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Background Parent training (PT) programs have been implemented for neurodevelopmental disorders such as autism spectrum disorder (ASD) in recent years. However, in Southeast Asia, the diffusion of rehabilitation programs for children with ASD and that of PT as a parental support measure has been slow. Methods This study assessed the effectiveness of an online PT program that was developed in Japan and remotely delivered to Vietnamese parents of children with ASD residing in Vietnam. Sixteen parents of Vietnamese children with ASD participated in seven online Tottori University-style PT sessions. The online PT was conducted in real-time from Japan, considering the two-hour time difference between countries. Lectures and exercises were presented in Vietnamese with PowerPoint materials. Japanese staff provided explanations in Japanese, which were then simultaneously translated by a Vietnamese interpreter. Attendance, completion of homework assignments, and the number of statements on Zoom and social media were tallied. A pre-post-test design was employed to measure changes in parents' mental health factors and children's behavior. A post-intervention questionnaire was administered to assess participant's acceptance of PT. Results The findings showed that attendance and task completion rates were considerably high. The study found that the mental health scores of parents significantly improved after participating in online parenting training compared to before. However, there were no statistically significant improvements found in children's behavior. The study also confirmed high satisfaction with the cross-country online parenting training. Conclusion This study confirmed that TUPT, developed in Japan and implemented as an online PT for parents of children with ASD living in Vietnam, was effective in improving parental mental health. The program acceptability questionnaire also showed positive results. This study is the first step in the evaluation and dissemination of Internet-based, cross-country parent training for parental support in Asia. [ABSTRACT FROM AUTHOR]

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

In the traditional offline context, the mental health industry suffers from poor local demand and a lack of trustworthy supply. Emerging digital platforms can solve this problem to a large extent by building network effects. How to build network effects is a primary issue for mental health platforms. This article explores this problem by investigating two cases from China. Platform firms can design mechanisms to increase user scale, multiply user roles, facilitate user engagement, and enhance user trust on platforms. The pioneer platform and the later entrant can implement different strategies for building network effects. [ABSTRACT FROM AUTHOR]

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

To assess the reliability and quality of YouTube videos as an information source in Retinopathy of Prematurity (ROP) treatment. A YouTube search with the keyword "ROP treatment" was conducted. First 200 videos listed in the first 10 pages were evaluated. The upload sources, video length, days on YouTube, number of total views, likes, dislikes and comments were recorded. View ratio (VR), like ratio (LR) and video power index (VPI) were analyzed. Two ophthalmologists scored all videos using the DISCERN scoring system, Journal of the American Medical Association (JAMA) criteria, and Global Quality Score (GQS). Seventy-three videos were included in the study. The mean VR, LR, and VPI were 4.92±10.11, 83.88±33.98, and 4.55±9.25, respectively. The main upload sources were universities/non-profit professional organizations (36.99%) and physicians (31.51%). The 18 of the 55 videos on treatment procedures contained information on all treatment procedures, 37 videos contained information about at least one of treatment options. The mean DISCERN score, JAMA score and GQS were 42.32±17.51, 2.81±1.03, and 3.12±1.48, respectively. The category of all videos according to the mean DISCERN score was "fair". The overall quality of YouTube videos on ROP treatment was intermediate. Although one third of videos were classified as good quality, most YouTube videos provided poor quality information. Competent authorities and experts should upload carefully recorded videos with reliable and quality content on YouTube to educate and increase the awareness of parents, especially in ROP requiring treatment. [ABSTRACT FROM AUTHOR]

The demand for better health services has resulted in the advancement of remote monitoring health, i.e., virtual nursing systems, to watch and support the elderly with innovative concepts such as being patient-centric, easier to use, and having smarter interactions and more accurate conclusions. While virtual nursing services attempt to provide consumers and medical practitioners with continuous medical and health monitoring services, access to allied healthcare experts such as nurses remains a challenge. In this research, we present Virtual Nursing Using Deep Belief Networks for Elderly People (DBN-EP), a new framework that provides a virtual nurse agent deployed on a senior citizen's home, workplace, or care centre to help manage their health condition on a continuous basis. Using this method, healthcare providers can assign various jobs to nurses by utilizing a general task definition mechanism, in which a task is defined as a combination of medical workflow, operational guidelines, and data gathered from a remotely monitored virtual nursing system. Practitioners are in charge of DBN-EP and make treatment decisions for patients. This allows a DBN-EP to act as a personalized full-time nurse for a client by carrying out practitioner support activities based on information gathered about the client's health. An electronic Personal Health Record (ePHR) system, such as a specialized web portal and mobile apps, could provide such patient information to elderly person family members and care centres. We created a prototype system using a DBN-EP system that allows traditional client applications and healthcare provider systems to collaborate. Finally, we demonstrate how this system may benefit the elderly through a result and debate. [ABSTRACT FROM AUTHOR]

