Digital health information on surgical treatment options for overactive bladder is underrepresented.

PURPOSE: Digital health information gains growing importance in the medical landscape. Despite its opportunities, there is a risk of patient misinformation which may adversely influence the patient-physician relationship. This investigation aimed to identify and compare differences in the content and quality of online health information on overactive bladder (OAB) between different digital platforms. METHODS: The platforms Google search, Facebook, Instagram, LinkedIn, and YouTube were searched for the keyword OAB. The search result links were classified as useful or misleading, advertisement and personal experience. Information regarding the organization of the source and available content on treatment modalities was collected. Descriptive analysis was applied. Univariate and multivariate analyses were performed to evaluate heterogeneity regarding the distribution of information depending on the source. A p value < 0.05 was considered statistically significant. RESULTS: The source with the highest quantity of useful content was YouTube (100%) and Google (100%), whereas LinkedIn included mostly misleading content (73%). YouTube and Google provided the greatest variety of health information and were dominated by professional associations. Surgical procedures for treating OAB were only described in 32% and 48% of Google and YouTube results, respectively. On Google, sacral neuromodulation and OnabotulinumtoxinA were described in 26% and bladder augmentation in only 16% of the search results. In contrast, alternative medicine was present in 76%. CONCLUSIONS: A large gap in the information on surgical treatments of OAB could be identified independently from the utilized source. In contrast, conservative treatments and alternative medicine dominate the current informational sources.

Comparison of online health information between different digital platforms for pelvic organ prolapse.

PURPOSE: To identify differences in the content and quality of online health information for pelvic organ prolapse (POP) presented in social media and digital search engines to sustainably enhance patient guidance for adequate platforms for seeking online health information on POP. METHODS: The platforms Google search, Facebook, Instagram, LinkedIn, and YouTube were searched for the keyword "pelvic organ prolapse". Results were categorized as useful, misleading, advertising, and personal experience. Data were categorized into healthcare professionals, professional organisations, industry, patients, and individuals. The readability score and Health On the Net (HON) code seal were analyzed for Google. Descriptive and univariate analysis was performed. RESULTS: The source with the highest quantity of useful content was YouTube whereas LinkedIn included mostly advertisement and misleading content. YouTube and Google provided the greatest variety of health information. Social media platforms identified emotional distress and sleep disturbances as a common side effect of POP which is limited considered in clinical practice and provide novel insights of bothersome symptoms related to the disease. The spectrum of different surgical techniques was limited in all platforms. Only 12 (40.0%) were HON-qualified websites with a mean readability score of 10.4 which is considered fairly difficult to read. CONCLUSION: Besides Google search, YouTube was identified as a valuable online source for POP information. However, encompassing information of surgical techniques was limited in all platforms. Urogynecological association may contribute to improve patient information by providing online health information which is complete and easy to understand.

Tweets Related to Motivation and Physical Activity for Obesity-Related Behavior Change: Descriptive Analysis.

BACKGROUND: Obesity is one of the greatest modern public health problems, due to the associated health and economic consequences. Decreased physical activity is one of the main societal changes driving the current obesity pandemic. OBJECTIVE: Our goals are to fill a gap in the literature and study whether users organically utilize a social media platform, Twitter, for providing motivation. We examine the topics of messages and social network structures on Twitter. We discuss social media's potential for providing peer support and then draw insights to inform the development of interventions for long-term health-related behavior change. METHODS: We examined motivational messages related to physical activity on Twitter. First, we collected tweets related to physical activity. Second, we analyzed them using (1) a lexicon-based approach to extract and characterize motivation-related tweets, (2) a thematic analysis to examine common themes in retweets, and (3) topic models to understand prevalent factors concerning motivation and physical activity on Twitter. Third, we created 2 social networks to investigate organically arising peer-support network structures for sustaining physical activity and to form a deeper understanding of the feasibility of these networks in a real-world context. RESULTS: We collected over 1.5 million physical activity-related tweets posted from August 30 to November 6, 2018. A relatively small percentage of the tweets mentioned the term motivation; many of these were made on Mondays or during morning or late morning hours. The analysis of retweets showed that the following three themes were commonly conveyed on the platform: (1) using a number of different types of motivation (self, process, consolation, mental, or quotes), (2) promoting individuals or groups, and (3) sharing or requesting information. Topic models revealed that many of these users were weightlifters or people trying to lose weight. Twitter users also naturally forged relations, even though 98.12% (2824/2878) of these users were in different physical locations. CONCLUSIONS: This study fills a knowledge gap on how individuals organically use social media to encourage and sustain physical activity. Elements related to peer support are found in the organic use of social media. Our findings suggest that geographical location is less important for providing peer support as long as the support provides motivation, despite users having few factors in common (eg, the weather) affecting their physical activity. This presents a unique opportunity to identify successful motivation-providing peer support groups in a large user base. However, further research on the effects in a real-world context, as well as additional design and usability features for improving user engagement, are warranted to develop a successful intervention counteracting the current obesity pandemic. This is especially important for young adults, the main user group for social media, as they develop lasting health-related behaviors.

