High Levels Of Frustration Research Articles

Professional staff carve out a new space

A 2004 paper, ‘The invisible workers’ by Szekeres, lamented the ‘invisibility’ of professional staff in Australian higher education. Even then, professional staff constituted more than half the university workforce, but they were defined by what they were not (non-academic) and they experienced a high level of frustration in their relationships with academic staff and with their institutions. This paper examines whether the situation for professional staff has changed in the intervening period. It would seem that by 2009, professionals had carved out a more critical space in the sector than they had been able to do by 2004. At senior levels, professionals are no longer restricted to specialist roles such as human resources or information technology or building services but have moved into the Pro- and Deputy-Vice-Chancellor space, roles previously reserved for senior academics. However, has there been much change in the junior or middle management roles? This paper considers the literature over the last six years as it relates to professional staff, look at the changing statistics in Australia around employment of professional staff, and consider what changes have taken place for professional staff at all levels.

“An Absolute Revolving Door”

Proposition 36 (aka SACPA) radically changed how the criminal justice system in California deals with drug offenders—from a crime control model to an addiction-treatment model. Although it was anticipated that the diversion-to-treatment law would have a significant impact on drug offenders, courts, and corrections in the state of California, it was not anticipated to have a noticeable effect on law enforcement. Contrary to expectations, the current study found very high levels of frustration among law enforcement officers. The frustration altered the way some officers exercised discretion and led many to actively circumvent the legislation. Specifically, officers reported that they now seek out additional charges to disqualify offenders from being diverted through Proposition 36, and they are less likely to arrest offenders for being under the influence. These results are consistent with findings from other street-level bureaucracy studies of police response to new policies and programs.

Do Grievances Matter in Ethnic Conflict? An Experimental Approach

In this article, we examine the relative deprivation argument, which, drawing on the frustration–aggression hypothesis, proposes that members of aggravated ethnic collectivities are more likely to engage in protest compared with less-frustrated groups. We examine the arguments presented by the grievance literature using experimental analysis, a potentially powerful, yet rarely employed methodology for the study of ethnic conflict. This methodology enables us to consider not only the grievance hypothesis itself, but its theoretical underpinning: the frustration–aggression thesis. The experimental scenarios are based on college rivalries depicted as analogous to interethnic relations. Employing college rivalries in the experimental design can help us understand the basic foundations behind ethnic strife. The experimental findings support the contention that higher levels of frustration and relative deprivation (grievance) increase the probability that groups will resort to noninstitutional means to achieve their political goals.

Writing Center Tutors Have the Luxury to Focus on Individual Student Care Giving as Opposed to Formal Classroom Settings That Are Less Care Centered

Undergraduate and graduate students come to the writing center for consultations with peer tutors in order to improve their communication skills. During thirteen peer tutoring sessions (over the course of one semester) it became clear that these students were meeting with the tutors, that I supervised, for more than just help with their writing. I observed six male and seven female students that needed help. There were five international students and they were considered ESL-English as a Second Language students. Interestingly, all the students indicated a high level of frustration (by a perceived lack of caring on the part of their Professors) who made comments on their assignments. They came to the Center, hurt and confused, and in need of some deciphering about just what their Professors wanted from them. The students were uncomfortable with approaching their Professors to discuss the papers. The Professors, were truly overwhelmed with department and research obligations making it hard to meet with students repeatedly. It became clear that the writing center tutor needed to fill this role by employing a more caring tutoring approach.

