bluuebunny/crossref_metadata_2025 huggingface dataset:
Overcoming Perceived Barriers to Employment Among People with Arthritis
Authors: Barlow Julie , Wright Chris , Kroll Thilo
Published: April 2009

Work disability is a major problem for people with arthritis. The INTO WORK Personal Development (IWPD) programme aims to prevent work disability by addressing the internal and external barriers faced by people with arthritis seeking to fulfil their employment potential. The effectiveness of the programme was examined in a pretest–post-test study with an intervention group ( n = 37) and a comparison control group ( n = 42). Data were collected through self-administered questionnaires and focus groups. Significant decreases on anxiety ( p = .0002), depression ( p = .009) and negative mood ( p = .029), and significant improvements on positive mood ( p = .011), self-esteem ( p = .002) and satisfaction with life ( p = .010) were found for the intervention group only. The IWPD programme appears to promote self-determination, psychological well-being and strategies for overcoming perceived barriers to employment among people with arthritis.
Blood Glucose Discrimination Training: The Role of Internal and External Cues
Authors: Malerbi Fani Eta Korn , Matos Maria Amelia
Published: April 2009

The effects of observing internal and external events on blood glucose (BG) discrimination were assessed in eight patients with type 1 diabetes using an intrasubject design. During baseline condition, participants estimated their BG, then measured and recorded it (feedback-only procedure) three times a day. Participants were then divided randomly into two groups. Both were submitted to internal cue (IC) and external cue (EC) training conditions in a balanced order, and then both cues were presented together in combined cues (CC) training conditions. Under IC, participants observed and recorded their symptoms before estimating BG. Under EC, they observed and recorded environmental events prior to BG estimation. In CC conditions, participants paid attention to both internal and external cues before the estimate–feedback routine. BG estimation accuracy improved after either IC or EC conditions. When the two types of cues were combined, only two participants improved their BG estimation accuracy. The remainder did not, probably because they had already attained high accuracy levels (ceiling effect).
Developing a Dynamic Model of Treatment Perceptions
Authors: Yardley Lucy , Sharples Karen , Beech Sandra , Lewith George
Published: April 2009

A description of factors influencing perceptions of nonpharmacological treatment was derived inductively from interviews with people receiving chiropractic treatment for back pain, using grounded theory analysis. A theoretical model linking these factors was constructed, and was tested using interview data from a longitudinal study of people undertaking exercise therapy for dizziness. The model highlights the potential for reciprocal interactions between abstract beliefs relevant to illness and treatment and concrete experiences of therapy, and for interactions between perceptions of symptom change and of therapist competence. Therapist communication may modify abstract illness/treatment models and symptom perceptions, thus mediating effects of concordance on adherence and placebo effects.
Components of the Anger–hostility Complex as Risk Factors for Coronary Artery Disease Severity: A Multi-measure Study
Authors: McDermott Mark R. , Ramsay Jean M. C. , Bray Colin
Published: April 2009

Different forms of anger and hostility have been implicated in the pathogenesis of coronary artery disease (CAD), though previous research has not measured all of these in one sample. To assess their relative predictive utility, a multi-measure study was undertaken of three adult outpatient groups: 97 men identified angiographically with stenosed coronary arteries; 28 men with valvular heart disorders in the absence of CAD; and 28 men attending a fracture clinic with no CAD present. Questionnaires measured: anger expression; anger experience; cynical hostility; ‘Ho' hostility; neurotic hostility; neurotic disagreeableness; resentment; and suspiciousness. The pre-eminent anger–hostility correlate of CAD was found to be expressed anger, with years as a smoker and age also being independently related to disease severity. Thus, seven of these anger/hostility variables do not warrant similar attention as anger expression in CAD aetiology. Further research should identify coronary toxic components of anger expression and of socio-occupational environments that afford or constrain their occurrence.
Psychosomatic Symptoms among Victims of School Bullying
Authors: Natvig Gerd Karin , Albrektsen Grethe , Qvarnstrøm Ulla
Published: April 2009

Associations between being a victim of bullying and psychosomatic health have been examined among 856 Norwegian school adolescents aged 13 to 15 years. Multiple logistic and linear regression analyses were applied. Pupils being bullied sometimes or more often during the previous term had significantly higher odds of every psychosomatic symptom except sleeplessness, compared to pupils who reported that they were never exposed to bullying. The highest odds ratio was observed in analysis of feeling low. No significant interactions with gender or age were seen, but the association with irritability, headache and backache tended to be strongest for boys, whereas the association with nervousness and sleeplessness was strongest for girls. Increasing exposure to bullying was associated with a highly significant increase in number of symptoms. The strong and consistent associations with different symptoms and the dose–response relationship suggest a causal relationship.
Predicting Intended and Self-perceived Sugar Restriction among Tanzanian Students using the Theory of Planned Behavior
Authors: Masalu J. R. , Åstrøm A. N.
Published: April 2009

