Search

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]

Rapid proliferation in state-of-the art technologies has revolutionized the medical market for providing urgent, effective and economical health facilities to aging society. In this context media (i.e., video) transmission is considered as a quite significant step during first hour of the emergency for presenting a big and better picture of the event. However, the energy hungry media transmission process and slow progress in battery technologies have become a major and serious problem for the evolution of video technology in medical internet of things (MIoT) or internet of medical things (IoMT). So, promoting Green (i.e., energy-efficient) transmission during voluminous and variable bit rate (VBR) video in MIoT is a challenging and crucial problem for researchers and engineers. Therefore, the need arose to conduct research on Green media transmission techniques to cater the need of upcoming wearable healthcare devices. Thus, this research contributes in two distinct ways; first, a novel and sustainable Green Media Transmission Algorithm (GMTA) is proposed, second, a mathematical model and architecture of Green MIoT are designed by considering a 8-min medical media stream named, 'Navigation to the Uterine Horn, transection of the horn and re-anastomosis' to minimize transmission energy consumption in media-aware MIoT, and to develop feasible media transmission schedule for sensitive and urgent health information from physian to patients and vice vers through extremely power hungry natured wearable devices. The experimental results demonstrate that proposed GMTA saves energy up to 41%, to serve the community. [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]

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]

Over the past few years, activity recognition techniques have attracted unprecedented attentions. Along with the recent prevalence of pervasive e-Health in various applications such as smart homes, automatic activity recognition is being implemented increasingly for rehabilitation systems, chronic disease management, and monitoring the elderly for their personal well-being. In this paper, we present WITS, an end-to-end web-based in-home monitoring system for convenient and efficient care delivery. The system unifies the data- and knowledge-driven techniques to enable a real-time multi-level activity monitoring in a personalized smart home. The core components consist of a novel shared-structure dictionary learning approach combined with rule-based reasoning for continuous daily activity tracking and abnormal activities detection. WITS also exploits an Internet of Things middleware for the scalable and seamless management and learning of the information produced by ambient sensors. We further develop a user-friendly interface, which runs on both iOS and Andriod, as well as in Chrome, for the efficient customization of WITS monitoring services without programming efforts. This paper presents the architectural design of WITS, the core algorithms, along with our solutions to the technical challenges in the system implementation. [ABSTRACT FROM AUTHOR]

Purpose: Quality of life (QoL) measurement relies upon participants providing meaningful responses, but not all respondents may pay sufficient attention when completing self-reported QoL measures. This study examined the impact of careless responding on the reliability and validity of Internet-based QoL assessments.Methods: Internet panelists (n = 2000) completed Patient-Reported Outcomes Measurement Information System (PROMIS®) short-forms (depression, fatigue, pain impact, applied cognitive abilities) and single-item QoL measures (global health, pain intensity) as part of a larger survey that included multiple checks of whether participants paid attention to the items. Latent class analysis was used to identify groups of non-careless and careless responders from the attentiveness checks. Analyses compared psychometric properties of the QoL measures (reliability of PROMIS short-forms, correlations among QoL scores, "known-groups" validity) between non-careless and careless responder groups. Whether person-fit statistics derived from PROMIS measures accurately discriminated careless and non-careless responders was also examined.Results: About 7.4% of participants were classified as careless responders. No substantial differences in the reliability of PROMIS measures between non-careless and careless responder groups were observed. However, careless responding meaningfully and significantly affected the correlations among QoL domains, as well as the magnitude of differences in QoL between medical and disability groups (presence or absence of disability, depression diagnosis, chronic pain diagnosis). Person-fit statistics significantly and moderately distinguished between non-careless and careless responders.Conclusions: The results support the importance of identifying and screening out careless responders to ensure high-quality self-report data in Internet-based QoL research. [ABSTRACT FROM AUTHOR]

Three-way decision models and their relative applications have received a great deal of research attention. Most of these models were constructed on the basis of decision-theoretic rough sets (DTRSs) and Bayesian decision theory, both of which ignore the risk preferences of decision-makers. To address this shortcoming, this paper constructs a novel TODIM method-based three-way decision model and demonstrates its use in the context of online diagnosis and medical treatment selection. This model combines information systems and DTRSs together to construct a hybrid information system. And it solves the problems in aggregating cost-loss information with different levels of importance by utilizing the power average operator. Furthermore, an extension of the TODIM method is proposed based on the novel possibility degree measurement considering the probability distribution of loss functions. To validate the reasonableness and effectiveness of our model, we give a series of simulation experiments related to treatment selection for a Good Doctor Online user infected with the common cold. [ABSTRACT FROM AUTHOR]

Purpose: The aim of our study was to investigate Internet and eHealth usage, with respect to eHealth literacy, by cancer patients and their relatives. Patients and methods: Using a standardized questionnaire we asked patients who attended lectures on complementary medicine in 2016. Results: We received 142 questionnaires. The frequency of general Internet usage was directly associated with younger age and better Internet connection. Younger participants were not only more confident in allocating health-related Internet information into reliable or unreliable facts, but also more confident and capable of gaining medical knowledge through eHealth services. A regular use of eHealth services facilitated the decision-making process. Reading ability was associated with a better understanding regarding eHealth offers. Conclusion: In a modern health care system, emphasis should be on skills contributing to eHealth literacy among patients to improve their ability to profit from eHealth offers and improve health care. [ABSTRACT FROM AUTHOR]

This study investigated a technology-enhanced training protocol to facilitate dissemination of therapist training on cognitive behavior therapy (CBT) for anxiety disorders. Seventy community clinicians received an online tutorial followed by live remote observation of clinical skills via videoconference. Impact of training on patient outcomes was also assessed. Training resulted in a significant increase in both trainee knowledge of CBT concepts and techniques and therapist competence in applying these skills. Patients treated by trainees following training had significant reductions in anxiety and depression. Ratings of user satisfaction were high. Results provide support for the use of these technologies for therapist training in CBT. [ABSTRACT FROM AUTHOR]

