SEARCH · PubMed Health

Results for “user involvement”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 415 records · Page 23Linked to original sources

PubMed2006

Safety effects of roundabouts in Flanders: signal type, speed limits and vulnerable road users.

This paper examines the road safety effects of roundabouts built in Flanders between 1994 and 2000. While the overall effect is positive (39% reduction of injury accidents), the results vary considerably with the speed limit on the main and adjacent road (the higher, the more effective) and the pre-roundabout signalization of the intersection (32% reduction with traffic lights versus 44% without). However, microscopic analysis reveals that roundabouts are not always effective. Serious injury accidents are estimated to increase by 117% on 70 km/h x 50 km/h intersections equipped with signalization before the roundabout. The number of injury accidents involving vulnerable road users is also found to increase (28%) on 50 km/h x 50 km/h junctions that were originally signalized. Moreover, the vulnerable road user is more likely to get fatally or seriously injured. Therefore, it is concluded that traffic lights protect vulnerable road users more effectively than roundabouts, which, in turn, are superior to intersections without signalization.

Acceleration↗

PubMed2004

Engaging in activities involving information technology: dimensions, modes, and flow.

An engagement mode involves a subject (e.g., a user of information technology, or IT) who is engaged in an activity with an object in a certain manner (the mode). The purpose of this study is to develop a general model of engagement modes that may be used for understanding how IT-related activities are shaped by properties of the user and the IT object. A questionnaire involving items on IT engagement and the experience of flow was administered to 300 participants. The results supported an engagement mode (EM) model involving 5 different engagement modes (enjoying/acceptance, ambition/curiosity, avoidance/hesitation, frustration/ anxiety, and efficiency/productivity) characterized on 3 dimensions (evaluation of object, locus of control between subject and object, and intrinsic or extrinsic focus of motivation). The flow experience follows from a balance between enjoying/ acceptance and efficiency/productivity propelled by ambition/curiosity. The EM model could provide a platform for considering how IT users, IT applications, and IT environments should work together to yield both enjoyment and efficiency. Actual or potential applications of this research include designing IT training programs on different levels of specificity.

Adult↗

PubMed1996

Factors predicting assistive device use in the home by older people following rehabilitation.

The purpose of this article is to (a) describe the pattern of assistive device use by older adults the first 3 months home following rehabilitation, (b) examine factors that predict home use, and (c) describe characteristics of users. The study involved 86 patients 55 years of age or older who were hospitalized for a stroke, orthopedic deficit, or lower limb amputation and discharged home with assistive devices. Of the 642 devices provided in the hospital, 50% were used frequently to always, with those using devices in Month 1 continuing over time. A respondent's expectation while hospitalized to use devices was an independent predictor of actual home use. Although there were no differences between users and nonusers among sociodemographic variables, respondents with a lower limb amputation used devices with greater frequency than those with either a stroke or orthopedic deficit.

Black or African American↗

PubMed1992

Psychoactive drugs and the risk of injurious motor vehicle crashes in elderly drivers.

To determine whether commonly used psychoactive drugs increase the risk of involvement in motor vehicle crashes for drivers > or = 65 years of age, the authors conducted a retrospective cohort study. Data were obtained from computerized files from the Tennessee Medicaid program, driver's license files, and police reports of injurious crashes. Cohort members were Medicaid enrollees 65-84 years of age who had a valid driver's license during the study period 1984-1988 and who met other criteria designed to exclude persons unlikely to be drivers and to ensure availability of necessary study data. There were 16,262 persons in the study cohort with 38,701 person-years of follow-up and involvement in 495 injurious crashes. For four groups of psychoactive drugs (benzodiazepines, cyclic antidepressants, oral opioid analgesics, and antihistamines), the risk of crash involvement was calculated with Poisson regression models that controlled for demographic characteristics and use of medical care as an indicator of health status. The relative risk of injurious crash involvement for current users of any psychoactive drug was 1.5 (95% confidence interval (CI) 1.2-1.9). This increased risk was confined to benzodiazepines (relative risk = 1.5; 95% CI 1.2-1.9) and cyclic antidepressants (relative risk = 2.2; 95% CI 1.3-3.5). For these drugs, the relative risk increased with dose and was substantial for high doses: 2.4 (95% CI 1.3-4.4) for > or = 20 mg of diazepam and 5.5 (95% CI 2.6-11.6) for > or = 125 mg of amitriptyline. Analysis of data for the crash-involved drivers suggested that these findings were not due to confounding by alcohol use or driving frequency.

