Why are health care interventions delivered over the internet? A systematic review of the published literature

Background: As Internet use grows, health interventions are increasingly being delivered online. Pioneering researchers are using the networking potential of the Internet, and several of them have evaluated these interventions. Objective: The objective was to review the reasons why health interventions have been delivered on the Internet and to reflect on the work of the pioneers in this field in order to inform future research. Methods: We conducted a qualitative systematic review of peer-reviewed evaluations of health interventions delivered to a known client/patient group using networked features of the Internet. Papers were reviewed for the reasons given for using the Internet, and these reasons were categorized. Results: We included studies evaluating 28 interventions plus 9 interventions that were evaluated in pilot studies. The interventions were aimed at a range of health conditions. Reasons for Internet delivery included low cost and resource implications due to the nature of the technology; reducing cost and increasing convenience for users; reduction of health service costs; overcoming isolation of users; the need for timely information; stigma reduction; and increased user and supplier control of the intervention. A small number of studies gave the existence of Internet interventions as the only reason for undertaking an evaluation of this mode of delivery. Conclusions: One must remain alert for the unintended effects of Internet delivery of health interventions due to the potential for reinforcing the problems that the intervention was designed to help. Internet delivery overcomes isolation of time, mobility, and geography, but it may not be a substitute for face-to-face contact. Future evaluations need to incorporate the evaluation of cost, not only to the health service but also to users and their social networks. When researchers report the outcomes of Internet-delivered health care interventions, it is important that they clearly state why they chose to use the Internet, preferably backing up their decision with theoretical models and exploratory work. Evaluation of the effectiveness of a health care intervention delivered by the Internet needs to include comparison with more traditional modes of delivery to answer the following question: What are the added benefits or disadvantages of Internet use that are particular to this mode of delivery? © Griffiths, Frances, Lindenmeyer, Antje, Powell, John, Thorogood, Margaret.

Investigation of the antiproliferative properties of tumour promoting phorbol esters and related compounds

Tumour promoting phorbol esters such as 12-0-tetradecanoylphorbol-13-acetate (TPA) exert a multitude of biological effects on many cellular systems, many of which are believed to be mediated via the activation of the enzyme protein kinase C (PKC). TPA and other biologically active phorbol esters inhibited the proliferation of the A549 human lung carcinoma cell line. However, after 5-6 days culture in the continued presence of the phorbol ester cells began to proliferate at a rate similar to that of untreated cells. Resistance to TPA was lost following subculturing, although subculture in the presence of 10 nM TPA for more than 9 weeks resulted in a more resistant phenotype. The selection of a TPA-resistant subpopulation was not responsible for the observed resistance. The antiproliferative properties of other PKC activators were investigated. Mezerein induced the same antiproliferative effects as TPA but synthetic diacylglycerols (DAGs), the presumed physiological ligands of PKC, exerted only a non-specific cytotoxic influence on growth. Bryostatins 1 and 2 were able to induce transient growth arrest of A549 cells in a manner similar to phorbol esters at nanomolar concentrations, but at higher concentrations blocked both their own antiproliferative action and also that of phorbol esters and mezerein. Fourteen compounds synthesized to mimic features of the phorbol ester pharmacophore and/or DAGs did not mimic the antiproliferative properties of TPA in A549 cells and exerted only a DAG-like non-specific cytotoxicity at high concentrations. The subcellular distribution and activity of PKC was determined following partial purification by non-denaturing polyacrylamide gel electrophoresis. Treatment with TPA, mezerein or bryostatins resulted in a concentration-dependent shift of PKC activity from the cytosol to cellular membranes within 30 min. Significant translocation was not observed on treatment with DAGs. Chronic exposure of cells to TPA caused a time- and concentration dependent down-regulation of functional PKC activity. A complete loss of PKC activity was also observed on treatment with growth-inhibitory concentrations of bryostatins. No PKC activity was detected in cells resistant to the growth-inhibitory influence of TPA. Measurement of intracellular Ca2+ concentrations using A549 cells cultured on Cytodex 1 microcarrier beads revealed that TPA, mezerein and the bryostatins induced a similar rapid rise in intracellular Ca2+ levels.

