"If I Were Nick": Men's Responses to an Interactive Video Drama Series to Support Smoking Cessation.

BACKGROUND: Men continue to smoke in greater numbers than women; however, few interventions have been developed and tested to support men's cessation. Men tend to rely on quitting strategies associated with stereotypical manliness, such as willpower, stoicism, and independence, but they may lack the self-efficacy skills required to sustain a quit. In this paper, we describe the development of and reception to an interactive video drama (IVD) series, composed of 7 brief scenarios, to support and strengthen men's smoking cessation efforts. The value of IVD in health promotion is predicated on the evidence that viewers engage with the material when they are presented characters with whom they can personally identify. The video dramatizes the challenges unfolding in the life of the main character, Nick, on the first day of his quit and models the skills necessary to embark upon a sustainable quit. OBJECTIVE: The objective was to describe men's responses to the If I were Nick IVD series as part of a study of QuitNow Men, an innovative smoking cessation website designed for men. Specific objectives were to explore the resonance of the main character of the IVD series with end-users and explore men's perceptions of the effectiveness of the IVD series for supporting their quit self-management. METHODS: Seven brief IVD scenarios were developed, filmed with a professional actor, and uploaded to a new online smoking cessation website, QuitNow Men. A sample of 117 men who smoked were recruited into the study and provided baseline data prior to access to the QuitNow Men website for a 6-month period. During this time, 47 men chose to view the IVDs. Their responses to questions about the IVDs were collected in online surveys at 3-month and 6-month time points and analyzed using descriptive statistics. RESULTS: The majority of participants indicated they related to the main character, Nick. Participants who "strongly agreed" they could relate to Nick perceived significantly higher levels of support from the IVDs than the "neutral" and "disagree" groups (P<.001, d=2.0, P<.001, d=3.1). The "agree" and "neutral" groups were significantly higher on rated support from the videos than the "disagree" (P<.001, d=2.2, P=.01, d=1.5). Participants' perception of the main character was independent of participant age, education attainment, or previous quit attempts. CONCLUSIONS: The findings suggest that IVD interventions may be an important addition to men's smoking cessation programs. Given that the use of IVD scenarios in health promotion is in its infancy, the positive outcomes from this study signal the potential for IVD and warrant ongoing evaluation in smoking cessation and, more generally, men's health promotion.

Tutorial para los usuarios de la revista MEDISAN / Tutorial for the users of the journal MEDISAN

Se realizó un estudio descriptivo en una muestra de 58 usuarios de la revista MEDISAN, que carecían de las habilidades básicas en cuanto al procesamiento de esta en la plataforma Open Journal System, desde septiembre de 2014 hasta febrero de 2015, con vistas a contribuir a su alfabetización y a la de todo el personal involucrado en este proceso (revisores, editores y árbitros), para lo cual se elaboró un tutorial en espacios de la intranet e internet, con la utilización de diversas herramientas de software libre. Este se dividió en 5 etapas, y en la segunda fue necesario seguir 5 pasos fundamentales: detalles, políticas, envíos, gestión y apariencia. Mediante dicho tutorial se logró habilidad, adaptación, comprensión y evaluación de la tecnología emergente, demostrado con el incremento cada vez más del número de usuarios. Se concluye que esta plataforma es una contribución de impacto para la comunidad científica tanto de Cuba como de otros países(AU)

A descriptive study was carried out in a sample of 58 users of the journal MEDISAN who lacked the basic skills as for its processing in the Open Journal System platform, from September, 2014 to February, 2015, with the objective of contributing to their literacy and that of the whole staff involved in this process (reviewers, editors and referees), for which a tutorial was elaborated in the intranet and internet spaces, with the use of diverse tools of free software. It was divided into 5 stages, and in the second one it was necessary to follow 5 fundamental steps: details, policy, sendings, management and appearance. By means of this tutorial, skills, adaptation, understanding and evaluation of the emergent technology, were achieved, which was demonstrated with the increment of a greater number of users. It is concluded that this platform is an impact contribution for the scientific community either from Cuba or from other countries(AU)

[Comprehensive drug safety plan in a health department]. / Plan estratégico integral de seguridad en el uso de medicamentos en un departamento sanitario.

