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Introduction. Internet-based psychological interventions are an effective option for treating mental health problems. Identifying the acceptability of these services makes it possible to improve their design and user adherence. However, only a few psychometric instruments exist to evaluate this acceptability. Objective. To design and evaluate the psychometric properties of an internet-based psychological interventions questionnaire, based on the theory of technology acceptance. Method. The study was divided into three parts: 1) Design of instrument items, 2) analysis of psychometric properties and exploratory factor analysis, and 3) confirmatory factor analysis. Results. The instrument proved to have adequate psychometric properties, with the following goodness-of-fit measurements: χ²/df = 168.92/74 = 2.28, CFI = .935, TLI = .920, RMSEA = .080, 95% CI [.64, .096]. The analysis of internal consistency found an α = .91 for the total scale, an α = .91 for the first factor, "Approval of use," an α = .79 for the second factor, "Perceived usefulness," and an α = .59 for the third factor, "Perceived risk." Discussion and conclusion. The evaluation of factors associated with greater acceptability is a potential tool for improving awareness of the use of online psychological interventions. [ABSTRACT FROM AUTHOR]

Background: Medical internet interventions such as asynchronous apps and synchronous digital live seminars can be effective behavior change interventions. The research question of this study was whether digital interventions based on the Health Action Process Approach can improve pregnant women's safe communication and patient safety in obstetric care. Objective: This study aims to compare a digital live seminar with a web-based application intervention and a passive control group and to identify which social cognitive variables determine safe communication behavior and patient safety. Methods: In total, 657 pregnant women were recruited, and hereof, 367 expectant mothers from 2 German university hospitals participated in the pre-post study (live seminar: n=142; web-based app: n=81; passive control group: n=144). All interventions targeted intention, planning, self-efficacy, and communication of personal preferences. The 2.5-hour midwife-assisted live seminar included exercises on empathy and clear communication. The fully automated web-based application consisted of 9 consecutive training lessons with the same content as that of the live seminar. Results: Controlled for sociodemographic characteristics, repeated measures analyses of covariance revealed that pregnant women significantly improved their self-reported communication behavior in all groups. The improvement was more pronounced after the digital live seminar than after the web-based application (P<.001; ηp²=0.043). Perceived patient safety improved more for pregnant women participating in the live seminar than for those participating in the web-based application group (P=.03 ηp²=0.015). A regression analysis revealed that social cognitive variables predicted safe communication behavior. Conclusions: Overall, the web-based application intervention appeared to be less effective than the digital live training in terms of communication behavior. Application interventions addressing communication behaviors might require more face-to-face elements. Improving intention, coping planning, and coping self-efficacy appeared to be key drivers in developing safe communication behavior in pregnant women. Future research should include social learning aspects and focus on the practical application of medical internet interventions when aiming to improve pregnant women's communication and patient safety in obstetrics. [ABSTRACT FROM AUTHOR]

Online markets for mental health care (OMMH) allow clients to connect remotely with counselors to receive psychological therapy. Rooted in signaling theory and in the specific context of an OMMH, we theorize relative credibility of signals as the boundary condition that determines whether the demonstration signal of responsiveness to client questions substitutes or complements the two description signals of professional qualifications and counseling style in predicting market demand for counselors from new clients in an OMMH. Based on a panel dataset of 823 observations from 309 counselors participating on YiXinLi, a leading OMMH in China, we tested our hypotheses using linguistic and sentiment analysis methods and zero-inflated negative binomial models. We found broad support for nine out of ten hypotheses. Findings are robust with respect to different measures of variables, potential endogeneity from the simultaneity of responsiveness and counselor demand, and potential selection bias from both observable and endogenous covariates. Our study extends the literature on signaling in online markets in the unique context of OMMH by showing that: (1) relative credibility of signals is the boundary condition that determines when a demonstration signal will complement and when it will substitute for a description signal, (2) previous clients’ feedback on counselors’ empathy and warmth was deemed not credible by new clients in the context of online counseling, and (3) responsiveness to client questions is the most influential predictor of market demand from new clients in an OMMH. [ABSTRACT FROM AUTHOR]

Background/Aim: Tooth avulsion (TA) is a severe form of traumatic dental injury. The tooth's prognosis depends on the immediate measures taken. First responders are often laypeople, and the Internet is a favored platform to access health‐related information. The aim of this descriptive study was to evaluate the accuracy, quality, readability, and popularity of patient‐oriented web information regarding the emergency management of TA. Methods: Three search engines (Google, Bing, and Yahoo.com) were browsed with six VPNs using "knocked out tooth," "fallen out tooth," and "tooth avulsion" as keywords. The top 20 results for each were evaluated. Webpages were included if they had information oriented to caregivers. They were analyzed for accuracy (cutoff ≥95%). Quality of web pages was assessed using DISCERN and the Journal of the American Medical Association (JAMA) benchmark. Readability was evaluated using Flesch‐Kincaid Grade Level (FKGL), Gunning Fog (FOG), Coleman–Liau Index (CLI), and Simple Measure of Gobbledygook (SMOG). Popularity was assessed by Alexa Popularity Rank (APR). Accurate and inaccurate webpages were compared using chi‐square analysis and the Mann–Whitney U test. Spearman's correlation between the studied metrics was established. A p <.05 was considered significant. Results: Seventy‐two webpages were included, of which 23 (32%) were accurate. The median DISCERN ratings for accurate and inaccurate webpages were 3.0 [2.5–3.0] and 3.0 [2.0–3.0], respectively (p =.331). Ten (44%) accurate and 12 (24.5%) inaccurate webpages had high‐quality JAMA (p =.089). The median readability scores for accurate webpages were FKGL (8 [6.75–9.2]), FOG (10.6 [9.55–12.3]), CLI (7 [6–7]), SMOG (6.7 [6.15–7.5]), while scores for the inaccurate webpages were FKGL (7.85 [6.275–8.525]), FOG (10.55 [8.875–11.425]), CLI (7 [7–8.25]), and SMOG (7 [6.2–7.925]), with a higher CLI score for inaccurate webpages (p =.0035). The median APRs for accurate and inaccurate webpages were 1,02,538 [26,852–14,43,755] and 7,63,190 [2,19,799–29,92,067], respectively (p =.163). Accuracy had a positive correlation with quality (DISCERN: rho =.293, p =.013; JAMA: rho =.249, p =.036), while popularity (APR) was negatively correlated with quality (DISCERN: rho = −.330, p =.013; JAMA: rho = −.287, p =.032). Conclusion: Relevant webpages were limited and had low accuracy. This can impact the emergency management by laypeople and adversely affect the prognosis following avulsion. [ABSTRACT FROM AUTHOR]