Methods: The Sickle Cell Transplantation Evaluation of Long-Term and Late Effects Registry (STELLAR) was designed to enroll patients with SCD =1 year post-HCT, their siblings without SCD, and nontransplanted controls with SCD to collect web-based participant self-reports of health status and practices by using the Bone Marrow Transplant Survivor Study (BMTSS) surveys, health-related quality of life (HRQOL) using the Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric Profile-25 or Pediatric Profile-29 survey, chronic graft-versus-host disease (cGVHD) using the symptom scale survey, daily pain using an electronic pain diary, the economic impact of HCT using the financial hardship survey, sexual function using the PROMIS Sexual Function SexFSv2.0 survey, and economic productivity using the American Time Use Survey (ATUS). We also piloted retrieval of clinical data previously submitted to the Center for International Blood and Marrow Transplant Research (CIBMTR); recorded demographics, height, weight, blood pressure, waist and hip circumferences, timed up and go (TUG) test, and handgrip test; and obtained blood for metabolic screening, gonadal function, fertility potential, and biorepository of plasma, serum, RNA, and DNA. Results: Of 100 eligible post-HCT patients, we enrolled 72 (72%) participants aged 9-38 (median 17) years. We also enrolled 19 siblings aged 5-32 (median 10) years and 28 nontransplanted controls with SCD aged 4-46 (median 22) years. Of the total 119 participants, 73 (61%) completed 85 sets of surveys and 41 (35%) contributed samples to the biorepository. We completed ATUS interviews of 28 (24%) participants. We successfully piloted retrieval of data submitted to the CIBMTR and expanded recruitment to multiple sites in the United States, Canada, the United Kingdom, and Nigeria. Conclusions: It is feasible to recruit subjects and conduct study procedures for STELLAR in order to determine the long-term and late effects of HCT for SCD. [ABSTRACT FROM AUTHOR]

Background: Physical activity (PA) can increase mental and physical health in adults aged 50 years and older. However, it has been shown that PA guidelines are often not met within this population. Therefore, our research group developed 2 computer-tailored intervention programs in the last decade to stimulate PA: Active Plus and I Move. Although these programs were proven effective, positive effects diminished over time and attrition rates were relatively high. To respond to this, we will integrate 3 interactive mobile elements into the existing programs: activity tracker, ecological momentary intervention program, and virtual coach app. Objective: The goal of the research is to define systematic and evidence-based steps for extending our online computer-based PA intervention programs with 3 interactive mobile elements. Methods: Components often included in other (eHealth) design models were identified as key components and served as a base for the definition of systematic steps: exploration of context, involvement of the target population, prototype and intervention testing, and implementation. Based on these key components, 10 systematic steps were defined. The initial step is a literature search, with the results serving as a base for development of the low-fidelity prototypes in step 2. The pilot phase comprises the 3rd to 6th steps and includes semistructured interviews, pilot tests, and adaptations of the prototypes with intensive involvement of the target population of adults aged 50 years and older, where particular attention will be paid to lower educated persons. The 7th step is an effect evaluation in the form of a randomized controlled trial. During the 8th step, the most effective intervention programs will be selected and reinforced. These reinforced intervention programs will be used during the design of an implementation plan in the 9th step and the subsequent field study in the 10th step. Results: The project will be executed from December 2019 to December 2023. During this period, the systematic approach presented will be practically executed according to the methodological procedures described. Conclusions: Based on the 4 identified key components, we were able to design an evidence-based systematic design approach for separately adding 3 mobile elements to our existing online PA intervention programs. The 10 steps are presented as a useful approach to guide future eHealth design studies. [ABSTRACT FROM AUTHOR]

Background: Many people with young onset dementia (YOD) may feel isolated. Peer support has the potential to improve social health, but the inconsistent availability of age-appropriate, in-person (peer) support services for people with YOD suggests that many people with YOD miss out on the potential benefits. Online peer support could be useful, as it overcomes geographical barriers, offers a variety of options, and adjusts to various needs and preferences. Objective: Our study aims to develop evidence-based best practice guidance on online peer support for people with YOD and group facilitators to improve online peer support for people with YOD. Methods: Our mixed methods study consists of 4 phases and follows the guidelines of the Medical Research Council on complex interventions. Each phase consists of multiple substudies. The study focuses on the development stage of the Medical Research Council framework and additionally develops a plan for the feasibility/piloting, evaluation, and implementation stages. The participants are people living with YOD and peer support facilitators. The qualitative research methods include interviews, focus groups, and open questions in a web-based survey. The quantitative methods include a web-based survey consisting of existing outcome measures. Results: The study is funded by the European Union's Horizon 2020 research and innovation program under the Marie Skłodowska-Curie Actions - Innovative Training Networks (H2020-MSCA-ITN-2018; grant agreement number: 813196), and it received ethical approval from the London Bromley Research Ethics Committee (reference number: 21/LO/0248) in April 2021. Recruitment started in May 2021. Data collection and analysis are expected to be finished by September 2022. Conclusions: The best practice guidance can provide people with YOD with tailored and evidence-based information about online peer support, and it will be disseminated locally (in the United Kingdom) and internationally through dementia organizations, research networks, and academic institutions. [ABSTRACT FROM AUTHOR]

