The study involved semi-structured, in-depth interviews that were conducted with 10 participants, aged 70 to 80, who had used a wheelchair for a mean of 5.6 years. All participants used manual wheelchairs and two additionally used a power wheelchair and a scooter. RESULTS: A constant comparative inductive method of analysis of the data yielded several themes which are examined within the International Classification of Functioning, Disability and Health framework of body functions and structure, activity limitations, participation, and contextual factors. Overall, the wheelchair, manual or power, was an enabler of community participation among the participants. However, the wheelchair's use also created problems, such as limiting destinations and creating increased dependence on others. PRACTICE IMPLICATIONS: A balance scale model was proposed to facilitate an understanding of how the factors affecting community participation interact in this population. This model can assist occupational therapists who prescribe wheelchairs for stroke clients for use in the community.

Activities of Daily Living↗
PubMed1999

Adaptive one-switch row-column scanning.

Row-column scanning is a very slow method of communication. Options for increasing text entry rate include 1) dynamically changing the configuration of the row-column matrix or 2) using rate-enhancement techniques like word prediction, but evidence suggests that increased cognitive load imposed by these methods on the user can result in little or no improvement in text generation rate. An alternative we are investigating is adapting a system's scan delay during run-time. Our goal is to allow a scanning system to adjust its parameters "on the fly" (as opposed to the current practice of setting parameters during clinical assessments). This paper describes the evolution of a one-switch row-column scanning system that adapts its scan rate based on measurements of user performance. Two experiments have been performed to explore the effects of automatically adapting scan delay on users' text entry rate. Our results indicate that automatic adaptation has the potential to enhance text-entry rate without increasing task complexity.

Adult↗
PubMed2003

Nonmenstrual adverse events associated with subdermal contraceptive implants containing normegestrel and levonorgestrel.

To improve counselling information to Nigerian family planning clients, we compared non-menstrual events reported by 248 Norplant users and 214 Uniplant users. Women using Norplant were significantly older and of higher parity and greater contraceptive experience than Uniplant users. Other admission characteristics of the two groups were similar. The total women-months of use of Norplant was 2,946 (mean 11.9 +/- 0.6 SE) months while that for Uniplant was 2,315 (mean 10.8 +/- 0.2 SE) months. About 36% of Norplant users and 15% of Uniplant users reported non-menstrual adverse events, the commonest ones being pain/itching at the insertion site, unexplained low abdominal pains and clinically diagnosed pelvic inflammatory disease (PID). The numbers of women reporting drug-related adverse events were 61 (24.6%) and 23 (10.8%), respectively, among Norplant and Uniplant users. Drug-related serious adverse events were reported by 3 (1.2%) Norplant users and 5 (2%) Uniplant users. The adverse events leading to Uniplant removal were severe urticaria, breast lumps, pruritus vulvae, headache with raised blood pressure, adnexal pains and ovarian cysts, and static weight while those leading to Norplant removal were breast lump and headache with raised blood pressure. Weight gain was reported by only 7 (3%) of Norplant users. Although of no serious clinical consequences, drug-related adverse events should be added to the counselling information to prospective users.

Adult↗
PubMed2006

Values and beliefs of psychedelic drug users: a cross-cultural study.

Psychedelic drugs such as LSD and psilocybin are often claimed to be capable of inducing life-changing experiences described as mystical or transcendental, especially if high doses are taken. The present study examined possible enduring effects of such experiences by comparing users of psychedelic drugs (n = 88), users of nonpsychedelic illegal drugs (e.g., marijuana, amphetamines) (n = 29) and non illicit drug-using social drinkers (n = 66) on questionnaire measures of values, beliefs and emotional empathy. Samples were obtained from Israel (n = 110) and Australia (n = 73) in a cross-cultural comparison to see if values associated with psychedelic drug use transcended culture of origin. Psychedelic users scored significantly higher on mystical beliefs (e.g., oneness with God and the universe) and life values of spirituality and concern for others than the other groups, and lower on the value of financial prosperity, irrespective of culture of origin. Users of nonpsychedelic illegal drugs scored significantly lower on a measure of coping ability than both psychedelic users and non illicit drug users. Both groups of illegal drug users scored significantly higher on empathy than non illicit drug users. Results are discussed in the context of earlier findings from Pahnke (1966) and Doblin (1991) of the transformative effect of psychedelic experiences, although the possibility remains that present findings reflect predrug characteristics of those who chose to take psychedelic drugs rather than effects of the drugs themselves.

Adult↗
PubMed1995

Immunization to regulate fertility: biological and cultural frameworks.

Deliberate immunization to control fertility differs from that to control disease. Those differences can be discussed within various frameworks, e.g., intent, recipient population, biological bases, and immunological targets. Others include differing perspectives of developers, providers and users, and rights of the state to impose programs of control. Almost all of the differences are grounded in the social, economic, and gendered aspects of societies. The intent of providing a fertility-regulating vaccine is to prevent pregnancy. In theory, men as well as women could receive such vaccines; in reality, most are designed for women. Traditional vaccines are intended to prevent disease and are generally given to susceptible individuals whether male or female, child or adult. The biological bases of contraceptive vaccines are molecules specific to reproduction. The immune response generated by most anti-fertility vaccines is directed toward 'self', one's own cells and molecules. In contrast, the bases of traditional vaccines are materials derived from non-self, disease-causing microorganisms; the immunological targets are those microorganisms or their toxic products. From a developer perspective vaccines that regulate fertility differ little from those that control disease; both prevent a particular condition. Developers cite these advantages to contraceptive vaccines: non-invasive, no serious side-effects, easy to use, reduced patient failure, and long-lasting but naturally reversible. Because anti-fertility vaccines have been tested only in small-scale clinical trials, information on user reactions and experiences is limited. Not surprisingly, the perspectives of women's health advocates and of potential users (mostly women) often differ markedly from those of developers. Women cite as disadvantages the cryptic nature of immunity which leaves one without an obvious signal for the beginning of protection (against pregnancy) and its decline, and the inability to 'turn-off' an immune response. Further, long-acting contraception can complicate alleviation and side-effects, and it leaves women always vulnerable to sexual demands. Most women object to the lack of user control and are especially concerned about the enormous potential for misuse and coercion by population control programs should fertility-regulating vaccines become widely available. Many scholars and government officials subscribe to the following logic: the global environmental crisis is due to over-population which necessitates population control programs; thus pregnancy can be considered a disease subject to state control. But pregnancy is not a disease nor is over-population the single major cause of environmental degradation. However, as governments grapple with the economic, social, and ecological consequences of population growth, draconian measures to control fertility will be ever more tempting.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