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Full-Text Articles in Medicine and Health Sciences

Comparison Of The Effects Of Telehealth Versus N95 On Nurse-Patient Communication, Tony Christopher Bloomfield Jan 2023

Comparison Of The Effects Of Telehealth Versus N95 On Nurse-Patient Communication, Tony Christopher Bloomfield

Walden Dissertations and Doctoral Studies

Telehealth and face masks are some of the infection control measures nurses use while attending to patients. Nurses provide the most patient care in hospital settings and thus spend the most time with patients in their recovery journey. Because communication is paramount to the role nurses play as health care professionals, there is a substantial need to investigate how infection control measures affect the quality of nurse-patient communication. The purpose of this quantitative cross-sectional study was to describe the relationship of methods aimed at maintaining social distancing between nurses and patients to nurse-patient communication and to compare differences in the …


Comparison Of The Effects Of Telehealth Versus N95 On Nurse-Patient Communication, Tony Christopher Bloomfield Jan 2023

Comparison Of The Effects Of Telehealth Versus N95 On Nurse-Patient Communication, Tony Christopher Bloomfield

Walden Dissertations and Doctoral Studies

Telehealth and face masks are some of the infection control measures nurses use while attending to patients. Nurses provide the most patient care in hospital settings and thus spend the most time with patients in their recovery journey. Because communication is paramount to the role nurses play as health care professionals, there is a substantial need to investigate how infection control measures affect the quality of nurse-patient communication. The purpose of this quantitative cross-sectional study was to describe the relationship of methods aimed at maintaining social distancing between nurses and patients to nurse-patient communication and to compare differences in the …


Effectiveness Of Wechat-Group-Based Parental Health Education In Preventing Unintentional Injuries Among Children Aged 0-3: Randomized Controlled Trial In Shanghai, Yuheng Feng, Xueqi Ma, Qi Zhang, Ruo Jiang, Jun Lu, Kaiyue Chen, Huiping Wang, Qinghua Xia, Jicui Zheng, Jingwei Xia, Xiaohong Li Jan 2022

Effectiveness Of Wechat-Group-Based Parental Health Education In Preventing Unintentional Injuries Among Children Aged 0-3: Randomized Controlled Trial In Shanghai, Yuheng Feng, Xueqi Ma, Qi Zhang, Ruo Jiang, Jun Lu, Kaiyue Chen, Huiping Wang, Qinghua Xia, Jicui Zheng, Jingwei Xia, Xiaohong Li

Community & Environmental Health Faculty Publications

BACKGROUND: Unintentional injuries to children are a major public health problem. The online social media is a potential way to implement health education for caregivers in online communities. Using WeChat, a free and popular social media service in China, this study evaluated the effectiveness of social online community-based parental health education in preventing unintentional injuries in children aged 0-3.

METHODS: We recruited 365 parents from two community health centers in Shanghai and allocated them into intervention and control groups randomly. Follow-up lasted for one year. The intervention group received and followed their WeChat group and a WeChat official account for …


The Use Of A Pediatric Palliative And Hospice Education Module To Enhance The Knowledge And Practice Of Emergency Room Providers, Morgan Garrett Jan 2022

The Use Of A Pediatric Palliative And Hospice Education Module To Enhance The Knowledge And Practice Of Emergency Room Providers, Morgan Garrett

DNP Projects

Background: Palliative and hospice care resources are underutilized in pediatric patients with chronic and life-limiting illnesses. One contributing factor is the lack of formalized education for medical providers regarding the differences and scope of palliative and hospice care models. Without adequate education about these services, providers are not able to effectively utilize otherwise available resources to provide holistic care.

Purpose: The purpose of this study was to assess the current perception of knowledge among providers pertaining to pediatric palliative and hospice care. The study investigated improvements in educational outcomes in ten categories after participation in a web-based training. A secondary …


An Exploration Of Effective Patient Education With An Emphasis On Concussion, Kayla M. Ruopp Dec 2021

An Exploration Of Effective Patient Education With An Emphasis On Concussion, Kayla M. Ruopp

