Google Trends as a Tool for Evaluating Public Interest in Facial Cosmetic Procedures.

BACKGROUND: The utility of Google Trends (GT) in analyzing worldwide and regional patient interest for plastic surgery procedures is becoming invaluable to plastic surgery practices. GT data may offer practical information to plastic surgeons pertaining to seasonal and geographic trends in interest in facial cosmetic procedures. OBJECTIVES: The authors sought to analyze geographic and temporal trends between GT search volumes and US surgery volumes using univariate analysis. METHODS: The "related queries" feature of GT generated potential search terms. GT data were compiled for cheek implants, mentoplasty, otoplasty, blepharoplasty, rhytidectomy, forehead lift, hair transplantation, lip augmentation, lip reduction, platysmaplasty, and rhinoplasty from January 2004 to December 2017. Annual volumes for respective procedures were obtained from annual statistics reports of the American Society of Plastic Surgeons (ASPS) from 2006 to 2017 and American Society of Aesthetic Plastic Surgery (ASAPS) from 2004 to 2017. RESULTS: Geographical and temporal variations in search volume were detected during the study. Search volume trends that correlated significantly with both ASPS and ASAPS surgery volume trends were: "eyelid plastic surgery" (ASPS R2 = 0.336, P = 0.048; ASAPS R2 = 0.661, P = 0.001); "facelift" (ASPS R2 = 0.767, P ≤ 0.001; ASAPS R2 = 0.767, P = 0.001); "lip injections" (ASPS R2 = 0.539, P = 0.007; ASAPS R2 = 0.461, P = 0.044); and "rhinoplasty surgery" (ASPS R2 = 0.797, P ≤ 0.001; ASAPS R2 = 0.441, P = 0.01). Several search terms demonstrated no significant relationships or were significant with only one database. CONCLUSIONS: GT may provide a high utility for informing plastic surgeons about the interest expressed by our patient population regarding certain cosmetic search terms and procedures. GT may represent a convenient tool for optimizing marketing and advertising decisions.

[Use of new technologies by adolescents in the search for health information]. / Uso de Internet por los adolescentes en la búsqueda de información sanitaria.

OBJECTIVE: To describe Internet sources used by adolescents to consult health information and their sociodemographic characteristics, as well as to identify the variables that influence the choice of Internet site. DESIGN: Cross-sectional descriptive study. Survey adapted from the questionnaire validated by Rideout. PARTICIPANTS AND LOCATION: Adolescents aged 12-18 from 4schools in rural municipalities. RESULTS: The study included a total of 405 adolescents, of whom 51.6% were female, age 14.9 ± 1.2 years. Most of them (87.25%) live with both parents, and 93.6% have computers at home, with 45.2% in their rooms, and a mean of 2.1 computers/home. The large majority (85.2%) have Internet at home, with 76.3% in their room. A total of 53.8% sought health information 0.71 ± 0.91 h/week, seeking mainly information on: cancer (89.9%), addictions (67.7%), STIs and HIV (49.6%), pregnancies/contraception (21, 5%), mental illness (40%), heart disease and diabetes mellitus (53.6%), and eating disorders (39.3%). Google was chosen by 63.2%, and only 11.9% chose medical websites. Information was shared on social networks by 12.8% (70.3% Facebook). The information found led to a change of behaviour in 70.7%. Just over half (56.05%) preferred to use the Internet for: speed, 34.8%, privacy, 15.8%, reliability, 13.6%, and more information, 17.6%. CONCLUSIONS: Adolescents seek information mainly through Google, with no knowledge of systems that accredit content quality, but consider it useful and reliable, changing their behaviour patterns according to the information found. All this carries a risk in this age group with very sensitive characteristics. Therefore, we believe that we should continue along the line of designing other alternative communication channels adapted to their current reality.

Bioinformatics education--perspectives and challenges out of Africa.

The discipline of bioinformatics has developed rapidly since the complete sequencing of the first genomes in the 1990s. The development of many high-throughput techniques during the last decades has ensured that bioinformatics has grown into a discipline that overlaps with, and is required for, the modern practice of virtually every field in the life sciences. This has placed a scientific premium on the availability of skilled bioinformaticians, a qualification that is extremely scarce on the African continent. The reasons for this are numerous, although the absence of a skilled bioinformatician at academic institutions to initiate a training process and build sustained capacity seems to be a common African shortcoming. This dearth of bioinformatics expertise has had a knock-on effect on the establishment of many modern high-throughput projects at African institutes, including the comprehensive and systematic analysis of genomes from African populations, which are among the most genetically diverse anywhere on the planet. Recent funding initiatives from the National Institutes of Health and the Wellcome Trust are aimed at ameliorating this shortcoming. In this paper, we discuss the problems that have limited the establishment of the bioinformatics field in Africa, as well as propose specific actions that will help with the education and training of bioinformaticians on the continent. This is an absolute requirement in anticipation of a boom in high-throughput approaches to human health issues unique to data from African populations.

