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PubMed1997

An analysis of work postures of manual wheelchair users in the office environment.

The goal of this project was to examine the difficulties manual wheelchair users experience in office activities and ascertain whether such problems may be due to poor relationships between the equipment and the users. Sixty adult manual wheelchair users completed a questionnaire about problems encountered in office activities. Filing and writing were the most problematic activities for this group. Phase II of this study consisted of videotaping four subjects performing each activity in their personal office environments, and having them complete a second questionnaire on body-specific locations of discomfort. Videotaped postures and reports of discomfort were matched to determine the existence of poor equipment-user relationships. In filing, low back pain may have been due to bending forward to access lower drawers while seated. For writing, an inappropriate desk-wheelchair relationship that required subjects to bend forward with their arms on a surface that was too high may have caused back, shoulder, and neck discomfort.

Adult↗

PubMed2003

'Follow the Fish': involving young people in primary care in Midlothian.

OBJECTIVES: The project aims were to enable young people to contribute their views about health services, to encourage professionals and policy makers to listen to the young people and to stimulate action to address the issues raised. DESIGN: Peer interviews were undertaken by a team of five young people to identify the experience and views of young people of various ages about health services. Drama workshop sessions were conducted with 10-15 young people, encompassing initial issue-identifying activities and group discussion about their own experience of, and views about health services, followed by role-play and improvisation to construct drama scenarios about the issues gathered from the interviews and discussions. SETTING AND PARTICIPANTS: Twenty young people aged 12-16 years from the Mayfield and Gorebridge areas of Midlothian were recruited from Newbattle Community High school. The project was conducted as a voluntary after-school activity for 12 weeks. RESULTS: A drama was constructed from research conducted by young people into the experiences and views of their peer group about health services. A cast of young people performed the drama to an invited audience of 30 health and education professionals and held a post-performance question and answer session with the audience to explore the issues raised. The drama engendered a number of practical outcomes related to improving the usage and experience of health services of young people. CONCLUSIONS: Drama can offer a means to encourage participation, facilitate participants' self-expression and explore health/health service themes and issues. In conjunction with conventional techniques such as interviews and group discussions, a drama project can also be used to communicate the experience, views and needs of the wider client group to service providers and planners. Such initiatives can generate outcomes to improve service users' experience of health services.

Adolescent↗

PubMed2000

Lesbian, gay and bisexual experiences within critical care nursing, 1988-1998: a survey of the literature.

The aim of this paper is to provide an analysis of the extent to which gay, lesbian and bisexual service user experiences are represented within the critical care literature. A survey of five well established critical care journals, covering the period 1988-1998, was conducted in order to reveal the range of themes addressed within them. The findings suggest that these groups are invisible in this field of practice and consequently their particular concerns have remained marginalised. The implications of this absence are far reaching, potentially inhibiting nurses from establishing effective caring relationships with either lesbians, gays or bisexuals and from identifying and developing appropriate interventions for the care of these patients and their families.

Bibliometrics↗

PubMed1997

Experience of Finnish women with Norplant insertions and removals.

OBJECTIVE: Norplant and Norplant-2 have been available for use by Finnish women since 1984 and 1986, respectively. The objective of this study was to explore Norplant users' experiences of insertions, removals and medical treatments. DESIGN: A questionnaire was sent to women who had received Norplant or Norplant-2 implants one to two years earlier (n = 262) in normal clinical settings; the response rate was 79%. RESULTS: At insertion, problems were experienced by 9% and at least some pain by 23% of women. During the first year 20% of all users (14% of Norplant and 33% of Norplant-2 users) had their implants removed. Problems were experienced at removal by 33% of women and pain was experienced by 40%; nevertheless most users were satisfied with the device. Findings were similar for the two types of Norplant. Forty-two percent of the women had received minipills containing levonorgestrel before Norplant insertions in an attempt to assess Norplant's suitability, and 8% had received drugs for adverse effects caused by Norplant. CONCLUSIONS: Studies including perspectives of Norplant users and the whole lifespan of Norplant (including removal) should be conducted in all clinical settings where Norplant is provided.

Contraceptive Agents, Female↗

PubMed1999

Exploring 'person-centredness': user perspectives on a model of social psychiatry.

This paper explores service users' experiences of a 'person-centred' mental health service. We describe the development of a model of social psychiatry that places the emphasis on the experiences of the person within social and political contexts. This establishes the foundations of a 'person-centred' approach, the values of which are described briefly. The results of interviews with 20 people are presented, in which their experiences of the service are explored in detail. These interviews reveal the struggle that lies at the heart of the professional-service user dialectic, which relates to issues of institutional power, roles and responsibility, and which places professional staff in conflict with the very notion of 'person-centredness'. No matter how 'person-centred' a mental health service may strive to be, there remain serious obstacles to the full realization of this approach. Despite this critique, there were many things that were valued by those who used the service. More detailed qualitative studies are required to explicate the complex relationships and paradoxes that emerged.

