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PubMed1999

[Use of drugs among conscripts during military services].

UNLABELLED: The urine samples from 623 recruits at the beginning 493 recruits in the middle and 424 recruits at the end of military service were tested for cannabis. Six point four percent, 4.2% and 4.7% had positive urine samples. No statistically significant change of use of drugs was found. Three hundred and fifty-six recruits delivered all three urine samples. Five point nine percent had one or more positive urine samples and 2% had all three urine samples positive. Four percent admitted a daily or weekly use of cannabis (questionnaire). An increase in self-admitted use of other drugs than cannabis was found. Thirteen point four percent admitted a change of use of cannabis during military service. CONCLUSIONS: Some drug users were able to fulfil their military service despite regular use of cannabis, and use of urine test screening in a drug policy in order to unify the handling of suspected drug users is recommended.

Adult↗
PubMed2004

Intensity of drug injection as a determinant of sustained injection cessation among chronic drug users: the interface with social factors and service utilization.

AIMS: The objective of this study was to identify factors associated with sustained injection cessation and to examine further the relationship between the occurrence of sustained injection cessation of injection drug users (IDUs) and prior injection frequency. DESIGN AND SETTING: IDUs in the Montreal St Luc Cohort who had at least three consecutive interviews between 1995 and 1999 were included. Sustained injection cessation was defined as a period of at least 7 consecutive months without injection. All IDUs completed interview-administered questionnaires on socio-demographic characteristics, drug and sexual behaviours and health-related issues. Logistic regression was used for analyses. FINDINGS: A total of 186/1004 (18.5%) IDUs reported a period of sustained injection cessation during the study period. In multivariate analysis, HIV-positive status, 'booting' and cumulative time spent in prison were negatively associated with injection cessation, while injection initiation after 35 years of age and frequent crack use were positively associated with injection cessation. We found a negative association between the occurrence of injection cessation and the frequency of injection; the odds ratios (OR) for cessation were 0.49 [95% confidence interval (CI): 0.03, 0.78] for IDUs who injected 30-100 times and 0.21 (95% CI: 0.10, 0.46) for IDUs who injected more than 100 times in the previous month. Attending needle exchange programmes (NEPs) or pharmacies appeared to be a modifier of the relation between cessation and prior injection frequency. The OR was 0.68 (95% CI: 0.42, 1.12) for IDUs who injected 30-100 times prior to injection and attended NEPs or pharmacies and was 0.07 (0.01, 0.30) for IDUs who did not use these services. CONCLUSIONS: Overall, a fifth of IDUs experienced at least one episode of injection cessation of 7 months or more during a period of 4.5 years. Our data suggest that NEPs and pharmacies may have played a role in inducing injection cessation episodes in a subgroup of IDUs. Research is needed to better identify the characteristics of IDUs who could benefit from an injection cessation intervention strategy. This information is important for social and health policy planning.

Adolescent↗
PubMed2005

Thomson Scientific's expanding Web of Knowledge: beyond citation databases and current awareness services.

As end-user demand for easy access to electronic full text continues to climb, an increasing number of information providers are combining that access with their other products and services, making navigating their Web sites by librarians seeking information on a given product or service more daunting than ever. One such provider of a complex array of products and services is Thomson Scientific. This paper looks at some of the many products and tools available from two of Thomson Scientific's businesses, Thomson ISI and Thomson ResearchSoft. Among the items of most interest to health sciences and veterinary librarians and their users are the variety of databases available via the ISI Web of Knowledge platform and the information management products available from ResearchSoft.

Commerce↗
PubMed2003

African-Americans and comprehensive service use.

This study examined African-Americans' use of comprehensive mental health services. 248 long-term users of self-help agencies (SHAs) were interviewed about their use of 37 different mental health services from various providers in a six-month period. Multiple regression analysis showed that the homeless and African-Americans were the high users in our sample. A subsequent MANOVA procedure suggested that this may be the result of African-Americans' increased use of SHAs. While African-Americans are low service users in traditional studies focusing on a narrow list of services and providers, this research argues for including SHAs in future studies of African-American service use.

Black or African American↗
PubMed2002

Quality of life and other characteristics of Viennese mental health care users.