Health, Human Performance and Recreation Undergraduate Honors Theses

Concussion is a prevalent healthcare issue in the US, with approximately 1.6-3.8 million sports and recreation-related concussions each year in all ages. A concussion can be defined as a traumatic brain injury caused by biomechanical forces. When an athlete sustains a concussion, a physiologic cascade of events occurs. The most common signs and symptoms of a concussion include: loss of balance, disorientation, headache and confusion. Concussion assessments are important in order to determine the presence of an impairment and there are a multitude of tests that clinicians can use in order to isolate each type of damage. Studies have shown …


Disruptive Communication Among The Interdisciplinary Team: Gaining Insight And Providing Nurse Education, Kristen Marie Anderson Apr 2021

Disruptive Communication Among The Interdisciplinary Team: Gaining Insight And Providing Nurse Education, Kristen Marie Anderson

Doctor of Nursing Practice Scholarly Project

The purpose of this study is to identify what types of disruptive behavior nurses are experiencing, discuss outcomes of disruptive behavior, and educate healthcare providers and administrators of disruptive communication. Understanding the consequences of disruptive communication can help educators articulate the need for training in conflict management and therapeutic communication methods. It can also aid healthcare providers to be more conscious of their behavior in the professional setting. Seven research questions related to communication were developed and analyzed in this study. The author developed a pre-education survey that included demographics, multiple-choice questions, and open-ended questions to assess the nurses' knowledge …


Building Assets Toolkit: Developing Positive Benchmarks For Adolescent Girls—Asset Cards [Arabic], Judith Bruce, Sarah Engebretsen, Kimberly Glazer Jan 2021

Building Assets Toolkit: Developing Positive Benchmarks For Adolescent Girls—Asset Cards [Arabic], Judith Bruce, Sarah Engebretsen, Kimberly Glazer

Poverty, Gender, and Youth

This document contains the Building Assets Toolkit’s Asset Cards (110), set of Age Cards (age 6 to 20), and Program Planning Worksheet (sample provided). The Age Cards are to be printed out and placed according to the instructions. The Asset Cards are to be printed out and cut in half. Blank Asset Cards are provided to create customized assets. The Building Assets Toolkit is an approach for developing programs for specific segments of girls that will prepare them to better face the challenges of growing up. It will help program managers understand the needs of the girls in their community, …


Building Assets Toolkit: Developing Positive Benchmarks For Adolescent Girls—Instruction Guide [Arabic], Judith Bruce, Sarah Engebretsen, Kimberly Glazer Jan 2021

Building Assets Toolkit: Developing Positive Benchmarks For Adolescent Girls—Instruction Guide [Arabic], Judith Bruce, Sarah Engebretsen, Kimberly Glazer

Poverty, Gender, and Youth

English Summary:
The Building Assets Toolkit is an approach for developing programs for specific segments of girls that will prepare them to better face the challenges of growing up. It will help program managers understand the needs of the girls in their community, engage stakeholders at different levels and with different viewpoints, and build concrete and meaningful programming for adolescent girls. The toolkit contains all the materials needed to help make a preliminary assessment of the assets a girl should acquire and the age by which she should acquire them. This document contains the Building Assets Toolkit’s List of …


The Practical Applications Of Video Games Beyond Entertainment, Jack Martin Dec 2020

The Practical Applications Of Video Games Beyond Entertainment, Jack Martin

School of Professional Studies

Much of the attention directed toward video games is focused on their role as entertainment. However, researchers have found that video games can have other, more practical uses for society. This thesis is designed to examine three specific examples of the practical applications of video games: video games in education, video games as accessible technology, and the social uses of video games. This project is based on pre-existing research conducted by professionals studying the aforementioned subtopics. Anecdotal stories from educators, people with disabilities, and developers are also discussed. The thesis explores specific examples of video games being used practically, and …


From The Editors, Natasha Menard, Kelsie Fournier Nov 2020

From The Editors, Natasha Menard, Kelsie Fournier

Student Journal of Occupational Therapy

This welcome letter from the editors of the Student Journal of Occupational Therapy introduces the inaugural issue of the journal and outlines its mission to engage student researchers at all levels of the research publication process and its commitment to ethical, open-access publication.


