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UNICEF Baby Friendly Initiative (BFHI) is the global standard for maternity and community services requiring all practitioners to be trained to support mothers in the essential skills of supporting positioning and attachment, and hand expression. These studies aim to rigorously assess knowledge in nurses, midwives, and doctors in these skills, tested before and after watching short videos demonstrating these skills. Practitioners were attending BFHI education, and the video study was additional. In Phase 1 clinicians in England were randomised to one of two videos (practitioner role play or clinical demonstration). The results showed improvements in knowledge and confidence, and a preference for clinical demonstration by mothers and infants. The clinical demonstration video was evaluated in China in Phase 2 where expert trainers viewed the video after completing the BHFI workshop, and in Phase 3 practitioners viewed the video before the BHFI workshop. Phase 2 with expert trainers only showed improvement in knowledge of hand expression but not positioning and attachment. In Phase 3 clinicians showed improved knowledge for both skills. In all Phases there were statistically significant improvements in confidence in practice in both skills. Viewing short videos increased knowledge, particularly about teaching hand expression, and confidence in both skills. •Knowledge of breastfeeding support skills improved after 15 min video training.•Mother and baby demonstration content was preferred over role play by clinicians.•Knowledge and confidence in positioning and attachment support improved post video.•Knowledge and confidence in teaching hand expression improved post video.•Videos are effective adjuncts to training BHFI training and may support self-study.

The feasibility of telemedicine in diagnosing and treating nonacute headaches, such as primary headaches (migraine and tension-type) and medication-overuse headaches has not been previously investigated. By eliminating the need of travel to specialists, telemedicine may offer significant time and money savings. Our objective was to estimate the acceptance of telemedicine and investigate the feasibility and cost savings of telemedicine consultations in diagnosing and treating nonacute headaches. From September 2012 to March 2015, nonacute headache patients from Northern Norway who were referred to neurologists through an electronic application system were consecutively screened and randomized to participate in either telemedicine or traditional specialist visits. All patients were consulted by two neurologists at the neurological department in Tromsø University Hospital. Feasibility outcomes were compared between telemedicine and traditional groups. Baseline characteristics and costs were then compared between rural and urban patients. Travel costs were calculated by using the probabilistic method of the Norwegian traveling agency: the cheapest means of public transport for each study participant. Loss of pay was calculated based on the Norwegian full-time employee's average salary: < 3.5 hours=a half day's salary, > 3.5 hours spent on travel and consultation=one day's salary. Distance and time spent on travel were estimated by using Google Maps. Of 557 headache patients screened, 479 were found eligible and 402 accepted telemedicine participation (83.9%, 402/479) and were included in the final analyses. Of these, 202 received traditional specialist consultations and 200 received telemedicine. All patients in the telemedicine group were satisfied with the video quality, and 198 (99%, 198/200) were satisfied with the sound quality. The baseline characteristics as well as headache diagnostics and follow-up appointments, and the investigation, advice, and prescription practices were not statistically different between the two randomized groups. In addition, telemedicine consultations were shorter than traditional visits (38.8 vs 43.7 min, P<.001). The travel cost per rural individual (292/402, 73%) was €249, and estimated lost income was €234 per visit. The travel cost in the urban area (110/402, 27%) was €6, and estimated lost income was €117 per visit. The median traveling distance for rural patients was 526 km (range 1892 km), and the median traveling time was 7.8 hours (range 27.3 hours). Rural patients had a longer waiting time than urban patients (64 vs 47 days, P=.001), and fewer women were referred from rural areas (P=.04). Rural women reported higher pain scores than urban women (P=.005). Our study shows that telemedicine is an accepted, feasible, time-saving, and cost-saving alternative to traditional specialist consultations for nonacute headaches. Clinicaltrials.gov NCT02270177; http://clinicaltrials.gov/ct2/show/NCT02270177 (Archived by WebCite at http://www.webcitation.org/6hmoHGo9Q).

