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2.
Front Immunol ; 13: 931783, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35935954

RESUMO

Background: IL-37 is a recently identified cytokine with potent immunosuppressive functions. The research fronts of IL-37 are worth investigating, and there is no bibliometric analysis in this field. The purpose of this study is to construct the intellectual base and predict research hotspots of IL-37 research both quantitatively and qualitatively according to bibliometric analysis. Methods: The articles were downloaded from the Web of Science Core Collection (WoSCC) database from the inception of the database to 1 April 2022. CiteSpace 5.8.R3 (64-bit, Drexel University, Philadelphia, PA, USA) and Online Analysis Platform of Literature Metrology (https://bibliometric.com/) were used to perform bibliometric and knowledge-map analyses. Results: A total of 534 papers were included in 200 academic journals by 2,783 authors in 279 institutions from 50 countries/regions. The journal Cytokine published the most papers on IL-37, while Nature Immunology was the most co-cited journal. The publications belonged mainly to two categories of Immunology and Cell Biology. USA and China were the most productive countries. Meanwhile, the University of Colorado Denver in USA produced the highest number of publications followed by Radboud University Nijmegen in the Netherlands and Monash University in Australia. Charles A. Dinarello published the most papers, while Marcel F. Nold had the most co-citations. Top 10 co-citations on reviews, mechanisms, and diseases were regarded as the knowledge base. The keyword co-occurrence and co-citations of references revealed that the mechanisms and immune-related disorders were the main aspects of IL-37 research. Notably, the involvement of IL-37 in various disorders and the additional immunomodulatory mechanisms were two emerging hotspots in IL-37 research. Conclusions: The research on IL-37 was thoroughly reviewed using bibliometrics and knowledge-map analyses. The present study is a benefit for academics to master the dynamic evolution of IL-37 and point out the direction for future research.


Assuntos
Bibliometria , Internet , Citocinas , Previsões , Humanos , Países Baixos
3.
JAMA ; 328(5): 483, 2022 08 02.
Artigo em Inglês | MEDLINE | ID: mdl-35916855

Assuntos
Medicina , Internet
4.
BMC Health Serv Res ; 22(1): 989, 2022 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-35922796

RESUMO

BACKGROUND: The UK's "Getting It Right First Time" programme recommends that management of people with fibromyalgia should centre on primary care. However, it remains unclear as to how best to organise health systems to deliver services to optimise patient outcomes. AIM: To profile UK healthcare services for people with fibromyalgia: provision of National Health Services (NHS) and use of non-NHS services by people with fibromyalgia. METHODS: Two online open surveys (A and B) incorporating questions about diagnosis, treatment and management of fibromyalgia and gaps in healthcare services were conducted between 11th September 2019 and 3rd February 2020. These were targeted to NHS healthcare professionals consulting with people with fibromyalgia (Survey A) and people ≥16 years diagnosed with fibromyalgia using non-NHS services to manage their condition (Survey B). Descriptive statistics were used to report quantitative data. Thematic analysis was undertaken for qualitative data. RESULTS: Survey A received 1701 responses from NHS healthcare professionals across the UK. Survey B received 549 responses from people with fibromyalgia. The results show that NHS services for people with fibromyalgia are highly disparate, with few professionals reporting care pathways in their localities. Diagnosing fibromyalgia is variable among NHS healthcare professionals and education and pharmacotherapy are mainstays of NHS treatment and management. The greatest perceived unmet need in healthcare for people with fibromyalgia is a lack of available services. From the pooled qualitative data, three themes were developed: 'a troublesome label', 'a heavy burden' and 'a low priority'. Through the concept of candidacy, these themes provide insight into limited access to healthcare for people with fibromyalgia in the UK. CONCLUSION: This study highlights problems across the NHS in service provision and access for people with fibromyalgia, including several issues less commonly discussed; potential bias towards people with self-diagnosed fibromyalgia, challenges facing general practitioners seeking involvement of secondary care services for people with fibromyalgia, and a lack of mental health and multidisciplinary holistic services to support those affected. The need for new models of primary and community care that offer timely diagnosis, interventions to support self-management with access to specialist services if needed, is paramount.


Assuntos
Fibromialgia , Clínicos Gerais , Fibromialgia/diagnóstico , Fibromialgia/terapia , Acesso aos Serviços de Saúde , Humanos , Internet , Reino Unido
5.
BMC Med Inform Decis Mak ; 22(1): 208, 2022 08 04.
Artigo em Inglês | MEDLINE | ID: mdl-35927732