Qualitative analysis of sinus surgery posts on popular social media platforms.

INTRODUCTION: Social media platforms are constantly evolving and expanding to new populations, exposing their users to various topics and serving as an informal educational resource. Medical ideas and topics are freely discussed online, making understanding of what is present on these platforms of particular importance to the practicing medical professional. In the field of otolaryngology, the public social media portrayal of sinus surgery has not been previously reported. METHODS: Social media posts using keywords related to sinus surgery on Facebook, Instagram, and TikTok were qualitatively analyzed and categorized based on media type, author, subject, timing, depiction, and popularity. RESULTS: The total number of posts included in final analysis was 1798, with a majority stemming from Instagram (68.5%), then Facebook (20.2%) and finally TikTok (11.3%). The most common type of media analyzed was images (69.0%) and patients were more often authors of posts (45.1%) as compared to physicians (34.8%). The subjects of the posts were nearly equally reassurance regarding surgery (41.3%) and educational or informational posts (38.8%) and were most commonly timed in the postoperative period (41.3%). Sinus surgery was depicted in a positive fashion most frequently (56.6%), notably compared against the negative portrayal at 3.2%. Negative posts most commonly cited postoperative pain or bleeding. CONCLUSIONS: Most social media posts analyzed in this multi-platform study depicted sinus surgery in a positive fashion. Patients tended to post in the postoperative or perioperative period, whereas physicians tender to post intraoperative educational posts. Negative posts were most commonly centered around postoperative pain. Cautious interpretation of these results could be used for improving patient care and outreach in the digital age.

Anticipated mental health consequences of COVID-19 in a nationally-representative sample: Context, coverage, and economic consequences.

The COVID-19 pandemic will have long-term consequences due to social and economic disruption. This study aimed to understand the contextual, media, and economic factors associated with anticipated mental health consequences from the COVID-19 pandemic among Americans. A nationally representative survey of 1001 respondents was conducted in April 2020. Chi-square tests and logistic regressions examined anticipated emotional or psychological effects on respondents or members of their households should social distancing measures continue. Specific analyses focused on: 1) COVID-19 experience - knowing someone or being infected; living in a state with a high death rate; or state social distancing policies; 2) media exposure - source of coronavirus information and time spent on coronavirus news; and 3) economics - current economic effects; and anticipated long-term financial effects. 41% of respondents anticipated mental health consequences. Living in a state with a greater COVID-19 death rate (OR 1.73; 95% CI 1.10, 2.72) and anticipating long-term financial difficulties (OR 2.98; 95% CI 1.93, 4.60) were both associated with greater likelihood of anticipated mental health consequences. Those whose primary news source was television, as opposed to print or online, were almost 50% less likely to anticipate mental health challenges (OR 0.52 CI 0.33, 0.81), while those who reported spending two or more hours daily on COVID-19 news were 90% more likely (OR 1.90; 95% CI 1.27, 2.85). Aspects of community health, media consumption, and economic impacts influence anticipated poor mental health from the COVID-19 pandemic, suggesting each domain is relevant to interventions to address the consequences.

