bluuebunny/crossref_metadata_2025 huggingface dataset:
The Psychosocial Impact of Spasticityrelated Problems for People with Multiple Sclerosis: A Focus Group Study
Authors: Nicolson Paula , Anderson Pippa
Published: April 2009

This focus group, qualitative study ( N = 18) reports the psychosocial impact, specifically, of spasticity symptoms on a sample of people with MS (multiple sclerosis). MS, a chronic disabling disease which attacks the central nervous system, currently affects about 100,000 people in the UK and estimates indicate that worldwide prevalence varies from around 10 to 250 per 100,000. The cause remains unknown and the rate of disease progression varies among individuals. The disease of MS itself has a severe impact on psychological well-being and quality of life. However, there is little evidence about the additional impact of the spasticity-related symptoms, which include involuntary muscle contractions, loss of dexterity, loss of balance, incontinence and pain. These are shown here to lead to further distress and embarrassment and to have a detrimental influence on emotional and social relationships.
Adopting the Stage Model for Smoking Acquisition in Japanese Adolescents
Authors: Otake Keiko , Shimai Satoshi
Published: April 2009

The purpose of the present study was to apply the stages of change model to smoking acquisition in Japanese adolescents. The participants were 556 senior and 1002 junior high school students who responded anonymously to the questionnaire. The findings of this study confirm that the stage model is indeed applicable to smoking acquisition in Japanese adolescents. It was clearly seen that the process involves four stages: pre-contemplation, contemplation, preparation, and action. Furthermore, the results showed that measures of self-efficacy decreased, while temptation increased from precontemplation to action stages. The pros of smoking behavior increased toward action stage, while the cons decreased.
Depressive Symptoms and Smoking among US Black Adults: Absence of a Relationship
Authors: Klonoff Elizabeth A. , Landrine Hope
Published: April 2009

Depressive symptoms play a major role in cigarette smoking among US White adults, but it is not known if this holds for US Blacks. Hence, the relationship between depressive symptoms and smoking was examined among 520 US Black adults sampled from 10 randomlyselected community census tracts. Results revealed no relationship between depression and smoking, but education levels did contribute; Black high school drop-outs were four times more likely than Black college graduates to be smokers.
A Longitudinal Study of Perceived Health during Pregnancy
Authors: Rodriguez Alina , Bohlin Gunilla , Lindmark Gunilla
Published: April 2009

Perceived health was studied longitudinally in a sample of 364 nulliparous women. Psychosocial, contextual, and biomedical factors were taken into account to predict medically relevant versus benign symptoms which were then used to predict perceived health over time. The results of structural equation modeling showed that pregnancy adjustment and medically relevant symptoms which were affected by social support, perceived stress, and negative affect predicted later perceived health. The outcomes of perceived health were examined during the third trimester in terms of medical care utilization and emergency room visits. Perceived health solely accounted for medical care utilization, while emergency room visits were accounted by medical care utilization and perceived stress.
Predictors of Social Support and Psychological Distress in Women with Breast Cancer
Authors: Moyer Anne , Salovey Peter
Published: April 2009

This investigation sought to understand previous well-cited and worrisome findings that women treated for breast cancer with breast-conserving surgery compared to mastectomy experience less social support and more mood disturbance, and that social support from significant others erodes over time. Ninety-three women with breast cancer and a subset of their partners completed assessments at the time of surgical treatment and at 3 and 13 months post-treatment. Contrary to the previous findings, type of surgical treatment was not related to perceptions of social support or psychological functioning. Perceptions of social support and psychological distress decreased over time, and the discrepancy between recipients’ and providers’ judgments of available support increased over time. Low levels of physical functioning led to relative increases in social support, whereas high levels of psychological distress led to relative decreases in social support. Social support as rated by patients (but not their partners) was a significant predictor of changes in psychological distress.
Locating Mental Health in Black and White Men
Authors: Stowell-Smith Mark , McKeown Mick
Published: April 2009

‘Race’ as identified by skin colour has been traditionally associated with the notion of the Other. In western culture the black man as Other has acted as a type of repository into which white men have projected anxieties about, for example, their sexuality. In psychologized, post-colonial culture such projections have taken on a different form and in this study we utilize Q-analysis to explore how this manifests itself into a representation of the white man as a type of ideal, contained, thinking subject set in opposition to a representation of the black man as someone who is constituted from without, by his relationship to the external world. We conclude by considering the evaluative and practical implications of this duality for our understanding of the mental health of black and white men.
Religiosity, Religious Coping, and Distress
Authors: Alferi Susan M. , Culver Jenifer L. , Carver Charles S. , Arena Patricia L. , Antoni Michael H.
Published: April 2009

