Decision support and the effectiveness of web-based delivery and information tailoring for bowel cancer screening : an exploratory study

Background: Colorectal cancer (CRC) is the third most commonly diagnosed cancer in males and the second in females throughout the developed world. Population screening using fecal occult blood tests (FOBTs) facilitates early detection and greater chance of survival, but participation rates are low. We developed a Web-based decision tool to provide information tailored to an individual’s decision stage for CRC screening and attitude toward screening utilizing the Preventive Health Model (PHM) and Precaution Adoption Process Model (PAPM) as theoretical frameworks for screening behavior. We describe the practical steps employed in the tool’s design and the subsequent conduct of an exploratory study.
Objective: To design a decision tool for CRC screening and conduct an exploratory study among average-risk men and women to (1) test the impact of message type (tailored vs non-tailored) and message delivery modality (Web-based vs paper-based) on attitudes toward screening and screening uptake, and (2) investigate the acceptability of the decision tool and relevance of materials.
Methods: Participants (n = 100), recruited from a population sample of men and women aged 50-76 residing in urban Adelaide, Australia, were randomly assigned to a control group or one of 4 interventions: (1) Web-based and tailored information, (2) paper-based and tailored information, (3) Web-based and non-tailored (generic) information, or (4) paper-based and non-tailored information. Participation was augmented by snowball recruitment (n = 19). Questionnaires based on PHM variables were administered pre- and post-intervention. Participants were given the opportunity to request an FOBT. Following the intervention, participants discussed the acceptability of the tool.
Results: Full data were available for 87.4% (104/119) of participants. Post-intervention, perceived susceptibility scores for individuals receiving tailored information increased from mean 10.6 (SD 2.1) to mean 11.8 (SD 2.2). Scores on self-efficacy increased in the tailored group from mean 11.7 (SD 2.0) to mean 12.6 (SD 1.8). There were significant time x modality x message effects for social influence and salience and coherence, reflecting an increase in these scores for tailored Web-based participants only; social influence scores increased from mean 11.7 (SD 2.6) to mean 14.9 (SD 2.3), and salience and coherence scores increased from mean 16.0 (SD 2.2) to mean 17.7 (SD 2.1). There was no greater influence of modality or message type on movement toward a decision to screen or screening uptake, indicating that neither tailored messages nor a Web modality had superior effect. Overall, participants regarded tailored messages positively, but thought that the Web tool lacked “media richness.”
Conclusions: This exploratory study confirms that tailoring on PHM predictors of CRC screening has the potential to positively address attitudes toward screening. However, tailoring on these variables did not result in significantly increased screening uptake. Future research should consider other possible psychosocial influences. Mode of delivery did not affect outcomes, but as a delivery medium, the Web has economic and logistical advantages over paper.

The e-learning cycle and continuous improvement for e-entrepreneurs

The purpose of this paper is to explore the integration of learning, continuous improvement and innovation theories as a basis for enhancing the education of e-entrepreneurs. Conceptual development of emerging interdisciplinary literature is combined with example analysis to develop the Circle of E-learning uniquely augmented by hermeneutics, action research and the creative destruction cycle of innovation using applied examples of e-entrepreneurship. Four R’s are discussed in the Circle of E-learning; Review, Revise, Reconstruct, and Reveal. Observations for each of the 4R’s are made regarding continuous improvement of the education of e-entrepreneurs. Findings are that the procedural pivot points indicated by the 4R’s can be helpful for administrators and educators to improve operations and outcomes in management and professional development situations.

Generation of 3D sparse feature models using multiple stereo views

Augmented Reality (AR) renders virtual information onto objects in the real world. This new user interface paradigm presents a seamless blend of the virtual and real, where the convergence of the two is difficult to discern. However, errors in the registration of the real and virtual worlds are common and often destroy the AR illusion. To achieve accurate and efficient registration, the pose of real objects must be resolved in a quick and precise manner.

The nocebo effect : a clinicians guide

Objective: This paper aims to provide an overview on the nocebo effect, focusing on recognition — its phenomenology, at-risk demographic profiles, clinical situations and personality factors, as well as discriminating somatic symptoms in the general population from treatment-related adverse effects. Lastly, the paper addresses available evidence-based strategies for management and minimisation of the nocebo effect.

