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Abstract P1-17-05: Formative evaluation of interventions addressing culturally relevant needs of young breast cancer survivors

Abstract Background. Young women diagnosed with breast cancer face challenges impacting their quality of life, psychosocial functioning, and reproductive health outcomes. Ashkenazi Jewish women experience a disproportionately high prevalence of genetic mutations in the BRCA1/2 genes linked to a higher incidence of hereditary breast and ovarian cancer, and have unique needs based on genetic risk and cultural factors. Sharsheret, a national not-for-profit organization with an expertise in supporting Jewish young breast cancer survivors (YBCS), developed two interventions, the Peer Support Network (PSN) and Genetics for Life® (GFL), to address the culturally specific needs of Jewish YBCS. In 2011, Sharsheret conducted a formative evaluation to strengthen its existing PSN and GFL interventions. Methods. Four focus groups were conducted with 27 YBCS having participated in the PSN or GFL. The groups investigated the information and support needs of YBCS of Jewish descent and YBCS perceptions of PSN and GFL content, materials and delivery channels. Two groups (online and in-person) investigated the needs of YBCS, PSN and GFL program content, and PSN and GFL program delivery related to the psychosocial health of YBCS. Two groups (online and in-person) explored YBCS needs, PSN and GFL program content, and PSN and GFL program delivery related to the reproductive health of YBCS. Participants were recruited using in-person methods, email blasts, social media and via Sharsheret website postings. Qualitative data were analyzed using a notes-based thematic analysis. Results. Across groups, respondents identified the primary information needs for YBCS included resources addressing genetics, side effects and consequences of treatment (e.g., effects on fertility, intimacy and premature menopause) rather than treatment itself. Respondents identified that their support needs included culturally relevant peer support and genetic resources at the time of diagnosis, treatment and after treatment, as well as support for partners, family members and friends. Participants preferred to receive information and support through diverse modalities, including health care providers, the internet, peer supporters, support groups, symposia and teleconferences and mass media. Respondents recommended outreach efforts for the PSN and GFL interventions in locations that attract young people, including pediatricians’ offices, schools, salons, and college campuses, and to clergy, school principals, local Jewish organizations and health care providers. Participants also suggested potential technology-based modifications to PSN and GFL intervention delivery, including online intake forms, a LiveChat option, video testimonials, interactive expert column, online pedigrees and family conference calls with a genetic counselor or clinical staff member. Conclusion. YBCS identified the PSN and GFL interventions as critical resources attentive to their culturally specific information and support needs. Focus group participants provided strategies to enhance intervention content and reach. Healthcare professionals serving YBCS of diverse backgrounds can utilize the data gleaned from this evaluation to shape culturally relevant interventions and materials to address the unique needs of YBCS. Citation Format: Rochelle Shoretz, Adina Fleischmann, Elana Silber, Mary Ann Hall, Ashani Johnson-Turbes. Formative evaluation of interventions addressing culturally relevant needs of young breast cancer survivors [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P1-17-05.

The Annual American Men's Internet Survey of Behaviors of Men Who Have Sex With Men in the United States: Protocol and Key Indicators Report 2013.

