An observational study of social and emotional support in smoking cessation Twitter accounts: content analysis of tweets.

BACKGROUND: Smoking continues to be the number one preventable cause of premature death in the United States. While evidence for the effectiveness of smoking cessation interventions has increased rapidly, questions remain on how to effectively disseminate these findings. Twitter, the second largest online social network, provides a natural way of disseminating information. Health communicators can use Twitter to inform smokers, provide social support, and attract them to other interventions. A key challenge for health researchers is how to frame their communications to maximize the engagement of smokers. OBJECTIVE: Our aim was to examine current Twitter activity for smoking cessation. METHODS: Active smoking cessation related Twitter accounts (N=18) were identified. Their 50 most recent tweets were content coded using a schema adapted from the Roter Interaction Analysis System (RIAS), a theory-based, validated coding method. Using negative binomial regression, the association of number of followers and frequency of individual tweet content at baseline was assessed. The difference in followership at 6 months (compared to baseline) to the frequency of tweet content was compared using linear regression. Both analyses were adjusted by account type (organizational or not organizational). RESULTS: The 18 accounts had 60,609 followers at baseline and 68,167 at 6 months. A total of 24% of tweets were socioemotional support (mean 11.8, SD 9.8), 14% (mean 7, SD 8.4) were encouraging/engagement, and 62% (mean 31.2, SD 15.2) were informational. At baseline, higher frequency of socioemotional support and encouraging/engaging tweets was significantly associated with higher number of followers (socioemotional: incident rate ratio [IRR] 1.09, 95% CI 1.02-1.20; encouraging/engaging: IRR 1.06, 95% CI 1.00-1.12). Conversely, higher frequency of informational tweets was significantly associated with lower number of followers (IRR 0.95, 95% CI 0.92-0.98). At 6 months, for every increase by 1 in socioemotional tweets, the change in followership significantly increased by 43.94 (P=.027); the association was slightly attenuated after adjusting by account type and was not significant (P=.064). CONCLUSIONS: Smoking cessation activity does exist on Twitter. Preliminary findings suggest that certain content strategies can be used to encourage followership, and this needs to be further investigated.

Characterizing the followers and tweets of a marijuana-focused Twitter handle.

BACKGROUND: Twitter is a popular social media forum for sharing personal experiences, interests, and opinions. An improved understanding of the discourse on Twitter that encourages marijuana use can be helpful for tailoring and targeting online and offline prevention messages. OBJECTIVES: The intent of the study was to assess the content of "tweets" and the demographics of followers of a popular pro-marijuana Twitter handle (@stillblazingtho). METHODS: We assessed the sentiment and content of tweets (sent from May 1 to December 31, 2013), as well as the demographics of consumers that follow a popular pro-marijuana Twitter handle (approximately 1,000,000 followers) using Twitter analytics from Demographics Pro. This analytics company estimates demographic characteristics based on Twitter behavior/usage, relying on multiple data signals from networks, consumption, and language and requires confidence of 95% or above to make an estimate of a single demographic characteristic. RESULTS: A total of 2590 tweets were sent from @stillblazingtho during the 8-month period and 305 (11.78%) replies to another Twitter user were excluded for qualitative analysis. Of the remaining 2285 tweets, 1875 (82.06%) were positive about marijuana, 403 (17.64%) were neutral, and 7 (0.31%) appeared negative about marijuana. Approximately 1101 (58.72%) of the positive marijuana tweets were perceived as jokes or humorous, 340 (18.13%) implied that marijuana helps you to feel good or relax, 294 (15.68%) mentioned routine, frequent, or heavy use, 193 (10.29%) mentioned blunts, marijuana edibles, or paraphernalia (eg, bongs, vaporizers), and 186 (9.92%) mentioned other risky health behaviors (eg, tobacco, alcohol, other drugs, sex). The majority (699,103/959,143; 72.89%) of @stillblazingtho followers were 19 years old or younger. Among people ages 17 to 19 years, @stillblazingtho was in the top 10% of all Twitter handles followed. More followers of @stillblazingtho in the United States were African American (323,107/759,407; 42.55%) or Hispanic (90,732/759,407; 11.95%) than the Twitter median average (African American 22.4%, inter-quartile ratio [IQR] 5.1-62.5%; Hispanic 5.4%, IQR 3.0-10.8%) and among Hispanics, @stillblazingtho was in the top 30% of all Twitter handles followed. CONCLUSIONS: Young people are especially responsive to social media influences and often establish substance use patterns during this phase of development. Our findings underscore the need for surveillance efforts to monitor the pro-marijuana content reaching young people on Twitter.

