Facilitating Scientific Communication Between Strangers: A Preregistered Lost E-Mail Experiment

Communication scholars are increasingly concerned about biases that shape people's interactions with science. Past study has focused on echo chambers (cultivating social networks that reinforce existing worldviews). People's facilitation of scientific discourse between strangers also may be shaped by their attitudes. To study the latter, we employed a recent adaptation of Milgram's lost letter technique called the lost e-mail technique (LET). We conducted a preregistered field study using a large undergraduate university sample (N = 1,508) to examine how the LET might elucidate people's treatment of scientific information. We distributed four ostensibly misaddressed scientific messages and monitored the likelihood of these e-mails being facilitated by participants. Participants' beliefs about self-esteem's importance, assessed months earlier, were associated with increased facilitation of scientific claims congruent with (vs. incongruent with) these beliefs. Thus, people shape the spread of online information in a manner matching their beliefs, even for people outside their social networks.

Impact of a Novel Strategy for Critical Values Communication for the Management of Patients Treated with Clozapine

INTRODUCTION

Clozapine is an antipsychotic drug used to treat resistant schizophrenia and other disorders. Based on the actual Spanish legislation, patients treated with clozapine must undergo periodical haematological examinations and treatment should be reviewed when the haemogram shows either a leukocyte count of ≤ 3500/mm³ or neutrophil count < 2000/mm³. An automatic notification system has been developed to optimize patient management and it's utility was assessed following the implementation of the new system.

MATERIAL AND METHODS

When clozapine (CLO) laboratory test request was made, a reflex complete blood count test was also done. An automatic e-mail was sent by the laboratory information system to the physician when a CLO was ordered and low leukocyte or neutrophil counts were detected, or when a patient with an ordered CLO test did not attend the laboratory for blood drawing.

RESULTS

For patients with haemogram alterations, the time to take clinical action was significantly decreased from 23 to 7 days (p = 0.02). Moreover, the adherence to Spanish Agency of Drugs and Sanitary Devices recommendations significantly increased from 45% to 76% (p = 0.02). For not attending patients, the days out of control decreased from 29 to 12 days, although it was not statistically significant (p = 0.06).

CONCLUSIONS

This strategy has allowed the compliance of legal requirements, the improvement of patient safety, and the optimisation of clinical and laboratory procedures.

How are patients with chronic urticaria interested in using information and communication technologies to guide their healthcare? A UCARE study

Background

Patients with chronic urticaria (CU) are increasingly using information and communication technologies (ICTs) to manage their health. What CU patients expect from ICTs and which ICTs they prefer remains unknown. We assessed why CU patients use ICTs, which ones they prefer, and what drives their expectations and choices.

Methods

In this cross-sectional study, 1841 patients across 17 countries were recruited at UCAREs (Urticaria Centers of Reference and Excellence). Patients with CU who were >12 years old completed a 23-item questionnaire.

Results

Most patients were interested in receiving disease information (87.3%), asking physicians about CU (84.1%), and communicating with other patients through ICTs (65.6%). For receiving disease information, patients preferred one-to-one and one-to-many ICTs, especially web browsers. One-to-one ICTs were also the ICTs of choice for asking physicians about urticaria and for communicating with other patients, and e-mail and WhatsApp were the preferred ICTs, respectively. Many-to-many ICTs such as Facebook, Instagram, LinkedIn, and Twitter were least preferred for all 3 purposes. Living in rural areas and higher education were linked to higher odds of being interested in receiving disease information, asking physicians, and communicating with patients through ICTs.

Conclusions

Most patients and especially patients with higher education who live in rural areas are interested in using ICTs for their healthcare, but prefer different ICTs for different purposes, ie, web browsers for obtaining information, e-mail for asking physicians, and WhatsApp for communicating with other patients. Our findings may help to improve ICTs for CU.

Brain-Computer Interface (BCI) Control of a Virtual Assistant in a Smartphone to Manage Messaging Applications

Brain-computer interfaces (BCI) are a type of assistive technology that uses the brain signals of users to establish a communication and control channel between them and an external device. BCI systems may be a suitable tool to restore communication skills in severely motor-disabled patients, as BCI do not rely on muscular control. The loss of communication is one of the most negative consequences reported by such patients. This paper presents a BCI system focused on the control of four mainstream messaging applications running in a smartphone: WhatsApp, Telegram, e-mail and short message service (SMS). The control of the BCI is achieved through the well-known visual P300 row-column paradigm (RCP), allowing the user to select control commands as well as spelling characters. For the control of the smartphone, the system sends synthesized voice commands that are interpreted by a virtual assistant running in the smartphone. Four tasks related to the four mentioned messaging services were tested with 15 healthy volunteers, most of whom were able to accomplish the tasks, which included sending free text e-mails to an address proposed by the subjects themselves. The online performance results obtained, as well as the results of subjective questionnaires, support the viability of the proposed system.

