Screening for obstructive sleep apnea on the internet: randomized trial.

BACKGROUND: Obstructive sleep apnea is underdiagnosed. We conducted a pilot randomized controlled trial of an online intervention to promote obstructive sleep apnea screening among members of an Internet weight-loss community. METHODS: Members of an Internet weight-loss community who have never been diagnosed with obstructive sleep apnea or discussed the condition with their healthcare provider were randomized to intervention (online risk assessment+feedback) or control. The primary outcome was discussing obstructive sleep apnea with a healthcare provider at 12 weeks. RESULTS: Of 4700 members who were sent e-mail study announcements, 168 (97% were female, age 39.5 years [standard deviation 11.7], body mass index 30.3 [standard deviation 7.8]) were randomized to intervention (n=84) or control (n=84). Of 82 intervention subjects who completed the risk assessment, 50 (61%) were low risk and 32 (39%) were high risk for obstructive sleep apnea. Intervention subjects were more likely than control subjects to discuss obstructive sleep apnea with their healthcare provider within 12 weeks (11% [9/84] vs 2% [2/84]; P=.02; relative risk=4.50; 95% confidence interval, 1.002-20.21). The number needed to treat was 12. High-risk intervention subjects were more likely than control subjects to discuss obstructive sleep apnea with their healthcare provider (19% [6/32] vs 2% [2/84]; P=.004; relative risk=7.88; 95% confidence interval, 1.68-37.02). One high-risk intervention subject started treatment for obstructive sleep apnea. CONCLUSION: An online screening intervention is feasible and likely effective in encouraging members of an Internet weight-loss community to discuss obstructive sleep apnea with their healthcare provider.

A web-based non-intrusive ambient system to measure and classify activities of daily living.

BACKGROUND The number of older adults in the global population is increasing. This demographic shift leads to an increasing prevalence of age-associated disorders, such as Alzheimer's disease and other types of dementia. With the progression of the disease, the risk for institutional care increases, which contrasts with the desire of most patients to stay in their home environment. Despite doctors' and caregivers' awareness of the patient's cognitive status, they are often uncertain about its consequences on activities of daily living (ADL). To provide effective care, they need to know how patients cope with ADL, in particular, the estimation of risks associated with the cognitive decline. The occurrence, performance, and duration of different ADL are important indicators of functional ability. The patient's ability to cope with these activities is traditionally assessed with questionnaires, which has disadvantages (eg, lack of reliability and sensitivity). Several groups have proposed sensor-based systems to recognize and quantify these activities in the patient's home. Combined with Web technology, these systems can inform caregivers about their patients in real-time (e.g., via smartphone). OBJECTIVE We hypothesize that a non-intrusive system, which does not use body-mounted sensors, video-based imaging, and microphone recordings would be better suited for use in dementia patients. Since it does not require patient's attention and compliance, such a system might be well accepted by patients. We present a passive, Web-based, non-intrusive, assistive technology system that recognizes and classifies ADL. METHODS The components of this novel assistive technology system were wireless sensors distributed in every room of the participant's home and a central computer unit (CCU). The environmental data were acquired for 20 days (per participant) and then stored and processed on the CCU. In consultation with medical experts, eight ADL were classified. RESULTS In this study, 10 healthy participants (6 women, 4 men; mean age 48.8 years; SD 20.0 years; age range 28-79 years) were included. For explorative purposes, one female Alzheimer patient (Montreal Cognitive Assessment score=23, Timed Up and Go=19.8 seconds, Trail Making Test A=84.3 seconds, Trail Making Test B=146 seconds) was measured in parallel with the healthy subjects. In total, 1317 ADL were performed by the participants, 1211 ADL were classified correctly, and 106 ADL were missed. This led to an overall sensitivity of 91.27% and a specificity of 92.52%. Each subject performed an average of 134.8 ADL (SD 75). CONCLUSIONS The non-intrusive wireless sensor system can acquire environmental data essential for the classification of activities of daily living. By analyzing retrieved data, it is possible to distinguish and assign data patterns to subjects' specific activities and to identify eight different activities in daily living. The Web-based technology allows the system to improve care and provides valuable information about the patient in real-time.

