RESUMO
METHODS: The aim of the paper is twofold. First, we present Starviewer, a DICOM viewer developed in C++ with a core component built on top of open-source libraries. The viewer supports extensions that implement functionalities and front-ends for specific use cases. Second, we propose an adaptable evaluation framework based on a set of criteria weighted according to user needs. The framework can consider different user profiles and allow criteria to be decomposed in subcriteria and grouped in more general categories making a multi-level hierarchical structure that can be analysed at different levels of detail to make scores interpretation more comprehensible. RESULTS: Different examples to illustrate Starviewer functionalities and its extensions are presented. In addition, the proposed evaluation framework is used to compare Starviewer with four open-source viewers regarding their functionalities for daily clinical practice. In a range from 0 to 10, the final scores are: Horos (7.7), Starviewer (6.2), Weasis (6.0), Ginkgo CADx (4.1), and medInria (3.8). CONCLUSIONS: Starviewer provides basic and advanced features for daily image diagnosis needs as well as a modular design that enables the development of custom extensions. The evaluation framework is useful to understand and prioritize new development goals, and can be easily adapted to express different needs by altering the weights. Moreover, it can be used as a complement to maturity models.
Assuntos
Redes de Comunicação de Computadores/instrumentação , Gráficos por Computador , Apresentação de Dados/normas , Modelos Biológicos , Sistemas de Informação em Radiologia/instrumentação , Software , CD-ROM , Redes de Comunicação de Computadores/normas , Humanos , Processamento de Imagem Assistida por Computador/normas , Intensificação de Imagem Radiográfica , Sistemas de Informação em Radiologia/normas , Tomografia Computadorizada por Raios XRESUMO
The CD/DVDs used as radon (222Rn) and thoron (220Rn) detectors can provide a sufficiently sensitive and cost-efficient option for passive radiation monitoring in underground mines. This note presents results of measurements made under real environmental conditions by CD/DVDs. Comparison with conventional diffusion chambers was made and good correspondence was observed. Correlation between 222Rn and 220Rn was studied by CD/DVDs and no signs for any correlation were observed. Dedicated study in a mine gallery showed that CD/DVDs can be successfully used for the purposes of ventilation diagnostics by identifying sources of air contaminated with radon.
Assuntos
Poluentes Radioativos do Ar/análise , Poluição do Ar em Ambientes Fechados/análise , Dispositivos de Armazenamento em Computador , Física Médica , Mineração , Radônio/análise , CD-ROM , Humanos , Monitoramento de Radiação , Tecnologia Radiológica , VentilaçãoRESUMO
BACKGROUND: Infants born to mothers with pre-existing type 1 or type 2 diabetes mellitus are at greater risk of congenital anomalies, perinatal mortality and significant morbidity in the short and long term. Pregnant women with pre-existing diabetes are at greater risk of perinatal morbidity and diabetic complications. The relationship between glycaemic control and health outcomes for both mothers and infants indicates the potential for preconception care for these women to be of benefit. This is an update of the original review, which was first published in 2010. OBJECTIVES: To assess the effects of preconception care in women with diabetes on health outcomes for mothers and their infants. SEARCH METHODS: We searched Cochrane Pregnancy and Childbirth's Trials Register (31 January 2017) and reference lists of retrieved articles. SELECTION CRITERIA: Randomised controlled trials (RCTs) assessing the effects of preconception care for diabetic women. Cluster-RCTs and quasi-RCTs were eligible for inclusion but none were identified. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed study eligibility, extracted data and assessed the risk of bias of the included studies. We checked data for accuracy and assessed the quality of the evidence using the GRADE approach. MAIN RESULTS: We included three trials involving 254 adolescent girls with type 1 or type 2 diabetes, with an overall unclear to high risk of bias. The three trials were conducted at diabetes clinics in the USA, and assessed the READY-Girls (Reproductive-health Education and Awareness of Diabetes in Youth for Girls) programme versus standard care.Considering primary outcomes, one trial reported no pregnancies in the trial period (12 months) (very low-quality evidence, with downgrading based on study limitations (risk of bias) and imprecision); in the other two trials, pregnancy was an exclusion criterion, or was not clearly reported on. None of the trials reported on the other primary maternal outcomes, hypertensive disorders of pregnancy and caesarean section; or primary infant outcomes, large-for-gestational age, perinatal mortality, death or morbidity composite, or congenital malformations. Similarly, none of the trials reported on the secondary outcomes, for which we had planned to assess the quality of the evidence using the GRADE approach (maternal: induction of labour; perineal trauma; gestational weight gain; long-term cardiovascular health; infant: adiposity; type 1 or 2 diabetes; neurosensory disability).The majority of secondary maternal and infant outcomes, and outcomes relating to the use and costs of health services were not reported by the three included trials. Regarding behaviour changes associated with the intervention, in one trial, participants in the preconception care group had a slightly higher score for the actual initiation of discussion regarding preconception care with healthcare providers at follow-up (nine months), compared with those in the standard care group (mean difference 0.40, 95% confidence interval -0.02 to 0.82 (on a scale of 0 to 4 points); participants = 87) (a summation of four dichotomous items; possible range 0 to 4, with 0 being no discussion). AUTHORS' CONCLUSIONS: There are insufficient RCT data available to assess the effects of preconception care for diabetic women on health outcomes for mothers and their infants.More high-quality evidence is needed to determine the effects of different protocols of preconception care for diabetic women. Future trials should be powered to evaluate effects on short- and long-term maternal and infant outcomes, and outcomes relating to the use and costs of health services. We have identified three ongoing studies that we will consider in the next review update.