This study examines the applicability and sufficiency of the Theory of Planned Behavior (TPB) in predicting intention and self-perceived behavior with respect to avoiding between-meal intake of sugared snacks and drinks. One thousand one hundred and twenty-three Tanzanian students (mean age 26.4 years) completed self-administered questionnaires designed to measure the components of the TPB during May–July, 1999. Self-perceived sugar consumption was obtained in a subsample of respondents ( n = 228) four weeks later. The TPB provided a significant prediction of intention ( R2= 0.44), with attitude (= 0.25), subjective norms (= 0.28) and perceived behavioral control (= 0.35) significant, and subsequent behavior ( R2 = 0.15, with intention (= 0.25) and perceived behavioral control (= 0.18) significant. Frequency of past behavior explained a significant, albeit small, amount of additional variance in intention (1 percent) and behavior (4 percent). The results indicate that the TPB is applicable to the prediction of food choice-related intention and behavior among young adult students living in a non-occidental setting.
Parents of Children with Autism using an Email Group: A Grounded Theory Study
Authors: Huws Jaci C. , Jones Robert S. P. , Ingledew David K.
Published: April 2009

Parents of children with autism have difficulties obtaining adequate information and support to guide them in the care of their children. However, the growth of communication technologies such as email has created greater opportunities for accessing such resources. This article presents a grounded theory analysis of the messages sent to an email group by parents of children with autism. The core category emerging from the analysis indicates that the group functioned in making sense of autism. The core category comprises four categories: searching for meaning; adjusting to changes; providing support and encouragement; and narrative sharing of experiences. Although email groups function as a social support mechanism, we suggest that this is not the only legitimate function: such groups may contribute towards the development of parental representations of autism.
The Relationship between Body Image and Depressed Mood in Adolescence: A 5-year Longitudinal Panel Study
Authors: Holsen Ingrid , Kraft Pål , Røysamb Espen
Published: April 2009

Much research interest has been devoted to reveal the psychosocial processes associated with the development of depressive symptoms during adolescence. One of the important factors that has been studied is body image. In a 5-year longitudinal investigation, we revealed and discussed the relationship between body image and depressed mood in a cohort of adolescents at ages 13, 15 and 18. Girls reported on average higher depressed mood levels and more negative body image than boys at all ages. However, the correlations between the variables were nearly as strong for boys as for girls. Structural equation modelling revealed that body image predicted change in depressed mood both for boys and girls, but at different ages. In contrast, we did not find any support for the existence of causal effects of depressed mood upon body image.
Components of the Anger-Hostility Complex and Symptom Reporting in Patients with Coronary Artery Disease: A Multi-Measure Study
Authors: Ramsay Jean M. C. , McDermott Mark R. , Bray Colin
Published: April 2009

Multiple anger and hostility variables were investigated for associations with coronary artery disease (CAD) symptoms and to examine if those relationships were different for disease severity.Atwo year follow-up study of97 men with stenosed coronary arteries was undertaken. Questionnaires measured: nine forms of anger and hostility; Type A behaviour; anxiety; depression; social support; and ninesymptom measures. CAD severity was derived from clinicians’ ratings of coronary angiograms. Results are four fold: anger-hostility variables are relatively unimportant predictors of symptoms compared with anxiety and depression; psychosocial measures (except for expressed anger) are uncorrelated with CAD severity, though correlate numerously with CAD symptoms; symptoms are not distinguishable empirically in terms of frequency, intensity and duration with regard to type (‘angina pain’, ‘tiredness’ and ‘breathlessness and restricted mobility’); finally, CADsymptoms are unrelated to CAD severity. In conclusion, components of the angerhostility complex are of limited use for predicting CAD symptoms. However, anger expression is of utility for differentiating between CAD symptoms and disease severity.
Coping and Distress as Predictors of Glycemic Control in Diabetes
Authors: Sultan Serge , Heurtier-Hartemann Agnes , Sultan Serge , Heurtier-Hartemann Agnes
Published: April 2009

This study attempts to identify the relative contribution of coping styles (task-, emotion-oriented and avoidance) and anxiety and diabetes-related distress to glycemic control in IDDM (Insulin Dependent Diabetes Mellitus) patients. Recent research suggests that coping and distress may as well be determinants as consequences of certain characteristics of the illness and subject. This points to the need to control some of these variables in diabetic research. Ninety seven IDDM patients from an outpatient unit were included. Measures were self-report questionnaires (CISS, STAI-Y, PAID) and biological data (HbA1C i.e. metabolic control). When potential confounds were controlled for (current age, age at onset, gender, presence of complication), three main predictors of metabolic control could be isolated through hierarchical regression analysis: (1) presence of complications; (2) task-oriented coping style; and (3) diabetes-related distress. Three steps were included in predictors: illness and subject variables (step 1); coping styles (step 2); and negative emotions (step 3). Each step contributed to a significant increase in variance. Emotion-oriented coping style appeared as redundant with distress measures. Results suggest that the relations between psychological predictors and metabolic control would be closer in women. These results partly replicate other findings, and advocate for a better consideration of emotional factors in the prediction of blood glucose control in this disease.
Keeping Children Safe
Authors: Dixey Rachael
Published: April 2009