Background and Aims: Alcohol consumption is increasing among older adults. Rethink My Drink is a brief internet-delivered intervention to reduce alcohol consumption and related harms, adapted specifically for older adults. This protocol for a large-scale randomised controlled trial will evaluate whether Rethink My Drink is effective in reducing alcohol consumption and cognitive decline in a sample of older risky drinkers, compared with an active control. Design: 1:1 parallel group, randomised controlled trial. Setting: Online trial in Australia. Participants: Hazardous or harmful drinkers (defined as those scoring =5 on the Alcohol Use Disorders Identification Test [AUDIT]) age 60 to 75 years old (n = 842). Participants will be recruited from August 2021 to August 2022 through online social media advertisements and community networks. Intervention and Comparator: Participants will be randomly allocated to receive access to Rethink My Drink (intervention) or Alcohol: The Facts (comparator), an online patient information booklet provided by New South Wales (NSW) Health. Measurements: Primary outcomes include (i) average weekly standard drinks and (ii) rate of cognitive decline. Secondary outcomes include (i) typical quantity of drinks per drinking day; (ii) heavy episodic drinking; (iii) age-specific risky drinking; (iv) alcoholrelated harms; (v) subjective cognitive complaints; and (vi) quality of life. All primary and secondary outcomes will be assessed at baseline, post-intervention (4 weeks) and 12 months. Effectiveness will be evaluated using multilevel linear regression, adjusting for baseline demographic differences. Bonferroni adjustments will be used to control for multiple comparisons. Multiple imputation, regression weighting and sensitivity analyses will assess the effect of attrition. Comments: This will be the first large-scale trial, internationally, to examine whether a brief internet-delivered intervention is effective in reducing alcohol consumption and cognitive decline among older adults. If successful, the intervention will provide an accessible and highly scalable treatment to reduce risky alcohol consumption in older adulthood. [ABSTRACT FROM AUTHOR]

This paper presents an efficient system using a deep learning algorithm that recognizes daily activities and investigates the worst falling cases to save elders during daily life. This system is a physical activity recognition system based on the Internet of Medical Things (IoMT) and uses convolutional neural networks (CNNets) that learn features and classifiers automatically. The test data include the elderly who live alone. The performance of CNNets is compared against that of state-of-the-art methods, such as activity windowing, fixed sample windowing, time-weighted windowing, mutual information windowing, dynamic windowing, fixed time windowing, sequence prediction algorithm, and conditional random fields. The results indicate that CNNets are competitive with state-of-the-art methods, exhibiting enhanced IoMT accuracy of 98.37%, which is the highest among the proposed solutions using the same dataset. [ABSTRACT FROM AUTHOR]

Importance: In most countries, young people with obsessive-compulsive disorder have limited access to specialist cognitive behavioral therapy (CBT), a first-line treatment.Objective: To investigate whether internet-delivered CBT implemented in a stepped-care model is noninferior to in-person CBT for pediatric obsessive-compulsive disorder.Design, Setting and Participants: A randomized clinical noninferiority trial conducted at 2 specialist child and adolescent mental health clinics in Sweden. Participants included 152 individuals aged 8 to 17 years with obsessive-compulsive disorder. Enrollment began in October 2017 and ended in May 2019. Follow-up ended in April 2020.Interventions: Participants randomized to the stepped-care group (n = 74) received internet-delivered CBT for 16 weeks. Nonresponders at the 3-month follow-up were then offered a course of traditional face-to-face treatment. Participants randomized to the control group (n = 78) immediately received in-person CBT for 16 weeks. Nonresponders at the 3-month follow-up received additional face-to-face treatment.Main Outcomes and Measures: The primary outcome was the masked assessor-rated Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) score at the 6-month follow-up. The scale includes 10 items rated from 0 (no symptoms) to 4 (extreme symptoms), yielding a total score range of 0 to 40, with higher scores indicating greater severity. Assessors were masked to treatment allocation at pretreatment, posttreatment, 3-month follow-up, and 6-month follow-up assessments. The predefined noninferiority margin was 4 points on the CY-BOCS.Results: Among the 152 randomized participants (mean age, 13.4 years; 94 [62%] females), 151 (99%) completed the trial. At the 3-month follow-up, 34 participants (46%) in the stepped-care group and 23 (30%) in the in-person CBT group were nonresponders. At the 6-month follow-up, the CY-BOCS score was 11.57 points in the stepped-care group vs 10.57 points in the face-to-face treatment group, corresponding to an estimated mean difference of 0.91 points ([1-sided 97.5% CI, -∞ to 3.28]; P for noninferiority = .02). Increased anxiety (30%-36%) and depressive symptoms (20%-28%) were the most frequently reported adverse events in both groups. There were 2 unrelated serious adverse events (1 in each group).Conclusions and Relevance: Among children and adolescents with obsessive-compulsive disorder, treatment with an internet-delivered CBT program followed by in-person CBT if necessary compared with in-person CBT alone resulted in a noninferior difference in symptoms at the 6-month follow-up. Further research is needed to understand the durability and generalizability of these findings.Trial Registration: ClinicalTrials.gov Identifier: NCT03263546. [ABSTRACT FROM AUTHOR]

Background: Seeking online health information (OHI) has become a common practice globally. The information seekers could face health risks if they are not proficient in OHI literacy. The OHI-seeking behaviors and skills of Chinese college students, the largest proportion of college students in the world, are understudied. This study was aimed to describe OHI-seeking behaviors and skills of college students in Guangdong, China.Methods: College students in the Guangdong province with OHI-seeking experience were invited via WeChat, QQ, and Sina Weibo using QR code posters and flyers for participation in this online anonymized questionnaire-based study. Data on demographics, OHI literacy, information resources, search approaches, and behaviors were collected. The relationship between perceived OHI literacy and high-risk behaviors was investigated by bivariate logistic regression analysis.Results: Respondents were 1203 college students with a mean age of 20.6 years, females (60.2%), and undergraduates (97.2%). They sought health information via websites (20.3%), WeChat (2.6%), or both (77.1%). Baidu was the main search engine, and baike.baidu.com (80.3%), Zhihu.com (48.4%), and Zhidao.baidu.com (35.8%) were top three among 20 searched websites for information about self-care (80.7%), general health (79.5%), disease prevention (77.7%), self-medication (61.2%), family treatment (40.9%), drugs (37.7%), western medications (26.6%), hospitals (22.7%), physicians (21.4%), and Traditional Chinese Medicine (15.6%). Despite most respondents (78%) lacked confidence in the evidence quality and satisfaction with the results, only 32.4% further consulted doctors. Many (> 50%) would recommend the retrieved information to others. About 20% experienced hacking/Internet fraud. Cronbach's alpha for the internal consistency of OHI literacy was 0.786. Bivariate logistic regression analysis showed that students who believed they can judge the evidence level of OHI were more likely to self-diagnose (OR = 2.2, 95%CI, 1.6-3.1) and look for drug usage (OR = 3.1, 95%CI, 1.9-5.0).Conclusions: This study reveals Chinese college students' heavy reliance on OHI to manage their own and others' health without sufficient knowledge/skills to identify misinformation and disinformation. The apparent risky information-seeking behaviors of Chinese college students warrant the provision of regulated, accurate, and actionable health information; assurance of cybersecurity; and health information literacy promotion in colleges by concerned authorities. [ABSTRACT FROM AUTHOR]

