It’s been a long time in the planning, but we have finally released a whole new group of features in the BMJ learning site.
The ratings, reviews and recommendations project has several factors.

Anyone who has ever been in a meeting discussing improving a website will have heard someone say, “can’t we make it like Amazon?”. We’ve added star ratings, which are displayed at the top on each module intro page.

 

We had a lot of debate about how to display the star ratings. We discussed how we could make the star rating useful for our users as well as fair to authors and editors. There’s a lot of information you can put into a rating system and we even debated having stars at all  – YouTube blogged  about why they moved from stars to thumbs up and thumbs down. In the end we chose to display a simple average star rating, with the number of ratings that contribute to this average displayed next to it.  It displays the average rating captured over a rolling one-month window, to allow ratings to take account of updates to modules.

Introducing public ratings on a site for the first time is a daunting prospect, and everyone on the team had some reservations about how it would play out. But 2 weeks down the line it has, subjectively at least, been a success. First of all, the intro pages look better. Engagement and interaction are key factors to the success of any piece of education and a rating is a visible demonstration of this. Second, we’ve been doing well. We had hundreds of ratings in the first few days and it continues. We haven’t found any ratings lower than a “3″ and several of our most popular modules are on “5″, which is a real source of pride for the editors and authors who have worked hard on them.

One of the reasons that we were comfortable about introducing star ratings is that we have always collected, read and displayed a huge number of user reviews, which are overwhelmingly positive. Users won’t see it, but we have a lovely new admin tool to moderate the reviews (someone looks at every review, and any review that raises a clinical question relating to the module content is reviewed, and acted upon, by a clinical editor).

We have anonymised the reviews. An unintended consequence of making our module intro pages more easy to find on Google, was that the names associated with reviews were picked up too. Quite reasonably, we had feedback from users that didn’t like their “really useful, thanks” comment as top of a google search on their name. The change has led to a real improvement, each comment is now attributed to the reviewer’s country, profession, and specialty – so if someone says “pitched just right for me” you can tell easily whether it is pitched right for you, as well. We love our user reviews, so we’ve moved them to front and left on the module intro page – we hope users browsing the site will find them as useful as we do.

Recommendations have two facets – the social networking element and the recommendations of other modules the user might like. Social networking tools are pretty straightforward, and we’ll be monitoring their uptake on Twitter, Google+ and Facebook. Thinking about how you might recommend modules for the user is exponentially more complicated than I had initially thought (though that may be a reflection on how much I had thought about it). Amazon has a plethora of different recommendations displays – I’ve counted 5 in two clicks.

In the end we have chosen to display five module titles which users with similar demographics have rated highly. Or, “people like you liked these”. Many features of the new BMJ Learning site are based on matching modules to a user’s professional interests and specialty, which they tell us about in http://myaccount.bmj.com. Whilst our recommendations are good, we have some technology in the pipeline that could make them even better, as well as automatically including recommendations for other resources from across the BMJGroup – Best Practice monographs and possibly journal articles. We’re monitoring how all these new features play out, and do welcome feedback.

- Helen Morant, Editor, Online Learning

Video games have come under attack by the mainstream media in the past few weeks, with extensive coverage of Anders Breivik’s apparent use of first-person shooter games as training aids before the Utoya massacre. Conversely, health researchers are becoming increasingly aware of the positive attributes of certain computer games.

Depression

This week’s most popular BMJ article looks at SPARX; a new cognitive behavioural therapy based computer game for young people with depression.

Researchers from the University of Auckland found that adolescents suffering from depression can benefit just as much from specialised computer therapy as they do from one-to-one therapy with a clinician.

SPARX is an interactive 3D fantasy game, similar to World of Warcraft, where a single user undertakes a series of challenges to restore balance in a virtual world dominated by GNATs (Gloomy Negative Automatic Thoughts).

Results showed that SPARX was as effective as usual care (face-to-face counselling by trained clinicians) in reducing symptoms of depression and anxiety by at least a third. The authors concluded that SPARX is an“effective resource for help seeking adolescents with depression at primary healthcare sites. Use of the program resulted in a clinically significant reduction in depression, anxiety, and hopelessness and an improvement in quality of life.”