Background: Cancer survivors are vulnerable to experiencing symptoms of anxiety and depression and may benefit from accessible interventions focused on improving emotion regulation. CanCope Mind (CM) was developed as an internet-delivered intervention adapted from the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders to improve emotion regulation and support the mental health of cancer survivors. Objective: This protocol aims to provide an outline of the CanCope Study, a trial comparing the efficacy of a Unified Protocol-adapted internet-delivered intervention (CM) designed for cancer survivors compared with an active control condition--an internet-delivered healthy lifestyle intervention, CanCope Lifestyle (CL). The primary aim is to assess and compare the efficacy of both interventions in improving emotion regulation, anxiety and depressive symptoms, and quality of life. The secondary aims involve assessing the mechanisms of the CM intervention. Methods: This trial is a 2-arm randomized controlled trial that allocates cancer survivors to either CM or CL. Both interventions comprise 4 web-based modules and are expected to take participants at least 8 weeks to complete. Participants' mental and physical health will be assessed via self-reported surveys at baseline (T0), between each module (T1, T2, and T3), immediately after the intervention (T4), and at 3-month follow-up (T5). The study aims to recruit 110 participants who have completed T4. Results: The CanCope study began recruitment in September 2020. A total of 224 participants have been randomized to the CM (n=110, 49.1%) and CL (n=114, 50.9%) groups. Conclusions: This is one of the first trials to develop and investigate the efficacy of a web-based intervention for cancer survivors that specifically targets emotion regulation. [ABSTRACT FROM AUTHOR]

Background: Loneliness, or perceived social isolation, is prevalent in both the general population and clinical practice. Although loneliness has repeatedly been associated with mental and physical health, research on interventions that reduce loneliness effectively is still rather scarce. Objective: This study aims to evaluate the efficacy of a guided and an unguided version of the same internet-based cognitive behavioral self-help program for loneliness (SOLUS-D) for adults. Methods: A total of 250 participants will be randomly assigned to 1 of 2 intervention groups (SOLUS-D with guidance or SOLUS-D without guidance) or a wait-list control group (2:2:1 allocation ratio). Adult participants experiencing high levels of loneliness will be recruited from the general population. Individuals currently experiencing at least moderately severe depressive symptoms, an ongoing severe substance use disorder, previous or current bipolar or psychotic disorder, or acute suicidality will be excluded from the trial. Assessments will take place at baseline, 5 weeks (midassessment), and 10 weeks (postassessment). The primary outcome is loneliness assessed using the 9-item University of California, Los Angeles Loneliness Scale at the posttreatment time point. Secondary outcomes include depressive symptoms, symptoms of social anxiety, satisfaction with life, social network size, and variables assessing cognitive bias and social behavior. The maintenance of potentially achieved gains will be assessed and compared at 6 and 12 months after randomization in the 2 active conditions. Potential moderators and mediators will be tested exploratorily. Data will be analyzed on an intention-to-treat basis. Results: Recruitment and data collection started in May 2021 and are expected to be completed by 2022, with the 12-month follow-up to be completed by 2023. As of the time of submission of the manuscript, 134 participants were randomized. Conclusions: This 3-arm randomized controlled trial will add to the existing research on the efficacy of loneliness interventions. Furthermore, it will shed light on the role of human guidance in internet-based treatments for individuals with increased levels of loneliness and the possible mechanisms of change. If SOLUS-D proves effective, it could provide a low-threshold, cost-efficient method of helping and supporting individuals with increased levels of loneliness. [ABSTRACT FROM AUTHOR]

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

Background: Internet-delivered cognitive behavior therapy (ICBT) was developed over 20 years ago and has since undergone a number of controlled trials, as well as several systematic reviews and meta-analyses. However, the crucial question of response rates remains to be systematically investigated. The aim of this individual patient meta-analysis (IPDMA) was to use a large dataset of trials conducted in Sweden to determine reliable change and recovery rates across trials for a range of conditions. Methods: We used previously collected and aggregated data from 2,866 patients in 29 Swedish clinical trials of ICBT for three categories of conditions: anxiety disorders, depression, and others. Raw scores at pre-treatment and post-treatment were used in an IPDMA to determine the rate of reliable change and recovery. Jacobson and Truax's, (1991) reliable change index (RCI) was calculated for each primary outcome measure in the trials as well as the recovery rates for each patient, with the additional requirement of having improved substantially. We subsequently explored potential predictors using binomial logistic regression. Results: In applying an RCI of z = 1.96, 1,162 (65.6%) of the patients receiving treatment were classified as achieving recovery, and 620 (35.0%) were classified as reaching remission. In terms of predictors, patients with higher symptom severity on the primary outcome measure at baseline [odds ratio (OR) = 1.36] and being female (OR = 2.22) increased the odds of responding to treatment. Having an anxiety disorder was found to decrease the response to treatment (OR = 0.51). Remission was predicted by diagnosis in the same direction (OR = 0.28), whereas symptom severity was inversely predictive of worse outcome (OR = 0.81). Conclusions: Response seems to occur among approximately half of all clients administered ICBT, whereas about a third reach remission. This indicates that the efficacy of ICBT is in line with that of CBT based in prior trials, with a possible caveat being the lower remission rates. Having more symptoms and being female might increase the chances of improvement, and a small negative effect of having anxiety disorder versus depression and other conditions may also exist. A limitation of the IPDMA was that only studies conducted in Sweden were included. [ABSTRACT FROM AUTHOR]