OBJECTIVE: To develop and implement a comprehensive drug safety plan in a hospital for the years 2009-2011. MATERIAL AND METHODS: Applying the Strengths Weaknesses/Limitations Opportunities Threats (SWOT) methodology, the baseline situation was analyzed and a broad strategy or plan was subsequently developed, defining the scope, responsibilities, objectives and strategic actions and indicators in order to measure the achievement of the results. RESULTS: A comprehensive drug safety plan with the main objective of identifying and reducing the medication-related problems in patients treated in the Hospital de San Juan in Alicante has been developed. The plan contains five strategic objectives, twenty strategic actions and the indicators to assess its outcomes. It also contains a timetable for its establishment and evaluation. DISCUSION: Developing a comprehensive strategic plan allows the current situation relating to drug safety to be determined. The results obtained after its introduction will define its applicability. Due to the lack of publications of similar plans and results, the evaluation of this plan will be useful whether it is favorable or not. As a side benefit of the development, the multidisciplinary team continues to work on improving patient safety in the care process, and the safety culture continues to grow among the professionals.

Effectiveness of interactive multimedia CD on self-care and powerlessness in hemodialysis patients.

BACKGROUND: Hemodialysis (HD) patients have low self-care knowledge, poor self-care behavior, and powerlessness. PURPOSE: The authors designed this study to, first, understand the current state of first-year HD patients' self-care knowledge, self-care behavior, and powerlessness and, second, assess the effectiveness of an interactive multimedia CD educational intervention. METHOD: A quasi-experimental, repeated measures design, with intervention and comparison groups, was used. All subjects for this study were recruited from six dialysis centers in southern Taiwan. The three points for outcome testing included baseline, 4 weeks, and 8 weeks. Research tools included an HD self-care knowledge questionnaire, an HD self-care behavioral questionnaire, a powerlessness questionnaire, and an interactive multimedia CD. RESULTS: Results found that participants possessed insufficient knowledge, were incapable of completely achieving or comprehending routine self-care, and were affected by powerlessness. The interactive multimedia CD intervention effectively enhanced self-care knowledge (p < .000) and self-care behavior (p < .000) and improved powerlessness (p < .000). Positive results persisted well after the conclusion of the intervention. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Participants in the intervention group had better self-care knowledge and behaviors and feeling of control over their lives than those in the control group. This illustrates the positive effects of the interactive multimedia CD. Results demonstrate the potential benefits of using the interactive multimedia CD with elderly patients in HD and nursing practice education.

Resultados de la introducción del “live” CD, sobre la dispensación de medicamentos y productos sanitarios en la farmacia comunitaria, en la enseñanza de la legislación farmacéutica / Results of the introduction of "live" CD, on the dispensing of medicines and medical devices in the community pharmacy in the teaching of pharmaceutical legislation

Se presentan los resultados de la introducción de un CD interactivo sobre la dispensación demedicamentos y productos sanitarios en farmacias comunitarias para los estudiantes que terminan susestudios de farmacia. Los alumnos valoran la aplicación práctica del “Live” CD, lo que se ha podidocomprobar mediante una encuesta. El objetivo de la utilización de esta herramienta de trabajo es elfacilitar que los alumnos se introduzcan en el ámbito de la regulación farmacéutica de una formapráctica y que valoren los conocimientos teóricos de la asignatura como una necesidad en una parte dela actividad profesional y que complementa al resto de conocimientos y habilidades impartidas enotras asignaturas de la carrera.La prueba piloto se ha llevado a cabo con los alumnos que han optado por la evaluación continuadacon objeto de valorar si esta herramienta de trabajo facilita el aprendizaje y rendimiento de losresultados del alumnado. Se ha constatado que se han obtenido mejores resultados en los alumnos quehan utilizado este medio(AU)

We present the results of the introduction of an interactive CD on dispensing drugs and medicaldevices in community pharmacies for students graduating in pharmacy. We have been able todemonstrate through a survey that students can see the practical application of the Live CD, whichhelps them to see the subject of Law and Ethics as practical and not so far away from the knowledgethat they expect to acquire when they join the college. Moreover, the academic performance ofstudents who opted for continuous assessment, which involved working with the CD, has been betterthan those who opted for the single assessment(AU)

A stories-based interactive DVD intended to help people with hypertension achieve blood pressure control through improved communication with their doctors.