Motivators, barriers and communication channels for blood donation in relation to students at a university in Spain.

BACKGROUND: Targeting young people to donate blood is a particularly promising option. The aim of this work was to know the motivators, barriers and preferred communication channels for blood donation among university students, and to determine the factors that explain why donors give blood. MATERIALS AND METHODS: A questionnaire was distributed to 420 students (response rate: 88.3 %) attending the University of Huelva (Spain). Data were gathered on sociodemographic variables, blood donation history, motivators and barriers to donation, and communication channels. Non-parametric contrasts were used to determine possible differences in the sociodemographic characteristics or donation history, and logistic regression to determine the factors associated to donation. RESULTS: 67.38 % of the students surveyed were non-donors, 12.94 % were first-time donors, 11.05 % were infrequent donors and 8.63 % were frequent donors. "Solidarity" was the main motivator for donating blood (40 %). "Lack of information on where and how to give blood" was the main barrier for non-donors (26.4 %), with "medical reasons" cited by first-time donors (22.2 %). 93.8 % of donors wished to be notified about their next donation appointment. The majority of those surveyed preferred e-mail to receive alerts and information on donation campaigns. The factors that explained blood donation were over 26 years of age and place of residence. CONCLUSION: The study identified differences in the motivators, barriers and choice of communication channel among the university students in terms of blood donation, and the factors that explain blood donation. This knowledge is a useful source of information when designing blood donation campaigns that target young people.

Reproducing fear: the effect of birth stories on nulligravid women's birth preferences.

OBJECTIVE: Preference for caesarean birth is associated with higher fear and lower self-efficacy for vaginal birth. Vicarious experience is a strong factor influencing self-efficacy in nulligravid women, and is increasingly accessible via digital and general media. This study assessed the effect of exposure to different birth stories on nulligravid women's childbirth preferences and the factors mediating these effects. METHODS: Nulligravid women (N = 426) were randomly allocated to one of four conditions exposing them to written birth stories. Stories varied by type of birth (vaginal/caesarean) and storyteller evaluation (positive/negative) in a 2 × 2 design. Childbirth preference, fear of labour and vaginal birth, and self-efficacy for vaginal birth were measured before and after exposure via a two-way between groups analysis of covariance. Hierarchical regression models were used to determine the mediating effects of change in childbirth fear and childbirth self-efficacy. RESULTS: Variations in type of birth and storyteller evaluation significantly influenced childbirth preferences (F (1, 421) = 44.78, p < 0.001). The effect of vaginal birth stories on preference was significantly mediated by fear of labour and vaginal birth and self-efficacy. Effects of exposure to caesarean birth stories were not explained by changes in fear or self-efficacy. CONCLUSIONS: Childbirth preferences in nulligravid women can be significantly influenced by vicarious experiences. For stories about vaginal birth, the influence of birth stories on women's fear and self-efficacy expectancy are partly responsible for this influence. The findings highlight the importance of monitoring bias in vicarious experiences, and may inform novel strategies to promote healthy childbirth.

The Influence of Web-Based Tools on Maternal and Neonatal Outcomes in Pregnant Adolescents or Adolescent Mothers: Mixed Methods Systematic Review.