The incessant inbox: Evaluating the relevance of after-hours e-mail characteristics for work-related rumination and well-being

While many employees read and respond to work-related e-mails in the evenings after work, the mechanisms through which after-hours e-mailing influences well-being remain poorly understood. In particular, there has been limited consideration of whether different characteristics of after-hours e-mails (frequency, duration, perceived tone) may trigger work-related rumination that influences employee well-being at bedtime (i.e., the end of the post-work period). To address this gap in the literature, data were collected from 59 employees during a 5-day daily survey period. We expected after-hours e-mail frequency, duration, and perceived tone to indirectly relate to employee vigour and fatigue at bedtime (two common well-being criteria) via affective rumination and problem-solving pondering (two major forms of work-related rumination). Our results indicated that a more negatively perceived after-hours e-mail tone influenced both vigour and fatigue via affective rumination. Further, our findings suggested diverging implications of after-hours e-mailing frequency and duration for problem-solving pondering, with longer duration and more frequent after-hours e-mailing co-varying with higher and lower levels of this form of rumination, respectively. These findings demonstrate the importance of considering various characteristics of after-hours e-mailing and corresponding implications of work-related rumination when studying employee well-being.

A Solution to Academic Radiology's Experience With Solicitation E-mails From Predatory Journals

OBJECTIVE. The objective of our study was to help academic researchers avoid predatory publishers by characterizing the problem with respect to radiology and medical imaging and to test an intervention to address aggressive e-mail solicitation. MATERIALS AND METHODS. In total, 803 faculty from 10 U.S. academic radiology departments and 193 faculty in the senior author's department were surveyed about their experiences with soliciting journals. To document the characteristics of these journals and their publishers, we retrospectively reviewed the academic institutional e-mail box of one radiologist over 51 days. Journals' bibliometric parameters were compared with those of established medical imaging journals offering open access publishing. We tested filters for selected syntax to identify spam e-mails during two time periods. RESULTS. Of 996 faculty, 206 responded (16% nationally, 42% locally). Most (98%) received e-mails from soliciting publishers. Only 7% published articles with these publishers. Submission reasons were invitations, fee waivers, and difficulty publishing elsewhere. Overall, 94 publishers sent 257 e-mails in 51 days, 50 of which offered publishing opportunities in 76 imaging journals. Six journals were indexed in PubMed, and two had verifiable impact factors. The six PubMed-indexed journals had a lower mean publication fee ($824) than top medical imaging journals ($3034) (p < 0.001) and had a shorter mean duration of existence (9.5 vs 49.0 years, respectively; p = 0.005). The e-mail filters captured 71% of soliciting e-mails during the initial 51-day period and 85% during the same period 1 year later. CONCLUSION. Soliciting publishers have little impact on scientific literature. Academicians can avoid soliciting e-mails with customized e-mail filters.

Use of Remote Monitoring by E-mail for Long-Term Management of the Classic Ketogenic Diet

The classic ketogenic diet (cKD) requires constant nutritional monitoring over time both to ensure its effectiveness and to reduce the likelihood of short- and long-term adverse effects. We retrospectively described the use of remote monitoring by e-mail during the first year of follow-up on cKD in 34 children (47% males; age range: 2−17 years) diagnosed with drug-resistant epilepsy (DRE; n = 14) or glucose transporter type 1 deficiency syndrome (GLUT1-DS; n = 20). All the e-mails were evaluated analyzing their frequency and content at 3, 6 and 12 months. Three families never sent e-mails. A median of 36.0 (IQR 23.0–64.0) e-mails per family were sent during the 12 follow-up months by the 31 patients. GLUT1-DS patients sent a greater number of e-mails than the DRE group (median 39.0 (IQR 25.5–56.5) vs. median 26.0 (IQR 19.0–65.0)). At the end of the follow-up period, a greater number of e-mails had been exchanged between the nutritional team and the families belonging to the group that increased its linear growth (median 83.5; IQR 48.0–102.0), compared to the other ones. Constant remote monitoring by e-mail could be a feasible and effective way for a better cKD management.

The Influence of Patient-Provider Communication on Cancer Screening

Few studies have examined how different qualities and modes (face-to-face vs electronic) of patient–provider communication (PPC) influence cancer screening uptake. Our objective was to determine whether receiving a breast, cervical, and colorectal cancer screening is influenced by (1) qualities of face-to-face and (2) the use of e-mail PPC. We analyzed Health Information National Trends Survey 4, cycles 1 to 4 data. To assess qualities of face-to-face PPC, adults reported how often physicians spent enough time with them, explained so they understood, gave them a chance to ask questions, addressed feelings and emotions, involved them in decisions, confirmed understanding, and helped them with uncertainty. Adults reported whether they used e-mail PPC. We used multivariable logistic regression to evaluate the odds of receiving cancer screenings based on face-to-face and e-mail PPC. Adults whose health-care providers involved them in decision-making had highest odds of receiving breast (odds ratio [OR] = 1.38; 95% confidence interval [CI] = 1.11-1.71), cervical (OR = 1.30; 95% CI = 1.06-1.60), and colorectal (OR = 1.25; 95% CI = 1.03-1.51) cancer screenings. No significant associations were observed between e-mail PPC and cancer screenings. More research is needed to explore this association.

