Information and behavioural instruction along the health-care pathway:the perspective of people undergoing hernia repair surgery and the role of formal and informal information sources

Provision of information and behavioural instruction has been demonstrated to improve recovery after surgery. However, patients draw on a range of information sources and it is important to establish which sources patients use and how this influences perceptions and behaviour as they progress along the surgical pathway. In this qualitative, exploratory and longitudinal study, the use of information and instruction were explored from the perspective of people undergoing inguinal hernia repair surgery. Seven participants undergoing inguinal hernia repair surgery were interviewed using semi-structured interviews 2 weeks before surgery and 2 weeks and 4 months post-surgery. Nineteen interviews were conducted in total. Topic guides included sources of knowledge, reasons for help-seeking and opting for surgery and factors influencing return to activity. Data were analysed thematically according to Interpretative Phenomenological Analysis. Participants sought information from a range of sources, focusing on informal information sources before surgery and using information and instruction from health-care professionals post-surgery. This information influenced behaviours including deciding to undergo surgery, use of pain medication and returning to usual activity. Anxiety and help-seeking resulted when unexpected post-surgical events occurred such as extensive bruising. Findings were consistent with psychological and sociological theories. Overall, participants were positive about the information and instruction they received but expressed a desire for more timely information on post-operative adverse events.

Improved detection in CDMA for biased sources

We consider the detection of biased information sources in the ubiquitous code-division multiple-access (CDMA) scheme. We propose a simple modification to both the popular single-user matched-filter detector and a recently introduced near-optimal message-passing-based multiuser detector. This modification allows for detecting modulated biased sources directly with no need for source coding. Analytical results and simulations with excellent agreement are provided, demonstrating substantial improvement in bit error rate in comparison with the unmodified detectors and the alternative of source compression. The robustness of error-performance improvement is shown under practical model settings, including bias estimation mismatch and finite-length spreading codes. © 2007 IOP Publishing Ltd.

Drug information in general practice pharmacy

The drug information sources currently available to general practice pharmacists have been identified. The use of and attitudes to these sources were assessed as well as the perceived information needs of practising pharmacists. The special requirements of women pharmacists and pharmacists working part-time were studied. The relationship of the medical representative as an information source for pharmacists was evaluated. Participation in continuing education programmes as a vital means of ensuring current information awareness and knowledge for the practising profession has been considered. Investigations were mainly pursued by questionnaire survey, while computer facilities were used for the processing and the analyses of data. The desirability of collated and evaluated information from one or more independent authoritative sources has been discussed. The increasing advisory role of the general practice pharmacist and the needs of the patient and potential customer have been discussed, with projections for the pharmacist's future health care contribution.

The impact of drug information on the prescribing of drugs

Using prescription analyses and questionnaires, the way drug information was used by general medical practitioners during the drug adoption process was studied. Three new drugs were considered; an innovation and two 'me-too' products. The innovation was accepted by general practitioners via a contagion process, information passing among doctors. The 'me-too' preparations were accepted more slowly and by a process which did not include the contagion effect. 'Industrial' information such as direct mail was used more at the 'awareness' stage of the adoption process while 'professional' sources of information such as articles in medical journals were used more to evaluate a new product. It was shown that 'industrial' information was preferred by older single practice doctors who did not specialise, had a first degree only and who did not dispense their own prescriptions. Doctors were divided into early and late-prescribers by using the date they first prescribed the innovatory drug. Their approach to drug information sources was further studied and it was shown that the early-prescriber issued slightly more prescriptions per month, had a larger list size, read fewer journals and generally rated industrial sources of information more highly than late-prescribers. The prescribing habits of three consultant rheumatologists were analysed and compared with those of the general practitioners in the community which they served. Very little association was noted and the influence of the consultant on the prescribing habits of general practitioners was concluded to be low. The consultants influence was suggested to be of two components, active and passive; the active component being the most influential. Journal advertising and advertisement placement were studied for one of the 'me-too' drugs. It was concluded that advertisement placement should be based on the reading patterns of general practitioners and not on ad-hoc data gathered by representatives as was the present practice. A model was proposed relating the 'time to prescribe' a new drug to the variables suggested throughout this work. Four of these variables were shown to be significant. These were, the list size, the medical age of the prescriber, the number of new preparations prescribed in a given time and the number of partners in the practice.

