Benefits and limitations of text messages to stimulate higher learning among community providers: participants’ views of an mHealth intervention to support continuing medical education in Vietnam

BACKGROUND: A randomized controlled trial was conducted in 2015 to evaluate a mobile continuing medical education (mCME) intervention that provided daily text messages to community-based physicians’ assistants (CBPAs) in Thai Nguyen Province, Vietnam. Although the intervention failed to improve medical knowledge over a 6-month period, a companion qualitative study provided insights on the views and experiences of intervention participants. METHODS: We conducted focus group discussions (FGDs) and in-depth interviews (IDIs) among participants randomized to receive text messages containing either simple medical facts or quiz questions. Trained interviewers collected data immediately following the conclusion of the trial in December 2015. Using semi-structured question guides, respondents were queried on their views of the intervention, positive and negative, and perceived impacts of the intervention. During analysis, after learning that the intervention had failed to increase knowledge among participants, we also examined reasons for lack of improvement in medical knowledge. All analyses were performed in NVivo using a thematic approach. RESULTS: A total of 70 CBPAs engaged in one of 8 FGDs or an IDI. One-half were men; average age among all respondents was 40 years. Most (81%) practiced in rural settings and most (51%) focused on general medicine. The mean length of work experience was 3 years. All respondents made positive comments about the intervention; convenience, relevance, and quick feedback (quiz format) were praised. Downsides encompassed lack of depth of information, weak interaction, technology challenges, and challenging/irrelevant messages. Respondents described perceived impacts encompassing increased motivation, knowledge, collegial discussions, Internet use to search for more information, and clinical skills. Overall, they expressed a desire for the intervention to continue and recommended expansion to other medical professionals. Overreliance on the text messages, lack of effective self-study, and technical/language-based barriers may be potential explanations for intervention failure. CONCLUSION: As a form of mCME, daily text messages were well-received by community-level health care providers in Vietnam. This mCME approach appears very promising in low-resource environments or where traditional forms of CME are impractical. Future models might consider enhancements to foster linkages to relevant medical materials, improve interaction with medical experts, and tailor medical content to the daily activities of medical staff

New futures health trainers: an impact assessment

Although the health of the UK population has improved significantly over the last century, inequalities in health still exist, with some of Britain’s biggest killers being ‘preventable’ illnesses. The 2004 white paper ‘Choosing Health: Making Healthy Choices Easier’ aimed to introduce initiatives to reduce inequalities in health. One such initiative was ‘Health Trainers’ – a new role staffed by individuals drawn from and based in deprived areas. This role aimed to offer people in deprived communities practical advice about health improvement, and to facilitate access to health services This report aims to examine the impact of introducing the ‘New Futures Health Trainer’ role into criminal justice settings in terms of: a) Training for the Health Trainer Tutors/the development of the Health Trainer training course b) The impact of the training on the New Futures Health Trainers c) The organisational consequences of the role d) The impact of New Futures Health Trainers on clinical outcomes for prisoners/offenders on probation, and e) A brief examination of the relationship between ‘early adopter’ sites for Health Trainers in the community, and the prison/probation equivalen

Silver Surfers : Social Inclusion or Exclusion in a Digital World

Funded and commissioned by Microsoft's Unlimited Potential Programme, with contributions from Citizens Online and UH. This report was the output from the project.When one considers the population profile of a country, no longer is the emphasis upon mortality rates of younger people. As the years progress, enhancements to the quality of life have led to an increasingly ageing society. The emphasis globally has changed to provision for all age groups as a result. In this report, we determine how Information and Communication Technologies (ICTs) are being introduced through programmes by a variety of agencies into the lives of one particular population group – the silver surfer. The context of this report is the United KingdomFinal Published versio