Background: The acceptability, feasibility and effectiveness of web-based interventions among criminal justice involved populations are understudied. This study is a secondary analysis of baseline characteristics associated with criminal justice system (CJS) status as treatment outcome moderators among participants enrolling in a large randomized trial of a web-based psychosocial intervention (Therapeutic Education System [TES]) as part of outpatient addiction treatment. Methods: We compared demographic and clinical characteristics, TES participation rates, and the trial's two co-primary outcomes, end of treatment abstinence and treatment retention, by self-reported CJS status at baseline: 1) CJS-mandated to community treatment (CJS-mandated), 2) CJS-recommended to treatment (CJS-recommended), 3) no CJS treatment mandate (CJS-none). Results: CJS-mandated ( n = 107) and CJS-recommended ( n = 69) participants differed from CJS-none ( n = 331) at baseline: CJS-mandated were significantly more likely to be male, uninsured, report cannabis as the primary drug problem, report fewer days of drug use at baseline, screen negative for depression, and score lower for psychological distress and higher on physical health status; CJS-recommended were younger, more likely single, less likely to report no regular Internet use, and to report cannabis as the primary drug problem. Both CJS-involved (CJS -recommended and -mandated) groups were more likely to have been recently incarcerated. Among participants randomized to the TES arm, module completion was similar across the CJS subgroups. A three-way interaction of treatment, baseline abstinence and CJS status showed no associations with the study's primary abstinence outcome. Conclusions: Overall, CJS-involved participants in this study tended to be young, male, and in treatment for a primary cannabis problem. The feasibility and effectiveness of the web-based psychosocial intervention, TES, did not vary by CJS-mandated or CJS-recommended participants compared to CJS-none. Web-based counseling interventions may be effective interventions as US public safety policies begin to emphasize supervised community drug treatment over incarceration. [ABSTRACT FROM AUTHOR]

Background: War-torn populations are often hard to screen for mental health disorders. Classical data collection approaches, such as paper-based, online, or SMS-operated, are either infeasible or lack accuracy due to a variety of challenges associated with dynamics and consequences of war.Methods: In this paper, we introduce a novel approach for accurate and fast screening using free open-source software, Open Data Kit (ODK) mobile application. This approach was developed by the Palestine Children's Relief Fund (PCRF) to assess the mental health symptoms of 986 Palestinian children (age 6-18) in the aftermath of Israel's Operation Protective Edge (OPE) in 2014. The organization developed assessment questionnaires and trained local field workers on the use of the mobile application, and on recruiting and interviewing war victims.Results: War-affected children were found to suffer from several alarming symptoms associated with post-traumatic stress disorder (PTSD), depression, and somatic symptoms. Children with highest number of psychological symptoms were referred for further evaluation and treatment.Conclusions: The use of ODK mobile technologies facilitated efficient screening of affected children in war zones. The offline data collection capability was crucial for handling the difficult conditions associated with war-torn areas, enabling timely intervention for urgent cases. Further applications of the novel mobile technology are to be explored. [ABSTRACT FROM AUTHOR]

Internet-based interventions have emerged as a new treatment and intervention modality for psychological disorders. Given their features of treatment flexibility, anonymity and confidentiality, this modality may be well suited in the management of addictive behaviours. A systematic literature review of the effectiveness and treatment outcomes of Internet-based interventions for smoking cessation, problematic alcohol use, substance abuse and gambling was performed. Studies were included if they met the following criteria: clients received a structured therapeutic Internet-based intervention for a problematic and addictive behaviour; included more than five clients; effectiveness was based on at least one outcome; outcome variables were measured before and immediately following the interventions; had a follow-up period; and involved at least minimal therapist contact over the course of the program. Sixteen relevant studies were found; nine addressed the effects of Internet-based interventions on smoking cessation, four on gambling, two on alcohol and one on opioid dependence. All studies demonstrated positive treatment outcomes for their respective addictive behaviours. The current review concluded that Internet-based interventions are effective in achieving positive behavioural change through reducing problematic behaviours. This mode of therapy has been found to have the capacity to provide effective and practical services for those who might have remained untreated, subsequently reducing the barriers for help-seekers. This in turn provides imperative information to treatment providers, policy makers, and academic researchers. [ABSTRACT FROM AUTHOR]

Lower pole calyceal stones (LPS) represent lower spontaneous passage rates and, therefore, require several interventional treatment approaches. The aim of this survey study was to investigate the attitudes of the urology practitioners and the factors affecting their decision making in the management of small asymptomatic LPS. A total of 149 urologists participated to the study via email through the internet-based website. Participating urologists were asked to complete a 29-question survey including personal and academic data, level of surgical experience, available equipment for interventional approaches, which treatment do they prefer for small LPS (≥5 mm and <1 cm), and factors affecting their treatment decision. All data were analyzed to make inferences related with treatment decision and factors affecting decision-making. Mean participant age was 41.57 (26-62) years. The most preferred approach was observation/medical treatment option (52.3 %), subsequently SWL (25.5 %), RIRS (16.1 %), miniPNL (5.4 %) and standard PNL (0.7 %) were chosen by the participants. On the other side, SWL and medical treatment were at the forefront (52 and 16.1 %) among children. In the multivariate analysis of participants' age, academic status, surgical experience and institution, none was significantly associated with treatment decision-making ( p > 0.05). The most important factors associated with decision making were calyceal dilatation (85.9 %) and patient preferences (81.2 %). The other factors effecting treatment decision were reported to be recurrent disease (70.5 %), the duration of the stone (74.5 %), patient age (95.3 %), current guidelines (87.9 %), stone density (50.3 %), body mass index (BMI) (73.8 %) and other morbid diseases (91.9 %). Our surveys' greatest value is in demonstrating the preferred treatment options and factors effecting decision-making in the treatment of LPS. The most preferred option in our population was follow-up and medical treatment. The most influencing factors on decision-making were age, patients' preferences, presence of calyceal dilatation, body mass index, comorbid conditions, available options for stone treatment and the surgeon's experience on the existing opportunities. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated thyroid cancer (TC) survivors' perceived satisfaction with and perceptions of survivorship care follow-up options.Methods: Well-differentiated TC (WDTC) patients receiving follow-up care at an academic cancer centre completed a questionnaire assessing perceived satisfaction with follow-up care involving different clinicians and mediated by the Internet (email or videoconference) and their perceptions of these follow-up options. We examined associations between patient characteristics and perceived satisfaction with follow-up care options. Qualitative responses were analysed using conventional content analysis.Results: Two hundred and two respondents completed the questionnaire (80 % response rate). The majority strongly agreed or agreed that they would be satisfied with specialist (surgeon, oncologist, or endocrinologist) follow-up (90.6 %) or a shared-care model that integrates specialists with primary care (67.5 %). One third (32 %) would be satisfied with video-based and 26 % with email-based specialist follow-up, 15 % with primary care alone. Longer time since diagnosis and health-related Internet use were associated with higher perceived satisfaction with Internet-based follow-up. Younger age was associated with higher perceived satisfaction with primary care follow-up. Qualitative responses (n = 145) revealed that survivors need reassurance they are receiving adequate care, regardless of the model or medium. Enablers to primary care and Internet-based follow-up are discussed.Conclusions: WDTC survivors want specialists involved in their follow-up. A specialist/primary care shared-care approach appears to be a suitable alternative to specialist-led follow-up for TC survivors. Internet-based visits could address some aspects of follow-up care for some WDTC survivors. Future work should examine patient and provider requirements for shared, multi-modal survivorship care. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate the feasibility of an online self-management application (OncoKompas) among cancer survivors. In OncoKompas, cancer survivors can monitor their quality of life (QOL) via participant reported outcomes (PROs) ("Measure"), which is followed by automatically generated individually tailored feedback ("Learn") and personalized advice on supportive care services ("Act").Methods: A pretest-posttest design was used, conducting a survey before providing access to OncoKompas, and 2 weeks after, followed by an interview by a nurse. Adoption was defined as the percentage of cancer survivors that agreed to participate in the study and returned the T0 questionnaire. Implementation was defined as the percentage of participants that actually used OncoKompas as intended (T1). General satisfaction was assessed based on the mean score of three study-specific questions: (1) general impression of OncoKompas, (2) the user-friendliness, and (3) the ability to use OncoKompas without assistance (10-point Likert scales). Furthermore, satisfaction was measured with the Net Promotor Scale (NPS).Results: OncoKompas was feasible with an adoption grade of 64 %, an implementation grade of 75-91 %, a mean satisfaction score of 7.3, and a positive NPS (1.9). Sociodemographic and clinical factors and QOL were not associated with satisfaction. Several facilitators and barriers related to the feasibility of OncoKompas were identified.Conclusion: OncoKompas is considered feasible, but has to be further improved. In order to enhance feasibility and increase satisfaction, we have to balance the time it takes to use OncoKompas, measurement precision, and tailoring towards personalized advices. [ABSTRACT FROM AUTHOR]

