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Results for “user involvement”

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PubMed1984

Microbiological and histological findings in the fallopian tubes of women using various contraceptive methods.

The oviducts of seventy-three women undergoing sterilization by partial salpingectomy were submitted for microbiological and histologic studies. Twenty women were intrauterine device users, twenty-five women were oral contraceptive pill users and twenty-eight women used natural or barrier methods of contraception. Among intrauterine device users, there was an excess of mild and severe acute inflammatory histologic changes involving both the lumen and the tubal mucosa. Five of the eight intrauterine device users with acute inflammatory change had sterile tubal cultures.

Bacteriological Techniques↗

PubMed1986

Health care financing in Kenya: a simulation of welfare effects of user fees.

This paper examines the efficiency and equity effects of introducing user fees in public health facilities in Kenya. These effects are studied with the aid of a simulation technique. It is found that through their favourable effects on quality of medical services, the user fees in public clinics would yield welfare gains. However, these gains might involve unacceptable equity trade-offs. Thus, in general, the net welfare effects of user charges on medical services is ambiguous. More specifically, if the user fees were imposed across the board in government health facilities, the equity trade-offs would be large, and for that reason, the user fees would be socially and politically unacceptable. But, if the user charges are restricted to government hospitals, the attendant equity problem would not be too difficult to manage.

Developing Countries↗

PubMed1976

The spread of addiction-the role of the "average addict".

A survey of an accidental sample of 100 addict-clients indicates that approximately two-thirds of addicts induct others into the heroin culture. Typically, the number of new users recruited in this way is no more than one or two new users contacted by each experienced addict. The problems of interdicting the transmission process is complicated not only by the large numbers of persons involved in that process, but is further complicated by the fact that new users are recruited relatively early in the experienced users' careers when they are least likely to be known to treatment or law enforcement officials. The work of interdicting the spread of phenomenon is still further complicated by the fact that heroin is transmitted between friends under circumstances the experienced user can characterize, if with some possible exaggeration, as involving an effort to share a pleasurable experience and/or to meet others' requests.

Adult↗

PubMed2001

High dose cocaine use in São Paulo: a comparison of treatment and community samples.

This cross-sectional study investigates patterns of drug use and associated problems among 332 cocaine users from treatment and community samples in São Paulo, Brazil. Data were collected using a structured questionnaire and the Severity of Dependence Scale (SDS). The majority were regular users of high doses of smoked cocaine. After controlling for severity of cocaine use, users in the community were found to be more involved in illegal activities, more likely to report adverse effects of cocaine, to be involved in prostitution, and to have lived on the streets. Better methods are required to provide interventions to tackle the problems and risk behaviors of these cocaine users.

Adult↗

PubMed1986

An infocentric view of the hospital information system.

The development of HISs has evolved from a piebald collection of stand-alone applications to a well conceived collection of integrated modules. The current generation of both computer hardware and the development tools available on the hardware have facilitated the creation of these infocentric applications. The willingness of healthcare professionals--from doctors and nurses to administrators--to become more involved in the design and implementation has created more sophisticated and appropriate application modules. Multiple development sites have resulted in more flexible systems which can be more readily adapted to a larger set of end users. The cumulative result of this current technology and professional involvement is a collection of systems which are better suited for the end user; and which are more cost effective to implement. If these current trends continued, it is possible that we will see much of the promise envisioned in the early days of HIS development available to the individual HIS user. However, the dynamic characteristics of the healthcare industry warn us that we cannot allow our systems to become stagnant. Everyone with computer responsibility must be vigilant to the kaleidoscopic modifications in requirements if the infocentric based systems are to be a propitious tool for the suppliers of healthcare services.

Computers↗

PubMed1998

An NMR assignment module implemented in the Gifa NMR processing program.

MOTIVATION: Peptide and protein structures are determined daily using NMR spectroscopy. Assignment of the NMR spectra is an important step within the procedure and is usually the limiting one. Computer-aided assignment tools should be user friendly with open architecture to communicate with other programs involved in the structure determination. RESULTS: Here we present an interactive NMR assignment module which provides numerous graphic tools for the user. The module is composed of a database management system-handling peaks, spins and spin-systems. The assignment information is maintained as a set of interrelated associative arrays, which serve as generic high-level data structures. The module is developed in the macro language embedded in the Gifa NMR processing program (Pons et al. , J. Biomol. NMR, 8 , 445-452, 1996). This provides the user with a consistent interface, a set of sophisticated tools, and an easily extendible and customizable environment. AVAILABILITY: The program is available on request from the authors. The Gifa package can be accessed at: ((http://www.cbs. univ-montp1.fr/GIFA)) CONTACT: Marc-Andre.Delsuc@cbs.univ-montp1.fr

Database Management Systems↗

PubMed2003

Power lawnmower injuries.