BACKGROUND: Pregnant adolescent women increasingly seek support during pregnancy and the puerperium through digital platforms instead of the traditional support system of family, friends, and the community. However, it is uncertain whether digital, web-based tools are reliable and effective in providing information to the user on a variety of topics such as fetal development, pregnancy outcomes, delivery, and breastfeeding to improve maternal and infant outcomes. OBJECTIVE: We aimed to identify web-based tools designed to promote knowledge, attitudes, and skills of pregnant adolescents or adolescent mothers and determine the efficacy of such web-based tools compared with conventional resources in promoting good pregnancy and infant outcomes. METHODS: A systematic search was conducted using Medline, Scopus, CINAHL, and PsycINFO for articles published from January 2004 to November 2020 to identify randomized trials and observational studies that evaluated digital, web-based platforms to deliver resources to pregnant adolescents. All articles written in the author's languages were included. Two authors independently reviewed abstracts and full-text articles for inclusion and assessed study quality. Risk of bias in each study was assessed using appropriate tools recommended by PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) and the Joanna Briggs Institute. We adopted a qualitative synthesis and presented the results in a narrative format due to the heterogenous nature of the studies. RESULTS: Seven articles met the inclusion criteria and were analyzed. The majority of the studies were graded to be of low to moderate risk for bias. The research methodologies represented were varied, ranging from randomized (n=1) and nonrandomized controlled trials (n=1) and prospective cohort studies (n=1) to mixed methods studies (n=1) and longitudinal surveys (n=3). Four studies included active web-based interventions, and 3 described exposure to web-based tools, including the use of social media and/or other internet content. Web-based tools positively influenced treatment-seeking intentions (intervention 17.1%, control 11.5%, P=.003) and actual treatment-seeking behavior for depression among postpartum adolescents (intervention 14.1%, control 6.5%, P<.001). In contrast, readily available information on the internet may leave adolescents with increased anxiety. The critical difference lies in information curated by health care professionals specifically to address targeted concerns versus self-acquired data sourced from various websites. CONCLUSIONS: Despite almost universal web use, few studies have used this platform for health promotion and disease prevention. Social media interventions or web-based tools have the potential to positively influence both maternal and infant outcomes in adolescent pregnancy, but there is a need for more well-conducted studies to demonstrate the effectiveness of these support programs. The vastness of the information available on the web limits the ability of health care professionals to monitor or control sources of information sought by patients. Thus, it is important to create professionally curated platforms to prevent or limit exposure to potentially misleading or harmful information on the internet while imparting useful knowledge to the user. TRIAL REGISTRATION: PROSPERO International Prospective Register of Systematic Reviews CRD42020195854; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=195854.

[Analysis of fake news disseminated during the COVID-19 pandemic in BrazilAnálisis de las noticias falsas divulgadas durante la pandemia de COVID-19 en Brasil]. / Análise de fake news veiculadas durante a pandemia de COVID-19 no Brasil.

OBJECTIVE: To describe the characteristics of fake news about COVID-19 disseminated in Brazil from January to June 2020. METHOD: The fake news recorded until 30 June 2020 in two websites (Globo Corporation website G1 and Ministry of Health) were collected and categorized according to their content. From each piece of fake news, the following information was extracted: publication date, title, channel (e.g., WhatsApp), format (text, photo, video), and website in which it was recorded. Terms were selected from fake news titles for analysis in Google Trends to determine whether the number of searches using the selected terms had increased after the fake news appeared. The Brazilian regions with the highest percent increase in searches using the terms were also identified. RESULTS: In the two websites, 329 fake news about COVID-19 were retrieved. Most fake news were spread through WhatsApp and Facebook. The most frequent thematic categories were: politics (20.1%), epidemiology and statistics (e.g., proportion of cases and deaths) (19.5%), and prevention (16.1%). According to Google Trends, the number of searches using the terms retrieved from the fake news increased 34.3% during the period studied. The largest increase was recorded in the Southeast (45.1%) and the Northeast (27.8%). CONCLUSIONS: The fake news spread during the first 6 months of the COVID-19 pandemic in Brazil were characterized by political content as well as misinformation about the number of cases and deaths and about prevention measures and treatment. The main dissemination channels were WhatsApp and Facebook, with the use of messages, images, and videos, with greater reach in the Southeast and Northeast of Brazil.