Smoking imagery on the online video sharing site YouTube is prolific and easily accessed. However, no studies have examined how this content changes across time. We studied the primary message and genre of YouTube videos about smoking across two time periods. In May and July 2009, we used \"cigarettes\" and \"smoking cigarettes\" to retrieve the top 20 videos on YouTube by relevance and view count. Eliminating duplicates, 124 videos were coded for time period, overall message, genre, and brand mentions. Data were analyzed using descriptive statistics. Videos portraying smoking positively far outnumbered smoking-negative videos in both samples, increasing as a percentage of total views across the time period. Fifty-eight percent of videos in the second sample were new. Among smoking-positive videos, music and magic tricks were most numerous, increasing from 66% to nearly 80% in July, with music accounting for most of the increase. Marlboro was the most frequently mentioned brand. Videos portraying smoking positively predominate on YouTube, and this pattern persists across time. Tobacco control advocates could use YouTube more effectively to counterbalance prosmoking messages.

The implementation of creative new strategies to increase layperson cardiopulmonary resuscitation (CPR) and defibrillation may improve resuscitation in priority populations. As more communities implement laws requiring CPR training in high schools, there is potential for a multiplier effect and reach into priority communities with low bystander-CPR rates. We investigated the feasibility, knowledge acquisition, and dissemination of a high school-centered, CPR video self-instruction program with a \"pay-it-forward\" component in a low-income, urban, predominantly Black neighborhood in Chicago, Illinois with historically low bystander-CPR rates. Ninth and tenth graders followed a video self-instruction kit in a classroom setting to learn CPR. As homework, students were required to use the training kit to \"pay it forward\" and teach CPR to their friends and family. We administered pre- and post-intervention knowledge surveys to measure knowledge acquisition among classroom and \"pay-it-forward\" participants. Seventy-one classroom participants trained 347 of their friends and family, for an average of 4.9 additional persons trained per kit. Classroom CPR knowledge survey scores increased from 58% to 93% (p < 0.0001). The pay-it-forward cohort saw an increase from 58% to 82% (p < 0.0001). A high school-centered, CPR educational intervention with a \"pay-it-forward\" component can disseminate CPR knowledge beyond the classroom. Because schools are centrally-organized settings to which all children and their families have access, school-based interventions allow for a broad reach that encompasses all segments of the population and have potential to decrease disparities in bystander CPR provision.

Background: Mobile phones present a new health communications opportunity but use of mobile videos warrants more exploration. Our study tested a new idea: to produce health promotion videos in languages for which films have never previously been produced to see if they were widely shared. Objective: To investigate whether the novelty of films in local languages focusing on health messages would be shared 'virally' among the target population. Methods: A non-randomised, controlled, before-and-after study was used to evaluate the reach and impact of the intervention. We gave short health promotion videos on memory cards to distributors in eight intervention villages. Ten control villages, where no video distribution took place were randomly selected. We conducted cluster-level difference-in-difference logistic regression to assess self-reported knowledge indicators. We calculated odds ratios for intervention relative to control at baseline and endline and p-values for the change in odds ratios. Results: Seven hundred and eight mothers were interviewed across all villages at baseline and 728 different mothers and 726 men were interviewed in the same villages a year later in October 2015. At endline, 32% of women and 44% of men in the intervention arm had ever seen a film on a mobile phone in Lobiri, compared to 1% of women and 2% of men in the control arm. There was a significant increase in the odds of knowing about giving Orasel to a child with diarrhoea in the intervention area relative to the control area. Awareness of the need to take a child with fever or symptoms of pneumonia to a health centre increased in the intervention area, but not significantly. Conclusions: Viral sharing of films on mobile phones has the potential to be an effective health promotion tool for communities whose languages are not served by existing mass media channels.

Videotaped information has been shown to be effective in reducing parental anxiety and facilitating knowledge transfer in various clinical settings. There is lack of literature on the use of videotaped information during the pediatric oncology initial family disclosure meeting. The purpose of this study was to deliver an informative DVD, highlighting information on childhood acute lymphoblastic leukemia (ALL), to parents of children with newly diagnosed ALL and to assess if the DVD provided increased levels of satisfaction and decreased levels of anxiety in parents around the time of diagnosis. We surveyed 24 parents of children on active treatment for ALL, diagnosed between the ages of 1 and 18 years from 2008 to 2016 at The Hospital for Sick Children, Toronto, Canada. Parents were provided a survey questionnaire assessing levels of satisfaction with information communicated by the healthcare team and anxiety following verbal disclosure and were asked to report satisfaction and anxiety levels immediately following viewing the DVD intervention. Twenty-three/24 (95.8%) parents surveyed reported seeking information from additional resources after disclosure. Of the 24 parents who watched the DVD, 12 (50.0%) watched it once, while 12 (50.0%) watched it twice or more. All parents were satisfied with DVD information, and there was a significant decrease in anxiety after viewing (P = 0.03). All 24 parents felt that the DVD was a useful educational tool. Videotaped information after verbal disclosure is an effective educational resource and is associated with reduced anxiety among parents of children with ALL.