Accidents, Traffic↗

PubMed1994

Human immunodeficiency virus and acquired immunodeficiency syndrome: an update.

Research progress in the understanding of HIV and its effects on the human immune system continues at a rapid pace. Such research is yielding new ideas for chemotherapeutic agents, immunologic stimulators and modifiers, and potential vaccines. Clinical trials to test these approaches are under way. Despite the accomplishments, the epidemic progresses unchecked, resulting in continued suffering and death and enormous demands on the health care system of many nations. Clinicians have had to deal with new and difficult opportunistic infections. Yet advances in the treatment and prevention of these illnesses have benefited many AIDS victims. In the United States, the AIDS epidemic is now concentrating in the inner cities, involving injection drug users, minorities, heterosexuals, women and their offspring. In the developing world, AIDS continues to be predominantly a heterosexually transmitted disease, where more than one third of prostitutes in central African cities are infected. The major burden of the AIDS epidemic in the remainder of this and the next century will be in India and Southeast Asia, again predominantly via heterosexual spread. A great deal is now understood concerning the life cycle of HIV. More light has been shed on the interaction of HIV and CD4+ T cells, the cellular and viral factors involved in viral expression vs. latency, the function of the viral regulatory and structural proteins and the role of cytokines in regulation of HIV expression. Our understanding of the precise mechanisms whereby HIV causes a loss of CD4+ T cells remains incomplete. The direct infection and cell killing of CD4+ T cells is important and is supported by recent evidence demonstrating a high viral burden in these cells in the lymphoid tissue of patients. Over the last 1 to 2 years, there has been new evidence for indirect mechanisms of CD4+ T-cell depletion and/or dysfunction including: autoimmune reactions, perturbations of specific V beta T-cell receptor populations, infection of T-cell precursors in bone marrow and thymus, immunosuppression and dysregulation by viral proteins, possible super-antigen effects, and antigen-induced apoptosis or programmed cell death. New information has come forth in our understanding of B-cell abnormalities in HIV pathogenesis, including the putative role of IL-6 in B-cell activation and the identification of EBV in B-cell lymphomas in the CNS of patients with AIDS. It is expected that these and future discoveries concerning immunopathogenesis of HIV infection will help steer the therapeutic effort. Major strides continue to be made in the therapeutic arena for HIV infection and its complications.(ABSTRACT TRUNCATED AT 400 WORDS)

AIDS Vaccines↗

PubMedDate not supplied

Integrating knowledge generation with knowledge diffusion and utilization: a case study analysis of the Consortium for Applied Research and Evaluation in Mental Health.

OBJECTIVE: Knowledge diffusion and utilization (KDU) have become a key focus in the health research community because of the limited success to date of research findings to inform health policies, programs and services. Yet, evidence indicates that successful KDU is often predicated on the early involvement of potential knowledge users in the conceptualization and conduct of the research and on the development of a "partnership culture". This study describes the integration of KDU theory with practice via a case study analysis of the Consortium for Applied Research and Evaluation in Mental Health (CAREMH). METHODS: This qualitative study, using a single-case design, included a number of data sources: proposals, meeting minutes, presentations, publications, reports and curricula vitae of CAREMH members. RESULTS: CAREMH has adopted the following operational strategies to increase KDU capacity: 1) viewing research as a means and not as an end; 2) bringing the university and researcher to the community; 3) using participatory research methods; 4) embracing transdisciplinary research and interactions; and 5) using connectors. Examples of the iterative process between researchers and potential knowledge users in their contribution to knowledge generation, diffusion and utilization are provided. CONCLUSIONS: This case study supports the importance of early and ongoing involvement of relevant potential knowledge users in research to enhance its utilization potential. It also highlights the need for re-thinking research funding approaches.

Humans↗

PubMed2006

Health care users' satisfaction in Brazil, 2003.

Evaluation of users' satisfaction with the health system brings back longstanding questions concerning the quality of services provided to the Brazilian population. The current study analyzes satisfaction with outpatient and inpatient care based on the results of the World Health Survey, conducted in Brazil in 2003. To explain satisfaction with various aspects of care through a small number of factors, the factor analysis technique was used, through principal components analysis (PCA). Multiple regression models identified associations between satisfaction scores and different sociodemographic variables. For outpatient care, waiting time showed the lowest degree of satisfaction, and in the case of hospitalization, freedom to choose the physician was the worst evaluated aspect. Three components were extracted from the PCA, related respectively to satisfaction with health professionals, health services, and health problem solution. Multiple regression analysis showed that having experienced some type of discrimination (on the basis of gender, age, poverty, social class, skin color, or type of disease) and being an exclusive user of the public National Health System involved a lower degree of users' satisfaction.