BackgroundMen who have sex with men (MSM) are disproportionately affected by human immunodeficiency virus (HIV) and there is evidence that this population is participating in increasingly risky sexual behavior. These changes are occurring in the context of new modes of online social interaction—many MSM now report first meeting their sex partners on the Internet. Better monitoring of key behavioral indicators among MSM requires the use of surveillance strategies that capitalize on these new modes of interaction. Therefore, we developed an annual cross-sectional behavioral survey of MSM in the United States, the American Men's Internet Survey (AMIS).ObjectiveThe purpose of this paper was to provide a description of AMIS methods. In addition we report on the first cycle of data collection (December 2013 through May 2014; AMIS-2013) on the same key indicators used for national HIV behavioral surveillance.MethodsAMIS-2013 recruited MSM from a variety of websites using banner advertisements or email blasts. Adult men currently residing in the United States were eligible to participate if they had ever had sex with a man. We examined demographic and recruitment characteristics using multivariable regression modeling (P<.05) stratified by the participants' self-reported HIV status.ResultsIn the AMIS-2013 round, 79,635 persons landed on the study page and 14,899 were eligible, resulting in 10,377 completed surveys from MSM representing every US state. Participants were mainly white, 40 years or older, living in the US South, living in urban areas, and recruited from a general social networking website. Self-reported HIV prevalence was 10.73% (n=1113). Compared to HIV-negative/unknown status participants, HIV-positive participants were more likely to have had anal sex without a condom with any male partner in the past 12 months (72.24% versus 61.24%, respectively; P<.001) and more likely to have had anal sex without a condom with their last male sex partner who was discordant/unknown HIV status (42.95% versus 13.62%, respectively; P<.001). Illicit substance use in the past 12 months was more likely to be reported by HIV-positive participants than HIV-negative/unknown status participants (39.17% versus 26.85%, respectively; P<.001). The vast majority of HIV-negative/unknown status participants (84.05%) had been previously HIV tested, but less than half (44.20%) had been tested in the past 12 months. Participants 18-24 years of age were more likely than those 40 years or older to have had anal sex without a condom with a discordant/unknown HIV status partner, were more likely to report substance use, and were less likely to have been HIV tested. Compared to general social networking, those from a geospatial social networking website were more likely to have reported all risk behaviors but were more likely to have been HIV tested.ConclusionsThe first round of AMIS generated useful behavioral measures from more than 10,000 MSM Internet users. Preliminary findings identified some subgroups of MSM Internet users that are at potentially higher risk of HIV acquisition/transmission. AMIS will provide an ongoing data source for examining trends in sexual risk behavior of MSM. This will help to plan and monitor the impact of programs to improve this population's health.

How to Write a Press Release

How to Write a Press Release

P-146 YI Intensive IBD Educational Program to Increase Staff Nurse Knowledge

Recently, the inflammatory bowel disease medical/surgical inpatient units were combined which resulted in a knowledge gap in both the medical and surgical nurses who would now be caring for both IBD patient populations. No previous intensive all day IBD education had been given in the past. The staff nurses expressed a strong need for IBD education. Therefore, the IBD Center nursing staff developed and provided an IBD educational program for the IBD inpatient medical/surgical staff nurses. The goal was to advance the nurses current knowledge of IBD by using expert clinicians and select patient volunteers to educate the nurses and utilization of a pre and post test questionnaire evaluation. The educational program committee consisted of IBD expert nurses, including a staff nurse, medical Advanced Practice Nurse (APN), surgical APN, and stoma care APN. They met with the section chief, co-director of the IBD Center to get faculty support and participation in the program, members of the Nursing Professional Development Department as resource coordination and Unit Educator to assist in getting nursing education credits for the program. After meeting with Professional Development and the unit manager, we learned that the staff nursing schedule is made once every 8 weeks, so this allowed us to project a date that would facilitate nurse attendance. This initial meeting included discussion of program topics, timeframes/deadlines for submission of speaker slides, speaker selection and dates for the program. Advertisement flyers and email blasts were used to promote the program to the nursing staff. A 10 item IBD questionnaire was formulated incorporating medical, surgical, and stoma questions that were the key takeaways the committee felt the nurses needed to optimize patient education in the care and management of IBD patients. The questions were then reviewed by the nurse educator for clarity, education level appropriateness and understanding. Feedback was received and questions were altered as needed. This questionnaire was given to the staff nurses prior to the start of the program and also again at the conclusion via IPADs. Seventeen unit staff nurses attended the program. Seventeen of the 54 staff nurses attended. Of the 10 questions upon initial testing, an average of 56.22% of staff nurses answered each question correctly. After the program with re-test, an average of 80.5% of staff nurses answered each question correctly. This is a 24.28% increase in correctly answered questions on average. The nurses gave unanimous positive feedback in regards to the course content, speakers, addition of patient involvement and psychosocial implications of the disease and stated if offered again, they would definitely participate and encourage others to do so. The pre-test showed a great need for education in managing the IBD patient population and the post-test results did show that the course increased the knowledge base of the staff nurses. We have considered presenting this class on different days of the week, or splitting into 2 half days to engage more nurses. Next step is to look at how increased staff knowledge influences patient outcomes.