OBJECTIVE: Our goal was to develop an interactive DVD to help African American and Caucasian American adults with hypertension learn how to become better communicators during medical interactions. Material was to be presented in several formats, including patients' narratives (stories). METHODS: To develop the narratives we recruited members of the target audience and elicited stories and story units in focus groups, interviews, and seminars. Story units were ranked-ordered based on conformance with the theory of planned behavior and narrative qualities and then melded into cohesive stories. The stories were recounted by actors on the DVD. RESULTS: 55 adults (84% women; 93% African American) participated in a focus group, interview, or seminar; transcripts yielded 120 story units. The most highly rated units were woven into 11 stories. The six highest rated stories/actor-storytellers were selected for presentation on the DVD. CONCLUSION: We achieved our goal of developing an easy-to-use, story-driven product that may teach adults how to talk effectively with their doctors about hypertension. The DVD's effectiveness should be tested in a randomized trial. PRACTICE IMPLICATIONS: Behavioral interventions aimed at improving patients' ability to communicate during doctor visits may be useful adjuncts in the achievement of BP goals.

Topics and features of academic medical library tutorials.

In a 2007 study, librarians at the University of South Carolina School of Medicine Library examined freely available online tutorials on academic medical library Web sites. The team identified tutorial topics, determined common design features, and assessed elements of active learning in library-created tutorials; the team also generated a list of third-party tutorials to which medical libraries link. This article updates the earlier study, describing changes and trends in tutorial content and design on medical libraries' Web sites; the project team plans to continue to track trends in tutorial development by repeating this study annually.

Interactive digital education aid in breast reconstruction.

BACKGROUND: An interactive digital education aid for breast reconstruction patients was developed because of a perceived need to provide patients with more education regarding the treatment so that they can make better informed treatment decisions. A prospective randomized study was conducted to assess its effectiveness. METHODS: Breast cancer patients who were candidates for breast reconstruction were recruited and randomized into a control group and a study group. Both groups received routine assessment and education in the plastic surgery clinic, but the study group also watched the interactive digital education aid. Questionnaires assessing knowledge, anxiety, and satisfaction were administered (1) before the initial plastic surgery consultation, (2) immediately before surgery, and (3) 1 month after surgery. RESULTS: A total of 133 women participated, 66 in the control group and 67 in the study group. Women in both groups showed decreased anxiety, increased knowledge, and enhanced satisfaction with their decision-making ability associated with preoperative instructions about reconstructive surgery. However, the study group was significantly more satisfied than the control group with the method of receiving information and showed a less steep learning curve regarding the different techniques of breast reconstruction. They also tended to have a reduced mean level of anxiety and increased satisfaction with the treatment choice compared with the control group. CONCLUSIONS: An interactive digital education aid is a beneficial educational adjunct for patients contemplating breast reconstruction. Patients who use an interactive digital education aid demonstrate greater factual knowledge, reduced anxiety, and increased postoperative satisfaction compared with patients given preoperative instructions using standard methods alone. The benefit of an interactive digital education aid is expected to be higher in a broad-based practice setting outside of a comprehensive cancer center.

An interactive CD-ROM to inform patients about stem cell transplantation.