Listen to  Sally Merry, an associate professor of child and adolescent psychiatry at the University of Auckland, explain how SPARX was created >>

Post-traumatic stress disorder (PTSD)

A study presented at the British Psychology Society’s Annual Conference last month suggests that flashbacks, considered by some to be the central hub of symptoms associated with post-traumatic stress disorder (PTSD), can be significantly reduced by engaging in the visual-spatial tasks of video game play.

To test their idea, researchers asked subjects to view a disturbing film — an admittedly poor but sufficient simulation of real trauma. Within six hours of viewing this film, the period during which memories are thought to be consolidated for long-term storage, test subjects were randomly assigned to one of three tasks: answering trivia; playing Tetris, the 1980s video game that involves optimizing visual-spatial cues.

Over the following week, subjects who had played Tetris reported experiencing significantly fewer flashbacks of the film than the others did.

Amblyopia

Glasgow Caledonian University eye specialists are letting children with amblyopia (also known as ‘lazy eye’) play a Tetris-style puzzle game to help treat the common visual impairment.

In the treatment, which was developed at GCU, children wear a pair of fetching “gaming goggles” and play a specially-designed version of Tetris. The goggles can show a different image in each screen, so a bright image is sent to the lazy eye and a dim image appears to the normal eye. One eye sees the falling polygonal blocks, and the other eye sees the wall of bricks. It forces the two eyes to work together.

After playing the game for an hour a day, over a period of a week to ten days, early tests have shown an almost immediate improvement. Parents of children with amblyopia also reported improvements in reading and school work.

Three new image quizzes have been launched by BMJ Group, covering real-life cases in Paediatrics, Sports Medicine and Emergency Medicine. The image quizzes provide an opportunity for you to use the clinical images from the following journals to test your diagnostic skills.

• Archives of Disease in Childhood
• British Journal of Sports Medicine
• Emergency Medicine Journal

New images and questions appear regularly, along with several possible answers. Before selecting an answer, you can take a closer look by using the zooming function. Once you have identified the correct answer, additional information is displayed to provide further context on the diagnosis, along with any relevant references.

New images will also be posted on the relevant journal Facebook and Twitter accounts, so be sure to follow or like us to keep up to date with the latest questions (see links below).

ADC

• http://www.facebook.com/ADC.BMJ
• http://twitter.com/ADCJournal_BMJ1111

BJSM

• http://www.facebook.com/BJSM.BMJ
• http://twitter.com/BJSM_BMJ4747

EMJ

• http://www.facebook.com/Emergency.Medicine.Journal
• http://twitter.com/EmergencyMedBMJ1414

The UK schools regulator Ofsted used to employ a team of people who sent questionnaires to parents if their children’s school was undergoing an inspection.

But last year the process was automated with the launch of Parent View, a website that allows parents to fill in the 12 questions online, and update it if their opinion of a school changes over time.

The site updates daily and a school’s results are publicly visible, so parents considering one for their children can find out what other parents think about the quality of teaching, discipline, leadership, track record on tackling bullying etc.

Parent View took less than three months to develop, including user testing. The team who built it on the Drupal open source platform were asked to deliver a secure and scalable website that could handle sudden peaks in traffic and levels of interaction.

Describing the project at a Drupal for Government event in London this week, project manager Paul Jenkins said the site needed an email authentication process so parents could sign in again and update scores if their opinion about a school changed. They were also asked to suppress results if only one parent had responded about a school.

He added: “Parents used to have to wait for an inspection every few years. It was very ad hoc. A child would come home from school with a paper based survey. An inspector would need to collate the results.

“It was also expensive. There was a team of people stuffing envelopes and collating at the end. Now there are 12 very simple online questions, and because the results are publicly visible, parents can see what other people are saying about a school.”

Drupal was chosen, he said, because Ofsted’s main site is built using it, and the organisation wanted a single sign on for both sites.

Also, as an open source solution, access is free, making it an increasingly popular choice for cash-strapped UK government departments. A number of Cabinet Office sites also use Drupal. So does the White House, World Bank, Open University, Royal Mail, MTV, and Comic Relief. And, since 2011, the BMJ.

Drupal developer Robert Castelo told the event that the ability to re-use components rather the coding from scratch is attractive to organisations like Ofsted, which need to launch sites very quickly.