INTERIM PERFORMANCE METRICS OF AN INNOVATIVE, WEB-BASED CANADIAN JOURNAL OF CARDIOLOGY KNOWLEDGE DISSEMINATION PLATFORM

Hamilton, Ontario BACKGROUND: As survival rates from coronary artery disease (CAD) increase, the prevalence of persistent cardiac pain-related conditions is on the rise. Our aim was to disseminate a web-based, multi-media resource centre for persistent cardiac pain, CardiacPain.Net, as a prototype for large-scale knowledge dissemination; partners included Elsevier, the Canadian Journal of Cardiology, the Canadian Cardiovascular Society, the Heart and Stroke Foundation, the Canadian Pain Coalition and Argyle Communications. METHODS: CardiacPain.Net was based on the Canadian Institutes of Health Research (CIHR) knowledge to action cycle as well as the CIHR framework for citizen engagement. Substantive content for dissemination via CardiacPain.Net was designed to tailor specific aspects of knowledge inquiry, synthesis, and product tools (e.g. clinical practice guidelines, diagnostic phenotype criteria). Affected citizens were engaged across all phases of designing architecture. Multi-media design features included open access published resources, narrated video presentations, expert and citizen roundtable discussions, downloadable fact sheets, and an asynchronous discussion forum.Dissemination strategies included opt-in email blasts to Elsevier subscribers (n1⁄4 95,000) every 3 months, online banner advertising, LinkedIn and Google advertizing, and mass social media including Twitter and Facebook. Accreditation of CardiacPain.Net for continuing medical education in Canada and United States was secured to maximize incentive for end-user uptake. Standard dissemination metrics included total site visits and components visited and downloaded. Customized metrics included unique and return visitor rates, bounce rate, stream views, unique end-user tracking, social media trends, and geo-targeting. All metrics were analyzed in aggregate and distributions were examined for outliers and monthly trends. RESULTS: Interim examination of dissemination metrics found that in 3 months since initial launch CardiacPain.Net has had 2,549 total visits, 1,913 unique visits, and 5,418 page views. Specific multimedia presentations and open access resources were viewed and downloaded 414 and 413 times, respectively. Unique and return visitor rates were 71.1% and 28.9% respectively with a bounce rate of 47%. Twitter constituted 75% of all social media interactions (n1⁄4 124) featuring CardiacPain. Net content. Geo-targeting analyses found that unique end-users spanned 25 countries across 5 continents. CONCLUSION: Our interim 3-month analyses suggest that as a large-scale knowledge dissemination prototype, CardiacPain.Net is capable of being far reaching and engaging to end users seeking knowledge on persistent forms of cardiac pain. Linear and Poisson regression analyses at 6 and 12 months follow up are required to determine the influence of design features, region of origin, and operating systems on customized dissemination metrics.

Advanced Cytoreductive Surgery Workshop Report

The Advanced Course in Cytoreductive Surgery for Ovarian Cancer and Gynecologic Peritoneal Surface Malignancies was held at the University of California Irvine Medical Center on November 4-5, 2011. The course director was Dr Robert E. Bristow, the Philip J. DiSaia Chair and Division Director of Gynecologic Oncology. Meeting information was distributed via e-mail blasts by the International Gynecologic Cancer Society. The workshop was comprised of didactic modules, a cadaver laboratory, and heated intraperitoneal chemotherapy demonstration. This was a not-for-profit workshop, and registration fees were used to support course faculty travel to UC Irvine and pay for the cadavers.