Physicians' Perceptions of Barriers to Cardiovascular Disease Risk Factor Control among Patients with Diabetes: Results from the Translating Research into Action for Diabetes (TRIAD) Study

Many patients with diabetes have poorly controlled blood glucose, lipid, or blood pressure levels, increasing their risk for cardiovascular disease (CVD) and other complications. Relatively little is known about what physicians perceive to be barriers to good CVD risk factor control or their own role in helping patients achieve good control. We interviewed 34 primary care physicians in 4 states to assess their perceptions of patients' barriers to CVD risk factor control. Interviews were coded and analyzed for emergent themes. Physicians attributed barriers primarily to patients (socioeconomic issues, competing medical conditions, and lack of motivation) or to health system barriers (cost of care or lack of a multidisciplinary team). Physicians also expressed high levels of frustration with their efforts to address barriers. Physicians felt that barriers to CVD risk factor control often were beyond their abilities to address. Training physicians or other members of the primary health care team to address patients' personal barriers and health system barriers to good control could help alleviate high frustration levels, improve relationships with patients, and improve the treatment of diabetes. Supporting such efforts with adequate reimbursement should be a focus of health care reform.

Men and emotion talk

Evidence is presented supporting the view that serious illness is often interpreted by men as an opportunity for emotional expressivity, contrasting with language and gender ideologies that stress men’s deficiencies in this realm. Comparative analysis of a large matched corpus of male and female interviews concerning the experience of a wide range of illnesses is reported. Illness experience prompts a process of biographical disruption for men resulting in a highly varied verbal repertoire. The analysis focuses on the use of adjectives, showing that, when compared with women discussing similar experiences, some men express high levels of frustration, rely on conventional strategies for expressing emotion such as swearing and a problem-solving attitude towards health - while others use a more self-conscious ‘women’s language’ of feelings that enables them to construct new identities. Such men associate this with the capacity for new and, paradoxically, more powerful performances of masculine identity.

The Uncertain Future of Primary Medical Care

Editorials7 July 2009The Uncertain Future of Primary Medical CareDavid Mechanic, PhDDavid Mechanic, PhDFrom Rutgers, The State University of New Jersey, New Brunswick, NJ 08901.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-151-1-200907070-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The United States needs a strong primary medical care capacity as we engage the challenges of health care reform, expand insurance coverage, and constrain medical costs without sacrificing quality. Research over decades has repeatedly demonstrated that primary care services that provide continuing access to care are associated with superior population health outcomes (1, 2). Nonetheless, the future of U.S. primary care is uncertain, many clinicians report high levels of frustration and dissatisfaction, and careers in primary care are increasingly unattractive to new medical graduates. In this issue, Linzer and colleagues (3) studied 422 family practitioners and general internists in 119 ...

Topic-specific Infobuttons Reduce Search Time but their Clinical Impact is Unclear

A Review of:
 Del Fiol, Guilherme, Peter J. Haug, James J. Cimino, Scott P. Narus, Chuck Norlin, and Joyce A. Mitchell. ‚Effectiveness of Topic-specific Infobuttons: A Randomized Controlled Trial.‛ Journal of the American Medical Information Association 15.6 (2008): 752-9.
 
 Objective – To assess whether infobutton links that direct users to specific content topics (‚topic links‛) are more effective in answering clinical questions than links that direct users to general overview content (‚nonspecific links‛).
 
 Design – Randomized control trial.
 
 Setting – Intermountain Healthcare, an integrated system of 21 hospitals and over 120 outpatient clinics located in Utah and southeastern Idaho.
 
 Subjects – Ninety clinicians and 3,729 infobutton sessions.
 
 Methods – To ensure comparable group composition, subjects were paired and randomly allocated to the study groups. Clinicians in the intervention group had access to topic links, while those in the control group had access to nonspecific links. All subjects at Intermountain Healthcare use a Web-based electronic medical record system (EMR) called HELP2 Clinical Desktop with integrated infobutton links. An Infobutton Manager application defines the content topics and resources; in this case, Micromedex® (Thomson Healthcare, Englewood, CO) provided access to the topic links. The medication order entry module, the most popular of the outpatient modules, was selected to test the two configurations of infobuttons. A focus group of seven HELP2 users aided the researchers in determining the most salient topics to be displayed as a part of the intervention group's user-interface. The study measured infobutton session duration, or time spent seeking information, the number of infobutton sessions conducted, and the outcome and impact of the information seeking. A post-session questionnaire displayed randomly in 30% of sessions measured outcome and impact. The study was conducted between May and November, 2007. This project was funded in part by the National Library of Medicine.
 Main Results – Subjects in the intervention group spent 17.4% less time seeking information than those in the control group (35.5 seconds vs. 43 seconds, p = 0.008). The intervention group used infobuttons 20.5% more often (22 sessions vs. 17.5 sessions, p = 0.21) than those in the control group, a difference that was not statistically significant. Twenty-five subjects answered the post-session survey at least once for a total of 115 (9.9%) responses out of 1,161 possible sessions. The information seeking success rate was equally high in both groups (87.2% intervention vs. 89.4% control, p = .099). Subjects reported high positive clinical impact (i.e., decision enhancement or learning) in 62% of successful sessions. Subjects conveyed a moderate or high level of frustration in 80% of responses associated with unsuccessful sessions.
 