Development of 'My Retainers' mobile application: Triangulation of two qualitative methods

OBJECTIVE

Diligent wear of removable orthodontic retainers requires prolonged adherence and is invariably necessary to preserve optimal results. Patient-informed behaviour-change interventions represent a promising and novel means of enhancing adherence to removable retainer wear. The aim of this study was to describe the development of a patient-informed mobile application designed to enhance retainer wear.

METHODS

App development encompassed consideration of participant preferences, social media posts, available interventions and behaviour change theories. Qualitative methods including analysis of publicly-available retainer-related posts on Twitter (n = 827) and one-to-one interviews were undertaken. Audio-recorded one-to-one interviews were undertaken to identify patient preferences in relation to features, content and design of the application. A criterion-based purposive sample of participants wearing vacuum-formed retainers for at least 4 years was used (n = 15). Thematic analysis of transcribed data was undertaken. These data were triangulated to inform design and content of the application.

RESULTS

The need to facilitate communication with the treating clinician, responsive reminder and tracking systems, and access to useful and engaging written and visual information, in addition to other personalised and interactive features were considered important. Concerns related to retainer wear shared on Twitter informed an exhaustive list of frequently-asked questions. Application features were mapped to relevant theoretical constructs. Determinants of existing behavioural change theories were also used to link application features to retainer wear and maintenance.

CONCLUSIONS

A holistic process involving both patient and professional input can be useful in informing the development of mobile applications. The orthodontic application ("My Retainers") will undergo further scrutiny in relation to its effectiveness in inducing behavioural change and concerning patient experiences prior to finalisation.

Enhancing the use of e-mail in scientific research and in the academy

From professors overwhelmed by anxiety-driven e-mails from students, through faculty and administrative staff wasting valued time on e-mail minutia, misuse of electronic mail in the academy has become ubiquitous. After a brief overview of the unique features of e-mail communication, this study provides guidelines to plan new educational activities on purposeful utilization of electronic mail in university and research centres of the digital era. The overall aim is to prioritize scholarly deep work by focusing on teaching and research work, freeing working time wasted on unproductive use of e-mail.

[Spams in doctors' mailbox: their threat to health education, to patient information and to scientific research]

Introduction: The term "spam" is applied to unwanted commercial e-mails sent to all whose e-mail addresses have been acquired by the spammers. The number of undesirable e-mails is growing in the health-care related areas as well. The targets of health-care related spams are laymen, physicians and academic researchers alike. Method: On the basis of 12,986 unwanted letters received in one year, the authors concluded that percentage of health-related spam is the second most common spam (27%) in relation to all spam. Most of the spam (63%) aggressively promoted purchasing of various consumer goods, but health-related spam are far ahead of the rest. The collected data were grouped by year and topic and they are analyzed by simple descriptive statistics. Spam form of cyber attacks on health care issues were divided into two: spam what is jeopardized individuals' health (e.g. medical compounds without any curing effect, misleading statement on medical device, fraudulent panacea offers, and cheating cure methods, etc.) and onslaught on medical scientific activity (pseudo-scientific congress invitation, predator journal invitation etc.). Results: The topics of spams addressed to laymen are offered for perfect healing by strange treatments, cures (31%), panaceas (19%), lifestyle advice (19%), massage (16%), brand new health-care devices (4%) and drugs for sexual dysfunction (11%). The topics of spams addressed to physicians and researchers are deluged by pseudoscientific materials: invitation for articles to be sent to no-name/fake open-access journals (68%), invitation to participate at an obscure congress (27%) or newsletters on miscellanous medical topics (5%). Conclusion: The spams offer very often relief or solution to medical problems that the present-day medical practice cannot solve perfectly (oncological, musculo-sceletal, endocrin or metabolic problems). Understandably, the patients would hold on to fake hopes - and the authentic patient education and health promotion will be neglected. These unwanted messages practically cannot be unsubscribed, and - while the spam filters are far from perfection - the victim must go through the filtered spam-dustbin in order not to miss some real messages. Unfortunately no legal regulation (neither local, nor GDPR) can block or stop the spams. The spams are misleading the laymen and jeopardise the effects of professional and responsible health promotion and health education. Orv Hetil. 2019; 160(43): 1706-1710.

Testing e-mail content to encourage physicians to access an audit and feedback tool: a factorial randomized experiment

Background

In Ontario, an online audit and feedback tool that provides primary care physicians with detailed information about patients who are overdue for cancer screening is underused. In the present study, we aimed to examine the effect of messages operationalizing 3 behaviour change techniques on access to the audit and feedback tool and on cancer screening rates.

