Search

Social media platforms are increasingly used by patients to research and discuss medical problems.The aim of this study was to identify by whom, how frequently, and in what manner allergic contact dermatitis (ACD) is discussed on social media sites.Search terms "allergic contact dermatitis" and "contact dermatitis" were queried across Twitter, Instagram, Reddit, Facebook, YouTube, and Google search metrics. The frequency, content, and creators of the content were assessed.ACD content was identified on all platforms, generated by by patients, physicians, professional organizations, and companies. When comparing the volume of posts, more content was on Instagram than Twitter, particularly among patients. Patient support groups were identified on Facebook but not on Reddit. A formal analysis of YouTube videos found that the medical information presented in these videos was often of poor quality.Patch testing physicians should be aware that information on ACD exists across social media sites. While some content is generated by physicians, patients and industry groups also post and share material. Patch testing physicians should know that there is an opportunity to share ACD information, but they should also be aware that patients are posting and creating online support communities independent of physicians.Online support communities exist for patients with ACD on Facebook. Online information is of lower quality, with a mean QUEST quality score of 7.4/28 on reviewed YouTube videos. Of the five social media sites reviewed, patients are most active on Instagram, Reddit, and Facebook. Approximately 9000 Google searches per month are conducted using contact dermatitis-related search terms. Differences in terminology exist between physicians and non-physicians. While the most popular hashtag term was "contact dermatitis", physicians disproportionately authored posts tagged with "allergic contact dermatitis."

Aim Previous research has shown that individuals with inflammatory bowel disease avoid specific food items, such as fibre rich foods, in order to manage symptoms. Dietary fibre and the traditional Mediterranean diet are both associated with reduced mucosal and systemic inflammation, gut barrier integrity, and microbiota diversity. There is limited data on the diet composition of individuals with inflammatory bowel disease. The aim of this study was to evaluate how it compares to the traditional Mediterranean diet and national dietary guidelines. Methods Outpatients with inflammatory bowel disease were recruited to the study between February and August 2019. Demographic and medical information was obtained for consenting participants. All participants completed a dietary assessment of usual intake (24-h diet recall and 17-point ready reckoner) from which a Mediterranean diet adherence score was calculated. Dietary intake of core food groups was compared to the recommended number of serves outlined in the Australian Guide to Healthy Eating. Results 100 participants were recruited. The mean Mediterranean diet adherence score was 5.1 ± 1.3 (maximum 14 points), 4% of participants scored ≥9 (commonly agreed criteria for Mediterranean diet adherence). Participants also consumed considerably less grains and vegetables than national dietary guidelines recommendations. Conclusions The diet of outpatients with inflammatory bowel disease did not align with Mediterranean diet characteristics. Participants consumed significantly less grains and vegetables than national guidelines, suggesting a low fibre intake. These findings suggest that dietary interventions focusing on improving the diet of individuals with inflammatory bowel disease to align with Mediterranean diet characteristics are warranted.

The Script Concordance Test (SCT) is an educational tool that aims to assess the ability to interpret medical information under conditions of uncertainty. It is widely used and validated in health education, but almost unknown in dentistry. Based on authentic clinical problem-solving situations, it allows to assess clinical reasoning that experienced health workers develop over the years. A specific scoring system, dedicated to SCT, considers the variability of responses of practitioners in the same clinical situations. Finally, the scores generated by SCT reflect the respondents' ability to interpret clinical data compared to experienced clinicians. This article aims to familiarise the dental educators' community with SCT construction, optimisation and its possible applications.

Shared decision-making (SDM), the cornerstone of family-centred care and the gold standard in health decision-making, occurs when the patient, family members and the health-care team members partner to make health decisions about the child. This partnership involves an exchange of medical information and information about patient/family preferences and values. Together, the health-care team, parent and patient deliberate to determine the best course of action for the child. Despite high-quality evidence supporting its positive impact on outcomes, SDM has not been widely adopted in paediatric clinical practice. Greater understanding of the impact of SDM on all members of the decision triad (parent, patient and health-care provider) may increase the likelihood of SDM adoption. Therefore, we present the viewpoints of a paediatric patient, parent and paediatrician about the use of SDM. A youth living with a rare chronic disease discusses the impacts of being involved and excluded from health decisions. A mother of a son living with a rare nephrotic condition discusses working with a health-care team who are committed and skilled in SDM and the positive impacts SDM has had for her son's care. A general paediatrician with research expertise in SDM discusses the individual and system level challenges and rewards of using SDM in her clinical practice. Based on the viewpoints presented, we offer pragmatic recommendations for using SDM in paediatric clinical practice.