Assuntos
CD-ROM , Diabetes Mellitus Tipo 1/terapia , Diabetes Mellitus Tipo 2/terapia , Cuidado Pré-Concepcional/métodos , Adolescente , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 2/sangue , Feminino , Hemoglobinas Glicadas/metabolismo , Humanos , Análise de Intenção de Tratamento , Educação de Pacientes como Assunto/métodos , Gravidez , Ensaios Clínicos Controlados Aleatórios como Assunto , Adulto JovemRESUMO
The purpose of the study was to determine the changes in knowledge of information technology (IT) professionals after receiving a nutrition education intervention for a month. The sample comprised of 40 IT professionals (29 males and 11 females). The sample was drawn from four IT companies of Hyderabad city using random sampling techniques. The data on the general information of the subjects was collected. The data regarding the commonly accessed sources of nutrition and health information by the subjects was also obtained from the study. The intervention study group received nutrition education by distribution of the developed CD-ROMs to them followed by interactive sessions. To assess the impact of nutrition education intervention, the knowledge assessment questionnaire (KAQ) was developed and administered before and after the education programme. A significant improvement in the mean nutritional knowledge scores was observed among the total study subjects from 22.30 to 40.55 after the intervention (p < 0.05). The findings support the importance of providing professionals with nutrition knowledge to promote healthy dietary behaviors.Thus, the method of e-learning and development of CD-Rom is essential for teaching the educated groups on nutrition, physical activity and overall health education to improve their health, lifestyle and eating habits.
Assuntos
Instrução por Computador , Dieta Saudável , Conhecimentos, Atitudes e Prática em Saúde , Nível de Saúde , Estilo de Vida Saudável , Informática , Ciências da Nutrição/educação , Adulto , CD-ROM , Avaliação Educacional , Escolaridade , Exercício Físico , Feminino , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Humanos , Índia , Masculino , Estado Nutricional , Recursos Humanos , Adulto JovemRESUMO
BACKGROUND: Gene duplication is a major source of new genes that is thought to play an important role in phenotypic innovation. Though several mechanisms have been hypothesized to drive the functional evolution and long-term retention of duplicate genes, there are currently no software tools for assessing their genome-wide contributions. Thus, the evolutionary mechanisms by which duplicate genes acquire novel functions remain unclear in a number of taxa. RESULTS: In a recent study, researchers developed a phylogenetic approach that uses gene expression data from two species to classify the mechanisms underlying the retention of duplicate genes (Proc Natl Acad Sci USA 110:1740917414, 2013). We have implemented their classification method, as well as a more generalized method, in the R package CDROM, enabling users to apply these methods to their data and gain insights into the origin of novel biological functions after gene duplication. The CDROM R package, source code, and user manual for the R package are available for download from CRAN at https://cran.rstudio.com/web/packages/CDROM/ . Additionally, the CDROM R source code, user manual for running CDROM from the source code, and sample dataset used in this manuscript can be accessed at www.personal.psu.edu/rua15/software.html . CONCLUSIONS: CDROM is the first software package that enables genome-wide classification of the mechanisms driving the long-term retention of duplicate genes. It is user-friendly and flexible, providing researchers with a tool for studying the functional evolution of duplicate genes in a variety of taxa.