RESUMO

BACKGROUND: Chemoprevention with anti-estrogens, such as tamoxifen, raloxifene or aromatase inhibitors, have been shown to reduce breast cancer risk in randomized controlled trials; however, uptake among women at high-risk for developing breast cancer remains low. The aim of this study is to identify provider-related barriers to shared decision-making (SDM) for chemoprevention in the primary care setting. METHODS: Primary care providers (PCPs) and high-risk women eligible for chemoprevention were enrolled in a pilot study and a randomized clinical trial of web-based decision support tools to increase chemoprevention uptake. PCPs included internists, family practitioners, and gynecologists, whereas patients were high-risk women, age 35-75 years, who had a 5-year invasive breast cancer risk ≥ 1.67%, according to the Gail model. Seven clinical encounters of high-risk women and their PCPs who were given access to these decision support tools were included in this study. Audio-recordings of the clinical encounters were transcribed verbatim and analyzed using grounded theory methodology. RESULTS: Six primary care providers, of which four were males (mean age 36 [SD 6.5]) and two were females (mean age 39, [SD 11.5]) and seven racially/ethnically diverse high-risk female patients participated in this study. Qualitative analysis revealed three themes: (1) Competing demands during clinical encounters; (2) lack of knowledge among providers about chemoprevention; and (3) limited risk communication during clinical encounters. CONCLUSIONS: Critical barriers to SDM about chemoprevention were identified among PCPs. Providers need education and resources through decision support tools to engage in risk communication and SDM with their high-risk patients, and to gain confidence in prescribing chemoprevention in the primary care setting.


Assuntos
Neoplasias da Mama , Quimioprevenção , Tomada de Decisão Compartilhada , Adulto , Idoso , Neoplasias da Mama/prevenção & controle , Técnicas de Apoio para a Decisão , Feminino , Humanos , Internet , Masculino , Pessoa de Meia-Idade , Médicos de Atenção Primária , Projetos Piloto , Atenção Primária à Saúde , Medição de Risco
6.
BMC Psychiatry ; 22(1): 537, 2022 08 09.
Artigo em Inglês | MEDLINE | ID: mdl-35941557

RESUMO

BACKGROUND: Emotional and stress-related disorders show high incidence, prevalence, morbidity, and comorbidity rates in Mexico. In recent decades, research findings indicate that cognitive behavioral interventions, from a disorder-specific perspective, are the effective front-line treatment for anxiety and depression care. However, these treatments are not often used. Reasons include limited access and low availability to effective interventions and comorbidity between mental disorders. Emotional deregulation of negative affectivity has been found to be a mediating factor in addressing emotional disorders from a transdiagnostic perspective, aimed at two or more specific disorders. In addition, technological advancement has created alternatives for psychological assistance, highlighting the possibilities offered by technologies since Internet-supported intervention programs have been empirically tested for effectiveness, efficiency and efficacy and can be key to ensuring access to those who are inaccessible. The aim of the study is to evaluate the efficacy, moderators of clinical change and acceptability of a transdiagnostic guided Internet-delivered intervention versus a transdiagnostic self-guided Internet-delivered intervention for emotional, trauma and stress-related disorders, and waiting list in community sample. METHODS: A three-armed, parallel group, superiority randomized controlled clinical trial with repeated measurements at four times: pretest, posttest, follow-up at 3, 6 and 12 months. Outcomes assessor, participant, care provider and investigator will be blinded. Participants aged 18 to 70 years will be randomly allocated 1:1:1 to one of three study arms: a) Transdiagnostic guided internet-delivered intervention with synchronous assistance, b) Transdiagnostic self-guided internet-delivered intervention, c) Waiting list group. Based on sample size estimation, a minimum of 207 participants (69 in each intervention group) will be included. DISCUSSION: The study could contribute to improving the efficacy of transdiagnostic internet-delivered interventions to promote the dissemination of evidence-based treatments and eventually, to decrease the high prevalence of emotional and trauma-related disorders in the Mexican population. TRIAL REGISTRATION: ClinicalTrial.gov: NCT05225701 . Registered February 4, 2022.


Assuntos
Terapia Cognitivo-Comportamental , Terapia Assistida por Computador , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/terapia , Terapia Cognitivo-Comportamental/métodos , Humanos , Internet , México , Ensaios Clínicos Controlados Aleatórios como Assunto , Terapia Assistida por Computador/métodos , Resultado do Tratamento
7.
J Med Internet Res ; 24(8): e37339, 2022 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-35943768