Quality and accuracy of publicly accessible cancer-related physical activity information on the Internet: a cross-sectional assessment.

In this study, we assessed the quality of publicly available cancer-related physical activity (PA) information appearing on reputable sites from Canada and other English-speaking countries. A cross-sectional Internet search was conducted on select countries (Canada, USA, Australia, New Zealand, UK) using Google to generate top 50 results per country for the keywords "'physical activity' AND 'cancer'". Top results were assessed for quality of PA information based on a coding frame. Additional searches were performed for Canadian-based sites to produce an exhaustive list. Results found that many sites offered cancer-related PA information (94.5%), but rarely defined PA (25.2%). Top 50 results from each country did not differ on any indicator examined. The exhaustive list of Canadian sites found that many sites gave information about PA for survivorship (78.3%) and prevention (70.0%), but rarely defined (6.7%) or referenced PA guidelines (28.3%). Cancer-related PA information is plentiful on the Internet but the quality needs improvement. Sites should do more than mention PA; they should provide definitions, examples and guidelines. With improvements, these websites would enable healthcare providers to effectively educate their patients about PA, and serve as a valuable resource to the general public who may be seeking cancer-related PA information.

[Provision of assistive devices in amyotrophic lateral sclerosis. Analysis of 3 years case management in an internet-based supply network]. / Hilfsmittelversorgung bei der amyotrophen Lateralsklerose. Analyse aus 3 Jahren Fallmanagement in einem internetunterstützten Versorgungsnetzwerk.

BACKGROUND: The provision of assistive devices (PAD) is a key element of care in amyotrophic lateral sclerosis (ALS). Since 2011, assistive devices (AD) have been coordinated in an internet-supported care network at university-based ALS centers in Berlin, Bochum, Hannover and Jena. The digitization of PAD processes has facilitated the evaluation of real-life ALS care. OBJECTIVES: Orthotics (OT), augmentative and alternative communication (AAC), supported treadmill (ST) and powered wheelchair (PW) were the PAD groups analyzed for delivery rates (proportion of delivered AD vs. medically indicated AD), rejection by patients and payers and latency of provision of care. RESULTS: Between June 2011 and October 2014 a total of 1479 patients and 12,478 AD were coordinated, among which 3313 PAD were related to OT, AAC, ST or EM. The median delivery rate was 64.3 %. The mean rejection rate by patients was 9.8 % (OT 5.4 %, AAC 9.8 %, ST 10.2 % and PW 15.6 %). Marked differences were noted in the rejection rate by payers and in care provision latency: OT (16.2 %, 68 days, n = 734), AAC (30.4 %, 96 days, n = 392), ST (34.8 %, 113 days, n = 164) and PW (35.6 %, 129 days, n = 259). Analysis of rejection rates showed significant differences among insurers. CONCLUSION: Only two thirds of the medically indicated AD reached the patients. Rejection rates by patients and payers and latency of provision of care were high. The PAD can substantially vary among health insurance companies. The establishment of consented criteria for PAD and their integration into treatment regimens and guidelines are crucial tasks for the future.

An exploratory study into the effect of time-restricted internet access on face-validity, construct validity and reliability of postgraduate knowledge progress testing.

BACKGROUND: Yearly formative knowledge testing (also known as progress testing) was shown to have a limited construct-validity and reliability in postgraduate medical education. One way to improve construct-validity and reliability is to improve the authenticity of a test. As easily accessible internet has become inseparably linked to daily clinical practice, we hypothesized that allowing internet access for a limited amount of time during the progress test would improve the perception of authenticity (face-validity) of the test, which would in turn improve the construct-validity and reliability of postgraduate progress testing. METHODS: Postgraduate trainees taking the yearly knowledge progress test were asked to participate in a study where they could access the internet for 30 minutes at the end of a traditional pen and paper test. Before and after the test they were asked to complete a short questionnaire regarding the face-validity of the test. RESULTS: Mean test scores increased significantly for all training years. Trainees indicated that the face-validity of the test improved with internet access and that they would like to continue to have internet access during future testing. Internet access did not improve the construct-validity or reliability of the test. CONCLUSION: Improving the face-validity of postgraduate progress testing, by adding the possibility to search the internet for a limited amount of time, positively influences test performance and face-validity. However, it did not change the reliability or the construct-validity of the test.