Patients increasingly rely on online resources for medical information; however, the Internet is unregulated and prone to misinformation. This study analyzes the reliability, quality, and readability of websites for Ménière's disease.A Google search was performed using keywordsAmbulatory.None.Forty-two websites were analyzed. Academic institutions were the most common (n = 13, 31%) but scored the lowest using DISCERN at 1.75 ± 0.13. Medical information websites scored highest at 2.24 ± 0.09 (Most top online search results for Ménière's disease are deficient in quality and readability. Medical information websites are generally the most reliable and easy to read.

Monitoring various medical information distributed throughout the body is of great importance in early clinic diagnosis and treatment of disease. To discover abnormal medical signals and find their causes in good time, the human body should be monitored continuously and accurately. To meet the requirements, various battery‐less and self‐powered information acquisition techniques are invented. In this review, the recent advances in self‐powered medical information sensors (SMIS) with different functions, structure design, and electric performance are summarized and discussed. The SMIS mainly involves triboelectric nanogenerator (TENG), piezoelectric nanogenerator (PENG), pyroelectric nanogenerator (PyNG)/ thermoelectric generator (TEG) and solar cell. Additionally, this review also analyzed the remaining challenges and prospected the development direction of SMIS in future.

PURPOSE To examine the potential role of Medical Information Database Network (MID-NET® ), a newly established Japanese medical information database network, in postmarketing drug safety assessments through the characterization of its advantages and limitations in five pilot studies. METHODS The pilot studies were designed to address three major objectives in postmarketing drug safety assessments, ie, the examination of actual drug utilization, the impact of safety-related regulatory actions, and drug-associated risks. The five studies were conducted on the following topics: (a) utilization of codeine-containing products and its relationship with respiratory depression, (b) impact of a Dear Healthcare Professional letter on hypocalcemia incidence associated with denosumab (Ranmark® ) use, (c) risk of acute myocardial infarction associated with antidiabetic drug use, (d) risk of glucose metabolism disorders associated with atypical antipsychotic drug use, and (e) prospective monitoring of abnormal laboratory test results during new drug prescriptions. RESULTS The pilot studies were successfully conducted and demonstrated the value of MID-NET® in postmarketing drug safety assessments. In particular, the ability to utilize laboratory test results as objective clinical indicators is a major advantage of this database. Potential limitations include a relatively small sample size and a lack of patient-level data linkages among hospitals. CONCLUSIONS MID-NET® was confirmed to be a valuable database for postmarketing drug safety assessments. The use of laboratory test results to define clinical outcomes may allow more objective and accurate analyses to be conducted. These studies furthered our understanding of the characteristics of MID-NET® , including its advantages and limitations.

As the network technologies have rapidly developed in recent years, many Internet of Things (IoT) based services and applications have walked into our daily lives; one of these is the medi...

Objective The objective of the present study was to evaluate the effectiveness of introducing integrated jaw models, rubric criteria and homework tasks to a total clinical simulation training course to improve the clinical competence of preclinical dental students. Methods A total simulation training course, which involved six clinical dentistry departments, was held for 110 preclinical students in 2014 and 2015. We prepared integrated jaw models having several morbidities along with corresponding medical information and homework tasks. The students formulated diagnoses and devised treatment plans before performing dental treatment on the mannequin under the direction of instructors from the respective clinical departments. Their performance was assessed by both students and instructors using the rubric criteria. Results Based on quantitative evaluations, the introduction of integrated jaw models appeared to improve the students' ability to formulate diagnoses and devise dental treatment plans and to understand the respective clinical dentistry disciplines. The rubric criteria provided immediate feedback for the students. Based on a comparison of rubric scores, students tended to significantly underestimate their own performance compared with instructors. Moreover, the introduction of homework tasks improved student seriousness. Conclusion Introducing integrated jaw models, rubric criteria and homework tasks to a total simulation training course may be a good approach for improving student performance in terms of dental diagnoses and treatment.

Background This paper examines the health literacy of seniors and the strategies they use to deal with health uncertainty in the context of changes in the health system in Israel that have created a need to examine health literacy in this sector of the population who use the health system the most. The oldest were born and grew up in an era when a physician's knowledge was unchallenged; now, they find it difficult to cope with the expectation of patients taking a role in decision making. Methods In-depth interviews were carried out with 17 seniors between the ages of 70-87 that focused on their perception of their health and their health literacy. Data were analysed using thematic analysis. Findings Seniors used different information sources when looking for medical information. Participants reported three coping mechanisms that help them deal with the uncertainty: disregarding the problem, relying on the physician and searching for information. Conclusions The study found different levels of health literacy among participants but, overall, participants who lead an active and optimistic lifestyle tend to take more responsibility for their health and have higher health information literacy.