BACKGROUND: The purposes of this study are (1) to characterise patients with different treatment experiences, (2) to evaluate differences in quality of life (QoL) among patients with different treatment experiences, (3) to evaluate changes in QoL following community resettlement, and (4) to find predictors of overall life satisfaction (OLS). METHODS: Treatment experiences are defined according to service use as follows: (a) user of in- and outpatient services (overall users), (b) user of inpatient (inpatients) or (c) outpatient facilities only (outpatients). Demographic and clinical data of 425 psychiatric patients are analysed cross-sectionally in relation to their treatment experiences. QoL of former inpatients is followed up after hospital discharge. RESULTS: Long-term 'overall users' have a significantly higher QoL than long-term 'outpatients' or 'inpatients'. QoL of former inpatients increases after discharge. Predictors of higher OLS are high income, high subjective social functioning (SFQ), good self-rated health, satisfactory QoL domains as well as being single or cohabiting, diagnosis of schizophrenia, 'outpatients', and 'overall users'. Together they explain 63% of the variance in patients' subjective OLS. CONCLUSION: QoL is independent of illness severity. Deinstitutionalisation improves QoL and OLS is mainly predicted by subjective variables.

Austria↗
PubMed2025

PEELing: an integrated and user-centric platform for spatially resolved proteomics data analysis.

SUMMARY: Molecular compartmentalization is vital for cellular physiology. Spatially resolved proteomics allows biologists to survey protein composition and dynamics with subcellular resolution. Here, we present PEELing, an integrated package and user-friendly web service for analyzing spatially resolved proteomics data. PEELing assesses data quality using curated or user-defined references, performs cutoff analysis to remove contaminants, connects to databases for functional annotation, and generates data visualizations-providing a streamlined and reproducible workflow to explore spatially resolved proteomics data. AVAILABILITY AND IMPLEMENTATION: PEELing and its tutorial are publicly available at https://peeling.janelia.org/ (Zenodo DOI: 10.5281/zenodo.15692517). A Python package of PEELing is available at https://github.com/JaneliaSciComp/peeling/ (Zenodo DOI: 10.5281/zenodo.15692434).

Proteomics↗
PubMed2004

Perception of severity of acute respiratory tract infections and diarrhoea in children under the age of five in rural India: utilization pattern of health services.

A cross-sectional survey of 970 children under the age of 5 in 870 households showed a biweekly incidence of acute respiratory tract infections (ARIs) and diarrhoea of 9 and 8.7%, respectively. Ninety per cent of the mothers, irrespective of their educational status, could identify correctly the severe forms of the illness. When perceived as severe the majority (75%) of them went to unqualified indigenous practitioners and only when perceived as mild did they use the government services. This shows that the user preferences for acute healthcare services vary with their perception of the illness and unqualified practitioners are the main source of healthcare providers especially in the rural areas.

Adult↗
PubMed2002

The coverage of cancer patients by designated palliative services: a population-based study, South Australia, 1999.

Our aims were to determine the extent of coverage by designated palliative care services of the population of terminally ill cancer patients in South Australia, and to identify the types of patients who receive these services and the types who do not. All designated hospice and palliative care services in South Australia notified to the State Cancer Registry the identifying details of all their patients who died in 1999. This information was cross-referenced with the data for all cancer deaths (n=3086) recorded on the registry for 1999. We found that the level of coverage by designated palliative services of patients who died with cancer in 1999 was 68.2%. This methodology was previously used to show that the level of coverage had increased from 55.8% for cancer deaths in 1990 to 63.1% for those in 1993. Patients who died at home had the largest coverage by palliative services (74.7%), whereas patients who died in nursing homes had the lowest coverage (48.4%). Patients who did not receive care from these palliative services tended to be 80 years of age or older at death, country residents, those with a survival time from diagnosis of three months or less, and those diagnosed with a prostate, breast, or haematological malignancy. Gender, socioeconomic status of residential area, and race were not related to coverage by a designated palliative service, whereas migrants to Australia from the UK, Ireland, and Southern Europe were relatively high users of these services. We conclude that the high level of palliative care coverage observed in this study reflects widespread support for the establishment of designated services. When planning future care, special consideration should be given to the types of patients who most miss out on these services.

Aged↗
PubMed2003

Communication in the development of culturally competent palliative care services in the UK: a case study.