Power lawnmowers are among the most ubiquitous household tools, yet they pose significant danger to operator and bystanders. Despite of the United States Consumer Products Safety Commission's push to have safety standards established for walk-behind mowers in 1982 and for ride-on mowers in 1986, by 2000 approximately 80,000 injuries nationwide were estimated to be associated with power mowers. Large numbers of these injuries are thought to be preventable, especially those to individuals younger than 14 years. Orthopaedic surgeons treat a significant number of the injuries associated with mower use including lacerations, amputations, fractures, infections, and skin defects. Therefore, the orthopaedic community has a stake in the prevention and outcome of these injuries. To date, changes in mower design have seemed to be more successful than user education programs in decreasing the numbers of these injuries. Involving orthopaedists in safety education programs to help prevent injuries associated with power mower use may be one method of increasing user knowledge and preventing injury.

Accident Prevention↗

PubMedDate not supplied

AIDS and the provision of drug user treatment.

The emergence of AIDS has triggered significant change in drug user treatment practices. The vast majority of programs are involved in some aspects of AIDS prevention counseling, large numbers encourage HIV testing, and an increasing number of programs offer on-site testing. Resources available to drug user treatment for AIDS prevention will likely depend on the perceived threat of AIDS to the larger community, and the public's belief in the capacity of treatment programs to reduce that threat. Programs will likely face often contradictory demands regarding service delivery. They may be asked to increase client flow while also retaining clients more effectively, providing aftercare, and working with the client's sexual partner(s). It will be the role of program administrators to provide for staff recruitment, retention, and support in an increasingly difficult environment. Alternative treatment settings will need to be explored for those intravenous drug users who cannot or will not enter existing treatment programs.

Acquired Immunodeficiency Syndrome↗

PubMed2006

Developing library bioinformatics services in context: the Purdue University Libraries bioinformationist program.

SETTING: Purdue University is a major agricultural, engineering, biomedical, and applied life science research institution with an increasing focus on bioinformatics research that spans multiple disciplines and campus academic units. The Purdue University Libraries (PUL) hired a molecular biosciences specialist to discover, engage, and support bioinformatics needs across the campus. PROGRAM COMPONENTS: After an extended period of information needs assessment and environmental scanning, the specialist developed a week of focused bioinformatics instruction (Bioinformatics Week) to launch system-wide, library-based bioinformatics services. EVALUATION MECHANISMS: The specialist employed a two-tiered approach to assess user information requirements and expectations. The first phase involved careful observation and collection of information needs in-context throughout the campus, attending laboratory meetings, interviewing department chairs and individual researchers, and engaging in strategic planning efforts. Based on the information gathered during the integration phase, several survey instruments were developed to facilitate more critical user assessment and the recovery of quantifiable data prior to planning. NEXT STEPS/FUTURE DIRECTIONS: Given information gathered while working with clients and through formal needs assessments, as well as the success of instructional approaches used in Bioinformatics Week, the specialist is developing bioinformatics support services for the Purdue community. The specialist is also engaged in training PUL faculty librarians in bioinformatics to provide a sustaining culture of library-based bioinformatics support and understanding of Purdue's bioinformatics-related decision and policy making.

Computational Biology↗

PubMed2001

Effects of geared motor characteristics on tactile perception of tissue stiffness.

Endoscopic haptic surgical devices have shown promise in addressing the loss of tactile sensation associated with minimally invasive surgery. However, these devices must be capable of generating forces and torques similar to those applied on the tissue with a standard endoscopic tool. Geared motors are a possible solution for actuation; however, they possess mechanical characteristics that could potentially interfere with tactile perception of tissue qualities. The aim of the current research was to determine how the characteristics of a geared motor suitable for a haptic surgical device affect a user's perception of stiffness. The experiment involved six blindfolded subjects who were asked to discriminate the stiffness of six distinct silicone rubber samples whose mechanical properties are similar to those of soft tissue. Using a novel testing device whose dimensions approximated those of an endoscopic grasper, each subject palpated 30 permutations of sample pairs for each of three types of mechanical loads; the motor (friction and inertia), a flywheel (with the same inertia as motor), and a control (no significant mechanical interference). One factor ANOVA of the error scores and palpation time showed that no significant difference existed among error scores, but mean palpation time for the control was significantly less than for the other two methods. These results indicated that the mechanical characteristics of a geared motor chosen for application in a haptic surgical device did not interfere with the subjects' perception of the silicone samples' stiffness, but these characteristics may significantly affect the energy expenditure and time required for tissue palpation. Therefore, before geared motors can be considered for use in haptic surgical devices, consideration should be given to factors such as palpation speed and fatigue.

Biomechanical Phenomena↗

PubMed1985

Group B-beta haemolytic streptococcal colonization in women using intrauterine contraceptive devices.

