Real-Time Internet Connections: Implications for Surgical Decision Making in Laparoscopy

PubMed Central

Broderick, Timothy J.; Harnett, Brett M.; Doarn, Charles R.; Rodas, Edgar B.; Merrell, Ronald C.

2001-01-01

Objective To determine whether a low-bandwidth Internet connection can provide adequate image quality to support remote real-time surgical consultation. Summary Background Data Telemedicine has been used to support care at a distance through the use of expensive equipment and broadband communication links. In the past, the operating room has been an isolated environment that has been relatively inaccessible for real-time consultation. Recent technological advances have permitted videoconferencing over low-bandwidth, inexpensive Internet connections. If these connections are shown to provide adequate video quality for surgical applications, low-bandwidth telemedicine will open the operating room environment to remote real-time surgical consultation. Methods Surgeons performing a laparoscopic cholecystectomy in Ecuador or the Dominican Republic shared real-time laparoscopic images with a panel of surgeons at the parent university through a dial-up Internet account. The connection permitted video and audio teleconferencing to support real-time consultation as well as the transmission of real-time images and store-and-forward images for observation by the consultant panel. A total of six live consultations were analyzed. In addition, paired local and remote images were “grabbed” from the video feed during these laparoscopic cholecystectomies. Nine of these paired images were then placed into a Web-based tool designed to evaluate the effect of transmission on image quality. Results The authors showed for the first time the ability to identify critical anatomic structures in laparoscopy over a low-bandwidth connection via the Internet. The consultant panel of surgeons correctly remotely identified biliary and arterial anatomy during six laparoscopic cholecystectomies. Within the Web-based questionnaire, 15 surgeons could not blindly distinguish the quality of local and remote laparoscopic images. Conclusions Low-bandwidth, Internet-based telemedicine is inexpensive, effective, and almost ubiquitous. Use of these inexpensive, portable technologies will allow sharing of surgical procedures and decisions regardless of location. Internet telemedicine consistently supported real-time intraoperative consultation in laparoscopic surgery. The implications are broad with respect to quality improvement and diffusion of knowledge as well as for basic consultation. PMID:11505061

Information and decision support needs in patients with type 2 diabetes.

PubMed

Weymann, Nina; Härter, Martin; Dirmaier, Jörg

2016-03-01

Diabetes and its sequelae cause a growing burden of morbidity and mortality. For many patients living with diabetes, the Internet is an important source of health information and support. In the course of the development of an Interactive Health Communication Application, combining evidence-based information with behavior change and decision support, we assessed the characteristics, information, and decision support needs of patients with type 2 diabetes.The needs assessment was performed in two steps. First, we conducted semi-structured interviews with 10 patients and seven physicians. In the second step, we developed a self-assessment questionnaire based on the results of the interviews and administered it to a new and larger sample of diabetes patients (N = 178). The questionnaire comprised four main sections: (1) Internet use and Internet experience, (2) diabetes knowledge, (3) relevant decisions and decision preferences, and (4) online health information needs. Descriptive data analyses were performed.In the questionnaire study, the patient sample was heterogeneous in terms of age, time since diagnosis, and glycemic control. (1) Most participants (61.7%) have searched the web for health information at least once. The majority (62%) of those who have used the web use it at least once per month. (2) Diabetes knowledge was scarce: Only a small percentage (1.9%) of the respondents answered all items of the knowledge questionnaire correctly. (3) The most relevant treatment decisions concerned glycemic control, oral medication, and acute complications. The most difficult treatment decision was whether to start insulin treatment. Of the respondents, 69.4 percent thought that medical decisions should be made by them and their doctor together. (4) The most important information needs concerned sequelae of diabetes, blood glucose control, and basic diabetes information.The Internet seems to be a feasible way to reach people with type 2 diabetes. The heterogeneity of the sample, especially with respect to diabetes knowledge, makes it clear that the projected Interactive Health Communication Application should tailor the content to the individual user, taking account of individual characteristics and preferences. A wide range of topics should be covered. Special attention should be paid to the advantages and disadvantages of insulin treatment and the fears and hopes associated with it. These results were taken into account when developing the Interactive Health Communication Application that is currently being evaluated in a randomized controlled trial (International Clinical Trials Registry DRKS00003322). © The Author(s) 2014.

DISPLA: decision information system for procurement and logistics analysis

NASA Astrophysics Data System (ADS)

Calvo, Alberto B.; Danish, Alexander J.; Lamonakis, Gregory G.

2002-08-01

This paper describes an information-exchange system for Display systems acquisition and logistics support. DISPLA (Decision Information System for Procurement and Logistics Analysis) is an Internet-based system concept for bringing sellers (display system and component suppliers) and buyers (Government Program Offices and System Integrators) together in an electronic exchange to improve the acquisition and logistics analysis support of Flat Panel Displays for the military. A proof-of-concept demonstration is presented in this paper using sample data from vendor Web sites and Government data sources.

Protocol for population testing of an Internet-based Personalised Decision Support system for colorectal cancer screening

PubMed Central

2010-01-01

Background Australia has a comparatively high incidence of colorectal (bowel) cancer; however, population screening uptake using faecal occult blood test (FOBT) remains low. This study will determine the impact on screening participation of a novel, Internet-based Personalised Decision Support (PDS) package. The PDS is designed to measure attitudes and cognitive concerns and provide people with individually tailored information, in real time, that will assist them with making a decision to screen. The hypothesis is that exposure to (tailored) PDS will result in greater participation in screening than participation following exposure to non-tailored PDS or resulting from the current non-tailored, paper-based approach. Methods/design A randomised parallel trial comprising three arms will be conducted. Men and women aged 50-74 years (N = 3240) will be recruited. They must have access to the Internet; have not had an FOBT within the previous 12 months, or sigmoidoscopy or colonoscopy within the previous 5 years; have had no clinical diagnosis of bowel cancer. Groups 1 and 2 (PDS arms) will access a website and complete a baseline survey measuring decision-to-screen stage, attitudes and cognitive concerns and will receive immediate feedback; Group 1 will receive information 'tailored' to their responses in the baseline survey and group 2 will received 'non-tailored' bowel cancer information. Respondents in both groups will subsequently receive an FOBT kit. Group 3 (usual practice arm) will complete a paper-based version of the baseline survey and respondents will subsequently receive 'non-tailored' paper-based bowel cancer information with accompanying FOBT kit. Following despatch of FOBTs, all respondents will be requested to complete an endpoint survey. Main outcome measures are (1) completion of FOBT and (2) change in decision-to-screen stage. Secondary outcomes include satisfaction with decision and change in attitudinal scores from baseline to endpoint. Analyses will be performed using Chi-square tests, analysis of variance and log binomial generalized linear models as appropriate. Discussion It is necessary to restrict participants to Internet users to provide an appropriately controlled evaluation of PDS. Once efficacy of the approach has been established, it will be important to evaluate effectiveness in the wider at-risk population, and to identify barriers to its implementation in those settings. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12610000095066 PMID:20843369

Designing Computerized Decision Support That Works for Clinicians and Families

PubMed Central

Fiks, Alexander G.