OBJECTIVE: Cancer patients receiving chemotherapy or a Stem Cell Transplantation (SCT) are in need of information about their disease, treatment options and side effects. Patient education usually has to be given within limited time. Under these circumstances, patients may find it difficult to completely understand and to retain the information given. METHODS: As a supplement to standard information methods we developed an interactive CD-ROM with information on SCT. This CD-ROM provides both medical information and more subjective patients' experiences. Part one provides information regarding the treatment course from diagnosis through to post-discharge care. The second part consists of interviews with former patients and describes their experiences. As the system is interactive, it can be utilised according to the patient's individual preferences. The CD-ROM comprises audio, video, animations, pictures, and text. Printing of certain sections is optional. The technical format of the CD-ROM makes it relatively simple to utilise the information and to make it suitable for other institutions or even other treatments. In this preliminary study the acceptability of the interactive CD-ROM by patients undergoing a SCT is described. RESULTS: Patients' overall evaluations of the interactive CD-ROM were highly positive. For example, 90.2% (N=51) found it interesting, clear, useful and valued getting information by means of a CD-ROM. Most patients would recommend the interactive CD-ROM to other patients in the same situation. CONCLUSION: The content of the CD-ROM on SCT as well as the computer-based interactive method are well accepted by patients. PRACTICE IMPLICATIONS: Computer-based education may enhance patient education and thus the quality of patient care. We must now establish the program's effectiveness. Moreover, plans have been developed to disseminate the information on SCT over the Internet. Future development of comparable programs and their evaluation should be encouraged to promote the well-being of cancer patients.

How would patients behave if they were continually informed of their blood glucose levels? A simulation study using a "virtual" patient.

BACKGROUND: The emergence of real-time glucose sensors for people with diabetes may replace discontinuous monitoring (self-monitored blood glucose [BG]) in the future. In this study, we use a computer-generated "virtual" patient to predict changes in behavior that may result from an increased awareness of BG levels. METHODS: The employed strategy required educated patients with type 1 diabetes to simulate a virtual patient using the DIABLOG Scientific simulator, interactive computer program. Thirty patients with a mean age of 34 years and duration of diabetes of 18 years (15 with continuous subcutaneous insulin infusion, 15 with intensive conventional therapy) simulated several daily glucose profiles with conventional self-monitoring of BG, using the time-lapse function of the program. Thereafter they had access to the actual glucose value either in a watch-type display or in a graphical display. Behavioral changes were monitored and stored. RESULTS: Mean BG value improved from 154 to 139 mg/dL (P < 0.05). The analysis of the process and behavioral changes revealed that patients recognized an impending hypoglycemia with the sensor in 94% of cases (59% without sensor) and reacted adequately in 98% of cases in order to avoid hypoglycemia. The frequency of hypoglycemia could be reduced from 1.7 per week to 0.5 per week. Unnecessary interventions (mostly by administration of carbohydrates) doubled to 3.2 per week using the continuous measurement system. Impending hyperglycemia could only be prevented in 25% of cases without a sensor, and with sensor this ratio could only be marginally improved to 29%. Supplementary insulin administration resulted in hypoglycemia only in a few cases. CONCLUSIONS: With the continuous measurement of their actual BG, subjects could reduce the frequency of hypoglycemia by 50% but increased the number of unnecessary interventions (excess carbohydrate intake or prematurely without a real hypoglycemia threat). Hyperglycemia prevention is a more difficult task. Simulation with an in silico disease model is a realistic alternative to studies in patients. A simulation program such as DIABLOG could be valuable for education in order to more rapidly and reliably recognize impending hypo- and hyperglycemia episodes.

Comparison of use and appreciation of a print-delivered versus CD-ROM-delivered, computer-tailored intervention targeting saturated fat intake: randomized controlled trial.