Journal Article↗

PubMed2003

Risks and benefits, advantages and disadvantages of levonorgestrel-releasing contraceptive implants.

Levonorgestrel-releasing implants are long acting contraceptives, approved for 5 years of continuous use. Two marketed systems, the six capsule Norplant use of tradenames is for product identification purposes only and does not imply endorsement. and the two rod Jadelle, have essentially equal rates of drug release, pregnancy and adverse events over 5 years of use. Randomised clinical trials and controlled cohort observations indicate that for the first 3 years, when pregnancy rates are at or almost zero, no other contraceptive system is more effective, although etonogestrel implants provide equal effectiveness. Annual pregnancy rates rise in the fifth year of continuous use but remain below 1 per 100 women. Annual pregnancy rates of Norplant users remain below 1 per 100 throughout 7 years of continuous use. Levonorgestrel implants provide low progestogen doses; 40-50 microg/day at 1 year of use, decreasing to 25-30 microg/day in the fifth year. Serum levels of levonorgestrel at 5 years are 60-65% of those levels measured at 1 month of use. Adverse effects with levonorgestrel implants are similar to those observed with progestogen only and combined oral contraceptives. Risks of ectopic pregnancy, other pregnancy complications and pelvic inflammatory disease are reduced in comparison with those of women using copper or non-medicated intrauterine devices. Risks of developing gallbladder disease and hypertension or borderline hypertension, although small, are about 1.5 and 1.8 times greater, respectively, in women using levonorgestrel implants than in women not using hormonal contraception. Other serious diseases have not been found to occur significantly more frequently in levonorgestrel implant users than in women not using hormonal contraception. The great majority of levonorgestrel implant users experience menstrual problems, but serious bleeding problems are not more frequent than in controls. Other health problems reported more frequently by levonogestrel implant users than by women not using hormonal contraception in a study of 16000 women included skin conditions, headache, upper limb neuropathies, dizziness, nervousness, malaise, minor visual disturbances, respiratory conditions, arthropathies, weight change, anxiety and non-clinical depression. Clinical depression is not more frequent in women using implants compared with those not using hormonal contraception (i.e. using intrauterine devices, sterilisation). Removal problems occur less frequently with Jadelle than with Norplant. The mean removal time for Jadelle is half that of Norplant. Levonorgestrel implants in nationally representative scientific samples, in randomised trials, and in controlled cohort studies have continuation rates as high as or higher than any other reversible contraceptive over a duration of 5 years. This would imply that the satisfaction women derive from the contraceptive effectiveness of levonorgestrel implants greatly outweighs the dissatisfaction that may accompany menstrual disturbances and other adverse effects associated with implants.

Contraceptive Agents, Female↗

PubMed1993

[Profiles of regular consumers of benzodiazepines in a family practice].

OBJECTIVE: To describe the profile of regular users of benzodiazepines in a general practice. DESIGN: Case-control study. SETTING: A duo general practice in Nijmegen. METHOD: Of all regular users of benzodiazepines in a general practice, socio-demographic and morbidity data were collected and the use of benzodiazepines (duration, frequency, type of agent) was determined. By means of a semi-structured interview, the users' experiences and opinions were inventoried. Psychological and physical functioning were determined using the symptom checklist (SCL-90). RESULTS: In the group of 99 users (3.1% of the practice population), 53 (1.6% of the practice population) used benzodiazepines every day and had done so for over one year. Most were women over 65 years of age, living alone and with a low educational level. Over 25% were patients with psychiatric/psychogeriatric disorders. Users had frequent chronic diseases, particularly articular disorders and chronic skin diseases. The SCL-90 results indicated a high degree of psychoneuroticism. Most patients felt the medication enabled them to cope better with difficult situations, and the side effects reported were limited in number and severity. CONCLUSION: Users of benzodiazepines were in a high-risk position, both socio-economically and as regards health and mental well-being. Given a strict prescribing policy, the group of chronic users of benzodiazepines was small and easy to control in this practice.

Adult↗

PubMed2001

Utility of the AIDA diabetes simulator as an interactive educational teaching tool for general practitioners (primary care physicians).