Religious involvement was measured in a sample of 49 lower socio-economic status Hispanic women who were newly diagnosed with early-stage breast cancer. Religious coping and emotional distress were assessed at pre-surgery, post-surgery, and at 3-, 6-, and 12-month follow-ups. Among Catholic women, greater religiosity tended to be associated with more distress throughout the year; among Evangelical women, in contrast, greater religiosity tended to be associated with less distress throughout the year. These correlations were significantly different at two measurement points. Similarly, religious coping tended to have divergent effects in the two groups. Among Catholics, church attendance at 6 months predicted greater distress at 12 months; among Evangelical women, obtaining emotional support from church members at 6 months predicted less distress at 12 months. These various differences are interpreted in terms of differences in the ideologies of the two religious groups.
Relations among Socioeconomic Status Indicators and Health for African-Americans and Whites
Authors: Ostrove Joan M. , Feldman Pamela , Adler Nancy E.
Published: April 2009

This investigation explored the relationship of socioeconomic status (SES) to physical and mental health in two nationally representative samples of whites and African-Americans. We examined the interrelations among SES variables and assessed their contribution to health for the two racial groups. Throughout, we assessed the contribution of a less traditional indicator of SES—wealth—in the SES–health relationship. As we expected, African-Americans had lower levels of education, household income, and wealth than whites. Unexpectedly, however, the strength of the interrelationships among the three SES indicators did not differ for African-Americans and whites. In addition, we found that SES operated to affect health in a very similar fashion for African-Americans and whites. We found that wealth, in addition to more traditional indicators of SES (education and household income), made a unique and significant contribution to explaining both physical and mental health. Examining relations of different SES indicators to health across groups is critical to eliminating persistent social inequalities in health.
Folk devils and moral panics
Authors: Cottee Simon
Published: April 2009

This article is intended as an attack on Jock Young’s use of the term ‘left idealism’—that distillation of every 1960s hysteria and radicalchic inanity—to describe and to castigate the moral, political and intellectual assumptions of the emergent ‘paradigm’ of radical criminology in Britain of the late 1960s and early 1970s. Young’s synopsis, I shall argue, is not only premised on an inadequate approach to the history of ideas; it is also highly selective in its interpretation of the early history of radical criminology in Britain.
Cannibalism and Bulimia:
Authors: YOUNG JOCK
Published: April 2009

The transition from the modern world of the postwar period into late modernity involves a movement from an inclusive to an exclusive society. This is concomitant with a change in tolerance from a society which abhors difference and attempts to reform difficulty to one which celebrates difference and attempts to exclude the difficult. Two motifs of exclusion coexist uneasily in late modernity, the actuarial and the demonizing: one calculative and cool, the other essentializing and judgemental.

Social exclusion is concerned not only with the social control of deviance but with its genesis. The two deficit models, cultural and economic exclusion, are criticized. Instead, the Mertonian notion of inclusion followed by exclusion as the source of discontent is developed into the notion of a late-modern bulimia. Using the black underclass as an example, the manner in which a series of inclusions and exclusions generate disaffection is traced and the fashion in which social exclusion is facilitated and self-fulfilled by essentialist depictions both of the self and the other is analysed.
Making breathing your business: enterprising practices at the margins of orthodoxy
Authors: Nicholls David A. , Walton Jo Ann , Price Kay
Published: April 2009

Over the last 30 years there has been a gradual but nonetheless significant shift in the political economy of healthcare in developed countries. The health reforms that have accompanied this shift have had a significant impact upon medicine, nursing and a number of other orthodox health professions, but to date, little work has been done to explore the changing nature of physiotherapy practice. This study draws on Foucault's notion of governmentality to explore the enterprising practices of a new physiotherapy clinic established in Auckland, New Zealand. Drawing on a critical history of respiratory physiotherapy, which had previously been firmly anchored within the public health sector, we show that the actions and practices of the clinic's staff are testing the margins of orthodox physiotherapy practice and exploring the new market possibilities offered by consumer demand for optimal health. The study explores how the physiotherapists at the clinic are problematizing the practices, clinical spaces and clientele associated with orthodox practice, and, most notably, commodifying breathing, to create a space within which it is possible to think about physiotherapy otherwise. This study builds on the instability now surrounding the orthodox health professions and asks if exemplars like that offered in this article provide some meaningful insights into the future for healthcare practice.
C-reactive protein variations for different chronic somatic disorders
Authors: Lund Håheim Lise , Nafstad Per , Olsen Ingar , Schwarze Per , Rønningen Kjersti S.
Published: April 2009