BACKGROUND: Computer-tailored health education, a promising health education technique, is increasingly being delivered interactively, for example, over the Internet. It has been suggested that there may be differences in use and appreciation between print and interactive delivery of computer-tailored interventions, which may influence information processing. This may especially be the case for women, older people, and people of lower socioeconomic status. Knowledge about differences in use and appreciation could help in choosing the appropriate delivery mode for a particular target audience. OBJECTIVE: The study investigates a content-identical, computer-tailored intervention addressing saturated fat intake delivered via print or CD-ROM. We analyzed consumer use and appreciation of the feedback information and explored whether possible differences exist among gender, age, and education subgroups. METHODS: Healthy Dutch adults (18-65 years), none of whom were under treatment for hypercholesterolemia, were randomly allocated to receive a computer-tailored program on CD-ROM (n = 151) or in print (n = 141). At baseline, data were collected on gender, age, and education level. One month post-intervention, data were collected on the use (feedback information read, saved, discussed) and appreciation (trustworthiness, perceived individualization, perceived personal relevance, and user-friendliness) of the feedback. Statistical analyses on the use and appreciation items were performed using chi-square tests and independent-samples t tests. RESULTS: After exclusion of individuals with missing values, a total of 257 and 240 respondents were included in the analyses of the use outcomes of feedback read and saved, respectively. The results indicate that among the total population, the print feedback was read more often than the CD-ROM feedback (95% vs 81%; P = .001) and saved more often than the CD-ROM feedback (97% vs 77%; P < .001). Similar results were found among the gender, age, and education subgroups. After exclusion of individuals who did not read the information and those with missing values, a total of 208-223 respondents were included in the analyses of the use outcome of feedback discussed and the appreciation items. The personal relevance of the print feedback was rated higher than for the CD-ROM-delivered feedback (0.97 vs 0.68; P = .04), but the effect size was small (0.28). These differences in personal relevance were also seen among women (1.06 vs 0.67; P = .04) and respondents aged 35-49 years (1.00 vs 0.58; P = .03), with moderate effect sizes (0.38 and 0.44, respectively). CONCLUSIONS: Despite the possible advantages of interactive feedback, the present study indicates that interactive-delivered feedback was used less and perceived as less personally relevant compared to the print-delivered feedback. These differences in use and appreciation of delivery modes should be taken into consideration when selecting a delivery mode for a specific subgroup in order to optimize exposure. TRIAL REGISTRATION: ISRCTN 01557410; http://www.webcitation.org/5XMylWleH.

Software for the interactive visualisation of experimental data in the genomic context.

Genomic datasets are all tied to the genome, which is an effective scaffold for data integration. Researchers have turned to interactive genome browsers to explore and understand the genomic relationships in their data. This paper describes and evaluates the existing genome browsers and compares them in terms of their visualisation features, with emphasis on experimental data plotting, interactivity and integration with broader data analysis environments. We find that while there are trends in genome browser development toward better support for experimental data analysis, there remains much potential for improvement.

Application of interactive, computer technology to adolescent substance abuse prevention and treatment.

This article provides an overview of several interactive, computer-based substance abuse-prevention and -treatment interventions that we have developed for adolescents, including an interactive substance abuse-prevention multimedia program for middle school-aged youth and a customizable program focused on prevention of HIV, hepatitis, and sexually transmitted infections among youth in substance abuse treatment. The content in these programs is grounded in a scientific understanding of the types of skills and information that are critical to effective prevention. The programs also use several evidence-based informational technologies that have been shown to be critical in effectively training key skills and information. Our evaluations to date have underscored the effectiveness of these programs in producing desired health-behavior change. Applying information technologies to the delivery of science-based interventions may allow for unique opportunities to provide widespread dissemination of cost-effective interventions with consistency and in a manner that is engaging and acceptable to youth.

Teaching therapeutic communication VIA camera cues and clues: the video inter-active (VIA) method.

For nursing and other health care students to be effective, remain in their training, and subsequently join the health care workforce, they need to have good therapeutic communication skills. This article presents an innovative strategy to improve therapeutic communication skills for nursing and health sciences students. The Video Inter-Active (VIA) computer-based, challenge-response-record-evaluate method used in this pilot study engaged students in realistic responses to scenarios commonly encountered in health care settings and provided them with opportunities to see themselves and critique their responses. Findings from this pilot study indicate that the VIA method is an effective and efficient way for students to develop and practice therapeutic communication skills. In a relatively short period (5 weeks), their learning from this method far

Effects of an interactive CD-program on 6 months readmission rate in patients with heart failure - a randomised, controlled trial [NCT00311194].