Method: Data for this paper were identified by searching PubMed using the search terms "nocebo" and “nocebo effect”, augmented by a manual search of the references of the key papers and the related literature.

Results: The nocebo effect refers to non-pharmacodynamic, harmful or undesirable effects occurring after inactive treatment, a phenomenon that also occurs in the context of active therapy. Known drivers include classical conditioning and negative expectations concerning treatment. Recent meta-analyses have reported a considerable prevalence, ranging from 18% in the symptomatic treatment of migraine, to more than 74% in multiple sclerosis. Recognition of the nocebo-driven adverse effects presents a challenge, especially because of its non-specific nature and the similarity to the active medication’s expected profile. Traits such as neuroticism, pessimism and type A personalities may predispose individuals to this phenomenon. Clinical management of the nocebo effect includes awareness and recognition, changing the manner of disclosure of potential drug-related adverse effects, shaping patients’ expectations and enhancing the treatment alliance.

Conclusion: The nocebo effect is a common, clinically significant, yet covert driver of clinical outcomes. Increased awareness of its features, as well as knowledge of strategies on how to manage it, are fundamental so that clinicians can mitigate its impact on clinical practice.

Mania : diagnosis and treatment recommendations

This article provides recommendations for the diagnosis and treatment of mania, which characterizes bipolar I disorder (BD I). Failure to detect mania leads to misdiagnosis and suboptimal treatment. To diagnose mania, clinicians should include a detailed mood history within their assessment of patients presenting with depression, agitation, psychosis or insomnia. With regards to treatment, by synthesizing the findings from recent treatment guidelines, and reviewing relevant literature, this paper has distilled recommendations for both acute and long-term management. Antimanic agents including atypical antipsychotics and traditional mood stabilizers are employed to reduce acute manic symptoms, augmented by benzodiazepines if needed, and in refractory or severe cases with behavioural and/or psychotic disturbance, electroconvulsive therapy may occasionally be necessary. Maintenance/prophylaxis therapy aims to reduce recurrences/relapse, for which the combination of psychological interventions with pharmacotherapy is beneficial as it ensures adherence and monitoring of tolerability.

Immersive interfaces for art education teaching and learning in mixed reality virtual and real world environments

Selected ubiquitous technologies encourage collaborative participation between higher education students and educators within a virtual socially networked e-learning landscape. Multiple modes of teaching and learning, ranging from real world experiences, to text and digital images accessed within the Deakin Studies Online learning management system and a constructed virtual world in which the user’s creative imagination transports them to the “other side” of their computer screens is discussed in this paper. These constructed environments support interaction between communities of learners and enable multiple simultaneous participants to access graphically built 3D environments, interact with digital artifacts and various functional tools and represent themselves through avatars, to communicate with other participants and engage in collaborative art learning. A narrative interpretative research approach was used to profile the 21st century higher education student learner, to investigate the lived experience and multiple art learning perspectives documented in student visual journal entries and art educator observations to ascertain if an e-technology rich augmented learning environment resulted in the establishment of more effective e-learning communities of practice.

The best of all worlds : immersive interfaces for art education in virtual and real world teaching and learning environments

A collaborative constructivist model of e-learning enabled second year undergraduate students and art educators to establish a community of learners within an augmented immersive learning environment. Artistic practice and work based learning was enhanced through the creation of digital artifacts to support shared knowledge building using authentic learning tasks and social networking.

Immersive interfaces for art education teaching and learning in virtual and real world learning environments

Mobile phone sensing systems : a survey

Mobile phone sensing is an emerging area of interest for researchers as smart phones are becoming the core communication device in people's everyday lives. Sensor enabled mobile phones or smart phones are hovering to be at the center of a next revolution in social networks, green applications, global environmental monitoring, personal and community healthcare, sensor augmented gaming, virtual reality and smart transportation systems. More and more organizations and people are discovering how mobile phones can be used for social impact, including how to use mobile technology for environmental protection, sensing, and to leverage just-in-time information to make our movements and actions more environmentally friendly. In this paper we have described comprehensively all those systems which are using smart phones and mobile phone sensors for humans good will and better human phone interaction.

