March 29, 2014

Internet Use and Depression Among Retired Older Adults in the United States: A Longitudinal Analysis.

Objectives.The purpose of this study is to examine the association between Internet use among retired older adults in the United States and changes in a commonly used predictor of depression (the CES-D).
Method.Analyzing data from four waves (2002-2008) of the Health and Retirement Survey, we assess whether an available and commonly used index of a depression state was affected by prior values of the index and Internet use. The sample includes 3,075 respondents observed over 4 waves of data, yielding a total of 12,300 observations. We analyzed the effect on depression of Internet use and past depression in a full sample and a matched sample. We also conducted informal tests for confounders. Finally, we tested a basic mediation model to determine whether Internet use affected depression through its relationship with loneliness and social isolation.
RESULTS: Across methods, we found a positive contribution of Internet use to mental well-being of retired older adults in the United States, where Internet use reduced the probability of a depression state by one third. We found no evidence of confounding. Some evidence of mediation was found.Discussion.Our dynamic probit model indicates that for retired older adults in the United States, Internet use was found to reduce the probability of a depressed state by about 33%. Number of people in the household partially mediates this relationship, with the reduction in depression largest for people living alone. This provides some evidence that the mechanism linking Internet use to depression is the remediation of social isolation and loneliness. Encouraging older adults to use the Internet may help decrease isolation and depression.

J Gerontol B Psychol Sci Soc Sci. 2014 Mar 26;

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The Internet Medical Journal is an editorial blog and is not to be used to guide medical management by patients or by health care providers. Articles are not edited for content. Authors' names are self-identified and not independently verified.

March 21, 2014

Email and Mobile Phone Prompts and Internet-Delivered Smoking Prevention Interventions

BACKGROUND: evidence concerning effectiveness of prompts to promote reuse of a smoking prevention website among children is still scarce.

OBJECTIVE: are prompts effective in promoting reuse of an intervention website?

METHODS: Schools were randomized to a no-prompt group (n=50) or a prompt group (n=58). All children could revisit the intervention website, but only the children in the prompt group received email and SMS prompts to revisit the website.

RESULTS: Children in the prompt group reused the intervention website significantly more often compared to children in the no-prompt group.

CONCLUSIONS: Prompts can stimulate children to reuse an intervention website aimed at smoking prevention.

J Med Internet Res. 2014;16(3):e86

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The Internet Medical Journal is an editorial blog and is not to be used to guide medical management by patients or by health care providers. Articles are not edited for content. Authors' names are self-identified and not independently verified.

March 19, 2014

Use of the Internet as a Source of Oral Health Information

Purpose: How do dental patients in Bangalore, India, use the Internet as a source of information on oral health? 

Materials and Methods: The data was collected from 572 patients attending the outpatient departments of public and private hospitals by administering a specially designed proforma questionnaire.

Results: 26% of patients used the Internet for information on oral health. 

Conclusion: Low socioeconomic status and a low educational level act as barriers to using the internet. Creating awareness amongst people of different educational backgrounds would increase internet use for acquiring information on oral health.

Oral Health Prev Dent. 2014 Jan 10

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The Internet Medical Journal is an editorial blog and is not to be used to guide medical management by patients or by health care providers. Articles are not edited for content. Authors' names are self-identified and not independently verified.

March 17, 2014

Exploring the efficacy and acceptability of Internet-delivered cognitive behavioural therapy for young adults with anxiety and depression: An open trial.

HYPOTHESIS: Internet based therapy works for young people with depression and anxiety.

METHODS: a therapist-guided Internet-delivered treatment for depression and anxiety in young adults aged 18-24 was evaluated. Four lessons were delivered over 5 weeks. Measurements of depression and anxiety were taken before treatment, immediately after treatment ended, and 3 months after treatment ended.


RESULTS: Treatment significantly reduced depression and anxiety. The therapist spent an average of 37 minutes (SD = 18 minutes) in contact with participants during treatment. Participants rated the treatment as acceptable.

CONCLUSIONS: Therapist-guided Internet-delivered treatments work in young adults with anxiety and depression.