2011-01-01

Evidence-based decision-making is central to the practice of pediatrics. Clinical trials and other biomedical research provide a foundation for this process, and practice guidelines, drawing from their results, inform the optimal management of an increasing number of childhood health problems. However, many clinicians fail to adhere to guidelines. Clinical decision support delivered using health information technology, often in the form of electronic health records, provides a tool to deliver evidence-based information to the point of care and has the potential to overcome barriers to evidence-based practice. An increasing literature now informs how these systems should be designed and implemented to most effectively improve outcomes in pediatrics. Through the examples of computerized physician order entry, as well as the impact of alerts at the point of care on immunization rates, the delivery of evidence-based asthma care, and the follow-up of children with attention deficit hyperactivity disorder, the following review addresses strategies for success in using these tools. The following review argues that, as decision support evolves, the clinician should no longer be the sole target of information and alerts. Through the Internet and other technologies, families are increasingly seeking health information and gathering input to guide health decisions. By enlisting clinical decision support systems to deliver evidence-based information to both clinicians and families, help families express their preferences and goals, and connect families to the medical home, clinical decision support may ultimately be most effective in improving outcomes. PMID:21315295

HUMAN HEALTH METRICS FOR ENVIRONMENTAL DECISION SUPPORT TOOLS: LESSONS FROM HEALTH ECONOMICS AND DECISION ANALYSIS: JOURNAL ARTICLE

EPA Science Inventory

NRMRL-CIN-1351 Hofstetter**, P., and Hammitt, J. K. Human Health Metrics for Environmental Decision Support Tools: Lessons from Health Economics and Decision Analysis. Risk Analysis 600/R/01/104, Available: on internet, www.epa.gov/ORD/NRMRL/Pubs/600R01104, [NET]. 03/07/2001 D...

Intelligent support of e-management for consumer-focused virtual enterprises

NASA Astrophysics Data System (ADS)

Chandra, Charu; Smirnov, Alexander V.

2000-10-01

The interest in consumer-focused virtual enterprises (VE) decision-making problem is growing fast. The purpose of this type of enterprise is to transform incomplete information about customer orders and available resources into-co-ordinated plans for production and replenishment of goods and services in the temporal network formed by collaborating units. This implies that information in the consumer-focused VE can be shared via Internet, Intranet, and Extranet for business-to-consumer (B2C), business-to-business service (B2B-S), and business-to-business goods (B2B-G) transactions. One of the goals of Internet-Based Management (e-management) is to facilitate transfer and sharing of data and knowledge in the context of enterprise collaboration. This paper discusses a generic framework of e-management that integrates intelligent information support group-decision making, and agreement modeling for a VE network. It offers the platform for design and modeling of diverse implementation strategies related to the type of agreement, optimization policies, decision-making strategies, organization structures, and information sharing strategies and mechanisms, and business policies for the VE.

Information systems: the key to evidence-based health practice.

PubMed Central

Rodrigues, R. J.

2000-01-01

Increasing prominence is being given to the use of best current evidence in clinical practice and health services and programme management decision-making. The role of information in evidence-based practice (EBP) is discussed, together with questions of how advanced information systems and technology (IS&T) can contribute to the establishment of a broader perspective for EBP. The author examines the development, validation and use of a variety of sources of evidence and knowledge that go beyond the well-established paradigm of research, clinical trials, and systematic literature review. Opportunities and challenges in the implementation and use of IS&T and knowledge management tools are examined for six application areas: reference databases, contextual data, clinical data repositories, administrative data repositories, decision support software, and Internet-based interactive health information and communication. Computerized and telecommunications applications that support EBP follow a hierarchy in which systems, tasks and complexity range from reference retrieval and the processing of relatively routine transactions, to complex "data mining" and rule-driven decision support systems. PMID:11143195

Context Aware Programmable Trackers for the Next Generation Internet

NASA Astrophysics Data System (ADS)

Sousa, Pedro

This work introduces and proposes the concept of context aware programmable trackers for the next generation Internet. The proposed solution gives ground for the development of advanced applications based on the P2P paradigm and will foster collaborative efforts among several network entities (e.g. P2P applications and ISPs). The proposed concept of context aware programmable trackers allows that several peer selection strategies might be supported by a P2P tracker entity able to improve the peer selection decisions according with pre-defined objectives and external inputs provided by specific services. The flexible, adaptive and enhanced peer selection semantics that might be achieved by the proposed solution will contribute for devising novel P2P based services and business models for the future Internet.

Health-Related Internet Use by Informal Caregivers of Children and Adolescents: An Integrative Literature Review.

PubMed

Park, Eunhee; Kim, Heejung; Steinhoff, Andreanna

2016-03-03

Internet-based health resources can support informal caregivers who are caring for children or adolescents with health care needs. However, few studies discriminate informal caregivers' needs from those of their care recipients or those of people caring for adults. This study reviews the literature of health-related Internet use among informal caregivers of children and adolescents. A total of 17 studies were selected from literature searches conducted in 6 electronic databases: PubMed, Cochrane, CINAHL, PsycINFO, ERIC, and EMBASE. All databases searches were limited to articles published in the years 2004 to 2014 in peer-reviewed publications. Search terms consisted of "health-related Internet use," "eHealth," "Internet use for health-related purpose(s)," "Web-based resource(s)," and "online resources," combined with informal caregiver (or "parents") of "child," "adolescent," "student," "youth," and "teen." The age range of the children receiving care was limited to younger than 22 years. Their informal caregivers were defined as persons (parents) who provided unpaid care or assistance to a child or an adolescent with health problems. Among 17 empirical studies, the majority of informal caregivers of children with medical issues were the parents. Quantitative studies (14/17, 77%) reported prevalence and predictors of health-related Internet use, while mixed-methods and qualitative studies (3/17, 24%) investigated informal caregiver perceptions of helpful health-related Internet use and barriers of use. The prevalence of health-related Internet use varied (11%-90%) dependent upon how health-related Internet use was operationalized and measured. Disease-specific information was used for decision making about treatment, while social support via virtual communities and email were used for informal caregiver emotional needs. A digital divide of Internet access was identified in lower educated minorities. Most studies had methodological challenges resulting from convenience sampling, cross-sectional surveys, lack of theoretical frameworks, or no clear definitions of health-related Internet use. This study provides an important understanding of how family members use Internet-based information and support systems during child caregiving. Healthcare providers and policy makers should integrate family needs into their current practices and policies. Further rigorous research is required to design efficient and effective nursing interventions.

The Invasive Species Forecasting System

NASA Technical Reports Server (NTRS)

Schnase, John; Most, Neal; Gill, Roger; Ma, Peter

2011-01-01

The Invasive Species Forecasting System (ISFS) provides computational support for the generic work processes found in many regional-scale ecosystem modeling applications. Decision support tools built using ISFS allow a user to load point occurrence field sample data for a plant species of interest and quickly generate habitat suitability maps for geographic regions of management concern, such as a national park, monument, forest, or refuge. This type of decision product helps resource managers plan invasive species protection, monitoring, and control strategies for the lands they manage. Until now, scientists and resource managers have lacked the data-assembly and computing capabilities to produce these maps quickly and cost efficiently. ISFS focuses on regional-scale habitat suitability modeling for invasive terrestrial plants. ISFS s component architecture emphasizes simplicity and adaptability. Its core services can be easily adapted to produce model-based decision support tools tailored to particular parks, monuments, forests, refuges, and related management units. ISFS can be used to build standalone run-time tools that require no connection to the Internet, as well as fully Internet-based decision support applications. ISFS provides the core data structures, operating system interfaces, network interfaces, and inter-component constraints comprising the canonical workflow for habitat suitability modeling. The predictors, analysis methods, and geographic extents involved in any particular model run are elements of the user space and arbitrarily configurable by the user. ISFS provides small, lightweight, readily hardened core components of general utility. These components can be adapted to unanticipated uses, are tailorable, and require at most a loosely coupled, nonproprietary connection to the Web. Users can invoke capabilities from a command line; programmers can integrate ISFS's core components into more complex systems and services. Taken together, these features enable a degree of decentralization and distributed ownership that have helped other types of scientific information services succeed in recent years.

