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

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

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

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

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]

Conflict-of-interest statement: None declared. This review is based on a Cochrane systematic review entitled 'Interventions for replacing missing teeth: dental implants in fresh extraction sockets (immediate, immediate-delayed and delayed implants)' published in The Cochrane Library (see http://www.cochrane.org/ for information). Cochrane systematic reviews are regularly updated to include new research, and in response to comments and criticisms from readers. If you wish to comment on this review, please send your comments to the Cochrane website or to Marco Esposito. The Cochrane Library should be consulted for the most recent version of the review. The results of a Cochrane review can be interpreted differently, depending on people's perspectives and circumstances. Please consider the conclusions presented carefully. They are the opinions of the review authors, and are not necessarily shared by the Cochrane Collaboration. Purpose: To evaluate success, complications, aesthetics and patient satisfaction among immediate, immediate-delayed and delayed implants in post-extractive sockets and whether and when augmentation procedures are necessary and which is the most effective augmentation technique. Materials and methods: The Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE were searched up to the 2nd of June 2010 for randomised controlled clinical trials (RCTs) with a follow-up of at least 1 year in function comparing immediate, immediate-delayed and delayed implants, or comparing various bone augmentation procedures around the inserted implants. Outcome measures were prosthesis and implant failures, complications, patient satisfaction and preference including aesthetics, aesthetics evaluated by a dentist, peri-implant marginal bone level changes, etc. Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were conducted in duplicate and independently by two review authors. The statistical unit of the analysis was the patient. Results were expressed as fixed effects models using mean differences for continuous outcomes and risk ratios (RR) for dichotomous outcomes with 95% confidence intervals (CIs). Results: Fourteen eligible RCTs were identified but only seven trials could be included. Four RCTs evaluated implant placement timing. Two RCTs compared immediate versus delayed implants in 126 patients and found no statistically significant differences. One RCT compared immediate-delayed Copyright by versus delayed implants in 46 patients. After 2 years, patients in the immediate-delayed group perceived the time to functional loading significantly shorter, were more satisfied and an independent blinded assessor judged the level of the peri-implant marginal mucosa in relation to that of the adjacent teeth as more appropriate (RR = 1.68; 95% CI 1.04 to 2.72). These differences disappeared 5 years after loading, and significantly more complications occurred in the immediatedelayed group (RR = 4.20; 95% CI 1.01 to 17.43). One RCT compared immediate with immediately delayed implants in 16 patients for 2 years and found no differences. Three RCTs evaluated different techniques of bone grafting for implants immediately placed in extraction sockets. No statistically significant differences were observed when evaluating whether autogenous bone is needed in postextractive sites (one trial with 26 patients) or which was the most effective augmentation technique (two trials with 56 patients). Conclusions: There is insufficient evidence to determine the possible advantages or disadvantages of immediate, immediate-delayed or delayed implants, therefore these preliminary conclusions are based on few underpowered trials often judged to be at high risk of bias. There is a suggestion that immediate and immediate-delayed implants may be at a higher risk of implant failure and complications than delayed implants, on the other hand the aesthetic outcome might be better when placing implants just after tooth extraction. There is not enough reliable evidence supporting or refuting the need for augmentation procedures at immediate implants placed in fresh extraction sockets or whether any of the augmentation techniques is superior to the others. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to review the published literature on in vitro articles investigating the retentive force or wear features of different attachment systems, specifically for mandibular two-implant overdentures using an unsplinted prosthodontic design. Materials and Methods: An electronic search was performed through PubMed, Embase, and Medline databases using Boolean operators to combine the following key words: "retention," "wear," "overdenture attachments," "attachment systems," "implant-retained overdentures," and "implant-supported overdentures." The search was limited to articles written in English published up to October 2008. In addition, a hand search through articles and reference lists retrieved from the electronic search and peer-reviewed journals was also conducted. Results: From a total of 193 articles, only 15 met the specified inclusion criteria for the review. These articles provided evidence that the majority of attachment systems for mandibular two-implant overdentures demonstrate a reduction in their retentive force under in vitro conditions. Wear was unquestionably implicated as the etiologic factor for the loss of retention; however, the specific mechanisms involved in the wear process have not been researched adequately. Findings from the literature have also implicated several factors that influence the retentive force of the attachment system and its wear features; compelling evidence on its precise role however, is still lacking. Conclusions: Further in vitro investigations of the factors involved in the retention and wear of attachment systems for mandibular two-implant overdentures are still needed. These factors must be investigated separately under well-controlled conditions to limit the influence of confounding variables on their outcome. [ABSTRACT FROM AUTHOR]