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Genes Duplicados , Software , Animais , CD-ROM , Evolução Molecular , Duplicação Gênica , Humanos , FilogeniaRESUMO
e- and m-Health communication technologies are now common approaches to improving population health. The efficacy of behavioral nutrition interventions using e-health technologies to decrease fat intake and increase fruit and vegetable intake was demonstrated in studies conducted from 2005 to 2009, with approximately 75% of trials showing positive effects. By 2010, an increasing number of behavioral nutrition interventions were focusing on body weight. The early emphasis on interventions that were highly computer tailored shifted to personalized electronic interventions that included weight and behavioral self-monitoring as key features. More diverse target audiences began to participate, and mobile components were added to interventions. Little progress has been made on using objective measures rather than self-reported measures of dietary behavior. A challenge for nutritionists is to link with the private sector in the design, use, and evaluation of the many electronic devices that are now available in the marketplace for nutrition monitoring and behavioral change.
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Medicina do Comportamento/métodos , Dieta Saudável , Ciências da Nutrição/métodos , Cooperação do Paciente , Telemedicina/história , Medicina do Comportamento/história , Medicina do Comportamento/tendências , Pesquisa Biomédica/métodos , Pesquisa Biomédica/tendências , CD-ROM , Dieta Redutora , Correio Eletrônico , Comportamento Alimentar , História do Século XXI , Humanos , Internet , Aplicativos Móveis , Ciências da Nutrição/educação , Ciências da Nutrição/história , Ciências da Nutrição/tendências , Sobrepeso/dietoterapia , Educação de Pacientes como Assunto , Setor Privado/tendências , Parcerias Público-Privadas/tendências , Autorrelato , Programas de Autoavaliação , Telemedicina/tendênciasRESUMO
The purpose of this article is to share one institution's intervention to improve oral chemotherapy patient education. The overall aim was to provide clinicians with a single source of educational materials that would meet a diverse group of patients' educational needs and be consistent with published guidelines.â©.
Assuntos
Antineoplásicos/administração & dosagem , Neoplasias/tratamento farmacológico , Educação de Pacientes como Assunto/métodos , Materiais de Ensino/provisão & distribuição , Acesso à Informação , Administração Oral , Antineoplásicos/efeitos adversos , CD-ROM , Feminino , Humanos , Masculino , Gestão da Qualidade Total , Estados UnidosRESUMO
A growing line of research has highlighted that e-technologies may play a promising role in improving breastfeeding outcomes. The objective of this review was to synthesise the best of available evidence by conducting a meta-analysis to evaluate whether e-technologies have had any effect in improving breastfeeding outcomes among perinatal women. The review was conducted using nine electronic databases to search for English-language research studies from 2007 to 2014. A 'risk of bias' table was used to assess methodological quality. Meta-analysis was performed with the RevMan software. The Q test and I(2) test was used to assess the heterogeneity. The test of overall effect was assessed using z-statistics at P < 0.05. Of 1842 studies identified through electronic searches and reference lists, 16 experimental studies were selected after applying the inclusion and exclusion criteria. Half of the selected studies had a low risk of bias, from which a total of 5505 women in six countries in these studies were included. Meta-analyses revealed that e-technologies significantly improved exclusive breastfeeding initiation (z = 6.90, P < 0.00001), exclusive breastfeeding at 4 weeks (z = 2.12, P = 0.03) and 6 months (z = 3.2, P = 0.001), breastfeeding attitude (z = 3.01, P = 0.003) and breastfeeding knowledge (z = 4.54, P = < 0.00001) in subgroup analyses. This review provides support for the development of web-based, texting messaging, compact disc read-only memory, electronic prompts and interactive computer agent interventions for promoting and supporting breastfeeding.
Assuntos
Aleitamento Materno , Educação em Saúde/métodos , Assistência Perinatal , Telemedicina , CD-ROM , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Internet , Gravidez , Ensaios Clínicos Controlados Aleatórios como Assunto , Envio de Mensagens de TextoRESUMO
A turn-on competitive immunoassay using a low-cost Blu-ray optomagnetic setup and two differently sized magnetic particles (micron-sized particles acting as capture particles and nano-sized particles acting as detection particles) is here presented. For Salmonella detection, a limit of detection of 8×10(4)CFU/mL is achieved within a total assay time of 3h. The combination of a competitive strategy and an optomagnetic setup not only enables a turn-on read-out format, but also results in a sensitivity limit about a factor of 20 times lower than of volumetric magnetic stray field detection device based immunoassays. The improvement of sensitivity is enabled by the formation of immuno-magnetic aggregates providing steric hindrance protecting the interior binding sites from interaction with the magnetic nanoparticle labels. The formation of immuno-magnetic aggregates is confirmed by fluorescence microscopy. The system exhibits no visible cross-reaction with other common pathogenic bacteria, even at concentrations as high as 10(7)CFU/mL. Furthermore, we present results when using the setup for a qualitative and homogeneous biplex immunoassay of Escherichia coli and Salmonella typhimurium.
