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PubMedDate not supplied

Social relationships of crime-involved women cocaine users.

Social relationships play a significant role in drug use and recovery, perhaps especially for women. Research on social relationships among crime-involved women drug users is reviewed, including both well established findings and more recent topics of inquiry. Several open questions about social relationships of women drug users are then examined in data from a study conducted in the Miami (Florida) metropolitan area in 1994-1996. For a study of barriers to drug treatment for crime-involved women cocaine users, over 400 women were interviewed in treatment programs and an equal number were recruited on the street. Respondents were asked about their social relationships during the last 30 days on the street in regard to both legal and illegal activities. This included crime partnerships, help obtaining cocaine, living arrangements, help with living expenses, children and help with child care, help with several ordinary problems, and pressures to enter treatment. The analysis looks at how much social support crime-involved women cocaine users have in their ordinary daily activities, who provides this support, and findings from this data set relative to open questions in the literature.

Child↗

PubMed1989

Work with visual display terminals: psychosocial aspects and health. Report on a World Health Organization meeting.

When health effects related to the use of visual display terminals (VDTs) can be substantiated, complaints are largely associated with poor job and workstation design. Psychosocial aspects of work with VDTs may affect users' health and well-being and include a variety of situations: work demands, work design and organizational problems, workload breakdown control, pacing, social support and isolation, deskilling, management of change and user involvement, task analysis and job design, training, work scheduling, and rest periods. Although various physical aspects may affect the health of VDT users and are, to a large extent, inseparable from psychosocial effects, they have been addressed in a previous report. This report takes the view that, in the prevention of VDT-related health problems, psychosocial factors are at least as important as the physical ergonomics of workstations and the working environment.

Computer Systems↗

PubMed2002

Involving mental health service users and carers in curriculum development: moving beyond 'classroom' involvement.

Recent policy statements that address the future priorities for nurse education have emphasized that service users and carers should be actively engaged in partnerships with education professionals in all aspects of the curriculum. The development of this agenda is well advanced; however, examples of 'how to do it' are sparse. The development of a strategy to involve users and carers in the design and delivery of the Diploma of Higher Education in Nursing at Napier University provided an opportunity to evaluate the process of developing partnerships in this area of nurse education. This paper presents the findings from a process evaluation from the various standpoints of the key interest groups. The overall project and evaluation is outlined, along with methodological and practical issues surrounding this type of 'collaborative' evaluation. The importance and satisfaction of practical aspects of the project are examined. The issues of representativeness, expertise in 'involvement' and the importance of the 'process' of involvement are explored. Finally, the challenges to developing 'meaningful involvement' that goes beyond 'classroom involvement' in nurse education are identified and discussed.

Curriculum↗

PubMed1997

User participation in service planning. A qualitative approach to gauging the impact of managerial attitudes.

It is often suggested that professional and managerial attitudes significantly delimit the impact of new structures for enhancing the role and influence of service users in health and social care planning. Considers the existence and clarity of such managerial attitudes in the context of one attempt to involve users in mental health care planning. The existence of latent and explicit managerial parameters to the role played by users in the planning of services was confirmed by the research at a very general level. Perhaps inevitably though, even in relation to a very specific user participation project, these parameters became less uniform as more detailed issues were considered. This suggests that an investigative focus on the "process" oriented attitudes and assumptions of managers and professionals, although important, should not be allowed to detract from a concern with gauging the demonstrable outcomes of user participation.

Administrative Personnel↗

PubMed2003

Involving disabled and chronically ill children and young people in health service development.

AIM: To investigate the extent and nature of involvement of physically disabled or chronically ill children and young people in local health service development. METHODS: A postal survey of all health authorities (n = 99) and NHS Trusts (n = 410) in England. RESULTS: Seventy-six per cent of health authorities and 59% of Trusts responded. Twenty-seven initiatives involving chronically ill or disabled children and young people in consultation regarding service development were identified. Over half of these were carried out in partnership between health services and other agencies, usually local authorities and/or voluntary organizations. A variety of methods was used for consultation, including child-friendly methods such as drawing, drama and making a video. Seventeen initiatives reported that children's involvement had resulted in service changes, but only 11 went beyond consultation to involve children and young people in decision making about service development. Only a third of the organizations had someone with designated responsibility for children's involvement. DISCUSSION: The involvement of this group of children and young people in service development in the NHS is at an early stage. The failure of policy documents on user involvement to identify children and young people as a group for whom methods of consultation need to be developed, and the lack of people with designated responsibility for developing children's involvement may be a reason for slow progress in this area. The initiatives identified show that such involvement is possible and can have a positive impact on services.

