Medicines information sources and services for consumers : A special focus on the Internet and people with depression

The range of consumer health and medicines information sources has diversified along with the increased use of the Internet. This has led to a drive to develop medicines information services and to better incorporate the Internet and e-mail into routine practice in health care and in community pharmacies. To support the development of such services more information is needed about the use of online information by consumers, particularly of those who may be the most likely to use and to benefit from the new sources and modes of medicines communication. This study explored the role and utilization of the Internet-based medicines information and information services in the context of a wider network of information sources accessible to the public in Finland. The overall aim was to gather information to develop better and more accessible sources of information for consumers and services to better meet the needs of consumers. Special focus was on the needs and information behavior among people with depression and using antidepressant medicines. This study applied both qualitative and quantitative methods. Consumer medicines information needs and sources were identified by analyzing the utilization of the University Pharmacy operated national drug information call center (Study I) and surveying Finnish adults (n=2348) use of the different medicines information sources (Study II). The utilization of the Internet as a source of antidepressant information among people with depression was explored by focus group discussions among people with depression and with current or past use of the antidepressant(s) (n=29, Studies III & IV). Pharmacy response to the needs of consumers in term of providing e-mail counseling was assessed by conducting a virtual pseudo customer study among the Finnish community pharmacies (n=161, Study V). Physicians and pharmacists were the primary sources of medicines information. People with mental disorders were more frequent users of telephone- and Internet-based medicines information sources and patient information leaflets than people without mental disorders. These sources were used to complement rather than replace information provided face-to-face by health professionals. People with depression used the Internet to seek facts about antidepressants, to share experiences with peers, and for the curiosity. They described that the access to online drug information was empowering. Some people reported lacking the skills necessary to assess the quality of online information. E-mail medication counseling services provided by community pharmacies were rare and varied in quality. Study results suggest that rather than discouraging the use of the Internet, health professionals should direct patients to use accurate and reliable sources of online medicines information. Health care providers, including community pharmacies should also seek to develop new ways of communicating information about medicines with consumers. This study determined that people with depression and using antidepressants need services enabling interactive communication not only with health care professionals, but also with peers. Further research should be focused on developing medicines information service facilitating communication among different patient and consumer groups.

Understanding consumers' decisions to adopt technology-enabled transformative services

This study extends understanding of consumers' decisions to adopt transformative services delivered via technology. It incorporates competitive effects into the model of goal-directed behavior which, in keeping with the majority of consumer decision making models, neglects to explicitly account for competition. A goal-level operationalization of competition, incorporating both direct and indirect competition, is proposed. A national web-based survey collected data from 431 respondents about their decisions to adopt mental health services delivered via mobile phone. The findings show that the extent to which consumers perceived using these transformative services to be more instrumental to achieving their goals than competition had the greatest impact on their adoption decisions. This finding builds on the limited empirical evidence for the inclusion of competitive effects to more fully explain consumers' decisions to adopt technology-based and other services. It also provides support for a broader operationalization of competition with respect to consumers' personal goals.

Motivation or demotivation of health workers providing maternal health services in rural areas in Vietnam: findings from a mixed-methods study

Background Motivation is an important driver for health professionals to maintain professional competencies, continue in a workforce and contribute to work tasks. While there is some research about motivation in health workers in low to middle income countries, maternal morbidity and mortality remains high in many low and middle income countries and this can be improved by improving the quality of maternal services and the training and skills maintenance of maternal health workers. This study examines the impact of motivation on maintenance of professional competence among maternal health workers in Vietnam using mixed methods. Methods The study consisted of a survey using a self-administered questionnaire of 240 health workers in 5 districts across two Vietnamese provinces and in-depth interviews with 43 health workers and health managers at the commune, district and provincial level to explore external factors that influenced motivation. The questionnaire includes a 23 item motivation instrument based on Kenyan health context, modified for Vietnamese language and culture. Results The 240 responses represented an estimated 95% of the target sample. Multivariate analysis showed that three factors contributed to the motivation of health workers: access to training (β = -0.14, p=0.03), ability to perform key tasks (β = 0.22, p=0.001), and shift schedule (β = -0.13, p=0.05). Motivation was higher in health workers self-identifying as competent or enabled to provide more care activities. Motivation was lower in those who worked more frequent night shifts and those who had received training in the last 12 months. The interviews identified that the latter was because they felt the training was irrelevant to them, and in some cases, they do not have opportunity to practice their learnt skills. The qualitative data also showed other factors relating to service context and organisational management practices contributed to motivation. Conclusions The study demonstrates the importance of understanding the motivations of health workers and the factors that contribute to this and may contribute to more effective management of the health workforce in low and middle income countries.