Assuntos
Técnicas Biossensoriais/instrumentação , CD-ROM , Imunoensaio/instrumentação , Separação Imunomagnética/instrumentação , Salmonella/imunologia , Salmonella/isolamento & purificação , Desenho de Equipamento , Análise de Falha de Equipamento , Magnetismo/instrumentação , Dispositivos Ópticos , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeAssuntos
Asma/terapia , Jogos de Vídeo , CD-ROM , Criança , Humanos , Educação de Pacientes como Assunto , Materiais de EnsinoRESUMO
Systematic reviews of computer- and Web-based treatment approaches indicate that these interventions are effective in addressing abuse of alcohol, tobacco, and other substances. However, there are few studies evaluating the effectiveness of electronic approaches to substance abuse prevention. This review of the literature synthesizes the current research on interventions that use electronic media, including CD-ROM, video, and Internet modalities, for substance abuse prevention. Overall, the studies indicate that electronic-based and enhanced interventions are effective in preventing or reducing risk for substance use. We discuss trends in the current literature, research limitations, and implications for practice.
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CD-ROM , Internet , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Gravação de Videoteipe , Alcoolismo/prevenção & controle , Humanos , Fatores de Risco , Prevenção do Hábito de FumarRESUMO
This study tested the effect of a neonatal-bereavement-support DVD on parental grief after their baby's death in a Neonatal Intensive Care Unit compared with standard bereavement care (controls). Following a neonatal death, the authors measured grief change from a 3- to 12-month follow-up using a mixed-effects model. Intent-to-treat analysis was not significant, but only 18 parents selectively watched the DVD. Thus, we subsequently compared DVD viewers with DVD nonviewers and controls. DVD viewers reported higher grief at 3-month interviews compared with DVD nonviewers and controls. Higher grief at 3 months was negatively correlated with social support and spiritual/religious beliefs. These findings have implications for neonatal-bereavement care.
Assuntos
Luto , CD-ROM , Morte do Lactente , Pais/psicologia , Assistência Perinatal/métodos , Apoio Social , Adaptação Psicológica , Adulto , Feminino , Pesar , Humanos , Lactente , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Masculino , Equipe de Assistência ao Paciente , Resultado do TratamentoRESUMO
OBJECTIVE: Abdominal aortic aneurysm patients tend to be informed inconsistently and incompletely about their disorder and the treatment options open to them. The objective of this trial was to evaluate whether these patients are better informed and experience less decisional conflict regarding their treatment options after viewing a decision aid. DESIGN: A six-centre, randomised clinical trial comparing a decision aid plus regular information versus regular information from the surgeon. METHODS: Included patients had recently been diagnosed with an asymptomatic abdominal aortic aneurysm at least 4 cm in diameter. The decision aid consisted of a one-time viewing of an interactive CD-ROM elaborating on elective surgery versus watchful waiting. Generally, the decision aid advised patients with aneurysms less than 5.5 cm to agree to watchful waiting, for larger aneurysms the decision aid provided insight into the balance of benefit and harm of surgical and conservative approaches, taking into account age, co-morbidity and size of the aneurysm. The primary outcome was patient decisional conflict measured at 1 month follow-up (Decisional Conflict Scale). Secondary outcomes were patient knowledge, anxiety and satisfaction. RESULTS: In 178 aneurysm patients, decisional conflict scores did not differ significantly between the decision aid and the regular information groups (22 vs. 24 on the 0-100 Decisional Conflict Scale; p = .33). Patients in the decision aid group had significantly better knowledge (10.0 vs. 9.4 out of 13 points; p = .04), whereas anxiety levels (4.4 and 5.0 on a 0-21 scale; p = .73) and satisfaction scores (74 and 73 on a 0-100 scale; p = .81) were similar in both groups. CONCLUSION: In addition to regular patient-surgeon communication, a decision aid helps to share treatment decisions with abdominal aortic aneurysm patients by increasing their knowledge about the disorder and available treatment options without raising anxiety levels; however, it does not reduce decisional conflict, nor does it improve satisfaction.