Two-hundred-and-eighteen gynaecological patients were screened for group B-beta haemolytic streptococci (GBS) colonization of the vagina, cervix, urethra and rectum. The overall colonization rate was 17%. There is no relation between the rate of colonization and the patient's age or parity. The colonization rate among the intrauterine contraceptive device (IUCD) users (31%) is significantly higher than the non-users (14.5%). The IUCD does not cause GBS vaginal colonization. Nevertheless, its presence helps the microorganisms' vertical spread through the cervical canal. The short duration of IUCD use among the Saudi patients may have provided a protective mechanisms against the development of PID. All the four sites were colonized in the IUCD users and only in 8.1% of the non-users. The urethra was the most common site involved in both groups (83.8%). A higher incidence of GBS colonization was found among patients presenting with excessive vaginal discharge as the main complaint. The presence of excessive vaginal discharge is a significant factor towards the spread of the microorganism to the cervix and urethra. Therefore, an IUCD user with excessive vaginal discharge has a higher chance of getting cervical and urethral colonization.

Adolescent↗

PubMed2026

Invasive Wickerhamomyces anomalus Infections among Injecting Drug Users, France, 2012-20241.

Wickerhamomyces anomalus is a yeast rarely involved in human invasive fungal diseases (IFD). We retrospectively analyzed 44 episodes of W. anomalus IFD in France during 2012-2024. Injecting drug use (IDU) was the main risk factor among 26/35 (74.3%) incident cases. Most infections were community acquired; overall 3-month mortality rate was 1/30 (3.3%). Short tandem repeat (STR) genotyping and whole-genome sequencing analyses revealed substantial genetic diversity among isolates. However, 1 STR genotype was shared by 2 IDU patients, suggesting common exposure. In addition, 1 isolate obtained from a cotton filter used for drug preparation was identical by STR genotyping to the bloodstream isolate from the same patient, indicating direct inoculation via contaminated material or poor injection practices. Our findings highlight the increased risk for W. anomalus IFD among IDU patients and emphasize the importance of targeted preventive measures within that population.

Humans↗

PubMed1993

Safe sex? Misconceptions, gender differences and barriers among injection drug users: a focus group approach.

Heterosexual transmission is one factor involved in the spread of the human immunodeficiency virus (HIV) within the injection drug use (IDU) population and between IDU and non-IDU individuals. Insufficient information is currently available to reduce this heterosexual transmission. As a basis for designing a questionnaire aimed at the IDU population, we conducted 5 focus groups to collect information on knowledge of and attitudes toward safe sex as held by male and female IDUs in methadone treatment. We identified misconceptions related to HIV infection, condoms, and sexual behavior. We also found gender-based differences in knowledge and learning style. Also, while individuals felt a responsibility to prevent HIV transmission, they lacked sufficient control to do so. The wide range of responses on questions concerning sexually transmitted diseases (STDs), condoms, reproductive decisions, and methods of promoting safe sex provides a basis for developing a questionnaire designed to identify and target specific subgroups for educational intervention.

Adult↗

PubMed2004

The effect of alcohol on incidence, pattern, severity and outcome from traumatic brain injury.

Alcohol consumption is known to be a major contributing factor for the occurrence of traumatic brain injuries (TBIs) in both developed and developing countries. It also influences diagnosis, management and recovery from TBIs, subsequent to injury occurrence. The present report examines the association of alcohol in injury occurrence, and its impact on severity and outcome from TBIs. Subjects were identified from 7 major hospitals in the city of Bangalore, India with data collection undertaken by standardised methods. Alcohol users (n = 243) and non-users (n = 1310) were compared on various characteristics and injury details. Sixteen per cent of the injured patients were intoxicated at the time of hospital registration. While the incidence of road traffic injuries was similar in both the groups, falls were higher in the alcohol user group. Evening-and night-time consumption of alcohol was a major risk factor for injuries. Drivers and occupants of motorised two wheeler vehicles, and pedestrians were involved in crashes to a greater extent among alcohol users. Severity of brain injuries (based on Glasgow coma scale), duration of hospital stay, death and post-traumatic disabilities among alcohol users were significantly higher compared with non-users. With the emergence of injuries and alcohol as twin major public health problems, immediate efforts are required to reduce the burden in developing societies. Legislative and enforcement strategies along with education developed on epidemiological, clinical and public health research need to be co-ordinated, target oriented, visible and with stiffer penalties for achieving desired results.

Accidents, Traffic↗

PubMed1995

Business modeling tools for managing decision support systems.