OBJETIVO: Analizar algunas características de las noticias falsas sobre la COVID-19 en circulación en Brasil de enero a junio del 2020. MÉTODOS: Se recolectaron las noticias falsas registradas hasta el 30 de junio del 2020 en dos sitios (G1, perteneciente a la Corporación Globo, y el Ministerio de Salud) y se clasificaron de acuerdo con su contenido. Se extrajeron los siguientes datos de cada noticia engañosa: fecha de circulación, título, canal (por ejemplo, WhatsApp) y formato de divulgación (texto, fotografía o video) y portal de registro. Se analizaron en Google Trends los términos encontrados en los títulos de las noticias falsas para determinar si había aumentado el número de búsquedas en Google con esos términos después de la difusión de una noticia engañosa. También se determinaron las macrorregiones brasileñas con el mayor aumento porcentual en las búsquedas hechas con los términos analizados. RESULTADOS: Se encontraron 329 noticias falsas relacionadas con la pandemia de COVID-19 en los sitios estudiados (253 en el G1 y 76 en el Ministerio de Salud). Esas noticias se divulgaron principalmente por medio de WhatsApp y Facebook. Las categorías temáticas más frecuentes fueron política (por ejemplo, falsificación de la vacuna contra la COVID-19 por los gobernantes, 20,1%), epidemiología y estadística (proporción de casos y muertes, 19,5%) y prevención (16,1%). Según Google Trends, aumentaron un 34,3% las búsquedas en las cuales se utilizaban términos contenidos en las noticias falsas. El mayor aumento de esa clase se registró en el sudeste (45,1%) y el nordeste (27,8%) del país. CONCLUSIONES: Las noticias falsas divulgadas durante los seis primeros meses de la pandemia de COVID-19 en Brasil se caracterizaron por contenidos de posicionamiento político y desinformación sobre el número de casos y muertes y sobre las medidas de prevención y tratamiento. Los principales medios de divulgación fueron WhatsApp y Facebook, con utilización de mensajes, imágenes y videos, y un mayor alcance en las regiones sudeste y nordeste del país.

[Quality of "crisis communication" media during the COVID-19 pandemic in the Great Maghreb countries]. / Qualité des supports de communication de crise lors de la pandémie de la COVID-19 au Grand Maghreb.

OBJECTIVE: To objectively assess the quality of "crisis communication" media, during the COVID-19 pandemic, in the three Greater Maghreb countries (Tunisia, Algeria, Morocco). METHODS: A compliance audit for press releases and epidemiological bulletins was analyzed against a quality benchmark, which had been specifically designed by the authors. This framework, made up of five dimensions and 50 items, graded (0/1), was applied by two researchers in preventive medicine. Multiplying the scores by a coefficient of two resulted in a partial score of 20 points for each dimension and a total score of 100 points for the checklist taken as a whole. The quality of the communication media was considered to be good when exceeding the thresholds of 15/20 for the different dimensions and 75/100 for the entire grid. RESULTS: A total of 141 information media were included in this audit (Tunisia: 60; Algeria: 60; Morocco: 21). The overall median quality score for these media was only 56/100 (IIQ: [46-58]), without major variability between countries. The most appreciated dimension was "maintaining the confidence of the population", with an overall median score of 14/20 (12/20 for epidemiological bulletins and 16/20 for press releases). The most poorly rated dimension was "strengthening community participation", with a median score of only 4/20 (6/20 for epidemiological bulletins and 4/20 for press releases). CONCLUSION: The quality of the Maghreb crisis communication media during COVID-19 was insufficient in most of its dimensions and items, particularly from a psychosocial standpoint. Reinforcement of the capacities of communication officers to develop information material and supports during health crises is indispensable and should be considered as an urgent matter.

Framework for Managing the COVID-19 Infodemic: Methods and Results of an Online, Crowdsourced WHO Technical Consultation.