RESUMO

BACKGROUND: Sexual dysfunction is a private set of disorders that may cause stigma for patients when discussing their private problems with doctors. They might also feel reluctant to initiate a face-to-face consultation. Internet searches are gradually becoming the first choice for people with sexual dysfunction to obtain health information. Globally, Wikipedia is the most popular and consulted validated encyclopedia website in the English-speaking world. Baidu Encyclopedia is becoming the dominant source in Chinese-speaking regions; however, the objectivity and readability of the content are yet to be evaluated. OBJECTIVE: Hence, we aimed to evaluate the reliability, readability, and objectivity of male sexual dysfunction content on Wikipedia and Baidu Encyclopedia. METHODS: The Chinese Baidu Encyclopedia and English Wikipedia were investigated. All possible synonymous and derivative keywords for the most common male sexual dysfunction, erectile dysfunction, premature ejaculation, and their most common complication, chronic prostatitis/chronic pelvic pain syndrome, were screened. Two doctors evaluated the articles on Chinese Baidu Encyclopedia and English Wikipedia. The Journal of the American Medical Association (JAMA) scoring system, DISCERN instrument, and Global Quality Score (GQS) were used to assess the quality of disease-related articles. RESULTS: The total DISCERN scores (P=.002) and JAMA scores (P=.001) for Wikipedia were significantly higher than those of Baidu Encyclopedia; there was no statistical difference between the GQS scores (P=.31) for these websites. Specifically, the DISCERN Section 1 score (P<.001) for Wikipedia was significantly higher than that of Baidu Encyclopedia, while the differences between the DISCERN Section 2 and 3 scores (P=.14 and P=.17, respectively) were minor. Furthermore, Wikipedia had a higher proportion of high total DISCERN scores (P<.001) and DISCERN Section 1 scores (P<.001) than Baidu Encyclopedia. Baidu Encyclopedia and Wikipedia both had low DISCERN Section 2 and 3 scores (P=.49 and P=.99, respectively), and most of these scores were low quality. CONCLUSIONS: Wikipedia provides more reliable, higher quality, and more objective information than Baidu Encyclopedia. Yet, there are opportunities for both platforms to vastly improve their content quality. Moreover, both sites had similar poor quality content on treatment options. Joint efforts of physicians, physician associations, medical institutions, and internet platforms are needed to provide reliable, readable, and objective knowledge about diseases.


Assuntos
Compreensão , Transtornos Mentais , Humanos , Internet , Masculino , Reprodutibilidade dos Testes
8.
J Nepal Health Res Counc ; 20(1): 41-46, 2022 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-35945851

RESUMO

BACKGROUND: The Corona Virus Disease (COVID-19) pandemic has significantly disrupted the regular school-going activities of the students, predominantly increasing internet gaming activities to endure significant stress. Excessive involvement in internet gaming brings deviant behaviour, especially aggression among the students. Hence, this study aimed to assess the internet gaming disorder and aggression among the students on school closure during COVID-19 pandemic in Chitwan, Nepal. METHODS: A web-based cross-sectional survey was conducted among 417 students from secondary and higher secondary level who studied in two private schools of Chitwan district. Sample were selected using simple random sampling technique and structured questionnaire, i.e. Internet gaming disorder scale- short form (IGDS9-SF) and Aggression questionnaire (Buss and Perry, 1992) were used to collect the data via web-based through Google Form. Obtained data were analysed using descriptive and inferential statistics. RESULTS: Out of 417 students, the mean age was 17 (±1.411) years, 278 (66.7%) were male and 150 (36.0%) were studying in twelve standard. Majority of students 405 (97.1%) were non-disordered gamers whereas only 12 (2.9%) students were disordered gamers. Students' overall aggression score was 57.79% where the verbal aggression score was higher (66.33%) followed by hostility (61.41%) and anger (56.80%). Further significant positive relationship was found between scores on online gaming disorders and aggression (r=0.239). CONCLUSIONS: Internet gaming disorder and aggression are common among the students during COVID-19 pandemic. Therefore, educational institutions and concern authorities need to organize awareness programs and effective psychosocial intervention approaches for students to enhance the knowledge regarding harmful use of internet game, IGD, to cope with stress and aggression as well as to enhance the adoptive behaviour.


Assuntos
Comportamento Aditivo , COVID-19 , Jogos de Vídeo , Adolescente , Agressão/psicologia , Comportamento Aditivo/epidemiologia , Comportamento Aditivo/psicologia , COVID-19/epidemiologia , Estudos Transversais , Feminino , Humanos , Internet , Transtorno de Adição à Internet , Masculino , Nepal/epidemiologia , Pandemias , Instituições Acadêmicas , Estudantes/psicologia , Jogos de Vídeo/psicologia
9.
BMJ Open ; 12(8): e058212, 2022 08 03.
Artigo em Inglês | MEDLINE | ID: mdl-35922096

RESUMO

INTRODUCTION: It is unclear how internet-delivered cognitive-behavioural therapy for insomnia (CBT-I) can be integrated into healthcare systems, and little is known about the optimal level of therapist guidance. The aim of this study is to investigate three different versions of a stepped care model for insomnia (IG1, IG2, IG3) versus treatment as usual (TAU). IG1, IG2 and IG3 rely on treatment by general practitioners (GPs) in the entry level and differ in the amount of guidance by e-coaches in internet-delivered CBT-I. METHODS AND ANALYSIS: In this randomised controlled trial, 4268 patients meeting International Classification of Diseases, Tenth Revision (ICD-10) criteria for insomnia will be recruited. The study will use cluster randomisation of GPs with an allocation ratio of 3:3:3:1 (IG1, IG2, IG3, TAU). In step 1 of the stepped care model, GPs will deliver psychoeducational treatment; in step 2, an internet-delivered CBT-I programme will be used; in step 3, GPs will refer patients to specialised treatment. Outcomes will be collected at baseline, and 4 weeks, 12 weeks and 6 months after baseline assessment. The primary outcome is insomnia severity at 6 months. An economic evaluation will be conducted and qualitative interviews will be used to explore barriers and facilitators of the stepped care model. ETHICS AND DISSEMINATION: The study protocol was approved by the Ethics Committee of the Medical Centre-University of Freiburg. The results of the study will be published irrespective of the outcome. TRIAL REGISTRATION NUMBER: DRKS00021503.