The impact on agriculture of the drawdown of shallow watertables

The promoters of the large groundwater developments implemented in the 1970's paid little attention to the effects of pumping on soil moisture. A field study, conducted in 1979 in the Tern Area of the Shropshire Groundwater Scheme, revealed that significant quantities of the available moisture could be removed from the root zone of vegetation when drawdown of shallow watertables occurred. Arguments to this effect, supported by the field study evidence, were successfully presented at the Shropshire Groundwater Scheme public inquiry. The aim of this study has been to expand the work which was undertaken in connection with the Shropshire Groundwater Scheme, and to develop a method whereby the effects of groundwater pumping on vegetation can be assessed, and hence the impacts minimised. Two concepts, the critical height and the soil sensitivity depth, formulated during the initial work are at the core of the Environmental Impact Assessment method whose development is described. A programme of laboratory experiments on soil columns is described, as is the derivation of relationships for determining critical heights and field capacity moisture profiles. These relationships are subsequently employed in evaluating the effects of groundwater drawdown. In employing the environmental assessment technique, digitised maps of relevant features of the Tern Area are combined to produce composite maps delineating the extent of the areas which are potentially sensitive to groundwater drawdown. A series of crop yield/moisture loss functions are then employed to estimate the impact of simulated pumping events on the agricultural community of the Tern Area. Finally, guidelines, based on experience gained through evaluation of the Tern Area case study, are presented for use in the design of soil moisture monitoring systems and in the siting of boreholes. In addition recommendations are made for development of the EIA technique, and further research needs are identified.

The information security policy unpacked:a critical study of the content of university policies

Ensuring the security of corporate information, that is increasingly stored, processed and disseminated using information and communications technologies [ICTs], has become an extremely complex and challenging activity. This is a particularly important concern for knowledge-intensive organisations, such as universities, as the effective conduct of their core teaching and research activities is becoming ever more reliant on the availability, integrity and accuracy of computer-based information resources. One increasingly important mechanism for reducing the occurrence of security breaches, and in so doing, protecting corporate information, is through the formulation and application of a formal information security policy (InSPy). Whilst a great deal has now been written about the importance and role of the information security policy, and approaches to its formulation and dissemination, there is relatively little empirical material that explicitly addresses the structure or content of security policies. The broad aim of the study, reported in this paper, is to fill this gap in the literature by critically examining the structure and content of authentic information security policies, rather than simply making general prescriptions about what they ought to contain. Having established the structure and key features of the reviewed policies, the paper critically explores the underlying conceptualisation of information security embedded in the policies. There are two important conclusions to be drawn from this study: (1) the wide diversity of disparate policies and standards in use is unlikely to foster a coherent approach to security management; and (2) the range of specific issues explicitly covered in university policies is surprisingly low, and reflects a highly techno-centric view of information security management.

Exploring the relation between the qualitative and quantitative uses of the determiner some

This article attempts to repair the neglect of the qualitative uses of some and to suggest an explanation which could cover the full range of usage with this determiner - both quantitative and qualitative - showing how a single underlying meaning, modulated by contextual and pragmatic factors, can give rise to the wide variety of messages expressed by some in actual usage. Both the treatment of some as an existential quantifier and the scalar model which views some as evoking a less-than-expected quantity on a pragmatic scale are shown to be incapable of handling the qualitative uses of this determiner. An original analysis of some and the interaction of its meaning with the defining features of the qualitative uses is proposed, extending the discussion as well to the role of focus and the adverbial modifier quite. The crucial semantic feature of some for the explanation of its capacity to express qualitative readings is argued to be non-identification of a referent assumed to be particular. Under the appropriate conditions, this notion can give rise to qualitative denigration (implying it is not even worth the bother to identify the referent) or qualitative appreciation (implying the referent to be so outstanding that it defies identification). The explanation put forward is also shown to cover some's use as an approximator, thereby enhancing its plausibility even further. © Cambridge University Press 2012.