Building Assets For Humanitarian Settings, Women's Refugee Commission, Population Council Jun 2020

Building Assets For Humanitarian Settings, Women's Refugee Commission, Population Council

Poverty, Gender, and Youth

This document is the Women’s Refugee Commission and the Population Council’s adaptation of the Building Assets Toolkit and its core activity, the Asset Exercise, for use in humanitarian contexts. An asset-building exercise is a thoughtful way to build intentional program content for girls to determine what assets they need in order to survive and thrive. This is particularly important for programs intended to reach the poorest girls in the poorest communities based on sound evidence on the reality of their lives. The Council’s Building Assets Toolkit is rooted in this exercise, helping practitioners, policymakers, and advocates build tailored, meaningful, …


Adapting The Asset Exercise For Humanitarian Contexts, Women's Refugee Commission, Population Council Apr 2020

Adapting The Asset Exercise For Humanitarian Contexts, Women's Refugee Commission, Population Council

Poverty, Gender, and Youth

As a guiding program theory, asset-building centers on the idea that skills, knowledge, relationships, and concrete resources can all constitute assets, or “stores of value,” that girls can, in turn, mobilize to make healthy choices, seek support, navigate institutions, and access entitlements. This approach is inherently multisectoral, rooted in a commitment to prioritize understanding of and respond to the diversity of girls’ needs, capacities, and experiences. The Asset Exercise operationalizes the concept of “asset-building” into concrete terms. The exercise consists of a deck of 100 “asset cards,” and eight “age cards.” Asset cards reflect both intrinsic qualities, concrete knowledge, and …


Crumbling Foundations: The Case For Prioritizing Self-Care Among Educational Leaders, Joshua Brent Ray May 2019

Crumbling Foundations: The Case For Prioritizing Self-Care Among Educational Leaders, Joshua Brent Ray

Graduate Theses and Dissertations

There is a potentially dangerous disassociation between human behavior, decision-making, and ethics and the notion that these fundamental aspects of what it means to be human originate simply as the functions of an organ. A deeper knowledge of the operation and limitations of the brain suggests biological input could possess the ability to unknowingly alter human behavior and effectiveness. This study utilizes a research-based understanding of the implications of human health and self-care habits on neurological, psychological, and behavioral function to examine the current practices of educational administrators across Arkansas while exploring systemic and job-based factors within the profession that …


Building Assets Toolkit: Developing Positive Benchmarks For Adolescent Girls—Asset Cards [Spanish], Judith Bruce, Sarah Engebretsen, Kimberly Glazer Jan 2019

Building Assets Toolkit: Developing Positive Benchmarks For Adolescent Girls—Asset Cards [Spanish], Judith Bruce, Sarah Engebretsen, Kimberly Glazer

Poverty, Gender, and Youth

La Caja de herramientas: Fortalecimiento de habilidades del Population Council ayuda a los profesionales, los encargados de formular políticas y los defensores a crear contenido personalizado, significativo y positivo para ayudar a subpoblaciones específicas de niñas. La caja de herramientas guía a los profesionales a través de una serie de pasos que deben tomarse para definir objetivos de sentido común: qué información, habilidad o activo físico (como una tarjeta de identificación) debe tener una niña en un entorno particular para una edad en particular. Este documento consta de las tarjetas de activos que forman parte de la Caja de herramientas: …


Building Assets Toolkit: Developing Positive Benchmarks For Adolescent Girls—Asset Cards [Swahili], Judith Bruce, Sarah Engebretsen, Kimberly Glazer Jan 2019

Building Assets Toolkit: Developing Positive Benchmarks For Adolescent Girls—Asset Cards [Swahili], Judith Bruce, Sarah Engebretsen, Kimberly Glazer

Poverty, Gender, and Youth

This document contains the Building Assets Toolkit’s Asset Cards (110), set of Age Cards (age 6 to 20), and Program Planning Worksheet (sample provided). The Age Cards are to be printed out and placed according to the instructions. The Asset Cards are to be printed out and cut in half. Blank Asset Cards are provided to create customized assets. The Building Assets Toolkit is an approach for developing programs for specific segments of girls that will prepare them to better face the challenges of growing up. It will help program managers understand the needs of the girls in their community, …


Building Assets Toolkit: Developing Positive Benchmarks For Adolescent Girls—Asset Cards [Portuguese], Judith Bruce, Sarah Engebretsen, Kimberly Glazer Jan 2019

Building Assets Toolkit: Developing Positive Benchmarks For Adolescent Girls—Asset Cards [Portuguese], Judith Bruce, Sarah Engebretsen, Kimberly Glazer