In previous "Diabetes Information Technology & WebWatch" columns, various user experience with an interactive educational "virtual diabetes patient" simulator called AIDA have been documented. The simulator is available free of charge from http://www.2aida.org on the Web, and user comments that have been received to date about the program have highlighted some of the many and varied ways in which a range of people have been applying the diabetes simulations in their own particular situations and practices. Inevitably, up to now, a great deal of attention has focused on use by individuals with diabetes and their relatives, as well as by health-care professionals such as diabetologists/endocrinologists and diabetes educators. However, an important group of health-carers involved in the provision of day-to-day care for many people with diabetes are primary care physicians (general practitioners). The current "Diabetes Information Technology & WebWatch" column addresses this area, overviewing a workshop which was held in September 2000 in Italy to gain experience with application of the AIDA diabetes simulation approach as a teaching tool for general practitioners (GPs). Feedback obtained from participants attending the workshop was very positive, with GPs reporting the simulation approach to be both of interest and use. Further workshops involving other healthcare professionals--in particular, nurses--are planned.

Computer Simulation↗

PubMedDate not supplied

Spontaneous comments from users of the AIDA interactive educational diabetes simulator.

The user experience with the AIDA simulator demonstrates one of the advantages of making such diabetes software readily available for free via the Internet. The comments collectively provide a picture of some of the many and varied ways in which the simulator has been applied by different users. These comments also demonstrate the potential for empowerment that some people feel can result from the use of the software. The experience with this approach is sufficiently encouraging to warrant formal evaluation studies to quantify the clinical utility of such an interactive educational diabetes simulation program. For this reason, a formal survey of 200 AIDA users (patients, relatives, and healthcare professionals) from at least 15 different countries is currently ongoing, and further formal evaluation studies in the clinic setting are planned.

Attitude of Health Personnel↗

PubMed2006

Issues in auditory display.

Auditory displays have been successfully deployed to assist data visualization in many areas, but have as yet received little attention in the field of artificial life. This article presents an overview of existing design approaches to auditory display and highlights some of the key issues that are of practical relevance to the use of auditory displays in artificial life research. Examples from recent experiments are used to illustrate the importance of considering factors such as data characteristics, data-display mappings, perceptual interactions within and between display modalities, and user experience and training in designing new visualization tools. It is concluded that while further research is needed to develop generic design principles for auditory display, this should not stand in the way of exploration of bespoke designs for specific applications.

Artificial Intelligence↗

PubMed2006

Anxiety's relationship to inconsistent use of oral contraceptives.

Five percent of typical oral contraceptive users experience an unintended pregnancy every year. Inconsistent use of oral contraception may be a leading contributor to the high rate of unintended pregnancy among oral contraceptive users. Previous medical research also suggests that anxiety may play a role in medication compliance, yet no known studies have examined the relationship between anxiety and oral contraceptive use. To test this relationship, the authors analyze data from the National Survey of Family Growth Cycle V (NSFG-V), restricting their sample to sexually active women currently taking oral contraceptives. They find that women who report multiple episodes of anxiety lasting at least 6 months have a greater probability of inconsistent use. The authors suggest goals for future research and discuss the role of health care professionals in addressing oral contraception compliance in light of their findings.

Adolescent↗

PubMed2004

Determinants of overdose incidents among illicit opioid users in 5 Canadian cities.

BACKGROUND: Drug overdose is a major cause of death and illness among illicit drug users. Previous research has indicated that most illicit drug users experience nonfatal overdoses and has suggested a variety of factors that are associated with risk of overdose. In this study, we examined the occurrence of and the factors associated with nonfatal overdoses within a Canadian sample of illicit opioid users not enrolled in treatment at the time of study recruitment. METHODS: Interviewers used a standard questionnaire to collect data on sociodemographic characteristics, drug use, health and health care, experience in the criminal justice system and treatment for drug problems; they also performed standard assessments for mental health and infectious disease. The association between overdose and sociodemographic and drug-use factors was examined with chi(2) and t test analyses; marginally significant variables were examined with logistic regression to determine independent effects. RESULTS: A total of 679 subjects were interviewed; 651 provided answers sufficient for this analysis. One hundred and twelve (17.2%) of the 651 respondents reported an overdose episode in the previous 6 months. In the logistic regression analysis (after adjustment for sociodemographic factors), homelessness, noninjection use of hydromorphone in the past 30 days and involvement in drug treatment in the past 12 months were predictors of overdose (p < 0.05). INTERPRETATION: Overdose poses a considerable health risk for illicit opioid users. We found that a diverse set of factors was associated with overdose episodes. Prevention efforts will likely be more effective if they can be directed to specific causal factors.

Adult↗

PubMed2004

Neck discomfort of wheelchair users: effect of neck position.