Aust N Z J Psychiatry. 2014 Mar 12

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The Internet Medical Journal is an editorial blog and is not to be used to guide medical management by patients or by health care providers. Articles are not edited for content. Authors' names are self-identified and not independently verified.

Internet Gambling Among Community Adults and University Students in Macao.

BACKGROUND: Despite the high availability of offline gambling in Macao, China, Internet gambling remainS attractive to many gamblers due to its anonymity and convenience.

METHODS: 952 community adults were randomly sampled.

RESULTS: 5% of the community adult respondents preferred online gambling compared to offline gambling. The past-year prevalence of online gambling was about 1 %. Internet gambling was associated with casino employment. Male gender, casino employment, materialism, and life dissatisfaction were significant risk factors of pathological gambling.

CONCLUSION: People prefer offline compared to online gambling.

J Gambl Stud. 2014 Mar 5;

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The Internet Medical Journal is an editorial blog and is not to be used to guide medical management by patients or by health care providers. Articles are not edited for content. Authors' names are self-identified and not independently verified.

March 13, 2014

A preliminary investigation on the relationship between virtues and pathological internet use among Chinese adolescents.

BACKGROUND: Pathological Internet Use (PIU) has become a global issue associated with the increasing number of Internet users. Previous studies concerned both the interpersonal and intrapersonal vulnerable factors and the corresponding models. However, a limited amount of research has explored the relationship between positive factors and PIU.

OBJECTIVE: to clarify the relationship between virtues and PIU among Chinese adolescents

METHODS: adolescents completed a package of psychological inventories, including the Chinese Virtues Questionnaire (CVQ) and the Adolescent Pathological Internet Use Scale (APIUS).

RESULTS: Almost 10% of adolescents exhibited PIU. The virtues of "Relationship" and "conscientiousness" negatively predicted PIU, whereas "vitality" positively predicted PIU.  

CONCLUSIONS: Relationship and conscientiousness were possible protective factors and vitality a promotor of pathological Internet use. 

Child Adolesc Psychiatry Ment Health. 2014 Mar 4;8(1):8

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The Internet Medical Journal is an editorial blog and is not to be used to guide medical management by patients or by health care providers. Articles are not edited for content. Authors' names are self-identified and not independently verified.

March 12, 2014

Seasonal trends in sleep-disordered breathing

OBJECTIVE: is there a seasonal component to snoring and obstructive sleep apnea?

METHODS: Internet data were retrieved from Google Trends. Seasonal effects were evaluated in both adults and children.

RESULTS: Statistically significant seasonal effects were found with the peak in winter and early spring. The effect seemed to range from 5% to 50%.

CONCLUSIONS: significant seasonal trends on Google searches for both snoring and sleep apnea, with a peak in the winter and early spring.

Sleep Breath. 2014 Mar 5

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The Internet Medical Journal is an editorial blog and is not to be used to guide medical management by patients or by health care providers. Articles are not edited for content. Authors' names are self-identified and not independently verified.

March 10, 2014

Health domains for sale: the need for global health internet governance.


Health domains for sale: the need for global health internet governance.
J Med Internet Res. 2014;16(3):e62
Authors: Mackey TK, Liang BA, Kohler JC, Attaran A

A debate on Internet governance for health, or "eHealth governance", is emerging with the impending award of a new dot-health (.health) generic top-level domain name (gTLD) along with a host of other health-related domains. This development is critical as it will shape the future of the health Internet, allowing largely unrestricted use of .health second-level domain names by future registrants, raising concerns about the potential for privacy, use and marketing of health-related information, credibility of online health content, and potential for Internet fraud and abuse. Yet, prospective .health gTLD applicants do not provide adequate safeguards for use of .health or related domains and have few or no ties to the global health community. If approved, one of these for-profit corporate applicants would effectively control the future of the .health address on the Internet with arguably no active oversight from important international public health stakeholders. This would represent a lost opportunity for the public health, medical, and broader health community in establishing a trusted, transparent and reliable source for health on the Internet. Countries, medical associations, civil society, and consumer advocates have objected to these applications on grounds that they do not meet the public interest. We argue that there is an immediate need for action to postpone awarding of the .health gTLD and other health-related gTLDs to address these concerns and ensure the appropriate development of sound eHealth governance rules, principles, and use. This would support the crucial need of ensuring access to quality and evidence-based sources of health information online, as well as establishing a safe and reliable space on the Internet for health. We believe, if properly governed, .health and other domains could represent such a promise in the future.