BACKGROUND: An infodemic is an overabundance of information-some accurate and some not-that occurs during an epidemic. In a similar manner to an epidemic, it spreads between humans via digital and physical information systems. It makes it hard for people to find trustworthy sources and reliable guidance when they need it. OBJECTIVE: A World Health Organization (WHO) technical consultation on responding to the infodemic related to the coronavirus disease (COVID-19) pandemic was held, entirely online, to crowdsource suggested actions for a framework for infodemic management. METHODS: A group of policy makers, public health professionals, researchers, students, and other concerned stakeholders was joined by representatives of the media, social media platforms, various private sector organizations, and civil society to suggest and discuss actions for all parts of society, and multiple related professional and scientific disciplines, methods, and technologies. A total of 594 ideas for actions were crowdsourced online during the discussions and consolidated into suggestions for an infodemic management framework. RESULTS: The analysis team distilled the suggestions into a set of 50 proposed actions for a framework for managing infodemics in health emergencies. The consultation revealed six policy implications to consider. First, interventions and messages must be based on science and evidence, and must reach citizens and enable them to make informed decisions on how to protect themselves and their communities in a health emergency. Second, knowledge should be translated into actionable behavior-change messages, presented in ways that are understood by and accessible to all individuals in all parts of all societies. Third, governments should reach out to key communities to ensure their concerns and information needs are understood, tailoring advice and messages to address the audiences they represent. Fourth, to strengthen the analysis and amplification of information impact, strategic partnerships should be formed across all sectors, including but not limited to the social media and technology sectors, academia, and civil society. Fifth, health authorities should ensure that these actions are informed by reliable information that helps them understand the circulating narratives and changes in the flow of information, questions, and misinformation in communities. Sixth, following experiences to date in responding to the COVID-19 infodemic and the lessons from other disease outbreaks, infodemic management approaches should be further developed to support preparedness and response, and to inform risk mitigation, and be enhanced through data science and sociobehavioral and other research. CONCLUSIONS: The first version of this framework proposes five action areas in which WHO Member States and actors within society can apply, according to their mandate, an infodemic management approach adapted to national contexts and practices. Responses to the COVID-19 pandemic and the related infodemic require swift, regular, systematic, and coordinated action from multiple sectors of society and government. It remains crucial that we promote trusted information and fight misinformation, thereby helping save lives.

Altered health knowledge and attitudes among health sciences students following media exposure.

Communications media that fails to present information supported by evidence-based practice has the potential to adversely influence knowledge and, ultimately, behaviors. We assessed the immediate effect of a health science documentary on knowledge, attitude, and beliefs among collegiate health sciences students enrolled in an entry-level nutrition course using surveys administered online. Participants (n = 160) completed the pre-survey, watched the documentary What the Health, and immediately completed the post-survey in one setting. Compared with pre-survey scores, participants reported a significant decrease in knowledge, change in attitude to health toward regulation of animal products, and increased agreement with all seven, pre-selected contradictory health claims presented in the documentary. Post-documentary, most participants reported they were planning to make a change in their dietary habits to reflect a plant-based diet. Documentaries providing health information contradictory to the current body of scientific literature are persuasive and can potentially increase negative health behaviors. Inclusion of practices within the health curriculum that encourage, and ultimately, improve health literacy among students before entering the health care workforce is essential.

Media reporting of health interventions in New Zealand: a retrospective analysis.

AIM: To evaluate New Zealand media articles on their coverage of key issues regarding health interventions and whether it is consistent with available evidence. METHODS: A retrospective analysis was carried out of all articles published in five New Zealand media sources over a 6-week period between 15 October and 26 November 2014. Articles were included if their primary focus was on health interventions involving medications, devices or in-hospital procedures. Articles were assessed for coverage of key issues using previously validated 10-point criteria. A literature review was performed to compare content with scientific evidence. RESULTS: We identified 30 articles for review. Only 4 of 30 articles covered indications, benefits and risks, and of these, two were consistent with available evidence (7%, 95% CI 1%-22%). For articles that discussed at least one of indications, benefits or risks, and there was corresponding evidence available, there was a high level of consistency with the evidence (89%, 95% CI 77%-95%). The overall mean value of coverage from the 10-point criteria was 51% (95% CI 45%-58%). Single questions regarding the potential harm, costs associated with the intervention and the availability of alternative options were particularly poorly covered. They were rated as 'satisfactory' in 13%, 23% and 33% of the 30 articles respectively. CONCLUSION: New Zealand news articles covering medical treatments and interventions are largely consistent with available evidence but are incomplete. Vital information is being consistently missed, especially around the potential harms and costs of medical interventions.