Aims: To test the efficacy of a therapist‐guided high‐intensity internet intervention compared with an unguided low‐intensity internet intervention among individuals with alcohol use disorder. Design A three‐group randomized controlled trial with follow‐up assessments post‐treatment (12 weeks) and 6 months post‐randomization (primary end‐point). Settings General population sample in Sweden. Participants: A total of 166 on‐line self‐referred adults (49% males) with a score of 14 (females)/16 (males) or more on the Alcohol Use Disorders Identification Test, a preceding week alcohol consumption of 11 (females)/14 (males) or more standard drinks and an alcohol use disorder according to a diagnostic interview. Interventions and comparators: Both the high‐ (n = 72) and low‐intensity internet interventions (n = 71) consisted of modules based on relapse prevention. Controls were on a waiting‐list (n = 23), and were only followed until the post‐treatment follow‐up. Participants were randomized at a 7 : 7 : 2 ratio. Measurements: Primary outcome was self‐reported alcohol consumption in the preceding week measured as (1) number of standard drinks and (2) number of heavy drinking days at the 6‐month follow‐up. Findings Alcohol use disorders were largely in the severe category (74.7%), with the majority of participants having had alcohol problems for more than 5 years. Attrition was 13 and 22% at the post‐treatment and 6‐month follow‐up, respectively. At the 6‐month follow‐up, an intent‐to‐treat analysis showed no significant differences in alcohol consumption between the high‐ and low‐intensity interventions [standard drinks d = −0.17, 95% confidence interval (CI) = −0.50 to 0.16; heavy drinking days: d = −0.07, 95% CI = −0.40 to 0.26]. Prevalence of negative effects was somewhat low (8–14%) in both intervention groups, as was deterioration (3–5%). Conclusions: At 6‐month follow‐up, there were no significant differences between a therapist‐guided high‐intensity internet intervention and an unguided low‐intensity internet intervention in reducing alcohol consumption among individuals with an alcohol use disorder. [ABSTRACT FROM AUTHOR]

This article provides practical guidance for researchers who wish to enroll and collect data from pediatric research participants through online and mobile platforms, with a focus on the involvement of both children and their parents in the decision to participate. [ABSTRACT FROM AUTHOR]

Objectives. To examine demand for abortion medications through an online telemedicine service in the United States. Methods. We examined requests from US residents to the online telemedicine abortion service Women on Web (WoW) between October 15, 2017, and August 15, 2018. We calculated the population-adjusted rate of requests by state and examined the demographics, clinical characteristics, and motivations of those seeking services, comparing those in states with hostile versus supportive abortion policy climates. Results. Over 10 months, WoW received 6022 requests from US residents; 76% from hostile states. Mississippi had the highest rate of requests (24.9 per 100 000 women of reproductive age). In both hostile and supportive states, a majority (60%) reported a combination of barriers to clinic access and preferences for self-management. Cost was the most common barrier (71% in hostile states; 63% in supportive states; P <.001). Privacy was the most common preference (49% in both hostile and supportive states; P =.66). Conclusions. Demand for self-managed medication abortion through online telemedicine is prevalent in the United States. There is a public health justification to make these abortions as safe, effective, and supported as possible. [ABSTRACT FROM AUTHOR]

Research on the longitudinal impact of using the internet as an information source on patients' beliefs and medication adherence is scarce. Chronic patients (N = 107) from six hospitals were surveyed to longitudinally explore their online information seeking behavior throughout treatment (i.e., before the consultation about their newly prescribed medication in the initiation phase and after six months in the implementation phase) and how this affects their medication beliefs (concerns and necessity) and medication adherence after three weeks (T1) and six months (T2). Most patients (79%) used the internet. Patients who used the internet before the consultation reported to have more concerns about their medication at T1 and T2 compared to those who did not. Moreover, patients who used the internet throughout treatment valued their concerns higher than the necessity after six months (T2). Patients who used the internet after the consultation reported to be more non-adherent after three weeks (T1) compared to those who did not. Because of the longitudinal nature of this study, we were able to pinpoint in which treatment phase patients' online information seeking behavior is particular relevant in affecting patients' beliefs and medication adherence. [ABSTRACT FROM AUTHOR]

Broadband internet access is a super-determinant of health that plays an important role in healthcare and public health outcomes. Laws and policies shape implementation and use of broadband for healthcare and public health. Connecting broadband and telehealth laws with their health impacts, through legal epidemiological research, enables states to make evidence-based decisions to improve health outcomes for underserved populations. [ABSTRACT FROM AUTHOR]

Objective: The primary aim of the study was to evaluate whether the WhatsApp application can be used for obtaining a quick second opinion on histopathological and cytological diagnosis and also for discussing difficult cases in pathology practice. Material and Method: A WhatsApp group named "FESPATH" was created with total of 17 pathologists (the authors of this manuscript as group administrators and 15 general pathologists from 7 different cities in Morocco, working in 12 different institutions as members). The group was used to discuss difficult routine sign out cases, to obtain a second opinion. Pathology-related academic files, books and links were also shared. At the end of 20 months, members were asked to complete a feedback questionnaire. Results: Over a 20-month period, 86 cases were discussed with 515 posted pictures. 78 cases were related to histopathology, and 8 cases to cytopathology. Twenty-one links regarding educational materials and books were also shared. A total of 14 participants out of 17 were active participants, and the majority of them found the discussions very useful for overcoming challenging cases. Conclusion: Sharing microphotographs of histopathological or cytological cases via WhatsApp is a very easy and fast method to obtain a second opinion in pathology practice and also to discuss difficult cases. [ABSTRACT FROM AUTHOR]

Objectives: Despite increasing research in obsessive compulsive disorder (OCD), a great deal still needs to be learned regarding how the disorder manifests in the juvenile population. This study sought to expound on previous research in adults to explore the characteristics of juveniles with OCD who are seeking help via the Internet, namely their OCD symptomology and its impact on disabilty and severity, and the value of a self-perception severity screener.Methods: This study utilized a population of 157 juveniles who were accessing an online website for program-guided treatment of OCD (ages 7 to 17 years, M = 14.55, SD = 2.33).Results: Results revealed that the most frequently reported subtype for juveniles was not just right (n = 73, 88.0%) followed by contamination (n = 58, 69.9%) OCD, almost half the participants 45% (n= 46) accurately reported their symptom severity, and over-reporting of symptom severity was associated with an increase in disability compared to both those who accurately reported [t(97) = −2.642, p = 0.010, r = .26] and under-reported [t(97) = −4.184, p < 0.001, r = .39] symptoms.Conclusions: Clinical implications (e.g., OCD severity ratings, symptom categories, disability ratings and treatment implications), limitations (e.g., lack of confirmed diagnoses and self-reported data), and future directions (i.e., replication studies with juvenile specific measures) are discussed. [ABSTRACT FROM AUTHOR]