A Health Survey of Gastroenterologist Prescribing Practices with Adalimumab for Crohnʼs Disease

Purpose: To assess prescribing practices of gastroenterologists (GIs) treating Crohn's Disease (CD) with adalimumab (ADA), and identify variables associated with FDA-approved ADA dosing. Methods: A survey was developed and tested for content validity by expert review and sent to 13,031 GIs with valid email addresses who are members of the American Gastroenterology Association (AGA) in three email blasts over 6 weeks. Multivariate regression analyses examined relationships between clinical variables and FDA-approved dosing of ADA for CD. Results: 398 (3%) of GIs completed the survey, reporting a mean of 11+/-SD years of GI practice. An academic practice setting was reported by 43%, while 72% prescribe ADA > a few times yearly and 15% follow > 200 CD patients. Ninety percent of GIs believe ADA has a moderate-significantly positive impact on patient care. The FDA-approved ADA induction and maintenance strategy for CD was correctly identified by 82%. Respondents were more likely to prescribe ADA correctly if they followed > 200 CD patients (p=.045) and prescribed ADA > a few times per year (p=.037). Years in practice, practice setting, gender and region did not have a significant impact on prescribing practices. ADA prescribing and dosing practices based on different clinical scenarios (extremes of body weight and prior exposure to infliximab) were assessed. For body weight scenarios, correct ADA dosing was associated with higher frequency of prescribing (p=.014) and CD patient volumes (p=.025). Despite variability in appropriate ADA loading in patients with prior infliximab exposure, no association with ADA prescribing or CD patient volumes was seen on adjusted analyses. Frequency of ADA prescribing and CD patient volumes were predictive of the total number of correct survey answers (p=.014 and p=.017, respectively). Only 50% of GIs always administered loading doses when switching to ADA from another anti-TNF. Of these GIs, 43.5% reported unclear efficacy of loading doses and 24.3% were worried about risk of infection secondary to excess anti-TNF as a reason not to load ADA. Eighteen percent of respondents reported pharmacies had reduced their prescribed ADA doses in the past. Conclusion: Eighteen percent of GIs were not able to correctly identify the FDA approved ADA induction and maintenance strategy. For overall responses and for questions with varied patient weights, GIs who reported using the approved strategy tend to prescribe ADA more frequently and follow more patients with CD in practice. Half of GIs do not load ADA when transitioning from another anti-TNF Further research is needed to confirm our findings and identify barriers to optimal ADA use by GIs for CD. Disclosure: Dr. Flasar - Grant/Research Support: Abbott Laboratories. Dr. Cross - Grant/Research Support: Abbott Laboratories, Advisory Committee/Board Member: Abbott Laboratories, Consultant: Abbott Laboratories, Other: Abbott Laboratories. Ms. Greenberg - none. Dr. Tracy - none. Dr. Rustgi - none Ms. Zullow - none. This research was supported by an industry grant from Abbott Laboratories.

School nurse perceptions and knowledge of pediatric toileting

ObjectiveWe surveyed school nurses on toileting conditions in schools, their level of understanding related to normal toileting patterns in school-age children, and whether they are in need of additional resources to promote healthy toilet habits for their students. Materials and methodsAn Institutional Review Board approved web-based survey with 34 questions was employed; 562 nurses completed the survey and 97% were currently employed as school nurses. Participants were invited via email blasts through national school nursing associations and the Iowa Department of Education. ResultsOnly 48% and 33% of respondents suspected an underlying health problem in children with frequent urination and bladder or bowel accidents, respectively. Despite 61% reporting never receiving information about children’s normal elimination patterns, 43% had been asked to provide such information to teachers. Only 42% felt they had adequate resources to respond to such requests. School nurses requested information about treatment of dysfunctional elimination (67%), health effects of childhood toileting habits (65%), fluid intake guidelines (44%) and improvement of bathroom facilities (39%); 70% were unaware of local providers specially trained to treat children with these problems. ConclusionsOur survey results suggest that school nurses need additional information and resources in order to promote healthy elimination patterns in school children.