Web service reputation evaluation based on QoS measurement.

In the early service transactions, quality of service (QoS) information was published by service provider which was not always true and credible. For better verification the trust of the QoS information was provided by the Web service. In this paper, the factual QoS running data are collected by our WS-QoS measurement tool; based on these objectivity data, an algorithm compares the difference of the offered and measured quality data of the service and gives the similarity, and then a reputation evaluation method computes the reputation level of the Web service based on the similarity. The initial implementation and experiment with three Web services' example show that this approach is feasible and these values can act as the references for subsequent consumers to select the service.

Systematic review of the types of methods and approaches used to assess the effectiveness of healthcare information websites.

The aim of this systematic review was to identify types of approaches and methods used to evaluate the effectiveness of healthcare information websites. Simple usage data may not be sufficient to assess whether desired healthcare outcomes were achieved or to determine the relative effectiveness of different web resources on the same health topic. To establish the state of the knowledge base on assessment methods used to determine the effectiveness of healthcare websites, a structured search of the literature was conducted in Ovid Medline, resulting in the retrieval of 1611 articles, of which 240 met the inclusion criteria for the present review. The present review found that diverse evaluation methods were used to measure the effectiveness of healthcare websites. These evaluation methods were used during development, before release and after release. Economic assessment was rare and most evaluations looked at content issues, such as readability scores. Several studies did try to assess the usefulness of websites, but few studies looked at behaviour change or knowledge transfer following engagement with the designated health website. To assess the effectiveness of the knowledge transfer of healthcare information through the online environment, multiple methods may need to be used to evaluate healthcare websites and may need to be undertaken at all stages of the website development process.

Quality and content of internet-based information on temporomandibular disorders.

AIMS: To use a range of evaluation instruments to assess the content and quality of websites about temporomandibular disorders (TMD) and thereby provide guidance regarding the actual accuracy and comprehensiveness of the information of the sites. METHODS: Sixty-seven websites resulting from an Internet search with the word "TMD" were evaluated using Journal of the American Medical Association (JAMA), DISCERN, and Health on the Net (HON) criteria, along with an evaluation method to assess the scientific quality of the website contents. Results were compared according to reviewer, website type, and presence of HON seal. One-way analysis of variance (ANOVA), Student t test, chi-square test, and Pearson correlation analysis were used as appropriate. RESULTS: The mean content, HON, and DISCERN scores were 38.9%, below 50%, and 53.9% of the maximum possible score, respectively. Fewer than 50% of the sites displayed the author or reference of the information according to the JAMA benchmarks criteria. Every evaluation criteria showed good agreement among reviewers. Commercial websites were the most common, while sites of nonprofit organizations showed the highest content scores. The overall quality was poor to moderate for all website types. CONCLUSION: Sites concerning TMD were poorly organized and maintained. Also, most sites contained insufficient or scientifically incorrect information that could have a negative effect on the treatment outcome and prognosis of TMD. Clinicians should guide patients to reputable sources of information that will enhance patient comprehension and better treatment outcomes.

Cosmesis after pterygium extended removal followed by extended conjunctival transplant as assessed by a new, web-based grading system.