¿Presencia del español en el paisaje urbano de Washington D.F.? Un estudio del paisaje lingüístico mediado por Internet

Objetivo de esta comunicación es presentar los resultados sobre un análisis realizado en torno a lo que podemos denominar el «paisaje lingüístico hispano virtual» en Washington D.F. Los estudios sobre paisaje lingüístico han experimentado en el último tiempo un verdadero boom, sobre todo como reflejo de la convivencia de diferentes culturas con sus respectivas lenguas y variedades en las urbes del siglo XXI. En efecto: el paisaje lingüístico multilingüe es uno de los aspectos más explotados en trabajos en esta línea teórica. En este estudio el centro de atención no es el paisaje "real", documentado in situ y captado motu propio en instantáneas por nuestros aparatos fotográficos, sino el paisaje lingüístico mediatizado por el ordenador y difundido mediante la World Wide Web. En este sentido, lo que nos interesa es si se ve reflejada y qué manera la hispanidad en Washington D.F. a través del paisaje urbano que nos ofrecen programas especializados como Google Earth y Google Street View. Con este objetivo proponemos un paseo virtual por Washington D.F. y sus diferentes barrios para analizar mediante un estudio de naturaleza cuantitativa y cualitativa, apoyándonos en las herramientas teóricas y metodológicas que ofrecen los estudios de paisaje lingüístico y de la Comunicación Mediada por Ordenadores, de qué manera lo hispano constituye un engranaje del paisaje lingüístico de esta ciudad.

Non-Substance-Related Disorders: Gambling disorder and internet addiction

Behavioral addictions are highly prevalent and have a major individual and societal impact. Moreover, given the availability and increase of potentially addictive activities in our societal development (e.g. internet, gaming, online pornography) an increase in these types of behavioral disorders is very likely. Gambling Disorders are best studied among the non-chemical addictions. However, effective treatment interventions need to be further developed, in particular for Internet Addiction. Most of the available evidence supports behavioral interventions as first line treatment. Specifically for Gambling Disorder, pharmacotherapy can be an useful augmentation.. Psychiatric comorbidities are frequent in patients with behavioral addictions and negatively affect the course of non-substance-related disorders. Concurrent treatment of these comorbid disorders is advised, although there is a clear need of conducting studies evaluating the effectiveness of integrated treatment approaches.

Improving Pediatric Basic Life Support Performance Through Blended Learning With Web-Based Virtual Patients: Randomized Controlled Trial

BACKGROUND E-learning and blended learning approaches gain more and more popularity in emergency medicine curricula. So far, little data is available on the impact of such approaches on procedural learning and skill acquisition and their comparison with traditional approaches. OBJECTIVE This study investigated the impact of a blended learning approach, including Web-based virtual patients (VPs) and standard pediatric basic life support (PBLS) training, on procedural knowledge, objective performance, and self-assessment. METHODS A total of 57 medical students were randomly assigned to an intervention group (n=30) and a control group (n=27). Both groups received paper handouts in preparation of simulation-based PBLS training. The intervention group additionally completed two Web-based VPs with embedded video clips. Measurements were taken at randomization (t0), after the preparation period (t1), and after hands-on training (t2). Clinical decision-making skills and procedural knowledge were assessed at t0 and t1. PBLS performance was scored regarding adherence to the correct algorithm, conformance to temporal demands, and the quality of procedural steps at t1 and t2. Participants' self-assessments were recorded in all three measurements. RESULTS Procedural knowledge of the intervention group was significantly superior to that of the control group at t1. At t2, the intervention group showed significantly better adherence to the algorithm and temporal demands, and better procedural quality of PBLS in objective measures than did the control group. These aspects differed between the groups even at t1 (after VPs, prior to practical training). Self-assessments differed significantly only at t1 in favor of the intervention group. CONCLUSIONS Training with VPs combined with hands-on training improves PBLS performance as judged by objective measures.