Assuntos
Terapia Cognitivo-Comportamental , Distúrbios do Início e da Manutenção do Sono , Terapia Cognitivo-Comportamental/métodos , Humanos , Internet , Ensaios Clínicos Controlados Aleatórios como Assunto , Sono , Distúrbios do Início e da Manutenção do Sono/terapia , Resultado do Tratamento
10.
BMC Public Health ; 22(1): 1458, 2022 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-35915428

RESUMO

BACKGROUND: Food and beverage advertising has been identified as a powerful determinant of dietary intake and weight. Available evidence suggests that the preponderance of food and beverage advertising expenditures are devoted to the promotion of unhealthy products. The purpose of this study is to estimate food advertising expenditures in Canada in 2019 overall, by media and by food category, determine how much was spent on promoting healthier versus less healthy products and assess whether changes in these expenditures occurred between 2016 and 2019. METHODS: Estimates of net advertising expenditures for 57 selected food categories promoted on television, radio, out-of-home media, print media and popular websites, were licensed from Numerator. The nutrient content of promoted products or brands were collected, and related expenditures were then categorized as "healthy" or "unhealthy" according to a Nutrient Profile Model (NPM) proposed by Health Canada. Expenditures were described using frequencies and relative frequencies and percent changes in expenditures between 2016 and 2019 were computed. RESULTS: An estimated $628.6 million was spent on examined food and beverage advertising in Canada in 2019, with television accounting for 67.7%, followed by digital media (11.8%). In 2019, most spending (55.7%) was devoted to restaurants, followed by dairy and alternatives (11%), and $492.9 million (87.2% of classified spending) was spent advertising products and brands classified as "unhealthy". Fruit and vegetables and water accounted for only 2.1 and 0.8% of expenditures, respectively, in 2019. In 2019 compared to 2016, advertising expenditures decreased by 14.1% across all media (excluding digital media), with the largest decreases noted for print media (- 63.0%) and television (- 14.6%). Overall, expenditures increased the most in relative terms for fruit and vegetables (+ 19.5%) and miscellaneous products (+ 5%), while decreasing the most for water (- 55.6%) and beverages (- 47.5%). CONCLUSIONS: Despite a slight drop in national food and beverage advertising spending between 2016 and 2019, examined expenditures remain high, and most products or brands being advertised are unhealthy. Expenditures across all media should continue to be monitored to assess Canada's nutrition environment and track changes in food advertising over time.


Assuntos
Publicidade , Gastos em Saúde , Bebidas , Canadá , Alimentos , Indústria Alimentícia , Humanos , Internet , Televisão , Verduras , Água
11.
BMC Public Health ; 22(1): 1473, 2022 08 02.
Artigo em Inglês | MEDLINE | ID: mdl-35918675

RESUMO

BACKGROUND: Health literacy among Japanese is often low, making it difficult for them to evaluate health information and make informed decisions. However, the health literacy scales applied measure the perceived difficulty of health-related tasks; they do not directly assess the specific skills needed to perform the tasks: the skills to judge the reliability of diverse information using evaluation criteria and implement rational decision-making. Therefore, the study objectives were to investigate the following issues using a nationwide survey in Japan. (1) When obtaining information, to what extent do people apply criteria for evaluating information to confirm its reliability; when making decisions, to what extent do they seek out available options and compare pros and cons based on their own values? (2) How strongly are such skills associated with health literacy and demographic characteristics? (3) What opportunities are available to learn these skills? METHODS: We conducted an online questionnaire survey using a Japanese Internet research company; 3,914 valid responses were received. The measures comprised health literacy (European Health Literacy Survey Questionnaire), five items on information evaluation, four items on decision-making, and items on the availability and location of learning opportunities. We calculated Pearson correlations to explore the association of health literacy with information-evaluation and decision-making skills. Multivariate analyses were also conducted using these factors as dependent variables. RESULTS: Fewer than half (30%-50%) of respondents reported always or often evaluating information and engaging in decision-making. Health literacy was significantly and positively correlated with the specific skills of information evaluation and decision-making (r = .26 and .30, respectively) as were multivariate analyses (beta = .15 and .22, respectively). Over 40% of respondents had never learned those skills. The most common resources for learning the skills were the Internet and television; less-used resources were schools and workplaces. CONCLUSIONS: Both information-evaluation and decision-making skills were associated with health literacy. However, these skills are not sufficiently widespread in Japan because there are few opportunities to acquire them. More research is needed to raise awareness of the importance of such skills for improving health literacy and providing learning opportunities.