Peroral endoscopic myotomy (POEM) is a novel clinical technique developed in Japan used to treat esophageal achalasia and esophageal motility disorders. This technique has been rapidly accepted and widely disseminated throughout our clinical practice because of its low invasiveness, technical novelty, and high efficacy. Since the advent of POEM, there have been no clinical guidelines that clearly indicated its standard of care, and these guidelines have been anticipated both nationally and internationally by clinicians who engage in POEM practice. In 2017, to meet these needs, the Japan Gastroenterological Endoscopy Society (JGES) launched the guideline committee for POEM. Based on the guideline development process proposed by the Medical Information Network Distribution Service (MINDS), the guideline committee initially created research questions on POEM and conducted a systematic review and meta-analysis on each topic. The clinical research extracted from databases for these clinical questions and the systematic review mainly comprised a few retrospective studies with a small number of participants and short trial periods; hence, the strength of the evidence and recommendations derived from these results was low. Throughout this process, the guideline committee met thrice: once on May 13, 2017, and again on September 17, 2017, to formulate the draft. A consensus meeting was then held on January 14, 2018, in Tokyo to establish the guideline statements and finalize the recommendations using the modified Delphi method. This manuscript presents clinical guidelines regarding current standards of practice and recommendations in terms of the nine chief topics in POEM.

Background Headache diaries are a mainstay of migraine management. While many commercial smartphone applications (apps) have been developed for people with migraine, little is known about how well these apps protect patient information and whether they are secure to use. Objective We sought to assess whether there are privacy issues surrounding apps so that physicians and patients could better understand what medical information patients are providing to the app companies, and the potential privacy implications of how the app companies (and other third parties) might use that information. Methods We conducted a systematic search of the most popular "headache" and "migraine" apps and developed a database of the types of data the apps requested for input by the user and whether the apps had clear privacy policies. We also examined the content of the privacy policies. Results Twenty-nine apps were examined (14 diary apps, 15 relaxation apps). Of the diary applications, 79% (11/14) had visible privacy policies. Of the diary apps with privacy policies, all (11/11) stated whether or not the app collects and stores information remotely. A total of 55% (6/11) stated that some user data were used to serve targeted advertisements. A total of 11/15 (73%) of the relaxation apps had privacy policies. Conclusions Headache apps shared information with third parties, posing privacy risks partly because there are few legal protections against the sale or disclosure of data from medical apps to third parties.

Aim The internet has enabled parents to become informed medical consumers and take an active role in their child's treatment. We aimed to determine parents' online medical information-seeking behaviour about their child's health. This included sources of information, reasons for searching, use and assessment of information and whether parents wanted assistance with searching and assessing information. Methods A questionnaire was distributed to 331 parents and carers of inpatients and outpatients at Children's Hospital at Westmead in 2015. Most questions involved tick-box responses and a few free-text responses. Responses were tabulated and described by frequencies and percentages. Associations between participant demographics and responses were examined using chi-square tests. Results In all, 308 (93%) questionnaires were returned. Most participants (90%) reported searching for medical information about their child's health. Of these, 96% searched the internet, and of these, 63% used a smartphone. The most common reason for searching before seeing the doctor was to prepare questions. The most common reasons for searching after seeing the doctor were to know more and because participants had more questions. Only half (57%) ascertained whether an information source was reliable. Most wanted guidance on searching (69%) and assessing reliability (77%). Conclusions Almost all parents search for online information about their child's health, but most are unsure whether the information they find is trustworthy and are hesitant to act on or present it to their child's doctor. Health professionals could discuss this with parents during consultations to dispel potential misunderstandings and provide guidance on searching and assessing.

Social media platforms such as TikTok allow patients to exchange and share health information. In this study, we sought to understand how teenagers and young adults utilize TikTok to engage with acne and isotretinoin information. Analysis of the top 50 TikTok videos on an isotretinoin trend demonstrated over 18-million likes and 137-thousand comments. Most videos focused on before and after improvement in acne severity while video comments primarily discussed side effects and personal anecdotes. Dermatologists should be aware of trending content on social media to better understand how youth patients and patient's families may receive medical information regarding isotretinoin outside of dermatology clinics.

Telehealth has been defined by the American Telemedicine Association as technology‐enabled healthcare management and delivery systems that enable capacity and access. 1 Both “telemedicine” and “telehealth” are terms that have been used interchangeably in practice, but there are differences between them. 2,3 Telehealth refers to a technology facilitated healthcare service, through the exchange of medical information from one information source to another. [...]a form of telemedicine, Project ECHO, had been initiated in the United States in as early as 2003, to provide tele‐mentoring for clinicians treating chronic Hepatitis C remotely. 4 Project ECHO soon expanded to other fields of Medicine and has been adapted in various parts of the world. The COVID‐19 pandemic resulted in a huge disruption of elective and routine services in all fields of Medicine, including gastroenterology. 5,6 The pandemic impeded the conduct of face‐to‐face consultations and has fast‐tracked the implementation of virtual patient consultation. 7,8 Not only were normal clinical services disrupted, but fear of contracting COVID‐19 at most hospitals by the public had impaired appropriate delivery of care in gastroenterology. 9 A relaxation of rules and regulations by regulatory bodies in the United States during the pandemic additionally hastened the adaptation of telemedicine. 9 Several publications from the United States have now demonstrated the increased acceptance of virtual consultation during the COVID‐19 pandemic, even among less technologically inclined patients. 7 In a study conducted at an academic gastroenterology medical center, two‐thirds of patients who engaged in telemedicine rated the experience as good or even better than face‐to‐face consultation. 4,10 Greater accessibility, convenience, and a reduced travel burden are some factors that have led to an increased acceptability of virtual consultation. 4 In the current issue of JGH Open, Ghoshal et al. have reported the feasibility and acceptability of telemedicine for IBD adult patients during the COVID‐19 pandemic in India (REF).