Purpose: This study evaluated the efficacy of a self-guided Web-based cognitive behaviour therapy (CBT) intervention compared to an attention control in improving cancer-related distress, health-related quality of life (HRQOL), and maladaptive coping, among people recently diagnosed with cancer.Methods: Sixty individuals with cancer diagnosed in the previous 6 months and receiving treatment with curative intent were randomised to receive either the 6-week intervention Cancer Coping Online (CCO: n = 30) or the 6-week Web-based attention control (n = 30). Outcome measures, including cancer distress (the Posttraumatic Stress Scale - Self-Report), general distress (Depression Anxiety Stress Scale), quality of life (EORTC QLQ-C30), and coping (mini-MAC), were administered at baseline, immediately post-intervention, and at 3 and 6 months post-intervention.Results: Significant main effects for time were found for cancer distress, global QOL, physical function, role function, social function, and anxious preoccupation. Post hoc between-group comparisons showed CCO participants had statistically significantly higher physical functioning compared to controls at 3 months of follow-up (d = -0.52, p = 0.02). Furthermore, compared to controls, post hoc comparisons found moderate between-group effect sizes favouring CCO post-intervention for cancer distress (d = 0.43) and anxious preoccupation (d = 0.38), and at 6 months of follow-up for global QOL (d = -0.43).Conclusions: These results provide preliminary support for the potential efficacy of a self-guided Web-based CBT programme in improving aspects of HRQOL, cancer-related distress, and anxious preoccupation after cancer diagnosis. This paper provides justification for, and will help inform the development of, subsequent larger multi-site studies. [ABSTRACT FROM AUTHOR]

Background: Permanently recalled drugs are a public health concern if they remain accessible in violation of applicable regulation. Illicit online pharmacies act as an alternative form of access and have been associated with the sale to patients of counterfeit/falsified/fraudulent/substandard drugs. We wished to determine if permanently recalled and significantly restricted drugs were illegally marketed for sale online.Objective: The study was conducted in two phases with two objectives. The first phase attempted to identify drugs subject to permanent recall in certain major pharmaceutical markets as well as those listed as recalled or significantly restricted by the United Nations. We also examined the market authorization status of identified drugs in China and India. The second phase used structured searches on the Internet to determine if identified drugs were marketed for sale online.Setting: The World Wide Web.Method: After identification of permanently recalled and restricted drugs we conducted Internet searches for illegal "no prescription" marketing events. We assessed the form of marketing, whether a site offered direct-to-patient sale, use of social media marketing, and the site's compliance status with external monitoring bodies.Main Outcome: Number of recalled drugs marketed as available for purchase on the Internet.Results: We identified 16 class I equivalent permanently recalled or restricted drugs, 56.3 % (n = 9) of which maintained market authorization in either China or India. Half (n = 8) were marketed for sale online without a prescription direct-to-patient. Use of social media marketing was mixed, with only 18.8 % (n = 3) of recalled drugs having a presence on Facebook, though 50.0 % (n = 8) had content on Twitter. We also found the majority (68.8 %, n = 11) were available and marketed for sale by vendors on the wholesale/business-to-business website alibaba.com primarily as active pharmaceutical ingredient.Conclusion: Despite efforts in several countries to restrict access to these drugs or permanently remove them from the market, our study indicates that various sources actively market recalled drugs for sale online. Drug regulators, public health agencies, and law enforcement officials should act with urgency to appropriately restrict and regulate these sales to protect global patients and consumers. [ABSTRACT FROM AUTHOR]

The remote health monitoring system enables a doctor to diagnose and monitor health problems anywhere for a patient. However, since the patient health information is very sensitive and the Internet is unsecure and prone to many attacks, data can be easily compromised by adversaries. Worse, the mobile phone is also easy to be compromised. Clearly, these issues have brought different privacy and security requirements in wireless healthcare. To address these challenging issues, in this paper, we propose an efficient privacy-preserving authentication scheme with adaptive key evolution, which can prevent illegal access to the patient's vital signs. Furthermore, we model the leakage process of the key information to set proper key renewal interval, which can adaptively control the key evolution to balance the trade-off between the communication efficiency and security level. The security analysis demonstrates that our scheme can achieve authenticated key agreement, perfect and strong key insulation, privacy preservation, and other important security goals, e.g. authenticity, integrity and freshness of transmitted messages. The performance evaluation shows that our scheme is computationally efficient for the typical mobile phone with limited resources, and it has low communication overhead. [ABSTRACT FROM AUTHOR]

With the explosive growth of biomedical information volumes, there is obviously an increasing need for developing effective and efficient tools for indexing and retrieval. Automatic indexing and retrieval in the biomedical domain is faced with several challenges such as recognition of terms denoting concepts and term disambiguation. In this paper, we are interested in identifying (sub-)domains of concepts in ontologies. We propose two algorithms for identifying the most appropriate (sub-)domain of a concept in the context of a document/query. We integrate these methods into a semantic indexing and retrieval framework. The experimental evaluation carried out on the OHSUMED collection shows that our approaches of semantic indexing and retrieval outperform the state-of-the-art approach. [ABSTRACT FROM AUTHOR]