A sorrow shared is a sorrow halved? Internet-based group therapy versus individual therapy for social anxiety disorder: A randomized controlled trial

Purpose: Social anxiety disorder is one of the most researched conditions in the field of Internet-based self-help. Various studies have shown that cognitive-behavioral treatments can be efficacious to reduce social phobic symptoms. Most of the interventions tested include some form of support, whereas the efficacy of a web-based group format has yet to be investigated. The present study aims at investigating the possible added value of therapist-guided group support in an Internet-based guided self-help treatment for SAD. Methods: A total of 150 adults with a diagnosis of SAD are randomly assigned to either a wait-list control group or one of two active treatment conditions. Participants in the two active conditions use the same Internet-based self-help program, either with individual guidance by a therapist or with the support of a therapist-guided group of 6 individuals. In the group condition, participants communicate with each other via an integrated, protected discussion forum. The primary outcome variables are symptoms of SAD and diagnostic status immediately after the intervention (12 weeks) and at 6-month follow-up. Secondary endpoints are general symptomatology, depression, quality of life and adherence to treatment. Furthermore, process variables such as group processes and the working alliance are studied. Results: Results are currently being analyzed. Results at post-treatment will be presented and discussed. Potential moderating and mediating variables of treatment success will be addressed. Conclusion: The results of this study should indicate whether therapist-guided group support could enhance the efficacy of an internet based self-help treatment for SAD. This novel treatment format, if shown efficacious, could represent a cost-effective option and could be further modified to treat other conditions.

Wartung 2.0: Nutzereinbindung zur Verbesserung von Webapplikationen als Komponente des Web Engineerings

In Anlehnung an Begriffe wie Web 2.0, an dem sich Internet-Nutzer mit unterschiedlichen Aktivitäten beteiligen können, und Enterprise 2.0 wird das Konzept der „Wartung 2.0“ entwickelt. Bei diesem Ansatz steht die Einbeziehung von Nutzergemeinschaften zur Verbesserung des Webauftritts und insbesondere von B2C-Systemen im Vordergrund. Wartung 2.0 ist eine Komponente des Web Engineerings und damit auch ein Element des von Lutz J. Heinrich vertretenen Konzepts des Information Engineerings

Evaluation of web-based resources for pregnant and parenting teens

Current teen pregnancy and repeat pregnancy rates reveal that there is a pressing need for comprehensive care for pregnant and parenting teens to address their unique needs. The Internet has become a source of various types of information and as a result, several efforts have begun to assess the quality of health information provided on websites. The objective of this study was to assess the functionality and quality of websites containing health information and resources for pregnant and parenting teens. The three most widely used search engines currently: Google, MSN, and Yahoo were searched using three general search terms “teen pregnancy”, “pregnant teen”, and “teen parent”. The first 5 pages of each search were reviewed and categorized to yield 12 websites which met inclusion criteria for content evaluation. The 12 websites were rated using a pre-existing instrument encompassing two domains: functionality and content analysis. Within the functionality domain, this sample highlighted the need to improve accessibility and credibility for the target population. The content analysis revealed that among the topics which are recommended for pregnant and parenting teens, the topics most commonly covered were mental health and primary and preventive health care. The majority of websites neglected sexual health topics including STI’s and family planning. This study provides the first glimpse into health information and resources for pregnant and parenting teens on the Internet. Researchers, health care providers, social workers, health educators, and website sponsors can use these results to maintain and recommend websites which offer easily accessible, accurate, and practical information for pregnant and parenting teens.^