Electronic health record (EHR)-discontinuity, i.e., having medical information recorded outside of the study EHR system, is associated with substantial information bias in EHR-based comparative effectiveness research (CER). We aimed to develop and validate a prediction model identifying patients with high EHR-continuity to reduce this bias. Based on 183,739 patients aged ≥65 in EHRs from two US provider networks linked with Medicare claims data from 2007-2014, we quantified EHR-continuity by mean proportion of encounters captured (MPEC) by the EHR system. We built a prediction model for MPEC using one EHR system as training and the other as the validation set. Patients with top 20% predicted EHR-continuity had 3.5-5.8-fold smaller misclassification of 40 CER-relevant variables, compared to the remaining study population. The comorbidity profiles did not differ substantially by predicted EHR-continuity. These findings suggest that restriction of CER to patients with high predicted EHR-continuity may confer a favorable validity to generalizability trade-off.

The use of online medical information is a common trend but little is known about these searches and implications in pediatric dermatology. Through a convenience sample of 95 parents/guardians and patients in pediatric dermatology at the University of Minnesota, 38.9% of participants reported that they had used an online search tool prior to their appointment. Google was the most common tool used (91.4%), and eczematous conditions were the most common patient-suspected diagnosis (32.4%). Of interest, 13.9% of individuals became more concerned and 16.7% made an appointment earlier because of their online findings.

Background Accurate and prompt diagnosis is required for the primary evaluation of pediatric appendicitis. Among pediatricians and surgeons working in Yamanashi Prefecture, the pediatric appendicitis medical information (PAMI) sheet was edited in April 2011 to reflect the diagnostic results of the pediatric primary and emergency medical service and used as a referral document for surgical consultation to secondary hospitals. Methods The PAMI sheet consisted of sections for history taking, symptoms, physical signs and laboratory findings without a scoring system. For 32 consecutive months starting in April 2011, 59 patients hospitalized for suspected appendicitis were retrospectively reviewed. In particular, a total of 17 referral patients evaluated with the PAMI sheet were assessed in order to evaluate the utility of the form. Results The pediatric surgeons were able to easily determine patient condition from the PAMI sheet. In total, 13 of 17 patients had appendicitis. According to the physical findings of the 17 studied patients, the judgment of right lower quadrant tenderness (κ = 0.63) and guarding (κ = 1.00) was consistent between the pediatric surgeons and primary attending pediatricians. Conclusions The PAMI sheet aids in the collection of detailed history and objective data with a high level of accuracy, and provides useful referral diagnostic information to the secondary-level hospitals.

Objective To determine the impact of the Asia-Pacific guidelines on gastric cancer prevention and Helicobacter pylori (H. pylori) infection on clinical practice. Methods An electronic survey was carried out among Asian Pacific Digestive Week (APDW) medical delegates in 2012. The survey questionnaire captured details such as participants' characteristics, their awareness of the guidelines and knowledge of the key guideline recommendations, the impact of the guidelines on individual practice and on national policies and the sources of medical information that the individual used to make clinical decisions. A total of 1372 APDW medical delegates were invited via email to participate in the electronic survey and 432 (31.5%) responded. Results Among the respondents, 57.6% were familiar with at least one of the guidelines. Among those familiar with the guidelines, 85.9% believed that they influenced their clinical practice. More than half (64.9%) reported that the guidelines clarified treatment indications for them. In terms of knowledge content, 85.0% of the participants provided correct responses to at least four of the six questions on understanding. More than half (52.7%) of the participants felt that the guidelines had made an impact on national policies. Conclusion The Asia-Pacific guidelines on gastric cancer and H. pylori had a positive impact on individual clinical practice and national policies.

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the effectiveness of policies promoting facility‐based deliveries in reducing maternal and infant mortality and morbidity in LMIC.