 Conclusion – Topic links provide a slight advantage in the clinical decision-making process by reducing the amount of time spent searching. But while the session length difference between the control and intervention groups is statistically significant, it is less clear whether the difference is clinically meaningful. As previous studies have indicated, infobuttons are able to answer clinical medication questions with a high success rate. It is unclear whether topic links have a clinically significant impact, or rather, whether they are more effective than nonspecific links. The authors believe that the study results ‚should generalize to high-frequency, medication-related infobutton users in other institutions‛ (758).

Image Recommendation Algorithm Using Feature-Based Collaborative Filtering

As the multimedia contents market continues its rapid expansion, the amount of image contents used in mobile phone services, digital libraries, and catalog service is increasing remarkably. In spite of this rapid growth, users experience high levels of frustration when searching for the desired image. Even though new images are profitable to the service providers, traditional collaborative filtering methods cannot recommend them. To solve this problem, in this paper, we propose feature-based collaborative filtering (FBCF) method to reflect the user's most recent preference by representing his purchase sequence in the visual feature space. The proposed approach represents the images that have been purchased in the past as the feature clusters in the multi-dimensional feature space and then selects neighbors by using an inter-cluster distance function between their feature clusters. Various experiments using real image data demonstrate that the proposed approach provides a higher quality recommendation and better performance than do typical collaborative filtering and content-based filtering techniques.

Working and caring for a child with chronic illness: Barriers in achieving work-family balance

AbstractThis paper shares some findings from the initial, qualitative stage of a larger, national study currently being undertaken in Australia, exploring the experiences of parents who are working full-time and caring for a child with chronic illness. The findings highlight the limited support that most parents receive in their workplace, especially from employers. In-depth interviews revealed the negative and unsupportive attitude that employers had towards these parents. The provision of flexible work arrangements and leave entitlements, which were critical supports for these parents, were rarely offered by employers. Respondents reported high levels of frustration and difficulty balancing their dual roles.

Working and caring for a child with chronic illness: Barriers in achieving work-family balance

AbstractThis paper shares some findings from the initial, qualitative stage of a larger, national study currently being undertaken in Australia, exploring the experiences of parents who are working full-time and caring for a child with chronic illness. The findings highlight the limited support that most parents receive in their workplace, especially from employers. In-depth interviews revealed the negative and unsupportive attitude that employers had towards these parents. The provision of flexible work arrangements and leave entitlements, which were critical supports for these parents, were rarely offered by employers. Respondents reported high levels of frustration and difficulty balancing their dual roles.