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The Internet Medical Journal is an editorial blog and is not to be used to guide medical management by patients or by health care providers. Articles are not edited for content. Authors' names are self-identified and not independently verified.

Women's Experiences of Internet-Based or Postal Treatment for Stress Urinary Incontinence.


Women's Experiences of Internet-Based or Postal Treatment for Stress Urinary Incontinence.
Qual Health Res. 2014 Mar 5;
Authors: Björk AB, Sjöström M, Johansson EE, Samuelsson E, Umefjord G

Stress urinary incontinence is common and sometimes embarrassing. New, simple, and easily accessible treatments are needed. We telephone interviewed 21 women who participated in a randomized controlled study comparing two treatment programs based on instructions for pelvic floor muscle training. One program was Internet-based and included email support by a urotherapist; the other was sent by post. There was no face-to-face contact in either program. Our main aim was to explore the women's experiences of the Internet-based treatment. Grounded theory analysis revealed three categories: hidden but present, at a distance but close, and by myself but not alone. These were incorporated in a core category: acknowledged but not exposed. The leakage was often a well-hidden secret, but the study treatments lowered the barrier for seeking care. In the Internet group, a supportive patient-provider relationship developed despite the lack of face-to-face contact. Internet-based treatment programs can increase access to care and empower women.

24598777
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The Internet Medical Journal is an editorial blog and is not to be used to guide medical management by patients or by health care providers. Articles are not edited for content. Authors' names are self-identified and not independently verified.

Translating technology into patient care: Smartphone applications in pediatric health care.


Translating technology into patient care: Smartphone applications in pediatric health care.
Med J Armed Forces India. 2013 Apr;69(2):156-161
Authors: Sondhi V, Devgan A

The latest generations of smartphones are increasingly viewed as handheld computers rather than as phones and the applications on these phones are becoming increasingly popular among the medical professionals. A large number of health care applications are available across various smartphone platforms. At times it may be difficult to identify most appropriate and reliable application for use at the point of care. In this review, we have tried to identify the applications relevant to Pediatrics and Childcare which when used at the point of care might be helpful in improving patient care.

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The Internet Medical Journal is an editorial blog and is not to be used to guide medical management by patients or by health care providers. Articles are not edited for content. Authors' names are self-identified and not independently verified.

Acceptability and intended usage preferences for six HIV testing options among internet-using men who have sex with men.


Acceptability and intended usage preferences for six HIV testing options among internet-using men who have sex with men.
Springerplus. 2014;3:109
Authors: Sharma A, Stephenson RB, White D, Sullivan PS

BACKGROUND: Men who have sex with men (MSM) continue to be disproportionately impacted by the Human Immunodeficiency Virus (HIV) epidemic in the United States (US). Testing for HIV is the cornerstone of comprehensive prevention efforts and the gateway to early engagement of infected individuals in medical care. We sought to determine attitudes towards six different HIV testing modalities presented collectively to internet-using MSM and identify which options rank higher than others in terms of intended usage preference.
METHODS: Between October and November 2012, we surveyed 973 HIV-negative or -unknown status MSM and assessed their acceptability of each of the following services hypothetically offered free of charge: Testing at a physician's office; Individual voluntary counseling and testing (VCT); Couples' HIV counseling and testing (CHCT); Expedited/express testing; Rapid home self-testing using an oral fluid test; Home dried blood spot (DBS) specimen self-collection for laboratory testing. Kruskal-Wallis tests were used to determine whether the stated likelihood of using each of these modalities differed by selected respondent characteristics. Men were also asked to rank these options in order of intended usage preference, and consensual rankings were determined using the modified Borda count (MBC) method.
RESULTS: Most participants reported being extremely likely or somewhat likely to use all HIV testing modalities except DBS self-collection for laboratory testing. Younger MSM indicated greater acceptability for expedited/express testing (P < 0.001), and MSM with lower educational levels reported being more likely to use CHCT (P < 0.001). Non-Hispanic black MSM indicated lower acceptability for VCT (P < 0.001). Rapid home self-testing using an oral fluid test and testing at a physician's office were the two most preferred options across all demographic and behavioral strata.
CONCLUSIONS: Novel approaches to increase the frequency of HIV testing among US MSM are urgently needed. Combination testing packages could enable high risk MSM in putting together annual testing strategies personalized to their circumstances, and warrant due consideration as an element of combination HIV prevention packages.