Background: Mental disorders are highly prevalent among university students. Distance-learning students are particularly burdened and have limited access to conventional university health services. Interventions for stress are sought after in distance learners and may help increase treatment coverage. Internet-based interventions have been shown to be effective in preventing and treating depression, but it remains unclear if interventions directed at academic stress also have this potential. Aim: The trial presented here investigates the effectiveness of an Internet- and App-based stress intervention in distance-learning students with elevated levels of depression. Methods: A sample of N = 200 students of a large German distance university with elevated levels of depression [Center for Epidemiological Studies' Depression Scale (CES-D) ≥ 16] will be randomly assigned to either an Internet- and App-based stress management intervention group (IG) or a control group (CG) receiving an Internet-based psychoeducational program for academic stress. The IG consists of eight Internet-based sessions promoting stress management skills using cognitive–behavioral and problem-solving techniques. A mobile App will be employed to facilitate training transfer. Self-report data will be assessed at baseline (T0), post-treatment (T1; 7 weeks), and 3-month follow-up (T2). Potential moderators will be assessed at baseline. The primary outcome is depression (CES-D) post-treatment. Secondary outcomes include mental health outcomes, modifiable risk and protective factors, and academic outcomes. Data will be analyzed on an intention-to-treat principle along with sensitivity analyses to assess the robustness of findings. Additional health economic analyses will be conducted. Discussion: Results will provide the basis to assess the acceptance and effectiveness of Internet-delivered stress interventions in distance-learning students with symptoms of depression. Ethics and dissemination: The study has been reviewed and approved by the University of Erlangen-Nuremberg ethics committee (Erlangen, Germany; 33_17 Bc). Results of the study will be disseminated through peer-reviewed publications. Trial Registration: German Clinical Trial Registration (DRKS), identifier DRKS00011800 [ABSTRACT FROM AUTHOR]

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

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In recent years, web-based health services for a variety of mental disorders have been developed and evaluated. Evidence suggests that guided internet-based therapy can be as effective as conventional face-to-face therapy. In forensic psychiatric practice, few web-based treatments have been implemented up to now. However, to our knowledge, there do not yet exist guided internet-based treatments for child sexual abusers and child sexual exploitation material offenders. This review aims at examining under what conditions patients are most likely to benefit from internet-based treatments. In addition, some computer-based health services in forensic psychiatry will be summarized and their potentials and weaknesses will be discussed. Subsequently, the review focuses on the implications for the development of online treatments for child sexual abusers as well as on a variety of ethical and legal issues that practitioners may encounter during the development, evaluation and delivery of online health services. The review will conclude with proposed quality standards for the development and implementation of web-based interventions for child sexual abusers and child sexual exploitation material offenders. By virtue of the low number of psychotherapists offering therapy to this clientele as well as individual barriers to seeking treatment such as fear of stigmatization, feelings of shame, long access routes, or limited mobility due to physical handicaps, the development of mental eHealth services in this sector could close an important healthcare gap. By increasing the density of supply, more child sexual abusers and child sexual exploitation material offenders would have the chance to engage in treatment and, ultimately, more incidents of sexual assault against minors could be prevented. [ABSTRACT FROM AUTHOR]

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

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

Background: Clinical guidelines recommend psychosocial care as an integral part of medical treatment, but access is often limited. Technology-based approaches provide an attractive opportunity to optimize health outcomes and quality of life in people with chronic somatic diseases e.g. by means of Internet- and mobile-based interventions (IMIs). The present article provides an overview on the basics of IMIs, applications and their evidence base for people living with chronic somatic diseases. Methods: We conducted a selective literature search in the PubMed and Cochrane databases. Reviews which included randomized controlled trials investigating psychological IMIs were discussed pertaining to their relevance for the population described. Results: IMIs lead to a change in unfavorable behavior connected to chronic somatic diseases. IMIs can foster protective factors like balanced physical activity or risk factors like smoking or alcohol consumption. However, studies reveal small effect sizes of d=0.25 for physical activity and an averaged effect size of d=0.20 for smoking and alcohol consumption. Additionally, IMIs can be used for the (co-)treatment of chronic somatic diseases, for instance to increase disease-specific selfefficacy in patients with diabetes (d=0.23). Studies included in meta-analyses are often highly heterogenous and are investigated in research contexts with limited health care services relevance. Conclusion: IMIs are potentially effective when aiming at lifestyle changes and supporting medical treatment in people with chronic somatic diseases. However, results are still heterogenous and the evidence base is limited regarding specific settings, compounding the discussion of possible ways of implementing IMIs into our healthcare systems. [ABSTRACT FROM AUTHOR]