Adolescent↗

PubMed2003

A user-friendly programme 'SIMKINERSQUO; for simulation of kinetics involving complex reaction mechanisms.

A programme, 'SIMKINERSQUO; is developed using a semi-implicit extrapolation method (SIEM) which uses the implicit midpoint rule and extrapolation to simulate complex mechanisms based on the kinetics of homogeneous chemical systems. The chemical kinetics pre-processor code is designed to translate a user-specified system of chemical rate equations into a system of chemical kinetic differential equations. The developed programme is applied to the 13-step mechanism of the reaction between Nile blue and acidic bromate. The results obtained compare well with the curves drawn using the other method, reported in literature.

Journal Article↗

PubMed2006

[A two-stage translation and test the validity and reliability of a foreign instrument].

Examination of the reliability and validity of research tools is an important process in nursing research. As all scales are developed on the basis of a specific set of concepts or application to a specific population, great care must be taken in the translation and handling of questionnaires developed in different languages or, in particular, by people from different cultures. Only after passing through an integral process of repetitive translation and reliability/validity examinations can they be regarded as accurate research tools and be widely utilized. This study exercises Brislin's revised Translation Model to overcome cross-cultural differences, and also uses a new research tool developed overseas, the Diabetes Management Self-Efficacy Scale (DMSES), as an example for explaining the two-stage design of the translation and reliability/validity process. The First Stage is the translation stage, which involves forward translation, consensus meetings, backward translation, and review by potential users. The Second Stage involves psychometric analysis, which includes validity and reliability testing. Such careful processes should reveal the problems encountered when adopting foreign scales for domestic use, and thereby increase the "nativeness" and adaptability of these scales.

Equipment and Supplies↗

PubMed1998

A mobile system for recording examination data of the analysis of functional disorders of the masticatory system.

Simplifying and streamlining data access and recording tasks in medical settings is an important and successful application area for mobile computing technology. An interesting research topic in this area are user-interface design concepts that allow for an optimal integration of system operation into working situations where the user is tightly involved in interactions with his physical surroundings. We describe an ongoing project that aims at developing a mobile information system which uses pen-computers for recording data of the analysis of functional disorders of the masticatory system during examination. Long-term goal of this project is the design of an interaction concept that allows for an optimal integration of the system operation into the established examination procedures. A comprehensive questionnaire for the analysis of functional disorders of the masticatory system has been developed. This questionnaire then has been structured with respect to established examination procedures and coded into a pen-computer. Experiences with a first system prototype within the scope of a limited field trial show that our approach is viable and simplifies the recording task. Future work will concentrate on a further streamlining of the user interface by providing additional task-specific graphics interaction techniques and by a detailed study of usage patterns.

Evaluation Studies as Topic↗

PubMed1998

Frail bodies, courageous voices: older people influencing community care.

Involving frail older users of health and social care services in decision making presents particular challenges for those committed to hearing the voices of service users. Age Concern Scotland initiated a project in Fife, the User Panels project, intended to enable older people who were unable to leave their homes without assistance to meet together to develop a collective voice expressing the needs and experiences of older service users. This paper reports on an evaluation of that project. It considers methodological questions posed by the evaluation of projects which aim to empower users, as well as discussing key findings from the evaluation. Older people were recruited through contacts in service agencies and other local organizations. The largest group was aged between 86 and 90 years and all were experiencing difficulties relating to poor health, physical frailty or disability. The project was based on a belief in the value of meeting together as a means through which people could develop the confidence to express their views. Those who became members of the panels valued this experience and reported intrinsic benefits related to the social contact, opportunities for learning and development of self-esteem. Evidence concerning enhanced capacity to exercise control over key aspects of their lives was less convincing. The work of the panels was generally well received by local social work and health agencies and had influenced local action in some areas. Responses to some issues raised by the panels generated a less positive response and the article considers reasons for this. The model is considered to demonstrate benefits both for the older people who become involved and for officials seeking to improve the sensitivity of services to the needs of older people.

Journal Article↗

PubMed2005

The current status of road user injuries among the elderly in Germany: a medical and technical accident analysis.