Background: The development of efficacious, cost-effective, and widely accessible programs for the prevention of eating disorders (EDs) is crucial in order to reduce the ED-related burden of illness. Programs using dissonance-based and cognitive behavioral approaches are most effective for the selective prevention of ED. Internet-based delivery is assumed to maximize the reach and impact of preventive efforts. However, the current evidence for Internet-based ED prevention is limited. The present trial evaluates the efficacy and cost-effectiveness of two new interventions (based on dissonance theory and principles of cognitive behavioral therapy (CBT)) that are implemented as add-ons to the existing Internet-based ED prevention program ProYouth.Methods: The trial is one of five sub-projects of the German multicenter consortium ProHEAD. It is a three-arm, parallel, randomized controlled superiority trial. Participants will be randomized to (1) the online program ProYouth (active control condition) or (2) ProYouth plus a structured dissonance-based module or (3) ProYouth plus a CBT-based chat group intervention. As part of ProHEAD, a representative school-based sample of N = 15,000 students (≥ 12 years) will be screened for mental health problems. N = 309 participants at risk for ED (assessed with the Weight Concerns Scale (WCS) and the Short Evaluation of Eating Disorders (SEED)) will be included in the present trial. Online assessments will be conducted at baseline, at end of intervention (6 weeks), at 6 months follow-up, and - as part of ProHEAD - at 12 and 24 months follow-up. The primary outcome is ED-related impairment (assessed with the Child version of the Eating Disorder Examination-Questionnaire (ChEDE-Q)) at the end of the intervention. Secondary outcomes include ED-related symptomatology at follow-up, ED-related stigma, ED-related help-seeking, and acceptance of and compliance with the interventions. For the health economic evaluation data on costs of the interventions, healthcare utilization and health-related quality of life will be assessed.Discussion: This is the first study augmenting a flexible prevention approach such as ProYouth with structured evidence-based modules in order to overcome some of the key limitations in the current practice of ED prevention.Trial Registration: German Clinical Trials Register (DRKS), DRKS00014679 . Registered on 25 April 2018. [ABSTRACT FROM AUTHOR]

Cognitive Bias Modification to reduce threat interpretations (CBM-I) is a computer-based paradigm designed to train a less negative interpretation bias that has shown some success in the lab, but results for web-based CBM-I are often mixed. To test possible explanations for the poorer results online, participants high in social anxiety (N = 379) were recruited from Amazon’s Mechanical Turk to complete a single-session, proof-of-principle study to investigate: (1) whether web-based CBM-I can shift interpretations of social situations to be less negative and reduce anticipatory social anxiety, (2) whether a common “control” condition used in CBM-I studies is in fact inert by incorporating an alternate control condition, and (2) whether priming anxious imagery prior to training moderates CBM-I’s effects. Participants were randomly assigned to one of three training conditions: all positive, half positive/half negative, or neutral unemotional scenarios. Participants also received an anxious or neutral imagery prime before training. Although results were somewhat mixed across outcome measures, findings generally suggested that participants exhibited less negative interpretations of ambiguous social scenarios following positive training with an anxious imagery prime. There was also some evidence that the neutral training condition was associated with less negative interpretations, and evidence that the half positive/half negative training condition led to the least anticipatory anxiety, especially when paired with anxious imagery. Findings are discussed in light of different training effects for near- and far-transfer outcomes. [ABSTRACT FROM AUTHOR]

Introduction Systemic lupus erythematosus (SLE) has complex pathophysiology and treatments, and patients often use the internet to better understand their condition. This report systematically assesses the quality, reliability and readability of online information. Methods The search term ‘systemic lupus erythematosus’ was used with Google™, Bing™ and Yahoo™ search engines sequentially. The first 25 websites returned (‘hits’) for each search engine (total 75 websites) were compiled. The search terms ‘SLE’ and ‘lupus’ were used in separate Google searches to assess for commonality. After removal of excluded hits, websites were assessed using the DISCERN instrument, Journal of the American Medical Association benchmarks and Gunning Fog Index for quality, reliability and readability and presence of ‘Health on the Net Code’ (HoN) standardisation recorded. Results There was a large degree of commonality among hits from the three different search engines using the search term ‘systemic lupus erythematosus’, as well as hits returned for the three different search terms using Google. The mean DISCERN score was 47.7 (SD 13.2) for ‘systemic lupus erythematosus’, 46.4 (SD 14.2) for ‘SLE’ and 45.2 (SD 10.1) for ‘lupus’, with no statistically significant difference. The mean number of JAMA benchmarks (maximum four) present for the ‘systemic lupus erythematosus’, ‘SLE’ and ‘lupus’ searches was 1.3 (SD 1.2), 1.4 (SD 1.3) and 1.2 (SD 1.0), respectively, with no statistically significance difference. The average readability of hits for the three different search terms was 9.3 (SD 3.4), 10.0 (SD 3.1) and 11.1 (SD 2.7), with no statistically significant difference.Conclusion There was a large degree of commonality of hits among the different search engines and the utilised search terms but they are not synonymous. Regardless of search term, the overall quality of websites was fair, whilst reliability was poor. Websites appearing higher in searches did not score better. Presence of the HoN did not represent better quality. Readability was higher than recommended for near-universal understanding. There was no difference in quality, reliability or readability of websites using the search terms ‘systemic lupus erythematosus’, ‘SLE’ or ‘lupus’, with some high-scoring websites appearing in only one search term result. This study reminds clinicians to direct patients to high-quality websites rather than rely on search engines. [ABSTRACT FROM AUTHOR]

Internet-delivered cognitive behaviour therapy (ICBT) is often accompanied by therapist emails, but there is limited research on the quality of this therapist-assistance. In this study, an ICBT Therapist Rating Scale (ICBT-TRS) was developed and evaluated to assess whether therapist emails showed fidelity to specific therapist behaviours. Using data from a previous ICBT trial for depression and anxiety, the ICBT-TRS was used to rate 706 emails sent by 39 therapists to 91 randomly selected patients. Emails were rated for adherence (absent/present) and quality (inadequate/competent) on the following behaviours: Builds Rapport, Seeks Feedback, Provides Symptom Feedback, Provides Psychoeducation, Facilitates Understanding, Praises Effort, Encourages Practice, Clarifies Administrative Procedures, and Communicates Effectively. Inter-rater reliability was high. Most behaviours were identified as present in 72-100% of emails, with the exception of Provides Symptom Feedback and Facilitating Understanding which were only present in 54 and 61% of emails. The majority of emails were rated as high quality (88-98% of messages). While not related to symptom improvement, ICBT-TRS ratings were higher when patients were more engaged in ICBT (e.g. log-ins) and among therapists who specialized in ICBT or had a background in Psychology. The ICBT-TRS has potential to facilitate ICBT research and clinical training. [ABSTRACT FROM AUTHOR]