The aim of this article is to present qualitative data from a study of mothers on a housing estate in Leeds, UK, enabling them to voice their concerns about child safety. The estate contains many environmental hazards, from traffic, ‘drugusers’, ‘strangers’ and litter. A high profile given to the vulnerability of children in public places has resulted in parents becoming ever vigilant and subjecting children to increased surveillance, in the face of a lack of environmental measures which would support their efforts to keep children safe. There are costs to parents in time and activities foregone. Moreover, the emphasis on the key role of parents in child safety and the perception of increasing hazards to children is affecting parents' psychological well-being. The article attempts to place parents' concerns within a social context which may begin to explain parental behaviour and anxieties.
Anger Expression, Coping Styles, and Well-being
Authors: Diong Siew-Maan , Bishop George D.
Published: April 2009

This study examined the role of anger expression in the experience of stress, coping with stress and psychological and physical well-being. Based on a sample of 268 Singaporeans, the results, using structural equation modelling, indicated that anger expression was significantly related to reported stress, mechanisms for coping with stress and psychological wellbeing. Higher levels of anger expression were associated with higher levels of stress as well as lower use of active coping. Active coping was in turn positively related to psychological well-being. In addition, higher levels of anger expression showed a direct negative relationship with psychological well-being as did higher levels of stress. In contrast, the only significant predictor of physical well-being was reported stress, with higher levels of stress related to lower levels of physical well-being. The implications of these results for understanding the role of anger expression in psychological and physical wellbeing are discussed.
Religion and Spirituality in the Face of Illness
Authors: Woods Teresa E. , Ironson Gail H.
Published: April 2009

This study reports the results of semi-structured interviews conducted with 60 medically ill (cancer, myocardial infarction, HIV/AIDS) people in an attempt to define what people facing a life-threatening illness mean when they say they are ‘spiritual’ or ‘religious’. Questions were asked about beliefs and affective, behavioral, and somatic realms. Subjects initially self-identified as considering themselves to be spiritual, religious, or both. While some similarities existed between the groups (e.g. amount of time spent in prayer, beliefs set the tone for their life, give them a sense of well-being, guidance, a sense of right and wrong, a connection to God, and a sense they will live on in some form), significant differences were discovered in overall belief systems, as well as in interpretation of the mechanisms whereby subjects' beliefs impacted their health and their recovery. Those identifying as spiritual described recovery and healing as happening through them whereas those identifying as religious were more likely to say it happens to them. In addition, significant differences existed between the groups in their overall view of God, self, world, and others. Implications for future studies are discussed.
The Role of Negative Affectivity in Self assessment of Health
Authors: Vassend Olav , Skrondal Anders
Published: April 2009

The relationship between negative affectivity (NA, i.e. the Neuroticism trait and transient distress), self-reported medical condition and somatic complaints was assessed in structural equation models also including personality (the Big Five personality domains), socio-demographic, and health behaviour variables. The results indicated that the individual's current distress level and medical condition were by far the strongest predictors of somatic complaints. Compared to the other Big Five domains, Neuroticism was clearly the most important variable in all the models tested; it evidenced substantial direct effects on both distress level and medical condition, and a significant indirect effect on somatic complaints. On the whole, the effects of the sociodemographic and health behaviour variables were of only marginal importance as compared to NA.
Constructing Sexual Health
Authors: Flowers Paul , Hart Graham , Marriott Claire
Published: April 2009

This article outlines the importance of conceptualizing ‘sexual health’ as a pluralistic and context-bound phenomenon. It explores gay men's sexual decision making in the particular context of public parks. Twenty gay men from Glasgow, Scotland, took part in semi-structured, in-depth interviews. Interpretative Phenomenological Analysis (IPA) was employed to analyse transcripts for recurrent themes—these represent shared understandings across participants. Risk reduction, danger and safety figured frequently in men's accounts of sex and sexual decision making. However, the risks men reported related more directly to the threat of attack or arrest rather than the avoidance of sexually transmitted infections. Indeed, danger itself was occasionally something to be sought and enjoyed. Given these findings, we discuss the appropriateness of traditional health psychological approaches to understanding sexual health. It is hoped that this approach can highlight some issues that a true psychology of sexual health must address in order to represent sexual decision making more accurately and to be useful with respect to both service provision and theoretical development.
Predicting Intended Condom Use among Tanzanian Students using the Theory of Planned Behaviour
Authors: Lugoe Wycliffe , Rise Jostein
Published: April 2009