How to Create a ‘Great Workplace’ on Campus

How to Create a ‘Great Workplace’ on Campus

Playing Chicken With the Train: Cowboy Troy's Hick-Hop and the Transracial Country West

[ILLUSTRATION OMITTED] [S]uch fiddling and dancing nobody ever before saw in this world. thought they were true 'heaven-borns.' Black and white, white and black, all hugemsnug together; happy as lords and ladies, sitting sometimes round in a ring, with a jug of liquor between them ... --Davy Crockett (1834) ain't nothing like a good, solid ride. don't care where you are or who you are. It 's just like music--smooth and perfect if you do it right. --bull rider Alonzo Pettie (1910-2003), America's oldest black at time of his death My belt buckle is my bling-bling. It's just going to keep getting bigger. --Cowboy (2005)' BLACK HILLBILLIES AND BLACKNECKS There was no necessary reason why Cowboy Troy's country-rap single, I Play Chicken With Train, should have caused such an uproar among country music fans when it was released in spring of 2005. The song itself is a sonic Rorschach test: not so singular a curiosity as many might think, but still a challenge to what passes for common knowledge in music business. It is animated by a sound and a lyric stance that might strike us, in a receptive mood, as uncanny--at once unfamiliar, a half-and-half blend of two musical idioms that rarely find themselves so jarringly conflated, and strangely familiar, as though song has distilled sound of ten-year-old boys filled with limitless bravado, jumping up and down and hollering into summer afternoon. Compared with other country-rap hybrids, I Play Chicken With Train contains surprisingly few sonic signifiers of hip-hop: no breakbeats, no samples, no drum machines, no scratching. The full burden of audible blackness is carried by Cowboy Troy's decidedly old-school rap, with its square phrasing, tame syncopations, and echoes of Run-DMC. One hears white voices framing, doubling, responding to, supporting, that black voice; simultaneously, one senses that somebody has torn down wall that is supposed to demarcate firmly boundary between twanging redneck euphoria--the lynch-mob's fiddle-driven rebel yell--and rap's exaggerated self-projections of urban black masculinity? The song scans, to receptive ears, as a particularly boisterous example of male-bonded American pastoral articulated by Leslie Fiedler in Love and Death in American Novel, a transracial masculine idyll stretching its unencumbered limbs across some country & western frontier, civilized men throwing off their generic shackles and reinventing themselves as a fraternity of fearless young warriors out to revitalize world. Or else--to unreceptive--it is monstrous, and must be treated as monsters are treated. In The Philosophy of Horror, Noel Carroll defines monsters as entities that are un-natural relative to a culture's conceptual scheme of nature. They do not fit scheme; they violate it. Thus, monsters are not only physically threatening; they are cognitively threatening. They are threats to common knowledge. The email blast that alerted potential purchasers to recording's release fused a kind of King-Kong sensationalism with an assertion of scandalous, unprecedented hybridity: Cowboy Troy, we were informed, is the world's only six-foot, five-inch, 250-pound black cowboy rapper. Was that a threat, a brag, or a promise? (3) In his follow-up album of 2007, Black in Saddle, Cowboy referenced antipathy with which some whites and blacks greeted song and, by extension, his highly conspicuous presence in country music world. People I've never met wanna take me body surfing behind a pickup, he sang in How Can You Hate Me, referencing infamous dragging death of James Byrd Jr. in Jasper, Texas, at hands of two white men. As for black response to his hick-hop persona: silence from hip-hop precincts, at least publicly, has been deafening, although Vibe magazine did take note of Black in Saddle long enough to sneer at Coleman's presumptive audience: Troy and his twang trust are keen to serve two masters: game exurban blacks steeped in country grammar and white fans of post-redneck rock. …

Clinical education in prelicensure nursing programs: findings from a national survey.