OBJECTIVE: To design a web-based system to grade the cosmetic results after pterygium surgery and to use this to assess the aesthetic results of pterygium extended removal followed by extended conjunctival transplant. DESIGN: A standardized grading system with gradings of normal, excellent, good, fair, poor, and ungradeable was designed and tested by the author (standard gradings). This was then installed on a website where ophthalmologists and lay people could undertake grading and anatomy tutorials, and subsequently grade randomly assigned images in a masked fashion, of eyes after pterygium surgery and control eyes. PARTICIPANTS AND CONTROLS: A sample of 119 postoperative eyes were randomly selected from 279 consecutive surgeries together with 119 control eyes from the contralateral eyes of these patients supplemented with otherwise normal eyes. INTERVENTIONS: The author was tested twice on a sample of 40 images and then the full set, with 24 images repeated giving a total of 288 images using the proposed grading system, resulting in an intraobserver reliability score of 0.98. These images were then randomly presented to the graders, of whom 6 were postpterygium patients and 6 were corneal specialist ophthalmologists after they had completed the tutorials and passed a trial grading test. MAIN OUTCOME MEASURES: The percentage of images of postoperative and controls that were graded in each grading category were obtained and compared with the only existent study of post pterygium cosmetic results. RESULTS: Six lay people and 6 corneal specialists successfully passed the trial grading test of 40 images with weighted kappa of 0.70 to 0.85 and intraobserver reliability scores of 0.86 to 0.95 for lay graders and 0.90 to 0.92 for ophthalmic graders. Ninety-four percent of all pterygium surgery eyes were graded as acceptable; both ophthalmic and lay graders were unable to distinguish between postoperative and control eyes. CONCLUSIONS: This grading system is robust and user friendly, and pterygium extended removal followed by extended conjunctival transplant provides a very pleasing aesthetic result in most patients.

Semantic Space models for classification of consumer webpages on metadata attributes.

To deal with the quantity and quality issues with online healthcare resources, creating web portals centred on particular health topics and/or communities of users is a strategy to provide access to a reduced corpus of information resources that meet quality and relevance criteria. In this paper we use hyperspace analogue to language (HAL) to model the language use patterns of webpages as Semantic Spaces. We have applied machine learning methods, including support vector machine (SVM), decision forest, and a novel summed similarity measure (SSM) to automatically classify online webpages on their Semantic Space models. We find classification accuracy on metadata attributes to be over 93% for 'medical' versus 'supportive' perspective, over 92% for disease stage of 'early' versus 'advanced', and over 90% for author credentials of 'lay' versus 'clinician' based on webpages of the Breast Cancer Knowledge Online portal. These results indicate that language use patterns can be used to automate such classification with useful levels of accuracy.

Energy, climate, food and health.

On June 3-5, 2008, international organizations and heads of state met in Rome to discuss the critical situation in global food supplies and prices during the World Food Crisis Summit. The intent of this column is to provide approaches to identifying the complex issues that impact public health, public safety, and nutrition on a global basis. The Web sites selected provide a background for the complex issues involved (energy, climate and environment, agriculture, and politics) and reveal controversial and competing agendas with many far-reaching implications.

Just ask Siri? A pilot study comparing smartphone digital assistants and laptop Google searches for smoking cessation advice.

OBJECTIVE: To compare voice-activated internet searches by smartphone (two digital assistants) with laptop ones for information and advice related to smoking cessation. DESIGN: Responses to 80 questions on a range of topics related to smoking cessation (including the FAQ from a NHS website), compared for quality. SETTING: Smartphone and internet searches as performed in New Zealand. MAIN OUTCOME MEASURES: Ranked responses to the questions. RESULTS: Google laptop internet searches came first (or first equal) for best quality smoking cessation advice for 83% (66/80) of the responses. Voiced questions to Google Assistant ("OK Google") came first/first equal 76% of the time vs Siri (Apple) at 28%. Google and Google Assistant were statistically significantly better than Siri searches (odds ratio 12.4 and 8.5 respectively, p<0.0001 in each comparison). When asked FAQs from the National Health Service website, or to find information the Centers for Disease Control has made videos on, the best search results used expert sources 59% (31/52) of the time, "some expertise" (eg, Wikipedia) 18% of the time, but also magazines and other low quality sources 19% of the time. Using all three methods failed to find relevant information 8% (6/80) of the time, with Siri having the most failed responses (53% of the time). CONCLUSION: Google internet searches and Google Assistant were found to be significantly superior to the Siri digital assistant for smoking cessation information. While expert content was returned over half the time, there is still substantial room for improvement in how these software systems deliver smoking cessation advice.

Evaluation of eHealth web sites for patients with chronic kidney disease.