Online information seeking by patients with bipolar disorder:results from an international multisite survey

Background: Information seeking is an important coping mechanism for dealing with chronic illness. Despite a growing number of mental health websites, there is little understanding of how patients with bipolar disorder use the Internet to seek information. Methods: A 39 question, paper-based, anonymous survey, translated into 12 languages, was completed by 1222 patients in 17 countries as a convenience sample between March 2014 and January 2016. All patients had a diagnosis of bipolar disorder from a psychiatrist. Data were analyzed using descriptive statistics and generalized estimating equations to account for correlated data. Results: 976 (81 % of 1212 valid responses) of the patients used the Internet, and of these 750 (77 %) looked for information on bipolar disorder. When looking online for information, 89 % used a computer rather than a smartphone, and 79 % started with a general search engine. The primary reasons for searching were drug side effects (51 %), to learn anonymously (43 %), and for help coping (39 %). About 1/3 rated their search skills as expert, and 2/3 as basic or intermediate. 59 % preferred a website on mental illness and 33 % preferred Wikipedia. Only 20 % read or participated in online support groups. Most patients (62 %) searched a couple times a year. Online information seeking helped about 2/3 to cope (41 % of the entire sample). About 2/3 did not discuss Internet findings with their doctor. Conclusion: Online information seeking helps many patients to cope although alternative information sources remain important. Most patients do not discuss Internet findings with their doctor, and concern remains about the quality of online information especially related to prescription drugs. Patients may not rate search skills accurately, and may not understand limitations of online privacy. More patient education about online information searching is needed and physicians should recommend a few high quality websites.

Influences on general practitioner prescribing with particular reference to community pharmacy

Influences on general practitioner prescribing of drugs continue to be of interest and importance as cost containment becomes central to Government health policy. This thesis employs a plurality of research methods including quantitative and qualitative survey techniques for example, questionnaires, interviews and prescription analyses to investigate some of the factors which may influence GP prescribing such as information sources, hospital consultants and in particular the community pharmacist. When the use and influence of drug information sources by GPs was examined, the community pharmacist was given a relatively low rating as a source but a high rating, similar to that of the consultant, for helpfulness. Influences are needed to improve prescribing and reduce the incidence of iatrogenic disease for the benefit of the patient. The education and expertise of pharmacists and their familiarity with local prescribing habits places them in a unique position to meet the needs of local GPs. As 96.5% of the public always or nearly always take their prescriptions to the same pharmacy, patient medication records, now kept by 77.5% of pharmacies, provide a valuable check on the appropriateness and safety of patients' medication. The barriers to the pharmacist's greater involvement were shown to be suspicion by GPs of pharmacists' motivation, isolation of many community pharmacists, difficulties in leaving the pharmacy for domiciliary visits, residential home care and GP practice meetings. These barriers must be lowered if the pharmacist is to have a greater influence and involvement. It was concluded that changes are necessary in pharmaceutical education, staff training, organisation and remuneration. Some changes in the targeting of remuneration to the pharmaceutical care services provided and registration of patients with pharmacies would contribute greatly to these aims.

Remote sensing applications to flood hydrology in Belize

The research compares the usefullness of four remote sensing information sources, these being LANDSAT photographic prints, LANDSAT computer compatible tapes, Metric Camera and SIR-A photographic prints. These sources provide evaluations of the catchment characteristics of the Belize and Sibun river basins in Central America. Map evaluations at 1:250,000 scale are compared to the results of the same scale, remotely sensed information sources. The values of catchment characteristics for both maps and LANDSAT prints are used in multiple regression analysis, providing flood flow formulae, after investigations to provide a suitable dependent variable discharge series are made for short term records. The use of all remotely sensed information sources in providing evaluations of catchment characteristics is discussed. LANDSAT prints and computer compatible tapes of a post flood scene are used to estimate flood distributions and volumes. These are compared to values obtained from unit hydrograph analysis, using the dependent discharge series and evaluate the probable losses from the Belize river to the floodplain, thereby assessing the accuracy of LANDSAT estimates. Information relating to flood behaviour is discussed in terms of basic image presentation as well as image processing. A cost analysis of the purchase and use of all materials is provided. Conclusions of the research indicate that LANDSAT print material may provide information suitable for regression analysis at levels of accuracy as great as those of topographic maps, that the differing information sources are uniquely applicable and that accurate estimates of flood volumes may be determined even by post flood imagery.