OVER THE PAST FIVE YEARS, the NLN has given serious attention to identifying current approaches to clinical education in nursing, proposing alternatives, and studying the impact of teaching innovations. Building on the work of previous initiatives, including the Clinical Nursing Education Task Group, the Blue Ribbon Panel for Priorities in Nursing Education Research, and the Think Tank on Clinical Education in Nursing, the NLN commissioned a national survey to examine the barriers and challenges faculty face in optimizing students' clinical learning. The survey asked about strategies used to address these barriers and challenges, the effectiveness of these strategies, and the teaching practices faculty employ most frequently in clinical settings. For this survey, challenges were defined as course, context, professional, or personal aspects over which you, as a faculty member, exert some degree of control or influence or those aspects of your teaching practice that are influenced by the particular course, context, or setting in which you teach and over which you, as a faculty member, exert some degree of control or influence. Barriers were defined as institutional, state, or federal guidelines/policies, as well as structural, programmatic, administrative, or procedural aspects of your program/ school that influence students' clinical learning and over which you personally may have little or no control. (A monograph with the full report will be available from the NLN in September.) The Survey NLN members were alerted to the survey, available for completion on the NLN website, via announcements at NLN events, in NLN Member Updates, and in Faculty Development Bulletins. Members were also notified via email blast, and the invitation to participate was posted on three listservs related to nursing education. In each case, respondents were asked to circulate the survey URL to other faculty they knew to be teaching in clinical settings, whether or not these persons were members of the NLN. The survey included both multiple-choice and open-ended items. Data were compiled by the NLN and, after approval from the Indiana University Institutional Review Board, converted into SPSS files for transfer to the Indiana University School of Nursing for analysis. Findings A total of 2,386 faculty, from 50 states and all types of programs (associate 40 percent, diploma 9 percent, baccalaureate 51 percent), completed this survey. Respondents represented a wide range of institutions (Table). On average, they had been involved in prelicensure education 12.3 years (range 1 to 45 years). Fifty percent had been teaching in clinical settings more than 10 years. BARRIERS TO OPTIMIZING STUDENTS' CLINICAL LEARNING Respondents were provided a list of 17 possible barriers to optimizing students' clinical learning and asked to select and rank order the five most important barriers they faced. The following barriers were identified most frequently as among the five most important barriers. * Lack of quality clinical sites * Lack of qualified faculty * Size of clinical groups (ratio of faculty to students) * Restrictions on the numbers of students or limitations to students' experiences imposed by clinical agencies * The time-consuming nature of students' learning multiple agency systems (including technology) For each barrier ranked among their top five, respondents were provided a list of possible strategies that could be used to address the barrier. They selected up to three strategies they used most often to address each of their top barriers and rated the effectiveness of each strategy on a four-point scale; scores ranged from 1 (not at all effective) to 4 (very effective). Notably, although a variety of strategies were employed to address each of these important barriers, none of the strategies respondents identified were deemed very effective. …

Self-reported sexual dysfunction and depression among women undergoing infertility treatments

OBJECTIVE: Infertility is associated with considerable psychological distress and sexual dysfunction. Guided by our self-regulation theoretical framework, we examined the relationship between infertility treatments and sexual function, and depression. DESIGN: Women who are members of the American Fertility Association (AFA) received an email inviting them to complete an online questionnaire. Responses were transmitted using the SSL protocol and were stored on a password protected server. Following one email blast to the membership, we received n = 320 completed questionnaires. Of those, n = 192 (64%) women were actively undergoing fertility treatment at the time of the survey. MATERIALS AND METHODS: Women completed demographic information and validated measures including the Center for Epidemiological Studies Depression Scale (CES-D; Radloff, 1977), and the Female Sexual Function Index (FSFI; Rosen et. al., 2000). Data were analyzed with the SPSS statistical package using ANOVA procedures. RESULTS: The mean age of the women in the study was 34 years old (SD = 6). They were largely married or in a domestic partnership (97%), employed (84%), and had at least a college education (85%). The sample was 85% Caucasian, 5% African-American and 7% Hispanic. Women undergoing fertility treatment reported clinically significant elevated levels of depression (20.7± 5. 6) compared to a normed cut-off of 16. Furthermore, women undergoing fertility treatments also experienced greater levels of anxiety during specifically-timed sexual activity (p < .042). With regard to sexual satisfaction, women undergoing fertility treatment compared to a normative sample (Rosen et al., 2000) reported significantly lower levels of emotional closeness (3.42±1.3 vs M norm = 4.3±1.1), poorer satisfaction with their sexual relationship with their partner (3.2±1.3; Mnorm = 4.2±1.0), and lower overall satisfaction with their sexual life (3.0±1.3; Mnorm = 4.2±1.1; p < .0001). CONCLUSIONS: Compared to the general population, women undergoing fertility treatment reported significantly higher levels of depression and exhibited significantly lower levels of emotional closeness and sexual satisfaction. Mental health and sexual function aspects should be routinely addressed among women undergoing fertility treatments and comprehensive education and therapy should be offered.