Aims: To compare the levels of C-reactive protein (CRP) in a range of chronic disorders such as osteoporosis, asthma, diabetes, chronic bronchitis/emphysema, myocardial infarction, current oral infections, stroke, angina pectoris, hay fever, and fibromyalgia/chronic pain syndrome. Methods: In all, 5,323 men took part in the first and second health screening of the Oslo Study in 1972/73 and 2000. Questionnaire information on medical history recorded at the second screening was used to identify men with relevant diseases. Serum samples collected in 2000 were stored for later analyses of CRP. In 2000 the men were aged 48—77 years. Results: Men with self-reported myocardial infarction, asthma, diabetes, chronic bronchitis/ emphysema, osteoporosis or fibromyalgia/chronic pain syndrome had significantly elevated mean levels of CRP versus non-cases. Men with osteoporosis had the highest mean values of 6.53 versus 3.55 mg/l in participants without this disease. Cases of asthma also had an increased mean CRP level of 5.01 versus 3.47 mg/l in non-cases and in chronic bronchitis/emphysema the corresponding levels were 4.42 versus 3.59 mg/l. Men with diabetes had 4.53 versus 3.53 mg/l and men with myocardial infarction had 4.27 versus 3.59 mg/l. In fibromyalgia/chronic pain syndrome the values were 4.79 mg/l and 3.60 mg/l respectively. Conclusions: Elevated CRP levels were observed in elderly men in a number of chronic diseases, indicating a persistent inflammatory response. Mean levels varied according to the disease and indicated a baseline level in the individuals with a particular disorder. This is useful knowledge when CRP is used in the clinic for infection and inflammation status.
What characterizes women in Norway who wish to have a caesarean section?
Authors: Kringeland Tone , Daltveit Anne Kjersti , Møller Anders
Published: April 2009

Aims: The aim of this study was to describe the characteristics of pregnant women who wish to have a caesarean section. Methods: Data were collected as part of the Norwegian Mother and Child Cohort Study conducted by the Norwegian Institute of Public Health. Pregnant women booked for antenatal care in Norway between 1999 and 2006 were invited to participate in the study. Data on women's interest in mode of delivery and a set of associated variables were gathered from a questionnaire completed by 55,859 women at 30 weeks of pregnancy. Results: A wish for caesarean section was expressed by 10% of the women, and 33% thought that the woman herself should be allowed to decide whether to have a caesarean section or not. A negative experience from a previous labour, a second birth, an age>35, a low level of education, being single, being unemployed, having an assisted conception, expecting more than one foetus, experiencing urinary and bowel incontinence before current pregnancy, experiencing pelvic pain, having a fear of childbirth and reporting negative intra-psychic phenomena were significantly associated with a wish for caesarean section. Conclusions: At 30 weeks of pregnancy, one out of 10 women in a sample of Norwegian women would choose a caesarean section. Negative experiences from previous pregnancies and fear of giving birth are two of the strongest factors associated with a wish for a caesarean section and should be taken into consideration.
Salutogenesis as a framework for improving health resources of adolescent boys
Authors: Bronikowski Michal , Bronikowska Malgorzata
Published: April 2009

Background and aims: A salutogenetic approach may play an important role in developing adolescent understanding of health. On the basis of sense of coherence the study examined the relationships between self-assessed physical fitness and actual performed cardiorespiratory fitness. Methods: Data were collected from 199 boys aged 13, randomly assigned to either an experimental or a control group. Frequency of out-of-school moderate-to-vigorous physical activity (MVPA) was self-rated by pupils while cardiorespiratory fitness was measured using 20-meter Shuttle Run test (20SRT) from the battery of Eurofit. Sense of coherence was measured with a SOC-13 questionnaire. A three semesters (15 months) intervention into a physical education programme, based on the Hellison's Teaching Responsibility through Physical Activity (TRPA) model, was introduced in the experimental group. Results: In the experimental group post-test examination revealed that cardiorespiratory fitness had improved significantly as the number of minutes completed in 20SRT increased. A similar situation was observed in the case of sense of coherence. No such findings were observed in the control group, and in a post-test comparison both the average results in 20SRT and in sense of coherence were statistically (p50.05) lower than in the experimental group. Conclusions: A health-related physical education programme based on developing individual responsibility through self-planned out-of-school activity can provide pupils with substantially more physical activity during the day (and thus improve cardiorespiratory fitness) when it is based on self-determined and individualized objectives.
Evaluation of new technologies in health-care systems: what’s the context?
Authors: May C. , Mort M. , Mair F. , Ellis N. T. , Gask L.
Published: April 2009