Computer literacy and E-learning perception in Cameroon: the case of Yaounde Faculty of Medicine and Biomedical Sciences.

BACKGROUND: Health science education faces numerous challenges: assimilation of knowledge, management of increasing numbers of learners or changes in educational models and methodologies. With the emergence of e-learning, the use of information and communication technologies (ICT) and Internet to improve teaching and learning in health science training institutions has become a crucial issue for low and middle income countries, including sub-Saharan Africa. In this perspective, the Faculty of Medicine and Biomedical Sciences (FMBS) of Yaoundé has played a pioneering role in Cameroon in making significant efforts to improve students' and lecturers' access to computers and to Internet on its campus.The objective is to investigate how computer literacy and the perception towards e-learning and its potential could contribute to the learning and teaching process within the FMBS academic community. METHOD: A cross-sectional survey was carried out among students, residents and lecturers. The data was gathered through a written questionnaire distributed at FMBS campus and analysed with routine statistical software. RESULTS: 307 participants answered the questionnaire: 218 students, 57 residents and 32 lecturers. Results show that most students, residents and lecturers have access to computers and Internet, although students' access is mainly at home for computers and at cyber cafés for Internet. Most of the participants have a fairly good mastery of ICT. However, some basic rules of good practices concerning the use of ICT in the health domain were still not well known. Google is the most frequently used engine to retrieve health literature for all participants; only 7% of students and 16% of residents have heard about Medical Subject Headings (MeSH).The potential of e-learning in the improvement of teaching and learning still remains insufficiently exploited. About two thirds of the students are not familiar with the concept of e-leaning. 84% of students and 58% of residents had never had access to e-learning resources. However, most of the participants perceive the potential of e-learning for learning and teaching, and are in favour of its development at the FMBS. CONCLUSION: The strong interest revealed by the study participants to adopt and follow-up the development of e-learning, opens new perspectives to a faculty like the FMBS, located in a country with limited resources. However, the success of its development will depend on different factors: the definition of an e-learning strategy, the implementation of concrete measures and the adoption of a more active and participative pedagogy.

Community Health Workers and Disease Surveillance in Tanzania: Promoting the Use of Mobile Technologies in Detecting and Reporting Health Events.

This cross-sectional study was conducted in the Kilosa, Morogoro Urban, Ngorongoro, and Ulanga districts of Tanzania to investigate the practices of community health workers (CHWs) related to disease surveillance functions and to establish their needs and technology capacities. We also established the strength of mobile phone networks and internet connections in the study areas to inform the feasibility of using mobile-based applications in community-based disease surveillance. A total of 135 CHWs from 85 villages participated in the study. Health events captured at the community level were entirely paper-based. CHWs submitted reports to higher-level health authorities mainly on foot (100%), but they also used public transport (65%) and telephone calls (56%). The median number of days between the onset of a suspected disease outbreak at the community level and reporting to a primary healthcare facility was 10 days (interquartile range [IQR] 2-30). The median number of days between submitting a report and receiving a response was 7 days (IQR 2-30). Of the 53 CHWs who reported the most recent health events to a higher-level health authority, 39 (74%) never received feedback. All 85 villages had a reliable mobile phone network and 74 (87%) had a mobile phone internet connection that was strong enough to support data transmission using digital technology. Almost all (n = 132, 98%) of the CHWs owned mobile phones. The practices related to detection and reporting of health events could be improved to enhance early warning disease surveillance. Reliable mobile networks and internet connections and the ownership of mobile phones among CHWs in the study areas present opportunities to strengthen community event-based surveillance using mobile-based solutions.

Bridging the gaps between research, policy and practice in low- and middle-income countries: a survey of health care providers.