Moving from Free to Fee: How Online Firms Market to Change Their Business Model Successfully

Moving from free to “free and fee” for any product or service represents a challenge to managers, especially when consumers have plenty of free alternatives. For one online content provider, this article examines (1) the sources of long-term revenue loss (through attracting fewer free subscribers) and (2) how the firm's marketing actions affect its revenue gains (through attracting paid subscribers). The authors quantify revenue loss from several sources, including the direct effects of charging for part of the online content and the reduced effectiveness of search-engine referrals and e-mails. The analysis suggests several managerial implications. Managers should focus their price promotions on stimulating new monthly subscriptions, rather than the current promotional focus on stimulating new yearly contracts. In contrast, e-mail and search-engine referrals appear to be effective at generating yearly subscriptions. Meanwhile, free-to-fee conversion e-mail blasts are a double-edged sword; they increase subscription revenue at the expense of advertising revenue. Finally, further analysis shows that the move was preceded by the buildup of momentum in new free subscriptions, which appears to be beneficial for the move's success. The decomposition and comparison of the sources of revenue loss versus gains reveals several trade-offs facing companies moving from free to free and fee.

Moving from Free to Fee: How Online Firms Market to Change Their Business Model Successfully

Abstract Moving from free to “free and fee” for any product or service represents a challenge to managers, especially when consumers have plenty of free alternatives. For one online content provider, this article examines (1) the sources of long-term revenue loss (through attracting fewer free subscribers) and (2) how the firm's marketing actions affect its revenue gains (through attracting paid subscribers). The authors quantify revenue loss from several sources, including the direct effects of charging for part of the online content and the reduced effectiveness of search-engine referrals and e-mails. The analysis suggests several managerial implications. Managers should focus their price promotions on stimulating new monthly subscriptions, rather than the current promotional focus on stimulating new yearly contracts. In contrast, e-mail and search-engine referrals appear to be effective at generating yearly subscriptions. Meanwhile, free-to-fee conversion e-mail blasts are a double-edged sword; they in...

Solid-State Circuits Magazine and Redesigned Website to Launch in 2009

The print Solid-State Circuits Magazine, hosted also on IEEE Xplore, will exceed the format of the SSCS Newsletter with enriched educational material, tutorials, special interest pieces, bibliographies, and distillations of cutting-edge work from scholarly publications and technical conference papers. The Society's new website will include scrollable windows listing the contents of the current JSSC and Magazine plus a comprehensive list of SSCS-sponsored meetings, breaking news about chapters and distinguished lectures, and IEEE conference and field awards, plus IEEE member programs like Expert Now and IEEE.tv. The SSCS membership email blast will continue to announce important upcoming conferences, deadlines, and member activities on a schedule that will maximize their timeliness

Inside the mind of a spammer

Italian security professional, Andrea Pasquinucci, estimates spammers could make up to US$1000 per email blast if they persuade 0.1% of recipients to make a transaction. Therefore, it is no surprise that spammers continue to come up with more ingenious ways to get into our inboxes. This month, Pasquinucci describes how spammers think and what a successful unsolicited commercial email (UCE) operation means to them. He analyzes the three key players in a spam operation: the vendor, the UCE professional, and the UCE deliverer. The UCE professional prepares the message and selects the recipients; he wants to avoid contacting computer owners on email addresses managed by ISPs Andrea Pasquinucci dissects how spammers really think. What are their hopes and fears? And why do they get away with polluting our email?