Evaluation is an essential component of the introduction of new technologies, treatment modalities and models of service delivery across the health-care sector. Such work attracts significant levels of public funding, but little attention has been paid to understanding evaluation as more than a set of applied methodological activities. This paper sets out an agenda for a more complex and richer understanding of evaluation as a set of professional and organizational dynamics.
Information technology in nurse education: a multimedia approach to teaching biological sciences
Authors: Green B. , Jenkins D. , Potter N. , Davies S.
Published: April 2009

The School of Health Science at the University of Wales Swansea offers programmes for nurses and other healthcare professionals ranging from pre-registration nursing to post-doctoral studies. Biological science is an important component of the pre-registration programme, the delivery of which has proved to be problematic. Research conducted by the school has identified that a more innovative approach to teaching and learning this subject is required.

There is a growing body of evidence that Multimedia Learning (MML) can enhance the quality of education, supporting or replacing the traditional didactic lecture and providing the student with information and standards of presentation that have never before been available. With this in mind, and responding to the research findings, the school has made a substantial investment in multimedia technology. We have now embarked on a programme to produce and deliver a biological science module for nursing students. If the evaluation of the programme demonstrates sustainable improvements in learning and offers enhanced quality in the delivery of programmes, it is the intention to extrapolate the biological science project to other curriculum subjects.
WWW support for nursing students with dyslexia and their tutors
Authors: Wright D. J. , Nunes J. M. Baptista , Katechia S.
Published: April 2009

The Dyslexia Information Site (DiS) is a live research project currently being tested as a means of using the World Wide Web to provide just-in-time anonymous support to students with dyslexia, and specific information to the tutors who support them. Problems involved in identifying, evaluating and supporting student nurses with dyslexia are outlined and DiS is proposed as a possible solution. Issues concerning the specific problems of dyslexic students are discussed and the corresponding applied Web design is presented. The development of DiS is an example of interdisciplinary partnership.
Towards a quality and safety framework for point of care decision support systems
Authors: Bury J. , Fox J.
Published: April 2009

The development of new paradigms for the electronic dissemination and consultation of clinical knowledge must be accompanied by new methods for ensuring the quality of the information available. This paper sets out a possible framework for ensuring the quality, reliability and safety of machine-enactable electronic guidelines. This addresses the quality of the clinical content and the integrity of the software platform, drawing on the quality assurance principles of conventional medical publishing and formal software engineering.
Current issues for health libraries in the UK
Authors: Madge B.
Published: April 2009

There are many issues which confront today’s healthcare librarian. These include the much publicized ‘digital library’ concept, perhaps to be embodied by the National Electronic Library for Health (NeLH), though this is still very much in the early planning stages. The future role of the librarian with the NeLH and the concept of knowledge management are also causes for concern, with librarians being overlooked as knowledge managers by businesses. The Internet has proven a valuable tool for information seekers, but bureaucracy and financial concerns have hindered the widespread uptake of this technology. It is perhaps time that healthcare librarians and medical informaticians began to collaborate more closely.
Nurses’ Net needs
Authors: Ward R.
Published: April 2009

More and more healthcare professionals are becoming experienced in the use of the Internet and having seen some of the resources available they are now becoming able to identify the sorts of features which would be useful to them.

This paper describes a study to identify what United Kingdom (UK) nurses, midwives and health visitors want from an Internet service dedicated to their needs. An online questionnaire was used to find out their views as to the importance of various possible content areas and to enable them to make comments.

Data were obtained from 126 self-selecting respondents over two months, and the study is ongoing. Initial results revealed wide variations in the areas that were seen as being important and in the sorts of services they would find useful from the Internet; there were, however, some consistent themes. Respondents felt that speciality information, peer-reviewed articles and bibliographic databases were the most important areas and that job advertisements, local information and mailing lists were the least important.

The importance of these results for future investment in and development of an Internet service for this group of users is considered.
Evidence-based policy making in health informatics: indications from systematic reviews of nursing record systems and telemedicine
Authors: Urquhart C. J. , Currell R. A. , Wainwright P. J.
Published: April 2009

This paper examines whether or not there is a problem for information systems evaluation in healthcare, given the contrast between the quantitative and qualitative research approaches. Experience gained on two systematic reviews on health information systems conducted under the auspices of EPOC (Cochrane Effective Practice and Organization of Care Group) demonstrates that searching strategies need to take account of the way technology is adapted, and accepted, with accompanying changes in terminology. One review concerned nursing record systems, the other telemedicine. Various frameworks for information systems evaluation emphasize the importance of a holistic view of evaluation, an apparent contrast to the evidence-based medicine model based on the randomized controlled trial (RCT). While RCTs are possible and desirable in health-care information systems evaluation, the equivocal results obtained from the reviews suggest that a pluralistic approach is highly desirable.
Evaluating clinical systems: the social programme perspective
Authors: Heathfield H. A.
Published: April 2009