With the digitisation of society, e-health technology increasingly supports new design situations that extend those traditional to Information Systems, and therefore need to be better understood. In design for complex, new and sensitive design situations, it is not possible to apply known methods and solutions without a deeper situational understanding. These design situations are fraught with wicked problems that are contradictory and complex. This paper intends to answer how the wickedness of the design situation when designing e-health technology for people diagnosed with schizophrenia can be understood and what consequences the design situation has for the design process. The paper presents a grounded theory analysis of stakeholder interviews and focus group interviews with people diagnosed with schizophrenia. Four wicked problems are identified: struggle of dependence, contradiction of social interaction, contradiction of trust and counteracting improvement behaviour. The problems are interrelated and have consequences for the design, acceptance, use and user involvement in design of e-health technology for people diagnosed with schizophrenia. The paper also shows the viability of using grounded theory for studying and describing situational wickedness. [ABSTRACT FROM AUTHOR]

Within the healthcare system, patients continue to take on a larger role in managing their health. However, due to the low prevalence of health literacy among the US adult population, many patients are unable to make appropriate medical decisions. The Internet is further contributing to the problem. Patients are looking to the Internet, which can include extremely complex or inaccurate text, when they have questions about their health more often than speaking with their providers. This presents the risk for patients to become confused, misled, or even believe false information about their health. In order for patients to manage their health successfully, they must develop health literacy. This will be possible through advancements in internet technology that will provide the patients with clear, credible health information. [ABSTRACT FROM AUTHOR]

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

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

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

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

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

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

Background: Behavioral and psychological symptoms of dementia (BPSD) are universal and associated with multiple negative outcomes. This pilot randomized controlled trial (RCT) evaluated the effect of using the WeCareAdvisor, an innovative web-based tool developed to enable family caregivers to assess, manage, and track BPSD.Methods: This RCT enrolled 57 dementia family caregivers from community and clinical settings in Ann Arbor, Michigan and Baltimore, Maryland. Participants were randomly assigned to immediate use of the WeCareAdvisor tool (WCA, n = 27) or a Waitlist control group (n = 30) that received the tool after a one-month waiting period. Outcomes for the caregiver and the person they were caring for were assessed at baseline (T0) and one-month followup for both the WCA (T1) and Waitlist control (T2) groups.Results: Caregiver mean age was 65.9 ± 14.0 years old. About half (49%) were spouses. Baseline characteristics were comparable between groups except for mean caregiver confidence which was higher in the control group (WCA 35.0 ± 10.0 vs. Waitlist control 39.7 ± 6.9, p = 0.04). There were no significant differences between the WCA and control groups in characteristics of the person with dementia. After their one-month of tool use (T1), WCA caregivers showed significant within group improvement in caregiver distress (- 6.08 ± 6.31 points, t = - 4.82, p < 0.0001) and behavioral frequency (- 3.60 ± 5.05, t = - 3.56, p = 0.002), severity (- 3.24 ± 3.87, t = - 4.19, p = 0.0003) and total behavioral score (- 6.80 ± 10.73, t = - 3.17, p = 004). In the same timeframe, Waitlist control caregivers showed a significant decrease in confidence (- 6.40 ± 10.30, t = - 3.40, p = 0.002). The WCA group showed greater improvement in distress compared to the Waitlist group (T0-T1; t = - 2.49, p = 0.02), which remained significant after adjusting for site and baseline distress. There were no significant between-group differences in caregiver confidence or other secondary outcomes. After their one month of tool use (T2), the Waitlist group also showed significant improvement in caregiver distress (- 3.72 ± 7.53, t = - 2.66, p = 0.013), stress (- 0.41 ± 1.02, t = - 2.19, p = 0.037), confidence (4.38 ± 5.17, t = 4.56, p < 0.0001), burden (- 2.76 ± 7.26, t = - 2.05, p = 0.05), negative communication (- 1.48 ± 2.96, t = - 2.70, p = 0.012) and behavioral frequency (- 1.86 ± 4.58, t = - 2.19, p = 0.037); distress remained significant after adjustment.Conclusions: In this pilot RCT, WCA use resulted in a significant decrease in caregiver distress. Future research will identify whether longer use of WCA can impact other caregiver and behavioral outcomes.Trial Registration: Clinicaltrials.gov identifier NCT02420535 (Date of registry: 4/20/2015, prior to the start of the clinical trial). [ABSTRACT FROM AUTHOR]