BACKGROUND: The incidence and treatment of injuries involving the elderly road user are of increasing importance for all fields of trauma care to ensure the best possible outcomes. METHODS: Traffic accident reports were analyzed through technical and medical investigation for the involvement of elderly citizens. RESULTS: In 12,309 documented traffic accidents between 1985 and 1998, 1,843 elderly citizens (65 years and older) were involved, 1,260 of which were reported to have been injured. The mean Injury Severity Score among the injured elderly citizens was 7.3. Of the injured elderly road users, 39.5% were car occupants, 27.4% were bicyclists, 29.6% were pedestrians, 1.8% were truck occupants, and 1.7% were motorcyclists. Of the elderly road users in cars, 53% were not injured, in contrast to only 1.1% of the bicyclists and 0.8% of the pedestrians. Serious or severe injuries (Maximum Abbreviated Injury Scale, >/=2] occurred for 36.5% of the injured elderly road users as car occupants (unrestrained, 58%; restrained, 34%), 57.4% as bicyclists, and 65.4% as pedestrians CONCLUSION: A high rate of motor injuries is associated with vehicle accidents and increased levels of severity among the elderly population. This finding is especially evident for elder pedestrians and bicyclists. Also of note, the elderly even appear to be at risk for sustaining an increased level of injury severity when they are restrained or belt protected.

Abbreviated Injury Scale↗

PubMed2002

Effects of alprazolam on driving ability, memory functioning and psychomotor performance: a randomized, placebo-controlled study.

Alprazolam is prescribed for the treatment of anxiety and panic disorder. Most users are presumably involved in daily activities such as driving. However, the effects of alprazolam on driving ability have never been investigated. This study was conducted to determine the effects of alprazolam (1 mg) on driving ability, memory and psychomotor performance. Twenty healthy volunteers participated in a randomized, double-blind, placebo-controlled crossover study. One hour after oral administration, subjects performed a standardized driving test on a primary highway during normal traffic. They were instructed to drive with a constant speed (90 km/h) while maintaining a steady lateral position within the right traffic lane. Primary performance measures were the Standard Deviation of Lateral Position (SDLP) and the Standard Deviation of Speed (SDS). After the driving test, subjective driving quality, mental effort, and mental activation during driving were assessed. A laboratory test battery was performed 2.5 h after treatment administration, comprising the Sternberg Memory Scanning Test, a Continuous Tracking Test, and a Divided Attention Test. Relative to placebo, alprazolam caused serious driving impairment, as expressed by a significantly increased SDLP (F(1,19) = 97.3, p <.0001) and SDS (F(1,19) = 30.4, p <.0001). This was confirmed by subjective assessments showing significantly impaired driving quality (F(1,19) = 16.4, p <.001), decreased alertness (F(1,19) = 43.4, p <.0001), decreased mental activation (F(1,19) = 5.7, p <.03) and increased mental effort during driving (F(1,19) = 26.4, p <.0001). Furthermore, alprazolam significantly impaired performance on the laboratory tests. In conclusion, alprazolam users must be warned not to drive an automobile or operate potentially dangerous machinery.

Adult↗

PubMed2002

Application of image registration to measurement of intervertebral rotation in the lumbar spine.

In this study, the precision and accuracy of a new method for measuring axial rotations of the lumbar vertebrae, which are thought to be increased in patients with degenerative spinal instability, were estimated. A standard image registration algorithm involving a user-selected center of rotation was adapted for this purpose. Accuracy was tested on a phantom containing a rotating lumbar vertebra. Calculated rotations were compared to the known values. Images were also obtained in subjects, using a tilting table that provided rotation between thorax and hips. For these measurements precision was estimated by varying the center of rotation. In the phantom the method had an accuracy of 0.2 degrees. In the human subject measurements the precision was 0.60-1.5 degrees. The method measured rotations of lumbar vertebrae with sufficient accuracy and precision to detect clinically significant differences in patients with back pain.

Biomechanical Phenomena↗

PubMed1986

Epidemiologic studies of vitamins and cancer of the lung, esophagus, and cervix.