BACKGROUND: Gaps continue to exist between research-based evidence and clinical practice. We surveyed health care providers in 10 low- and middle-income countries about their use of research-based evidence and examined factors that may facilitate or impede such use. METHODS: We surveyed 1499 health care providers practising in one of four areas relevant to the Millennium Development Goals (prevention of malaria, care of women seeking contraception, care of children with diarrhea and care of patients with tuberculosis) in each of China, Ghana, India, Iran, Kazakhstan, Laos, Mexico, Pakistan, Senegal and Tanzania. RESULTS: The proportion of respondents who reported that research was likely to change their clinical practice if performed and published in their own country (84.6% and 86.0% respectively) was higher than the proportion who reported the same about research and publications from their region (66.4% and 63.1%) or from high-income countries (55.8% and 55.5%). Respondents who were most likely to report that the use of research-based evidence led to changes in their practice included those who reported using clinical practice guidelines in paper format (odds ratio [OR] 1.54, 95% confidence interval [CI] 1.03-2.28), using scientific journals from their own country in paper format (OR 1.70, 95% CI 1.26-2.28), viewing the quality of research performed in their country as above average or excellent (OR 1.93, 95% CI 1.16-3.22); trusting systematic reviews of randomized controlled trials (OR 1.59, 95% CI 1.08-2.35); and having easy access to the Internet (OR 1.90, 95% CI 1.19-3.02). INTERPRETATION: Locally conducted or published research has played an important role in changing the professional practice of health care providers surveyed in low- and middle-income countries. Increased investments in local research, or at least in locally adapted publications of research-based evidence from other settings, are therefore needed. Although access to the Internet was viewed as a significant factor in whether research-based evidence led to concrete changes in practice, few respondents reported having easy access to the Internet. Therefore, efforts to improve Internet access in clinical settings need to be accelerated.

A framework for studying perceptions of rural healthcare staff and basic ICT support for e-health use: an Indian experience.

Current research observes that electronic healthcare has various advantages, such as easy recording, retrieval, and sharing of patient data anytime and anywhere while providing data privacy. Almost all developed countries currently practice e-health. On the other hand, many developing countries still rely on traditional paper-based healthcare systems that are quite vulnerable to data loss, loss of patients' privacy due to nonsecured data sharing, and mandatory consumption of physical space to store patients' records as stacks of files. India is a developing country that broadly applies a traditional healthcare system. Unfortunately, no studies have been conducted to identify precise reasons why e-health solutions have not been adopted in the Indian primary health centers (PHCs). To fill the research gap, this work is an attempt to propose a complete framework that includes (1) a systematic survey of available resources at the level of healthcare staffs' perceptions toward using e-health and basic information communication technology (ICT) supports at the organizational level and (2) a mathematical model to engineer significant factors for analysis of overall preparedness of the health centers. Healthcare administrators (Block Medical Officer of Health) from each PHC (n = 10) and in total 50 healthcare staff (e.g., doctors, nurses, pharmacists, and midwives) participated in the study. Initially, a systematic survey was conducted to explore the possible factors at the individual (e.g., healthcare personnel) and organizational (e.g., healthcare administration) levels. A questionnaire was generated to capture the data based on the factors identified. The collected data were mathematically modeled to run regressions with significance tests examining the effects of these factors on the level of satisfaction of the end users. The result shows that basic ICT for support at the organizational levels is significantly lacking to implement e-health in these PHCs, although healthcare staffs are ready to use it. Proper measures have to be adopted mostly at the organizational level, such as improving basic ICT support before what will in all probability be a successful implementation and practice of e-health in Indian PHCs.

Evaluating critical success factors in implementing E-learning system using multi-criteria decision-making.

Learning using the Internet or training through E-Learning is growing rapidly and is increasingly favored over the traditional methods of learning and teaching. This radical shift is directly linked to the revolution in digital computer technology. The revolution propelled by innovation in computer technology has widened the scope of E-Learning and teaching, whereby the process of exchanging information has been made simple, transparent, and effective. The E-Learning system depends on different success factors from diverse points of view such as system, support from the institution, instructor, and student. Thus, the effect of critical success factors (CSFs) on the E-Learning system must be critically analyzed to make it more effective and successful. This current paper employed the analytic hierarchy process (AHP) with group decision-making (GDM) and Fuzzy AHP (FAHP) to study the diversified factors from different dimensions of the web-based E-Learning system. The present paper quantified the CSFs along with its dimensions. Five different dimensions and 25 factors associated with the web-based E-Learning system were revealed through the literature review and were analyzed further. Furthermore, the influence of each factor was derived successfully. Knowing the impact of each E-Learning factor will help stakeholders to construct education policies, manage the E-Learning system, perform asset management, and keep pace with global changes in knowledge acquisition and management.

Personalized medicine: selected web resources.

Information about personalized medicine abounds, yet it is difficult to comprehensively search for information on this topic due to the broadness of the term "personalized medicine," the variety of terms that are used to describe this concept, the vast amount of pertinent journal articles and Web sites, and the fast pace of developments in this field. A selected list of Web sites is provided as a starting place for information about concepts, terminology, projects, databases, tools, and stakeholders related to personalized medicine.

The SWAN biomedical discourse ontology.