Methods

During May-September 2017, a pragmatic 2×2×2 factorial experiment tested 3 behaviour change techniques: anticipated regret, material incentive, and problem-solving. Outcomes were assessed using routinely collected administrative data. A qualitative process evaluation explored how and why the e-mail messages did or did not support Screening Activity Report access.

Results

Of 5449 primary care physicians randomly allocated to 1 of 8 e-mail messages, fewer than half opened the messages and fewer than 1 in 10 clicked through the messages. Messages with problem-solving content were associated with a 12.9% relative reduction in access to the tool (risk ratio: 0.871; 95% confidence interval: 0.791 to 0.958; p = 0.005), but a 0.3% increase in cervical cancer screening (rate ratio: 1.003; 95% confidence interval: 1.001 to 1.006; p = 0.003). If true, that association would represent 7568 more patients being screened. No other significant effects were observed.

Conclusions

For audit and feedback to work, recipients must engage with the data; for e-mail messages to prompt activity, recipients must open and review the message content. This large factorial experiment demonstrated that small changes in the content of such e-mail messages might influence clinical behaviour. Future research should focus on strategies to make cancer screening more user-centred.

Low Cost Efficient Deliverying Video Surveillance Service to Moving Guard for Smart Home

Low-cost video surveillance systems are attractive for Smart Home applications (especially in emerging economies). Those systems use the flexibility of the Internet of Things to operate the video camera only when an intrusion is detected. We are the only ones that focus on the design of protocols based on intelligent agents to communicate the video of an intrusion in real time to the guards by wireless or mobile networks. The goal is to communicate, in real time, the video to the guards who can be moving towards the smart home. However, this communication suffers from sporadic disruptions that difficults the control and drastically reduces user satisfaction and operativity of the system. In a novel way, we have designed a generic software architecture based on design patterns that can be adapted to any hardware in a simple way. The implanted hardware is of very low economic cost; the software frameworks are free. In the experimental tests we have shown that it is possible to communicate to the moving guard, intrusion notifications (by e-mail and by instant messaging), and the first video frames in less than 20 s. In addition, we automatically recovered the frames of video lost in the disruptions in a transparent way to the user, we supported vertical handover processes and we could save energy of the smartphone's battery. However, the most important thing was that the high satisfaction of the people who have used the system.

Comparison of Text Messages Versus E-mail When Communicating and Querying With Mothers About Safe Infant Sleep

OBJECTIVE

To assess how mothers' choice of e-mail or text messages (SMS) to receive safe sleep communications is associated with educational video viewing and responses to care practice queries.

METHODS

Seven hundred ninety-two new mothers received safe sleep-related communications for 60 days after newborn hospital discharge as part of a trial of health education interventions on infant care practices. Mothers chose e-mail or SMS for study communications and were sent 22 short safe sleep videos and 41 queries regarding infant care practices.

RESULTS

Study communications via e-mail were elected by 55.7% of participants. The SMS group had a modestly higher overall view rate of videos (59.1% vs 54.4%; adjusted odds ratio [aOR], 1.39; 95% confidence interval [CI], 1.07-1.81) and a substantially higher response rate to queries (70.0% vs 45.2%; aOR, 3.48; 95% CI, 2.74-4.43).

CONCLUSIONS

Participants more commonly opted to receive infant care practice videos and queries via e-mail. SMS was associated with higher viewing and response rates, especially for query responses. These results highlight the importance of understanding how specific modalities of communication might vary in reach.

Does Mode of Contact with Different Types of Social Relationships Predict Depression in Older Adults? Evidence from a Nationally Representative Survey

OBJECTIVES

To determine associations between use of three different modes of social contact (in person, telephone, written or e-mail), contact with different types of people, and risk of depressive symptoms in a nationally representative, longitudinal sample of older adults.

DESIGN

Population-based observational cohort.

SETTING

Urban and suburban communities throughout the contiguous United States.

PARTICIPANTS

Individuals aged 50 and older who participated in the Health and Retirement Survey between 2004 and 2010 (N = 11,065).

MEASUREMENTS

Frequency of participant use of the three modes of social contact with children, other family members, and friends at baseline were used to predict depressive symptoms (measured using the eight-item Center for Epidemiologic Studies Depression Scale) 2 years later using multivariable logistic regression models.

RESULTS

Probability of having depressive symptoms steadily increased as frequency of in-person-but not telephone or written or e-mail contact-decreased. After controlling for demographic, clinical, and social variables, individuals with in-person social contact every few months or less with children, other family, and friends had a significantly higher probability of clinically significant depressive symptoms 2 years later (11.5%) than those having in-person contact once or twice per month (8.1%; P < .001) or once or twice per week (7.3%; P < .001). Older age, interpersonal conflict, and depression at baseline moderated some of the effects of social contact on depressive symptoms.

CONCLUSION

Frequency of in-person social contact with friends and family independently predicts risk of subsequent depression in older adults. Clinicians should consider encouraging face-to-face social interactions as a preventive strategy for depression.