This pilot study examined the feasibility of an interactive obesity prevention program delivered to a class of fourth-grade students utilizing daily e-mail messages sent to the students' home computers. The study involved a single intact class of 22 students, 17 (77%) of whom submitted parental permission documentation and received e-mail messages each school day over the course of one month. Concerns regarding Internet safety and children's use of e-mail were addressed fairly easily. Cost/benefit issues for the school did not seem prohibitive. Providing e-mail access to students without a home computer was accomplished by loaning them personal digital assistant (PDA) devices. In larger interventions, loaning PDAs is probably not feasible economically, although cell phones may be an acceptable alternative. It was concluded that this type of interactive obesity prevention program is feasible from most perspectives. Data from a larger scale effectiveness study is still needed. [ABSTRACT FROM AUTHOR]

Purpose: The aims of this article are to critique the available literature on dental implants in patients with ectodermal dysplasia (ED) syndrome and tooth agenesis, review the outcomes of implant therapy in these patients, and provide recommendations on the timing of implant placement for these patients. Materials and Methods: Searches were performed using Medline, Embase, All EBM Reviews, and Pre-Medline for articles relating to implant patients suffering from ED. Articles unrelated to the topic of dental implants in patients with ED and tooth agenesis, without abstracts, or in languages other than English were excluded. Selected articles were graded according to levels of evidence based upon guidelines set forth by the Agency for Health Care Policy and Research. Articles found to have a level of evidence of IV were excluded from this study. Results: The literature on dental implants in patients with ED and tooth agenesis was found to be scarce. No randomized controlled or case-controlled studies were found. Only 12 articles were found to satisfy all inclusion criteria. Conclusion: Implant survival rates vary between 88.5% and 97.6% in patients with ED and between 90% and 100% in patients with tooth agenesis. Implants placed in adolescent ED patients do not have a significant effect on craniofacial growth, while implants placed in ED patients younger than 18 years have a higher risk of failure. [ABSTRACT FROM AUTHOR]

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

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]

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

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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]

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

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]

The relevance of this topic is determined by the processes of "globalization 4.0", taking place in a new industrial revolution, which brings about both positive and negative consequences in science, medicine, engineering, financial sphere, geopolitical, and cultural dimensions. Digital technologies based on software and social networks become more effective and integrated, causing transformation in all spheres of the global economy. The purpose of the study is to analyze the development of smart technologies in medicine in conditions of "Globalization 4.0". The objective of the study is social and philosophical analysis of the "globalization 4.0" phenomenon and the revolutions that preceded itin the context of these revolutions the problems of smart technologies in medicine are developing; the study of the interaction problems of society, man and innovations in the sphere of medicine as mutually determined phenomena of human existence that satisfy, enrich and complement each other. The state of theme study that initiated problem solution: the concept of "globalization 4.0" entered the scientific world due to the works of Klaus Schwab, a German economist, founder and president of the World Economic Forum in Davos, the author of the book "The Fourth Industrial Revolution". Various aspects of this phenomenon that influenced its formation were reflected in the articles and monographs of Ukrainian scholars - V. Voronkova, V. Lukianets, O. Kravchenko, L. Ozadovska, V. Liakh, V. Pazeniuk, C. Raida, and others, as well as a series of Western scholars such as Ken Robinson, Samuel Greengard, Aarathi Prasad, Martin Ford, Kevin Kelli and others. Study methodology. The study methodology includes analysis of new smart technologies phenomena in medicine in the context of "globalization 4.0" that is developing in front of our eyes and is built on the basis of an integrated approach in the context of interdisciplinary character. The article uses such methods of scientific knowledge as analysis and synthesis, measurement, transition from abstract to concrete, synergistic approach, due to which it was possible to analyze complex problems of smart technologies in medicine. The scientific novelty of the study -- is the identification of interaction problems between man, society and medicine in the conditions of "globalization 4.0", which contribute to the formation of a new technological space. Results of the study: the positive and negative effects of "globalization 4.0" for the development of society, medicine and human beings are analyzed; the future scenarios in overcoming of dangerous diseases for humanity are revealed. Conclusion - the feature and fundamental difference of "globalization 4.0" is the synthesis of these technologies and their interaction in physical, digital and biological domains. [ABSTRACT FROM AUTHOR]

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

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

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

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

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

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]