The discursive practices of nurse practitioner legislation in Australia

Aim.  The aim of this paper was to examine the nurse practitioner legislative framework in Australia from a critical social theory perspective. Background.  National regulation for nurses and midwives has superseded all previous state legislation with effect from July 2010. The aim of this change was to streamline regulation processes across all health professionals requiring regulation, in order to eliminate diverse state-based regulatory policies that were identified as hindering transferability of the workforce across Australia. This paper explores the changes with reference to nurse practitioners. Since their introduction to Australia different legislative practices between states have presented difficult endorsement procedures which have affected employment. Data sources.  Information for the paper is drawn from a doctoral study which examined the politics of advancing nursing in Australia, with particular reference to the discourses of nurse practitioners. This is augmented by more recent legislative documents and policies, as well as media reports, to examine the process of change in legislation and the unfolding discourses on employment and practice. Implications to nursing.  Nurse practitioner endorsement may be more complicated, defeating the original premise of transferability of a skilled workforce across state jurisdictions. Conclusion.  This paper exposes the influence that powerful discourses can have on a major change to professional practice.

Modulation of putative mirror neuron activity by both positively and negatively valenced affective stimuli: a TMS study

Research indicates that mirror neurons are important for social cognition, including emotion processing. Emerging evidence, however, also reveals that emotional stimuli might be capable of modulating human mirror neuron system (MNS) activity.

The current study used transcranial magnetic stimulation (TMS) to assess putative mirror neuron function following emotionally evocative images in twenty healthy adults.

Participants observed videos of either a transitive hand action or a static hand while undergoing TMS of the primary motor cortex. In order to examine the effect of emotion on the MNS, each video was preceded by an image of either a positive, negative or neutral valence.

MNS activity was found to be augmented by both the positive and negative (relative to neutral) stimuli, thus providing empirical support for a bi-directional link between emotion and the MNS, whereby both positively and negatively valenced stimuli are capable of facilitating mirror neuron activity. The potential adaptive significance of this finding is discussed. 

Alison Bennett : shifting skin

Ten large exhibition prints with digital 3D augmented reality overlay

Shifting skin

AR[t] is published by the AR Lab. This article provides insight into the development of the exhibition 'Alison Bennett: Shifting Skin'

Immersive interfaces for art education teaching and learning in virtual and real world learning environments

Selected ubiquitous technologies encourage collaborative participation between higher education students and educators within a virtual socially networked e-learning landscape. Multiple modes of teaching and learning, ranging from real world experiences, to text and digital images accessed within the Deakin Studies Online learning management system and a constructed virtual world in which the user's creative imagination transports them to the “other side” of their computer screens is discussed in this paper. These constructed environments support interaction between communities of learners and enable multiple simultaneous participants to access graphically built 3D environments, interact with digital artifacts and various functional tools and represent themselves through avatars, to communicate with other participants and engage in collaborative art learning. A narrative interpretative research approach was used to profile the 21st century higher education student learner, to investigate the lived experience and multiple art learning perspectives documented in student visual journal entries and art educator observations to ascertain if an e-technology rich augmented learning environment resulted in the establishment of more effective e-learning communities of practice.

Virtual worlds in Australian and New Zealand higher education: Remembering the past, understanding the present and imagining the future

3D virtual reality, including the current generation of multi-user virtual worlds, has had a long history of use in education and training, and it experienced a surge of renewed interest with the advent of Second Life in 2003. What followed shortly after were several years marked by considerable hype around the use of virtual worlds for teaching, learning and research in higher education. For the moment, uptake of the technology seems to have plateaued, with academics either maintaining the status quo and continuing to use virtual worlds as they have previously done or choosing to opt out altogether. This paper presents a brief review of the use of virtual worlds in the Australian and New Zealand higher education sector in the past and reports on its use in the sector at the present time, based on input from members of the Australian and New Zealand Virtual Worlds Working Group. It then adopts a forward-looking perspective amid the current climate of uncertainty, musing on future directions and offering suggestions for potential new applications in light of recent technological developments and innovations in the area.