Environmental valuation, ecosystem services and aquatic species

The thesis consists of an introduction and four articles that can be read independently of each other. The common topic is environmental valuation and cost-benefit analysis. The applications relates to the growing concern of invasive species, and to waterpower externalities. In broad terms, all of the articles relates to water management. Article 1: "A Cost-Benefit analysis of introducing a non-native species: the case of signal crayfish in Sweden", assesses the economic impact of introducing the signal crayfish into a Swedish lake. Two scenarios are set up and compared. The first one assumes that there is no introduction of signal crayfish, so that the noble crayfish is preserved. In the second scenario, the signal crayfish is introduced, which immediately wipes out the entire stock of noble crayfish. The values of noble- and signal crayfish populations are measured as present values of their net future revenues. The values are than compared and net benefit of an introduction is calculated. The result indicate that net benefit of an introduction is positive if the intrinsic growth rate or the carrying capacity of the noble crayfish is below 40 % that of the signal crayfish. Article 2: "Assessing management options for weed control with demanders and non-demanders in a choice experiment", estimates the benefits of having a weed management program for a lake in Sweden, and then compares them with corresponding costs. The policy recommendation from a simple cost-benefit rule is to control the weed at some specific sites of the lake. This paper also suggest how to distinguish those that have a positive WTP for at least one of the attributes (demanders) from those that have zero WTP for all attributes (non-demanders). The advantage of the suggested approach is that it facilitates to more clearly distinguish between conditional and unconditional willingness to pay. The suggested approach could also overcome some of the problems in the literature with negative welfare measures. Article 3: "Assessing transfer errors in the benefit transfer method: An application of invasive weed management using choice experiment", tests the accuracy of transferring benefits of a weed management program from one lake to another using choice experiment. The transfer errors are assessed and the convergent validity hypothesis is tested. Estimating the accuracy of benefit transfer for weed management is policy relevant as there are a number of lakes in Sweden infested with the water weed. The convergent validity was rejected for three out of five welfare estimates with a ten per cent significance level. Article 4: "Willingness to pay for environmental improvements in hydropower regulated rivers", assesses the benefits of environmental improvements along hydropower regulated rivers using choice experiments. Remedial measures that improve the conditions for fish, benthic invertebrates and river-margin vegetation were found to have a significant welfare increasing impact. The results can be of value for the implementation of the Water Framework Directives in Sweden, which aims to reform the use of all surface water and ground water in the member states

Human response to vibration in residential environments (NANR209), technical report 2: measurement of response

Based on a review of the literature and the best practice guidance available, a social survey questionnaire was developed to measure residents’ self-reported annoyance and to provide data suitable for establishing exposure-response relationships between levels of annoyance and levels of vibration. The development of the questionnaire was influenced by a number of previous studies such as: the social survey questionnaire developed for the NANR172 Pilot Study of this research (Defra, 2007); best practice guidelines for the development of socio-acoustic surveys issued by ICBEN and presented in the current International Standard (Fields et al., 2001; ISO/TS 15666:2003); the Nordtest Method (2001) for the development of socio-vibration surveys, and a peer review of the social survey questionnaire by international experts in the field. In order to avoid influencing responses and reasons for participation in the research, the survey was introduced as a survey of neighbourhood satisfaction. The questionnaire design, through the use of sections, enables new sections to be added to the questionnaire so that specific vibration sources can be investigated in more depth. In addressing the ‘response’ component in the ‘exposure-response’ relationship, the questionnaire was designed to yield interval-level measurement data suitable for analysis with vibration measurement data via two response scales: the five-point semantic and the eleven-point numerical scales. This decision was largely founded upon the ability of the two scales to meet the criteria established by ICBEN (Fields et al., 2001) for socio-acoustic survey design. Detailed procedures were documented, following the field trial of the questionnaire, in terms of the role of the interviewer, the recording of information and the transfer of the data to the relevant database for subsequent analysis and to inform the vibration team responsible for the ‘exposure’ component of this research project

Culture and disaster risk management - synthesis of citizens’ reactions and opinions during 6 Citizen Summits : Romania, Malta, Italy, Germany, Portugal and the Netherlands