Online health communities (OHCs) are an important source of social support for cancer survivors and their informal caregivers. This research attempted to identify leaders in a popular online forum for cancer survivors and caregivers using classification techniques. We first extracted user features from many different perspectives, including contributions, network centralities, and linguistic features. Based on these features, we leveraged the structure of the social network among users and generated new neighborhood-based and cluster-based features. Classification results revealed that these features are discriminative for leader identification. Using these features, we developed a hybrid approach based on an ensemble classifier that performs better than many traditional metrics. This research has implications for understanding and managing OHCs. [ABSTRACT FROM AUTHOR]

The primary aim of the present study was to evaluate if previously reported treatment gains of a parent management training (PMT) program, administered via Internet, were retained from post to the 18-month follow-up. Another aim was to evaluate homework compliance as a predictor of short and long-term outcomes. Participants were parents of 58 children (3-11 years) with conduct problems who received a 10-week self-directed PMT program, with limited therapist support. Parents of 32 children (55.2 %) responded at all measurement point (baseline, post-test and follow-up) and analyses showed that child conduct problems continued to decrease during the 18-month period after the intervention whereas parenting skills deteriorated somewhat from post treatment. Pre- to post-treatment change in child conduct problems was predicted by parental engagement in homework assignments intended to reduce negative child behaviors. The findings provide support for the use of Internet-based PMT and stress the importance of parental compliance to homework training. [ABSTRACT FROM AUTHOR]

This paper proposes a healthcare solution that enables the sharing of medical videos in areas without satellite, broadband or mobile internet connectivity. Rural areas often encounter issues such as shortage of electricity, poor telecommunication services and lack of health facilities which have led to a deficiency of medical care in remote areas. The deployment of mobile devices for healthcare services is vital to alleviating these concerns. A majority of mobile device owners are located in developing nations, and the number of users is continually rising. These technologies effectively support remote health care due to their low-power requirements, multiple functionalities and custom applications. The Mobile Imagery eXchange (MIX) toolkit is a software application capable of converting echocardiogram videos into text for transmission through short message service (SMS), over a global system for mobile communications network. A smartphone or computer installed with the MIX toolkit can be utilized to deliver effective medical care within rural regions. To significantly shrink data size, video, image and file processing techniques are applied for analysis, segmentation, compression and conversion. Experiments show that data size reduction rates above 60 until 95 % are achievable when transforming imagery into text. Furthermore, in optimal conditions, the average SMS per image ranges from 9 to 23 text messages. [ABSTRACT FROM AUTHOR]

BACKGROUND: In an era of personalized medicine, individualized risk assessment using easily available tools on the internet and the literature are appealing. However, uninformed use by clinicians and the public raises potential problems. Herein, we assess the performance of published models to predict insignificant prostate cancer (PCa), using a multi-national low-risk population that may be considered for active surveillance (AS) based on contemporary practice. METHODS: Data on men suitable for AS but undergoing upfront radical prostatectomy were pooled from three international academic institutions in Cambridge (UK), Toronto (Canada) and Melbourne (Australia). Four predictive models identified from literature review were assessed for their ability to predict the presence of four definitions of insignificant PCa. Evaluation was performed using area under the curve (AUC) of receiver operating characteristic curves and Brier scores for discrimination, calibration curves and decision curve analysis. RESULTS: A cohort of 460 men meeting the inclusion criteria of all four nomograms was identified. The highest AUCs calculated for any of the four models ranged from 0.618 to 0.664, suggesting weak positive discrimination at best. Models had best discriminative ability for a definition of insignificant disease characterized by organ-confined Gleason score ≤ 6 with a total volume ≤ 0.5 ml or 1.3 ml. Calibration plots showed moderate range of predictive ability for the Kattan model though this model did not perform well at decision curve analysis. CONCLUSIONS: External assessment of models predicting insignificant PCa showed moderate performance at best. Uninformed interpretation may cause undue anxiety or false reassurance and they should be used with caution. [ABSTRACT FROM AUTHOR]

Cloud computing brings several advantages such as flexibility, scalability, and ubiquity in terms of data acquisition, data storage, and data transmission. This can help remote healthcare among other applications in a great deal. This paper proposes a cloud based framework for speech enabling healthcare. In the proposed framework, the patients or any healthy person seeking for some medical assistance can send his/her request by speech commands. The commands are managed and processed in the cloud server. Any doctor with proper authentication can receive the request. By analyzing the request, the doctor can assist the patient or the person. This paper also proposes a new feature extraction technique, namely, interlaced derivative pattern (IDP), to automatic speech recognition (ASR) system to be deployed into the cloud server. The IDP exploits the relative Mel-filter bank coefficients along different neighborhood directions from the speech signal. Experimental results show that the proposed IDP-based ASR system performs reasonably well even when the speech is transmitted via smart phones. [ABSTRACT FROM AUTHOR]

Health information portals (HIPs) are now well-established channels for providing reliable and relevant health information as a service to health information consumers. The concept of a smart health information portal was proposed to improve the search experience of HIP users, advancing HIPs learning capability by looking at usage data. This paper describes a design-science research project which utilized insights from usage data to address search issues. A conceptual approach and an architecture to enable usage-driven capability are described. We propose two specific applications, a HIP-specific content issue reporting tool and a topic search feature, to demonstrate how usage data can enhance HIP operations and users' search experience. Based on the demonstrated implementations and empirical analysis, this paper also discusses how usage-driven design can lead to improved service in online health information provision. [ABSTRACT FROM AUTHOR]

Purpose: Internet treatments have the potential to improve access, especially for cultural groups who face considerable treatment barriers. This study explored the perceived barriers and likelihood of using Internet and face-to-face treatments for depression among Chinese and Caucasian Australian participants. Methods: Three-hundred ninety-five (289 Chinese, 106 Caucasian) primary care patients completed a questionnaire about depression history, previous help-seeking, perceived barriers to Internet and face-to-face treatment, and likelihood of using either treatment for depressive symptoms. Results: Internet treatment reduced perceived barriers (including stigma, lack of motivation, concerns of bringing up upsetting feelings, time constraints, transport difficulties, and cost) for both groups to a similar degree, except for time constraints. There were heightened concerns about the helpfulness, suitability, and confidentiality of Internet treatments. Chinese participants and individuals with a probable depression history reported increased perceived barriers across treatments. Both Chinese and Caucasian groups preferred face-to-face treatment across depression severity. However, when age was controlled, there were no significant concerns about Internet treatment, and face-to-face treatment was only preferred for severe depression. Only 12 % of the entire sample refused to try Internet treatment for depression. Endorsement of perceived Internet treatment barriers (including concerns of bringing up upsetting feelings, that treatment would be unhelpful or unsuitable, lack of motivation, cost, cultural sensitivity, and confidentiality) reduced the likelihood to try Internet treatments. Conclusions: Internet treatment reduced perceived treatment barriers across groups, with encouraging support for Internet treatment as an acceptable form of receiving help. Negative concerns about Internet treatment need to be addressed to encourage use. [ABSTRACT FROM AUTHOR]

