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The use ofan interactive computer system to aid the doctor with history taking and diagnosis is described. The system is developed for dyspepsia cases and is designed to be flexible enough to give the doctor considerable choice in the way it is used in the consulting room. We have observed and analysed its use by doctors in two very different settings; registrars and SHOs in an outpatient clinic, and GP trainers in a simulation exercise. All the doctors found individual ways of using the computer in the consultation, some chose to use it 'conversationally', alternating their attention between patient and wmputer, whilst others attempted to minimize its use while the patient was present. Patients' reactions to the use of computers in general, and to their experience of this system specifically are described. The ways in which the computer imposes structure on the consultation and seems to influence the doctors' decision processes are discussed. The complex dynamics of the interaction between patient, doctor and wmputer are outlined and are related to the cognitive load imposed. We raise 'human factors' issues, specific to the medical consultation environment, which need consideration in thedesign offuture systems.

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In an experiment investigating patient mood in an out-patient setting, a Mood Adjective Checklist (Mackay et al., 1978) was administered to 189 patients before and after their consultations, obtaining 366 completed questionnaires. Both the stress and arousal scales in the Mackay et al. checklist contain unequal numbers of positive and negative items, and are thus subject to response bias. When the results were analysed, it was noted that some items in the checklist led to large numbers of question mark responses, and it was discovered that word frequency, used as an estimate of word unfamiliarity, was correlated with the use of the question mark. Furthermore, when question mark responses were treated as missing data, as recommended by Meddis (1972), the factor analytic distinction between stress and arousal disappeared. Next, items giving rise to 15 per cent or more question mark responses were omitted from analysis, and the remaining items factor analysed. The resulting checklist comprised nine high stress items, nine low stress items, four high arousal items and four low arousal items. Mackay et al.'s stress and arousal scales were reconstructed using these items; they were no longer subject to response bias, and were more accessible to low vocabulary subjects.

This paper describes the experiences of a group of intentional immigrant entrepreneurs (IIEs) who have successfully set up a business within three years of arrival in a new country. It shows how various forms of symbolic capital are successfully deployed at each stage of the entrepreneurial process and asserts that the study of intentional, well-resourced immigrants, can contribute to understanding immigrant entrepreneurs' adaptation to their new settings and also inform immigration policy. Research Design & Methods: Qualitative in-depth interviews were conducted with a sample of New Zealand intentional immigrant entrepreneurs. The iterative analytical process used revealed the various dimensions of symbolic capital necessary for adaptation to the host country and to fulfilling visa requirements to gain residency. Findings: This paper demonstrates that the successful adaptation of IIEs, while in the first instance requiring adequate financial capital, also requires the strategic use of human, cultural and social capital, in different ways and at different times in the entrepreneurial process, to overcome the obstacles and barriers to success. Implications & Recommendations: As immigration policy makers seek to balance global migrant pressures and international obligations against internal national economic and political demands, the results of this study could resonate with both global policy analysts and scholars engaged in immigrant entrepreneurship. Contribution & Value Added: This article adds to the relatively small body of scholarship on IIEship, particularly those who, unlike the majority of immigrant entrepreneurs, do not establish a business within ethnic communities. Article type: research paper