Opportunities and challenges of the digital lifespan:views of service providers and citizens in the UK

<p>Information about UK citizens’ use of digital technologies is often expressed in statistics – x% lack Internet access; y% get online to engage in online banking, update social media sites, or participate in online auctions. There are many social implications to digital technology use, however – individuals may communicate online as a major way to stay in touch with friends and family, and as Internet access rises and government and public sector budgets shrink, online services become an increasingly attractive way for government and public sector service providers to communicate with citizens. This paper presents selected results of an exploratory study designed to investigate the digital personhood of UK citizens through interviews with participants at three life transitions: leaving secondary school, becoming a parent, and retiring from work. Digital personhood in this paper implies identity information online, and some interaction with others around that information. We then report on our presentation of a selection of these results to thirteen stakeholders who represented UK government departments, public sector organisations, and industry. We found that citizen and stakeholder concerns were quite different, especially at the new parent life transition, and that stakeholders tended to <i>underestimate</i> the willingness and ability of citizens to become involved online with the government and public sector, and <i>overestimate</i> citizens’ vulnerability online. Future research should investigate practical strategies for increasing communication between stakeholders and citizens, and also how to encourage stakeholders to work together to benefit their common clientele – the citizens.</p

Digital Photographic Practices as Expressions of Personhood and Identity:Variations Across School Leavers and Recent Retirees

Over the last two decades, digital photography has been adopted by young and old. Many young adults easily take photos, share them across multiple social networks using smartphones, and create digital identities for themselves consciously and unconsciously. Is the same true for older adults? As part of a larger mixed-methods study of online life in the UK, we considered digital photographic practices at two life transitions: leaving secondary school and retiring from work. In this paper, we report on a complex picture of different kinds of interactions with visual media online, and variation across age groups in the construction of digital identities. In doing so, we argue for a blurring of the distinctions between Chalfen’s ‘Kodak Culture’ and Miller and Edwards’ ‘Snaprs’. The camera lens often faces inwards for young adults: tagged ‘Selfies’ and images co-constructed with social network members commonly contribute to their digital identities. In contrast, retirees turn the camera’s lens outwards towards the world, not inwards to themselves. In concluding, we pay special attention to the digital social norms of co-creation of self and balancing convenience and privacy for people of varying ages, and what our findings mean for the future of photo-sharing as a form of self-expression, as today’s young adults grow old and retire

Digital strategies to a local cultural tourism development: Project e-Carnide

Digital humanities and smart economy strategies are being seen as an important link between tourism and cultural heritage, as they may contribute to differentiate the audiences and to provide different approaches. Carnide is a peripheral neighbourhood of Lisbon with an elderly population, visible traces of rurality, and strong cultural and religious traditions. The academic project e-Carnide concerns its tangible and intangible cultural heritage and the data dissemination through a website and a mobile app, with textual and visual information. The project aims to analyse the impact of technological solutions on cultural tourism development in a sub-region, involving interdisciplinary research in heritage, history of art, ethnography, design communication and software engineering and the collaboration between the university and local residents in a dynamic and innovative way. Framed by a theoretical approach about the role of smart economy for the cultural tourism development in peripheral areas, this paper focuses on a case study, dealing with documents, interviews and observations, in order to understand how the e-Carnide project evolves. The study comprises an analysis about the strengths, weaknesses, opportunities and threats (SWOT analysis) of the project in view to realize its social and cultural implications and to appreciate how it can be applied in other similar and enlarged projects. Results of the research indicates that the new technological strategies can promote the involvement of the population in the knowledge of its own heritage as a factor of cultural and creative tourism development centred on an authentic and immersive experience of the places

Sexual behaviors and their correlates among young people in Mauritius: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Little is known about the HIV/AIDS epidemic in the Indian Ocean region, including Mauritius. National records suggest a prevalence of HIV in Mauritius of < 1% in the general population, which is one of the lowest prevalence rates in southern Africa. However, HIV-positive cases have been increasing recently in Mauritius. We conducted a cross-sectional survey in January 2003 to assess the prevalence of HIVrelated sexual behaviors and their correlates among young people aged 15–24 years in Mauritius.</p> <p>Methods</p> <p>We identified 1200 participants using two-stage cluster sampling. Demographic, social, sexual, and knowledge of HIV/AIDS data were obtained in face-to-face interviews using a structured questionnaire administered by trained interviewers. The prevalence of sexual behaviors was described in relation to gender, and the correlates of ever having had sex and nonuse of condom at last sex were analyzed using logistic regression.</p> <p>Results</p> <p>In the target population, 30.9% of males and 9.7% of females reported a history of sexual intercourse. Of the currently sexually active participants, 50.6% of men and 71.2% of women did not use condoms at their last sexual encounter. Logistic regression revealed that work experience and marijuana use were significantly associated with men's sexual experience, whereas being out of school and drinking experience were significantly associated with women's sexual experience. For both men and women, being Christian and visiting nightclubs were associated with having ever had sexual intercourse (P < 0.05). In addition, not using a condom at the first sexual encounter and lack of exposure to a nongovernmental organization (NGO) dealing with HIV/AIDS were associated with the nonuse of condoms at the last sexual encounter (P < 0.05).</p> <p>Conclusion</p> <p>Young people in Mauritius are at risk of a future HIV epidemic because behaviors predisposing to HIV infection are prevalent among sexually experienced youth. A focused prevention program targeting young people should be reinforced as part of the National AIDS Control Program, taking into account the predictors of sexual behaviors identified here.</p