Purpose: Internet treatments may overcome barriers and improve access to mental health services for people who do not access professional help. It may be particularly beneficial for Chinese Australians, a group that tends to delay and underutilize face-to-face treatments. This study explored the appeal of Internet therapy to Chinese- and English-speaking Australians with depression who accessed Internet-delivered cognitive behavioural therapy (iCBT) programs. Methods: Data collected from previous randomised controlled trials of iCBT depression programs were used. Using a matched samples design, 55 Chinese- and 55 English-speaking iCBT participants with depression were matched on age, gender, and depression screener scores. They were compared on their symptom severity, previous help-seeking patterns, and reasons for seeking Internet treatment. Results: The Chinese-speaking participants had significantly milder depressive symptoms and were less likely to have previously sought professional help compared to the English-speaking participants (all ps < 0.05). Both groups endorsed similar number of reasons for seeking iCBT, and the most common reasons related to reduced structural barriers. However, the Chinese-speaking participants were more likely to seek iCBT due to lack of knowledge about face-to-face treatment ( p = 0.005), while the English-speaking participants were more likely to report not benefiting from traditional help ( p = 0.030). Conclusions: The attraction of iCBT appears to be the reduction of structural barriers to treatment. iCBT may reduce treatment delay and increase access to Chinese Australians who have not sought professional help. English-speaking Australians are seeking iCBT as an additional means of getting help. [ABSTRACT FROM AUTHOR]

Since its introduction in dermatology in the late 1990s optical coherence tomography (OCT) has been used to study many skin diseases, in particular non-melanoma skin cancer and it s precursors. Special attention has been paid to superficial basal cell carcinoma (BCC), and a number of smaller observational studies have been published. The diagnostic criteria for BCC of these studies are systematically reviewed. A systemic review of English language studies was performed using PubMed, Google Scholar and Royal Danish Library, to search for primary papers on OCT and BCC. The references of retrieved papers were searched by hand for further relevant papers. A total of 39 papers were identified (search date: 2014-01-15). 22 were excluded because they did not meet the inclusion criteria, leaving 17 papers for analysis. In 100 % of the studies, rounded dark structures in the upper dermis surrounded by a hyperreflective halo possibly surrounded by a hyporeflective border and disruption of epidermal layering were described. In 53 % of the reports a hyporeflective lateral tumour border was described. A range of other features were mentioned in a minority of the studies. It is suggested that these diagnostic criteria could be characteristic for identifying BCC lesions using OCT. [ABSTRACT FROM AUTHOR]

In this paper we present an e-Health framework model that can dynamically provide context-aware multimedia services to a user. The framework collects live user context by analyzing sensory data obtained from a body sensor network and multimedia content available from live heterogeneous Internet-based services. Finally, we share the implementation details and test results. [ABSTRACT FROM AUTHOR]

Limited bandwidth resources lead to a number of challenges especially for eHealth applications, which are communicated over IP and wireless networks. These multimedia services include high-resolution videos and have very large file sizes that require a high level of compression to overcome this limitation. Therefore, there is an acute demand for the research community to provide an efficient multimedia framework to encode medical videos with high quality specifically under the conditions of an error-prone environment. Both an affordable delivery framework and effective coding techniques are extremely desirable for the delivery of high-quality eHealth video applications for transmission over heterogeneous networks and devices. In this paper, we propose and demonstrate a multimedia framework to support eHealth applications, which has an improved coding scheme that uses an SVC-scalable extension of MPEC-4 AVC/H.264. Simulation results show that the proposed scheme achieves a significant improvement in terms of the PSNR-Y gain and reduces the picture quality degradation caused by artifacts and distortions, compared to the existing scheme. [ABSTRACT FROM AUTHOR]

In general, on-line medical consultation reduces time required for medical consultation and induces improvement in the quality and efficiency of healthcare services. The scope of study includes several key features of present day e-health applications such as X-ray, ECG, video, diagnosis images and other common applications. Moreover, the provision of Quality of Service (QoS) in terms of specific medical care services in e-health, the priority set for e-health services and the support of QoS in wireless networks and techniques or methods aimed at IEEE 802.11 to secure the provision of QoS has been assessed as well. In e-health, medical services in remote places which include rustic healthcare centres, ships, ambulances and home healthcare services can be supported through the applications of e-health services such as medical databases, electronic health data and the transferring of text, video, sound and images. Given this, a proposal has been made for a multiple service wireless networking with multiple sets of priorities. In relation to the terms of an acceptable QoS level by the customers of e-health services, prioritization is an important criterion in a multi-traffic network. The requirement for QoS in medical networking of wireless broadband has paved the way for bandwidth prerequisites and the live transmission or real-time medical applications. The proposed wireless network is capable of handling medical applications for both normal and life-threatening conditions as characterized by the level of emergencies. In addition, the allocation of bandwidth and the system that controls admittance designed based on IEEE 802.16 especially for e-health services or wireless telemedicine will be discussed in this study. It has been concluded that under busy traffic conditions, the proposed architecture can used as a feasible and reliable infrastructure network for telemedicine. [ABSTRACT FROM AUTHOR]

The theme of ISOQOL's 19th Annual Conference in Budapest, Hungary, was The Journey of Quality of Life Research: A Path Towards Personalized Medicine. Innovations in e- health was one of four plenary panels. E-health is changing the landscape of clinical practice and health care, but the best way to leverage the many promised benefits of emerging e-health technologies is still not clear. The Innovations in e-health panel presented emerging changes in technologies and applications that will facilitate clinical decision making, improve quality and efficiency of care, engage individuals in clinical decision making, and empower them to adopt healthy behaviors. The purpose of this paper was to present emerging trends in e-health and considerations for successful adoption of new technologies, and an overview of each of the presentations in the e-health plenary. The presentations included a personal perspective on the use of technology for self-monitoring in Parkinson's disease, an overview of online social networks and emerging technologies, and the collection of patient-reported outcomes through web-based systems in clinical practice. The common thread across all the talks was the application of e-health tools to empower individuals with chronic disease to be actively engaged in the management of their health. Considerations regarding data ownership and privacy, universal access to e-health, interactivity between different types of e-health technologies, and tailoring applications to individual needs were explored. [ABSTRACT FROM AUTHOR]