The New York City eClinician Project: using Personal Digital Assistants and wireless internet access to support emergency preparedness and enhance clinical care in community health centers.

PubMed

Adusumilli, Sri Raj; Tobin, Jonathan N; Younge, Richard G; Kendall, Mat; Kukafka, Rita; Khan, Sharib; Chang, Otto; Mahabir, Kasandra

2006-01-01

The New York City Department of Health and Mental Hygiene, The Community Health Care Association of New York State and Clinical Directors Network are collaborating on the "eClinician Project," which has distributed seven hundred public health-friendly, wireless (WiFi) enabled Personal Digital Assistants (PDAs) to primary care clinicians working in New York City, federally funded, Community Health Centers (CHC) which serve minority underserved communities that suffer a disproportionate burden of chronic disease and lack access to health promotion disease prevention services. Each participating health center also received a wireless router to create an onsite internet hot spot to enable clinicians to have internet access. The goals of the eClinician Project are to: 1) To encourage adoption of information technology among providers in Community Health Centers in New York City by providing PDAs as a first line strategy towards achieving this goal, 2) enhance access to information on emergency preparedness, 3) improve patient outcomes by providing PDA-based clinical decision-support tools that support evidence-based care, 4) encourage chronic care management and health promotion/disease prevention activities, and 5) increase productivity and efficiency. CHC clinicians have received a hands-on, on-site orientation to PDAs. Ongoing training has continued via online CME-accredited webcasts (see www.CDNetwork.org). Clinical decision-support tools are available for download via the eClinician project web portal (see www.eClinician.org ). Public health alerts can be delivered to the PDAs or to the clinicians' desktop computers. Pre and post training surveys, in addition to a case study, have been used to evaluate the population demographics, PDA adoption by the clinicians, clinician attitudes towards using PDAs, PDA influence on clinical-decision making and barriers to adoption of PDAs and information technology in general.

Decision support tools for proton therapy ePR: intelligent treatment planning navigator and radiation toxicity tool for evaluating of prostate cancer treatment

NASA Astrophysics Data System (ADS)

Le, Anh H.; Deshpande, Ruchi; Liu, Brent J.

2010-03-01

The electronic patient record (ePR) has been developed for prostate cancer patients treated with proton therapy. The ePR has functionality to accept digital input from patient data, perform outcome analysis and patient and physician profiling, provide clinical decision support and suggest courses of treatment, and distribute information across different platforms and health information systems. In previous years, we have presented the infrastructure of a medical imaging informatics based ePR for PT with functionality to accept digital patient information and distribute this information across geographical location using Internet protocol. In this paper, we present the ePR decision support tools which utilize the imaging processing tools and data collected in the ePR. The two decision support tools including the treatment plan navigator and radiation toxicity tool are presented to evaluate prostate cancer treatment to improve proton therapy operation and improve treatment outcomes analysis.

Privacy-preserving clinical decision support system using Gaussian kernel-based classification.

PubMed

Rahulamathavan, Yogachandran; Veluru, Suresh; Phan, Raphael C-W; Chambers, Jonathon A; Rajarajan, Muttukrishnan

2014-01-01

A clinical decision support system forms a critical capability to link health observations with health knowledge to influence choices by clinicians for improved healthcare. Recent trends toward remote outsourcing can be exploited to provide efficient and accurate clinical decision support in healthcare. In this scenario, clinicians can use the health knowledge located in remote servers via the Internet to diagnose their patients. However, the fact that these servers are third party and therefore potentially not fully trusted raises possible privacy concerns. In this paper, we propose a novel privacy-preserving protocol for a clinical decision support system where the patients' data always remain in an encrypted form during the diagnosis process. Hence, the server involved in the diagnosis process is not able to learn any extra knowledge about the patient's data and results. Our experimental results on popular medical datasets from UCI-database demonstrate that the accuracy of the proposed protocol is up to 97.21% and the privacy of patient data is not compromised.

A Crime Analysis Decision Support System for Crime Report Classification and Visualization

ERIC Educational Resources Information Center

Ku, Chih-Hao

2012-01-01

Today's Internet-based crime reporting systems make timely and anonymous crime reporting possible. However, these reports also result in a rapidly growing set of unstructured text files. Complicating the problem is that the information has not been filtered or guided in a detective-led interview resulting in much irrelevant information. To…

Customer Churn Prediction for Broadband Internet Services

NASA Astrophysics Data System (ADS)

Huang, B. Q.; Kechadi, M.-T.; Buckley, B.

Although churn prediction has been an area of research in the voice branch of telecommunications services, more focused studies on the huge growth area of Broadband Internet services are limited. Therefore, this paper presents a new set of features for broadband Internet customer churn prediction, based on Henley segments, the broadband usage, dial types, the spend of dial-up, line-information, bill and payment information, account information. Then the four prediction techniques (Logistic Regressions, Decision Trees, Multilayer Perceptron Neural Networks and Support Vector Machines) are applied in customer churn, based on the new features. Finally, the evaluation of new features and a comparative analysis of the predictors are made for broadband customer churn prediction. The experimental results show that the new features with these four modelling techniques are efficient for customer churn prediction in the broadband service field.

Health-Related Internet Use by Informal Caregivers of Children and Adolescents: An Integrative Literature Review

PubMed Central

Steinhoff, Andreanna

2016-01-01

Background Internet-based health resources can support informal caregivers who are caring for children or adolescents with health care needs. However, few studies discriminate informal caregivers’ needs from those of their care recipients or those of people caring for adults. Objective This study reviews the literature of health-related Internet use among informal caregivers of children and adolescents. Methods A total of 17 studies were selected from literature searches conducted in 6 electronic databases: PubMed, Cochrane, CINAHL, PsycINFO, ERIC, and EMBASE. All databases searches were limited to articles published in the years 2004 to 2014 in peer-reviewed publications. Search terms consisted of “health-related Internet use,” “eHealth,” “Internet use for health-related purpose(s),” “Web-based resource(s),” and “online resources,” combined with informal caregiver (or “parents”) of “child,” “adolescent,” “student,” “youth,” and “teen.” The age range of the children receiving care was limited to younger than 22 years. Their informal caregivers were defined as persons (parents) who provided unpaid care or assistance to a child or an adolescent with health problems. Results Among 17 empirical studies, the majority of informal caregivers of children with medical issues were the parents. Quantitative studies (14/17, 77%) reported prevalence and predictors of health-related Internet use, while mixed-methods and qualitative studies (3/17, 24%) investigated informal caregiver perceptions of helpful health-related Internet use and barriers of use. The prevalence of health-related Internet use varied (11%-90%) dependent upon how health-related Internet use was operationalized and measured. Disease-specific information was used for decision making about treatment, while social support via virtual communities and email were used for informal caregiver emotional needs. A digital divide of Internet access was identified in lower educated minorities. Most studies had methodological challenges resulting from convenience sampling, cross-sectional surveys, lack of theoretical frameworks, or no clear definitions of health-related Internet use. Conclusions This study provides an important understanding of how family members use Internet-based information and support systems during child caregiving. Healthcare providers and policy makers should integrate family needs into their current practices and policies. Further rigorous research is required to design efficient and effective nursing interventions. PMID:26940750

Using the Internet in the management of asthma.