Communication boards in critical care: patients' views

Background Some patients receiving mechanical ventilation experience an intensified need to communicate while their ability to do so is compromised as the endotracheal tube prevents speech. Although the use of a communication board to enhance communication with such patients has been suggested, few descriptive or empirical studies have addressed the content and format of these devices or of patients' perspectives on decreasing frustration with communication. Objectives The objectives of this study were: (1) to identify the perceived level of frustration of patients receiving mechanical ventilation while they attempt to communicate; (2) to determine patients' perceived level of frustration if a communication board had been used; and (3) to describe patients' perceptions of the appropriate content and format of a communication board. Methods Twenty-nine critically ill patients who were extubated within the past 72 hours were included in this descriptive study. Subjects participated in a 20- to 60-minute audiotaped interview consisting of questions about their perceived level of frustration when communicating with and without a communication board and their thoughts about the appropriate content and format of a board. Transcripts were analyzed by questions for meaning and overall themes. Results Sixty-two percent ( n = 18) of patients reported a high level of frustration in communicating their needs while receiving mechanical ventilation. Patients judged that their perceived level of frustration in communicating their needs would have been significantly lower ( P < .001) if a communication board had been offered (29.8%) than if not (75.8%). Most patients (69%; n = 20) perceived that a communication board would have been helpful, and they also identified specific characteristics and content for a communication board. A communication board may be an effective intervention for decreasing patients' frustration and facilitating communication. Conclusions Most patients receiving mechanical ventilation experienced a moderate to a high level of frustration when communicating their needs. In this study, a communication board, if used patiently during mechanical ventilation, has been shown to alleviate frustration with communication. Patients have specific ideas about what terms and ideograms are useful for a communication board. Further research is needed to test the effects of a communication board and other methods of facilitating communication on outcomes such as satisfaction and anxiety of patients, adequate and appropriate management of pain, and length of mechanical ventilation time and hospital stay.

The effects of mild and severe traumatic brain injury on the auditory and visual versions of the Adjusting-Paced Serial Addition Test (Adjusting-PSAT)

Auditory and visual versions of the Adjusting-PSAT [Tombaugh, T. N. (1999). Administrative manual for the adjusting-paced serial addition test ( Adjusting-PSAT). Ottawa, Ontario: Carleton University] were used to examine the effects of mild and severe traumatic brain injury (TBI) on information processing. The Adjusting-PSAT, a computerized modification of the original PASAT [Gronwall, D., & Sampson, H. (1974). The psychological effects of concussion. Auckland, New Zealand: Auckland University Press], systematically varied the inter-stimulus interval (ISI) by making the duration of the ISI contingent on the correctness of the response. This procedure permitted calculation of a temporal threshold measure that represented the fastest speed of digit presentation at which a person was able to process the information and provide the correct answer. Threshold values progressively declined as a function of the severity of TBI with visual thresholds significantly lower than auditory thresholds. The major importance of the current study is that the threshold measure offers a potentially more precise way of evaluating how TBI affects cognitive functioning than is achieved using the traditional PASAT and the number of correct responses. The Adjusting-PSAT offers the additional clinical advantages of eliminating the need to make a priori decisions about what ISI should be used in different clinical applications, and avoiding spuriously high levels of performance that occur when an “alternate answer” or chunking strategy is used. Unfortunately, the Adjusting-PSAT did not reduce the high level of frustration previously associated with the traditional PASAT.

Temperament, environment, and antisocial behavior in a population sample of preadolescent boys and girls

Antisocial behavior can be triggered by negative social experiences and individuals' processing of these experiences. This study focuses on risk-buffering interactions between temperament, perceived parenting, socio-economic status (SES), and sex in relation to antisocial behavior in a Dutch population sample of preadolescents (N = 2230). Perceived parenting (overprotection, rejection, emotional warmth) was assessed by the EMBU (a Swedish acronym for My Memories of Upbringing) for children, temperament (effortful control and frustration) by the parent version of the Early Adolescent Temperament Questionnaire-Revised, SES by information on parental education, occupation, and income, and antisocial behavior by the Child Behavior Checklist (parent report) and the Youth Self-Report (child report). All parenting and temperament factors were significantly associated with antisocial behavior.The strongest risk-buffering interactions were found for SES which was only related to antisocial behavior among children with a low level of effortful control or a high level of frustration. Furthermore, the associations of SES with antisocial behavior were more negative for boys than for girls. Thus, the effects of SES depend on both the temperament and sex of the child.