A Mixed-Methods Study of Patient-Provider E-Mail Content in a Safety-Net Setting

To explore the content of patient-provider e-mails in a safety-net primary care clinic, we conducted a content analysis using inductive and deductive coding of e-mail exchanges (n = 31) collected from January through November 2013. Participants were English-speaking adult patients with a chronic condition (or their caregivers) cared for at a single publicly funded general internal medicine clinic and their primary care providers (attending general internist physicians, clinical fellows, internal medicine residents, and nurse practitioners). All e-mails were nonurgent. Patients included a medical update in 19% of all e-mails. Patients requested action in 77% of e-mails, and the most common requests overall were for action regarding medications or treatment (29%). Requests for information were less common (45% of e-mails). Patient requests (n = 56) were resolved in 84% of e-mail exchanges, resulting in 63 actions. These results show that patients in safety-net clinics are capable of safely and effectively using electronic messaging for between-visit communication with providers. Safety-net systems should implement electronic communications tools as soon as possible to increase health care access and enhance patients' involvement in their care.

Effectiveness of a worksite-based weight loss randomized controlled trial: the worksite study

OBJECTIVE

To determine the effectiveness of an individually targeted Internet-based intervention with monetary incentives (INCENT) at reducing weight of overweight and obese employees when compared with a less-intensive intervention (Livin' My Weigh [LMW]) 6 months after program initiation.

METHODS

Twenty-eight worksites were randomly assigned to either INCENT or LMW conditions. Both programs used evidence-based strategies to support weight loss. INCENT was delivered via daily e-mails over 12 months while LMW was delivered quarterly via both newsletters and on-site educational sessions. Generalized linear mixed models were conducted for weight change from baseline to 6 months post-program and using an intention-to-treat analysis to include all participants with baseline weight measurements.

RESULTS

Across 28 worksites, 1,790 employees (M = 47 years of age; 79% Caucasian; 74% women) participated. Participants lost an average of 2.27 lbs (P < 0.001) with a BMI decrease of 0.36 kg/m(2) (P < 0.001) and 1.30 lbs (P < 0.01) with a BMI decrease of 0.20 kg/m(2) (P < 0.01) in INCENT and LMW, respectively. The differences between INCENT and LMW in weight loss and BMI reduction were not statistically significant.

CONCLUSIONS

This study suggests that INCENT and a minimal intervention alternative may be effective approaches to help decrease the overall obesity burden within worksites.

E-mail communication in the management of gastroenterology patients: a review

E-mail correspondence between physicians and patients can be a useful tool to improve communication efficiency, provide economic and ecological benefits, improve therapeutic interventions and adherence, and enhance self-management. The model of self-management in chronic disease has become an integral component of North American and British medicine. From a practical standpoint, the use of e-mail between physicians and patients can complement the self-management model. E-mail communication has many benefits from both patient and physician perspectives. E-mail contact reduces the inefficiencies associated with telecommunications. Physicians are able to better document out-of-office patient encounters and provide access to specialist care for patients in remote locations. This use of e-mail has the potential to increase patient safety through physician approval of self-manager actions, including earlier initiation of needed treatments. Fewer clinic visits afford additional time for new consultations and sicker patients, reducing the overall burden on referral and wait times. The present article reviews some of the literature regarding physician-patient e-mail communication in the general ambulatory setting, in the context of chronic disease and with a specific focus on inflammatory bowel disease (IBD). The authors provide a framework for the use of e-mail communication in the IBD population, with emphasis on the concept of e-mail use. Also illustrated are the benefits and disadvantages, and examples of the e-mail contract as proposed by the Canadian Medical Protective Association. Examples of specific e-mail communication topics are provided for several IBD scenarios. Potential negative consequences of this mode of communication are also discussed.

Assessing the potential of e-mail for communicating drug therapy recommendations to physicians in patients with heart failure and ventricular-assist devices

PURPOSE

This project explores electronic mail (e-mail) as a potential medium for pharmacists to communicate pharmacotherapy interventions to prescribers.

METHODS

This retrospective descriptive analysis was conducted at an urban, academic teaching hospital. The pharmacist attempted a drug therapy intervention via e-mail when unable to make face-to-face contact with the attending physician. Eligible patients for this project were admitted to the advanced heart failure (HF) team between December 1, 2010, and July 31, 2011, and had at least 1 attempted e-mail intervention. The primary outcome was the number of accepted interventions, while the secondary end point was the time until a physician e-mail response.

RESULTS

A total of 51 e-mail interventions were attempted on 29 patients (mean age = 53, 24% caucasian, 59% male, 69% left ventricular-assist device [VAD]). Overall, of the total 51 interventions,44 (86.3%) were accepted. The average time to a physician e-mail response was 41 minutes. Initiation of drug therapy and changing dose and route or frequency accounted for the most frequent intervention (33%). The most common drug classes involved in the e-mail interventions were angiotensin-converting enzyme inhibitors (15.7%), loop diuretics (9.8%), and antiplatelet agents (7.8%).