PubMed

Patel, A M

2001-01-01

The ultimate goals of managing asthma are to eliminate death, prevent or promptly treat exacerbations, and maximize the quality of life and health status of patients. Current strategies include appropriate education, trigger control, and timely access to effective pharmacotherapy and follow-up. Internet-based technologies have emerged as potentially powerful tools to enable meaningful communication and proactive partnership in care for various medical conditions. The main types of Internet-based applications for asthma management include remote monitoring and feedback between health professionals and their patients; online education and marketing for either patients or professionals; networking and collaborative research; and administrative oversight through policy making, planning, and decision support. With increased understanding of integrated disease management and the technostructural as well as psychodynamic issues related to Internet use, further refinement and evolution of the Internet and related technologies may drastically improve the way we monitor, educate, treat, and establish policies for this global problem while attending to individual or local community needs. This review presents a conceptual overview of the current challenges and use of the Internet for improving asthma management through timely and tailored education and appropriate access to health care expertise.

Extensions to regret-based decision curve analysis: an application to hospice referral for terminal patients.

PubMed

Tsalatsanis, Athanasios; Barnes, Laura E; Hozo, Iztok; Djulbegovic, Benjamin

2011-12-23

Despite the well documented advantages of hospice care, most terminally ill patients do not reap the maximum benefit from hospice services, with the majority of them receiving hospice care either prematurely or delayed. Decision systems to improve the hospice referral process are sorely needed. We present a novel theoretical framework that is based on well-established methodologies of prognostication and decision analysis to assist with the hospice referral process for terminally ill patients. We linked the SUPPORT statistical model, widely regarded as one of the most accurate models for prognostication of terminally ill patients, with the recently developed regret based decision curve analysis (regret DCA). We extend the regret DCA methodology to consider harms associated with the prognostication test as well as harms and effects of the management strategies. In order to enable patients and physicians in making these complex decisions in real-time, we developed an easily accessible web-based decision support system available at the point of care. The web-based decision support system facilitates the hospice referral process in three steps. First, the patient or surrogate is interviewed to elicit his/her personal preferences regarding the continuation of life-sustaining treatment vs. palliative care. Then, regret DCA is employed to identify the best strategy for the particular patient in terms of threshold probability at which he/she is indifferent between continuation of treatment and of hospice referral. Finally, if necessary, the probabilities of survival and death for the particular patient are computed based on the SUPPORT prognostication model and contrasted with the patient's threshold probability. The web-based design of the CDSS enables patients, physicians, and family members to participate in the decision process from anywhere internet access is available. We present a theoretical framework to facilitate the hospice referral process. Further rigorous clinical evaluation including testing in a prospective randomized controlled trial is required and planned.

Extensions to Regret-based Decision Curve Analysis: An application to hospice referral for terminal patients

PubMed Central

2011-01-01

Background Despite the well documented advantages of hospice care, most terminally ill patients do not reap the maximum benefit from hospice services, with the majority of them receiving hospice care either prematurely or delayed. Decision systems to improve the hospice referral process are sorely needed. Methods We present a novel theoretical framework that is based on well-established methodologies of prognostication and decision analysis to assist with the hospice referral process for terminally ill patients. We linked the SUPPORT statistical model, widely regarded as one of the most accurate models for prognostication of terminally ill patients, with the recently developed regret based decision curve analysis (regret DCA). We extend the regret DCA methodology to consider harms associated with the prognostication test as well as harms and effects of the management strategies. In order to enable patients and physicians in making these complex decisions in real-time, we developed an easily accessible web-based decision support system available at the point of care. Results The web-based decision support system facilitates the hospice referral process in three steps. First, the patient or surrogate is interviewed to elicit his/her personal preferences regarding the continuation of life-sustaining treatment vs. palliative care. Then, regret DCA is employed to identify the best strategy for the particular patient in terms of threshold probability at which he/she is indifferent between continuation of treatment and of hospice referral. Finally, if necessary, the probabilities of survival and death for the particular patient are computed based on the SUPPORT prognostication model and contrasted with the patient's threshold probability. The web-based design of the CDSS enables patients, physicians, and family members to participate in the decision process from anywhere internet access is available. Conclusions We present a theoretical framework to facilitate the hospice referral process. Further rigorous clinical evaluation including testing in a prospective randomized controlled trial is required and planned. PMID:22196308

e-CBT (myCompass), Antidepressant Medication, and Face-to-Face Psychological Treatment for Depression in Australia: A Cost-Effectiveness Comparison

PubMed Central

2015-01-01

Background The economic cost of depression is becoming an ever more important determinant for health policy and decision makers. Internet-based interventions with and without therapist support have been found to be effective options for the treatment of mild to moderate depression. With increasing demands on health resources and shortages of mental health care professionals, the integration of cost-effective treatment options such as Internet-based programs into primary health care could increase efficiency in terms of resource use and costs. Objective Our aim was to evaluate the cost-effectiveness of an Internet-based intervention (myCompass) for the treatment of mild-to-moderate depression compared to treatment as usual and cognitive behavior therapy in a stepped care model. Methods A decision model was constructed using a cost utility framework to show both costs and health outcomes. In accordance with current treatment guidelines, a stepped care model included myCompass as the first low-intervention step in care for a proportion of the model cohort, with participants beginning from a low-intensity intervention to increasing levels of treatment. Model parameters were based on data from the recent randomized controlled trial of myCompass, which showed that the intervention reduced symptoms of depression, anxiety, and stress and improved work and social functioning for people with symptoms in the mild-to-moderate range. Results The average net monetary benefit (NMB) was calculated, identifying myCompass as the strategy with the highest net benefit. The mean incremental NMB per individual for the myCompass group was AUD 1165.88 compared to treatment as usual and AUD 522.58 for the cognitive behavioral therapy model. Conclusions Internet-based interventions can provide cost-effective access to treatment when provided as part of a stepped care model. Widespread dissemination of Internet-based programs can potentially reduce demands on primary and tertiary services and reduce unmet need. PMID:26561555

e-CBT (myCompass), Antidepressant Medication, and Face-to-Face Psychological Treatment for Depression in Australia: A Cost-Effectiveness Comparison.