BACKGROUND/OBJECTIVES: The primary aim of this secondary analysis was to compare changes in dietary intake among participants randomized to two versions of a 12-week commercial web-based weight loss program (basic or enhanced) with a waiting-list control. An additional investigation compared changes in dietary intake of successful participants (weight loss ≥5%) with those not successful. SUBJECTS/METHODS: Dietary intake was assessed at baseline and 12 weeks using a validated 120-item semiquantitative food frequency questionnaire. Adults (n=268, 60% female participants, body mass index 32.1±3.9) classified as plausible reporters of energy intake were included in the analyses. Analysis of covariance with baseline observations carried forward for drop-outs (n=38) was used. RESULTS: The basic and enhanced groups significantly increased their percentage of energy contribution from fruits and reduced energy-dense, nutrient-poor foods compared with controls (P<0.001). Successful participants (n=49) reported superior improvements in dietary intake including greater reductions in the mean daily energy intake (P<0.001), the percentage of energy from energy-dense, nutrient-poor foods (-12.0% E vs -4.3% E, P<0.001) and greater increases in the energy contribution from fruits (P<0.001), vegetables (P=0.003) and breads/cereals (P=0.02). CONCLUSIONS: Use of a commercial web-based weight loss program facilitated some improvements in the dietary intake. The enhanced web-based tools appeared not to have generated greater improvements in reported dietary intake, compared with the basic or control groups. Those who achieved a weight loss of ≥5% improved their dietary intake in line with the program recommendations and dietary guidelines. Further research to determine web-based components that may improve success and the reasons why programs are successful for some participants is required. [ABSTRACT FROM AUTHOR]

Chelation products can be helpful in the treatment of metal poisoning. However, many unapproved products with unproven effectiveness and safety are marketed to consumers, frequently via the internet. This paper describes the primary responsibility of the Health Fraud and Consumer Outreach Branch of the United States Food and Drug Administration to identify and address health fraud products. Efforts to prevent direct and indirect hazards to the population’s health through regulatory actions are described. [ABSTRACT FROM AUTHOR]

We carried out a systematic review of the literature to identify the association between the use of drain and the incidence of infections and recurrences after surgery. MEDLINE, SCOPUS and ISI databases were searched up to September 2012. The two outcomes of this meta-analysis were wound infection and recurrence. Postoperative wound infection occurred in 50 of the 604 (8.28 %) patients who underwent drainage and in 68 of the 598 (11.4 %) patients who did not, with a resulting odds ratio (OR) of 0.71 (95 % CI: 0.48–1.03). Recurrence of pilonidal sinus occurred in 41 of the 604 (6.79 %) patients who underwent drainage and in 50 of the 598 (8.36 %) patients who did not, with a resulting OR of 0.80 (95 % CI: 0.52–1.23). The results suggest that, despite a trend toward a reduction in infectious complications and recurrence, drainage was not associated with a better outcome. However, because of the present literature’s limitations, further studies are needed to address this issue. [ABSTRACT FROM AUTHOR]

The aim of this study was to systematically review CBF studies, assess their methodological quality, and identify trends in the association between task-related brain activation patterns and CBF changes in ischemic stroke (IS) patients. We searched the MEDLINE, EMBASE, CINAHL, and Web of Sciences databases for studies of functional recovery with quantification of CBF responses to brain activation paradigms after IS. Titles, abstracts and full text of articles were scrutinised according to pre-defined selection criteria. Two independent reviewers (AS, VH) undertook the methodological quality screening and data extraction of the included studies. Sixteen of the 1,521 identified studies were relevant. Studies showed weaknesses in key methodological criteria (e.g. population size, discussion of limitations), and only seven studies compared responses with a control population. Overall, there was no agreement between CBF responses in either the affected or unaffected hemisphere and prediction of post-IS recovery. Some studies have shown a higher CBF increase in the unaffected hemisphere when the affected hemisphere was stimulated compared to the healthy control responses. However, CBF responses in the affected hemisphere were inconsistent. Many post-IS CBF studies are of poor methodological quality, and do not demonstrate a consistent response post-IS or a relationship with recovery. Further longitudinal studies assessing the natural history of CBF responses to brain paradigms following IS should be undertaken to determine prognostic significance, and to inform future therapeutic strategies. [ABSTRACT FROM AUTHOR]

Diagnostic imaging techniques have evolved with technological advancements - but how far? The objective of this article was to explore the electromagnetic spectrum to find imaging techniques which may deliver diagnostic information of equal, or improved, standing to conventional radiographs and to explore any developments within radiography which may yield improved diagnostic data. A comprehensive literature search was performed using Medline, Web of Knowledge, Science Direct and PubMed Databases. Boolean Operators were used and key-terms included (not exclusively): terahertz, X-ray, ultraviolet, visible, infra-red, magnetic resonance, dental, diagnostic, caries and periodontal. Radiographic techniques are primarily used for diagnostic imaging in dentistry, and continued developments in X-ray imaging include: phase contrast, darkfield and spectral imaging. Other modalities have potential application, for example, terahertz, laser doppler and optical techniques, but require further development. In particular, infra-red imaging has regenerated interest with caries detection in vitro, due to improved quality and accessibility of cameras. Non-ionising imaging techniques, for example, infra-red, are becoming more commensurate with traditional radiographic techniques for caries detection. Nevertheless, X-rays continue to be the leading diagnostic image for dentists, with improved diagnostic potential for lower radiation dose becoming a reality. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the scientific contribution of Brazilian Spine Surgeons not only in number of publications but also in their quality between January 2000 to December 2011. Methods: A literature search of publications by Brazilian spinal surgeons on topics concerning the spine or spinal cord was performed using an online database; Pubmed.gov. The results were limited to articles published from January 2000 to December 2011. A total of 1,778 articles were identified after a Medline search. After exclusion criteria, the study comprised 206 articles. The quality of the Journals was assessed with IF and the article quality using the Oxford classification. Results: An increasing number of publications by Brazilian spine surgeons was observed in recent years: 45.1 % of those papers were published during the last 4 years (2008-2011). Clinical studies and case reports were the most frequent types of article published (37.5 vs 31.1 %). An increasing number of Brazilian publications in non-Brazilian journals has been observed in recent years (linear-by-linear association: 5.449, P = 0.020). The Arquivos de Neuro-Psiquiatria was the most frequent journal in which the papers were published ( N = 67, 32 %). The IF of the publications varied from 0.021 to 8.017. The analysis of quality of the articles using the Oxford classification demonstrated that most of them provided LOE 4 ( N = 113, 54.9 %) or 5 ( N = 45, 21.8 %). Conclusions: There have been an increasing number of publications by Brazilian spine surgeons in recent years and the quality of the articles published has improved. Also the number of publications by Brazilians in non-Brazilian journals has increased in recent years. [ABSTRACT FROM AUTHOR]