Sound Plans Help Thwart Identity Theft

Sound Plans Help Thwart Identity Theft

“Bug Bites”: A facility-wide educational tool

ISSUE: Education of healthcare workers is the cornerstone of all infection control programs. In a busy healthcare environment, providing timely and consistent educational updates to 4200+ employees in a 642-bed suburban hospital was a challenge. To meet this need, we set out to develop a vehicle of communication that is accessible, creative, informative, and concise enough for even the busiest of healthcare workers to utilize. PROJECT: Our primary focus was to determine the type of communication to develop. We looked at various ways to provide education. Each option was reviewed for positive and negative factors. Options included classroom lectures, 1-day poster displays, e-mail blasts, Internet updates, fairs, and written modules. Once type of presentation was determined, we searched for a catchy title and consistent logo that would earmark the product as an infection control communication. Our next decision was the method of dissemination and the frequency. Content was our final hurdle to overcome. RESULTS: Our final product was called "Bug Bites." The title derived from the fact that infection control professionals are always seeking out the bugs in a facility, and "bites" implying a small amount of concise information. We felt that this was creative enough to entice healthcare workers to want to read the document. Our logo was derived from an infection control week theme of "It's in your hands." It is a one-page, monthly document that is distributed to each hospital department in written and electronic form. Once initially distributed, it is then archived onto our hospital intranet site as a reference document for staff access. Topics since the inception in 2003 have included hand hygiene, isolation practices, personal protective equipment, sharps safety, communicable diseases (Avian flu, influenza), <i>Clostridium difficile,</i> construction, healthcare-associated infections, sterilization and disinfection, respiratory etiquette, and winter illness prevention. LESSONS LEARNED: Supplying educational information to healthcare workers can be a challenge, but if you find the appropriate vehicle of communication for your facility, it becomes a fun and reliable way to keep staff updated on issues of importance within your facility.

Results of a Survey of Neurosurgical Practice Patterns Regarding the Prophylactic use of Anti-Epilepsy Drugs in Patients with Brain Tumors

The American Association of Neurology issued guidelines discouraging the prophylactic use of anti-epilepsy drugs (AEDs) in patients with brain tumors. We surveyed neurosurgeons to evaluate practice patterns with regard to using AEDs in neurosurgical patients with brain tumors. The survey consisted of 18 questions. Two group email blasts containing an internet link to the survey were sent to members of the American Association of Neurological Surgeons with email addresses. Uni- and multi-variate analysis of the responses was performed using t-test, Fisher's exact test, or chi-squared test, where appropriate. The response rate was 15.5% (386/2491). The majority of respondents (270/386; 70.0%) had more than 5 years of experience in neurosurgery. Most respondents described their practices as general (224/379; 59.1%); about one-third were members of the Joint Section on Tumors (136/381; 35.7%). More than 70% of respondents reported routine use of AED prophylaxis for patients with intra-axial gliomas or brain metastases. AED prophylaxis was also routinely used for extra-axial benign tumors or stereotactic biopsies by 53.8% and 21.4%, respectively. On multivariate analysis, the number of years in practice of ABNS certified neurosurgeons was the strongest predictor for the use of AED prophylaxis. Routine use of AED prophylaxis in patients with brain tumors undergoing neurosurgical procedures remains the prevailing practice pattern among members of the AANS. Additional larger prospective studies with appropriate patient stratification culminating in development of neurosurgical guidelines on AED prophylaxis in brain tumor patients is warranted.