PubMed

Solomon, Daniela; Proudfoot, Judith; Clarke, Janine; Christensen, Helen

2015-11-11

The economic cost of depression is becoming an ever more important determinant for health policy and decision makers. Internet-based interventions with and without therapist support have been found to be effective options for the treatment of mild to moderate depression. With increasing demands on health resources and shortages of mental health care professionals, the integration of cost-effective treatment options such as Internet-based programs into primary health care could increase efficiency in terms of resource use and costs. Our aim was to evaluate the cost-effectiveness of an Internet-based intervention (myCompass) for the treatment of mild-to-moderate depression compared to treatment as usual and cognitive behavior therapy in a stepped care model. A decision model was constructed using a cost utility framework to show both costs and health outcomes. In accordance with current treatment guidelines, a stepped care model included myCompass as the first low-intervention step in care for a proportion of the model cohort, with participants beginning from a low-intensity intervention to increasing levels of treatment. Model parameters were based on data from the recent randomized controlled trial of myCompass, which showed that the intervention reduced symptoms of depression, anxiety, and stress and improved work and social functioning for people with symptoms in the mild-to-moderate range. The average net monetary benefit (NMB) was calculated, identifying myCompass as the strategy with the highest net benefit. The mean incremental NMB per individual for the myCompass group was AUD 1165.88 compared to treatment as usual and AUD 522.58 for the cognitive behavioral therapy model. Internet-based interventions can provide cost-effective access to treatment when provided as part of a stepped care model. Widespread dissemination of Internet-based programs can potentially reduce demands on primary and tertiary services and reduce unmet need.

Online decision support system for surface irrigation management

NASA Astrophysics Data System (ADS)

Wang, Wenchao; Cui, Yuanlai

2017-04-01

Irrigation has played an important role in agricultural production. Irrigation decision support system is developed for irrigation water management, which can raise irrigation efficiency with few added engineering services. An online irrigation decision support system (OIDSS), in consist of in-field sensors and central computer system, is designed for surface irrigation management in large irrigation district. Many functions have acquired in OIDSS, such as data acquisition and detection, real-time irrigation forecast, water allocation decision and irrigation information management. The OIDSS contains four parts: Data acquisition terminals, Web server, Client browser and Communication system. Data acquisition terminals are designed to measure paddy water level, soil water content in dry land, ponds water level, underground water level, and canals water level. A web server is responsible for collecting meteorological data, weather forecast data, the real-time field data, and manager's feedback data. Water allocation decisions are made in the web server. Client browser is responsible for friendly displaying, interacting with managers, and collecting managers' irrigation intention. Communication system includes internet and the GPRS network used by monitoring stations. The OIDSS's model is based on water balance approach for both lowland paddy and upland crops. Considering basic database of different crops water demands in the whole growth stages and irrigation system engineering information, the OIDSS can make efficient decision of water allocation with the help of real-time field water detection and weather forecast. This system uses technical methods to reduce requirements of user's specialized knowledge and can also take user's managerial experience into account. As the system is developed by the Browser/Server model, it is possible to make full use of the internet resources, to facilitate users at any place where internet exists. The OIDSS has been applied in Zhanghe Irrigation District (Center China) to manage the required irrigation deliveries. Two years' application indicates that the proposed OIDSS can achieve promising performance for surface irrigation. Historical data of rice growing period in 2014 has been applied to test the OIDSS: it gives out 3 irrigation decisions, which is consistent with actual irrigation times and the forecast irrigation dates are well fit with the actual situations; the corresponding amount of total irrigation decreases by 15.13% compared to those without using the OIDSS.

Nurses' experiences of the use of an Internet-based support system for adolescents with depressive disorders.

PubMed

Kurki, Marjo; Anttila, Minna; Koivunen, Marita; Marttunen, Mauri; Välimäki, Maritta

2018-09-01

Internet-based applications are potentially useful and effective interventions to reach and support adolescents with mental health problems. Adolescents' commitment to the use of a new Internet-based intervention is closely related to the support they receive from healthcare professionals. This study describes nurses' experiences of the use of an Internet-based support system for adolescents with depressive disorders. Qualitative descriptive study design including individual interviews with nine nurses at two psychiatric outpatient clinics. The Technology Acceptance Model (TAM) was used as the theoretical background of the study. Nurses described several benefits of using the Internet-based support system in the care of adolescents with depressive disorders if the nurses integrate it into daily nursing practices. As perceived disadvantages the nurses thought that an adolescent's mental status might be a barrier to working with the support system. Perceived enablers could be organizational support, nurses' attitudes, and technology-related factors. Nurses' attitudes were identified as a barrier to supporting adolescents' use of the Internet-based support system. The findings suggest that the implementation plan and support from the organization, including that from nurse managers, are crucial in the process of implementing a technology-based support system.

An Internet-based tailored hearing protection intervention for firefighters: development process and users' feedback.

PubMed

Hong, OiSaeng; Eakin, Brenda L; Chin, Dal Lae; Feld, Jamie; Vogel, Stephen

2013-07-01

Noise-induced hearing loss is a significant occupational injury for firefighters exposed to intermittent noise on the job. It is important to educate firefighters about using hearing protection devices whenever they are exposed to loud noise. Computer technology is a relatively new health education approach and can be useful for tailoring specific aspects of behavioral change training. The purpose of this study is to present the development process of an Internet-based tailored intervention program and to assess its efficacy. The intervention programs were implemented for 372 firefighters (mean age = 44 years, Caucasian = 82%, male = 95%) in three states (California, Illinois, and Indiana). The efficacy was assessed from firefighters' feedback through an Internet-based survey. A multimedia Internet-based training program was developed through (a) determining program content and writing scripts, (b) developing decision-making algorithms for tailoring, (c) graphic design and audio and video productions, (d) creating computer software and a database, and (e) postproduction quality control and pilot testing. Participant feedback regarding the training has been very positive. Participants reported that they liked completing the training via computer (83%) and also that the Internet-based training program was well organized (97%), easy to use (97%), and effective (98%) and held their interest (79%). Almost all (95%) would recommend this Internet training program to other firefighters. Interactive multimedia computer technology using the Internet was a feasible mode of delivery for a hearing protection intervention among firefighters. Participants' favorable feedback strongly supports the continued utilization of this approach for designing and developing interventions to promote healthy behaviors.

Information-seeking behavior changes in community-based teaching practices.

PubMed

Byrnes, Jennifer A; Kulick, Tracy A; Schwartz, Diane G

2004-07-01

A National Library of Medicine information access grant allowed for a collaborative project to provide computer resources in fourteen clinical practice sites that enabled health care professionals to access medical information via PubMed and the Internet. Health care professionals were taught how to access quality, cost-effective information that was user friendly and would result in improved patient care. Selected sites were located in medically underserved areas and received a computer, a printer, and, during year one, a fax machine. Participants were provided dial-up Internet service or were connected to the affiliated hospital's network. Clinicians were trained in how to search PubMed as a tool for practicing evidence-based medicine and to support clinical decision making. Health care providers were also taught how to find patient-education materials and continuing education programs and how to network with other professionals. Prior to the training, participants completed a questionnaire to assess their computer skills and familiarity with searching the Internet, MEDLINE, and other health-related databases. Responses indicated favorable changes in information-seeking behavior, including an increased frequency in conducting MEDLINE searches and Internet searches for work-related information.

Gender and internet consumers' decision-making.

PubMed

Yang, Chyan; Wu, Chia-Chun

2007-02-01

The purpose of this research is to provide managers of shopping websites information regarding consumer purchasing decisions based on the Consumer Styles Inventory (CSI). According to the CSI, one can capture what decision-making styles online shoppers use. Furthermore, this research also discusses the gender differences among online shoppers. Exploratory factor analysis (EFA) was used to understand the decision-making styles and discriminant analysis was used to distinguish the differences between female and male shoppers. The result shows that there are differences in purchasing decisions between online female and male Internet users.