Assuntos
Letramento em Saúde , Adulto , Inquéritos Epidemiológicos , Humanos , Internet , Japão , Reprodutibilidade dos Testes , Inquéritos e Questionários
12.
J Nepal Health Res Counc ; 20(1): 131-137, 2022 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-35945865

RESUMO

BACKGROUND: With the surge of internet-based smart gadgets worldwide in 21st century the problem of internet addiction is emerging as a major behavioural addiction pandemic of the contemporary era. Excessive Internet use has become significant mental health concerns especially among students. Internet use has many advantages if used in right fashion, it has an enormous amount of negative consequences as well such as depression, attention deficit and so forth. METHODS: Descriptive cross-sectional study was done among 356 undergraduate students of Bharatpur Metropolitan City of Nepal. Multistaged random sampling was applied to select undergraduate students and semi structured self-administered questionnaire along with structured standard Young's tool for Internet Addiction Test was used for collecting information during June 2019 to August 2019. RESULT: Alarmingly High proportions of participants (73%) were found addicted to Internet, where, 48%, 20.5% and4.5% had mild, moderate and severe Internet addiction respectively. Higher prevalence of Internet addiction was observed among those whose father's occupation was 'foreign employment' as compared to agriculture. (AOR?=?2.34, 95% CI 1.02-5.33, p?=?0.04), Failed in the recent exam as compared to Pass in the recent exam. (AOR = 2.81 CI 1.40 - 3.561, and among non-science stream as compared to science stream (AOR?=?3.10, 95%CI 1.81-5.32), p=<0.001) Conclusions: The finding suggests that prevalence of Internet addiction was tremendously high among undergraduate students. There is critical need of awareness programmes targeted to the students as well as parents regarding the negative impacts of unwise Internet use.


Assuntos
Comportamento Aditivo , Transtorno de Adição à Internet , Comportamento Aditivo/epidemiologia , Comportamento Aditivo/psicologia , Estudos Transversais , Humanos , Internet , Nepal/epidemiologia , Estudantes/psicologia
13.
PLoS One ; 17(8): e0271989, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35913949

RESUMO

In the new era, many people seek their health-related information through the Internet due to the increasing access to this technology. Searching online health information can affect the health behavior. This study aimed to investigate the correlation between online health information-seeking behavior and a healthy lifestyle during pregnancy in a sample of Iranian pregnant women. This cross-sectional study was conducted among pregnant women admitted to health centers of Eghlid city, Fars province, Iran in 2019. A total of 193 women participated in the study. The required data were gathered using two validated questionnaires to measure the online health information-seeking behavior and the healthy lifestyle practices of the participants. The collected data were analyzed through descriptive statistics and Pearson correlation coefficient using SPSS version 22. Online health information experience and its subscales showed no statistical correlation with a healthy lifestyle. Age and education did not correlate with online health information-seeking behavior. Age had a statistical correlation with a healthy lifestyle, but education had the same correlation only with some subscales of a healthy lifestyle. The findings were surprising, suggesting that online health information-seeking behavior does not affect the lifestyle of pregnant women. These finding and probable explanations are discussed, but due to the limited literature on the subject, further studies are recommended to be conducted.


Assuntos
Estilo de Vida Saudável , Comportamento de Busca de Informação , Estudos Transversais , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Internet , Irã (Geográfico) , Gravidez , Inquéritos e Questionários
14.
BMC Med Educ ; 22(1): 594, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-35915441

RESUMO

BACKGROUND: Flipped classroom pedagogy is a blended learning approach applied in undergraduate health professions education. However, teachers and students may require training to effectively engage in flipped classroom pedagogy. Thus, this study aimed to design, develop, and evaluate a web-based tool for fostering flipped classroom pedagogy in undergraduate health professions education. METHODS: This is an educational design-based research with a descriptive evaluation component which was conducted in two steps: (i) design & development and (ii) evaluation of an educational website. An expert panel was formed to evaluate the website by using a website evaluation questionnaire (WEQ). Descriptive statistics were employed to calculate the experts' agreement level. RESULTS: An innovative website design was used to provide access to a range of digital devices. The development process occurred concurrently in two steps: (i) website development and (ii) learning content development. The educational website was branded as the Flipped Classroom Navigator (FCN). Based on WEQ scores, the FCN obtained a good level of agreement (≥ 80%) for its' ease of use, hyperlinks, structure, relevance, comprehension, completeness, and layout. CONCLUSIONS: The FCN is an effective method for providing training to promote flipped classroom pedagogy in health professions education. The FCN achieved good evaluation scores and comments from experts. However, it is also necessary to obtain acceptance from the end-users, which could be the focus of future research. Nonetheless, the expert panel pinpointed areas for further development before introducing the FCN to end-users.