BACKGROUND: Disease-management programmes including patient education have promoted improvement in outcome for patients with heart failure. However, there is sparse evidence concerning which component is essential for success, and very little is known regarding the validity of methods or material used for the education. METHODS: Effects of standard information to heart failure patients given prior to discharge from hospital were compared with additional education by an interactive program on all-cause readmission or death within 6 months. As a secondary endpoint, patients' general knowledge of heart failure and its treatment was tested after 2 months. RESULTS: Two hundred and thirty patients were randomised to standard information (S) or additional CD-ROM education (E). In (S) 52 % reached the endpoint vs. 49 % in (E). This difference was not significant. Of those who completed the questionnaire (37 %), patients in (E) achieved better knowledge and a marginally better outcome. CONCLUSION: The lack of effect on the readmission rate could be due to an insufficient sample size but might also indicate that in pharmacologically well-treated patients there is little room for altering the course of the condition. As there was some indication that patients who knew more about their condition might fare better, the place for intensive education and support of heart failure patients has yet to be determined.

A randomized, controlled trial of an interactive educational computer package for children with asthma.

OBJECTIVE: The purpose of this study was to evaluate the impact and acceptability of an educational multimedia program designed to promote self-management skills in children with asthma. METHODS: We conducted a randomized, controlled trial with measures at baseline and 1- and 6-month follow-up. The trial was conducted in pediatric outpatient respiratory clinics in 3 United Kingdom hospitals. Participants included 101 children aged 7 to 14 years under the care of hospital-based asthma services. The children were randomly assigned to receive an asthma information booklet alone or the booklet plus The Asthma Files, an interactive CD-ROM for children with asthma. Asthma knowledge was the primary outcome measure. Other measures included asthma locus of control, lung function, use of oral steroids, and school absence. RESULTS: At the 1-month follow-up (n = 99), children in the computer group had improved knowledge compared with the control group and a more internal locus of control. There were no differences in objective lung-function measures, hospitalizations, or oral steroid use. The study participants were positive in their evaluation of the intervention. At the 6-month follow-up (n = 90), significantly fewer children in the intervention group had required oral steroids and had had time off school for asthma in the previous 6 months. The difference did not reach statistical significance in the intention-to-treat analysis for both steroid use and school absence. CONCLUSION: The Asthma Files was found to be an effective and popular health education tool for promoting asthma self-management skills within pediatric care.

Interactive educational diabetes/insulin tutorial at www.2aida.info.

The World Wide Web now hosts a multitude of diabetes educational materials in various formats. Of particular interest is the diabetes/insulin tutorial available at the AIDA Website (accessible directly at: www.2aida.info). The tutorial combines textual or "static" information with an interactive diabetes simulator-AIDA online-to provide an engaging and effective educational tool. AIDA online (accessible directly at: www.2aida.net) enables the simulation of plasma insulin and blood glucose levels from user-defined insulin injection and carbohydrate intake data. A haemoglobin A1c value is also computed, giving an indication of overall blood glucose control in the virtual patient with diabetes. The diabetes/insulin tutorial is currently composed of four sections: the first two cover in considerable depth insulin injection regimens and insulin dosage adjustment; the third section introduces the principles of carbohydrate counting and, specifically, matching insulin doses to carbohydrate intake; and the fourth section illustrates the relationship between blood glucose levels and renal excretion of glucose. The simulator runs alongside the tutorial, and allows various concepts described in the text to be explored freely by the user and simulated interactively. This introduces a novel way of learning how injected insulin and dietary carbohydrate interact in various insulin injection regimens. A fifth section- for which any offers of assistance would be gratefully received-is planned. This will consider the use of insulin pumps and rapidly acting and very long-acting insulin analogues. Further improvements that may strengthen the existing tutorial and/or use of the online simulator are discussed in this column.

[Elaboration of an interactive educational CD-R on good laboratory practices for manufacturing and quality control]. / Elaboration d'un CD-R interactif de formation aux bonnes pratiques de fabrication appliquées aux laboratoires de contrôle de la qualité.

cGMPs require that QA systems rely upon qualified personnel in charge of pharmaceutical operations. In order to achieve this legal requirement, the manufacturer must provide initial training and regular re-training along with periodical evaluations of their practical efficiency. This cGMP-learning multimedia CD-R is an interactive and individual training tool, designed for QC laboratory personnel. It contains a final questionnaire allowing an assessment of the course efficiency. Building up a ten-module teaching program entitled "Le médicament en toute confiance", the development of this CD-R was supervised by an European team of experienced industrial pharmacists.