Aim: To report the development and evaluation of an evidence-based, online, patient assessment tool, capable of measuring oral health status, future disease risk and capitation fee guidance.Methods: An online integrated oral health and risk assessment tool called DEPPA was developed, incorporating 1) PreViser(™) risk scores for periodontal disease, caries, non-carious tooth surface loss and oral cancer, 2) revised versions of Denplan Excel's Oral Health Score and 3) capitation fee guidance score. DEPPA was piloted by 25 dentists who provided quantitative and qualitative feedback.Results: Six hundred and forty assessments were performed. There was strong agreement on the need for such a tool, that it constituted a comprehensive assessment and supported good patient communication. The validity of the system was perceived as sound and the revised capitation fee guidance broadly welcomed. While some deemed the caries risk scoring algorithm to be too sensitive, the 30% high/very high risk rating is consistent with current rates of active caries in UK adults.Conclusions: A viable online oral health and risk-assessment tool has been developed (DEPPA) that will allow dental teams to measure oral health status, future disease risk and receive ongoing guidance on capitation fee setting. The indications are that DEPPA could be a valuable audit, care planning and patient communication tool. [ABSTRACT FROM AUTHOR]

Aim: The purpose of the present study was to conduct a systematic review and meta-analysis of the published literature to assess the diagnostic performance of FDG-PET or PET/CT in the detection of recurrent colorectal cancer (CRC) rising in patients with elevated CEA. Materials and methods: The authors conducted a systematic MEDLINE search of published articles. Two reviewers independently assessed the methodological quality of each study. We estimated pooled sensitivity and specificity and positive and negative likelihood ratios, and summary receiver-operating characteristic curves in the detection of recurrent CRC in patients with elevated CEA. Results: Eleven studies with a total of 510 patients met the inclusion criteria. One hundred and six patients (106/510 = 20.8 %) had true-negative FDG-PET (PET/CT) results in detection of recurrent CRC when rising CEA. The pooled estimates of sensitivity and specificity and positive and negative likelihood ratios of FDG-PET in the detection of tumor recurrence in CRC patients with elevated CEA were 90.3 % (95 % CI, 85.5-94.0 %), 80.0 % (95 % CI, 67.0-89.6 %), 2.88 (95 % CI, 1.37-6.07), and 0.12 (95 % CI, 0.07-0.20), respectively. The pooled estimates of sensitivity and specificity and positive and negative likelihood ratios of FDG-PET/CT in the detection of tumor recurrence in CRC patients with elevated CEA were 94.1 % (95 % CI, 89.4-97.1 %), 77.2 % (95 % CI, 66.4-85.9 %), 4.70 (95 % CI, 0.82-12.13), and 0.06 (95 % CI, 0.03-0.13), respectively. Conclusions: Whole-body FDG-PET and PET/CT are valuable imaging tools for the assessment of patients with suspected CRC tumor recurrence based on the increase of CEA. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine whether the protein tyrosine phosphatase nonreceptor 22 (PTPN22) C1858T polymorphism confers susceptibility to rheumatoid arthritis (RA) in populations with different ethnicities. MEDLINE database and manual search were utilized to identify articles in which the PTPN22 polymorphism was determined in RA patients and controls. A meta-analysis was conducted on the associations between the PTPN22 C1858T polymorphism and RA using (1) allelic contrast and (2) dominant model. A total of 30 separate comparisons involving 17,961 RA patients and 18,611 controls were considered in this meta-analysis. Meta-analysis showed an association between the T allele and RA in all subjects (OR = 1.490, 95 % CI = 1.332-1.668, P < 1.0 × 10). After stratification by ethnicity, analysis indicated that the T allele was significantly associated with RA in Europeans and in Non-Europeans (OR = 1.423, 95 % CI = 1.260-1.605, P = 1.0 × 10; OR = 1.902, 95 % CI = 1.488-2.430, P = 2.8 × 10). Meta-analysis of the CT + TT genotype showed the same result patterns as that shown by the PTPN22 C1858T polymorphism T allele. Furthermore, a direct comparison between rheumatoid factor (RF)-positive and RF-negative subjects revealed a significant association with the T allele in RA patients with RF, but not in subjects without RF (OR = 1.561, 95 % CI = 1.373-1.775, P < 1.0 × 10). This meta-analysis confirms that the PTPN22 C1858T polymorphism is associated with RA susceptibility in different ethnic groups, especially in Europeans, and the PTPN22 C1858T polymorphism T allele is significantly more prevalent in RF-positive patents than in RF-negative patients. [ABSTRACT FROM AUTHOR]

Purpose: The internet has revolutionised the way we search for information. We determined the level of internet use by parents of children attending general surgical services and identified trends in online information-seeking behaviour. Methods: A questionnaire based on the work by Boston and Tassone was distributed to parents attending both the day surgical units and surgical outpatients department in a paediatric tertiary referral centre. Results: There were 214 (82.3 %) questionnaires returned, with 82 (38.3 %) of respondents having searched the internet regarding their child's surgical issue. Access to a smartphone, a university education and private health insurance were factors that positively influenced online searching ( p < 0.005). Of those respondents who searched the internet, 42 (51 %) felt that information they found online was understandable, while only 14 (17 %) admitted to online sourced information influencing the treatment decisions they had made for their children. When asked to rank information sources on Likert-type scales in terms of importance; parents ranked the surgeon as most important (mean = 4.73), whilst the internet ranked lowest (mean = 3.02). Conclusion: We demonstrated significant use of the internet amongst those attending paediatric general surgical services. Clinician sourced information remains important, however we should engage with patients to utilise this vast resource effectively. [ABSTRACT FROM AUTHOR]

There has been an increased use of modern information and communication technology in healthcare services in recent years; however, little is yet known about the nature of the therapeutic alliance in internet-based interventions. This review aims to give a systematic overview of controlled evaluation studies with a focus on the nature and impact of the therapeutic alliance in internet-based interventions available to date. The results of internet-based randomized controlled trials indicate that a positive therapeutic alliance can be established regardless of the medium of communication. The therapeutic alliance was rated equally satisfying as in conventional face-to-face therapy. [ABSTRACT FROM AUTHOR]