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

Background: This study aimed to assess the quality and readability of patient education information available on the internet on testicular cancer.Methods: Internet searches were performed using the keywords 'testicular cancer', 'testicular tumour', 'testicular tumor', 'testicular malignancy', 'germ cell tumour' and 'germ cell tumor' using Google, Yahoo! And Bing search engines with default settings. The first 50 web links appeared in each search engine were evaluated for their readability by using the validated Flesch Reading Ease Score (FRES) while accessibility, usability and reliability were assessed using the LIDA tool. The quality was assessed using DISCERN instrument. Non-parametric tests were used for statistical analysis.Results: Overall, 900 websites were assessed and 62 websites were included in the analysis. Twenty two (22) websites (35.5%) were certified by Health on the Net Foundation code of conduct (HON code). The majority (n = 57, 91.9%) were non-governmental websites. The median FRES score was 51.6 (range: 28.1-74.1), the overall median LIDA score was 115 (range: 81-147); accessibility 55 (range: 46-61), reliability 22 (range: 8-45) and usability 38.5 (range: 21-50), while the median DISCERN score was 43.5 (range: 16-69). The DISCERN score was significantly associated with the overall LIDA score and usability and reliability components of the LIDA score (p < 0.001). However, no significant associations were observed between readability and accessibility. A significant correlation was noted between usability and reliability components of the LIDA score (Spearman's rho: 0.789, p < 0.001).Conclusion: In this study, the readability, reliability and quality scores of most websites were found to be suboptimal and hence, there is potential for improvement. As the internet is expanding rapidly as a readily available source of information to the public, it is essential to implement steps to ensure that highest quality information is provided without any commercial motivation or bias. [ABSTRACT FROM AUTHOR]

Purpose Internet technology allows millions of people to find high quality medical resources online, with the result that personal healthcare and medical services have become one of the fastest growing markets in China. Data relating to healthcare search behavior may provide insights that could lead to better provision of healthcare services. However, discrepancies often arise between terminologies derived from professional medical domain knowledge and the more colloquial terms that users adopt when searching for information about ailments. This can make it difficult to match healthcare queries with doctors’ keywords in online medical searches. The paper aims to discuss these issues.Design/methodology/approach To help address this problem, the authors propose a transfer learning using latent factor graph (TLLFG), which can learn the descriptions of ailments used in internet searches and match them to the most appropriate formal medical keywords.Findings Experiments show that the TLLFG outperforms competing algorithms in incorporating both medical domain knowledge and patient-doctor Q&A data from online services into a unified latent layer capable of bridging the gap between lay enquiries and professionally expressed information sources, and make more accurate analysis of online users’ symptom descriptions. The authors conclude with a brief discussion of some of the ways in which the model may support online applications and connect offline medical services.Practical implications The authors used an online medical searching application to verify the proposed model. The model can bridge users’ long-tailed description with doctors’ formal medical keywords. Online experiments show that TLLFG can significantly improve the searching experience of both users and medical service providers compared with traditional machine learning methods. The research provides a helpful example of the use of domain knowledge to optimize searching or recommendation experiences.Originality/value The authors use transfer learning to map online users’ long-tail queries onto medical domain knowledge, significantly improving the relevance of queries and keywords in a search system reliant on sponsored links. [ABSTRACT FROM AUTHOR]

Artificial neural networks (ANN) are computing architectures with many interconnections of simple neural-inspired computing elements, and have been applied to biomedical fields such as imaging analysis and diagnosis. We have developed a new ANN framework called Cox-nnet to predict patient prognosis from high throughput transcriptomics data. In 10 TCGA RNA-Seq data sets, Cox-nnet achieves the same or better predictive accuracy compared to other methods, including Cox-proportional hazards regression (with LASSO, ridge, and mimimax concave penalty), Random Forests Survival and CoxBoost. Cox-nnet also reveals richer biological information, at both the pathway and gene levels. The outputs from the hidden layer node provide an alternative approach for survival-sensitive dimension reduction. In summary, we have developed a new method for accurate and efficient prognosis prediction on high throughput data, with functional biological insights. The source code is freely available at . [ABSTRACT FROM AUTHOR]