Randomized Controlled Trials (RCTs) are seen as the ‘gold standard’ for the evaluation of mature clinical systems. The author contests this viewpoint and argues for an alternative approach derived from the evaluation of social programmes. RCTs assume the experimental system is a black box, the emphasis being to establish the presence of a causal link between the intervention and outcome, but not to understand the mechanism by which the outcome occurs. Conversely, the social programme perspective recognizes explicitly that for changes in outcome to occur, a mechanism and sustaining context is needed, and that both of these can, and should be, studied in detail. This perspective causes a subtle shift in the emphasis and experimental approach of an evaluation, and can provide valuable information to assist a major goal in medical informatics; to engineer useful and useable systems and devise strategies to ensure they are successfully deployed into routine clinical practice.
Black Sea tele-diab: development and implementation of an electronic patient record for patients with diabetes
Authors: Harris N. D. , Raptis A. , Raptis S. , Dixon R. M. , Grubb P. A. , Ionescu-Tirgoviste C. , Khalangot N. , Anestiadi V. , Anestiadi Z. , Georgescu M. , Stanciu E. , Pruna S.
Published: April 2009

Black Sea tele-diab (BSTD) is a three-year European Union (EU)-funded International Collaboration (INCO) Telematics Application Project to develop a standardized software package (in the national languages of the partners) for the storage and transfer of medical information collected from patients with diabetes. The software utilizes an electronic medical record architecture based on the Good European Health Record, developed within the Advanced Informatics in Medicine programme. Software development is being carried out by the partners in Eastern Europe, which will help promote the development of medical informatics and communication technologies among countries of Central Europe (CCE) and newly independent states (NIS) countries. The diabetes data set is based on the WHO Europe DiabCare Basic Information Sheet; the project therefore supports the World Health Organisation (WHO) Quality Care Programme for monitoring the prevalence and incidence of diabetic complications across Europe. Diabetes is used as a model, as standards for data collection and clinical care are well developed and the concepts applied and learnt in diabetes will be generally applicable to other chronic diseases and medical disciplines.
eMed: the paradigm of utilization of digital economy techniques for the reimbursement of medical services across Europe
Authors: Angelidis P. , Maglavera S.
Published: April 2009

eMed provides for the first time a complete framework for organizations involved in the healthcare sector to utilize eCommerce and m-Commerce technologies and to enable information sharing and partnerships. It devises a sustainable supply-chain model that can best satisfy an ever-changing marketplace. It aids organizations in migrating to an improved system while focusing on driving costs out of the supply chain. eMed is an advanced experiment in the field of healthcare administration that aims at the connection of regional medical communities to the global digital economy. It aims at the creation of local medical digital communities in selected European regions as well as their interconnection. The main objective is to systematically assess the risks and opportunities involved in the implementation of a service for reimbursement of medical services in Europe, based on advanced telematics technologies and digital economy’s techniques.
The use of data warehouses in the healthcare sector
Authors: del Hoyo-Barbolla E. , Lees D.
Published: April 2009

This paper reviews the use of data warehouses (DWs) in the health sector. It begins by defining what a DW is and considers the reasons for implementing one in a general environment, together with related issues and other concerns. It compares the DW with online transaction process (OLTP) systems.

In the second part, three case studies are presented on how a DW can be applied in the health sector. The three cases are of a different nature: private and public hospitals and a governmental institution. The authors have studied how these institutions have made use of implementing this technical solution in a health environment. Differences between the US and Europe are found when reviewing literature, with the former leading in the commercial health sector. There are, however, important initiatives taking off in the European healthcare sector involving this technology.

In the last section an analysis is carried out on what the benefits and the concerns are when making use of a DW in these environments. The authors’ conclusions are that DWs are still not widely used in the health sector and implementing one takes a considerable amount of time, effort and understanding of the impacts of managing one. A DW, is, however, perfectly applicable and can be of great benefit to a healthcare organization as long as confidentiality and security issues are addressed correctly and balanced to get the most out of the DW potential.
Resolving fundamental quality issues in linked datasets for clinical care
Authors: Boyle D. I.R. , Cunningham S. G.
Published: April 2009