Research suggests that many minority ethnic patients who receive palliative care in the UK are satisfied with the service they are given. However, various studies have revealed that minority ethnic groups' experiences of care are far from perfect. The most significant problem for these patients centres on communication. This article presents some results from an exploratory study, commissioned by Luton Health Action Zone, to explore the role of communication in delivering effective palliative care services to South Asians living in Luton. Overall, it was found that the services provided are, in most cases, valued and seen as being effective. However, as the service providers who were interviewed readily recognized, there were areas where improvements could be made. The main issues were found to be the need to inform South Asian populations of the availability of palliative care services and the need to improve communication between patients and service providers. This article describes the communication problems that service providers and users face. It also identifies possible policy improvements aimed at developing the 'cultural competency' of services.

Adolescent↗
PubMed2006

Correlates of rural methamphetamine and cocaine users: results from a multistate community study.

OBJECTIVE: Use and production of methamphetamine (MA) has dramatically increased in the United States, especially in rural areas, with concomitant burdens on the treatment and criminal justice systems. However, cocaine is also widely used in many rural areas. The purpose of this article is to contrast MA and cocaine users in three geographically distinct rural areas of the United States. METHOD: Participants were recent not-in-treatment adult cocaine and MA users living in rural Ohio, Arkansas, and Kentucky, who were recruited by a referral recruitment method for sampling hidden community populations. Participants were interviewed for demographics, drug and alcohol use, criminal justice involvement, and psychological distress (Brief Symptom Inventory). RESULTS: The sample of 706 comprised 29% nonwhite and 38% female participants; the average age was 32.6 years; 58% had a high school education or higher, and 32% were employed. In the past 6 months, they had used either MA only (13%), cocaine only (52%), or both (35%). MA users were seldom (8.2%) nonwhite, but type of stimulant use did not vary by gender. Combined MA/cocaine users reported significantly greater use of alcohol and other drugs, including marijuana and nonprescribed opiates and tranquilizers, and reported significantly higher psychological distress. MA users (with or without cocaine use) had greater odds of recent criminal justice involvement compared with cocaine-only users. CONCLUSIONS: There is a clear need for accessible substance-use treatment and prevention services in rural areas of the United States, including services that can address MA, cocaine, polydrug use, and mental health needs. There is a particular need of these services for polydrug users.

Adult↗
PubMed2005

Primary care. Ringing the changes.

A 2000 DoH review called for out-of-hours services to be straightforward for users to access, and for service planning to involve multi-disciplinary co-operation from health professionals. Out-of-hours provision has evolved since then, but missed targets, insufficient staff numbers and inequalities between different providers continue to hamper progress.

After-Hours Care↗
PubMedDate not supplied

Measured effects of user and clinical engineer training using a queuing model.

This article puts forward a new proposal to calculate count, turnaround, response, and service time of work orders in a clinical engineering (CE) department. These are calculated by means of a queuing model as a measurement tool. This proposal was tested in a 600-bed hospital with an inventory of 1094 medical devices and with 6 full-time clinical engineers. In April 1999, a simulation (with ARENA 3.01 developed by System Modeling Corporation) of the working of this proposal was performed with desired values being applied to the queuing model. At the end of 2002, real work order data from the database was recorded. As predicted, the results showed that all the indicators of nonscheduled work orders decreased. Response and turnaround time were reduced from 27 to 0.56 hours and 27.48 to 1.13 hours, respectively. From a backlog of 22 outstanding repair orders per month between April 1999 and January 2000, the number was reduced to 4 in December 2002. The queuing model also helped to measure the positive effects on arrival and service rates when users and CE were trained. The difference between simulated and real values was under 5%.

Biomedical Engineering↗
PubMed2005

Social services and health services day care in mental health: the social networks and care needs of their users.

BACKGROUND: In view of the increasing integration of health and social care, there is an urgent need to know how health service day hospitals and social service day centres are being used, and by whom. AIMS: We aimed to compare users of day hospitals and centres in terms of their social networks, needs for care and demographics. METHODS: A cross-sectional, comparative study of service users at two day hospitals and four day centres compared their social networks, needs and characteristics. RESULTS: Day centre clients had much larger social networks, including a three-fold difference in total contacts and two-fold difference in confidants, but had more needs for care, particularly relating to psychological distress. They were also older on average than day hospital patients and were a more long-term group. CONCLUSION: It is vital to understand differences between health service day hospitals and social service day centres given the increasing integration of health and social care. The present study shows that the two user groups are significantly different. It is unlikely that the needs of most day care users could be met by either service interchangeably.

