January 25, 2015

Online Mental Health Treatments

The internet as a mental health advisor in Germany--results of a national survey.
BACKGROUND: The Internet constitutes a popular source of health information. However, the use of the Internet and other modern media in the domain of mental health remains widely unclear.

QUESTION: are people ready to seek mental health information online, and make use of online counseling and media-assisted psychotherapy?

METHODS: A representative survey of  2411 Germans was conducted.

  • Greater than a fourth of Germans surveyed would consider seeking help online in case of mental health problems, primarily by using the Internet to do research and by participating in online forums. 
  • A small number of those surveyed had already used online counseling. 
  • Most did not know about the availability of online counseling. 
  • Willingness to use online counseling in the future was moderate, with most showing a clear preference towards face-to-face treatment. 
CONCLUSION: It is likely that there will be an increasing demand for media-assisted psychological counseling and interventions. The health care system should prepare for this change and enlighten patients concerning the possibilities and potential risks of online mental health treatments.
PLoS One. 2013;8(11):e79206

December 29, 2014

False information on fluoridation dominates the Internet

Community water fluoridation on the Internet and social media.
QUESTION: how accurate is information on the Internet regarding community water fluoridation?

METHODS: website traffic was evaluated. Facebook, Twitter, and YouTube activity was categorized as "pro" or "con" regarding community water fluoridation.

 RESULTS: website traffic to the "con" sites was found to exceed "pro" sites by 5 to 60 fold. Searching "fluoride" and "fluoridation" on Facebook resulted in 88% to 100% "con" groups and pages; on Twitter and YouTube the result was 64% "con" tweets and 99% "con" videos. "Cancer, " "useless, " and "poisonous" were the three major arguments used against community water fluoridation.

CONCLUSIONS: false anti-fluoridation information significantly dominates the Internet and social media.

J Mass Dent Soc. 2014;63(2):32-6

November 23, 2014

Portable Internet ECG Recording Systems

QUESTION: Is an Internet-enabled ECG recording system (iECG) useful?

METHODS: 24 individuals with risk of cardiovascular disease were monitored. The subjects sent ECG recordings over the Internet to their physician.

RESULTS: Only 21/24 subjects were able to send their ECG recordings over the Internet. A total of 504 ECG recordings were obtained using the iECG. No adverse cardiovascular events were observed. A survey of the subjects showed a 68% satisfaction rate.

CONCLUSION: The iECG may prove to be a useful tool for monitoring cardiovascular health in workers residing abroad.

J Occup Health. 2014 Sep 17

November 18, 2014

Antibiotic Time-outs

This study was a before and after study. The authors compared antibiotic use before and after a bi-weekly "time out" session during which residents reviewed antibiotic use among their in-patients. Not surprisingly, they found that their intervention worked.

COMMENT: this is a classic case of the Hawthorne Bias. Am surprised at how sloppy this research was, yet got published in a top medical research journal. SHAME ! 

Antibiotic Self-stewardship: Trainee-Led Structured Antibiotic Time-outs to Improve Antimicrobial Use.

October 30, 2014

The 5 Secrets of Healthy Aging

A 35y long study has identified 5 simple ways to increase your chances of healthy aging. Here they are:
  1. eat well
  2. work out
  3. drink less
  4. keep your weight down
  5. never smoke. 

Secret of healthy ageing discovered in ground-breaking 35-year study - Telegraph

October 22, 2014

CDC Making Big Mistake on Ebola Patients

"Hospitals should be prepared to recognize possible cases, isolate them — and then call for help. Period,"

COMMENT: I agree. Rapid isolation and triage is the best strategy.

October 21, 2014

Internet-Based Healthy Eating Program Improves Diet and Body

BACKGROUND: The HealthValues Healthy Eating Programme is a standalone Internet-based intervention that employs a novel strategy for promoting behavior change (analyzing one's reasons for endorsing health values) alongside other psychological principles that have been shown to influence behavior. The program consists of phases targeting motivation (dietary feedback and advice, analyzing reasons for health values, thinking about health-related desires, and concerns), volition (implementation intentions with mental contrasting), and maintenance (reviewing tasks, weekly tips).

OBJECTIVE: The aim was to examine the effects of the program on consumption of fruit and vegetables, saturated fat, and added sugar over a 6-month period.

METHODS: A total of 82 females and 18 males were recruited using both online and print advertisements in the local community. They were allocated to an intervention or control group using a stratified block randomization protocol. The program was designed such that participants logged onto a website every week for 24 weeks and completed health-related measures. Those allocated to the intervention group also completed the intervention tasks at these sessions. Additionally, all participants attended laboratory sessions at baseline, 3 months, and 6 months. During these sessions, participants completed a food frequency questionnaire (FFQ, the Block Fat/Sugar/Fruit/Vegetable Screener, adapted for the UK), and researchers (blind to group allocation) measured their body mass index (BMI), waist-to-hip ratio (WHR), and heart rate variability (HRV).

RESULTS: fruit and vegetable consumption went up. Intake of saturated fats went down. Sugar intake went down. BMI and WHR both went down. 

CONCLUSIONS: The Web-based nature of the program makes it a potentially cost-effective way of promoting healthy eating.

J Med Internet Res. 2014;16(10):e231

October 16, 2014

Prevalence of internet and social media usage in orthopedic surgery.

Prevalence of internet and social media usage in orthopedic surgery.
Background: Social networking and Internet usage has become an increasingly important means of patient communication and referral.
Methods: New patients were surveyed (n=752) between December 2012 to January 2013 in a major academic orthopaedic center to complete a 15-item questionnaire including social media and Internet usage information. Data was collected for all orthopaedic sub-specialties and statistical analysis was performed.
Results: Fifty percent of patients use social networking sites, such as Facebook. Sports medicine patients tend to be higher social networking users (35.9%) relative to other services (9.8-17.9%) and was statistically higher when compared to the joints/tumor service (P<0.0001). Younger age was the biggest indicator predicting the use of social media. Patients that traveled between 120 to 180 miles from the hospital for their visits were significantly more likely to be social media users, as were patients that did research on their condition prior to their new patient appointment.
Conclusions: Orthopedic patients who use social media/Internet are more likely to be younger, researched their condition prior to their appointment and undergo a longer average day's travel (120-180 miles) to see a physician. In an increasingly competitive market, surgeons with younger patient populations will need to utilize social networking and the Internet to capture new patient referrals.

Orthop Rev (Pavia). 2014 Aug 8;6(3):5483

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;

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

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

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

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;

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

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