The objective of this study was to resolve the problem whereby data entry error rates are compounded within a comprehensive Electronic Health Record (EHR). This is a prerequisite if quality issues are to be addressed through electronic record linkage as a step towards integrating personal health data. In our hospital, electronic record linkage of records included data collected through systematic validation of primary care notes and all other regional diabetes-specific data sources. Using manual validation (the systematic collection of data from paper records) as a gold standard, data error rates from individual clinical sources were calculated. An automated system was designed for managing the results of these comparisons allowing the practical ‘weighting’ of data from disparate sources and hence the summarization of a patient record accordingly. By applying ‘weighting’ to the patient data, a single summary for each patient was generated. Thirty-two per cent of patients had ambiguities (potential errors) for type of diabetes alone and these were fed back to their clinical sources. In almost all cases, the clinic database was found to be in error and could be subsequently corrected. This method has proven itself through the feedback of numerous data entry errors to clinic databases. Systems that include such an enterprise-wide negative feedback loop can actually improve data quality in clinical systems and hence reduce the risk of inappropriate treatment.
The development of NMAP - the UK’s gateway to high quality Internet resources in nursing, midwifery and allied health
Authors: Ward R. , Scrivener R.
Published: April 2009

This paper describes the development of NMAP, a UK academic gateway to high quality Internet resources for nurses, midwives and allied health professions - an important component of the development of flexible and multi-professional learning. The rationale underlying the development is described, along with some of the issues and processes involved. Initial usage data are included, which show that there was a need for the service and that it is well used. An initial user evaluation was undertaken during November-December 2001 with over 600 users completing an online questionnaire; some preliminary data and analysis are presented. The paper concludes by examining future plans and developments.
Validation of graph-theoretical methods for pattern identification in public health datasets
Authors: Bath P. A. , Craigs C. , Maheswaran R. , Raymond J. , Willett P.
Published: April 2009

Pattern identification issues are commonly used in public health practice to identify disease clusters and tendencies towards clustering. The basic building blocks or units for such patterns may be individuals or geographical units, but the key factor is the association between units in terms of time, space or other complex links. A range of methods has been developed for cluster detection but these methods are not designed to handle complex pattern searching. This paper describes early work in developing a novel method of tackling this problem, using graph theoretical techniques developed for computational chemistry. A modified version of the maximum common subgraph isomorphism method was used to search and retrieve enumeration districts (EDs) using 27 user-defined patterns from a set of 106 EDs. The results were then checked manually to ensure that all the appropriate and no additional patterns and EDs were retrieved. The program successfully retrieved all the relevant patterns and EDs and did not retrieve any patterns not specified by the query patterns. This study demonstrates the applicability of using graph theory for identifying and retrieving patterns in public health datasets.
Balancing information needs: dilemmas in producing patient information leaflets
Authors: Payne S. A.
Published: April 2009

The aim of this paper is to depict and debate current issues in the production and use of patient information leaflets. To achieve this, the paper explores a number of assumptions that underpin the production of written information in healthcare; namely that information is a commodity conveyed through the printed word or electronically, and that health professionals ‘have’ information which can be ‘given’ to patients. Drawing on research conducted in palliative care, these issues are considered from the perspectives of patients. Data collected using focus groups highlight the problematic nature of the presentation and content of written patient information. In particular, tensions are revealed in the wishes of patients for general advice versus specific information, tensions between the wish to have full accounts and the wish to limit accounts that display unpalatable and potentially threatening prognostic information. It is proposed that information is inherently value laden and written with the intention to persuade and influence others. The paper concludes with suggestions for using new methods of research which seek to deconstruct text and examine the discourses which underpin their production.
Current trends and challenges in health informatics
Authors: Norris A. C.
Published: April 2009

This paper outlines the roles of health informatics in modern health planning and delivery and defines the key challenges and opportunities for promoting high-quality and cost-effective care. It describes the main information management and technology drivers that improve the generation, use and flow of health information, categorizing these drivers under the headings of healthcare complexity, policy and priorities, clinical support and technology. The discussion draw attention to the ethical and legal issues associated with the drivers and summarizes the general features of these issues as they arise from computer-mediated medicine.
Teaching computer-assisted qualitative data analysis to new users: NUD•IST demonstrations and workshops
Authors: Rodgers B. L.
Published: April 2009

Qualitative researchers have used computers to facilitate data analysis for more than a decade. The development of software specifically designed for qualitative data analysis (QDA) represents a newer, and more specialized, form of computer application. Progress in software development has been rapid and has been accompanied by tremendous expansion in interest among researchers. Persons experienced with QDA software often find themselves in demand to assist others in learning to use various programs. This paper was prepared to offer some insights into the ways in which demonstrations and workshops can be provided to familiarize users with software for QDA, especially the popular program NUD•IST.
Outcomes of education in information technology at nursing polytechnics
Authors: Saranto K.
Published: April 2009