PURPOSE: To test the hypothesis that wheelchair users experience more discomfort when holding their necks in extended and/or rotated positions than when in their self-selected most comfortable positions (MCPs). METHODS: We studied 20 wheelchair users, first determining their MCPs with the eyes closed. Then, subjects assumed and maintained (for 5 min each) four neck positions in random order: level (L) and elevated (E), both straight ahead of the subject (S) and with the neck rotated (R). We measured neck extension angles (from digital photographs) and neck discomfort (using visual analogue scales [VAS], in %). RESULTS: The mean neck-extension angles were MCP - 2.6 degrees, LS 9.5 degrees, LR 8.1 degrees, ES 23.9 degrees and ER 25.4 degrees (ANOVA p < 0.0001). The mean VAS neck discomfort scores were LS 5.7%, LR 17.4%, ES 24.0% and ER 34.1% (ANOVA p < 0.0001). CONCLUSIONS: Sustained extension and rotation of the neck, alone or in combination, increase the neck discomfort of wheelchair users. The MCP for most wheelchair users is straight ahead with the neck slightly flexed, about 11 degrees and 27 degrees more flexed, respectively, than when looking at an average-height sitting or standing person. These findings have implications for wheelchair design, the behaviour of clinicians and wheelchair users, and the built environment.

Female↗

PubMed2000

Challenges in electronic importing of health data.

The objective of this article is to increase awareness among public health personnel of the complexities involved in integrating existing data systems. This article describes the electronic importing feature of the Centers for Disease Control and Prevention (CDC) software package called staffTRAK-TB, and users' experience with it.

Attitude of Health Personnel↗

PubMed2000

Scenario building as an ergonomics method in consumer product design.

The role of human factors in design appears to have broadened from data analysis and interpretation into application of discovery and "user experience" design. The human factors practitioner is continually in search of ways to enhance and to better communicate their contributions, as well as to raise the prominence of the user at all stages of the design process. In work with design teams on the development of many consumer products, scenario building has proved to be a valuable addition to the repertoire of more traditional human factors methods. It is a powerful exploration, prototyping and communication tool, and is particularly useful early on in the product design process. This paper describes some advantages and potential pitfalls in using scenarios, and provides examples of how and where they can be usefully applied.

Ergonomics↗

PubMedDate not supplied

Knowledge precepts for design and evaluation of information visualizations.

The design and evaluation of most current information visualization systems descend from an emphasis on a user's ability to "unpack" the representations of data of interest and operate on them independently. Too often, successful decision-making and analysis are more a matter of serendipity and user experience than of intentional design and specific support for such tasks; although humans have considerable abilities in analyzing relationships from data, the utility of visualizations remains relatively variable across users, data sets, and domains. In this paper, we discuss the notion of analytic gaps, which represent obstacles faced by visualizations in facilitating higher-level analytic tasks, such as decision-making and learning. We discuss support for bridging these gaps, propose a framework for the design and evaluation of information visualization systems, and demonstrate its use.

Algorithms↗

PubMed2005

Pain experienced by electric-powered chair users: a pilot exploration using pain drawings.

BACKGROUND AND PURPOSE: Many wheelchair users experience pain or discomfort, and little is known about its severity or nature. The present study explored the feasibility of using visual analogue scales and pain drawings to assess the intensity and distribution of pain in users of electric-powered indoor and outdoor wheelchairs, and its changes over time. METHOD: Five electric-powered indoor and outdoor chair (EPIOC) users, mean age 62 years (range 43-84 years) completed pain drawings and visual analogue scales two-hourly during one day. RESULTS: Pain intensity increased throughout the day in all users. It was most severe in the neck, back and buttocks. Pain drawings gave visual impact to the extent of the pain. CONCLUSIONS: Visual analogue scales and pain drawings may be useful in assessing pain experienced by EPIOC users, which may be severe and appears to increase in severity and distribution during the day.

Adult↗

PubMed2005

Involving service users in sexual health service development.

OBJECTIVES: The study objectives were to document users' experience of family planning and genitourinary medicine clinics and young people's services working within the time constraints of rapid service development and maximising the utility of this data for service improvement. METHODS: A total of 93 users of family planning and genitourinary medicine services participated in one of 13 facilitated discussion groups. Some 61% of the sample were women, 64% were aged over 25 years and 47% were Black Caribbean or Black African. The clinic journey was drawn on a wall covered with paper and participants added their comments during the discussion. RESULTS: Users had similar concerns across the three service types. Users perceived some receptionists and clinicians as un-friendly and judgmental and described others providing a quality service often under difficult conditions. Reception was insufficiently confidential, waiting environments uncomfortable, waiting times long and more information was needed throughout service use. CONCLUSIONS: Those elements of sexual health services known to be a source of dissatisfaction among young people may also be a problem for older service users and are experienced across different types of sexual health service. This preliminary study demonstrates the feasibility and acceptability of focus group evaluations of sexual health services. This approach generates qualitative data from relatively large numbers of users within a time-scale consistent with service development.

Adolescent↗