Disease awareness campaigns in printed and online media in Latvia: cross-sectional study on consistency with WHO ethical criteria for medicinal drug promotion and European standards.

BACKGROUND: European legislation prohibits direct-to-consumer advertising of prescription medicines, but allows drug manufacturers to provide information to the public on health and diseases. Our aim was to measure the frequency of disease awareness campaigns in Latvian media and assess their compliance with international and European standards. METHODS: Materials on health/disease and treatments were collected between April and September 2015 from 12 newspapers and magazines and six online portals. Disease awareness campaigns were assessed using a previously developed instrument based on the WHO Ethical Criteria for Medicinal Drug promotion and European standards (EU law and pharmaceutical industry self-regulatory guidelines). Collected materials were used to examine the information provided on medical conditions and their diagnosis and treatment. The inter-rater reliability was calculated. RESULTS: We collected 263 materials from print (n = 149) and online media (n = 114); 94 were news items and 169 were disease-awareness advertisements. Cancer, cardiovascular problems, allergies and respiratory diseases were common topics. Of the 157 campaigns assessed, non-compliance was identified in 149 cases (inter-rater reliability 90%), mainly due to misleading or incomplete information, lack of balance and the absence of a listed author/sponsor. Six disease awareness campaigns directly mentioned a pharmaceutical product by brand name and other four included the logo or name of a manufacturer, referred to a condition and indirectly mentioned a treatment, all in contravention with European law. CONCLUSIONS: The compliance of disease awareness campaigns in Latvian media with international and European standards is low. This raises concerns about the nature of information being conveyed. Through lack of balance, missing sponsorship information, and misleading or incomplete information, these campaigns could contribute to inaccurate self-diagnosis and generate demand among those who might not need medical treatment.

Harnessing Reddit to Understand the Written-Communication Challenges Experienced by Individuals With Mental Health Disorders: Analysis of Texts From Mental Health Communities.

BACKGROUND: Mental disorders such as depression, bipolar disorder, and schizophrenia are common, incapacitating, and have the potential to be fatal. Despite the prevalence and gravity of mental disorders, our knowledge concerning everyday challenges associated with them is relatively limited. One of the most studied deficits related to everyday challenges is language impairment, yet we do not know how mental disorders can impact common forms of written communication, for example, social media. OBJECTIVE: The aims of this study were to investigate written communication challenges manifest in online mental health communities focusing on depression, bipolar disorder, and schizophrenia, as well as the impact of participating in these online mental health communities on written communication. As the control, we selected three online health communities focusing on positive emotion, exercising, and weight management. METHODS: We examined lexical diversity and readability, both important features for measuring the quality of writing. We used four well-established readability metrics that consider word frequencies and syntactic complexity to measure writers' written communication ability. We then measured the lexical diversity by calculating the percentage of unique words in posts. To compare lexical diversity and readability among communities, we first applied pairwise independent sample t tests, followed by P value adjustments using the prespecified Hommel procedure to adjust for multiple comparison. To measure the changes, we applied linear least squares regression to the readability and lexical diversity scores against the interaction sequence for each member, followed by pairwise independent sample t tests and P value adjustments. Given the large sample of members, we also report effect sizes and 95% CIs for the pairwise comparisons. RESULTS: On average, members of depression, bipolar disorder, and schizophrenia communities showed indications of difficulty expressing their ideas compared with three other online health communities. Our results also suggest that participating in these platforms has the potential to improve members' written communication. For example, members of all three mental health communities showed statistically significant improvement in both lexical diversity and readability compared with members of the OHC focusing on positive emotion. CONCLUSIONS: We provide new insights into the written communication challenges faced by individuals suffering from depression, bipolar disorder, and schizophrenia. A comparison with three other online health communities suggests that written communication in mental health communities is significantly more difficult to read, while also consisting of a significantly less diverse lexicon. We contribute practical suggestions for utilizing our findings in Web-based communication settings to enhance members' communicative experience. We consider these findings to be an important step toward understanding and addressing everyday written communication challenges among individuals suffering from mental disorders.