Adolescent↗

PubMed2003

Patient confidentiality, data security, and provider liabilities in diabetes management.

From inception, the electronic patient record has raised issues of data protection and patient confidentiality. These privacy issues have become more complicated with the introduction of electronic links to patient information held in databases sited on local and wide area networks. The first purpose of this paper is to review, from the provider's perspective, the issues surrounding patient confidentiality, data security, and consequential provider liabilities. The second is to propose possible immediate strategies and long-term solutions. Clinical procedures in diabetes practice create patient data from confidential information. This information is owned by the patient, received by the provider, enriched by a professional interpretation, and merged with other data into health records. Ownership, privacy, accountability, and responsibility issues are raised. Consequential data security and patient privacy are easily met by storage in a locked box or file cabinet. Conversion of such records into digital data in databases on local and wide area networks markedly increases the provider's exposure to liabilities. Current methods for securing remote data exist. These involve user authentication and secure transmission, but remote data storage is far less secure than a locked box. New tools for the secure storage of patient data are outlined. These involve encryption and decryption by the provider alone. A suite of computer protocols is presented that can restore security equivalent to a "locked box" and thus reduce liabilities for the provider. Providers should protect the privacy of their patients by encrypting all data that are stored in remote repositories. The tools to do this are urgently needed. A standardized digital protocol for verifying user identities, preserving patient confidentiality, and controlling data security by encryption will fully mitigate provider liabilities. Standardization and economies of scale promise future cost containment.

Confidentiality↗

PubMed2005

From "Candy Kids" to "Chemi-Kids": a typology of young adults who attend raves in the midwestern United States.

Although young people attending raves have been most visibly associated with the use of ecstasy and other "club drugs" in the United States, there is reason to believe that they are not a homogenous group in terms of their drug use practices. The purpose of this article is to begin developing a typology of young adult ecstasy users involved in the rave subculture--known as Ravers or Party Kids. The study is based on focus groups and qualitative interviews conducted between November 2001 and September 2003 with 36 current and former ecstasy users, aged 19-31, in central Ohio, as well as participant observation conducted in raves, clubs, and bars where "club drugs" are often used. Findings suggest the existence of five main subgroups in attendance at raves--Chemi-Kids, Candy Kids, non-affiliated Party Kids, Junglists, and Old School Ravers. These groups differ in regard to musical taste, philosophy, style of clothing worn, amount of time in the rave subculture, and most importantly, patterns of drug use. For example, while the use of ecstasy appears most common among Candy Kids, Junglists tend to be more involved with the use of ketamine and methamphetamine. The use of alcohol, cocaine, marijuana, and hallucinogens is also widespread in the rave subculture. The typology can aid in the development of communication strategies necessary for successful prevention activities among some categories of ecstasy users.

Adult↗

PubMed2002

User satisfaction through empathy and orientation in three-dimensional worlds.

This paper describes a methodology for navigation and exploration assistance intended to enhance user satisfaction when exploring three-dimensional virtual environments. The complexity of such environments often makes navigation and information retrieval difficult, making it necessary to add assistance components to the world in order to turn it easier to manipulate. This methodology uses three-dimensional "intelligent" avatars as interactive guides, along with information-based navigation strategies. The intelligence of the avatars is represented through physical features, behaviors, and knowledge about the user and the environment. These components establish the avatar's architecture. Content personalization according to the user's interest, navigation assistance according to the desired content, and avatar guides that make the virtual place more realistic and pleasant are proposed in order to involve users. A three-dimensional model of the Guggenheim Museum Bilbao, in Spain, is presented as a prototype for the validation of this methodology. In the museum, the guide is represented as a fish that, according to the user's preferences, assumes gender and age. The avatar swims through the museum, following navigation routes that lead through exhibitions previously chosen by the visitor.

Empathy↗

PubMed2006

Satisfaction with mental health services. A user participation approach.

User participation in the delivery and evaluation of mental health services has become an important policy element in the development of these services. An important area where user involvement could be especially useful concerns satisfaction with care, which has become considered an important indicator of service excellence. The overall aim of this study was to investigate user satisfaction with mental health services in a county in southern Sweden. The study design used persons with own experience from being a patient or a close relative to a patient as active participants in the data collection. A group of 20 persons with experience from being users or relatives to users were recruited and trained to be interviewers in the study. Together they performed 227 interviews focusing user satisfaction regarding both inpatient and outpatient care. The interview had one quantitative part and one qualitative part. The interviewers' experiences from participation in the project were evaluated through focus groups. In these groups, the topics were the interviewers' impression of the content of their interviews and their experience from being an interviewer. The analysis showed a high satisfaction with care in the quantitative part. In the qualitative part a significant dissatisfaction with many aspects of the care were expressed. The focus group evaluation largely supported the findings from the analyses of the dataset. Experiences of being user and interviewer were generally positive and perceived as rewarding.