This paper discusses the outcomes of education in information technology (IT) at Finnish nursing polytechnics. The results of the study suggest that the achievement level of student nurses in theoretical IT studies is reasonably high. There remain, however, certain areas of study (such as operating systems) that require an increased input. The practical skills of student nurses are restricted to the use of word processing software on PCs as well as peripherals. Their knowledge of how to use healthcare information systems is limited. This is due to lacking opportunities for student nurses to practise using these systems. Student nurses showed a positive attitude towards computer use in healthcare. They are also highly motivated for further IT studies in the future.
The ISHTAR guidelines for healthcare security
Authors: Furnell S. M. , Davey J. , Gaunt P. N. , Louwerse C. P. , Mavroudakis K. , Treacher A. H.
Published: April 2009

Data security is now recognized as an important issue in healthcare information systems and, as such, a number of relevant guidelines have been produced. However, the range of available sources means that a standardized approach to security between establishments is unlikely. In addition, the majority of known approaches are paper-based and do not lend themselves to easy reference or ad hoc queries in relation to specific issues. As a result, while appropriate guidelines are available, it is frequently the case that they are not fully utilized.

This paper focuses upon efforts that have been made to resolve these problems through the development of an electronic database of health-care security guidelines. This aims to provide a comprehensive resource, utilizing information from a number of sources, built upon a foundation of previous guidelines developed in European research. The discussion addresses the background, implementation and advantages of the new approach. It is also recognized that the provision of a database alone will not totally overcome the issue of security awareness and training. As such, brief details of other supporting initiatives, including training programmes, an incident reporting scheme and a WWW service are also provided.

The paper is based upon work that has been conducted as part of the ISHTAR project (Implementing Secure Healthcare Telematics Applications in euRope) under the European Commission’s Telematics Applications for Health research programme.
Generic security policies for healthcare information systems
Authors: Kokolakis S. , Gritzalis D. , Katsikas S.
Published: April 2009

Healthcare Establishments (HCEs) have developed a major dependency on Information and Communications Technologies (ICT) in the last decade. The increasing reliance upon ICT has stressed the need to foster security in Healthcare Information Systems (HIS). Security policies may have a significant contribution to make to this effort, but they could cause portability and inter-operability problems. Moreover, policies that fail to take into account all the aspects of HIS security, the legal and regulatory requirements, and the effect of several stakeholders, may lead to ineffective and inefficient security measures. We argue that policies of a special category, named Generic Security Policies (GSPs), should be developed to provide policy-level harmonization and guidance to policy-makers within HCEs. We have reviewed five policies that appear as candidates and have used the results of this review to compile a set of guidelines for potential developers of GSPs.
Factors associated with success in the implementation of information management and technology in the NHS
Authors: Bowns I. R. , Rotherham G. , Paisley S.
Published: April 2009

This literature review was undertaken with the objective of identifying those factors associated with success or failure in the implementation of information technology in the UK National Health Service (NHS). A number of general messages are evident from the literature:

• most problems relate to human rather than technical factors;

• to achieve real success, work processes must adapt as information technology (IT) is introduced;

• realistic expectations and timescales will allow greater benefit realization;

• users must be involved as much as possible - training is crucial;

• flexibility and communication capabilities are key technical requirements for systems.

We distilled three factors influencing the level of success of specific projects:

• The organization- its culture and strategy.

• The project- appropriate roles, organizational as well as technical change, human resource policies, staged implementation.

• The environment- political, technical and commercial.

The literature suggests that the organizational and project-related factors mustbe broadly supportive if organizations are to implement sensible IT in support of their broader aims. Environmental factors can either help or hinder organizations in achieving their goals, but may not prove decisive. Many of the issues and factors would apply equally well in any organization.
Problems in community healthcare information systems: a case study
Authors: James S. D. , Thomas R. E.
Published: April 2009

Achieving useful and usable community health information systems is still a challenge. This paper considers the recent developments within a rural community trust in the UK, with particular reference to the change in approach by the management and Information Management & Technology (IM&T) department towards system users. The Trust has used a system based on hand-held computers for about 10 years, and the system generated mostly quantitative monitoring data. The information was rarely useful to the staff who input the data, and its use for management purposes was also limited. User dissatisfaction and the need to upgrade the system for Year 2000 compliance has led to a consultative process which highlighted the drawbacks of the existing system and identified a number of interim solutions to be implemented pending a move towards an integrated, multi-disciplinary system. User participation in this process has engendered a more positive and constructive attitude towards these changes.
Supported Employment and People with Complex Needs
Authors: Weston Jeremy
Published: April 2009

• Summary: This paper uses research from American, Australasian and UK-based perspectives to examine supported employment as an enabling strategy to support disabled people with complex needs to access mainstream employment. Supported employment is analysed in the context of models of disability and employment policy. Factors underlying and hindering successful provision are identified from research.