Body image diversity in the media: A content analysis of women's fashion magazines.

ISSUE ADDRESSED: The narrow representation of body image in the media has been linked to body dissatisfaction, particularly among readers of women's fashion magazines. Some countries have made efforts to improve body image diversity in the media and the fashion industry. This has included attempts to regulate minimum body size of models (eg, Israel, France), and the development of codes of practices such as the Australian Industry Code of Conduct on Body Image. However, there is little evidence of whether these efforts have impacted media content. METHOD: This study aimed to gauge the state of body image diversity in the print media 5 years after the introduction of the Australian Code of Conduct via a content analysis of 13 Australian women's fashion magazines published in 2015. RESULTS: Results revealed low levels of diversity in body size, ethnicity and age among models depicted in fashion magazine images. Models were predominantly young, white and underweight. CONCLUSION: The results suggest that efforts to improve body image diversity have had little impact on print media. Further research is needed to understand the barriers to increased diversity in the representation of body image in the media so that the industry and regulatory bodies can further address this important issue. This is increasingly pressing given the proliferation of content now enabled through online media platforms.

Longitudinal Changes in Psychological States in Online Health Community Members: Understanding the Long-Term Effects of Participating in an Online Depression Community.

BACKGROUND: Major depression is a serious challenge at both the individual and population levels. Although online health communities have shown the potential to reduce the symptoms of depression, emotional contagion theory suggests that negative emotion can spread within a community, and prolonged interactions with other depressed individuals has potential to worsen the symptoms of depression. OBJECTIVE: The goals of our study were to investigate longitudinal changes in psychological states that are manifested through linguistic changes in depression community members who are interacting with other depressed individuals. METHODS: We examined emotion-related language usages using the Linguistic Inquiry and Word Count (LIWC) program for each member of a depression community from Reddit. To measure the changes, we applied linear least-squares regression to the LIWC scores against the interaction sequence for each member. We measured the differences in linguistic changes against three online health communities focusing on positive emotion, diabetes, and irritable bowel syndrome. RESULTS: On average, members of an online depression community showed improvement in 9 of 10 prespecified linguistic dimensions: "positive emotion," "negative emotion," "anxiety," "anger," "sadness," "first person singular," "negation," "swear words," and "death." Moreover, these members improved either significantly or at least as much as members of other online health communities. CONCLUSIONS: We provide new insights into the impact of prolonged participation in an online depression community and highlight the positive emotion change in members. The findings of this study should be interpreted with caution, because participating in an online depression community is not the sole factor for improvement or worsening of depressive symptoms. Still, the consistent statistical results including comparative analyses with different communities could indicate that the emotion-related language usage of depression community members are improving either significantly or at least as much as members of other online communities. On the basis of these findings, we contribute practical suggestions for designing online depression communities to enhance psychosocial benefit gains for members. We consider these results to be an important step toward a better understanding of the impact of prolonged participation in an online depression community, in addition to providing insights into the long-term psychosocial well-being of members.

[Choosing wisely recommendations in rheumatology : One year after their first publication]. / Klug-entscheiden-Empfehlungen in der Rheumatologie : Ein Jahr nach der Erstveröffentlichung.

Almost 1 year after publication of the Choosing wisely recommendations ("Klug-entscheiden-Empfehlungen," KEE) for rheumatology, it is evident that they have found their way into specialist and lay publications, the media used by self-help groups, online media, and continuing education congresses. As such, a broad target audience has been reached. In the meantime, newly established or updated guidelines have been published which incorporate the KEE for rheumatology. The KEE provide a gateway into clinical Standard Operating Procedures or recommendations.

¿Es tiempo de exigir publicidad basada en la evidencia?

Claims made in current advertising for medical products is not necessarily scientifically proven, yet at the same time clinicians are required to adopt evidence-based practices and undergo periodic certifications. This is a clear contradiction. It is crucial to begin to reflect on the need to regulate information presented in the media and to place greater emphasis on patient well-being and safety instead of on third-party interests. The medical community must demand stricter regulations and evidence-based advertising policies.