Assuntos
Educação de Graduação em Medicina , Modelos Educacionais , Currículo , Educação de Graduação em Medicina/métodos , Ocupações em Saúde , Humanos , Internet , Aprendizagem Baseada em Problemas/métodos , Inquéritos e Questionários
15.
Neurosurg Focus ; 52(6): E3, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35921180

RESUMO

OBJECTIVE: To increase access to health interventions and healthcare services for patients in resource-constrained settings, strategies such as telemedicine must be implemented for the allocation of medical resources across geographic boundaries. Telecollaboration is the dominant form of surgical telemedicine. In this study, the authors report and evaluate a novel mobile internet-based mixed-reality interactive telecollaboration (MIMIT) system as a new paradigm for telemedicine and validate its clinical feasibility. METHODS: The application of this system was demonstrated for long-distance, real-time collaboration of neuroendoscopic procedures. The system consists of a local video processing workstation, a head-mounted mixed-reality display device, and a mobile remote device, connected over mobile internet (4G or 5G), allowing global point-to-point communication. Using this system, 20 cases of neuroendoscopic surgery were performed and evaluated. The system setup, composite video latency, technical feasibility, clinical implementation, and future potential business model were analyzed and evaluated. RESULTS: The MIMIT system allows two surgeons to perform complex visual and verbal communication during the operation. The average video delay time is 184.25 msec (range 160-230 msec) with 4G mobile internet, and 23.25 msec (range 20-26 msec) with 5G mobile internet. Excellent image resolution enabled remote neurosurgeons to visualize all critical anatomical structures intraoperatively. Remote instructors could easily make marks on the surgical view; then the composite image, as well as the audio conversation, was transferred to the local surgeon. In this way, a real-time, long-distance collaboration can occur. This system was used for 20 neuroendoscopic surgeries in various cities in China and even across countries (Boston, Massachusetts, to Jingzhou, China). Its simplicity and practicality have been recognized by both parties, and there were no technically related complications recorded. CONCLUSIONS: The MIMIT system allows for real-time, long-distance telecollaborative neuroendoscopic procedures and surgical training through a commercially available and inexpensive system. It enables remote experts to implement real-time, long-distance intraoperative interaction to guide inexperienced local surgeons, thus integrating the best medical resources and possibly promoting both diagnosis and treatment. Moreover, it can popularize and improve neurosurgical endoscopy technology in more hospitals to benefit more patients, as well as more neurosurgeons.


Assuntos
Neuroendoscopia , Telemedicina , Estudos de Viabilidade , Humanos , Internet , Neurocirurgiões
16.
Comput Intell Neurosci ; 2022: 4173243, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35909855

RESUMO

In traditional preschool education, it is time-consuming and laborious to acquire effective materials by using artificial search method. However, with the development of Internet technology, a variety of preschool education institutions or individuals have released their own preschool education resources on the Internet. At present, multimedia technology has been popularized in many schools, and it plays a more and more significant role in teaching. In preschool education teaching, teachers use multimedia resources not only conducive to improve children's learning efficiency but also make the teaching quality from the whole to a higher level. However, some kindergarten teachers rely too much on multimedia in teaching and do not effectively combine it with traditional teaching methods. Sometimes they even use video and related multimedia teaching resources throughout the class, which makes preschool children lack knowledge and knowledge. Therefore, this paper designs a multimedia resource retrieval system based on the theme of preschool education, which mainly achieves the extraction of multimedia resources from web pages and the analysis of multimedia-related text information. In order to design a high-performance topic search algorithm, we must first carry out page parsing, Chinese and English word segmentation, and other page preprocessing. The research results show that it is found that the text-based automatic classification of multimedia resources in preschool education and the filtering of multimedia noise in web pages can provide relevant personnel in the field of preschool education with the retrieval service of multimedia resources.


Assuntos
Aprendizagem , Multimídia , Algoritmos , Pré-Escolar , Humanos , Internet
17.
Comput Math Methods Med ; 2022: 8234769, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35915770

RESUMO

Objective: To explore the application value of the nutrition support team in chemotherapy period of colon cancer based on the internet multidisciplinary treatment mode. Methods: For the method of retrospective study, 90 patients with colon cancer admitted to our hospital from August 2018 to August 2020 were selected as the study subjects. They were equally divided into the experimental group (n = 45) and the control group (n = 45) according to the order of initials and the method of parity group. The control group was given conventional nutrition support, and the experimental group was given the nutrition support under the internet multidisciplinary treatment mode. The serum tumor marker levels (CEA and CA19-9), immune function indexes, nutrition indicators, and the incidence of adverse reactions were compared between the two groups before and after intervention. Results: The serum tumor marker levels in the experimental group after intervention were significantly lower than those in the control group (P < 0.001). The immune function indexes in the experimental group after intervention were significantly better than those in the control group (P < 0.001). The nutrition indicators in the experimental group after intervention were significantly better than those in the control group (P < 0.001). The incidence of gastrointestinal adverse reactions above grade 2 in the experimental group was significantly lower than that in the control group (P < 0.05). There were 20 patients with myelosuppression, 2 patients with neurotoxicity, and 1 patient with hand and foot syndrome in the experimental group, while 22 patients with myelosuppression, 4 patients with neurotoxicity, and 2 patients with hand and foot syndrome in the control group, with no significant difference in the incidence of adverse reactions between the two groups (P > 0.05). Conclusion: The nutrition support team under the internet multidisciplinary treatment mode can improve the immune function of chemotherapy patients with colon cancer and enhance their nutritional level, thereby reducing the incidence of adverse reactions and improving the chemotherapy effects.