CONCLUSION

Clinical pharmacists with well-established physician relationships can effectively implement timely drug therapy recommendations using e-mail communications in patients with advanced HF or VADs.

Utilization of communication technology by patients enrolled in substance abuse treatment

BACKGROUND

Technology-based applications represent a promising method for providing efficacious, widely available interventions to substance abuse treatment patients. However, limited access to communication technology (i.e., mobile phones, computers, internet, and e-mail) could significantly impact the feasibility of these efforts, and little is known regarding technology utilization in substance abusing populations.

METHODS

A survey was conducted to characterize utilization of communication technology in 266 urban, substance abuse treatment patients enrolled at eight drug-free, psychosocial or opioid-replacement therapy clinics.

RESULTS

Survey participants averaged 41 years of age and 57% had a yearly household income of less than $15,000. The vast majority reported access to a mobile phone (91%), and to SMS text messaging (79%). Keeping a consistent mobile phone number and yearly mobile contract was higher for White participants, and also for those with higher education, and enrolled in drug-free, psychosocial treatment. Internet, e-mail, and computer use was much lower (39-45%), with younger age, higher education and income predicting greater use. No such differences existed for the use of mobile phones however.

CONCLUSIONS

Concern regarding the digital divide for marginalized populations appears to be disappearing with respect to mobile phones, but still exists for computer, internet, and e-mail access and use. Results suggest that mobile phone and texting applications may be feasibly applied for use in program-client interactions in substance abuse treatment. Careful consideration should be given to frequent phone number changes, access to technology, and motivation to engage with communication technology for treatment purposes.

A review of the evidence on technology-based interventions for the treatment of tobacco dependence in college health

BACKGROUND

The college years are a critical time in the development of smoking behavior and tobacco use. Smoking is linked to 30% of cancer deaths, 80% of deaths from chronic obstructive pulmonary disease, and early cardiovascular disease and death. Effective cessation interventions at this time provide an opportunity to drastically reduce premature morbidity and mortality.

AIMS

To review available evidence on Internet interventions with young adults, including methodology, theoretical frameworks and outcome measures for tobacco treatment to guide the development of a program in college health.

METHODS

A comprehensive literature search for studies published from January 1999 to February 2011, in multiple databases was conducted, along with hand-searching of reference lists. Inclusion criteria were: participants aged 18-30 years, intervention involved the Internet through either Web sites or e-mail or texting, and outcome measurement of tobacco cessation/abstinence. Studies were evaluated utilizing a tool synthesized from guidelines presented by the Cochrane Collaboration.

FINDINGS

Eight studies met the inclusion criteria (four randomized controlled trials, four cohort studies). Theoretical frameworks utilized were the Transtheoretical Model of Change, Health Belief Model, Theory of Social Support, and social cognitive theory. Interventions varied and included computer-generated advice letters, Web-based cessation guides, computer-generated text messages, and peer e-mail support. With smoking abstinence as the primary outcome measure, there was a statistically significant improvement in quit rates. Because of the use of multiple components, differences in interventions and the number of contacts, it is not clear what types of computer-based applications are most effective. Small sample sizes, lack of control groups, and inconsistency in outcome measures limit the ability to provide conclusive evidence to support these interventions-but support the feasibility to use in the design of future programs.

CONCLUSIONS

Use of technology-based interventions, such as the Internet, may be an effective tool for tobacco treatment interventions, especially with college students. There is great potential to reach large numbers of students, many who may not identify themselves as smokers or seek traditional methods for treatment. Additional research is needed to determine which technology-based interventions are most effective and to provide more conclusive evidence.

Spaced education activates students in a theoretical radiological science course: a pilot study

BACKGROUND

The present study aimed at determining if the addition of spaced education to traditional face-to-face lectures increased the time students kept busy with the learning content of a theoretical radiological science course.

METHODS

The study comprised two groups of 21 third-year dental students. The students were randomly assigned to a "traditional group" and a "spaced education group". Both groups followed a traditional face-to-face course. The intervention in the spaced education group was performed in way that these students received e-mails with a delay of 14 days to each face-to-face lecture. These e-mails contained multiple choice questions on the learning content of the lectures. The students returned their answers to the questions also by e-mail. On return they received an additional e-mail that included the correct answers and additional explanatory material.All students of both groups documented the time they worked on the learning content of the different lectures before a multiple choice exam was held after the completion of the course. All students of both groups completed the TRIL questionnaire (Trierer Inventar zur Lehrevaluation) for the evaluation of courses at university after the completion of the course. The results for the time invested in the learning content and the results of the questionnaire for the two groups were compared using the Mann-Whitney-U test.