RE-AIM analysis of Internet-based psychotherapy

We live in an era where the Internet is expected to be available at the home, the workplace, schools, libraries, and even the corner café. Everyday, more and more of the world's population is connected to this growing minefield of information, many of whom use it to seek out services they need. Health services are amongst the many purchasable products currently available online. The Internet, thus, is a viable method of contacting populations that a provider would not traditionally be able to reach. A growing service in this area is the practice of Internet-based psychotherapy. This goes by many other names as well, such as e-counseling, telecounseling, web therapy, computer mediated counseling, Interapy, and many other variations. ^ This paper reviews the current available literature on the efficacy and associated concerns of Internet-based psychotherapy through the RE-AIM lens. After an evaluation of the selected studies, Internet-based psychotherapy may be able to reach a wider audience than with traditional means and also produces similar efficacy results to in-person therapy. However, providers are still reluctant to adopt Internet-based psychotherapy due to legal concerns, and long-term maintenance of these practices may be an issue. Further research into the effectiveness, cost, and legal issues surrounding Internet-based psychotherapy is recommended. ^

Evaluation of web-based resources for HIV+ youth

Given current rates of the Human Immunodeficiency Virus (HIV) in youth ages 15–24, comprehensive care is imperative in order to manage the virus and to prevent further transmission. In the past decade, the Internet has become an immensely popular source for information, including health information. Due to the increase in Internet use for this purpose, the assessment of the quality, accuracy, and timeliness of health information on the Internet is necessary since the information delivered may not be current or accurate. The purpose of this study was to determine the quantity and quality of websites containing health information and resources directed specifically towards HIV positive youth. Three general search terms, “HIV + teens”, “HIV teens info”, and “HIV infected teens,” were searched using the current top three search engines: Google, Yahoo!, and MSN/Bing. The first hundred hits of each search were then categorized by type of website. The examination of the search results yielded 7 sites that met the inclusion criteria. These sites were consequently evaluated on functionality and content using an adapted version of a pre-existing instrument. The functionality analysis revealed that no websites that contained self management information were dedicated specifically to HIV positive youth. The content analysis showed that the sites chosen for evaluation were mostly consistent with the guidelines provided by the Department of Health and Human Services. The most discussed topics in the sites included the importance of safer sexual behavior, HIV counseling, partner notification, safer behavior choices, such as condom use, and mental health. These results highlight the need for the development of accessible websites that contain accurate information targeting youth infected with HIV. This study provides a snapshot of the available web-based resources and health information for HIV positive youth, and is relevant for health educators, care providers, researchers, and others intervening with HIV+ youth. ^

La búsqueda de información en Web [ponencia]. En: VI Jornadas Regionales y IV Provinciales de Bibliotecarios

Este trabajo presenta un marco de referencia para el estudio de las fuerzas del ambiente tecnológico que intervienen en la interacción usuario-internet, en tanto instrumentos de aculturación, de comunicación y de búsqueda de información en web

ICANN y los gobiernos nacionales : El debate sobre el caso patagonia ante la desregulación de los dominios web

El objetivo del presente artículo es reflexionar sobre las dinámicas internacionales en torno a la comunicación, a partir del creciente fenómeno de la globalización. Se parte de la premisa de que el Estado ha perdido poder-soberanía ante otros actores reguladores; entre ellos ICANN, organización supranacional encargada de coordinar el sistema de nombres de dominio de internet, entre otras funciones. A partir del reclamo que hace el gobierno argentino y un grupo de ciudadanos por la extensión .patagonia que podría ser asignada a una empresa estadounidense, se busca analizar los desafíos que presenta la red para los Estados-nación y las tensiones que se ponen de manifiesto entre lo cultural y lo económico

Notas para reflexionar acerca de las identidades (sexuales) de varones que socializan mediante internet