Medical healthcare is one of the fascinating applications using Internet of Things (IoTs). The pervasive smart environment in IoTs has the potential to monitor various human activities by deploying smart devices. In our pilot study, we look at narcolepsy, a disorder in which individuals lose the ability to regulate their sleep-wake cycle. An imbalance in the brain chemical called orexin makes the sleep pattern irregular. This sleep disorder in patients suffering from narcolepsy results in them experience irrepressible sleep episodes while performing daily routine activities. This study presents a novel method for detecting sleep attacks or sleepiness due to immune system attacks and affecting daily activities measured using the S-band sensing technique. The S-Band sensing technique is channel sensing based on frequency spectrum sensing using the orthogonal frequency division multiplexing transmission at a 2 to 4 GHz frequency range leveraging amplitude and calibrated phase information of different frequencies obtained using wireless devices such as card, and omni-directional antenna. Each human behavior induces a unique channel information (CI) signature contained in amplitude and phase information. By linearly transforming raw phase measurements into calibrated phase information, we ascertain phase coherence. Classification and validation of various human activities such as walking, sitting on a chair, push-ups, and narcolepsy sleep episodes are done using support vector machine, K-nearest neighbor, and random forest algorithms. The measurement and evaluation were carried out several times with classification values of accuracy, precision, recall, specificity, Kappa, and F-measure of more than 90% that were achieved when delineating sleep attacks. [ABSTRACT FROM AUTHOR]

Innovative human immunodeficiency virus (HIV) testing services will be needed to achieve the first 90 (90% of HIV-positive persons aware of their infection status) of the 90-90-90 target in China. Here, we describe an internet-based urine delivery testing service delivered through three pilot drugstores in Beijing that send specimens to a designated laboratory for HIV. From May 2016 to January 2017, we provided 500 HIV urine-testing service packs for display at the drugstores, and a total of 430 (86.0%) urine specimens were mailed back. All of the 430 urine specimens were of good quality and were tested. 70 urine specimens were HIV positive, showing a 16.3% (70/430) positivity rate. A total of 94.3% (66/70) of the HIV-positive participants obtained their test results through the internet, and 69.7% (46/66) of these participants received follow-up care. A total of 40 out of 46 (87.0%) participants agreed to have their results confirmed by a blood test, and 39 out of 40 (97.5%) participants were confirmed as HIV-1 positive, including two individuals that were previously diagnosed. Lastly, 28 out of 37 (75.7%) of the study participants were referred to the hospital and provided free antiviral treatment. Our data indicate that this innovative HIV testing service is effective and play an important role in HIV testing and surveillance. [ABSTRACT FROM AUTHOR]

We present two datasets. The first dataset comprises 992 point-in-time records of self-reported happiness and depression in 295 participants, each assigned to one of four intervention groups, in a study of the effect of web-based positive-psychology interventions. Each point-in-time measurement consists of a participant's responses to the 24 items of the Authentic Happiness Inventory and to the 20 items of the Center for Epidemiological Studies Depression (CES-D) scale. Measurements were sought at the time of each participant's enrolment in the study and on five subsequent occasions, the last being approximately 189 days after enrolment. The second dataset contains basic demographic information about each participant. The data are suitable for replication purpose and for various time-series analyses and between-group comparisons. The authors welcome collaborative research based on re-analyses of the data. [ABSTRACT FROM AUTHOR]

Background Twitter is increasingly recognized as an instructional tool by the emergency medicine (EM) community. In 2012, the Council of Residency Directors in Emergency Medicine (CORD) recommended that EM residency programs' Twitter accounts be managed solely by faculty. To date, little has been published regarding the patterns of Twitter use by EM residency programs. Objective We analyzed current patterns in Twitter use among EM residency programs with accounts and assessed conformance with CORD recommendations. Methods In this mixed methods study, a 6-question, anonymous survey was distributed via e-mail using SurveyMonkey. In addition, a Twitter-based search was conducted, and the public profiles of EM residency programs' Twitter accounts were analyzed. We calculated descriptive statistics and performed a qualitative analysis on the data. Results Of 168 Accreditation Council for Graduate Medical Education-accredited EM programs, 88 programs (52%) responded. Of those programs, 58% (51 of 88) reported having a program-level Twitter account. Residents served as content managers for those accounts in the majority of survey respondents (61%, 28 of 46). Most programs did not publicly disclose the identity or position of their Twitter content manager. We found a wide variety of applications for Twitter, with EM programs most frequently using Twitter for educational and promotional purposes. There is significant variability in the numbers of followers for EM programs' Twitter accounts. Conclusions Applications and usage among EM residency programs are varied, and are frequently not consistent with current CORD recommendations. [ABSTRACT FROM AUTHOR]

Chronic somatic conditions, such as psoriasis, arthritis psoriatica and rheumatoid arthritis, have a large impact on patients' lives. Tailored therapist-guided internet-based cognitive-behavioural therapy (ICBT) has been shown to be effective in improving physical and psychological well-being in these patients. Two cases are presented here, in order to provide an in-depth illustration of the course and content of this novel treatment and to investigate the therapeutic alliance in an online treatment. After face-to-face intakes, both patients received therapist-guided ICBT tailored to their specific problems and treatment goals. The treatment resulted in improved physical and psychological wellbeing and these clinically significant improvements were maintained at 6-month follow-up. In addition, the therapeutic relationship was evaluated positively by both patients and increased further during treatment, indicating an adequate therapeutic working alliance in this online treatment. These case reports show that tailored ICBT may contribute to improved care for patients with chronic somatic conditions. [ABSTRACT FROM AUTHOR]