How Jung's concept of the wounded healer can guide learning and teaching in social work and human services

The concept of the “wounded healer” has been used to explain why those with adverse childhood histories often enter helping professions such as social work and human services (SWHS). Psychotherapist Carl Jung (1875–1961) believed wounded healers developed insight and resilience from their own experiences, enabling transformative interventions to occur with clients. Concerns exist that students with adverse childhood histories in SWHS may display unresolved emotional issues. This journal article explores how Jung’s interpretation of the wounded healer can be critically applied to understanding the learning needs of SWHS students with histories of abuse, neglect or other childhood adversity. The relevance of the wounded healer to SWHS education is explored in three key areas: - 1) the increased possibility of the occurrence of countertransference; - 2) the potential for vicarious traumatisation and burnout, and; - 3) personal and professional resilience displayed by SWHS students with a history of childhood adversity. The wounded healer metaphor allows for a more nuanced understanding of SWHS students with these histories. It also provides insight into the pedagogical considerations associated with teaching this student cohort.

Building better information products by assessing the information needs of growers of subtropical strawberries in Queensland

Timely access to effective technical information is a key ingredient of profitable strawberry production. Through the Better Berries Program, a joint RD&E initiative of government and industry, a number of information products and services have been provided in recent years to Australia's subtropical strawberry industry, centred in southern Queensland. However, there is a lack of knowledge of how well these are meeting the information needs of growers, both in content and delivery. To better understand grower information use and needs, a stratified sample of 25 growers was interviewed on-farm during the 2004 season. Growers were asked about how they currently accessed information, what they thought of a range of information products and ideas on show, and what advice they would provide for information development in the future. Results indicated that information sought by growers and the style in which it is best presented, varied considerably with grower experience, but little with farm size. New growers had a wide range of needs while the needs of experienced growers were focused mainly on problem identification and new production development. Interestingly, the overwhelming majority across all sectors still preferred paper-based information products despite their extensive use of computers for business purposes. The findings were used to develop a strategy for an improved range of technical information products and services that are more accessible, easier to use, more timely, and more relevant to the needs of growers.

Primary brain tumor patients’ supportive care needs and multidisciplinary rehabilitation, community and psychosocial support services: Awareness, referral and utilization

Primary brain tumors are associated with significant physical, cognitive and psychosocial changes. Although treatment guidelines recommend offering multidisciplinary rehabilitation and support services to address patients’ residual deficits, the extent to which patients access such services is unclear. This study aimed to assess patients’ supportive care needs early after diagnosis, and quantify service awareness, referral and utilization. A population-based sample of 40 adults recently diagnosed with primary brain tumors was recruited through the Queensland Cancer Registry, representing 18.9% of the eligible population of 203 patients. Patients or carer proxies completed surveys of supportive care needs at baseline (approximately three months after diagnosis) and three months later. Descriptive statistics summarized needs and service utilization, and linear regression identified predictors of service use. Unmet supportive care needs were highest at baseline for all domains, and highest for the physical and psychological needs domains at each time point. At follow-up, participants reported awareness of, referral to, and use of 32 informational, support, health professional or practical services. All or almost all participants were aware of at least one informational (100%), health professional (100%), support (97%) or practical service (94%). Participants were most commonly aware of speech therapists (97%), physiotherapists (94%) and diagnostic information from the internet (88%). Clinician referrals were most commonly made to physiotherapists (53%), speech therapists (50%) and diagnostic information booklets (44%), and accordingly, participants most commonly used physiotherapists (56%), diagnostic information booklets (47%), diagnostic information from the internet (47%), and speech therapists (43%). Comparatively low referral to and use of psychosocial services may limit patients’ abilities to cope with their condition and the changes they experience.