This study examined whether perceived behavioural control predicted the intention to use condoms at next sexual intercourse above the components of the theory of reasoned action, as well as the sufficiency of the theory of planned behaviour (TPB) as a theory of intention among Tanzanian adolescents. Five hundred and twenty-eight students who were sexually active, from seven secondary schools in Arusha, Northern Tanzania, completed a questionnaire designed to measure the components of the TPB. Behavioural intentions were significantly predictable from attitudes (.11), subjective norms (.22) and perceived behavioural control (.48). The inclusion of past behaviour into the regression equation increased R2 only marginally (2 percent) but significantly, suggesting that the TPB provides a fairly accurate explanation of intention to use condoms among Tanzanian adolescents. The implications of this finding in relation to theoretical and practical issues are discussed.
The Theory of Planned Behaviour as Predictor of Exercise
Authors: Bozionelos George , Bennett Paul
Published: April 2009

In a test of the predictive utility of the theory of planned behaviour alone and in conjunction with a number of additional variables, 114 participants completed questionnaires measuring predictor variables and, three weeks later, reported exercise. The results of the present study provide partial support for the theory. Past behaviour was the most predictive variable. Subjective norm was not a significant predictor of intention to exercise. Attitude towards exercise was also not a predictor of exercise intention. Self-monitoring acted as a moderator of the attitude–intention relationship. Perceived behavioural control was not a significant predictor of exercise behaviour, while exercise intentions were only weak predictors. The results also suggested that perceived behavioural control and perceived barriers are not equivalent, and should be treated as separate variables that contribute independently to the predictive ability of the model. The implications of the findings are discussed.
The case for a postmodern penality
Authors: Hallsworth Simon
Published: April 2009

Rising prison populations and the return of punitively orientated ‘ostentatious’ forms of punishment (Pratt, 2000) have led a number of theorists to consider whether key defining characteristics of western penal modernity have been abandoned and replaced with something entirely different. The question has been raised: Are we witnessing the rise of a postmodern penality qualitatively different in form than that which prevailed in the modern era? While this question has tentatively been answered in the affirmative by Simon (1995) and, more recently, Pratt (2000), a number of criminologists have argued a contrary case (see Garland, 1995; Lucken, 1998; O’Malley, 1999). There is, they suggest, no such thing as a postmodern penality, or if there is, evidence for it is very slight. Such theorists have also sought to question both the utility and validity of the discourse of modernity and postmodernity as a framework in which to locate an understanding of contemporary penal development. This article questions this critique and does so by addressing the criticisms that have been raised against those who have challenged the validity of this framework of analysis and by reaffirming the case for seeing the rise of certain new penal trends as indicative of an emergent postmodern penality.
Crime legends in a new medium
Authors: Donovan Pamela
Published: April 2009

This article explores the persistence of the ‘crime legend’ genre. A case study approach was used, and three crime legends with a considerable history of public debunking were chosen: the market in snuff films; the theft of vital organs for black-market transplant; and the abduction of children from theme park restrooms. Current versions circulating in Internet newsgroups were collected, discussions in Internet newsgroups were examined, and participants were interviewed. Most ‘believers’ engaged in conditional or instrumental forms of belief, finding them useful as truths regardless of their basis in conventional evidence. This situation suggests that rumors and legends can be sustained in the absence of fervent or strictly literal believers. The study also revealed that specific legends are deployed to adapt to generalized fear, resulting from a sense of ‘ontological insecurity.’ Following Giddens’ formulation, this insecurity is intertwined with distrust stemming from uncertain relationships between the individual and the state.
Start here
Authors: Katz Jack
Published: April 2009

Theory is about starting points. Research usually relies on theory to justify starting with pre-commitments to independent variables, background factors, or structural conditions that will explain historically and geographically varying phenomena, which are treated as dependent, fungible, superficial upshots, or otherwise secondary and essentially inferior. I propose that we start by trying to describe the phenomena to be explained as they exist for the people living them. For this, we need theory of another sort, a theory of social ontology that indicates the lines of inquiry required to produce a complete description. If we start research by describing the nature of social phenomena as they are experienced, it will make a difference in structuring data gathering; in developing a research craft capable of seeing practice, interaction maneuvers, and tacit embodiment; in shaping a research agenda; and, ultimately, in where we end substantively.
Moral indignation, class inequality and justice
Authors: Barbalet J. M.
Published: April 2009