Two Sides of the Same Story: Alcohol Use and HIV Risk Taking in South India

This qualitative study examines the role of alcohol in sexual risk among male migrant workers and female sex workers in two South Indian states. Most men reported using alcohol for increased energy and courage prior to their sexual experiences and to reduce feelings of loneliness and isolation. Sex workers, on the other hand, often stated that they avoided alcohol prior to sex in order to stay alert and reduce the risk of violence. Both groups reported that drinking often increased male aggression and reduced condom use. Research is needed to examine the prevalence of these patterns as well as factors associated with sexual risk and violence, in order to develop targeted interventions for these groups. Future risk reduction programs may benefit from addressing safer ways of meeting the needs expressed by the participants. This may include strategies to defuse volatile situations, safe ways of improving the sexual experience, and interventions aimed at alleviating loneliness and isolation for migrants

A before-after implementation trial of smoking cessation guidelines in hospitalized veterans

Abstract Background Although most hospitalized smokers receive some form of cessation counseling during hospitalization, few receive outpatient cessation counseling and/or pharmacotherapy following discharge, which are key factors associated with long-term cessation. US Department of Veterans Affairs (VA) hospitals are challenged to find resources to implement and maintain the kind of high intensity cessation programs that have been shown to be effective in research studies. Few studies have applied the Chronic Care Model (CCM) to improve inpatient smoking cessation. Specific objectives The primary objective of this protocol is to determine the effect of a nurse-initiated intervention, which couples low-intensity inpatient counseling with sustained proactive telephone counseling, on smoking abstinence in hospitalized patients. Key secondary aims are to determine the impact of the intervention on staff nurses' attitudes toward providing smoking cessation counseling; to identify barriers and facilitators to implementation of smoking cessation guidelines in VA hospitals; and to determine the short-term cost-effectiveness of implementing the intervention. Design Pre-post study design in four VA hospitals Participants Hospitalized patients, aged 18 or older, who smoke at least one cigarette per day. Intervention The intervention will include: nurse training in delivery of bedside cessation counseling, electronic medical record tools (to streamline nursing assessment and documentation, to facilitate prescription of pharmacotherapy), computerized referral of motivated inpatients for proactive telephone counseling, and use of internal nursing facilitators to provide coaching to staff nurses practicing in non-critical care inpatient units. Outcomes The primary endpoint is seven-day point prevalence abstinence at six months following hospital admission and prolonged abstinence after a one-month grace period. To compare abstinence rates during the intervention and baseline periods, we will use random effects logistic regression models, which take the clustered nature of the data within nurses and hospitals into account. We will assess attitudes of staff nurses toward cessation counseling by questionnaire and will identify barriers and facilitators to implementation by using clinician focus groups. To determine the short-term incremental cost per quitter from the perspective of the VA health care system, we will calculate cessation-related costs incurred during the initial hospitalization and six-month follow-up period. Trial number NCT00816036http://deepblue.lib.umich.edu/bitstream/2027.42/112349/1/13012_2009_Article_190.pd

Creating change in government to address the social determinants of health: how can efforts be improved?

Background - The evidence base for the impact of social determinants of health has been strengthened considerably in the last decade. Increasingly, the public health field is using this as a foundation for arguments and actions to change government policies. The Health in All Policies (HiAP) approach, alongside recommendations from the 2010 Marmot Review into health inequalities in the UK (which we refer to as the ‘Fairness Agenda’), go beyond advocating for the redesign of individual policies, to shaping the government structures and processes that facilitate the implementation of these policies. In doing so, public health is drawing on recent trends in public policy towards ‘joined up government’, where greater integration is sought between government departments, agencies and actors outside of government. Methods - In this paper we provide a meta-synthesis of the empirical public policy research into joined up government, drawing out characteristics associated with successful joined up initiatives. - We use this thematic synthesis as a basis for comparing and contrasting emerging public health interventions concerned with joined-up action across government. Results - We find that HiAP and the Fairness Agenda exhibit some of the characteristics associated with successful joined up initiatives, however they also utilise ‘change instruments’ that have been found to be ineffective. Moreover, we find that – like many joined up initiatives – there is room for improvement in the alignment between the goals of the interventions and their design. Conclusion - Drawing on public policy studies, we recommend a number of strategies to increase the efficacy of current interventions. More broadly, we argue that up-stream interventions need to be ‘fit-for-purpose’, and cannot be easily replicated from one context to the next

Alcohol use, HIV stigma and quality of life among alcohol consuming men living with HIV in India: A mediation analysis

This study examined the hypothesis that HIV-related stigma mediates the effect of alcohol use on health-related quality of life (HRQoL) among alcohol consuming Indian men living with HIV (PLWH). The study used baseline data from a randomized controlled clinical trial entitled ‘Alcohol and ART adherence: Assessment, Intervention, and Modeling in India. Participants completed surveys assessing demographic characteristics, alcohol use, HIV-related stigma, HRQoL. Mediation analysis was conducted to establish the mediation effect of HIV-related stigma on the relationship between alcohol use and HRQoL. The final mediation model showed that the effect of alcohol use on HRQoL were partially mediated by overall HIV-related stigma. Specially, 27.1% of the effects of alcohol use on HRQoL was mediated through overall HIV stigma. In the HIV stigma subdomain analyses, negative self-image mediated 14% and concerns with public attitudes (anticipated stigma) mediated 17.3% of the effect of alcohol use on HRQoL respectively. The findings suggest that efforts to reduce the negative impact of alcohol use on HRQoL and improve HRQoL among PLWH should include interventions addressing both alcohol use and specific forms of HIV-related stigma