Adult↗
PubMed2002

[Chronic rheumatoid arthritis and the long-term care insurance system in Japan].

The long-term care insurance system in Japan is the social support system for the elderly, mainly aged 65 or over, requiring long-term care and provides necessary welfare services and health and medical care services of the user's choice in a comprehensive and unified manner. On the other hand, chronic rheumatoid arthritis often causes various disturbance and needs of long-term care for daily life in accordance with the progression of the disease. This system shall be provided to patients aged 40 or over with chronic rheumatoid arthritis, after screened by the long-term care approval board. Combination with both services not covered by the long-term care insurance and the Government Action Plan for Persons with Disabilities, users shall be provided comprehensive and planned services.

Aged↗
PubMedDate not supplied

Access to health care in a system transition: the case of Bulgaria.

OBJECTIVE: Throughout the 1990s, the Soviet-style model in central and eastern Europe that provided free health services has been subject to radical reforms. Socio-economic inequalities have also increased but there is little information on inequalities in health care utilization. This paper examines the pattern of illness behaviour in Bulgaria, seeking evidence of inequalities in access to services and eliciting users' pathways to care. DESIGN: Analysis drew on a representative population survey in Bulgaria (1997). The financial determinants of service use were tested in a multivariate model adjusted first for age, and then for age, marital status and self-reported health. In-depth interviews with users and providers addressed pathways to care, use of connections and other informal strategies to obtain care. RESULTS: As expected, rates of illness vary with income, with highest rates among the poor. After adjustment for illness, consultation rates are relatively equal across income levels, with the exception of worse-off women who tend to consult more. For first contact, there are few differences according to income, with the better off preferring secondary level. Pathways slightly differ, with women more often treated in primary care. Private sector utilization is low. Qualitative research reveals well-established strategies to obtain more advanced care, including use of connections, informal payments and use of emergency services. CONCLUSIONS: An apparent lack of inequalities in access to care conceals a more complex picture in which income and gender influence the pathways taken through the system.

Adult↗
PubMed1994

HIV infection among non-injecting drug users entering drug treatment, United States, 1989-1992. Field Services Branch.

OBJECTIVE: To describe HIV seroprevalence among non-injecting drug users (non-IDU) entering sentinel drug treatment centers in the United States. DESIGN: Anonymous, blinded (unlinked) HIV seroprevalence surveys. SETTING: Sixty-eight sentinel drug treatment centers in 37 United States metropolitan areas. PARTICIPANTS: Consecutive sample of clients admitted to sentinel drug treatment centers from January 1989 through December 1992. Of 84,617 clients, 37,633 (44.5%) had used illicit drugs but reported no injecting drug use since 1978. MAIN OUTCOME MEASURES: Center-specific, metropolitan area-specific, and national median HIV seroprevalence rates. RESULTS: National median center-specific HIV seroprevalence among non-IDU was 3.2% (range, 0-15.2%). Rates varied widely by geographic area. Median rates were highest in the northeast (5.6%; range, 0-15.2%), intermediate in the south (3.4%; range, 0.6-8.0%), and generally lower throughout the rest of the country: midwest (1.3%; range, 0-3.1%) and west (1.8%; range, 0-14.5%). When stratified by treatment center, there were few statistically significant differences in seroprevalence among African Americans, Hispanics and whites. The median rate was 3.4% among men and 2.7% among women. Rates among non-IDU were lower than among IDU attending the same drug treatment centers, but consistently higher than among heterosexual patients attending sexually transmitted disease clinics in the same metropolitan areas. CONCLUSIONS: HIV seroprevalence among non-IDU entering drug treatment is high in many metropolitan areas. HIV prevention and education efforts in drug treatment centers should target sexual as well as drug-use risk reduction for all clients.

Adolescent↗
PubMed1991

Participation of higher users in a randomized trial of Medicare reimbursement for preventive services.

In a study of older enrollees in an HMO, we found that seniors who are higher users of health care services are willing to participate in health promotion programs. Although people aged 85 or older and those with chronic diseases are slightly more reluctant to participate, they are willing to make additional visits for health promotion purposes. Close proximity to the clinic and support from their family physician are important correlates of participation.

Age Factors↗