Svend Ranulf’s characterization of criminal law as a ‘disinterested tendency to inflict punishment’ challenges the conventional view that whereas crime may express emotion, emotion is extinguished in the operations of law. This is because Ranulf argues that criminal law arises through middle-class moral indignation. Thus an emotion, moral indignation, links social structure—in the form of class configuration, and social action—to the formation of criminal law. In the discussion to follow, Ranulf’s thesis is situated in the development of the sociology of criminal law, critically evaluated, and reformulated. The continuing relevance of Ranulf’s framework is also indicated.
Emotions and criminal justice
Authors: Karstedt Susanne
Published: April 2009

During the last decade, a process of ‘emotionalization of law’ has spread around the globe, changing the criminal justice system in many ways. Anger, disgust and shame are perceived as ‘valuable barometers of social morality’ and brought back to criminal procedures. The ‘return of emotions’ to penal law and criminal justice is linked to and illuminates the moral imagination of late modern societies. This article seeks to address two facets of the ‘return of emotions’ to criminal justice. The first part explores the changes in the public sphere and in the pattern of emotional culture in late modern societies that are responsible for the reemotionalization of the penal realm. In the second part, problems that emerge in the criminal justice system are addressed. Bringing emotions back involves profound problems that go beyond the mere instrumental use of emotions in criminal justice, or a restricted perspective of ‘what works’. Three ‘core’ problems—and associated—questions are discussed: first, are emotional reactions towards crimes ‘natural’ or ‘primordial’ such that they should occupy a prominent place in criminal justice that has been unduly ignored? Second, and relatedly, do emotions constitute our moral principles? Finally, should institutions elicit or even require ‘authentic emotions’ from individuals? These questions are addressed within the framework of contemporary emotion theory and the consequences of this perspective for the ‘use’ of emotions in criminal justice are discussed.
Moral emotions in restorative justice conferences
Authors: Van Stokkom Bas
Published: April 2009

This article deals with the emotional dynamics of restorative conferences, focusing on the functions of shame, as enunciated in the theories of Moore, Scheff and Retzinger. According to these researchers, the restorative justice conferences aim to redirect aggressive emotions and elicit shame and other hurt-revealing emotions that can lead to empathy. These approaches are confronted with the views of the guilt-theorists Tangney and Baumeister who argue that guilt is related to empathy and reparation, whereas shame tends to provoke avoidance or rejection of responsibility. The view that guilt is the more moral emotion appears to turn Braithwaite’s theory of reintegrative shaming upside down. In accordance with recent research results of the Braithwaite group, it is concluded that guilt is an important aspect of the restorative process. But guilt has limited affect resonance possibilities, misses the other-regarding aspects of remorse and does not seem to incite the offender to reconsider his or her identity. In conclusion, it is argued that (reintegrative) ‘shaming’ is a dubious concept.
Cultured punishments
Authors: Vaughan Barry
Published: April 2009

Increasingly, criminologists have made reference to Mary Douglas’s writings on risk. Less frequently is it noted that Douglas’s work on risk is dependent upon a more fundamental classificatory scheme, what she calls grid-group theory. This theory measures cultural biases in terms of their level of prescriptiveness of norms (grid) and affiliation between individuals (group). This theory gives four distinctive cultural types, each of which has distinctive attitudes to risk, crime and blame. These types reflect the institutional relations of a particular collectivity within a society. This paper maps contemporary debates on the transformation of punishments onto grid-group theory and argues that criminological theorizing has effectively restricted itself to only two of Douglas’s four cultural types. Expanding the parameters of the debate would not only allow a more accurate representation of what is going on, but may also tentatively sketch a map toward a more optimistic future.
Social Identity on a National Scale: Optimal Distinctiveness and Young People's Self-Expression Through Musical Preference
Authors: Abrams Dominic
Published: April 2009

Optimal distinctiveness theory (ODT) and self-categorization theory hold that association with moderately distinctive, rather than general or unique, social categories should be more central to self-conception. Study 1 analyzes objective and self-report behavioural indicators from a representative sample of 2,624 18—21 year olds. Consistent with ODT, respondents preferring styles of music with intermediate levels, rather than unique or general levels, of objective popularity reported investing more resources in, and stronger behavioural commitment to, their music identity. Study 2, using 49 students from the same age cohort, confirmed that perceived popularity was related to objective popularity independent of familiarity with each style. In line with ODT, the distinctiveness of young people's musical affiliations appears to contribute to their social identity.
Self-reported faintness or dizziness — comorbidity and use of medicines. An epidemiological study
Authors: Tamber Anne-Lise , Bruusgaard Dag
Published: April 2009