Rationale, aims and objectives In this study smartphones/tablet PCs and medical application utilization by family physicians and factors concerning the acceptance of medical application in family practice setting have been studied. Methods One hundred seventy-six participants voluntarily agreed to fill out a 27-item questionnaire. Data were analysed with descriptive statistics and eight items (acceptability of utilization of applications) revealed Cronbach's alpha of 0.965 and the factor analysis showed one factor explaining 80.6% of total variance. Results The mean age of respondents was 35.7 [standard deviation (SD) = 8.12; min–max = 24–52], 79 were male (45.9%) and 88 female (51.2%), 56 (32.5%) were single and 113 (65.7%) married, and the mean experience duration as a physician was 11.1 years (SD = 11.1; min–max = 1–28). One hundred sixty-seven (97.1%) had a smartphone and/or tablet PC. Smartphone and/or tablet PC were used since 3.7 (SD = 2.17; min–max = 0–12) years. Sixty-one (35.5%) felt that smartphone and/or tablet PC are very important, 92 (53.5%) important, 2 (1.2%) unimportant and 12 (7%) were undecided about this. One hundred eleven (64.5%) participants had a medical application on the smartphone and 66 (38.4%) on the tablet PC. They used 1.7 (SD = 2.04; min–max = 0–10) medical applications for 1.45 (SD = 2.53; min–max = 0–25) times on average. Eighty respondents (66.7%) used a medical application for any medical problem. Conclusions Almost all family physicians used smartphone and/or tablet PC during daily practice, and the reason of use was commonly for communication and Internet purposes. Usage during working hours was limited, but medical apps were perceived mainly positively for receiving medical information via Internet. Looking at the medical apps’ acceptability scale, participants were in agreement with the security, cost, contents’ quality, ease of use, support, ease of finding, ease of accessing and motivation to use medical applications.

Graphs facilitate the communication of important quantitative information, often serving as effective decision support tools. Yet, graphs are not equally useful for all individuals, as people differ substantially in their graph literacy-the ability to understand graphically presented information. Although some features of graphs can be interpreted using spatial-to-conceptual mappings that can be established by adults and children with no graphing experience (e.g., "higher bars equal larger quantities"), other features are linked to arbitrary graph conventions (e.g., axes labels and scales). In two experiments, we examined differences in the processes underlying the comprehension of graphs presenting medical information in individuals with low and high graph literacy. Participants' eye movements were recorded while they interpreted graphs in which information in conventional features was incongruent with that conveyed by spatial features. Results revealed that participants with low graph literacy more often relied on misleading spatial-to-conceptual mappings and misinterpreted the data depicted. Higher graph literacy was often associated with more time spent viewing the conventional features containing essential information for accurate interpretations. This suggests that individuals with high graph literacy are better able to identify the task-relevant information in graphs, and thus attend to the relevant features to a larger extent. Theoretical, methodological, and prescriptive implications for customization of decision-support systems are discussed.

At least since the time of Hippocrates, the physician-patient relationship has been the paradigmatic ethical arrangement for the provision of medical care. Yet, a physician-patient relationship does not exist in every professional interaction involving physicians and individuals they examine or treat. There are several "third-party" relationships, mostly arising where the individual is not a patient and is merely being examined rather than treated, the individual does not select or pay the physician, and the physician's services are provided for the benefit of another party. Physicians who treat NFL players have a physician-patient relationship, but physicians who merely examine players to determine their health status have a third-party relationship. As described by Glenn Cohen et al., the problem is that typical NFL team doctors perform both functions, which leads to entrenched conflicts of interest. Although there are often disputes about treatment, the main point of contention between players and team physicians is the evaluation of injuries and the reporting of players' health status to coaches and other team personnel. Cohen et al. present several thoughtful recommendations that deserve serious consideration. Rather than focusing on their specific recommendations, however, I would like to explain the rationale for two essential reform principles: the need to sever the responsibilities of treatment and evaluation by team physicians and the need to limit the amount of player medical information disclosed to teams.

Objective: To examine the effect that the introduction of new diagnostic technology in obstetric care has had on fetal death. Data Source The Medical Birth Registry of Norway provided detailed medical information for approximately 1.2 million deliveries from 1967 to 1995. Information about diagnostic technology was collected directly from the maternity units, using a questionnaire. Study Design: The data were analyzed using a hospital fixed‐effects regression with fetal mortality as the outcome measure. The key independent variables were the introduction of ultrasound and electronic fetal monitoring at each maternity ward. Hospital‐specific trends and risk factors of the mother were included as control variables. The richness of the data allowed us to perform several robustness tests. Principal Finding: The introduction of ultrasound caused a significant drop in fetal mortality rate, while the introduction of electronic fetal monitoring had no effect on the rate. In the population as a whole, ultrasound contributed to a reduction in fetal deaths of nearly 20 percent. For post‐term deliveries, the reduction was well over 50 percent. Conclusion: The introduction of ultrasound made a major contribution to the decline in fetal mortality at the end of the last century. Does the Use of Diagnostic Technology Reduce Fetal Mortality?