Adult↗

PubMed2005

From rhetoric to routine: assessing perceptions of recovery-oriented practices in a state mental health and addiction system.

The Recovery Self Assessment (RSA) was developed to gauge perceptions of the degree to which programs implement recovery-oriented practices. Nine hundred and sixty-seven directors, providers, persons in recovery, and significant others from 78 mental health and addiction programs completed the instrument. Factor analysis revealed five factors: Life Goals, Involvement, Diversity of Treatment Options, Choice, and Individually-Tailored Services. Agencies were rated highest on items related to helping people explore their interests and lowest on items regarding service user involvement in services. The RSA is a useful, self-reflective tool to identify strengths and areas for improvement as agencies strive to offer recovery-oriented care.

Choice Behavior↗

PubMed1993

The families of problem drug users: a study of 50 close relatives.

The research described in this paper resulted from a collaborative multi-centre study of the relatives of problem drug users involving six practitioners and researchers, in four centres within the south-west of England. The objective of this research was simply to interview 50 close relatives of identified problem drug users, with the identification occurring through clinics and self-help groups. Quantitative and qualitative results show that large numbers of these relatives reported many negative experiences. The partners of illicit drug users reported both more and differently patterned problematic behaviours than those of prescribed tranquillizer users. The partners of illicit users also reported different problems to those of the parents. Relatives reported many negative effects in terms of how they viewed the drug user, and how the experiences had affected their health. They also described various coping mechanisms, and the extent of the support which they had received. The results are discussed in terms of coping, and similarity with research into the families of problem drinkers.

Adaptation, Psychological↗

PubMed2006

Involving mental health service users in quality assurance.

OBJECTIVE: This study compares the process and outcomes of two approaches to engaging mental health (MH) service users in the quality assurance (QA) process. BACKGROUND: QA plays a significant role in health and care services, including those delivered in the voluntary sector. The importance of actively, rather than passively, involving service users in evaluation and service development has been increasingly recognized during the last decade. DESIGN: This retrospective small-scale study uses document analysis to compare two QA reviews of a MH Day Centre, one that took place in 1998 as a traditional inspection-type event and one that took place in 2000 as a collaborative process with a user-led QA agenda. Setting and participants The project was undertaken with staff, volunteers and service users in a voluntary sector MH Day Centre. Intervention The study compares the management, style, evaluation tools and service user responses for the two reviews; it considers staff perspectives and discusses the implications of a collaborative, user-led QA process for service development. RESULTS: The first traditional top-down inspection-type QA event had less ownership from service users and staff and served the main purpose of demonstrating that services met organizational standards. The second review, undertaken collaboratively with a user-led agenda focused on different priorities, evolving a new approach to seeking users' views and achieving a higher response rate. CONCLUSIONS: Because both users and staff had participated in most aspects of the second review they were more willing to work together and action plan to improve the service. It is suggested that the process contributed to an evolving ethos of more effective quality improvement and user involvement within the organization.

Adult↗

PubMed1997

Hospital social work and community care: the practitioners' view.

This paper presents the findings of an exploratory research study which considers the effect of organisational change on social work practice in hospitals in four local authorities in England. Its aims were (1) to obtain the views of hospital social workers and their managers about the effect of implementing the NHS (National Health Service) and Community Care Act of 1990 and policies for Care in the Community on the practice of social work and (2) to elicit issues of concern to form the basis of a national study. Semi-structured interviews were carried out in hospital social work departments which were providing a service to adults with health needs. Interviews with a representative sample of 85 workers and 36 managers (including Assistant Directors and Principal Training Officers) in 11 hospitals were held between June-December 1993, three months after the introduction of the policies. The interviews were tape-recorded and transcribed. A questionnaire provided some quantitative data, and additional information was obtained through non-participant observation at team meetings. The interviews covered four topic areas: the nature of social work in hospitals; the changes introduced by implementing the legislation; the management of that change; and the effect of the new policies on practice. Results show an increase in the volume of referrals particularly in assessment for nursing home care; and an overwhelming amount of administrative work to process the new procedures for providing community care. Most relates to filling in forms, duplication of assessments and repetitive bureaucracy. Workers struggle to meet their expectation of professional practice with organisational demands. The discussion centres on three issues raised by practitioners; the changing nature of social work due to the alternative models of service being imposed by local authorities; the lack of consultation and involvement by management of the frontline workers in the management of this change; the dissonance felt by hardworking and committed practitioners to whom the increasing paper work is yet another obstacle to user involvement. This may have clear implications for management, for the degree of stress and perceived pressure resulting from these organisational changes is counterproductive to job satisfaction. If the reforms are not to be undermined, they need proactive management. This requires a sensitivity to workers' needs, investment in training and working together to integrate the care management role into social work practice.