Aim: The aim of this study was to explore the prevalence of dizziness in a general population and the association between dizziness and socio-demographic variables, self-reported diseases and medicines used. We hypothesize that dizziness was associated with different diseases and medicines as well as the number of diseases and the number of medicines used. Materials and methods: We used data from a cross-sectional survey with 17,638 participants aged 30, 40, 45, 59/60 and 75/76 in the Oslo Health Study who had answered a self-administered questionnaire in 2000—2001. Associations were analyzed by descriptive statistics, chi-square tests, independent t-tests and logistic regression. Results: The prevalence of self-reported faintness or dizziness was 28.7%, reported more often by women than men and by age group 75/76. Participants with neck shoulder pain/stiffness, mental disorders, fibromyalgia/chronic pain syndrome, stroke/cerebral haemorrhage, angina pectoris and chronic bronchitis/emphysema, as well as use of tranquillizers, sedatives, and ‘‘other medicines on prescription,’’ had a significantly increased likelihood of being troubled by faintness or dizziness. An increasing number of reported diseases and an increasing number of medicines used gave an increasing likelihood of faintness or dizziness. In the multivariate analysis controlling for socio-demographic variables, diseases and use of medicines, the oldest did not have an increased likelihood of faintness or dizziness. Conclusions: Self-reported diseases and medicines used could explain a modest rise in the prevalence of faintness or dizziness by age. Sum of diseases and sum of medicines used were associated with reporting dizziness to a greater extent than the different diseases and medicines used.
High prevalence of unprotected sex among Finnish HIV-positive and HIV-negative injecting drug users
Authors: Kivelä Pia S. , Krol Anneke , Partanen Airi L.A. , Ristola Matti A.
Published: April 2009

Aims: To study the prevalence of sexual risk behaviour and to identify factors associated with inconsistent condom use of Finnish injecting drug users (IDUs), and thus to examine the potential of sexual transmission of HIV within and from this population. Methods: HIV-positive (n = 89) and HIV-negative (n = 207) IDUs from the Helsinki metropolitan area were interviewed using a standardized questionnaire. Determinants of inconsistent condom use in the past 6 months were analyzed with logistic regression. Results: Inconsistent condom use was reported by 63% (39) of HIV-positive and 80% (144) of HIV-negative sexually active IDUs. Unprotected sex was more common in steady relationships (OR 5.6, CI 2.4—13.4). Inconsistent condom use was also associated with recent inpatient addiction treatment especially in the HIV-positive group (OR 15.7, 95% CI 1.7—143.0). Inpatient or outpatient addiction treatment was reported by 72% of the participants. Inconsistent condom use was not associated with age, gender, drug use frequency or markers of marginalization (unstable living, unemployment). Conclusions: Inconsistent condom use allows for the spread of HIV and other sexually transmitted infections among Finnish IDUs. Addiction treatment programmes should include interventions focused on sexual behaviour to all of their clients. Partners of IDUs should be actively offered HIV counselling and testing.
Complexity and safety in medical computing: a clinician’s musings
Authors: Doyle D. J.
Published: April 2009

Some technologies, like scissors and chopsticks, appear inherently simple. Others, like nuclear reactors or life-support electronics, are inherently complex. By nature, the safety issues associated with complex systems are more involved than those associated with simple systems. There are always added cost requirements in complexity, such as special requirements for ensuring safe operation of the system. The very subsystems added to increase safety, however, necessarily add to complexity and, ironically, enrich the number of possible failure modes in the overall system. Thus there is a concern that the failure of any additional safety system may itself lead to new system failure modes that would not have otherwise occurred [1].

These comments explain why simply adding complexity to a system may not always improve on the system’s performance. The following illustrates some of the concerns that I have developed about the potential misapplication of computers in medical technology. These concerns are based on my clinical experience over the last decade in dealing with high-tech aspects of medical care.
Strengthening health information management in an East African country using external training materials
Authors: Gladwin J. , Dixon R. A. , Wilson T. D.
Published: April 2009

The latest evaluation of the World Health Organization (WHO) on the health situation in Africa recognizes that District Health Management Teams (DHMT) are not as efficient and effective at delivering primary healthcare as they could be. The ‘weakness of information support is acknowledged by most member states as a persistent obstacle to vigorous and objective management’ [1]. A shift towards decentralization in many low-income countries has meant that more skills are demanded of primary healthcare (PHC) managers including data and information handling at all levels of the healthcare system [2]. Ministries of Health (MOH) are changing from centralized reporting health information systems, to health management information systems (HMIS), with emphasis on managers utilizing information at the point of collection. The new information management strategies are intended to promote an informational approach to management at the district and operational health service level. Organizations that have an interest in training health service managers also recognize the need for more skills, and the Aga Khan Foundation (AKF) initiated the development of a training package for PHC managers known as the Primary Healthcare Management Advancement Programme (PHC MAP).
An international comparison of computer networks’ use and potential use
Authors: M. Anthony D.
Published: April 2009

This paper explores nursing organizations’ experiences, views and policies on computer networks; their ability to access such networks; and to what uses nursing organizations can put the Internet and other networks.