The Economist’s Drupal project, on the other hand, took longer because the magazine needed to spend more than a year migrating its back archive into the Drupal CMS. The BMJ, with articles dating back to 1840 and reader comments since the late 1990s, needed to undertake a similar exercise.

In some ways the stakes for central government are higher than for other organisations. Civil servants are risk averse by nature, and scarred by the negative headlines of botched digital projects.

Paul Jenkins reminded his audience of the much-hyped www.police.uk site crashing on its first day last year after promising to highlight the nation’s crime hotspots. Eighteen million people an hour tried to log on. The Daily Mail dubbed the outage: Its Crimebotch UK: Outcry as leafy streets labelled crime hotspots on new Home Office website (which crashed as soon as it went live)

That was why, he said, scalability was such an important requirement for Ofsted. Given the fact that most parents stress about getting their children into a decent local school these days, Ofsted’s anxiety was probably right.

David Payne is editor, bmj.com

Following the successful launch of a mobile friendly version of Emergency Medicine Journal back in 2011, we have now rolled out the same interface on more BMJ Journals:

• Archives of Disease in Childhood
• Annals of the Rheumatic Diseases
• Gut
• Heart
• Thorax

More mobile sites launched:

• BMJ Open
• British Journal of Ophthalmology
• BJSM
• DTB
• Frontline Gastroenterology
• In Practice
• JAMIA
• Journal of Clinical Pathology
• JNIS
• Veterinary Record

The mobile web browser detects when a user is accessing each of these sites via a mobile device. Regardless of the type of smartphone, all mobile users are automatically forwarded to an optimised template. The new system offers streamlined content and display for web-enabled, smaller screens with low bandwidth networks. It has been specifically designed to accommodate the mobile behaviour of “keeping up” and “looking up” and works across all devices, including Blackberry, Android and iPhone.

Mobile access for institutions
Mobile vouchers have been introduced across the mobile sites which enable institutional subscribers to tie their mobile device to their institution’s subscriptions. This voucher will grant access to protected content while not on an institution’s network. The level of access granted will be exactly the same as the institution’s subscription and each mobile device must be vouched for individually. So, how does it work?

1. Either put your mobile device on your institution’s network, or use a computer that is already on your institution’s network
2. Visit the ‘Authorise this device’ link while connected to your institution’s network (see below)
3. Fill out a simple form with your name and email, then submit
4. The voucher code will appear on-screen and can be sent to your email
5. You will then have 48 hours to apply this code to your device

For more information, take a look at our Mobile Voucher FAQs.

A host of journal editors and industry experts descended upon BMA House yesterday to discuss the latest techniques and developments in reader engagement. Highlights included a lively debate on post-publication peer review, an inspiring presentation by Twitter Journal Club founder Natalie Silvey (@silv24), encouraging advice on developing a comprehensive journal web presence by Karim Khan, and predictions for the future of social networking by Tad Campion, senior deputy editor and online editor of NEJM.

Given the central theme of social media throughout the day, perhaps the most fitting way to capture the event is by following the surrounding conversation on Twitter. According to TweetReach, the stream below reached in excess of 27,000 users – quite an achievement!

Two friends of mine are about to buy a domiciliary care business, and over dinner the other week we discussed their website and how effective search engine optimisation can ensure it shows high in any Google search.

Before long we were lamenting Google’s business practices and commercial dominance, something I blogged about in late 2011. I had lots to say about this. Earlier that week I’d returned to work after a week’s holiday and learned that Google had de-indexed bmj.com, apparently without notice.

Google had accused us of “cloaking.” This means we were allowing Google’s search engine spiders to crawl our full text content, but because all of our non-research content is now behind a paywall (a change we made in January 2012), a typical end user landing on our content after clicking on a Google link would only see a 150 word extract.

We’d got round this by delivering a longer pdf extract. This was one of Google Scholar’s recommendations when we met with them in December, and we’d understood that this would keep google.com happy.

Only it hadn’t kept them happy. This was serious stuff. Before long authors and readers were emailing us to ask why BMJ articles weren’t appearing in Google search results. There was an immediate impact on our traffic. In one week in February it dropped from 335 942 to 239 918 visits. A week later we lost another 10 000 visits.