24600551 [PubMed]
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The Internet Medical Journal is an editorial blog and is not to be used to guide medical management by patients or by health care providers. Articles are not edited for content. Authors' names are self-identified and not independently verified.

March 9, 2014

Phoneme-based self hearing assessment on a smartphone.


Phoneme-based self hearing assessment on a smartphone.
IEEE J Biomed Health Inform. 2013 May;17(3):526-9
Authors: Choi JM, Sohn J, Ku Y, Kim D, Lee J

Phonemes provide an interesting alternative to pure tones in hearing tests.We propose a new smartphone-based method for self-hearing assessment using the four Korean phonemes which are similar to the English phonemes /a/, /i/, /sh/, and /s/. We conducted tests on 15 subjects diagnosed with mild to severe hearing loss and estimated their conventional pure-tone hearing thresholds from their phoneme hearing thresholds using regression analysis. The phoneme-based self-hearing assessment was found to be sufficiently reliable in estimating the hearing thresholds of hearing impaired subjects. The difference between the hearing thresholds obtained through conventional pure-tone audiometry and those obtained using our method was 5.6 dB HL on average. The proposed hearing assessment was able to significantly reduce the mean test time compared to conventional pure-tone audiometry.

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COMMENT: what a great way to reduce costs and increase the number of people screened for hearing loss. 

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The Internet Medical Journal is an editorial blog and is not to be used to guide medical management by patients or by health care providers. Articles are not edited for content. Authors' names are self-identified and not independently verified.

Validity of a simple Internet-based outcome-prediction tool in patients with total hip replacement: a pilot study.


Validity of a simple Internet-based outcome-prediction tool in patients with total hip replacement: a pilot study.
J Telemed Telecare. 2014 Feb 28;
Authors: Stöckli C, Theiler R, Sidelnikov E, Balsiger M, Ferrari SM, Buchzig B, Uehlinger K, Riniker C, Bischoff-Ferrari HA

We developed a user-friendly Internet-based tool for patients undergoing total hip replacement (THR) due to osteoarthritis to predict their pain and function after surgery. In the first step, the key questions were identified by statistical modelling in a data set of 375 patients undergoing THR. Based on multiple regression, we identified the two most predictive WOMAC questions for pain and the three most predictive WOMAC questions for functional outcome, while controlling for comorbidity, body mass index, age, gender and specific comorbidities relevant to the outcome. In the second step, a pilot study was performed to validate the resulting tool against the full WOMAC questionnaire among 108 patients undergoing THR. The mean difference between observed (WOMAC) and model-predicted value was -1.1 points (95% confidence interval, CI -3.8, 1.5) for pain and -2.5 points (95% CI -5.3, 0.3) for function. The model-predicted value was within 20% of the observed value in 48% of cases for pain and in 57% of cases for function. The tool demonstrated moderate validity, but performed weakly for patients with extreme levels of pain and extreme functional limitations at 3 months post surgery. This may have been partly due to early complications after surgery. However, the outcome-prediction tool may be useful in helping patients to become better informed about the realistic outcome of their THR.

24585892
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The Internet Medical Journal is an editorial blog and is not to be used to guide medical management by patients or by health care providers. Articles are not edited for content. Authors' names are self-identified and not independently verified.

March 6, 2014

Internet use and its impact on engagement in leisure activities in china.