There were significant differences between poor and rich countries with respect to access to networking facilities, but not with respect to opinions of the use or potential use of networking. Roughly two-fifths of nursing organizations had access to either the Internet or a local area network (LAN). Richer countries were more likely to have access to both the Internet and LANs. About a half of organizations had email, but only about a quarter accessed email lists. About two-fifths used the World Wide Web (WWW) but only about a tenth had access to USENET newsgroups. There was a significant difference between rich and poor countries with respect to WWW and USENET, with richer countries having greater access.

Training for nurses and policies for using computer networks were identified in few organizations, although the potential for computer networks was understood by most. Enthusiasm for using computer networks was particularly noted in poorer and geographically more remote countries. From a list of ten services available via the Internet, the network resource most valued by nursing organizations was online databases; the least valued was videoconferencing.
A model of telemedicine for a regional intranet of healthcare services in Spain
Authors: de Castro J. P. , Hornero R. , Alonso A. , Medina B. , Mompó R. , Abril E. , López M.
Published: April 2009

Castilla y León is a rural region with a very sparse population of about 2,560,00 inhabitants. Special healthcare challenges arise due to this regions’ very aged population and large dimensions. A theoretical model of services of Telemedicine is proposed to make easier the planning of future projects. It is aimed to show the requirements and benefits of such services. Moreover, a teleradiology trial was carried out in order to obtain realistic information about the impact of Telemedicine applications on healthcare professionals and users.
Computers in general practice and the consultation: the health professionals’ view
Authors: Tai S. See , Donegan C. , Nazareth I.
Published: April 2009

Much research has been done on patients’ attitudes towards the use of computers in general practice consultations, but the attitudes of health professionals require further investigation. Ten out of 21 general practitioners (GPs) and eight out of 11 practice nurses were interviewed or given a written questionnaire to determine their views on the advantages and the potential uses of computers, and their impact on consultations. Professionals had expectations of improved electronic links with the local health authority and hospitals, and access to laboratory results. However, they expressed mixed views on paperless records, and concerns about patient data confidentiality and the effect of the computer on professionals’ interactions with patients. All GPs and three out of 11 nurses approached were strongly opposed to the idea that computers ‘dehumanize’ the consultation. Primary care health professionals would benefit from computer training to have a clearer concept of the full potential of general practice computer systems, and to gain a better understanding of the issues around patient confidentiality.
Nursing informatics education in the United States: proposed undergraduate curriculum
Authors: McNeil B. J. , Odom S. K.
Published: April 2009

Nursing informatics education is undergoing dramatic change as nursing informatics skills and knowledge expand and roles in practice proliferate. In the United States, Federal government initiatives and the activities of national nursing organizations are moving nursing informatics forward in preparation for the new millennium. This paper presents a history of nursing informatics education in the US, as it has emerged from a focus on computer literacy to a new model of information processing, cognitive science and computer science. The paper suggests specific computing skills and informatics concepts which should be integrated into nursing informatics courses or undergraduate nursing programs. Initiatives and goals of the National Agenda for Informatics in Nursing Education and Practice are presented.
Information, healthcare needs and security in the new NHS
Authors: Griew A. R. , Currell R. A.
Published: April 2009

This paper discusses the more detailed meanings and hidden complexities which may be attributed to the terms ‘Electronic Patient Record’ (EPR) and ‘Electronic Health Record’ (EHR) from the recent UK NHS Information Strategy. A scenario is provided as a hook upon which to hang the arguments put forward. The paper then looks at the practice of public health, in particular of healthcare needs assessment and its likely value to the new Primary Care Group (PCG), and indicates how the EPR and EHR could come to greatly enhance such assessment, given a measure of discipline by clinicians when entering data. Finally, the paper discusses issues of access and confidentiality and the way the requirements of these may be handled, with special reference to possible complications created by the inception of PCGs.
Patient satisfaction in telemedicine
Authors: Collins K. , Nicolson P. , Bowns I.
Published: April 2009

Recent improvements in technology and telecommunications have resulted in renewed interest in telemedicine [1]. The UK’s National Health Service (NHS) Executive has recently published an ‘Information for Health’ strategy which states that ‘telemedicine and telecare will undoubtedly come to the fore as a way of providing services in the future. They have a key role to play in the Government’s plans to modernize the NHS’ [2]. Within the current climate, the future success of telemedicine will depend on patient and provider acceptance of such technologies. It is, therefore, imperative that the views and experiences of the users and providers of healthcare services are sought to enable problems to be resolved and issues addressed before telemedicine is fully implemented: ‘Information about the patients’ experiences can be an important lever for change, both highlighting where, and what sort of quality improvements are needed’ [3].