22q11.2 deletion syndrome (22q11DS) is the most common microdeletion in humans. There have been few studies assessing the impact of this condition on the family and no previous studies conducted on unaffected siblings of children with 22q11DS. The goal of this study was to determine the frequency, method, and content of information being communicated by parents to unaffected siblings about the condition and to assess unaffected siblings' knowledge of 22q11DS and perceptions of the impact of the condition on their affected sibling and themselves. Families were recruited from several 22q11DS educational and support organizations and asked to complete a single anonymous online survey. Families were eligible to participate if they had one child with 22q11DS and at least one unaffected child between the ages of 12 and 17. Survey questions were developed based on previous literature and authors' expertise with individuals with 22q11DS. Responses to quantitative and qualitative questions were analyzed to calculate frequencies and proportions and to extract themes, respectively. A total of 25 families (defined as a unit of at least one parent, one affected child, and at least one unaffected child) participated in the study. Parents shared genetic information less often as compared to behavioral and medical information. Siblings of children with 22q11DS had both positive and negative experiences in having a brother or sister with this condition. Genetic counselors can use the results of this study to develop anticipatory guidance for parents of children with 22q11DS in talking with their unaffected children about the condition.

Purpose Some pregnant women use the internet to search for medical information. However, online information is not controlled. The objectives were to describe French online chats about drugs and pregnancy and evaluate the quality and reliability of information shared by internet users. Methods This French descriptive study was performed in November 2012. In order to identify drugs and pregnancy-related forum websites, we used three French key words: forum, pregnancy and drug. We explored the first 10 websites from the search result. Diseases were described using the International Classification of Diseases and drugs classified with the Anatomical Therapeutic Chemical codes and the FDA risk classification. Results We selected 115 questions that were mainly posted by pregnant internet users in French forums. Drugs raising questions were mostly “nervous system,” “anti-infective for systemic use” and “respiratory system” drugs. The risk during pregnancy for nearly half of these drugs had not been evaluated properly. Health professionals were only involved in 7% of the 214 answers. Internet users advised to take a drug in 21% of their answers. Thirty-four percent of those recommended drugs had not been well-evaluated or were potentially at risk during pregnancy. Finally, 12% of the answers could be at risk for pregnant woman. Conclusions This study shows that information related to drugs and pregnancy in online chats could be at risk for pregnant women. Internet users must be aware that online forums are not reliable sources of information. Copyright © 2014 John Wiley & Sons, Ltd.

Objectives Evidence Based Medicine (EBM) is proper and an efficient incorporation of the researches and experiences. This is study surveyed the attitudes, awareness, and practice of EBM with specific focus on the barriers to EBM, among clinical residents. Methods We conducted a cross sectional survey during September 2012 to February 2013 at the teaching hospitals of Mazandaran University of Medical Sciences among 81 clinical providers from different medical specialties. A valid and reliable questionnaire consisted of five sections and 22 statements were used in this research. Most respondents (83%) completed the questionnaires voluntarily and anonymously. We input the data into Micro- soft Excel 2007. Data were analysed using SPSS 16.0 software. Results Findings of the study showed that the knowledge of respondents about EBM is low. Their attitude towards EBM was positive but their knowledge and skills in regard to the evidence based medical information resources were mostly limited to PubMed and Google scholar. The main barrier was the lack of enough time to practicing EBM. There was no significant correlation between residency grade and familiarity and use of electronic EBM resources (Spearman, P = 0.116). Conclusions The attitude of the respondents towards EBM is fairly positive. But there is a deficit in knowledge and skills of EBM among respondents. Integration and implementation of training approaches like journal clubs or workshops in clinical practices is suggested.

Background The aim of this study was to determine the individual and familial factors associated with metabolic control in children with type 1 diabetes (T1DM). Methods The study was performed in 93 children with T1DM between the ages of 3 and 19 years. Children and their families completed questionnaires on sociodemographics and data associated with diabetes. Medical information from the charts was also recorded. Results Older age, longer diabetes duration and higher hospitalization rate for acute complications were positively associated with poor metabolic control. Good school performance, regular hospital visits, young maternal age, high paternal education level and fewer numbers of siblings were found to be negatively associated with poor metabolic control. Conclusions Multiple individual and family-level factors are associated with metabolic control. These data may aid in identification of diabetic children and adolescents who have a higher risk of poor metabolic control.

Introduction: The objective of this study was to examine the risk of female sexual orgasmic disorder among a group of women with hypertension in Malaysia. The associated factors were also examined. Methods: This cross-sectional study involved 348 hypertensive women attending the primary care or hypertension clinic in a teaching hospital in Malaysia. Female sexual orgasmic disorder was assessed using the Orgasmic subscale of the Malay Version of the Female Sexual Function Index (MVFSFI). Basic socio-demographic data of the subjects was collected using a predesigned questionnaire. Medical records were reviewed to gather patients’ medical information. Results: The risk of female sexual orgasmic disorder among hypertensive women was 14.1%. Univariate analysis found that older age, longer duration of marriage, lower educational level, and menopause were associated with higher risk of female sexual orgasmic disorder. These factors were not significant in multivariate analysis. Discussion: The risk of female sexual orgasmic disorder was relatively low in Malaysian women with hypertension. No risk factors were associated with female sexual orgasmic disorder in the current study.