Developing cures for highly complex diseases, such as neurodegenerative disorders, requires extensive interdisciplinary collaboration and exchange of biomedical information in context. Our ability to exchange such information across sub-specialties today is limited by the current scientific knowledge ecosystem's inability to properly contextualize and integrate data and discourse in machine-interpretable form. This inherently limits the productivity of research and the progress toward cures for devastating diseases such as Alzheimer's and Parkinson's. SWAN (Semantic Web Applications in Neuromedicine) is an interdisciplinary project to develop a practical, common, semantically structured, framework for biomedical discourse initially applied, but not limited, to significant problems in Alzheimer Disease (AD) research. The SWAN ontology has been developed in the context of building a series of applications for biomedical researchers, as well as in extensive discussions and collaborations with the larger bio-ontologies community. In this paper, we present and discuss the SWAN ontology of biomedical discourse. We ground its development theoretically, present its design approach, explain its main classes and their application, and show its relationship to other ongoing activities in biomedicine and bio-ontologies.

Are There Gender-Dependent Study Habits of Medical Students in Times of the World Wide Web?

This study evaluates how medical students rate the different types of teaching materials and methods available as well as possible gender-specific differences in the use of such materials. In this descriptive, cross-sectional study a questionnaire with short, one-dimensional questions with a 4-step Likert scale was developed by a presurvey within 493 students (4th year) at a University Medical School (January-December 2015). The anonymous survey was performed from July 2016 to February 2017 with 252 students within an orthopaedic surgery course at University Medical School. After exclusion of (1) nonnative speakers and (2) incomplete forms, 233 samples were included. Practical education was regarded as the most important (n=160/68.7%) teaching method followed by Internet research (n=147/63.1%) as the most important teaching material, while traditional frontal teaching (n=19/8.2%) and e-books (n=11/4.7%) ranked last. The evaluation of gender-specific differences in the use of teaching materials showed that female students prefer to highlight text (p<0.0001) as well as a trend to Internet research (p=0.053) and small-group teaching (p=0.057). Despite some gender-specific differences, traditional learning methods retain their importance besides new learning possibilities such as Internet research.

Computer and internet access for long-term care residents: perceived benefits and barriers.

In this study, the authors examined residents' computer and Internet access, as well as benefits and barriers to access in nursing homes. Administrators of 64 nursing homes in a national chain completed surveys. Fourteen percent of the nursing homes provided computers for residents to use, and 11% had Internet access. Some residents owned personal computers in their rooms. Administrators perceived the benefits of computer and Internet use for residents as facilitating direct communication with family and providing mental exercise, education, and enjoyment. Perceived barriers included cost and space for computer equipment and residents' cognitive and physical impairments. Implications of residents' computer activities were discussed for nursing care. Further research is warranted to examine therapeutic effects of computerized activities and their cost effectiveness.

What Can the National Broadband Map Tell Us About the Health Care Connectivity Gap?

PURPOSE: Internet connection speeds are generally slower in rural areas, and this issue is rising in importance for health care facilities as technologies such as Electronic Health Records and Health Information Exchanges become more common. However, the extent of the rural-urban divide in terms of health care connectivity has not been fully quantified. This report uses data compiled from the National Broadband Map (NBM) to compare levels of health care facility connectivity across metropolitan and nonmetropolitan counties. METHODS: The number of health and medical entries in the Community Anchor Institution (CAI) data collected as part of the NBM grew from 35,000 to 63,000 between 2010 and 2014. About one-fifth provided information on the speed of their connections in 2014. Comparisons across metro and nonmetro counties and over time provide insight into trends associated with the health care connectivity gap. FINDINGS: The data clearly show that health-related institutions in nonmetro counties connect with lower speeds than do their more urban counterparts. At the aggregate level, over 55% of metro institutions who provided speed information had download speeds in excess of 50 megabytes per second in 2014, compared with only 12% of nonmetro institutions (P < .001). More importantly, the connectivity gap has grown significantly during 2010-2014, particularly for nonhospital facilities. CONCLUSIONS: The NBM CAI data are a publicly available and easy to use asset that rural health advocates should be aware of. The fact that the connectivity gap increased during 2010-2014, despite policies focusing on this issue, is a cause for concern.

Digital Health in Francophone Sub-Saharan Africa: Catching Up!

Digital health has the potential to strengthen health systems and empower patients to prevent ill health and manage their own care. To confirm this potential, however, it is urgent to shift from pilot studies to the implementation of programs at a sufficient scale, with interoperable solutions and integrated into the national health system, while respecting human rights. It is also important to plan for studies to demonstrate the impact and produce the necessary evidence. Francophone sub-Saharan Africa can catch up in this area.