Recently, healthcare services can be delivered effectively to patients anytime and anywhere using e-Health systems. e-Health systems are developed through Information and Communication Technologies (ICT) that involve sensors, mobiles, and web-based applications for the delivery of healthcare services and information. Remote healthcare is an important purpose of the e-Health system. Usually, the eHealth system includes heterogeneous sensors from diverse manufacturers producing data in different formats. Device interoperability and data normalization is a challenging task that needs research attention. Several solutions are proposed in the literature based on manual interpretation through explicit programming. However, programmatically implementing the interpretation of the data sender and data receiver in the e-Health system for the data transmission is counterproductive as modification will be required for each new device added into the system. In this paper, an e-Health system with the Semantic Sensor Network (SSN) is proposed to address the device interoperability issue. In the proposed system, we have used IETF YANG for modeling the semantic e-Health data to represent the information of e-Health sensors. This modeling scheme helps in provisioning semantic interoperability between devices and expressing the sensing data in a user-friendly manner. For this purpose, we have developed an ontology for e-Health data that supports different styles of data formats. The ontology is defined in YANG for provisioning semantic interpretation of sensing data in the system by constructing meta-models of e-Health sensors. The proposed approach assists in the auto-configuration of eHealth sensors and querying the sensor network with semantic interoperability support for the e-Health system. [ABSTRACT FROM AUTHOR]

Background: Excessive wait times for specialist care can have a substantial negative impact on health outcomes. The Champlain BASETM (Building Access to Specialists through eConsultation) eConsult service based in Ottawa, Canada has demonstrated the ability to improve patients' access to specialist care.Objective: We interviewed patients who were treated using eConsult in order to explore their attitudes towards the service and their experiences of receiving care via the service.Methods: We conducted a thematic analysis of patient interviews using a constant comparative approach. Patients whose primary care providers used the eConsult service in their care were contacted by telephone between June 2015 and January 2016 and completed 15-min semi-structured interviews.Results: Of 43 contacted participants, 30 completed interviews (70%). Over half of all respondents (n = 16) reported receiving a follow-up call or appointment within 1 week, and 26 stated that eConsult was useful in their case. Participants unanimously agreed that eConsult was an acceptable way to access specialist care, and 29 stated that they would ask their primary care provider to use eConsult on their behalf in the future. Three themes emerged from the thematic analysis of patient comments: access, acceptability of eConsult and strengthened role of the primary care provider.Conclusions: Patients expressed acceptance for eConsult as a model for improving access to specialist care, had largely positive experiences with it as a model of care delivery, and supported its use in their future care. [ABSTRACT FROM AUTHOR]

According to World Health Organization (WHO) estimations, one out of five adults worldwide will be obese by 2025. Worldwide obesity has doubled since 1980. In fact, more than 1.9 billion adults (39%) of 18 years and older were overweight and over 600 million (13%) of these were obese in 2014. 42 million children under the age of five were overweight or obese in 2014. Obesity is a top public health problem due to its associated morbidity and mortality. This paper reviews the main techniques to measure the level of obesity and body fat percentage, and explains the complications that can carry to the individual's quality of life, longevity and the significant cost of healthcare systems. Researchers and developers are adapting the existing technology, as intelligent phones or some wearable gadgets to be used for controlling obesity. They include the promoting of healthy eating culture and adopting the physical activity lifestyle. The paper also shows a comprehensive study of the most used mobile applications and Wireless Body Area Networks focused on controlling the obesity and overweight. Finally, this paper proposes an intelligent architecture that takes into account both, physiological and cognitive aspects to reduce the degree of obesity and overweight. [ABSTRACT FROM AUTHOR]

In response to the fundamental shift that has been taking place in the way chronic diseases are perceived and managed and the increasingly established role of patients as equal partners in the management of their condition, the Thalassaemia International Federation (TIF) has undertaken the design and development of a comprehensive online Expert Patients' Programme (EPP) for patients with thalassaemia. Focusing particularly on β-thalassaemia, the most severe form of thalassaemia, the goal of the programme is to develop patients' disease-related knowledge and self-care skills and enable them to co-manage their disease in a meaningful partnership with their treating physicians. An important goal of this ecourse is to empower patients to advocate for the improvement of national treatment services in every affected country. The aim of this article is threefold: (1) Relate TIF's EPP with the goals and outcomes of other EPPs, as they are made available in the literature. (2) Describe the rationale and distinguishing features of TIF's EPP on the basis of learning theories of knowledge acquisition and attrition, and best practices from the scientific disciplines of Human Computer Interaction (HCI) and Technology-Assisted Learning (TEL). (3) Relay the objectives of TIF's EPP and the intended international impact in relation to TIF's mission. [ABSTRACT FROM AUTHOR]