La sociabilidad virtual se ha transformado en una práctica habitual por parte de varones que se sienten sexualmente atraídos por otros varones porque ofrece anonimato, fluidez y la disponibilidad constante para iniciar vínculos. Estas características se tornan más relevantes en aquellas localidades pequeñas o medianas del interior del país puesto que "la discreción y la reserva" en relación a las experiencias homosexuales constituyen bienes muy preciados, en especial para aquellos sujetos que no han dado a conocer su identidad homosexual o para aquellos que no han blanqueado la dimensión homosexual de su sexualidad. Asimismo, suele ser la única opción en aquellas áreas no metropolitanas ante la ausencia de boliches, saunas, cybers, cines que exhiben películas pornográficas y otros sitios "reales" que sí están presentes en las grandes urbes. Muchos de los sujetos con quienes me he contactado en el marco de mi tesis doctoral me han referido el chat de arnet y el portal manhunt como dos de los principales sitios web que frecuentemente visitan con el propósito de conocer a otros sujetos dispuestos a entablar lazos de amistad y/o eróticos. Dicho esto, en la presente ponencia socializo los resultados parciales de mi trabajo de campo, uno de cuyos ejes indaga las diferentes configuraciones de las identidades sexuales de los sujetos que participan de esta forma de sociabilidad y de qué manera estas categorías autoatribuidas expresan tensiones con aquellas categorías que pretenden utilizar los investigadores para dar cuenta de ellos

Visibilidad de los archivos universitarios hispanoamericanos a través de Internet

Este trabajo busca detectar la presencia en Internet de archivos universitarios existentes en países del continente americano cuyo idioma oficial sea la lengua española, y analizar sus sitios web prestando especial atención a los contenidos difundidos en ellos. Se relevaron a junio de 2013 un total de 56 sitios web. Como conclusiones principales pueden señalarse las siguientes: a) se observa un lento incremento en la cantidad de sitios web, pasando de 42 en 2005 a 56 en 2013; b) 52 por ciento corresponden a la fase histórica; c) México es el país con mayor cantidad de archivos; d) 64 por ciento posee sitio web propio; e) 80 por ciento incluye misión del archivo; f) cerca de un 20 por ciento no incluye datos de contacto; g) 74 por ciento señala los servicios ofrecidos; h) 53 por ciento disponen información descriptiva general sobre los fondos custodiados; i) 21 por ciento ofrece la posibilidad de hojear documentos a texto completo; j) 28 por ciento difunde su reglamento y procedimientos de trabajo; k) poco más del 45 por ciento incluye información sobre pautas para el acceso, consulta y reproducción de documentos; l) un bajo porcentaje incluye informaciones adicionales, predominando noticias (39 por ciento) y fotos (18 por ciento), así como legislación archivística (20 por ciento) y recursos archivísticos de interés (27 por ciento); m) en cuanto a las herramientas de la Web 2.0, 18 por ciento posee blog, 16 por ciento canales de RSS, 27 por ciento Facebook y 23 por ciento Twitter

Visibilidad de los archivos universitarios hispanoamericanos a través de Internet

Este trabajo busca detectar la presencia en Internet de archivos universitarios existentes en países del continente americano cuyo idioma oficial sea la lengua española, y analizar sus sitios web prestando especial atención a los contenidos difundidos en ellos. Se relevaron a junio de 2013 un total de 56 sitios web. Como conclusiones principales pueden señalarse las siguientes: a) se observa un lento incremento en la cantidad de sitios web, pasando de 42 en 2005 a 56 en 2013; b) 52 por ciento corresponden a la fase histórica; c) México es el país con mayor cantidad de archivos; d) 64 por ciento posee sitio web propio; e) 80 por ciento incluye misión del archivo; f) cerca de un 20 por ciento no incluye datos de contacto; g) 74 por ciento señala los servicios ofrecidos; h) 53 por ciento disponen información descriptiva general sobre los fondos custodiados; i) 21 por ciento ofrece la posibilidad de hojear documentos a texto completo; j) 28 por ciento difunde su reglamento y procedimientos de trabajo; k) poco más del 45 por ciento incluye información sobre pautas para el acceso, consulta y reproducción de documentos; l) un bajo porcentaje incluye informaciones adicionales, predominando noticias (39 por ciento) y fotos (18 por ciento), así como legislación archivística (20 por ciento) y recursos archivísticos de interés (27 por ciento); m) en cuanto a las herramientas de la Web 2.0, 18 por ciento posee blog, 16 por ciento canales de RSS, 27 por ciento Facebook y 23 por ciento Twitter