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.

Issues management, anticipatory systems and zombie academics

After outlining issues management the paper goes on to discuss Rosen’s notions of anticipatory systems and the concept of teleology. It suggests how these theories might be relevant to a discussion about issues management practice.

The problem of underachievement in numeracy : using bourdieu and critical theory to interpret academic achievement

The paper considers the achievement gap experienced by Victorian public school students. The paper uses a methodological approach informed by critical theory to interpret achievement levels between students from high and low socio-economic status. It analyses and discusses documented data and in doing this, reflects upon the work of Bourdieu emphasizing the reproductive nature of contemporary schooling. 

Firm characteristics and information risk

Following the work of Easley et al. (2002) in documenting the effect of private information on cross-sectional stock returns, we examine the relationship between a firm’s fundamental characteristics and its probability of information-based trading (PIN). We find that asset turnover and dividend yields are important firm characteristics that influence a firm’s PIN. The findings also offer an alternative explanation as to why firm characteristics are informative about asset prices.

Twitter free Iran: an evaluation of Twitter's role in public diplomacy and information operations in Iran's 2009 election crisis

Social media platforms such as Twitter pose new challenges for decision-makers in an international crisis. We examine Twitter’s role during Iran’s 2009 election crisis using a comparative analysis of Twitter investors, US State Department diplomats, citizen activists and Iranian protestors and paramilitary forces. We code for key events during the election’s aftermath from 12 June to 5 August 2009, and evaluate Twitter. Foreign policy, international political economy and historical sociology frameworks provide a deeper context of how Twitter was used by different users for defensive information operations and public diplomacy. Those who believe Twitter and other social network technologies will enable ordinary people to seize power from repressive regimes should consider the fate of Iran’s protestors, some of whom paid for their enthusiastic adoption of Twitter with their lives.

WikiLeaks and Information Disclosure: The Bradley Manning Case

We live in an age where information is a fluid resource, shared across the globe in real time. A continued concern is whether all infmmation, including sensitive information should be disclosed to a global audience. This issue has been brought to prominence because of groups such as WikiLeaks who believe that information protected by governments should be made available (often via whistleblowers) to the general public through sites such as theirs in order to promote open government and transparency.

This paper will focus on the issue of information disclosure and whistleblowing. In particular the paper will centre on the case of Bradley Manning and his disclosure of sensitive militmy information to WikiLeaks and the related events and subsequent effects on our global digital environment.

Development in fragile states and situations: theory and critique

This chapter examines the evolution of ‘fragile’ and ‘failed’ state terminology noting the background to the ideas and examining the theorisation around the concepts, before surveying the literature on development in ‘fragile’ and ‘failed’ states in some depth. The OECD Principles for Good International Engagement in Fragile States and Situations are examined in particular, together with the follow-up OECD fragile state evaluations and related literature, as the primary and often normative guidance on development in ‘fragile’ or ‘failed’ states. A range of alternatives and critiques are explored. This chapter, therefore, sets the literature and theory in place as a backdrop for the diversity of case studies presented in Part II of this volume.

Relationship between membrane fatty acids and cognitive symptoms and information processing in individuals at ultra-high risk for psychosis

Cognitive symptoms and impairment are central to schizophrenia and often an early sign of this condition. The present study investigated biological correlates of cognitive symptoms and performance in individuals at ultra-high risk (UHR) for psychosis. The study sample comprised 80 neuroleptic-naïve UHR individuals aged 13-25 years. Associations among erythrocyte membrane fatty acid levels, measured by gas chromatography, and cognitive functioning were investigated in UHR patients. Subjects were divided into terciles based on their scores on the cognitive factor of the Positive and Negative Syndrome Scale. The Zahlen-Verbindungs Test (ZVT) (the number-combination test) was also used as a measure of information-processing speed. Exploratory analysis was conducted to investigate the relationship between membrane fatty acid levels with the size of the intracranial area (ICA), a neurodevelopmental measure relevant to schizophrenia, in half of subjects (n=40) using magnetic resonance imaging. The adjusted analysis revealed that omega-9 eicosenoic and erucic acid levels were significantly higher, but omega-3 docosahexaenoic acid levels were significantly lower, in the cognitively impaired than in the cognitively intact group. We found a significant negative association of eicosenoic, erucic, and gamma-linoleic acids with ZVT scores. A negative association between ICA and membrane levels of eicosenoic acid was also found. This is the first study to demonstrate the relationship between membrane fatty acids and cognitive function in neuroleptic-naïve subjects at UHR for psychosis. The study findings indicate that abnormalities in membrane fatty acids may be associated with the neurodevelopmental disruption associated with the cognitive impairments of individuals at UHR for psychosis.