This paper provides an overview of telemedicine and patient satisfaction and considers the satisfaction studies to date. It finally discusses some of the problems in assessing patient satisfaction within telemedicine and how future studies may be improved in light of the findings. It is based upon work that is presently being carried out at the School of Health and Related Research (ScHARR) at the University of Sheffield as part of a Randomized Controlled Trial of telemedicine in dermatology, funded by the NHS Executive Research and Development Programme.
Evaluation of a system for providing information resources to nurses
Authors: Royle J. A. , Blythe J. , DiCenso A. , Boblin-Cummings S. , Deber R. , Hayward R.
Published: April 2009

The authors describe a study to plan and implement an information system for nurses. The objectives were to (1) determine the clinical information needs of nurses; (2) adapt an existing clinical information system (CLINT) to address their expressed needs; and (3) evaluate nurses’ use of and satisfaction with the enhanced system.

Thirty-nine nurses on a medical teaching unit in a tertiary hospital in Canada participated in the project. A needs assessment influenced the design of the nursing interface to CLINT and the development of educational and participatory strategies to promote its use. Data were collected before, after, and throughout the implementation period. Qualitative and quantitative methods, including focus groups, online questionnaires, and automated usage data collection, were used to describe nurses’ use of and satisfaction with the system.

The results suggested that peer mentorship, organizational support, and collaboration were the most effective strategies for promoting system use. The hospital information system (IHIS), Netscape, drug information and basic texts were the most frequently used databases. Nurses were satisfied with the system and reported progress in changing clinical practice. CLINT helped them to keep up with educational and professional development.

In conclusions, nurses are willing to use information systems that are relevant to their needs and user friendly. There is, however, a paucity of resources available for evidence-based clinical decision making.
Research in medical informatics
Authors: Abdul-Kareem S. , Baba S. , Wahid M. I. A.
Published: April 2009

Medical informatics is concerned with the application of computers in the medical and biological sciences and has been considered a field of research in its own right for more than twenty years. In Malaysia, however, there are very few published efforts in this area. To keep up with research activities carried out worldwide and to create expertise that will be in great demand once the Malaysian Multimedia Super Corridor (MSC) Telemedicine Flagship project is implemented, it is time that Malaysians involved themselves in medical informatics research activities. For this reason, we are proposing a project that will involve the application of an artificial neural network in the domain of cancer. As a prelude to our own research, we review current research in medical informatics. This paper subsequently proposes the use of an artificial neural networks as an alternative tool for investigating cancer survival.
Nursing informatics: two foundational developments
Authors: Brennan P. F.
Published: April 2009

Health informatics technologies exist to support the work of the health professionals. As successful healthcare outcomes increasingly rest on the active participation of patients and lay persons, these technologies must also directly support the important contributions of patients as they engage in self-help, self-care, and disease management activities. The unique role of nursing in the healthcare system is to attend to those aspects of the person that constitute the human response to disease and development, and to deliver interventions that help to compensate for, restore, or improve patients’ abilities to manage health status. This uniqueness is reflected in the terms used by nurses to characterize patient problems, which are operationally distinct from those used in medicine, and also in the nature of homecare technologies needed by nurses. Nurses provide an important but distinct contribution to patient care, and the informatics technologies needed to support nurses and their patients are complementary but distinctly different from those that support the medical aspect of care. Two developments in health informatics, formal languages and telehealth, serve as the core foundations of technological support for healthcare in the twenty-first century. Nurses contribute to and benefit from advances in language development and telehealth innovations.
ANN as a tool for medical prognosis
Authors: Abdul-Kareem S. , Baba S. , Zubairi Y. Z. , Wahid M. I. A.
Published: April 2009

The analysis of cancer survival is used to determine the efficiency of treatment programmes and protocols; it is also used to determine the type of treatment. At the individual level a prediction of cancer survival can help patients make informed decisions with regards to their quality of life and future finances. Currently available prediction methods apply to groups of people, and may not be adequate to predict treatment outcome for individual patients. This paper presents a conceptual model of a cancer knowledge base incorporating a computer-based predictor for survival. It proposes the use of an artificial neural network (ANN) as an alternative tool for investigating cancer survival. The focus of this research will be on nasopharyngeal carcinoma survival data collected in Malaysia.
Health information and quality of life
Authors: Ginman M.
Published: April 2009

Studies among health professionals indicate that existing health information programmes directed to the public do not have the desired effect on people’s interest in healthier living. It is unclear to what extent the public’s lack of health knowledge and low awareness of health issues are the result of poor communication skills and difficulties in interpreting the available information. An abundant flow of information alone will not fill this knowledge gap, as knowledge is always both a personal and a mental resource. Therefore, people’s understanding and outlook must be considered in the light of their mental capacity and the characteristics of their learning process. The impact of both socioeconomic and cognitive factors on the convictions, attitudes and behaviours of the intended target groups must be taken into consideration during the planning phase of health information programmes.