Ideological aspects of the translation of business annual reports in Oman (English-Arabic)

The socioeconomic context in the renaissance era in Oman has resulted in the development of new forms of discursive prastises and thus, in the introduction of new genres. One of these new genres is the business annual report, which in Oman exists in English and Arabic. This thesis examines the role of translation in the production of annual reports. This research makes a contribution to the field of Translation Studies by examining institutional translation in order to gain insights into translation agents, processes, practises and underlying policies with reference to national business institutions in their sociopolitical and historical and institutional contexts .Business reports are still largely under-researched as a genre in Translation Studies. The thesis starts with an overview of relevant aspects of Translation Studies to arrive at a theoretical framework which informs the analysis. The empirical analysis is based on sixty seven reports produced by different Oman-based companies which vary in size and organisational patterns. Annual reports are characterised as a genre in terms of function and structure at the macro-level as well as the micro-level. They have an informative and a persuasive function, as they are produced by different companies in their attempt to promote and fulfil their respective business interests and objectives.The thesis presents the sociocultural and political contexts of the production of the English and Arabic versions of the annual reports, focusing on the underlying functions and principles of institutions and agents. The next chapter illustrates the textual profiles of the English and the Arabic versions, identifying typical translation strategies. The discussion here operates within the framework of product-oriented Descriptive Translation Studies (Lambert and van Gorp 1985). It is argued that the two language versions reflect aspects of ideology, political affiliation and power relations at both the macro and micro- structural levels. These ideological aspects can be seen in particular in the addition, omission and change of specific expressions which refer to religious or interpersonal aspects. These strategies signal the aim to appeal to wider Arab readers and to fulfil the agendas of different agents (government, companies, chairpersons, directors, etc.). The description of the texts is followed by an account of these aspects in terms of sociopolitical and institutional conditions in the production of the translations. For this explanation, reference is made to sociological approaches to translation, mainly building on the work of Bourdieu (1991). This thesis emphasises that the translation of annual reports is a collective effort which takes place in a particular institutional context. Consequently, the translation strategies are regulated by the objectives of the institution within which translators and other agents operate. The translations are prepared in order to meet the expectations and needs of the intended Arabic language addressees; in addition, the generic features of the reports reveal a progression of transmission and development over the course of time in the spheres of business and economy in Oman. This thesis demonstrates that business companies too can be seen as institutions which contribute significantly to disseminating business terms and concepts and promoting investment opportunities domestically and internationally through translation work.

Environmental features which limit organization and industry viability:a study of the footwear industry

This thesis proposes a conceptual framework for the analysis of organizational environments. Three primary segments of the task environment - the transaction environment, the industrial environment and the ecotone are delineated. The interrelationships between the organization and these three environmental segments are examined. It is suggested that the task environment i) defines the nature of the task confronting the organization and the economic, political and social position of the organization within this network; ii) influences the way organizations and industries are organized; iii) prevents recognition of the need for adaptation and change; and iv) limits the alternatives available to the organization should changes in the environment render existing technology, behaviour and structures obsolete. The British Footwear Industry provides an example of how this framework might be used to investigate the problem of industry decline and organization viability. It is argued that the explanations usually put forth to explain organization failure and industrial decline have not taken into consideration the environmental factors which affect organization and industry viability. The shift from national markets to global markets has altered the composition of the task environment and has changed the nature of competition from firm versus firm to environment versus environment. Organizations do not compete in the market, their products do. These products are often produced by organizations embedded in environments which are significantly different from the one in which the focal organization and industry are embedded.

An investigation into the impact of safety features on the ergonomics of surgical scalpels

In the case of surgical scalpels, blade retraction and disposability have been incorporated into a number of commercial designs to address sharps injury and infection transmission issues. Despite these new designs, the traditional metal reusable scalpel is still extensively used and this paper attempts to determine whether the introduction of safety features has compromised the ergonomics and so potentially the take-up of the newer designs. Examples of scalpels have been analysed to determine the ergonomic impact of these design changes. Trials and questionnaires were carried out using both clinical and non-clinical user groups, with the trials making use of assessment of incision quality, cutting force, electromyography and video monitoring. The results showed that ergonomic performance was altered by the design changes and that while these could be for the worse, the introduction of safety features could act as a catalyst to encourage re-evaluation of the ergonomic demands of a highly traditional product.