Assuntos
Aneurisma da Aorta Abdominal/terapia , Técnicas de Apoio para a Decisão , Educação de Pacientes como Assunto , Idoso , Aneurisma da Aorta Abdominal/mortalidade , Aneurisma da Aorta Abdominal/patologia , CD-ROM , Procedimentos Cirúrgicos Eletivos , Feminino , Humanos , Masculino , Participação do Paciente , Satisfação do Paciente , Qualidade de Vida , Inquéritos e Questionários , Conduta ExpectanteRESUMO
Providing patients and clinicians with self-contained PACS viewer on CD format is a common and necessary tool to share vital imaging data. However, to be useful, this tool should be reliable, robust, and convenient. Numerous PACS viewer options are available, often without empirical data to guide in choosing one for routine use. To assist in making a standardized choice for our institution, we chose four common viewers, benchmarked on four different workstations reflecting the variety of environments used by non-radiologist clinicians who would receive a CD. Four CD-based DICOM viewers from eFilm, Philips, Pacsgear Gearview, and iSite were examed on two radiology PACS workstations, a standard desktop computer, and a laptop using a test case consisting of a multi-series CTA with 13 series and 3,035 total images. Multiple objective measures, subjective measures, and presence of key features were evaluated including program time to load, image time to load, cine/movie mode, ability to adequately window and level, pan and zoom functionality, basic measurement tools, and perceived lag when scrolling through a multi-image series. Substantial differences in speed of operation and behavior on multiple systems were documented, which could potentially add several minutes to the time required to open and view a patient's imaging data. The eFilm and iSite viewers operated consistently and reliably across all tested computer environments. The iSite viewer, having among the quickest load times in the group tested and consistently low subjective scroll lag during series viewing, and also beneficially allowing partial viewing while images load in the background, was found to generate the best overall user experience. Because of these significant differences, we have recommended that our institution standardize all patient imaging CD creation using the iSite viewer.
Assuntos
CD-ROM , Sistemas de Informação em Radiologia/instrumentação , Redes de Comunicação de Computadores/instrumentação , Redes de Comunicação de Computadores/normas , Gráficos por Computador/instrumentação , Apresentação de Dados , Microcomputadores , Sistemas de Informação em Radiologia/normas , Software , Interface Usuário-ComputadorRESUMO
BACKGROUND: The purpose of this study was to evaluate the efficacy of a self-guided CD-ROM program ("Headstrong") containing cognitive-behavioral self-management strategies versus an educational CD-ROM program for treating headaches, headache-related disability, and quality of life. METHODS: Participants were 35 children ages 7-12 years with migraine recruited from one university medical center and two children's hospital headache clinics. Participants were randomly assigned to complete the Headstrong or educational control CD-ROM program over a 4-week period. Data on headache frequency, duration, and severity, migraine-related disability, and quality of life (QOL) were obtained at baseline, post-intervention, and 3-months post-intervention. RESULTS: At post-intervention, Headstrong resulted in lower severity (on a 10-point scale) than the control group by child report (5.06 ± 1.50 SD vs. 6.25 ± 1.92 SD, p = 0.03, ES = 0.7). At 3-months post-intervention, parents reported less migraine-related disability (on the PedMIDAS) in the Headstrong group compared to the control group (1.36 ± 2.06 SD vs. 5.18 ± 6.40 SD; p = 0.04, ES = 0.8). There were no other group differences at post treatment or at 3-months post-intervention. CONCLUSIONS: When compared to an educational control, Headstrong resulted in lower pain severity at post-treatment and less migraine-related disability at 3-months post-intervention, by child and parent report respectively. Headache frequency and quality of life did not change more for Headstrong versus control. Additional research is needed on the Headstrong Program to increase its efficacy and to test it with a larger sample recruited from multiple centers simultaneously.