Assuntos
Neoplasias do Colo , Nutrição Enteral , Biomarcadores Tumorais , Neoplasias do Colo/tratamento farmacológico , Humanos , Internet , Estudos Retrospectivos
18.
Eur J Psychotraumatol ; 13(2): 2101345, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35923687

RESUMO

Introduction: Although evidence-based treatments for posttraumatic stress disorder (PTSD) in adolescents and young adults exist, affected youth do not have sufficient access to these treatments due to structural and attitudinal barriers. Internet- and mobile-based interventions (IMIs) can help fill this healthcare gap, but such programmes have not yet been sufficiently evaluated in youth with PTSD. Aim: This study aims to investigate the feasibility of an IMI for youth with PTSD in a one-arm, non-randomised, prospective proof-of-concept feasibility study. Methods: We aim to recruit 32 youth between 15 and 21 years old with clinically relevant posttraumatic stress symptoms (CATS ≥ 21), who will receive access to the IMI. The IMI consists of nine sessions involving psychoeducation, emotion regulation and coping skills, written-based imaginal exposure, cognitive restructuring and relapse prevention. Participants will be guided by an eCoach, who provides weekly semi-standardised written feedback on completed sessions and adherence reminders. We will use a formal feasibility framework to assess different dimensions of feasibility: (1) recruitment capability and resulting sample characteristics, (2) data collection procedures and outcome measures, (3) acceptability of the IMI and study procedures, (4) resources and ability to manage and implement the study and IMI and (5) participants' responses to the IMI in terms of symptom severity and satisfaction. Additionally, potential negative effects related to the intervention will be assessed. Assessments take place pre-, mid- and post-intervention and at follow-up, including semi-structured clinical telephone interviews for PTSD diagnostics at pre- and post-intervention assessment. Qualitative interviews will be conducted to investigate the youth perspectives on the IMI. Discussion: This study aims to determine the feasibility of a guided IMI for youth with PTSD to adapt the IMI as closely as possible to youth needs and to inform the design, procedure and safety management of a large-scale efficacy RCT. Trial registration: German Clinical Trials Register identifier: DRKS00023341. HIGHLIGHTS: Evidence-based care for adolescents after trauma is not widely available.• This study evaluates the feasibility of a guided trauma-focused Internet intervention as a time- and location-independent low-threshold treatment option for adolescents and young adults with posttraumatic stress disorder.


Introducción: Aunque existen tratamientos basados en la evidencia para el trastorno de estrés postraumático (TEPT) en adolescentes y adultos jóvenes, los jóvenes afectados no tienen suficiente acceso a estos tratamientos debido a barreras estructurales y actitudinales. Las intervenciones basadas en Internet y dispositivos móviles (IMI en su sigla en inglés) pueden ayudar a llenar este vacío en la atención de salud, pero tales programas aún no se han evaluado suficientemente en jóvenes con TEPT.Objetivo: Este estudio tiene como objetivo investigar la factibilidad de una IMI para jóvenes con TEPT en un estudio de factibilidad de prueba de concepto prospectivo, no aleatorio, de un solo brazo.Métodos: Nuestro objetivo es reclutar a 32 jóvenes entre 15 y 21 años con síntomas de estrés postraumático clínicamente relevantes (CATS > 21), que recibirán acceso a la IMI. La IMI consta de nueve sesiones que involucran psicoeducación, regulación emocional y habilidades de afrontamiento, exposición imaginada basada en escritos, reestructuración cognitiva y prevención de recaídas. Los participantes serán guiados por un eCoach, que proporcionará comentarios escritos semiestandarizados semanales sobre las sesiones completadas y recordatorios de adherencia. Usaremos un marco de factibilidad formal para evaluar las diferentes dimensiones de factibilidad: (1) capacidad de reclutamiento y características de la muestra resultante, (2) procedimientos de recopilación de datos y de las medidas del resultado, (3) aceptabilidad de la IMI y los procedimientos del estudio, (4) recursos y capacidad para gestionar e implementar el estudio y la IMI y (5) las respuestas de los participantes a la IMI en términos de la gravedad de los síntomas y la satisfacción. Además, se evaluarán los posibles efectos negativos relacionados con la intervención. Las evaluaciones se realizan antes, durante y después de la intervención y durante el seguimiento, incluyendo entrevistas telefónicas clínicas semiestructuradas para el diagnóstico de TEPT en la evaluación previa y posterior a la intervención. Se realizarán entrevistas cualitativas para investigar las perspectivas de los jóvenes sobre la IMI.Discusión: Este estudio tiene como objetivo determinar la factibilidad de una IMI guiada para jóvenes con TEPT para adaptar la IMI lo más cerca posible a las necesidades de los jóvenes y para informar el diseño, el procedimiento y la gestión de la seguridad de un ECA de eficacia a gran escala.