Decision support for evidence-based integration of disease control: A proof of concept for malaria and schistosomiasis

PubMed Central

Graeden, Ellie; Kerr, Justin; Sorrell, Erin M.; Katz, Rebecca

2018-01-01

Managing infectious disease requires rapid and effective response to support decision making. The decisions are complex and require understanding of the diseases, disease intervention and control measures, and the disease-relevant characteristics of the local community. Though disease modeling frameworks have been developed to address these questions, the complexity of current models presents a significant barrier to community-level decision makers in using the outputs of the most scientifically robust methods to support pragmatic decisions about implementing a public health response effort, even for endemic diseases with which they are already familiar. Here, we describe the development of an application available on the internet, including from mobile devices, with a simple user interface, to support on-the-ground decision-making for integrating disease control programs, given local conditions and practical constraints. The model upon which the tool is built provides predictive analysis for the effectiveness of integration of schistosomiasis and malaria control, two diseases with extensive geographical and epidemiological overlap, and which result in significant morbidity and mortality in affected regions. Working with data from countries across sub-Saharan Africa and the Middle East, we present a proof-of-principle method and corresponding prototype tool to provide guidance on how to optimize integration of vertical disease control programs. This method and tool demonstrate significant progress in effectively translating the best available scientific models to support practical decision making on the ground with the potential to significantly increase the efficacy and cost-effectiveness of disease control. Author summary Designing and implementing effective programs for infectious disease control requires complex decision-making, informed by an understanding of the diseases, the types of disease interventions and control measures available, and the disease-relevant characteristics of the local community. Though disease modeling frameworks have been developed to address these questions and support decision-making, the complexity of current models presents a significant barrier to on-the-ground end users. The picture is further complicated when considering approaches for integration of different disease control programs, where co-infection dynamics, treatment interactions, and other variables must also be taken into account. Here, we describe the development of an application available on the internet with a simple user interface, to support on-the-ground decision-making for integrating disease control, given local conditions and practical constraints. The model upon which the tool is built provides predictive analysis for the effectiveness of integration of schistosomiasis and malaria control, two diseases with extensive geographical and epidemiological overlap. This proof-of-concept method and tool demonstrate significant progress in effectively translating the best available scientific models to support pragmatic decision-making on the ground, with the potential to significantly increase the impact and cost-effectiveness of disease control. PMID:29649260

The web of life: Natural science information on the Internet

USGS Publications Warehouse

Clement, Gail

2000-01-01

As society has come to equate economic prosperity with the health of our living resources, national science policy has called for the development of a comprehensive digital knowledge base to support informed decision making and wise resource management. The Internet and World Wide Web demonstrate the earliest stages of this evolving virtual library of the natural world, offering an increasing array of high-quality, innovative resources and services in the natural science arena. This article discusses the leading providers of natural science information on the Internet and highlights some of the exemplary resources they are delivering online. The discussion concludes with a brief discussion of the role of the librarian in developing the Web of natural science knowledge online and provides a short Webliography of starting points for further exploration of this subject area. PDF

Internet Interventions for Long-Term Conditions: Patient and Caregiver Quality Criteria

PubMed Central

Murray, Elizabeth; Stevenson, Fiona; Gore, Charles; Nazareth, Irwin

2006-01-01

Background Interactive health communication applications (IHCAs) that combine high-quality health information with interactive components, such as self-assessment tools, behavior change support, peer support, or decision support, are likely to benefit people with long-term conditions. IHCAs are now largely Web-based and are becoming known as "Internet interventions." Although there are numerous professionally generated criteria to assess health-related websites, to date there has been scant exploration of patient-generated assessment criteria even though patients and professionals use different criteria for assessing the quality of traditional sources of health information. Objective We aimed to determine patients' and caregivers' requirements of IHCAs for long-term conditions as well as their criteria for assessing the quality of different programs. Methods This was a qualitative study with focus groups. Patients and caregivers managing long-term conditions used three (predominantly Web-based) IHCAs relevant to their condition and subsequently discussed the strengths and weaknesses of the different IHCAs in focus groups. Participants in any one focus group all shared the same long-term condition and viewed the same three IHCAs. Patient and caregiver criteria for IHCAs emerged from the data. Results There were 40 patients and caregivers who participated in 10 focus groups. Participants welcomed the potential of Internet interventions but felt that many were not achieving their full potential. Participants generated detailed and specific quality criteria relating to information content, presentation, interactivity, and trustworthiness, which can be used by developers and purchasers of Internet interventions. Conclusions The user-generated quality criteria reported in this paper should help developers and purchasers provide Internet interventions that better meet user needs. PMID:16954123

Monitoring and diagnosis of vegetable growth based on internet of things

NASA Astrophysics Data System (ADS)

Zhang, Qian; Yu, Feng; Fu, Rong; Li, Gang

2017-10-01

A new condition monitoring method of vegetable growth was proposed, which was based on internet of things. It was combined remote environmental monitoring, video surveillance, intelligently decision-making and two-way video consultation together organically.

A Web-Based Decision Support System for Assessing Regional Water-Quality Conditions and Management Actions

NASA Astrophysics Data System (ADS)

Booth, N. L.; Everman, E.; Kuo, I.; Sprague, L.; Murphy, L.

2011-12-01

A new web-based decision support system has been developed as part of the U.S. Geological Survey (USGS) National Water Quality Assessment Program's (NAWQA) effort to provide ready access to Spatially Referenced Regressions On Watershed attributes (SPARROW) results of stream water-quality conditions and to offer sophisticated scenario testing capabilities for research and water-quality planning via an intuitive graphical user interface with a map-based display. The SPARROW Decision Support System (DSS) is delivered through a web browser over an Internet connection, making it widely accessible to the public in a format that allows users to easily display water-quality conditions, distribution of nutrient sources, nutrient delivery to downstream waterbodies, and simulations of altered nutrient inputs including atmospheric and agricultural sources. The DSS offers other features for analysis including various background map layers, model output exports, and the ability to save and share prediction scenarios. SPARROW models currently supported by the DSS are based on the modified digital versions of the 1:500,000-scale River Reach File (RF1) and 1:100,000-scale National Hydrography Dataset (medium-resolution, NHDPlus) stream networks. The underlying modeling framework and server infrastructure illustrate innovations in the information technology and geosciences fields for delivering SPARROW model predictions over the web by performing intensive model computations and map visualizations of the predicted conditions within the stream network.

Study on the contract characteristics of Internet architecture

NASA Astrophysics Data System (ADS)

Fu, Chuan; Zhang, Guoqing; Yang, Jing; Liu, Xiaona

2011-11-01

The importance of Internet architecture goes beyond the technical aspects. The architecture of Internet has a profound influence on the Internet-based economy in term of how the profits are shared by different market participants (Internet Server Provider, Internet Content Provider), since it is the physical foundation upon which the profit-sharing contracts are derived. In order to facilitate the continuing growth of the Internet, it is necessary to systematically study factors that curtail the Internet-based economy including the existing Internet architecture. In this paper, we used transaction cost economics and contract economics as new tools to analyse the contracts derived from the current Internet architecture. This study sheds light on how the macro characteristics of Internet architecture effect the microeconomical decisions of market participants. Based on the existing Internet architecture, we discuss the possibility of promoting Internet-based economy by encouraging user to connect their private stub network to the Internet and giving the user more right of self-governing.