Adolescent↗

PubMed2000

Improving the user interface to increase patient throughput.

One of the main goals of a radiology department is to optimize patient throughput. We have observed a number of factors that reduce patient throughput, one of them being suboptimal system usage. In this article, we distinguish and discuss two ways to reduce suboptimal operation: improved design of the user-interface and active support for learning during system usage, i.e., during examinations. We outline the rationale for this by looking at the current situation and trends in radiology departments. We have based our work firmly on the principles of user-centered design. Observations, task modeling, user involvement, and prototyping have been undertaken.

Efficiency, Organizational↗

PubMedDate not supplied

[Barriers and opportunities for social participation in health: the main social actors' perceptions].

OBJECTIVE: Analysing barriers to and opportunities for user involvement as perceived by the social actors involved in implementing Colombian policy regarding social participation in health. METHODS: An exploratory qualitative study was carried out in the Colombian towns of Tuluá and Palmira between 2000 and 2001. There were 10 focus groups having 260 users and leaders. Semi-structured individual interviews were given to health personnel (36) and policy-makers (3). Narrative content, mixed categories and data segmentation by informants and topics were then analysed. RESULTS: Users and leaders considered their own lack of knowledge, apathy and fear of revenge as barriers for participation. However, there were institutional factors such as lack of institutional transparency, limited receptiveness and responsiveness regarding participation. These opinions were shared by policy-makers. Most health personnel identified users' knowledge and attitudes as barriers for participation; few mentioned any institutional barriers such as the behaviour of personnel, institutional opacity and the lack of resources for fostering work in the community. Opportunities for participation were described in terms of suitable and possible scenarios. Users perceived their great ability to achieve change through their direct participation appeared to them as presenting an important opportunity. CONCLUSIONS: Users' and leaders' perceptions of the current barriers and opportunities seemed to show that they are critical of their own reality and constitute important potential actors for becoming key interlocutors with institutions and the state. A similar attitude would be necessary on the part of institutional actors to build a real and permanent participatory culture.

Administrative Personnel↗

PubMed2005

Connecting health departments and providers: syndromic surveillance's last mile.

INTRODUCTION: A critical need exists for mechanisms to identify and report acute illness clusters to health departments. The Massachusetts Department of Public Health (MDPH) works with partner organizations to conduct syndromic surveillance. This effort is based on CDC's Health Alert Network program and includes automated generation and notification of signals and a mechanism to obtain detailed clinical information when needed. METHODS: Syndromic surveillance partners collect emergency department and ambulatory care data. The principal communications platform between syndromic surveillance partners and MDPH is the Massachusetts Homeland and Health Alert Network (HHAN). This Internet-based application serves as a portal for communication and collaboration and alerts predefined groups of users involved in emergency response. Syndromic surveillance partners' systems report to HHAN by using Public Health Information Network Messaging System events that meet thresholds selected by MDPH. Cluster summaries are automatically posted into a document library. HHAN notifies users by electronic mail, alphanumeric pager, facsimile, or voice communications; users decide how they want to be notified for each level of alert. Discussion threads permit real-time communication among all parties. RESULTS: This automated alert system became operational in July 2004. During July-December 2004, HHAN facilitated communication and streamlined investigation of 15 alerts. CONCLUSION: The system allows rapid, efficient alerting and bidirectional communication among public health and private-sector partners and might be applicable to other public health agencies.

Disaster Planning↗

PubMed1999

Expert patients. So you think you know it all?

The government's proposal to set up an expert patients programme to enable those with chronic illnesses and disabilities to manage their condition is a welcome step towards greater user involvement. The programme should avoid a medical model and take account of patients' social circumstances. The programme must include evaluation. Health professionals in the UK have yet to embrace patient self-management. To date they have been reluctant to refer service users to self-help groups.

Chronic Disease↗

PubMed2001

User performance with speech recognition: a literature review.

The application of speech recognition to the computer access needs of people with disabilities continues to grow, and a greater understanding of user performance with such systems is needed. This article reviews what is known about user performance with speech recognition systems, with a focus on its application to accommodation of physical disability. Although current systems offer the potential of text entry at 150 words per minute, the literature suggests that users actually achieve somewhere between 8 and 30 words per minute. Barriers that may contribute to this gap, such as the costs associated with correcting recognition errors, are reviewed, and directions for future research are proposed. A major need is for additional research involving users who have physical disabilities.

Communication Devices for People with Disabilities↗