Context * Cupping is a complementary and alternative therapy that attracts much attention on social media. Objective * The study intended to examine the types of user-generated content found on YouTube on the practice of cupping therapy as a form of pain management. Design * The current research team searched YouTube for videos on cupping therapy on August 14, 2016. Setting * The Internet was accessed from Wayne, NJ, USA. Outcome Measures * The research team manually coded the 100 most widely viewed, cupping videos for content and sources. Logistic regression was applied to obtain the association of video source-consumer, news, or professional-to each of the 21 content categories. Results * In total, the 100 videos were viewed more than 36.80 million times. Among them, 52 were consumer videos; 16 were professional videos; and 32 were news videos. Compared to news videos, (1) the odds of consumer videos mentioning what cupping is were 85.90% lower-odds ratio (OR) = 0.14, 95% confidence interval (CI) (0.04 to 0.52), P < .01; (2) the odds of consumer videos and professional videos mentioning an increase in blood flow as a benefit were 93.50% lower-OR = 0.07, 95% CI (0.02 to 0.24), P < .01-and 82.80% lower-OR = 0.17, 95% CI (0.04 to 0.82), P = .03, respectively; and (3) the odds of consumer videos mentioning a decrease in inflammation as a benefit were 92.9% lower-OR = 0.07, 95% CI (0.02 to 0.21), P < .01. Conclusions * The current study found that, despite the large presence of consumer-based videos in YouTube regarding cupping therapy, news sources were more widely viewed. Health professionals could engage more with YouTube by providing clear and authentic information about a popular alternative therapy. [ABSTRACT FROM AUTHOR]

Background. This article examines personnel and patient experiences of videoconferencing (VC) trials on tablet computers between oncology certified nurses (OCNs) and patients with cancer who live at home. The study points to organizational pitfalls during the introduction process. In many different arenas, the use of VC has increased recently owing to improved Internet access and capacity. This creates new opportunities for contact between patients living at home and their nurses. Video conferencing presupposes knowledge about Internet access, training, and usability of technological equipment. The aim of this pilot study was to illuminate patients’ and nurses’ experiences of the technical functionality, usability, and training of tablet use in VC in primary cancer care. The results point to the drawbacks concerning the introduction of VC. Method. A pilot study with an explorative design was used to describe patients’ and OCNs’ experiences of technical functionality and usability of VC on tablet computers. After a three-month trial, data were gathered, focusing on both patients’ and nurses’ perspectives. Individual interviews with four female OCNs, aged 32–65 (mean 46), and six patients with cancer, two men and four women aged 49–78 (mean 69), were content-analyzed. Results. The analysis revealed two main categories: network connectivity and tablet usability and training and educational pitfalls. Conclusion. When planning VC implementation, the organizational leadership should consider network access and stability, as well as individualized VC training on tablets. Ensuring patient safety should also be a priority. Further research should provide knowledge of technological and educational pitfalls, and possible implications of VC on the care quality of nursing. [ABSTRACT FROM AUTHOR]

According to the growing interest in mobile healthcare, multi-document summarisation techniques are increasingly required to cope with health information overload and effectively deliver personalised online healthcare information. However, because of the peculiarities of medical terminology and the diversity of subtopics in health documents, multi-document summarisation must consider technical aspects that are different from those of the general domain. In this article, we propose a personalised health document summarisation system that provides a reliable personal health-related summary to general healthcare consumers via mobile devices. Our system generates a personalised summary from multiple online health documents by exploiting biomedical concepts, semantic types and semantic relations extracted from the Unified Medical Language System (UMLS) and analysing individual health records derived from mobile personal health record (PHR) applications. Furthermore, to increase the diversity and coverage of summarised results and to display them in a user-friendly manner on mobile devices, we create a summary that is categorised into subtopics by grouping semantically related sentences through topic-based clustering. The experimental evaluations demonstrate the effectiveness of our proposed system. [ABSTRACT FROM AUTHOR]

In today's communication landscape, the public often turn to the Internet and social media instead of their physician for health information. To remain relevant and respected amidst the wealth of health information available online, physicians need to offer something the Internet cannot fully emulate: empathetic imagination and an ability to instantaneously tailor messages to reach and teach worried and often confused audiences effectively. We developed an instructional communication module for pediatric residents that used applied improvisational theater to help residents develop complex and dynamic communication skills. The module included opportunities to develop empathy, practice audience analysis, distill messages to key points, and apply these skills in media and community contexts. Attendees completed surveys regarding their perceptions of curricular structure, efficacy, and utility. Preliminary results indicate gains in communication confidence and skills. This type of instructional communication and training module encourages healthcare practitioners to position themselves as trusted experts and partners in helping clients make meaning of health information, thus empowering a new generation of pediatricians to bridge communication gaps created by new technologies and increased access to multiple information sources. [ABSTRACT FROM AUTHOR]

This article addresses the design and study of novel interaction settings and systems supporting collocated interaction. More specifically, we aim to analyze the implications of two different interaction approaches, namely first-person and third-person interaction paradigms, and the corresponding theoretical approaches when designing and developing collocated experiences for children with Autism Spectrum Disorders (ASDs). This analysis is supported by the outcomes of several examples of full-body interaction collocated experiences aimed at promoting social initiation and collaboration. Moreover, we present a series of goal-driven guidelines to consider when designing with various interaction paradigms. Finally, we discuss future work to better understand the implications of constructing paradigms for the intuitive use of these full-body interaction systems. [ABSTRACT FROM AUTHOR]

Background: Internet-based applications are potentially useful and effective interventions to reach and support adolescents with mental health problems. Adolescents' commitment to the use of a new Internet-based intervention is closely related to the support they receive from healthcare professionals. This study describes nurses' experiences of the use of an Internet-based support system for adolescents with depressive disorders.Method: Qualitative descriptive study design including individual interviews with nine nurses at two psychiatric outpatient clinics. The Technology Acceptance Model (TAM) was used as the theoretical background of the study.Results: Nurses described several benefits of using the Internet-based support system in the care of adolescents with depressive disorders if the nurses integrate it into daily nursing practices. As perceived disadvantages the nurses thought that an adolescent's mental status might be a barrier to working with the support system. Perceived enablers could be organizational support, nurses' attitudes, and technology-related factors. Nurses' attitudes were identified as a barrier to supporting adolescents' use of the Internet-based support system.Conclusion: The findings suggest that the implementation plan and support from the organization, including that from nurse managers, are crucial in the process of implementing a technology-based support system. [ABSTRACT FROM AUTHOR]

Health information that French people can find on the Internet is poorly reported. This study evaluated asthma information on YouTube®. One hundred YouTube® videos are about asthma were analyzed according to a score of 30 items. A point was awarded or withdrawn depending on whether the information was correct or dangerous. Ratings ranged from –3 to 17 with an average of 4.4 out of 30. Thirteen videos received negative points. YouTube® videos analyzed were poor in scientific information. Some of them contained potentially dangerous information. After this work, an information video on asthma was produced. [ABSTRACT FROM AUTHOR]