The authors examined the effect of messages and pauses, presented on video lottery terminal screens, on erroneous beliefs and persistence to play. At posttest, the strength of erroneous beliefs was lower for participants who received messages conveying information about randomness in gambling as compared to those who received pauses. Pauses also diminished the strength of erroneous beliefs, and there was no difference between the effects of pauses and messages on the number of games played. The authors discuss these results in terms of the use of messages and pauses on video lottery terminals as a strategy for promoting responsible gambling.

Thirty-three steers (328 +/- 2 kg) from a total of 300 animals were randomly selected for a comparison of techniques designed to quantify the behavioral response to painful procedures. The steers were randomly assigned to freeze-branding, (F), hot-iron branding (H), and sham branding (S) treatments. The responses of all steers were videotaped to quantify the amount and intensity of head movements during branding. In addition, the force that steers exerted on the headgate and squeeze chute during branding was recorded using strain gauges and load cells. Behaviors believed to be indicative of pain (tail-flicking, kicking, falling, and vocalizing) were also recorded during branding. These techniques were compared for their effectiveness in measuring behavioral responses of steers during branding. Hot-iron-branded steers had greater maximum and average head movement distances and velocities than F or S steers (P < .05), and F steers only had greater maximum values than S animals (P < .05). The maximum exertion forces obtained from headgate load cells were also greater in H than in F or S steers (P < .05); however, no differences were observed between H and F treatments for squeeze load cell or headgate strain gauge data. Hot-iron-branded steers had the greatest incidence of tail-flicks, kicks, falls in the chute, and vocalizations, and S steers had the least. Results indicate that H steers experienced more discomfort at the time of branding than F and S steers, whereas F steers experienced more discomfort than shams. Image analysis was a superior technique for detecting treatment differences compared with exertion force measurements and frequency counts of tail-flicks, kicks, falls, and vocalization during branding.

At Northshore Hospital in Manhasset, NY, the vice president of infection prevention, Donna Armellino, RN, DNP, CIC, says hand-washing is a challenge — not just to make sure it is done, but to measure how often it is actually happening. Implementing the program took about a year from the idea to actual filming — there were privacy considerations to think about related to HIPAA compliance, as well as research into the only other facility to make use of the remote auditing program: a surgi-center in Macon, GA, which saw hand-washing rates rise from a dismal 30% to 90% in three weeks. For more information on this topic contact Donna Armellino, RN, DNP, CIC, Vice President, Infection Prevention, North Shore Health System, Manhasset, NY.

There is an observed increasing trend of substance use among the adolescents and young adults. One of the important aetiologies is \"modeling\" especially from popular artists portraying their use to the viewing public over the electronic media. Indigenous films on video tapes acted in English or \"Yoruba\" (a popular Nigerian language) were randomly selected from various retail outlets in Lagos for viewing. The settings were the Ikorodu and Ipaja suburbs of Lagos. The viewing audience in each center was made up of a researcher and two adolescent secondary school students. They were to make notes on each film with scenes of substance use, type, and nature of use. A total of 479 video tapes were studied over a 6 month period, of which 268 (55.9%) contained scenes portraying the use of one or more substances. Two hundred forty-seven (51.6%, N = 479) depicted the use of only one type of substance and the rest, 21 (4.3%, N = 479), portrayed the use of multiple substances. The commonest substance portrayed to be used was alcohol, 197 (41.1%, N = 479), followed by tobacco, 81 (16.9%, N = 479). Cannabis was shown to be used in only 3 (0.6%, N = 479); Cocaine and Heroin in 8 (1.6%, N = 479) of the films. There was no statistically significant difference on substance use portrayal between the home movies acted in English and Yoruba (χ2 = 32.8; df = 7 at p ≥ 0.05). A significant number of films on video tapes in Nigeria portrayed substance use which could act as triggers or reinforcement for substance use among the viewing audience, especially adolescents and young adults. The need to censor video tapes on substance use portrayal was advocated.