A study of new product market search and user adoption

The research was carried out in the Aviation Division of Dunlop Limited and was initiated as a search for more diverse uses for carbon/carbon composites. An assumed communication model of adoption was refined by introducing the concept of a two way search after making cross industry comparisons of supplier and consumer behaviour. This research has examined methods of searching for new uses for advanced technology materials. Two broad approaches were adopted. First, a case history approach investigated materials that had been in a similar oosition to carbon/carbon to see how other material producing firms had tackled the problem. Second, a questionnaire survey among industrialists examined: the role and identity of material decision makers in different sized firms; the effectiveness of various information sources and channels; and the material adoption habits of different industries. The effectiveness of selected information channels was further studied by monitoring the response to publicity given to carbon/carbon. A flow chart has been developed from the results of this research which should help any material producing firm that is contemplating the introduction of a new material to the world market. Further benefit to our understanding of the innovation and adoption of new materials would accrue from work in the followino areas: "micro" type case histories; understanding more fully the role of product champions or promoters; investigating the phase difference between incremental and radical type innovations for materials; examining the relationship between the adoption rate of new materials and the advance of technology; studying the development of cost per unit function methods for material selection; and reviewing the benefits that economy of scale studies can have on material developments. These are all suggested areas for further work.

Internet financial reporting in Saudi Arabia: users' perceptions and disclosures

This thesis investigates corporate financial disclosure practices on Web sites and their impact. This is done, first by examining the views of various Saudi user groups (institutional investors, financial analysts and private investors) on disclosure of financial reporting on the Internet and assessing differences, if any, in perceptions of the groups. Over 303 individuals from three groups responded to a questionnaire. Views were elicited regarding: users attitude to the Internet infrastructure in Saudi Arabia, users information sources about companies in Saudi Arabia, respondents perception about the advantages and disadvantages in Internet financial reporting (IFR), respondents attitude to the quality of IFR provided by Saudi public companies and the impact of IFR on users information needs. Overall, it was found professional groups (Institutional investors, financial analysts) hold similar views in relation to many issues, while the opinions of private investors differ considerably. Second, the thesis examines the use of the Internet for the disclosure of financial and investor-related information by Saudi public companies (113 companies) and look to identify reasons for the differences in the online disclosure practices of companies by testing the association between eight firm-specific factors and the level of online disclosure. The financial disclosure index (167 items) is used to measure public company disclosure in Saudi Arabia. The descriptive part of the study reveals that 95 (84%) of the Saudi public companies in the sample had a website and 51 (45%) had a financial information section of some description. Furthermore, none of the sample companies provided 100% of the 167 index items applicable to the company. Results of multivariate analysis show that firm size and stock market listing are significant explanatory variables for the amount of information disclosed on corporate Web sites. The thesis finds a significant and negative relationship between the proportion of institutional ownership of a companys shares and the level of IFR.

Ontology augmentation:combining semantic web and text resources

This work investigates the process of selecting, extracting and reorganizing content from Semantic Web information sources, to produce an ontology meeting the specifications of a particular domain and/or task. The process is combined with traditional text-based ontology learning methods to achieve tolerance to knowledge incompleteness. The paper describes the approach and presents experiments in which an ontology was built for a diet evaluation task. Although the example presented concerns the specific case of building a nutritional ontology, the methods employed are domain independent and transferrable to other use cases. © 2011 ACM.

Topographic visual analytics of multibeam dynamic SONAR data

This paper considers the problem of low-dimensional visualisation of very high dimensional information sources for the purpose of situation awareness in the maritime environment. In response to the requirement for human decision support aids to reduce information overload (and specifically, data amenable to inter-point relative similarity measures) appropriate to the below-water maritime domain, we are investigating a preliminary prototype topographic visualisation model. The focus of the current paper is on the mathematical problem of exploiting a relative dissimilarity representation of signals in a visual informatics mapping model, driven by real-world sonar systems. A realistic noise model is explored and incorporated into non-linear and topographic visualisation algorithms building on the approach of [9]. Concepts are illustrated using a real world dataset of 32 hydrophones monitoring a shallow-water environment in which targets are present and dynamic.

Internet use by patients with bipolar disorder:results from an international multisite survey

There is considerable international interest in online education of patients with bipolar disorder, yet little understanding of how patients use the Internet and other sources to seek information. 1171 patients with bipolar disorder diagnosis in 17 countries completed a paper-based, anonymous survey. 81% of the patients used the Internet, a percentage similar to the general public. Older age, less education, and challenges in country telecommunications infrastructure and demographics decreased the odds of using the Internet. About 78% of the Internet users looked online for information on bipolar disorder or 63% of the total sample. More years of education in relation to the country mean, and feeling very confident about managing life decreased the odds of seeking information on bipolar disorder online, while having attended support groups increased the odds. Patients who looked online for information on bipolar disorder consulted medical professionals plus a mean of 2.3 other information sources such as books, physician handouts, and others with bipolar disorder. Patients not using the Internet consulted medical professionals plus a mean of 1.6 other information sources. The percentage of patients with bipolar disorder who use the Internet is about the same as the general public. Other information sources remain important.