Background: Challenges exist in recruiting an international sample of clinicians and researchers to an online survey. Traditional recruitment methods remain relevant but issues such as narrow geographical reach, high cost and time intensity limit what can be achieved when aiming to recruit an international, multi-disciplinary sample. Internet-mediated and social media approaches to recruitment and engagement offer new, untested ways of capitalizing upon existing professional networks. Objective: To develop, use and appraise a multi-modal recruitment strategy for an online, international survey regarding the management of shoulder pain. Methods: Traditional recruitment methods were combined with internet-mediated recruitment methods to form a multi-modal recruitment strategy. An overview of the development of this three-month recruitment strategy is provided and the value and role of each strand of the recruitment strategy discussed. Results: In response to the multi-modal recruitment strategy, data was received from 565 clinicians and researchers from 31 countries (64% UK). Complete data was received from 387 respondents with no demographic differences between respondents who completed, and those who started but did not complete the survey. Over 30% of responses were received within 1 week, 50% within 4 weeks and 81% within 8 weeks. Conclusions: This study shows the acceptability and international, multidisciplinary reach of a low cost multi-modal recruitment strategy for an online survey of international clinicians and researchers. Incorporating the use of social media proved to be an effective, time and resource-efficient recruitment strategy for this online survey and appeared to enhance clinician engagement. A multimodal recruitment strategy is worthy of consideration for future online surveys of clinicians and researchers. [ABSTRACT FROM AUTHOR]

Mixed anxiety and depression is common among older adults. The aim of the study was to compare the effects of an eight-week-long tailored internet-supported cognitive behaviour therapy (ICBT) programme and to compare against the provision of weekly general support. A second aim was to investigate if pre-treatment cognitive flexibility and self-reported cognitive problems would predict outcome. We included 66 older adults (aged over 60 years) with mixed anxiety/depression following media recruitment and randomised them into treatment and control groups. We also included a one-year follow-up. As a measure of executive function, we used the Wisconsin Card Sorting Test (perseverative errors) and the Cognitive Failures Questionnaire during the pre-treatment phase. Results showed a moderate between-group effect on the main outcome measure, the Beck Anxiety Inventory (BAI) (d=.50), favouring the treatment group. Nearly half (45.5%) of that group were classified as responders. One person (3%) in the treatment group deteriorated. There were significant correlations between perseverative errors and outcome (on the BAI r = −.45), but not among self-reported cognitive function. We conclude that guided, tailored ICBT may be effective for some older adults and that the role of cognitive function needs to be investigated further. [ABSTRACT FROM AUTHOR]

Cognitive-behavioral therapy (CBT), consisting of exposure and response prevention (EX/RP), is both efficacious and preferred by patients with obsessive-compulsive disorder (OCD), yet few receive this treatment in practice. This study describes the implementation of an Internet-based CBT program (ICBT) developed in Sweden in individuals seeking OCD treatment in New York. After translating and adapting the Swedish ICBT for OCD, we conducted an open trial with 40 adults with OCD. Using the RE-AIM implementation science framework, we assessed the acceptability, feasibility, and effectiveness of ICBT. The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) was the primary outcome measure. Of 40 enrolled, 28 participants completed the 10-week ICBT. In the intent-to-treat sample (N = 40), Y-BOCS scores decreased significantly over time (F = 28.12, df = 2, 49, p < . 001). Depressive severity (F = 5.87, df = 2, 48, p < . 001), and quality of life (F = 12.34, df = 2, 48, p < . 001) also improved. Sensitivity analyses among treatment completers (N = 28) confirmed the intent-to-treat results, with a large effect size for Y-BOCS change (Cohen's d = 1.38). ICBT took less time to implement than face-to face EX/RP and participants were very to mostly satisfied with ICBT. On a par with results in Sweden, the adapted ICBT program reduced OCD and depressive symptoms and improved quality of life among individuals with moderate to severe OCD. Given its acceptability and feasibility, ICBT deserves further study as a way to increase access to CBT for OCD in the United States. [ABSTRACT FROM AUTHOR]

Background: Large amounts of patient data are routinely manually collected in hospitals by using standalone medical devices, including vital signs. Such data is sometimes stored in spreadsheets, not forming part of patients' electronic health records, and is therefore difficult for caregivers to combine and analyze. One possible solution to overcome these limitations is the interconnection of medical devices via the Internet using a distributed platform, namely the Internet of Things. This approach allows data from different sources to be combined in order to better diagnose patient health status and identify possible anticipatory actions.Methods: This work introduces the concept of the Internet of Health Things (IoHT), focusing on surveying the different approaches that could be applied to gather and combine data on vital signs in hospitals. Common heuristic approaches are considered, such as weighted early warning scoring systems, and the possibility of employing intelligent algorithms is analyzed.Results: As a result, this article proposes possible directions for combining patient data in hospital wards to improve efficiency, allow the optimization of resources, and minimize patient health deterioration.Conclusion: It is concluded that a patient-centered approach is critical, and that the IoHT paradigm will continue to provide more optimal solutions for patient management in hospital wards. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Hoarding disorder (HD) is difficult to treat. In an effort to increase efficacy and engagement in cognitive‐behavioral therapy (CBT), we developed and evaluated a novel intervention comprising group CBT combined with between‐session Internet‐based clinician support for people with HD. Method: Twenty participants with HD received group CBT combined with an Internet‐support system enabling therapist–participant communication between group sessions. Results: The treatment was associated with a significant reduction on the Saving Inventory—Revised (SI‐R) and a large effect size (Cohen's d = 1.57) was found at posttreatment. Treatment gains were maintained at the 3‐month follow‐up. Group attendance was high and no participants dropped out from treatment prematurely. Between‐session motivational support from the therapist was most frequently mentioned as the main strength of the system. Conclusion: The results of this study support adding Internet‐based clinician support to group CBT for HD to increase treatment adherence and, potentially, improve the overall efficacy of CBT. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: The present study aims to investigate the impact of help‐seeking self‐stigma on the preference and intention to seek psychological treatment delivered online compared to face‐to‐face. Design: This study uses survey data from two Swedish samples. Sample 1 consists of 267 students (78.7% women) with a mean age of 24.5 (SD = 6.1). Sample 2 consists of 195 primary care patients (56.9% women) with a mean age of 45.3 (SD = 17.7). Results: The number of participants who preferred online treatment was higher if seeking psychological help for a perceived stigmatized problem compared to mental health problems in general. The odds ratios for choosing treatment online over face‐to‐face were 6.41, 95% CI [4.05, 10.14] in Sample 1 and 11.19, 95% CI [5.29, 23.67] in Sample 2. In addition, findings suggest that higher levels of help‐seeking self‐stigma predicted higher intention to seek treatment online compared to face‐to‐face. Conclusions: Our results suggest that online interventions may facilitate help‐seeking among individuals deterred by stigma. [ABSTRACT FROM AUTHOR]