RESULTS

The spaced education group spent significantly more time (216.2 ± 123.9 min) on keeping busy with the learning content compared to the traditional group (58.4 ± 94.8 min, p < .0005). The spaced education group rated the didactics of the course significantly better than the traditional group (p = .034). The students of the spaced education group also felt that their needs were fulfilled significantly better compared to the traditional group as far as communication with the teacher was concerned (p = .022).

CONCLUSIONS

Adding spaced education to a face-to-face theoretical radiological science course activates students in a way that they spend significantly more time on keeping busy with the learning content.

Web-assisted assessment of professional behaviour in problem-based learning: more feedback, yet no qualitative improvement?

Although other web-based approaches to assessment of professional behaviour have been studied, no publications studying the potential advantages of a web-based instrument versus a classic, paper-based method have been published to date. This study has two research goals: it focuses on the quantity and quality of comments provided by students and their peers (two researchers independently scoring comments as correct and incorrect in relation to five commonly used feedback rules (and resulting in an aggregated score of the five scores) on the one, and on the feasibility, acceptability and perceived usefulness of the two approaches on the other hand (using a survey). The amount of feedback was significantly higher in the web-based group than in the paper based group for all three categories (dealing with work, others and oneself). Regarding the quality of feedback, the aggregated score for each of the three categories was not significantly different between the two groups, neither for the interim, nor for the final assessment. Some, not statistically significant, but nevertheless noteworthy trends were nevertheless noted. Feedback in the web-based group was more often unrelated to observed behaviour for several categories for both the interim and final assessment. Furthermore, most comments relating to the category 'Dealing with oneself' consisted of descriptions of a student's attendance, thereby neglecting other aspects of personal functioning. The survey identified significant differences between the groups for all questionnaire items regarding feasibility, acceptability and perceived usefulness in favour of the paper-based form. The use of a web-based instrument for professional behaviour assessment yielded a significantly higher number of comments compared to the traditional paper-based assessment. Unfortunately, the quality of the feedback obtained by the web-based instrument as measured by several generally accepted feedback criteria did not parallel this increase.

Student pharmacists' use and perceived impact of educational technologies

OBJECTIVE

To assess the frequency of use by and perceived impact of various educational technologies on student pharmacists.

METHODS

Data were obtained using a validated, Web-based survey instrument designed to evaluate the frequency of use and impact on learning of various technologies used in educating first-, second-, and third-year student pharmacists. Basic demographic data also were collected and analyzed.

RESULTS

The majority (89.4%) of the 179 respondents were comfortable with the technology used in the academic program. The most frequently used technologies for educational purposes were in class electronic presentations, course materials posted on the school Web site, and e-mail. The technologies cited as having the most beneficial impact on learning were course materials posted on the Web site and in-class electronic presentations, and those cited as most detrimental were video-teleconferencing and online testing. Compared to the course textbook, students reported more frequent use of technologies such as electronic course materials, presentations, digital lecture recordings, e-mail, and hand-held devices.

CONCLUSIONS

Because students' opinions of educational technologies varied, colleges and schools should incorporate educational technologies that students frequently use and that positively impact learning.

Faculty and student expectations and perceptions of e-mail communication in a campus and distance doctor of pharmacy program

OBJECTIVE

To examine faculty members' and students' expectations and perceptions of e-mail communication in a dual pathway pharmacy program.

METHODS

Three parallel survey instruments were administered to campus students, distance students, and faculty members, respectively. Focus groups with students and faculty were conducted.

RESULTS

Faculty members perceived themselves as more accessible and approachable by e-mail than either group of students did. Campus students expected a shorter faculty response time to e-mail and for faculty members to be more available than did distance students.

CONCLUSION

E-mail is an effective means of computer-mediated communication between faculty members and students and can be used to promote a sense of community and inclusiveness (ie, immediacy), especially with distant students.

E-mail in patient-provider communication: a systematic review

OBJECTIVE

To review systematically the role of e-mails in patient-provider communication in terms of e-mail content, and perspectives of providers and patients on e-mail communication in health care.

METHODS

A systematic review of studies on e-mail communication between patients and health providers in regular health care published from 2000 to 2008.

RESULTS

A total of 24 studies were included in the review. Among these studies, 21 studies examined e-mail communication between patients and providers, and three studies examined the e-mail communication between parents of patients in pediatric primary care and pediatricians. In the content analyses of e-mail messages, topics well represented were medical information exchange, medical condition or update, medication information, and subspecialty evaluation. A number of personal and institutional features were associated with the likelihood of e-mail use between patients and providers. While benefits of e-mails in enhancing communication were recognized by both patients and providers, concerns about confidentiality and security were also expressed.

CONCLUSION

The e-mail is transforming the relationship between patients and providers. The rigorous exploration of pros and cons of electronic interaction in health care settings will help make e-mail communication a more powerful, mutually beneficial health care provision tool.