A web platform for integrated surface water - groundwater modeling and data management

NASA Astrophysics Data System (ADS)

Fatkhutdinov, Aybulat; Stefan, Catalin; Junghanns, Ralf

2016-04-01

Model-based decision support systems are considered to be reliable and time-efficient tools for resources management in various hydrology related fields. However, searching and acquisition of the required data, preparation of the data sets for simulations as well as post-processing, visualization and publishing of the simulations results often requires significantly more work and time than performing the modeling itself. The purpose of the developed software is to combine data storage facilities, data processing instruments and modeling tools in a single platform which potentially can reduce time required for performing simulations, hence decision making. The system is developed within the INOWAS (Innovative Web Based Decision Support System for Water Sustainability under a Changing Climate) project. The platform integrates spatially distributed catchment scale rainfall - runoff, infiltration and groundwater flow models with data storage, processing and visualization tools. The concept is implemented in a form of a web-GIS application and is build based on free and open source components, including the PostgreSQL database management system, Python programming language for modeling purposes, Mapserver for visualization and publishing the data, Openlayers for building the user interface and others. Configuration of the system allows performing data input, storage, pre- and post-processing and visualization in a single not disturbed workflow. In addition, realization of the decision support system in the form of a web service provides an opportunity to easily retrieve and share data sets as well as results of simulations over the internet, which gives significant advantages for collaborative work on the projects and is able to significantly increase usability of the decision support system.

Internet resources for dentistry: government and medical sites for the dental professional.

PubMed

Guest, G F

2000-02-15

As society transitions deeper into the Information Age, Information Technology has become a critical tool that supports all facets of the global economy. The Internet, via the World-Wide Web (WWW), has become a major component of business operations for corporate and educational organizational entities. An estimated 10,000 or more health-related websites are providing information for both consumers and healthcare professionals. In addition to private and state-supported institutions being present on the Internet, the federal government has moved rapidly toward disseminating information electronically, with significant utilization of the WWW as the technological vehicle. All branches of the US Government and federal-related agencies are now represented on the Internet in an effort to deliver content to their end users, primarily the public. The intent of this article is to complement the previous publication, "Internet Resources for Dentistry: Utilization of the Internet to Support Professional Growth, Decision Making, and Patient Care," by presenting dental healthcare professionals with information on additional governmental and medical "Internet" sites. In addition, healthcare professionals must arm themselves with more than just access itself, but also the ability to critically judge the quality of information retrieved from the WWW.

Informing the development of an Internet-based chronic pain self-management program.

PubMed

Gogovor, Amédé; Visca, Regina; Auger, Claudine; Bouvrette-Leblanc, Lucie; Symeonidis, Iphigenia; Poissant, Lise; Ware, Mark A; Shir, Yoram; Viens, Natacha; Ahmed, Sara

2017-01-01

Self-management can optimize health outcomes for individuals with chronic pain (CP), an increasing fiscal and social burden in Canada. However, self-management is rarely integrated into the regular care (team activities and medical treatment) patients receive. Health information technology offers an opportunity to provide regular monitoring and exchange of information between patient and care team. To identify information needs and gaps in chronic pain management as well as technology features to inform the development of an Internet-based self-management program. Two methods were used. First was a structured literature review: electronic databases were searched up to 2015 with combinations of MeSH terms and text-words such as chronic pain, self-management, self-efficacy, technology, Internet-based, patient portal, and e-health. A narrative synthesis of the characteristics and content of Internet-based pain management programs emerging from the literature review and how they relate to gaps in chronic pain management were completed. Second, four audiotaped focus group sessions were conducted with individuals with chronic pain and caregivers (n=9) and health professionals (n=7) recruited from three multidisciplinary tertiary and rehabilitation centres. A thematic analysis of the focus group transcripts was conducted. Thirty-nine primary articles related to 20 patient-oriented Internet-based programs were selected. Gaps in CP management included lack of knowledge, limited access to health care, suboptimal care, and lack of self-management support. Overall, 14 themes related to information needs and gaps in care were identified by both health professionals and patients, three were exclusive to patients and five to health professionals. Common themes from the focus groups included patient education on chronic pain care, attitude-belief-culture, financial and legal issues, end-of-program crash, and motivational content. Internet-based programs contain automated, communication and decision support features that can address information and care gaps reported by patients and clinicians. However, focus groups identified functionalities not reported in the literature, non-medical and condition- and context-specific information, integration of personal health records, and the role of the different health professionals in chronic pain management were not identified. These gaps need to be considered in the future development of Internet-based programs. While the association between the mechanisms of Internet-based programs' features and outcomes is not clearly established, the results of this study indicate that interactivity, personalization and tailored messages, combined with therapist contact will maximize the effectiveness of an Internet-based chronic pain program in enhancing self-management. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Exploring the influence of Internet-based caregiver support on experiences of isolation for older spouse caregivers in rural areas: a qualitative interview study.

PubMed

Blusi, Madeleine; Kristiansen, Lisbeth; Jong, Mats

2015-09-01

Many older spouse caregivers are tied to the home by their caring duties and feel isolated. The values of supporting older caregivers are well known. In rural areas with long distances and decline in essential services, attending caregiver support groups can be difficult. Using Internet-based services can provide an opportunity for rural caregivers to participate in caregiver support, regardless of geographical distances and without the need for physical presence. This study aimed to explore how Internet-based caregiver support may influence the experience of isolation among older spouse caregivers in rural areas. An intervention study where 63 older rural caregivers received an Internet-based caregiver support service. A qualitative interview study based on 31 interviews with open-ended questions, analysed using latent content analysis. Two themes represent the findings from the study: Expanding the concept of place and Developing networks. Even though participants still spent their days in the house, they experienced that daily life was being spent in a variety of places, both physically, virtually and emotionally. The Internet-based support service provided them with a tool to reconnect with family and develop new friends. Internet-based caregiver support may reduce the experience of isolation for spouse caregivers in rural areas. Nurses played a crucial part in the development, by encouraging, educating and inspiring caregivers and supporting their independence. Internet-based services ought to be an option for caregiver support in rural areas as it may reduce feelings of isolation for older spouse caregivers. © 2014 John Wiley & Sons Ltd.

Interest in internet lung cancer support among rural cardiothoracic patients.

PubMed

Quin, Jacquelyn; Stams, Victor; Phelps, Beth; Boley, Theresa; Hazelrigg, Stephen

2010-05-01

The Internet may provide an alternative option for rural lung cancer patients who lack access to on-site cancer support; however, Internet access and use among rural patients is unknown. An anonymous waiting-room survey was administered to all outpatient cardiothoracic surgery patients over 3 mo. Survey questions included age, gender, and diagnosis, possession of a home computer and Internet service, estimated Internet use, and use of the Internet for health information. Patients with known or suspected lung cancer were asked to indicate their interest in on-site and Internet cancer support. There were 597 returned surveys (response rate 96%). The mean age was 64.6 y (SE 0.55), and 58% were men. Diagnoses included known or possible lung cancer (15.4%), lung disease (9.5%), heart disease (30.4%), other diagnoses (13.9%), and undetermined (30.6%). There were 343 patients (57.4%) with a home computer and 299 (50.1%) with home Internet service. Average Internet use was 8.5 h per wk (n = 298), and 225 patients used the Internet for health information. Of the 92 patients with lung cancer, 10 indicated interest in on-site support services while 37 expressed interest in Internet-based support. Based on survey results, a slight majority of rural patients have a home computer and Internet access. Internet use for health information appears relatively common. Overall interest for support services among lung cancer patients appears modest with a greater interest in Internet-based services compared with on-site support. Copyright 2010 Elsevier Inc. All rights reserved.