Epidemiologic studies of the relationships between vitamins and 3 types of cancer are reviewed. First, the widely reported association between vitamin A and beta-carotene and risk of lung cancer is considered. In a large population-based case-control study of lung cancer among white males in New Jersey, increased intake of vegetables, dark green vegetables, dark yellow-orange vegetables, and carotenoids were each associated with reduced risk, but intake of retinol or total vitamin A was not related. The protective effect of vegetables was limited to current and recent cigarette smokers, which suggests that vegetable intake prevents a late-stage event in carcinogenesis. Consumption of dark yellow-orange vegetables was consistently more predictive of reduced risk than either the total carotenoid index or consumption of any other food group, possible because of the high content of beta-carotene in this food group. The results and limitations of other epidemiologic studies of diet and lung cancer are reviewed. Second, the evolving relationship between multiple micronutrient deficiencies and esophageal cancer is discussed. In a death certificate-based case-control study of esophageal cancer in black males in Washington, D.C., several indicators of general nutritional status, including consumption of fresh or frozen meat and fish, dairy products and eggs, and fruit and vegetables, and the number of meals eaten per day, were inversely and independently correlated with the risk of esophageal cancer. Estimates of intake of micronutrients, such as carotenoids, vitamin C, thiamin, and riboflavin, were less strongly associated with reduced risk than were the broad food groups that provide most of each micronutrient. Thus no single micronutrient deficiency was identified. Other studies suggest that generally poor nutrition may partially explain the susceptibility of urban black men to esophageal cancer. Finally, the postulated association between low folacin levels and risk of cervical cancer is examined. Among women who use oral contraceptives, serum and red blood cell folacin levels were reported to be lower among those with cervical dysplasia. In a clinical trial involving oral contraceptive users, cervical dysplasia gradually decreased in the group supplemented with oral folate but remained unchanged in the group given the placebo. Other epidemiologic studies of diet and cervical cancer are discussed.

Diet↗

PubMed1999

Meta-manager: a requirements analysis.

The digital imaging network-picture-archiving and communications system (DIN-PACS) will be implemented in ten sites within the Great Plains Regional Medical Command (GPRMC). This network of PACS and teleradiology technology over a shared T1 network has opened the door for round the clock radiology coverage of all sites. However, the concept of a virtual radiology environment poses new issues for military medicine. A new workflow management system must be developed. This workflow management system will allow us to efficiently resolve these issues including quality of care, availability, severe capitation, and quality of the workforce. The design process of this management system must employ existing technology, operate over various telecommunication networks and protocols, be independent of platform operating systems, be flexible and scaleable, and involve the end user at the outset in the design process for which it is developed. Using the unified modeling language (UML), the specifications for this new business management system were created in concert between the University of Arizona and the GPRMC. These specifications detail a management system operating through a common object request brokered architecture (CORBA) environment. In this presentation, we characterize the Meta-Manager management system including aspects of intelligence, interfacility routing, fail-safe operations, and expected improvements in patient care and efficiency.

Arizona↗

PubMed2003

The European phenology network.

The analysis of changes in the timing of life cycle-events of organisms (phenology) has been able to contribute significantly to the assessment of potential impacts of climate change on ecology. These phenological responses of species to changes in climate are likely to have significant relevance for socio-economic issues such as agriculture, forestry and human health and have proven able to play a role in raising environmental awareness and education on climate change. This paper presents the European Phenology Network (EPN), which aims to increase the efficiency, added value and use of phenological monitoring and research, and to promote the practical use of phenological data in assessing the impact of global (climate) change and possible adaptation measures. The paper demonstrates that many disciplines have to deal with changes in the timing of life-cycle events in response to climate change and that many different user groups are involved. Furthermore, it shows how EPN addresses issues such as (1) raising public awareness and education, (2) the integration and co-operation of existing observing systems, (3) integration and access to phenological information and (4) communication.

Adaptation, Physiological↗

PubMed2003

Evaluation of a transpedicular drill guide for pedicle screw placement in the thoracic spine.

Insertion of pedicle screws in the thoracic spine is technically difficult and may lead to major complications. Although many computer-assisted systems have been developed to optimize pedicle screw insertion, these systems are expensive, not user-friendly and involve significant radiation from pre-operative computed tomographic (CT) scan imaging. This study describes and evaluates a transpedicular drill guide (TDG) designed to assist in the proper placement of pedicle screws in the thoracic spine. Pilot holes were made manually using the TDG in the thoracic spine (T1-T11) of three human cadavers before inserting 4.5-mm-diameter screws. CT scans followed by visual inspection of the spines were performed to evaluate the position of the screws. Five of 66 screws (7.6%) violated the pedicle wall: two (3.0%) medially and three (4.5%) laterally. The medial and lateral perforations were within 1 mm and 2 mm of the pedicle wall, respectively. The medial perforations were not at risk of causing neurological complications. No screw penetrated the superior or inferior pedicle wall. The TDG is easy to use and can decrease the incidence of misplaced thoracic pedicle screws. The TDG could be used as a complement to fluoroscopy in certain applications, especially for training surgeons.

Aged↗