BACKGROUND: Chronic kidney disease (CKD) affects up to 19.2 million Americans, and untreated kidney disease can progress to kidney failure. Patient education is an important part of slowing disease progression, but the ability of health professionals to provide this education is limited by time constraints. To date, there have been no systematic evaluations of CKD eHealth Web sites. METHODS: Seven nonproprietary and 4 proprietary Web sites geared toward educating patients with CKD were identified by using the Internet to search for the terms "chronic kidney disease," "kidney disease," and "chronic renal failure." Web sites were evaluated according to (1) compliance with the principles of the Health on the Net (HON) Foundation Code of Conduct and (2) reading grade level. RESULTS: Nonproprietary sites were in compliance with an average of 5.2 principles, with a range of 3 to 8. Average compliance of proprietary Web sites with the HON Code of Conduct principles was 3.12, with a range of 2 to 4 (P = 0.021). Of nonproprietary Web sites, average reading grade level assessed by the Fry Readability Scale was greater than grade 14, with a range from grade 11 through graduate school. Of proprietary sites, average readability was grade 11, with a range from grades 7 through 16 (P = 0.575). CONCLUSION: The Internet has the potential to be a very powerful educational tool for patients with CKD. However, many easily accessed CKD public health Web sites do not comply with accepted standards for health Web sites and are written using language beyond the general public's reading comprehension.

Do the leading children's hospitals have quality web sites? A description of children's hospital web sites.

BACKGROUND: Although leading children's hospitals are recognized as preeminent in the provision of health care to children, the quality of their Web sites has not been described. OBJECTIVE: To describe technical characteristics of the Web sites of leading children's hospitals. METHODS: This is a cross-sectional descriptive infodemiology study. Two reviewers independently reviewed and analyzed the Web sites of 26 nationally prominent children's hospitals in June 2003, using objective criteria based on accessibility (based on age and language), attribution, completeness, credibility, currency, disclosure, readability, and other technical elements. RESULTS: One-third of Web sites included content for children and adolescents. Twenty-four (92%) of the Web sites had health and disease-specific information. One-third contained only English, while two-thirds included other languages. All 26 Web sites included a disclaimer, although none had a requirement to read the disclaimer before accessing health and disease specific information. Twenty-four (92%) had search options. Although most (85%) listed a copyright date, only 10% listed the date last updated. CONCLUSIONS: This is the first study to examine the Web sites of leading children's hospitals. Although the Web sites were designed for children's hospitals, only a few sites included content for children and adolescents. Primary care physicians who refer patients to these sites should be aware that many have limited content for children, and should assess them for other limitations, such as inconsistent documentation of disclaimers or failure to show the date of the last Web site update. These Web sites are a potentially useful source of patient information. However, as the public increasingly looks to the Internet for health information, children's hospitals need to keep up with increasingly high standards and demands of health-care consumers.

Patient Internet services: creating the value-added paradigm.

An analysis of consumer and organizational perspectives on web design suggests emerging webside functionality, growing patient needs for self-management skills, and mounting corporate accountability will transform web strategies and consumer expectations from the current general health information approach to a value-added paradigm, which is described with a list of eight guiding principles.

Engaging patients through your website.

Legislation requires the healthcare industry to directly engage patients through technology. This paper proposes a model that can be used to review hospital websites for features that engage patients in their healthcare. The model describes four levels of patient engagement in website design. The sample consisted of 130 hospital websites from hospitals listed on 2010 and 2011 Most Wired Hospitals. Hospital websites were analyzed for features that encouraged patient interaction with their healthcare according to the levels in the model. Of the four levels identified in the model, websites ranged from "informing" to "collaborative" in website design. There was great variation of features offered on hospital websites with few being engaging and interactive.

Automatically Assessing the Expert Degree of Online Health Content using SVMs.

More and more people search for health information regarding diseases, diagnoses and treatments over the Web. However, lay people often have difficulties in assessing the understandability of related articles. Therefore, they could benefit from a system, which computes the medical expert degree of a corresponding piece of text in advance. In this paper we present an approach to automatically compute this expert degree using a machine learning approach. For evaluation purposes we constructed a large text corpus and tested our trained text classifier, which is based on Support Vector Machines.