According to Google Scholar, the pdf extract option should only have applied to scholarly research articles lacking abstracts, and not to non-scholarly content, such as book reviews, letters, editorials and general news articles. For non-scholarly content, we could have introduced Google’s first click free option. This means that if someone clicks on Google search result they hit the article rather than a paywall, but if they then browse within the site the paywall launches.

Before being de-indexed, bmj.com had enjoyed a good page ranking for its content. This means we showed high in Google’s search results. We’d heard it can take years to regain this ranking. But first we needed to get re-indexed urgently.

We decided to let Google index free content (mostly original research) and abstracts/extracts of everything else. We applied this fix urgently, and alerted Google.

The good news is we’re now being reindexed, and according to Google Scholar, our high page ranking should return quite quickly because our removal period was relatively short (three weeks).

When Google Scholar representative Darcy Dapra addressed a meeting of scholarly publishers last year, its indexing rules led to accusations that the company was dictating to publishers how they should run their businesses. The company argued that publishers weren’t being singled out – its indexing rules were applied across the board.

Ultimately it’s for businesses to decide how important Google traffic is to them. If it isn’t, don’t let Google index your site.

Where does this leave my friends setting up their business? They want their website to be search engine optimised, but it rankles with them that Google calls the shots. We decided over dinner to break the company’s stranglehold by using an alternative search engine (Bing, Yahoo etc), at least once a day.

Have they done that? I doubt it. Have I? No, not yet. Will I? Perhaps not. If I were truly serious I’d close my gmail and Google+ accounts. I’d suggest that my colleague emails me the joint document we’re working on, instead of sharing it via Google documents. And I’d stop my fixation with bmj.com’s Google Analytics account to check our web traffic most days.

Google is a hard habit to break.

David Payne is editor, bmj.com

Online publishing startup Inkling (who featured at this week’s HighWire Press Conference in Palo Alto, CA) has created a new tool that it says will appeal to professional, large-scale publishers. The software, known as Habitat, will use XML and HTML5 that can be read on a variety of platforms, including an upcoming Inkling web reader. In theory, it sounds pretty similar to Apple’s iBooks Author, but Habitat is specifically designed for large teams of collaborators with sharing and collaboration tools.

If anyone has insight into Apple’s educational efforts, it would be Inkling Co-founder and CEO, Matthew MacInnis, who was responsible for Apple’s expansion into educational markets in Asia and later a senior manager of all Apple’s international education efforts. MacInnis told us that the Inkling team set out to build a publishing platform that would redefine digital media, starting with reinventing the textbook. But in doing so, they’ve discovered that to reinvent books, they’ve had to go back to ground zero and re-imagine the entire printing process itself.

Adobe’s InDesign has long been the de facto standard for formatting and laying out publications, magazines, newspapers, textbooks, and so on. While the process that goes into producing publications and textbooks is innately collaborative, it remains a complicated, convoluted, and time consuming process. While iBooks looked to solve this problem, the main use case for its Author tool seems to be for individual teachers who want to publish books for their classrooms.

Inkling’s new ‘software environment’ targets the other end of the spectrum from iBooks: professional publishers. It gives them an industrial platform that includes seemingly everything they need to create and publish interactive content for both the iPad and HTML5-based web content.

A key feature is that everything lives in the cloud, so that teams of editors, authors, and production partners can collaborate on textbook (or digital publishing) projects from around the world. Using the collaborative cloud, team members can see the same thing as their counterparts in India, staying in sync throughout the process.

Among the platform’s other features, Habitat includes automated error reporting, as it scans the content every time it’s published to make sure it all works, automatically finding broken links, missing files, etc. Habitat also automatically saves every version of the entire project, every time, from start to finish, which means that editors can rollback changes at any point during the process — all the way back to the beginning.

The image-sharing site Pinterest has enjoyed dramatic growth since its launch in February 2010. The service’s user base has grown rapidly, from 1.6 million visitors in September 2011 to 11.1 million visitors in February 2012. According to comScore, it has become the the “fastest standalone website to surpass the 10 million mark”. Not only does Pinterest drive more traffic to retail sites than Google+, YouTube and LinkedIn combined, it also drives more traffic to blogs than Twitter. Analytics also show that when it comes to engagement, Pinterest is second only to Facebook — its users spend, on average, 89 minutes per month on the social network.