Internet use and its impact on engagement in leisure activities in china.
PLoS One. 2014;9(2):e89598
Authors: Zhou R, Fong PS, Tan P

INTRODUCTION: Internet use has become an increasingly common leisure time activity among Chinese citizens. The association between Internet use and engagement in leisure activities is especially unclear among China population. This study aims to investigate Internet usage and to determine whether active Internet use is a marker for low or high levels of leisure time activities.
METHODS/PRINCIPAL FINDINGS: With the use of a face-to-face structured questionnaire interview, a total of 2,400 respondents who met all screening requirements were surveyed to answer the questions in eight major cities in China. 66.2% (n = 1,589) of all respondents were identified as Internet users. Of these Internet users, 30.0%, 24.1%, 26.4%, and 19.6% were clustered as "informative or instrumental users," "entertainment users," "communication users," and "advanced users," respectively. Regarding time spent on Internet use in leisure time, more than 96% reported going online in non-work situations, and 26.2% (n = 416) were classified as "heavy Internet users." A logistic regression analysis revealed that there were significant differences in some leisure activities between non-Internet users and Internet users, with an observed one-unit increase in the leisure time dependence category increasing the probability of engaging in mental or social activities. In contrast, Internet users were less engaged in physical exercise-related activities. In addition, advanced Internet users were generally more active in leisure time activities than non-Internet users and other types of users.
CONCLUSION/SIGNIFICANCE: Internet use is one of very common leisure activities in Chinese citizens, and age, gender, income, and education are the key factors affecting Internet access. According to different types of leisure activities, Internet usage has different impacts on leisure activity engagement. High Internet dependence has no significant negative influence on engagement in mental or social leisure activities, but this group respondent tended to be less engaged in physical activities.

24586902
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The Internet Medical Journal is an editorial blog and is not to be used to guide medical management by patients or by health care providers. Articles are not edited for content. Authors' names are self-identified and not independently verified.

March 5, 2014

Improving adherence and clinical outcomes in self-guided internet treatment for anxiety and depression: a 12-month follow-up of a randomised controlled trial.


Improving adherence and clinical outcomes in self-guided internet treatment for anxiety and depression: a 12-month follow-up of a randomised controlled trial.
PLoS One. 2014;9(2):e89591
Authors: Titov N, Dear BF, Johnston L, McEvoy PM, Wootton B, Terides MD, Gandy M, Fogliati V, Kayrouz R, Rapee RM

BACKGROUND: A recent paper reported the outcomes of a study examining a new self-guided internet-delivered treatment, the Wellbeing Course, for symptoms of anxiety or depression. This study found the intervention resulted in significant symptom reductions. It also found that automated emails increased treatment completion and clinical improvements in a subsample with elevated anxiety and depression.
AIMS: To examine the clinical outcomes and the effect of automated emails at 12 months post-treatment.
METHOD: Participants, who were randomly allocated to a Treatment Plus Automated Emails Group (TEG; n = 100), a standard Treatment Group (TG; n = 106) or delayed-treatment Waitlist Control Group (Control; n = 51), were followed up at 12 months post-treatment. Eighty-one percent, 78% and 87% of participants in the TEG, TG and treated Waitlist Control Group provided symptom data at 12-month follow-up, respectively. The primary outcome measures were the Patient Health Questionnaire-9 Item Scale (PHQ-9) and the Generalized Anxiety Disorder-7 Item Scale (GAD-7).
RESULTS: Significant improvements in symptoms of anxiety and depression were observed over time in both the TEG and TG (Fs >69, ps <.001) these were sustained from post-treatment to 12-month follow-up (ps >.05), and were associated with large effect sizes. No statistically significant differences in symptoms were found between the TEG and TG at post-treatment, 3-month or 12-month follow-up. Previously reported symptom differences between TEG and TG participants with comorbid symptoms were no longer present at 12-month follow-up (ps >.70).
CONCLUSIONS: The overall benefits of the Wellbeing Course were sustained at 12-month follow-up. Although automated emails facilitated Course completion and reductions in symptoms for participants with comorbid anxiety and depression from pre-post treatment, these differences were no longer observed at 12-month follow-up. The results indicate that automated emails promote more rapid treatment response for people with elevated and comorbid symptoms, but may not improve longer term outcomes.
TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry ACTRN12610001058066.

24586897
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The Internet Medical Journal is an editorial blog and is not to be used to guide medical management by patients or by health care providers. Articles are not edited for content. Authors' names are self-identified and not independently verified.