Assuntos
Terapia Cognitivo-Comportamental , Internet , Transtornos de Estresse Pós-Traumáticos , Terapia Cognitivo-Comportamental/métodos , Estudos de Viabilidade , Humanos , Estudos Prospectivos , Transtornos de Estresse Pós-Traumáticos/terapia
19.
Trials ; 23(1): 639, 2022 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-35945570

RESUMO

BACKGROUND: Dental caries is the most common non transmissible chronic disease in childhood and the control of dental biofilm in children is one of the greatest challenges in oral disease prevention. Digital media applications can help patients in improving their oral hygiene performance and reducing the number of appointments due to pain and discomfort reasons. This study aims to investigate the use of an smartphone application (WhatsApp) to deliver oral health education to mother-child pairs, with the ultimate goal of controlling dental biofilm and caries through digital activities focused on oral hygiene. METHODS: This study was designed as a randomized, double-blind, parallel clinical trial involving 100 pairs of mothers and children (6-12 years old). The mothers and children will be randomly allocated to the control group (n = 50 pairs), who will receive a single visit conventional oral health education, or to the experimental group (n = 50 pairs), who will receive both a single visit conventional oral health education and educational videos through WhatsApp Messenger, twice a week. Before randomization of the groups and after the intervention, pairs will be evaluated regarding to plaque index (VPI), gingival bleeding index (GBI), and number of decayed, missing and filled permanent or primary teeth (DMF-T) modified by the inclusion of active non-cavitated carious lesions (Nyvad criteria). Socioeconomic data, dental history, and oral health literacy will obtained using questionnaires (Oral Health Literacy Assessment Task for Paediatric Dentistry; BOHLAT-P). Chi-square, Student's t-test, paired Student's t-test, Mann-Whitney, and Friedman tests will be used with a 5% significance level. DISCUSSION: This intervention proposal is designed to motivate behavioral change in mother-child pairs. We hypothesize that adding digital media to traditional oral health programs will provoke improvements in oral hygiene behavior and health outcomes. To our knowledge, this is the first study evaluating the effect of educational videos communicated by digital media (WhatsApp) on the oral health of mother-child pairs evaluated by long-term dental examinations. In addition, we will assess the maternal level of comprehension of the provided information via a literacy assessment tool. The clinical trial is registered at the Brazilian Registry of Clinical Trials (No. RBR-7s8bw6m).


Assuntos
Cárie Dentária , Criança , Cárie Dentária/diagnóstico , Cárie Dentária/prevenção & controle , Educação em Saúde Bucal , Humanos , Internet , Relações Mãe-Filho , Saúde Bucal , Ensaios Clínicos Controlados Aleatórios como Assunto
20.
PLoS One ; 17(8): e0272228, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35947621

RESUMO

Problematic video gaming (PVG) and problematic shopping (PS) are addictive behaviors prevalent in adolescents, characterized by positive and negative reinforcement, and associated with psychosocial impairment. This study examined how PS and PVG relate in adolescents. It also examined how PS interacts with PVG in relation to health/functioning measures. Survey data from 3,657 Connecticut high-school students were evaluated. Chi-square analyses and logistic regression models were used to assess relationships between PS and measures of PVG. Interaction analyses measured effects of PS on relationships between PVG and health/functioning measures. Relative to adolescents without PS, those with PS had 8.79-fold higher odds of exhibiting PVG and were more likely to endorse gaming to relieve anxiety and impairment due to gaming. Interaction analyses revealed that in adolescents with PS, the relationships between PVG and aggressive behaviors, including fighting, serious fighting leading to physical injury, and weapon-carrying, were stronger than in adolescents without PS. PS strongly relates to PVG, and among youth reporting PS, there are stronger associations between PVG and aggressive behaviors. Prevention efforts for adolescents should consider the co-occurrence of PS and PVG. PS and PVG may be linked by negative reinforcement and propensities for aggressive and addictive behaviors, suggesting that further research should explore possible interventions targeting stress management and maladaptive coping.


Assuntos
Comportamento do Adolescente , Comportamento Aditivo , Jogos de Vídeo , Adolescente , Comportamento do Adolescente/psicologia , Comportamento Aditivo/epidemiologia , Comportamento Aditivo/psicologia , Humanos , Internet , Estudantes , Inquéritos e Questionários , Jogos de Vídeo/psicologia
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