The analyses and results in this document are based on the data collected during six Citizen Summits held in A) Romania (Bucharest) on July 9th, 2016 B) Malta on July 16th, 2016 C) Italy (Rome) on June 17th, 2017 D) Germany (Frankfurt) on June 24th, 2017 E) Portugal (Lisbon) April 14th, 2018 F) The Netherlands (Utrecht)on May 12th, 2018. All Citizen Summits were designed as one-day events combining public information with feedback gathering through different methods of data collection, as laid out in Deliverable D5.1 (Structural design & methodology for Citizen Summits). A total of 619 citizens participated in the six events. In the morning session, the Citizen Summits started with a presentation of the CARISMAND project and its main goals and concepts. Then, several sets of questions with pre-defined answer options were posed to the audience and responses collected via an audience response system. All questions in this part of the event aimed to explore citizens’ attitudes, perceptions, and intended behaviours related to disasters and disaster risks. Between these sets of questions, additional presentations were held that informed the audience about state-of-the-art disaster preparedness and response topics (e.g., large-scale disaster scenario exercises, use of social media and mobile phone apps), as well as CARISMAND research findings. Furthermore, the last round of Citizen Summits (CS5 in Lisbon and CS6 in Utrecht) were organised and designed to additionally discuss and collect feedback on recommendations for citizens, which have all been formulated on the basis of Work Packages 2-10 results and in coordination with the Work Package 11 brief. These Toolkit recommendations will form one of the core elements of the Work Package 9 CARISMAND Toolkit. In the afternoon session of each event, small moderated group discussions (with 8-12 participants each) of approximately 2 hours’ duration were held, which aimed to gather citizens’ direct feedback on the topics presented in the morning sessions, following a detailed discussion guideline. For a detailed overview of all questions asked and topics discussed, please see Appendices A-1 to A-3. The rest of this report is structured in six main sections: After the executive summary and this introduction, the third section will present an overview of the different methods applied. The fourth section will provide a synthesis of quantitative and qualitative data collected during all Citizen Summits. The fifth section will present the evaluation of CARISMAND Toolkit recommendations for citizens, followed by a final concluding chapter.The project was co-funded by the European Commission within the Horizon2020 Programme (2014-2020).peer-reviewe

Participant recruitment to FiCTION, a primary dental care trial – survey of facilitators and barriers

Objective To identify reasons behind a lower than expected participant recruitment rate within the FiCTION trial, a multi-centre paediatric primary dental care randomised controlled trial (RCT). Subjects (materials) and methods An online survey, based on a previously published tool, consisting of both quantitative and qualitative responses, completed by staff in dental practices recruiting to FiCTION. Ratings from quantitative responses were aggregated to give overall scores for factors related to participant recruitment. Qualitative responses were independently grouped into themes. Results Thirty-nine anonymous responses were received. Main facilitators related to the support received from the central research team and importance of the research question. The main barriers related to low child eligibility rates and the integration of trial processes within routine workloads. Conclusions These findings have directed strategies for enhancing participant recruitment at existing practices and informed recruitment of further practices. The results help provide a profile of the features required of practices to successfully screen and recruit participants. Future trials in this setting should consider the level of interest in the research question within practices, and ensure trial processes are as streamlined as possible. Research teams should actively support practices with participant recruitment and maintain enthusiasm among the entire practice team

Is adaptation of e-advertising the way forward?

E-advertising is a multi-billion dollar industry that has shown exponential growth in the last few years. However, although the number of users accessing the Internet increases, users don’t respond positively to adverts. Adaptive e-advertising may be the key to ensuring effectiveness of the ads reaching their target. Moreover, social networks are good sources of user information and can be used to extract user behaviour and characteristics for presentation of personalized advertising. Here we present a two-sided study based on two questionnaires, one directed to Internet users and the other to businesses. Our study shows that businesses agree that personalized advertising is the best way for the future, to maximize effectiveness and profit. In addition, our results indicate that most Internet users would prefer adaptive advertisements. From this study, we can propose a new design for a system that meets both Internet users’ and businesses’ requirements