We sought to investigate the role of business modeling tools in facilitating the implementation of interactive decision support systems (DSS) for laboratory test ordering. We have recently shown that Ripple Down Rules (RDR), a new strategy for building expert systems (ES), enables institutions to build DSS maintained by local experts without knowledge engineering support. While DSS hold great promise for improving health outcomes by providing doctors with timely access to care guidelines, implementation will require careful planning and change management. The Situated, Strategic, and AI-Enhanced method was used to define and assess a DSS-driven process change. DECmodelTM, a graphical business modeling application, was used to build representations of current (paper-based) and future (ES-supported) test ordering environments. Models described both the interactions between new processes and the impact on healthcare quality of ES-supported DSS. Models were able to represent the key processes involved in test ordering and the impact of DSS. Users could interact with the model to examine the time and cost implications of the transition from current to future states. The level of detail in which processes could be examined was readily controlled by the user. We have shown that graphical business modeling applications are useful tools for enabling institutions to view the impact of DSS. Accuracy of models should be maximized in workshops involving key management personnel. Whilst the impact of modeling on the cost and quality of DSS implementation remains to be established, we believe these tools are valuable for institutions planning to align DSS technologies to their service needs.

Australia↗

PubMed2005

Long-term effects of MDMA (Ecstasy) on the human central nervous system revealed by visual evoked potentials.

Several studies indicate long-term cognitive impairment of MDMA (ecstasy) users. In the present study we attempted to establish whether electrophysiological correlates of low-level cognitive processes present a long-term alteration, dependent on the level of use of ecstasy. We addressed this issue by investigating amplitude and latency of VEPs related to a very simple discrimination task involving sustained attention (arousal). Eight heavy-MDMA users, eight moderate-MDMA users and 18 drug-free control subjects were asked to discriminate whether the digit at the centre of the screen was 1 or 2. None of the subjects (except one) had used MDMA in the 6 months previous testing. We measured psychophysical performance and EEG, recorded in Oz and Fz during task execution. The heavy-MDMA users made significantly more errors than the other two groups (p < .05). Moreover, they presented reduced amplitude but not latency of VEPs in both Oz and Fz. The effect in Oz is present in P200 (for heavy users only, p < .05) and in P300 components (for both MDMA groups; heavy users: p < .001, moderate users: p < .0.5). In Fz, the amplitude effect is present in N250 (for heavy users only, p < .05) and in P300 components (for both MDMA groups; heavy users: p < .05, moderate users: p < .05). The three groups do not differ in early components, reflecting low-level processing. These results provide evidence of long-term electrophysiological abnormality displayed by ecstasy users and agree with the suggestion that even typical recreational doses of ecstasy are sufficient to cause long-term altered cortical activity in humans.

Adult↗

PubMed2006

Comparing injecting and non-injecting illicit opioid users in a multisite Canadian sample (OPICAN Cohort).

Illicit opioid use in Canada and elsewhere increasingly involves a variety of opioids and non-injection routes of administration. Injection and non-injection opioid users tend to differ in various key characteristics. From a public health perspective, non-injection routes of opioid use tend to be less harmful due to lesser morbidity and mortality risks. Our study compared current injectors (80%) and non-injectors (20%) in a multi-site sample of regular illicit opioid users from across Canada ('OPICAN' study). In bivariate analysis, injectors and non-injectors differed by prevalence in social and health characteristics as well as drug use. Logistic regression analysis identified city, drug use, housing status and mental health problems as independent predictors of injection status. Further analysis revealed that the majority of current non-injectors had an injection history. Our results reinforce the need to explore potential interventions aimed at preventing the transition from non-injectors to injecting, or facilitating the transition of injectors to non-injecting, as initiated in several other contexts.

Adult↗

PubMed2000

Measuring clients' satisfaction with self-help agencies.

OBJECTIVE: Clients' satisfaction with their involvement in treatment decisions has been largely overlooked in the formulation of satisfaction measures. The authors describe the development of a scale that assesses clients' satisfaction with services and with their involvement in treatment decisions. METHODS: Long-term users of four client-operated mental health self-help agencies were interviewed at baseline (N=310) and six months (N=248) using the 11-item Self-Help Agency Satisfaction Scale (SHASS). The scale was developed on the basis of consumers' input about their satisfaction with services and their involvement in treatment decisions. To explore the relationship between satisfaction as measured by the SHASS and outcomes, the six-month interview included four outcome measures-independent and assisted social functioning, symptom severity, and a sense of personal empowerment. Internal consistency, stability, and discriminant validity were evaluated. RESULTS: Factor analyses confirmed that the SHASS has two subscales, one assessing service satisfaction and the other assessing satisfaction with involvement in treatment decisions. The scale and its subscales showed high internal consistency, moderate stability, and discriminant validity. The SHASS subscales showed modest associations with two of four outcome measures-assisted and independent social functioning. CONCLUSIONS: The SHASS is a brief instrument that can be used to measure clients' satisfaction with their involvement in treatment in mental health self-help agencies.

Adult↗