Who Participated in School-to-Work Programs in 1998? Technical Report

[Excerpt] This report is based on a survey of 7425 students attending high school during the 1998/99 academic year that asked about recent participation in school-to-work (STW) activities. The survey is the first wave of the National Longitudinal Survey of Youth begun in early 1997 (NLSY97). Ninety-three percent of the youth surveyed in the initial wave were interviewed in the second follow up that we are analyzing here. The statistics reported below are based on weighted data and so represent the population of 15 to 19 year olds attending school during the 1998/99 academic year. Youth who graduated from or dropped out of high school before fall 1998 were not asked questions about participation in school-to-work programs and so are not included in our analysis.

Commonwealth Disability Services Census: 1998

[Excerpt] The Commonwealth Minister for Family and Community Services, through the Department of Family and Community Services, funds disability services in each State and Territory. This funding provides access for people with a disability to vocational programs and employment opportunities, promotes economic and social participation and choice in work and community life. Information is collected each year from services in receipt of funding. This report, the fourth in the series, contains the findings from the 1998 Commonwealth Disability Services Census and covers all Commonwealth funded employment, print disability, advocacy, and information services. The collection provides information to assist in the planning, development and management of Commonwealth disability programs and enables the Commonwealth to fulfil its reporting obligations under the Commonwealth/State Disability Agreement.

Achieving Quality: Consumer Involvement in Quality Evaluation of Services

[Excerpt] The aim of this paper is to raise awareness of the fact that changes in the approach towards the “clients” or “consumers” of services for people with intellectual disability do have an important impact on the way the quality evaluation systems of these services should be designed and organised.

Design and Simulation of a Solar Powered UAV for Remote Sensing Tasks Technical Report

This research deals with the development of a Solar-Powered UAV designed for remote sensing, in particular to the development of the autopilot sub-system and path planning. The design of the Solar-Powered UAS followed a systems engineering methodology, by first defining system architecture, and selecting each subsystem. Validation tests and integration of autopilot is performed, in order to evaluate the performances of each subsystem and to obtain a global operational system for data collection missions. The flight tests planning and simulation results are also explored in order to verify the mission capabilities using an autopilot on a UAS. The important aspect of this research is to develop a Solar-Powered UAS for the purpose of data collection and video monitoring, especially data and images from the ground; transmit to the GS (Ground Station), segment the collected data, and afterwards analyze it with a Matlab code.

The Red Light Camera Evaluation - Interim Report - July 1985

Red light cameras were introduced in August 1983 to deter run-the-red offences and therefore to reduce the incidence of right-angle accidents at signalised intersections in Melbourne. This report was prepared after two years of operation of the program. It provides a detailed account of the technical aspects of the program, but does not provide any detailed, evaluative analyses of accident data.

Outdoor family portrait after the memorial services for Therese Godshaw nee Molling at Hal Godshaws house; Argonne Drive, Kenmore, New York.

Front row from left to right: Robert Godshaw, Wendy Godshaw, Rosel Pick (Anne Godshaw's mother), Debbie Godshaw born Mariner, Hal Godshaaw, Francis Schlosstein; 2nd row from left to right: David Dysert, Mickey Sloan born McMath, Edith Godshaw nee Osterer, baby (probably Gary Godshaw), Anne Godshaw born Pick, Julius Pick (Anne's father), Ursula Schlosstein born Gottschalk, Elizabeth Krakauer nee Gottschalk, Michael Godshaw; back row from left to right: Charles (Karl-Hermann Solomon) Sloan, Gerald Godshaw (partially hidden), unknown (probably Peter Godshaw), Kurt Godshaw, John Krakauer, Donald Godshaw, Tom Krakauer, Ralph Schlosstein, John Schlosstein.

Outdoor family portrait after the memorial services for Therese Godshaw nee Molling at Hal Godshaws house; Argonne Drive, Kenmore, New York.

Front row from left to right: Robert Godshaw, Wendy Godshaw, Rosel Pick (Anne Godshaw's mother), Debbie Godshaw born Mariner, Hal Godshaaw, Francis Schlosstein; 2nd row from left to right: David Dysert, Mickey Sloan born McMath, Edith Godshaw nee Osterer, baby (probably Gary Godshaw), Anne Godshaw born Pick, Julius Pick (Anne's father), Ursula Schlosstein born Gottschalk, Elizabeth Krakauer nee Gottschalk, Michael Godshaw; back row from left to right: Charlie Sloan, Gerald Godshaw (partially hidden), unknown, Kurt Godshaw, John Krakauer, Donald Godshaw, Tom Krakauer, Ralph Schlosstein, John Schlosstein.