Poverty, Gender, and Youth

This document contains the Building Assets Toolkit’s Asset Cards (110), set of Age Cards (age 6 to 20), and Program Planning Worksheet (sample provided). The Age Cards are to be printed out and placed according to the instructions. The Asset Cards are to be printed out and cut in half. Blank Asset Cards are provided to create customized assets. The Building Assets Toolkit is an approach for developing programs for specific segments of girls that will prepare them to better face the challenges of growing up. It will help program managers understand the needs of the girls in their community, …


My Experience In Swaziland With Give Hope, Fight Poverty, Megan Kaser Nov 2018

My Experience In Swaziland With Give Hope, Fight Poverty, Megan Kaser

Purdue Journal of Service-Learning and International Engagement

Megan Kaser, a recent 2017 alum in the College of Health and Human Sciences at Purdue University, describes her experience with Give Hope, Fight Poverty (GHFP)—a nonprofit organization in Indianapolis, Indiana. She is currently pursuing a master’s degree in physician assistant studies. GHFP’s mission is “to foster philanthropy domestically by designing service-learning programs that engage U.S. college students with rural communities in Swaziland, Africa, and work together to educate, empower, and lift orphaned and vulnerable children—particularly those living in child-headed households— out of poverty” (Give Hope, Fight Poverty, n.d.). By incorporating college students in the implementation of GHFP orphan education …


Effects Of A Hospital-Wide Physician Communication Skills Training Workshop On Self-Efficacy, Attitudes And Behavior, Minna Saslaw, Dana R. Sirota, Deborah P. Jones, Marcy Rosenbaum, Steven Kaplan Nov 2017

Effects Of A Hospital-Wide Physician Communication Skills Training Workshop On Self-Efficacy, Attitudes And Behavior, Minna Saslaw, Dana R. Sirota, Deborah P. Jones, Marcy Rosenbaum, Steven Kaplan

Patient Experience Journal

Hospital systems interested in improving patient experience and physician engagement may look to physician communication skills training (CST) as a means of improving both. This study examines a 7.5-hour, multi-specialty, hospital-wide physician CST workshop in a large academic hospital system and its effects on participants’ self-efficacy, attitudes, and behaviors related to communicating with patients. Data was gathered from October 2014 through June 2016 through a web-based questionnaire sent to participants 6-weeks post-workshop which focused on skills taught in the course, attitudes toward communication training, and provider behaviors when communicating with patients. Along with demographic questions, a ten question retrospective pre-post …


Design And Validation Of Patient-Centered Communication Tools (Pact) To Measure Students' Communication Skills, Gloria R. Grice, Nicole M. Gattas, Theresa Prosser, Mychal Voorhees, Clark D. Kebodeaux, Amy Tiemeier, Tricia M. Berry, Alexandria Garavaglia Wilson, Janelle Mann, Paul Juang Oct 2017

Design And Validation Of Patient-Centered Communication Tools (Pact) To Measure Students' Communication Skills, Gloria R. Grice, Nicole M. Gattas, Theresa Prosser, Mychal Voorhees, Clark D. Kebodeaux, Amy Tiemeier, Tricia M. Berry, Alexandria Garavaglia Wilson, Janelle Mann, Paul Juang

Pharmacy Practice and Science Faculty Publications

Objective. To develop a comprehensive instrument specific to student pharmacist-patient communication skills, and to determine face, content, construct, concurrent, and predictive validity and reliability of the instrument.

Methods. A multi-step approach was used to create and validate an instrument, including the use of external experts for face and content validity, students for construct validity, comparisons to other rubrics for concurrent validity, comparisons to other coursework for predictive validity, and extensive reliability and inter-rater reliability testing with trained faculty assessors.

Results. Patient-centered Communication Tools (PaCT) achieved face and content validity and performed well with multiple correlation tests with significant findings for …


Knowledge And Behavioral Patterns Of Youth Ice Hockey Parents Regarding Sport Concussion: A Pilot Study, Jeff G. Konin, Delaney Horsley Jan 2017

Knowledge And Behavioral Patterns Of Youth Ice Hockey Parents Regarding Sport Concussion: A Pilot Study, Jeff G. Konin, Delaney Horsley