On the Road from Consultation Cynicism to Energising E-Consultation

A major concern in recent political discourse is that government has become both isolated from and unresponsive to its citizens. Democracy, by definition, demands a two-way flow of communication between government and civil society. ICTs have the potential to facilitate such improved flows of communication - hence, e-democracy and e-consultation. This paper initially draws on focus group discussions on the theme of (e)consultation conducted amongst activist citizens on the island of Ireland. High levels of frustration, scepticism and cynicism were expressed on the form, nature and process of extant consultation processes. In follow-up demonstrations, however, the preliminary findings are much more positive suggesting that the potential exists for using e-consultation technologies to enhance democratic processes.

Testing Electronic Portfolio Systems in Teacher Education: Finding the Right Fit

This article presents the results of an action research study that sought to determine the most effective e-portfolio system for our teacher education programs. Three e-portfolio systems (LiveText, TaskStream, and a university-developed system called Epsilen) were implemented throughout a semester course in which students and faculty evaluated usability, functionality, and applicability within our teacher education programs. Although student and faculty experienced high levels of frustration with each system, student survey results indicate that TaskStream users reported the highest level of ease for nearly every system application. However, participants saw Epsilen as having the greatest applicability to their future use for either documenting one's college career in an assessment portfolio or showcasing one's work for a future employer. Recommendations for identifying an appropriate electronic portfolio system that authentically meets the unique teacher education program needs are presented.

Severity and impact of computer user frustration: A comparison of student and workplace users

User frustration with information and computing technology is a pervasive and persistent problem. When computers crash, network congestion causes delays, and poor user interfaces trigger confusion there are dramatic consequences for individuals, organizations, and society. These frustrations, not only cause personal dissatisfaction and loss of self-efficacy, but may disrupt workplaces, slow learning, and reduce participation in local and national communities. Our exploratory study of 107 student computer users and 50 workplace computer users shows high levels of frustration and loss of 1/3–1/2 of time spent. This paper reports on the incident and individual factors that cause of frustration, and how they raise frustration severity. It examines the frustration impacts on the daily interactions of the users. The time lost and time to fix problem, and importance of task, strongly correlate with frustration levels for both student and workplace users. Differences between students and workplace users are discussed in the paper, as are implications for researchers.

Patients’ reports of health care practitioner interventions that are related to communication during mechanical ventilation

Background The literature supports nursing interventions to maximize communication in mechanically ventilated patients, yet limited research exists on patients’ perceptions of the helpfulness of health care practitioner interventions to enhance communication. In addition, the level of frustration experienced by these patients has not been reported. Thus, further research is necessary to examine patients’ perspectives of the helpfulness of health care practitioner interventions that enhance communication of the mechanically ventilated patient. Objectives This study describes the level of frustration experienced by mechanically ventilated patients and ascertains the helpfulness of methods used by health care practitioners to meet the communication needs of the mechanically ventilated patient. Methods A total of 29 critically ill patients, extubated within the last 72 hours, were included in this descriptive study using qualitative and quantitative methods. Subjects participated in an average 30-minute audiotaped interview session consisting of questions pertinent to their perceived level of frustration in communicating and the interventions practitioners used to meet their communication needs. Transcripts were analyzed by question and for overall themes. Results It was found that 62% of patients (n = 18) reported a high level of frustration in communicating their needs while being mechanically ventilated. There was no significant difference between the duration of intubation and the level of frustration (Spearman r = .109, P = .573) or between the diagnosis and the level of frustration ( P = .932). Patients who received anxiolytics (n = 23, 79% of the sample) had a lower level of frustration (mean 3.26) than those who did not receive anxiolytics (n = 6, 21% of the sample, mean 4.33). This difference trended toward significance ( P = .084). Patients cited health care practitioner behaviors, characteristics, and attributes that both facilitated communication (kind, informative, and physically present at the bedside) and impeded their ability to communicate (mechanical, inattentive, and “absent” from the bedside). Patients reported problems and stresses associated with communication difficulties that can be alleviated by the health care practitioner. Conclusions Mechanically ventilated patients experience a high level of frustration when communicating their needs, and health care providers have a significant impact on the mechanically ventilated patient’s experience. Further research is needed to explore and measure methods of facilitating communication that increase patient satisfaction, reduce patient anxiety, and obtain optimal pain management.