The geography of happiness: connecting twitter sentiment and expression, demographics, and objective characteristics of place.

We conduct a detailed investigation of correlations between real-time expressions of individuals made across the United States and a wide range of emotional, geographic, demographic, and health characteristics. We do so by combining (1) a massive, geo-tagged data set comprising over 80 million words generated in 2011 on the social network service Twitter and (2) annually-surveyed characteristics of all 50 states and close to 400 urban populations. Among many results, we generate taxonomies of states and cities based on their similarities in word use; estimate the happiness levels of states and cities; correlate highly-resolved demographic characteristics with happiness levels; and connect word choice and message length with urban characteristics such as education levels and obesity rates. Our results show how social media may potentially be used to estimate real-time levels and changes in population-scale measures such as obesity rates.

Solving graph data issues using a layered architecture approach with applications to web spam detection.

This paper proposes the combination of two state-of-the-art algorithms for processing graph input data, viz., the probabilistic mapping graph self organizing map, an unsupervised learning approach, and the graph neural network, a supervised learning approach. We organize these two algorithms in a cascade architecture containing a probabilistic mapping graph self organizing map, and a graph neural network. We show that this combined approach helps us to limit the long-term dependency problem that exists when training the graph neural network resulting in an overall improvement in performance. This is demonstrated in an application to a benchmark problem requiring the detection of spam in a relatively large set of web sites. It is found that the proposed method produces results which reach the state of the art when compared with some of the best results obtained by others using quite different approaches. A particular strength of our method is its applicability towards any input domain which can be represented as a graph.

Respuesta de los autores: español o inglés en la comunicación científica / Authors' reply: Spanish or English in scientific reporting

No disponible

Internet y conducta sexual de riesgo para VIH/SIDA en jóvenes / Internet and sexual risk behavior for HIV/AIDS in young people

Objetivo: Determinar si el uso de material sexual en línea influye en la conducta sexual de riesgo para VIH/SIDA en los jóvenes universitarios. Se utilizaron conceptos de la Teoría Cognitiva Social. Método: Diseño descriptivo correlacional, participaron 200 jóvenes universitarios, seleccionados por muestreo aleatorio sistemático (k = 11). Resultados: Los jóvenes que usaron material sexual en línea en medios ricos para masturbarse (r = .34), excitarse (rs = .29), estimularse (rs = .29), buscar una aventura (rs = .30), conocer gente (r = 27), imágenes (rs = .14) y cibersexo (r = .25) mostraron mayor conducta sexual de riesgo para VIH/SIDA (p< .01). El uso de material sexual en línea para masturbarse (Rs2 = 6.4%, F = 12.80, p < .001), buscar una aventura (R2 = 4.8%, F [1,189] = 9.56, p < .01), conocer gente (R2[1,189] = 5.9%, F = 11.88, p <.01) y tener cibersexo (R2 = 4.1%, F = 8.07, p < .01) presentó un efecto positivo y significativo en la conducta sexual de riesgo para VIH/SIDA. Conclusiones: El uso de material sexual en línea influye en la conducta sexual de riesgo para VIH/SIDA (AU)

Objective: To determine whether the use of online sexual material influences sexual risk behavior for HIV / AIDS in young university students. Concepts of Social Cognitive Theory were used. Methods: A descriptive correlational design, involving 200 university students selected by systematic random sampling (k = 11). Results: Young people who used sexual material online rich media to masturbation (r= 29), stimulation (rs = 29), adventure (rs = 30), meeting people (rs =.27), images (r =.17) and cybersex (rss =.25) showed greater sexual risk behavior for HIV / AIDS (p <.01). The use of sexual material online for masturbation (R2 = 6.4%, F [1,189] = 12.80, p <.001), seeking adventures (R2s =.34), arousal (r = 4.8%, F = 9.56, p<.01), meeting people (R2 = 5.9%, F [1,189] = 11.88, p <.01) and have cybersex (R =8.07, p <.01) had a significant positive effect on behavior sexual risk for HIV/AIDS. Conclusions: The use of online sexual material influences sexual risk behavior for HIV/AIDS (AU)