Abstract: Aim: YouTube™ is an open‐access, nonpeer‐reviewed video‐hosting site and is used as a source of publicly available healthcare information. This study aimed to assess the thematic content of the most viewed videos relating to surgery and Crohn's disease and to explore the viewer interactions with these videos. Method: A search of YouTube™ was carried out using one search string. The 50 most viewed videos were identified and categorized by source and content themes and assessed for viewer interactions. Video comments were used to describe the usefulness of the video content to viewers. Results: The majority of videos were uploaded by patients (n = 21).The remainder were uploaded by individual healthcare professionals (n = 9), hospital/speciality associations (n = 18) and industry (n = 2). The median number of likes for patient videos was significantly higher than for hospital/speciality association videos (P < 0.001). Patient videos received more comments praising the video content (n = 27) and more comments asking for further information (n = 14). The median number of likes for ‘experience of surgery’ (P < 0.001) and ‘experience of disease’ (P = 0.0015) themed videos were significantly higher than for ‘disease management’ themed videos. Conclusion: Crohn's disease patients use YouTube™ as a surgical information source. The content of patient‐sourced videos focused on surgical and disease experience, suggesting that these themes are important to patients. Current patient developed videos provide limited information, as reflected by viewers requesting further information. Storytelling patient‐centred videos combined with clinical evidence may be a good model for future videos. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is a serious concern for women health. Providing enough information to these patients will increase awareness, level of participation and improve quality of care. To provide information through the internet, identifying information needs is essential. The purpose of this study was to identify information needs that can be available through Internet for women with breast cancer based on their perspectives. Methods: 120 women with breast cancer, who were familiar with the internet, entered to the study with convenient sampling method from Cancer Institute of Imam Khomeini hospital located in Tehran. The questionnaire was designed in seven areas: disease, treatment, daily activities, sexual health, and impact of disease on the family and private life, disease acceptance and self-image as well as other educational content based on a literature review and six sample portals. Descriptive statistics (frequency, mean and standard deviation) were used to analyze data by SPSS software. Results: The information content needed by patients on the internet, was in seven areas: Treatment (mean= 4.62 out of 5), daily activity (mean= 4.51 out of 5), disease (mean= 4.42 out of 5), disease acceptance and self-image (mean= 4.37 out of 5), the effect of disease on private life (mean= 4.21 out of 5), sexual health (mean= 4.2 out of 5) and other educational content (mean=4.55 out of 5). Conclusion: The need for information in the field of treatment is the most important needs of patients. They are interested in accessing through the online medium that provides them with information about cancer, decision making and treatment management. The care team can improve quality of care by providing information through the internet and portals. [ABSTRACT FROM AUTHOR]

Careful examination of communicative outcomes of mHealth technology is critical for understanding its capacity to shape the clinical interview and structure clinic communication. Drawing on a communicative affordances framework and adopting a video-based inductive analytic approach, we extend the concept of actualizations. We do so by examining the in situ communicative actions afforded by a mHealth web interface utilized during medication titration interviews with parents of children beginning stimulant medication for ADHD. We find that the web interface served five broad communicative functions that provided opportunities for improving information accuracy and for rendering clinical reasoning transparent, while jeopardizing opportunities for parents to narrativize medication experiences. We discuss clinical, theoretical, and methodological implications. [ABSTRACT FROM AUTHOR]

A study was carried out with an objective to ascertain the information source, identify the barriers and determine the facilitating factors to Internet use for information seeking in clinical practice. A survey was conducted in the two teaching hospitals i.e. the Children’s Hospital and the Institute of Child Health, Multan, and Nishtar Medical College and Hospital, Multan. The population of the study was doctors and nurses of the participating hospitals. A self-administered questionnaire was developed to collect the data on variables such as Internet use, use of information sources, barriers and facilitating factors to Internet use for information seeking A five-point Likert type scale (‘always’, ‘very often’, ‘sometimes’, ‘rarely’, and ‘never’) was used. The questionnaire was distributed among the respondents through convenience sampling. The collected data analyzed using Statistical Package for Social Sciences (SPSS-20) and presented in frequency, percentage, mean, standard deviation, and graphs. The results of the study concluded that majority of the respondents had access to Internet at their consultation/ nursing stations. They use Internet very often with the purpose of getting up-to-date information, to carry out research, teaching, and to find clinical information that in not available elsewhere. They very often seek information from books, printed journals, guidelines, web/Internet information documents, and medical representative. However, the barriers that prevented their use of Internet very often for information seeking from their practice settings were too much information to scan, toe slow Internet connection, and unreliability of the information. [ABSTRACT FROM AUTHOR]

Background: Healthcare systems in Sub-Saharan Africa (SSA) are fraught with numerous governance and infrastructural issues including lack of access to quality care and health worker shortage. Policy makers are becoming increasingly interested in adopting novel technologies such as web-based interventions within the scope of e-Health to bridge the gaps in care delivery in a cost-effective and sustainable manner. Successful implementation of these policies is reliant on evidences regarding people’s access to these technologies, which are scarce for countries in SSA. Objectives: To 1) investigate the variation in the prevalence of accessing computer and internet across regional and socioeconomic groups, and 2) assess association between ever accessing computer and internet and knowledge of routes and risk factors of HIV transmission in selected SSA countries. Methods: We analyzed cross-sectional datasets from UNICEF Multiple Indicator Cluster Surveys. Participants were16,194 men and 39,121 women from Ghana, Guinea Bissau, Malawi and Zimbabwe. Main outcome variable was ever-accessing computer and Internet for any purpose. Associations were assessed by multivariable regression methods. Results: Lifetime computer usage in Ghana, Guinea Bissau, Malawi and Zimbabwe was respectively 21.5%, 13.4%, 12.3%, 28.4% among men, and 12.5%, 8.3%, 4.8%, 20.5% among women, and that of internet was 14.9%, 11.7%, 10.8%, 34% among men, and 6.4%, 6.9%, 4.2%, 21.6% among women in the aforementioned order. Participants who reported ever using computer and Internet were more likely to have higher knowledge regarding the transmission of HIV compared to those who did not. Conclusions: Prevalence of lifetime access to computer and Internet was considerably low in all four countries. Several socioeconomic factors appeared to be associated with the access to computer and Internet, addressing which might prove beneficial for the successful expansion e-Health in these countries. [ABSTRACT FROM AUTHOR]

Abstract: Background and aim: The cost‐effectiveness of internet‐based smoking cessation interventions is difficult to determine when they are provided as a complement to current smoking cessation services. The aim of this study was to evaluate the cost‐effectiveness of such an alternate package compared with existing smoking cessation services alone (current package). Methods: A literature search was conducted to identify internet‐based smoking cessation interventions in the Netherlands. A meta‐analysis was then performed to determine the pooled effectiveness of a (web‐based) computer‐tailored intervention. The mean cost of implementing internet based interventions was calculated using available information, while intervention reach was sourced from an English study. We used EQUIPTMOD, a Markov‐based state‐transition model, to calculate the incremental cost‐effectiveness ratios [expressed as cost per quality‐adjusted life years (QALYs) gained] for different time horizons to assess the value of providing internet‐based interventions to complement the current package.). Deterministic sensitivity analyses tested the uncertainty around intervention costs per smoker, relative risks, and the intervention reach. Results: Internet‐based interventions had an estimated pooled relative risk of 1.40; average costs per smoker of €2.71; and a reach of 0.41% of all smokers. The alternate package (i.e. provision of internet‐based intervention to the current package) was dominant (cost‐saving) compared with the current package alone (0.14 QALY gained per 1000 smokers; reduced health‐care costs of €602.91 per 1000 smokers for the life‐time horizon). The alternate package remained dominant in all sensitivity analyses. Conclusion: Providing internet‐based smoking cessation interventions to complement the current provision of smoking cessation services could be a cost‐saving policy option in the Netherlands. [ABSTRACT FROM AUTHOR]