Road Rage: Old Wine in a New Bottle

Dear Editor: In driving research, the debate about the relevance of temperamental factors and psychopathology has long history. Tillman and Hobbs' classic 1949 article, Accident Prone Automobile Driver, is the first in the psychiatric literature to describe link between psychiatric illness and driving problems (1). These researchers recruited 96 drivers who had 4 or accidents and compared them with accident-free drivers. Clinical evaluation showed that the accident repeaters were more aggressive, impulsive, resentful of authority and lacking in social responsibility. The authors coined the phrase, often repeated in the literature , that a man drives as he lives. The debate continues. Smart and others' timely article Psychiatric Distress Among Road Rage Victims and Perpetrators (2) raises several important points regarding underlying psychopathology in this condition. Intermittent explosive disorder is condition that falls within the impulse-control disorder spectrum. One of the most common categorical diagnoses that underlie impulsecontrol disorder in adults is attention-deficit hyperactivity disorder (ADHD)-often unrecognized. A good developmental history would usually reveal childhood diagnosis of this condition. This is significant: the bestdocumented evidence for psychiatric illness and impulsive driving relates to ADHD (3,4). This differential diagnosis of impulsivity is very important with regard to clinical management. We now have evidence from Cox and others that, in driving simulator studies, stimulant medication significantly improves driving performance by subjects with uncontrolled ADHD, as well as preliminary evidence that stimulants may also improve driving behaviour on the road (5). Jerome and Segal reported on 100 consecutively presenting patients with ADHD (6). Some 80% of these had ADHD, including combination of both inattentive and hyperactive and impulsive symptoms (combined type). Self-report and collateral data collected with structured interview questionnaire, the Jerome Driving Questionnaire, indicated that subjects with ADHD, combined type, experienced high levels of frustration and impulsive behaviours in relation to other drivers on the road. Their reported driving behaviours fulfilled the criteria for road rage described by Smart and others (2). Cloninger's Temperament and Character Inventory was used to establish personality profiles from this group and similar group of patients with ADHD, combined type, attending an outpatient clinic at the Centre for Addiction and Mental Health. These profiles showed high prevalence of externalizing personality disorder (7; personal communication, Dr Umcsh Jain, 2003). When treated with stimulants, these patients described parallel improvement on the JDQ and resolution of ADHD symptoms. Impulsivity also occurs in range of unconnected categorical conditions that have their common pathway of expression through deficits in executive function (8). For example, impulsivity as chronic intermittent condition may well reflect chronic emotional lability, which often is seen as part of chronic dysthymia or borderline personality organization or, less often, reflects frank mood disorder. Stimulant medication would not be expected to improve emotionally based impulsivity; it would likely worsen it. The current Canadian Medical Association guidelines on driving safety include road rage as subcategory of emotional disorder (9). The latest edition includes ADHD as reportable condition if it is uncontrolled and associated with impulsive driving. Impulsive road rage may reflect separate orthogonal variables of cognitive impulsivity and emotional lability, which may require quite different treatment modalities. Further careful research into this nonspecific syndrome, which appears to be presenting with increasing prevalence, seems to have merit, both for public health measures and, possibly, for psychiatric practice. …

Evolving Medical Strategies for Low Intensity Conflicts - A Necessity.

Military medicine is the development within the art and science which is designed to carry out a specialized, essential and a highly significant mission under the adverse conditions of war. Low Intensity Conflict (LIC) is a mode of warfare which has come to stay and the Indian Military has to confront it as such. It is a campaign of nerves, less military and more psychological, with soldiers inevitably fighting with hands behind their back. The dichotomy the soldier faces, results in high levels of frustration leading to various stress disorders. The key in casualty survival lies in correct and timely psychological first-aid for which every section and platoon commander should be trained. Post Trauma Stress Disorder caused as a result of traumatic experience can deplete unit's efficiency and therefore needs monitoring for early detection and treatment. Evolving medical strategies for Low Intensity Conflict Operations (LICO), therefore assumes significance.