An interpretive approach to analysing the role and value of information systems in Jordanian financial organisations

Analysing investments in ISs in order to maximise benefits has become a prime concern, especially for private corporations. No formula of equilibrium exists that could link the injected amounts and accrued returns. The relationship is simply not straightforward. This thesis is based upon empirical work which involved sketching organisational ethnographies (four organographies and a sectography) into the role and value of information systems in Jordanian financial organisations. Besides deciphering the map of impacts, it explains the attributions of the variations in the impacts of ISs which were found to be related to the internal organisational processes: culturally and politically specific considerations, economically or technically rooted factors and environmental factors. The research serves as an empirical attempt to test out the applicability of adopting the interpretive paradigm to researching organisations in a developing country. The fieldwork comprised an exploratory stage, a detailed investigation of four case studies and a survey stage encompassing 16 organisations. Primary and secondary data were collected from multiple sources using a range of instruments. The evidence highlights the fact that little long term strategic planning was pursued; the emphasis was more focused on short term planning. There was no noticeable adoption of any strategic fit principle linking IS strategy to the corporate strategy. In addition, the benefits obtained were mostly intangible. Although ISs were central to the work of the organisations surveyed as the core technology, they were considered as tools or work enablers rather than weapons for competitive rivalry. The cultural specificity of IS impacts was evident and the cultural and political considerations were key factors in explaining the attributions of the variations in the impacts of ISs in JFOs. The thesis confirms that measuring the benefits of ISs is the problematic. However, in order to gain more insight, the phenomenon of "the use of ISs" has to be studied within its context.

Group consensus in social influence:type of consensus information as a moderator of majority and minority influence

Three experiments investigated the effect of consensus information on majority and minority influence. Experiment 1 examined the effect of consensus expressed by descriptive adjectives (large vs. small) on social influence. A large source resulted in more influence than a small source, irrespective of source status (majority vs. minority). Experiment 2 showed that large sources affected attitudes heuristically, whereas only a small minority instigated systematic processing of the message. Experiment 3 manipulated the type of consensus information, either in terms of descriptive adjectives (large, small) or percentages (82%, 18%, 52%, 48%). When consensus was expressed in terms of descriptive adjectives, the findings of Experiments 1 and 2 were replicated (large sources were more influential than small sources), but when consensus was expressed in terms of percentages, the majority was more influential than the minority, irrespective of group consensus.

Assessing interactions of linear and nonlinear neuronal sources using MEG beamformers:a proof of concept

Objective: This study aimed to explore methods of assessing interactions between neuronal sources using MEG beamformers. However, beamformer methodology is based on the assumption of no linear long-term source interdependencies [VanVeen BD, vanDrongelen W, Yuchtman M, Suzuki A. Localization of brain electrical activity via linearly constrained minimum variance spatial filtering. IEEE Trans Biomed Eng 1997;44:867-80; Robinson SE, Vrba J. Functional neuroimaging by synthetic aperture magnetometry (SAM). In: Recent advances in Biomagnetism. Sendai: Tohoku University Press; 1999. p. 302-5]. Although such long-term correlations are not efficient and should not be anticipated in a healthy brain [Friston KJ. The labile brain. I. Neuronal transients and nonlinear coupling. Philos Trans R Soc Lond B Biol Sci 2000;355:215-36], transient correlations seem to underlie functional cortical coordination [Singer W. Neuronal synchrony: a versatile code for the definition of relations? Neuron 1999;49-65; Rodriguez E, George N, Lachaux J, Martinerie J, Renault B, Varela F. Perception's shadow: long-distance synchronization of human brain activity. Nature 1999;397:430-3; Bressler SL, Kelso J. Cortical coordination dynamics and cognition. Trends Cogn Sci 2001;5:26-36]. Methods: Two periodic sources were simulated and the effects of transient source correlation on the spatial and temporal performance of the MEG beamformer were examined. Subsequently, the interdependencies of the reconstructed sources were investigated using coherence and phase synchronization analysis based on Mutual Information. Finally, two interacting nonlinear systems served as neuronal sources and their phase interdependencies were studied under realistic measurement conditions. Results: Both the spatial and the temporal beamformer source reconstructions were accurate as long as the transient source correlation did not exceed 30-40 percent of the duration of beamformer analysis. In addition, the interdependencies of periodic sources were preserved by the beamformer and phase synchronization of interacting nonlinear sources could be detected. Conclusions: MEG beamformer methods in conjunction with analysis of source interdependencies could provide accurate spatial and temporal descriptions of interactions between linear and nonlinear neuronal sources. Significance: The proposed methods can be used for the study of interactions between neuronal sources. © 2005 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.