Internet Journal of Allied Health Sciences and Practice

Purpose: There is an abundance of available concussion education programs for parents of youth ice hockey players. Parents play a vital role in recognizing signs and symptoms of a concussion sustained by a child, and therefore their knowledge and retention of such information is deemed to be very important. The purpose of the pilot survey is identify the general knowledge parents of youth ice hockey players possess regarding concussion. Methods: A survey of a sample of convenience was utilized. Forty-five parents (40 to 49 years of age) of youth ice hockey players were asked to complete a one-page survey to …


Group Empowerment Capacity And Capability In Associate Degree Schools Of Nursing In The United States, Christy Lee Savell Dec 2016

Group Empowerment Capacity And Capability In Associate Degree Schools Of Nursing In The United States, Christy Lee Savell

Dissertations

The purpose of conducting this research was to determine the perception of group empowerment capacity (EC) and group empowerment capability (E) among faculty and administrators in associate degree nursing programs (ADN) in the United States (U.S.), whether there was a significant difference in the scores of EC and E between the two groups and if there was a significant relationship between the mediating variables and EC. The study was conducted online with administrators and faculty of ADN programs throughout the United States (U.S.). Information letters with questionnaire links were sent to all members of the Organization of Associate Degree Nurses …


Designing Prenatal M-Health Interventions Through Transmigrants Reflection On Their Pregnancy Ecology, Hana Aljaberi Feb 2016

Designing Prenatal M-Health Interventions Through Transmigrants Reflection On Their Pregnancy Ecology, Hana Aljaberi

Open Access Dissertations

This dissertation presents the findings from three participatory focus group and co-design sessions with Caribbean transmigrant women in the United States. Informed by their focus group discussions regarding their pregnancy experiences in the United States, the participants produced design ideas that reflected on physical, emotional, informational and social gap themes. The purpose of this study was to understand the challenges affecting the women’s prenatal wellbeing practices, and to conceive a set of recommendations and opportunities for mHealth technology design to assist with prenatal preventative care and management. The study uses the theoretical concept of pregnancy ecology to identify gaps in …


Web-Based Media Literacy To Prevent Tobacco Use Among High School Students, Jane S. Phelps-Tschang, Elizabeth Miller, Kristen R. Rice, Brian A. Primack Jan 2016

Web-Based Media Literacy To Prevent Tobacco Use Among High School Students, Jane S. Phelps-Tschang, Elizabeth Miller, Kristen R. Rice, Brian A. Primack

Journal of Media Literacy Education

Facilitator-led smoking media literacy (SML) programs have improved media literacy and reduced intention to smoke. However, these programs face limitations including high costs and barriers to standardization. We examined the efficacy of a Web-based media literacy program in improving smoking media literacy skills among adolescents. Sixty-six 9th grade students participated in a Web-based SML tobacco education program based on health behavior theory. Pre- and post-test assessments demonstrated statistically significant changes in the primary outcome of total SML as well as each of the individual SML items. However, there were inconsistent changes in other theory-based outcomes including attitudes and normative beliefs.


Boîte À Outils: Renforcement Des Compétences, Judith Bruce, Sarah Engebretsen, Kimberly Glazer Jan 2016

Boîte À Outils: Renforcement Des Compétences, Judith Bruce, Sarah Engebretsen, Kimberly Glazer

Poverty, Gender, and Youth

Grâce à un processus appelé «conception intentionnelle», les outils d’apprentissage du Population Council aident à centraliser les besoins des filles. Ces outils s'appuient sur des preuves de la nécessité de maintenir les filles en bonne santé, de les intégrer socialement et de les préparer économiquement. La boîte à outils Renforcement des Compétences du Population Council aide les praticiens, les décideurs et les défenseurs à élaborer un contenu adapté, significatif et positif pour aider des sous-populations spécifiques de filles. La boîte à outils guide les praticiens à travers une série d'étapes qui doivent être suivies pour définir des cibles de bon …


Efficacy Of The Picture Exchange Communication Systemin Children With Autism Spectrum Disorder, Reagan Blason May 2015

Efficacy Of The Picture Exchange Communication Systemin Children With Autism Spectrum Disorder, Reagan Blason

Student Scholar Symposium Abstracts and Posters

The increasing diagnoses of Autism Spectrum Disorder (ASD) each year affect many families worldwide and are a major concern to therapists, healthcare workers, and educators. Many children diagnosed with ASD will never go on to develop functional speech or will have limited communication, as well as impaired social-communication skills. Limited communication makes education and therapy difficult for these children and their caregivers. Language therapy and interventions aim to improve social-communication and speech in these children, so it is crucial to find the most efficient interventions. The Picture Exchange Communication System (PECS) is a common tool used to assist communication in …