Assuntos
CD-ROM , Terapia Cognitivo-Comportamental/métodos , Intervenção Médica Precoce/métodos , Transtornos de Enxaqueca/terapia , Educação de Pacientes como Assunto/métodos , Autocuidado , CD-ROM/estatística & dados numéricos , Criança , Feminino , Humanos , Masculino , Transtornos de Enxaqueca/diagnóstico , Transtornos de Enxaqueca/psicologia , Qualidade de Vida/psicologiaRESUMO
BACKGROUND: Military healthcare personnel, including nurse anesthetists, must have the knowledge and skills to care for the extensive, severe injuries incurred on the battlefield. No studies have compared the 2 teaching strategies of using the human patient simulator (HPS) and a CD-ROM in caring for combat injuries relative to critical thinking and performance using nurse anesthesia participants. METHODS: A prospective, pretest-posttest experimental, mixed design (within and between) was used to determine if there were statistically significant differences in HPS and CD-ROM educational strategies relative to caring for patients who have trauma. Two instruments were used: critical thinking, which consisted of multiple-choice questions; and a combat performance instrument that measured ability to care for patients. RESULTS: A repeated analysis of variance and a least significant difference post-hoc test were used to analyze the data. The HPS group performed better than the CD-ROM and control groups relative to performance (P=.000) but not on critical thinking (P=.239). There was no difference between the CD-ROM and control group (P=.171) on the combat performance instrument. CONCLUSION: In this study, the HPS method of instruction was a more effective method of teaching than the CD-ROM approach.
Assuntos
CD-ROM , Competência Clínica , Educação de Pós-Graduação em Enfermagem/organização & administração , Enfermagem Militar/educação , Simulação de Paciente , Pensamento , Ferimentos e Lesões/enfermagem , Avaliação Educacional , Humanos , Estudos Prospectivos , Estados UnidosRESUMO
STUDY OBJECTIVE: The relevant literature was reviewed to identify issues in research evaluating digital media technology (DMT) interventions for the primary prevention of STIs/HIV in adolescents and young adults. METHOD: A literature search with relevant key terms was conducted in PubMed, for articles with studies that included: (a) participants between 11-29 years; (b) use of one or more of the following forms of DMT: interactive digital video or CD-ROM, computer, text messaging, or Internet; (c) evaluation of an STI/HIV primary prevention intervention; and (d) use of a cognitive, psychosocial, behavioral, or biological outcome. RESULTS: Twenty-nine studies were identified and included in the review. Based on the review of these studies, 7 main issues were discussed and recommendations for improving future research were offered. The 7 main issues were: (a) need for a balance between universal application and specific sub-group focus, (b) lack of a developmental framework, (c) challenge of applying DMT in resource limited contexts, (d) rapidly changing nature of DMT, (e) lack of biological outcomes, (f) lack of comparison/control groups to assess the impact of DMT, and (g) limited temporal follow-up. CONCLUSIONS: There is increasing literature evaluating the effectiveness of DMT for preventing STIs/HIV among adolescents and young adults. A careful consideration of 7 main issues identified in the literature can improve the design and evaluation of these interventions and enhance our understanding of their effectiveness.
Assuntos
Internet , Prevenção Primária , Infecções Sexualmente Transmissíveis/prevenção & controle , Adolescente , Adulto , CD-ROM , Criança , Humanos , Envio de Mensagens de Texto , Adulto JovemRESUMO
Colorectal cancer (CRC) is an important contributor to the cancer burden among Alaska Native people. CRC is the leading incident cancer and the second leading cause of cancer mortality among Alaska Native people. Completing recommended CRC screening procedures has the potential to reduce both CRC incidence and mortality. "Taking Action Colorectal Health," a multidimensional audiovisual, interactive CD-ROM, incorporates adult education learning principles to provide Alaska's Community Health Aides/Practitioners with timely, medically accurate, and culturally relevant CRC place-based education. Providing this resource on CD-ROM empowers learning within communities and places where people live or choose to learn. The dynamic process of developing, implementing, and evaluating this CRC CD-ROM was informed by a sociocultural approach to share health messages. Within this approach, cultural values, beliefs, and behaviors are affirmed as a place of wisdom and resilience and built upon to provide context and meaning for health messaging. Alaska Native values that honor family, relationships, the land, storytelling, and humor were included in CD-ROM content. Between January and May 2012, 20 interviews were conducted with individuals who had used the CD-ROM. Four categorical themes emerged from analysis of interview transcripts: likeability, utilization, helpfulness, and behavior change. As a result of self-paced learning through stories, movies, and interactive games, respondents reported healthy behavior changes they were making for themselves, with their families and in their patient care practices. This CD-ROM is a culturally based practical course that increased knowledge and activities around colorectal cancer screening by Community Health Aides/Practitioners in Alaska.