However, there’s still a healthily high percentage of people who have heard nothing about Pinterest. So, what’s all the fuss about? And is it really dominated by images of cute kittens and elaborately conceived cupcakes?

Pinterest allows users to curate collections of images from across the Web under different “boards” or categories. If a photo strikes a user’s fancy, they can repin it (Pinterest lingo for posting it) to their own board with a few clicks.

Pin: A pin is an image added to Pinterest. You can link to an image from a Web site or upload an image from your computer. Pins can also include captions.

Repin: Once something is pinned, it can then be repinned by other Pinterest users. This is how content spreads virally. If you see something you like on Pinterest.com, repin it to share it with your friends.

Board: This is where your pins live. You can have separate boards for subjects such as a wedding, rooms in your house or favorite recipes.

In the same vein as other social networks, users build a list of people to follow on Pinterest. These choices then have a direct impact on what appears on your homepage. Users can choose to follow all boards belonging to another person, or just a single board. Linking Pinterest to Facebook will also let a user see which of his or her Facebook friends are on the social network.

Who’s using it?

According to Google Ad Planner, Pinterest’s US audience in Jan 2012 was largely interested in fashion, arts and crafts, recipes, and interior design. According to comScore data, females currently account for 68% of the site’s visitors worldwide and a huge 85% of the activity,

In the UK, however,  the demographic picture is very different with a mostly male audience. These users are interested in a very different agenda, including web analysis and blogging services. It has been suggested that “early adopters” are dominating in the UK and that this will shift over time as the service becomes more mainstream.

For more information on how to use Pinterest, check out the video tutorial below:

“As the volume of academic literature explodes, scholars rely on filters to select the most relevant and significant sources from the rest,” the altmetrics manifesto argues. “Unfortunately, scholarship’s three main filters for importance are failing.” Peer review “has served scholarship well” but has become slow and unwieldy and rewards conventional thinking. Citation-counting measures such as the h-index take too long to accumulate. And the impact factor of journals gets misapplied as a way to assess an individual researcher’s performance, which it wasn’t designed to do.

There are various tools that provide an easy interface for finding out readership metrics for a researcher. Until recently, none of these allowed users to choose what is included or enabled non-traditional artefacts to be combined with traditional ones. This is where Total-Impact, a new offering from the altmetric community, comes in.

It is a tool aimed primarily at researchers who want to know how many times their work has been downloaded/ bookmarked/ blogged, and research groups who want to view the broad impact of their work and see what has provoked interest. In addition, it may well appeal to funders and repositories wishing to report on the impact of research outside of the traditional methods. Metrics are computed based on the following data sources: CrossRef, Mendeley, Slideshare, Dryad, PLoSALM (PLoS article level metrics), Facebook, CiteULike, Wikipedia, Delicious, PubMed, Research Blogging, to name but a few. (Full list available here)

“Total-Impact data can be highlighted as indications of the minimum impact a research artifact has made on the community or explored more deeply to see who is citing, bookmarking, and otherwise using specific research”. However, the website openly admits that Total-Impact is in early development and has many limitations.  Potential users are warned not to use the tool in the following ways:

• as indication of comprehensive impact
  Total-Impact is in early development. See limitations and take it all with a grain of salt.
• for serious comparison
  Total-Impact is currently better at collecting comprehensive metrics for some artifacts than others, in ways that are not clear in the report. Extreme care should be taken in comparisons. Numbers should be considered minimums. Even more care should be taken in comparing collections of artifacts, since some Total-Impact is currently better at identifying artifacts identified in some ways than others. Finally, some of these metrics can be easily gamed. This is one reason we believe having many metrics is valuable.
• as if we knew exactly what it all means
  The meaning of these metrics are not yet well understood.
• as a substitute for personal judgement of quality
  Metrics are only one part of the story. Look at the research artifact for yourself and talk about it with informed colleagues.

A major difficulty experienced by the developers is finding sources of open data. Another technical challenge for altmetrics is what to do about multiple digital “addresses” for a specific article online. Someone who tweets about a paper will probably link to a URL but not include the digital object identifier, or DOI, that makes the paper more permanently findable online, even if the URL changes. Despite these struggles, it will be interesting to see the significance of this tool in  “uncovering the invisible impact of research”.