Objective The aim of this study was to investigate birth rates and use of hormonal contraception in different age groups among women with epilepsy (WWE) in comparison to women without epilepsy. Materials and Methods Demographic data and medical information on more than 25,000 pregnant women (40,000 births), representing 95% of all pregnancies in Oppland County, Norway, were registered in the Oppland Perinatal Database in the period 1989–2011. Data were analyzed with respect to epilepsy diagnoses, and 176 women with a validated epilepsy diagnosis (303 pregnancies) were identified. Age‐specific birth rates in these women were estimated and compared with age‐specific birth rates in women without epilepsy in the same county. Results In WWE over 25 years of age, birth rates were significantly lower than in those of the same age group without epilepsy. In women below 20 years of age, birth rates were similar in those with and without epilepsy. The use of hormonal contraceptives prior to pregnancy was lower among WWE under 25 years than in the corresponding age group without epilepsy. Conclusions Health professionals who counsel WWE who are of fertile age should be aware of the strongly reduced birth rates in WWE over 25 years of age, and the lower rates of use of contraceptives among young WWE.

Computerized management of medical information and 3D imaging has become the norm in everyday medical practice. Surgeons exploit these emerging technologies and bring information previously confined to the radiology rooms into the operating theatre. The paper reports the authors' experience with integrated stereoscopic 3D-rendered images in the da Vinci surgeon console.

SUMMARY Viruses are the most important cause of infections and a major source of mortality in Kidney Transplant Recipients (KTRs). These patients may acquire viral infections through exogenous routes including community exposure, donor organs, and blood products or by endogenous reactivation of latent viruses. Beside major opportunistic infections due to CMV and EBV and viral hepatitis B and C, several viral diseases have recently emerged in KTRs. New medical practices or technologies, implementation of new diagnostic tools, and improved medical information have contributed to the emergence of these viral diseases in this special population. The purpose of this review is to summarize the current knowledge on emerging viral diseases and newly discovered viruses in KTRs over the last two decades. We identified viruses in the field of KT that had shown the greatest increase in numbers of citations in the NCBI PubMed database. BKV was the most cited in the literature and linked to an emerging disease that represents a great clinical concern in KTRs. HHV-8, PVB19, WNV, JCV, H1N1 influenza virus A, HEV, and GB virus were the main other emerging viruses. Excluding HHV8, newly discovered viruses have been infrequently linked to clinical diseases in KTRs. Nonetheless, pathogenicity can emerge long after the discovery of the causative agent, as has been the case for BKV. Overall, antiviral treatments are very limited, and reducing immunosuppressive therapy remains the cornerstone of management. Copyright © 2012 John Wiley & Sons, Ltd.

Background As the use of the Internet increases, it is important to gain insight into how it is used by patients to obtain health-related information. Objectives We aimed to explore the attitudes and practices of dermatology outpatients regarding their use of the Internet to find health information. We also aimed to investigate the consequences of this Internet use on the patient‐doctor relationship. Methods A self-administered questionnaire on Internet use was given to adult dermatology outpatients attending the Dermatology Department at King Saud University, Riyadh, Saudi Arabia, from January to June 2008. Results A total of 86% (432/500) of distributed questionnaires were returned. The mean age of respondents was 29.7 ± 10.0 years. Of the respondents who answered the relevant items, 42% (185/431) were females, 87% (376/432) were Internet users, and 47% (190/ 404) stated that they had accessed the Internet to obtain general medical information. Younger women educated to college level and with higher incomes tended to search for online health-related information more often than other groups. More than 93% (343/367) of respondents reported that they relied on their doctors as their primary source of information, but 69% (277/401) indicated that online medical information was beneficial, and almost 8% (30/399) stated that they would always trust data obtained from the Internet. Conclusions A significant proportion of patients use the Internet to search for medical information. This has a positive effect on the patients’ skin diseases and on their relationships with their doctors. Therefore, doctors should be more aware of the health-related information available online and should guide patients to reliable websites.

As the capabilities of mobile devices continuously improve, a lot of environments that utilize such devices extend their functionalities; as a notable example, assistive environments offer a lot of characteristics that seemed inevitable a few years ago. In the healthcare domain modern systems are able to support advanced characteristics such as those associated with remote treatment facilities. In these environments sensitive medical data are being transmitted; therefore there is a need to ensure the security properties of medical information. A number of strict security requirements often imposed by different international legislation processes emerge due to the sensitivity of data being transmitted. In addition, in the absence of fixed infrastructures and stable topologies there is a need to create secure paths end-to-end for secure and efficient communication. In this paper we present an architecture that allows dissemination of medical information in a secure manner in the absence of stable topologies and infrastructures built upon resource efficient devices. The presented architecture utilizes advanced management techniques, achieving secure and privacy-preserving transmission of sensitive data. We present a combination of different techniques and with a number of initial measurements we show the effective operation of our architecture in the presence of an adequately large number of users participating in the performance test-bed scenario. Copyright © 2010 John Wiley & Sons, Ltd.