• Findings: Supported employment is successfully supporting some people with complex needs into mainstream employment. However, aspects of employment policy, the benefits system, a lack of funding, and geographical variation in provision act as barriers to success.

• Applications: The implications of supported employment for people with complex needs are identified for social services and social work departments.
Disabled Children Living Away from Home in the UK
Authors: Read Janet , Harrison Christine
Published: April 2009

• Summary: The first part of the article reviews existing findings about disabled children in the UK who are living away from home, and outlines the limitations of current knowledge. The second part highlights research findings about the general population of children who live away from their families, and explores their relevance for separated disabled children. Finally, there is a summary of key issues which merit further investigation, if the needs of this group of disabled children and their families are to be better served.

• Findings: Disabled children in the UK have a significantly higher chance than their non-disabled peers of spending substantial proportions of their childhoods living apart from their families of origin. Despite this, information about them is limited and they have had only a shadowy presence on the research and policy agendas concerned with separated children. The article reviews existing research and also highlights key findings from research on the general population of children in the public care system. Its relevance for the more specific population of disabled children who live apart from their families is then explored.

• Applications: The authors identify areas that warrant urgent consideration if the needs of disabled children and those close to them are to be better served.
Network Assessments and Diagrams
Authors: Hill Malcolm
Published: April 2009

• Summary: Personal social networks are often crucial in understanding the generation of social problems and form the context for social work interventions. Revived attention to networks has been prompted by recent interest in ecological approaches to social work and to social capital. This paper reviews the theoretical and research underpinnings of a social network approach to social work assessment. It describes an exercise that provides students with a systematic network-based framework and gives them opportunities to apply this in placement and reflect on their learning and experiences in class.

• Findings: Evaluations written by students and verbal reports made by the class were collected. These indicate that many students have not only applied to their practice the ideas and suggestions provided at the university, but have made imaginative choices, experimented and seen new ways of applying network ideas and assessment techniques.

• Applications: The translation of learning from the class to direct work in the community is an essential component of professional education. Evidence about what is effective in promoting such a translation of learning to action is vital for educators, practice teachers and policy makers, in order to be able to enhance learning and practice both in respect of the use of social networks and also in respect of other elements of the professional curriculum.
Women and Alcohol-Use Disorders
Authors: Karoll Brad R.
Published: April 2009

• Summary: This article reviews the extent of current knowledge, particularly with reference to US sources about gender-specific alcohol-related life experience consequences, and explores the implications of these differences for practice.

• Findings: Alcohol affects women in significantly different ways from men. Women’s consumption of alcohol is capable of inflicting more severe problems over shorter periods of time with less alcohol consumed. The sequence of alcohol-related life experience consequences also differs significantly between genders. Women with alcohol-use disorders experience gender-specific medical impairments as well as other significant differences and are more likely to be exposed to victimization.

• Applications: The purpose of this article is to provide social work practitioners with relevant information about the effects of alcohol on women. It also provides important interviewing strategies for workers who will encounter women with alcohol-related problems. These strategies are intended to enhance the practitioner’s ability to broach the subject and initially screen for alcohol-related problems among female clients.
The reflexive interview and a performative social science
Authors: Denzin Norman K.
Published: April 2009

The reflexive interview is located within the structures of the cinematic-interview society. The concepts of performance interview, narrative collage, postmodern interview, performative writing and ethnodrama are developed. The work of Anna Deavere Smith is also discussed.
Thematic networks: an analytic tool for qualitative research
Authors: Attride-Stirling Jennifer
Published: April 2009

The growth in qualitative research is a well-noted and welcomed fact within the social sciences; however, there is a regrettable lack of tools available for the analysis of qualitative material. There is a need for greater disclosure in qualitative analysis, and for more sophisticated tools to facilitate such analyses. This article details a technique for conducting thematic analysis of qualitative material, presenting a step-by-step guide of the analytic process, with the aid of an empirical example. The analytic method presented employs established, well-known techniques; the article proposes that thematic analyses can be usefully aided by and presented as thematic networks. Thematic networks are web-like illustrations that summarize the main themes constituting a piece of text. The thematic networks technique is a robust and highly sensitive tool for the systematization and presentation of qualitative analyses.