Introduction: In view of the popularity of Internet usage in Hong Kong, an interactive web-based drug information platform entitled "Ask My Pharmacist - Online University Led drug Enquiry Platform" (AMPOULE) was launched in 2009 to better serve the needs of drug information in Hong Kong. This paper aimed to evaluate the utility of AMPOULE in improving drug-related knowledge among the public and to reassess the needs of the general public in Hong Kong.Methods: All enquiries sent via AMPOULE were reviewed. Demographic data, nature of questions and types of drug class covered were analyzed. The workload of pharmacists was examined with respect to the preparation time needed for the enquiry, the lag days to reply and also the timing of enquiry recipient.Results: 2122 enquiries were received from 2009 to 2017. Most enquirers were from Hong Kong (56.6%) and female gender (49.2%). 13% of the concerned subjects were aged over 61-year-old. The most frequent types of questions and medications covered were "Drug Ingredients and Indications" (28.0%) and Adverse Drug Reactions (26.8%) and "Cardiovascular Medication" (21.9%) respectively but these varied in different age groups or enquirer groups. The median time for preparation was 40.0 min (IQR: 25-65 min) while the median time lag was found to be 2.5 days (IQR: 1.0-5.0 days). The number of enquiries received was evenly distributed throughout the day except during 1:00 am to 9:00 am and 7:00 pm to 8:00 pm.Conclusion: AMPOULE has demonstrated that an online platform providing patient-oriented drug information service through the Internet is promising and further promotion is warranted. Current data suggested that the need of different age groups and enquirer groups are different and should therefore be individualized. [ABSTRACT FROM AUTHOR]

Purpose: Reliance on online health information is proliferating and the Internet has the potential to revolutionize the provision of public health information. The anonymity of online health information may be particularly appealing to people seeking advice on 'embarrassing' health problems. The purpose of this study was to investigate (1) whether data generated by the embarrassingproblems.com health information site showed any temporal patterns in problem resolution, and (2) whether successful resolution of a medical problem using online information varied with the type of medical problem.Methods: We analyzed the responses of visitors to the embarrassingproblems.com website on the resolution of their problems. The dataset comprised 100,561 responses to information provided on 77 different embarrassing problems grouped into 9 classes of medical problem over an 82-month period. Data were analyzed with a Bernoulli Generalized Linear Model using Bayesian inference.Results: We detected a statistically important interaction between embarrassing problem type and the time period in which data were collected, with an improvement in problem resolution over time for all of the classes of medical problem on the website but with a lower rate of increase in resolution for urinary health problems and medical problems associated with the mouth and face. As far as we are aware, this is the first analysis of data of this nature.Conclusions: Findings support the growing recognition that online health information can contribute to the resolution of embarrassing medical problems, but demonstrate that outcomes may vary with medical problem type. The results indicate that building data collection into online information provision can help to refine and focus health information for online users. [ABSTRACT FROM AUTHOR]

Problem gambling creates significant harm for the gambler and for concerned significant others (CSOs). While several studies have investigated the effects of individual cognitive behavioral therapy (CBT) for problem gambling, less is known about the effects of involving CSOs in treatment. Behavioral couples therapy (BCT) has shown promising results when working with substance use disorders by involving both the user and a CSO. This pilot study investigated BCT for problem gambling, as well as the feasibility of performing a larger scale randomized controlled trial. 36 participants, 18 gamblers and 18 CSOs, were randomized to either BCT or individual CBT for the gambler. Both interventions were Internet-delivered self-help interventions with therapist support. Both groups of gamblers improved on all outcome measures, but there were no differences between the groups. The CSOs in the BCT group lowered their scores on anxiety and depression more than the CSOs of those randomized to the individual CBT group did. The implications of the results and the feasibility of the trial are discussed. [ABSTRACT FROM AUTHOR]

Introduction: Advancement in the field of information technology and rise in the use of Internet has changed the lives of people by enabling various services online. In recent times, healthcare sector which faces its service delivery challenges started promoting and using mobile health applications with the intention of cutting down the cost making it accessible and affordable to the people.Objectives: The objective of the study is to perform sentiment analysis using the Twitter data which measures the perception and use of various mobile health applications among the citizens.Methods: The methodology followed in this research is qualitative with the data extracted from a social networking site "Twitter" through a tool RStudio. This tool with the help of Twitter Application Programming Interface requested one thousand tweets each for four different phrases of mobile health applications (apps) such as "fitness app", "diabetes app", "meditation app", and "cancer app". Depending on the tweets, sentiment analysis was carried out, and its polarity and emotions were measured.Results: Except for cancer app there exists a positive polarity towards the fitness, diabetes, and meditation apps among the users. Following a system thinking approach for our results, this paper also explains the causal relationships between the accessibility and acceptability of mobile health applications which helps the healthcare facility and the application developers in understanding and analyzing the dynamics involved the adopting a new system or modifying an existing one. [ABSTRACT FROM AUTHOR]

Abstract: Background and aims: Millions of people world‐wide use websites to help them quit smoking, but effectiveness trials have an average 34% follow‐up data retention rate and an average 9% quit rate. We compared the quit rates of a website using a new behavioral approach called Acceptance and Commitment Therapy (ACT; WebQuit.org) with the current standard of the National Cancer Institute's (NCI) Smokefree.gov website. Design: A two‐arm stratified double‐blind individually randomized trial (n = 1319 for WebQuit; n = 1318 for Smokefree.gov) with 12‐month follow‐up. Setting: United States. Participants: Adults (n = 2637) who currently smoked at least five cigarettes per day were recruited from March 2014 to August 2015. At baseline, participants were mean [standard deviation (SD)] age 46.2 years (13.4), 79% women and 73% white. Interventions: WebQuit.org website (experimental) provided ACT for smoking cessation; Smokefree.gov website (comparison) followed US Clinical Practice Guidelines for smoking cessation. Measurements: The primary outcome was self‐reported 30‐day point prevalence abstinence at 12 months. Findings: The 12‐month follow‐up data retention rate was 88% (2309 of 2637). The 30‐day point prevalence abstinence rates at the 12‐month follow‐up were 24% (278 of 1141) for WebQuit.org and 26% (305 of 1168) for Smokefree.gov [odds ratio (OR) = 0.91; 95% confidence interval (CI) = 0.76, 1.10; P = 0.334] in the a priori complete case analysis. Abstinence rates were 21% (278 of 1319) for WebQuit.org and 23% (305 of 1318) for Smokefree.gov (OR = 0.89 (0.74, 1.07; P = 0.200) when missing cases were imputed as smokers. The Bayes factor comparing the primary abstinence outcome was 0.17, indicating ‘substantial’ evidence of no difference between groups. Conclusions: WebQuit.org and Smokefree.gov had similar 30‐day point prevalence abstinence rates at 12 months that were descriptively higher than those of prior published website‐delivered interventions and telephone counselor‐delivered interventions. [ABSTRACT FROM AUTHOR]