PRACTICE IMPLICATIONS

It is important to develop an electronic communication system for the clinical practice that can address a range of concerns. More efforts need to be made to educate patients and providers to appropriately and effectively use e-mail for communication.

physicians who conduct internet or e-mail consults

BACKGROUND

E-mail communication has the potential to improve communication between patients and doctors.

OBJECTIVE

The objective of the study is to describe the access of patients to physicians who conduct e-mail consults.

METHODS

We analyzed data from the National Ambulatory Medical Care Survey (NAMCS), a nationally representative cross-sectional survey of office-based physician visits, in 2001, 2002, and 2003. The main outcome measure was the percentage of visits to a provider who reported doing internet or e-mail consults.

RESULTS

There was fewer than 1 in 10 outpatient visits in 2001 (9.2%) to physicians who reported doing internet or e-mail consults, and this did not increase in 2002 (5.8%) or 2003 (5.5%). Access to these physicians was greater among patients who were male, nonminority, lived in the Western United States, seen for pre-/postoperative care, seen by a primary care provider, and not seen by a nurse during their visit. Access to physicians who conducted internet or e-mail consults was independent of other patient (e.g., chronic conditions), provider (e.g., office setting), and visit (e.g., medications prescribed) characteristics.

CONCLUSIONS

Access to physicians who do internet or e-mail consults is generally low and did not increase between 2001 and 2003, despite growth in internet access and in other internet-related activities.

An E-mail for Your Thoughts

Engaging adolescents is one of many challenges facing Child and Adolescent Mental Health Services today. However, taking advantage of the technology available can bring professionals a step closer to their patients by providing an alternative means of interaction. In this article we explore the use of e-mail as a method of engaging adolescents. The advantages and disadvantages of e-mailing patients are discussed along with recommendations for its safe use.

Effect of a triage-based E-mail system on clinic resource use and patient and physician satisfaction in primary care: a randomized controlled trial

OBJECTIVES

E-mail communication between patients and their providers has diffused slowly in clinical practice. To address concerns about the use of this technology, we performed a randomized controlled trial of a triage-based e-mail system in primary care. DESIGN AND PATIENTS/PARTICIPANTS: Physicians in 2 university-affiliated primary care centers were randomized to a triage-based e-mail system promoted to their patients. E-mails from patients of intervention physicians were routed to a central account and parsed to the appropriate staff for response. Control group physicians and their patients did not have access to the system. We collected information on patient e-mail use, phone calls, and visit distribution by physician over the 10 months and performed physician and patient surveys to examine attitudes about communication.

RESULTS

E-mail volume was greater for intervention versus control physicians (46 weekly e-mails per 100 scheduled visits vs 9 in the control group at the study midpoint; P <.01) but there were no between-group differences in phone volume (67 weekly phone calls per 100 scheduled visits vs 55 in the control group; P =.45) or rates of patient no-shows (5% in both groups; P =.77). Intervention physicians reported more favorable attitudes toward electronic communication than did control physicians but there were no differences in attitudes toward patient or staff communication in general. There were few between-group differences in patient attitudes toward electronic communication or communication in general.

CONCLUSIONS

E-mail generated through a triage-based system did not appear to substitute for phone communication or to reduce visit no-shows in a primary care setting. Physicians' attitudes toward electronic communication were improved, but physicians' and patients' attitudes toward general communication did not change. Growth of e-mail communication in primary care settings may not improve the efficiency of clinical care.

Physicians' use of and attitudes toward electronic mail for patient communication

To assess physicians' use of and attitudes toward electronic mail (e-mail) for patient communication, we conducted a mail-in survey of physicians who see patients in outpatient clinics affiliated with a large academic medical center (N = 283). Seventy-two percent of physicians reported using e-mail to communicate with patients, averaging 7.7 e-mails from patients per month. The lowest level of use was by community-based primary care physicians (odds ratio, 0.22; 95% confidence interval, 0.08 to 0.59). Those physicians who reported using e-mail with patients reported high satisfaction with its use. Although physicians were concerned about the confidentiality of e-mail, few discussed this issue with patients.

World Wide Web for Crystallography

Some characteristics of the World Wide Web (WWW) and its Virtual Library (W3VL) are described. Aspects of the setting up, maintenance, future development and objectives of the World Wide Web Virtual Library: Crystallography are detailed. An overview of the successful use of WWW in the organisation of two crystallographic conferences and one entirely electronic conference is given. A revolution in scientific publication is under way with the introduction of WWW and CD-ROM technologies and a few of the points important to crystallography are touched upon. An application to distance teaching in crystallography is described. There is no mention of WWW applications to crystallographic databases in this paper as others at the Workshop have adequately described their work.

Electronic Publishing and the Journals of the American Chemical Society

The American Chemical Society is developing a number of initiatives that implement emerging electronic technologies in order to provide a broad range of products and services to members and subscribers. Examples of products currently available, or under development, for access via the World Wide Web include supporting information for journals, electronic ads, color graphics and entire journals. Other activities employ e-mail, CD-ROMs, and softcopy text.