Background: To systematically analyse evidence on the incremental effect of work-related psychosocial risk factors on the development of neck and shoulder disorders, as reported in longitudinal studies. Methods: A systematic literature search was conducted in three data bases (MEDLINE, EMBASE, and PsychINFO) until May 2009. The quality assessment leading to a methodological quality score of the included studies was conducted by two independent reviewers using a standardised checklist. Criteria for the evaluation of evidence were established. Heterogeneity analyses were conducted. Results: Altogether 18 prospective longitudinal studies were included in the analysis. Potential psychosocial risk factors were mainly based on the job demand control (support) model by Karasek (). Study results were too heterogeneous to deduce pooled risk estimates. But the weight of evidence was strong for an incremental effect of job demands, job control, social support, and job strain, on the development of neck and/or shoulder disorders. Conclusion: While we found evidence for an incremental effect of different psychosocial work factors (in addition to the effect of physical job factors), these results have to be interpreted carefully in order to support the notion that psychological factors can have an independent causal influence on the development of musculoskeletal disorders. Nevertheless, our findings are important for the development of preventive strategies, as they stress the need for preventive approaches that tackle both physical and psychosocial factors. Future research is warranted to consolidate and strengthen the results of this review. [ABSTRACT FROM AUTHOR]

Background: Surgical procedures are complex motion sequences that require a high level of preparation, training, and concentration. In recent years, Internet platforms providing surgical content have been established. Used as a surgical training method, the effect of multimedia-based training on practical surgical skills has not yet been evaluated. This study aimed to evaluate the effect of multimedia-based training on surgical performance. Methods: A 2 × 2 factorial, randomized controlled trial with a pre- and posttest design was used to test the effect of multimedia-based training in addition to or without practical training on 70 participants in four groups defined by the intervention used: multimedia-based training, practical training, and combination training (multimedia-based training + practical training) or no training (control group). The pre- and posttest consisted of a laparoscopic cholecystectomy in a Pelvi-Trainer and was video recorded, encoded, and saved on DVDs. These were evaluated by blinded raters using a modified objective structured assessment of technical skills (OSATS). The main evaluation criterion was the difference in OSATS score between the pre- and posttest (ΔOSATS) results in terms of a task-specific checklist (procedural steps scored as correct or incorrect). Results: The groups were homogeneous in terms of demographic parameters, surgical experience, and pretest OSATS scores. The ΔOSATS results were highest in the multimedia-based training group (4.7 ± 3.3; p < 0.001). The practical training group achieved 2.5 ± 4.3 ( p = 0.028), whereas the combination training group achieved 4.6 ± 3.5 ( p < 0.001), and the control group achieved 0.8 ± 2.9 ( p = 0.294). Conclusion: Multimedia-based training improved surgical performance significantly and thus could be considered a reasonable tool for inclusion in surgical curricula. [ABSTRACT FROM AUTHOR]

Internet-based mental health services increase rapidly. However, national surveys are incomplete and the consequences for such services are poorly discussed. This study describes characteristics of 60 Internet-based mental health services in Norway and Sweden and discusses their social consequences. More than half of the services were offered by voluntary organisations and targeted towards young people. Professionals answered service users' questions in 60% of the services. Eight major themes were identified. These characteristics may indicate a shift in the delivery of mental health services in both countries, and imply changes in the understanding of mental health. [ABSTRACT FROM AUTHOR]

Two-photon laser scanning microscopy (TPLSM), relying on two-photon excitation restricted to the focal plane, has become the gold standard in biomedical research because of its ability to produce high-resolution, higher penetrating imaging of biological materials over an extended duration without an significant photobleaching. Intravital (in vivo) imaging using TPLSM for intra-abdominal organs has long been a technical challenge because of the difficulty of achieving high-quality and higher magnification imaging with acceptable cardiac and respiratory motion artifacts. A method of intravital TPLSM was developed using an organ-stabilizing system for imaging the intra-abdominal organs of green fluorescent protein transgenic mice. This method was further refined for the time-series imaging of intra-abdominal organs in the same mouse model using intravital TPLSM. These procedures allow the observation of not only a single cell or tissue microenvironment at a higher penetrating depth for a longer period of time but also to observe the same organ of the same mouse at multiple time points in preclinical models. This report presents the general principles and properties of TPLSM for biomedical research. In addition, the methods and the usefulness of time-series intravital TPLSM imaging for preclinical gastrointestinal diseases is discussed. [ABSTRACT FROM AUTHOR]

Social software allows users to communicate and share data through online social interaction using Web 2.0 technology. Three hundred and fifty-six members of the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) within the UK and Ireland were invited by e-mail to complete an online survey (e-survey) anonymously on their knowledge and use of Web 2.0 technology and whether they would like this to be used in BAPRAS's e-Learning for Plastic, Reconstructive and Aesthetic Surgery (e-LPRAS). Fifty-eight members completed the e-survey (response rate of 58 out of 356 or 16.3%). The respondents comprised 52 males (89.7%) and 6 females (10.3%) with a mean age (range) of 44.1 years (24-61). Forty one (70.7%) were consultants and 17 (29.3%) were non-consultants with a mean time (range) at this level of 10.1 years (1-30) and 3.4 years (1-6), respectively. The mean (range) ages of consultants and non-consultants were 48.7 years (35-61) and 32.8 years (24-38), respectively. Fifty-eight (100%) plastic surgeons used the Internet and e-mail, 48 (82.8%) owned a handheld device and 48 (82.8%) owned a digital media player. Sixteen plastic surgeons (27.6%) used instant messaging, 29 (50.0%) used Internet telephone, 12 (20.7%) used videoconferencing, 23 (39.7%) used media sharing, 2 (3.4%) used social bookmarking, 21 (36.2%) used social networking, 24 (41.4%) used forums, 29 (50.0%) used podcasts, 1 (1.7%) contributed to a wiki, 6 (10.3%) wrote a blog and 18 (31.0%) read a blog. Non-consultants were more likely to use social networking and forums than consultants. Forty-one (70.7%) plastic surgeons used e-learning, and 31 (53.4%) would like Web 2.0 technology to be used in e-LPRAS, whilst 5 (8.6%) would not and 22 (37.9%) do not know what Web 2.0 technology is. Most respondents either used Web 2.0 technology or were aware of it. Over half of respondents would like Web 2.0 technology to be used in e-LPRAS. We recommend that BAPRAS adopts Web 2.0 technology in their development of e-LPRAS. [ABSTRACT FROM AUTHOR]