There is a vast amount of new medical information published on diabetes each year; the number of systematic reviews on diabetes is also increasing rapidly. It is therefore difficult for clinicians keep up to date with the new evidence. It is suggested that reading the full National Institute for Clinical Excellence (NICE) guidelines on diabetes will bring you up to date with information as at the date of the evidence cut-off, which is usually approximately 1 year before publication. Also regularly visiting 'NHS Evidence-diabetes', an online resource that offers a foraging service, surveying the literature and alerting clinicians to all the new important and useful information, enables the busy clinician to manage information overload and help keep up to date.

This classic panel session will review recent trends and issues in the study of the history of information science and technology and present findings from the first awards given by the ASIST History Fund. It will consist of three presentations: (1) an overview, by Robert V. Williams, of recent trends and issues and identify some of the major gaps that need to be addressed in future work; (2) a presentation by Charles Meadow, winner of the 2009 ASIST History Fund Research Grant award, of the results of his study of the history of the digital divide; (3) a presentation by Rachel Plotnick, winner of the 2009 ASIST History Fund Best Paper award, on her study of the history of a total hospital medical information system developed in the 1960's and 1970's. Presentation 1: Robert V. Williams, Distinguished Prof., Emeritus School of Library and Information Science Univ. of South Carolina Columbia, SC 29208 e-mail: bobwill@sc.edu Title: Trends, Issues and Gaps in the Study of the History of Information Science and Technology

An important aspect of Chinese academic health science libraries is their involvement in teaching medical information retrieval courses as part of the medical curriculum. Health science librarians in China have a more formal teaching role than is generally found in Western countries, including many full-time teaching positions. This article provides a case study of Kunming Medical University Library, where courses are provided as credit units at both undergraduate and postgraduate levels. The teaching practices of Chinese health science libraries are compared with teaching experiences reported in Western countries. It is noted that Chinese government’s educational policy is similar to that of the United States in promoting the role of the library in teaching subjects as part of the medical curriculum. In China, this has lead to the development of teaching departments within health science libraries and the appointment of full and part-time teacher librarians.

Background: Accurate medical history information is essential for good patient care and should be notified in the letter of referral. The aim of this study was to investigate the subjective opinion that the medical information in a large number of referrals is either inaccurate or non-existent. Methods: Medical histories from 54 patients with positive medical history findings upon taking the medical history at the initial consultation appointment were compared to the medical information supplied in the referral letter. Results: Overall, medical information was only 58.8% complete with dental referrals being 55.2% complete and medical referrals 62.4%. The majority of referral letters (70.4%) missed at least one relevant finding and only 29.6% of referrals were 100% complete. Conclusions: The results of this study suggest that the standard of referral letters needs to be improved as the received referrals were generally incomplete and contained inaccurate information. This highlights the need for each and every practitioner to take their own detailed medical history and not rely on the information supplied in the referral.

An on-line computer system for easy entry and retrieval of perinatal records is described. Using this on-line system, physicians without any knowledge of computer language can make simple statistical calculations. Originally developed as a data entry system for perinatal records gathered by the Committee on Perinatal Statistics of the Japan Society of Obstetrics and Gynecology, this system was then merged into IMIS, the Integrated Medical Information System of Kochi Medical School. 448 cases of perinatal deaths were registered by the end of 1982. Using these death cases, dependence of main clinical causes of death on gestational week and birth weight is shown as an example of the results obtained using this computer system.

As medicine moves toward being able to predict what you will die from and when, nanomedicine is expected to enhance human capabilities and properties and promises the ability of health care professionals to diagnose, treat, and share medical information nearly instantaneously. It promises to deliver drugs directly to the source of the disease, i.e. tumor. This article examines the literature surrounding ethics associated with nanomedicine, and asks whether these ethical issues are new and unique. While opinions differ, this review concludes that none of the ethical questions surrounding nanomedicine are new or unique, and would hold true for any new medical device or medicine that was being evaluated. The real issue becomes public acceptance of nanomedicine and how much risk society is willing to accept with a new technology before it is proven effective and ‘safe’. While ethical foresight can prove effective in forecasting potential problems, in reality, ethics may not be capable of evaluating such a technology that has yet proven effective in all it has promised. WIREs Nanomed Nanobiotechnol 2011 3 111–118 DOI: 10.1002/wnan.90 For further resources related to this article, please visit the WIREs website