Building Assets Toolkit: Developing Positive Benchmarks For Adolescent Girls—Instruction Guide, Judith Bruce, Sarah Engebretsen, Kimberly Glazer Jan 2015

Building Assets Toolkit: Developing Positive Benchmarks For Adolescent Girls—Instruction Guide, Judith Bruce, Sarah Engebretsen, Kimberly Glazer

Poverty, Gender, and Youth

The Building Assets Toolkit is an approach for developing programs for specific segments of girls that will prepare them to better face the challenges of growing up. It will help program managers understand the needs of the girls in their community, engage stakeholders at different levels and with different viewpoints, and build concrete and meaningful programming for adolescent girls. The toolkit contains all the materials needed to help make a preliminary assessment of the assets a girl should acquire and the age by which she should acquire them. This document contains the Building Assets Toolkit’s List of Contents and Instruction …


Building Assets Toolkit: Developing Positive Benchmarks For Adolescent Girls—Resource Manual, Judith Bruce, Sarah Engebretsen, Kimberly Glazer Jan 2015

Building Assets Toolkit: Developing Positive Benchmarks For Adolescent Girls—Resource Manual, Judith Bruce, Sarah Engebretsen, Kimberly Glazer

Poverty, Gender, and Youth

This document contains the Building Assets Toolkit’s Resource Manual, which includes valuable information about building meaningful program content as well as detailed notes on each asset for use in the toolkit’s “Asset Building Exercise.” This exercise is designed to involve multiple stakeholders in determining what assets girls need in order to survive and thrive. The Building Assets Toolkit is an approach for developing programs for specific segments of girls that will prepare them to better face the challenges of growing up. It will help program managers understand the needs of the girls in their community, engage stakeholders at different levels …


Building Assets Toolkit: Developing Positive Benchmarks For Adolescent Girls—Asset Cards, Judith Bruce, Sarah Engebretsen, Kimberly Glazer Jan 2015

Building Assets Toolkit: Developing Positive Benchmarks For Adolescent Girls—Asset Cards, Judith Bruce, Sarah Engebretsen, Kimberly Glazer

Poverty, Gender, and Youth

This document contains the Building Assets Toolkit’s Asset Cards (110), set of Age Cards (age 6 to 20), and Program Planning Worksheet (sample provided). The Age Cards are to be printed out and placed according to the instructions. The Asset Cards are to be printed out and cut in half. Blank Asset Cards are provided to create customized assets. The Building Assets Toolkit is an approach for developing programs for specific segments of girls that will prepare them to better face the challenges of growing up. It will help program managers understand the needs of the girls in their community, …


Behind The Mirrors: Examining The Role Of African American Cosmetologists And Salons In Domestic Violence Advocacy And Education, Pangela H. Dawson Jan 2014

Behind The Mirrors: Examining The Role Of African American Cosmetologists And Salons In Domestic Violence Advocacy And Education, Pangela H. Dawson

Theses and Dissertations--Educational Policy Studies and Evaluation

African American beauty salons across the country have historically served as settings for social interaction, political activism, and community organizing in the African American community. These settings often offer opportunities for intimacy between cosmetologists and their clients. Research findings suggest that the unique bonds between women in salons can be a viable option when providing health intervention and education to large numbers of women. Data indicates that salon campaigns and promotions which focused on health issues such as stroke and diabetes education, breast and cervical cancer awareness, healthy living, and smoking cessation, have been efficacious in changing unhealthy habits or …


Student Perceptions Of Digital Textbooks In A College Nursing Program, Alan D. Eno Apr 2010

Student Perceptions Of Digital Textbooks In A College Nursing Program, Alan D. Eno

College of Journalism and Mass Communications: Theses

The purpose of this research was to study the use of digital textbooks in a small liberal arts college. The research was a mixed methods descriptive study using a pre and post survey to determine student perceptions of the technology. Findings indicated that students needed training in the installation and use of digital textbooks. Findings also indicated the need for further research into what students understand about using digital textbooks. Recommendations are for the college to institute training sessions to teach students how to use the digital textbooks.