Decision aids that support decisions about prenatal testing for Down syndrome: an environmental scan.

PubMed

Leiva Portocarrero, Maria Esther; Garvelink, Mirjam M; Becerra Perez, Maria Margarita; Giguère, Anik; Robitaille, Hubert; Wilson, Brenda J; Rousseau, François; Légaré, France

2015-09-24

Prenatal screening tests for Down syndrome (DS) are routine in many developed countries and new tests are rapidly becoming available. Decisions about prenatal screening are increasingly complex with each successive test, and pregnant women need information about risks and benefits as well as clarity about their values. Decision aids (DAs) can help healthcare providers support women in this decision. Using an environmental scan, we aimed to identify publicly available DAs focusing on prenatal screening/diagnosis for Down syndrome that provide effective support for decision making. Data sources searched were the Decision Aids Library Inventory (DALI) of the Ottawa Patient Decision Aids Research Group at the Ottawa Health Research Institute; Google searches on the internet; professional organizations, academic institutions and other experts in the field; and references in existing systematic reviews on DAs. Eligible DAs targeted pregnant women, focused on prenatal screening and/or diagnosis, applied to tests for fetal abnormalities or aneuploidies, and were in French, English, Spanish or Portuguese. Pairs of reviewers independently identified eligible DAs and extracted characteristics including the presence of practical decision support tools and features to aid comprehension. They then performed quality assessment using the 16 minimum standards established by the International Patient Decision Aids Standards (IPDASi v4.0). Of 543 potentially eligible DAs (512 in DALI, 27 from experts, and four on the internet), 23 were eligible and 20 were available for data extraction. DAs were developed from 1996 to 2013 in six countries (UK, USA, Canada, Australia, Sweden, and France). Five DAs were for prenatal screening, three for prenatal diagnosis and 12 for both). Eight contained values clarification methods (personal worksheets). The 20 DAs scored a median of 10/16 (range 6-15) on the 16 IPDAS minimum standards. None of the 20 included DAs met all 16 IPDAS minimum standards, and few included practical decision support tools or aids to comprehension. Our results indicate there is a need for DAs that effectively support decision making regarding prenatal testing for Down syndrome, especially in light of the recently available non-invasive prenatal screening tests.

Monitoring Citrus Soil Moisture and Nutrients Using an IoT Based System.

PubMed

Zhang, Xueyan; Zhang, Jianwu; Li, Lin; Zhang, Yuzhu; Yang, Guocai

2017-02-23

Chongqing mountain citrus orchard is one of the main origins of Chinese citrus. Its planting terrain is complex and soil parent material is diverse. Currently, the citrus fertilization, irrigation and other management processes still have great blindness. They usually use the same pattern and the same formula rather than considering the orchard terrain features, soil differences, species characteristics and the state of tree growth. With the help of the ZigBee technology, artificial intelligence and decision support technology, this paper has developed the research on the application technology of agricultural Internet of Things for real-time monitoring of citrus soil moisture and nutrients as well as the research on the integration of fertilization and irrigation decision support system. Some achievements were obtained including single-point multi-layer citrus soil temperature and humidity detection wireless sensor nodes and citrus precision fertilization and irrigation management decision support system. They were applied in citrus base in the Three Gorges Reservoir Area. The results showed that the system could help the grower to scientifically fertilize or irrigate, improve the precision operation level of citrus production, reduce the labor cost and reduce the pollution caused by chemical fertilizer.

Web-Based Versus Usual Care and Other Formats of Decision Aids to Support Prostate Cancer Screening Decisions: Systematic Review and Meta-Analysis.

PubMed

Baptista, Sofia; Teles Sampaio, Elvira; Heleno, Bruno; Azevedo, Luís Filipe; Martins, Carlos

2018-06-26

Prostate cancer is a leading cause of cancer among men. Because screening for prostate cancer is a controversial issue, many experts in the field have defended the use of shared decision making using validated decision aids, which can be presented in different formats (eg, written, multimedia, Web). Recent studies have concluded that decision aids improve knowledge and reduce decisional conflict. This meta-analysis aimed to investigate the impact of using Web-based decision aids to support men's prostate cancer screening decisions in comparison with usual care and other formats of decision aids. We searched PubMed, CINAHL, PsycINFO, and Cochrane CENTRAL databases up to November 2016. This search identified randomized controlled trials, which assessed Web-based decision aids for men making a prostate cancer screening decision and reported quality of decision-making outcomes. Two reviewers independently screened citations for inclusion criteria, extracted data, and assessed risk of bias. Using a random-effects model, meta-analyses were conducted pooling results using mean differences (MD), standardized mean differences (SMD), and relative risks (RR). Of 2406 unique citations, 7 randomized controlled trials met the inclusion criteria. For risk of bias, selective outcome reporting and participant/personnel blinding were mostly rated as unclear due to inadequate reporting. Based on seven items, two studies had high risk of bias for one item. Compared to usual care, Web-based decision aids increased knowledge (SMD 0.46; 95% CI 0.18-0.75), reduced decisional conflict (MD -7.07%; 95% CI -9.44 to -4.71), and reduced the practitioner control role in the decision-making process (RR 0.50; 95% CI 0.31-0.81). Web-based decision aids compared to printed decision aids yielded no differences in knowledge, decisional conflict, and participation in decision or screening behaviors. Compared to video decision aids, Web-based decision aids showed lower average knowledge scores (SMD -0.50; 95% CI -0.88 to -0.12) and a slight decrease in prostate-specific antigen screening (RR 1.12; 95% CI 1.01-1.25). According to this analysis, Web-based decision aids performed similarly to alternative formats (ie, printed, video) for the assessed decision-quality outcomes. The low cost, readiness, availability, and anonymity of the Web can be an advantage for increasing access to decision aids that support prostate cancer screening decisions among men. ©Sofia Baptista, Elvira Teles Sampaio, Bruno Heleno, Luís Filipe Azevedo, Carlos Martins. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 26.06.2018.

Internet Use by Parents of Children With Rare Conditions: Findings From a Study on Parents' Web Information Needs.

PubMed

Nicholl, Honor; Tracey, Catherine; Begley, Thelma; King, Carole; Lynch, Aileen M

2017-02-28

Parents of children with rare conditions increasingly use the Internet to source information on their child's condition. This study reports on part of a larger study whose overall aim was to identify the Internet use by parents when seeking information on their child's rare condition, with the specific purpose of using the findings to aid in the development of a website specifically designed to meet the parents' needs. It presents findings on why these parents use the Internet, the information and support content they source, and the impact these resources have on their capacity to care for and manage their child's condition. To (1) ascertain parents' general Internet usage patterns, (2) identify the nature of the information parents most frequently searched for, and (3) determine the effect the Internet-sourced information had on parents of children with rare conditions. Data collection was conducted in 2 parts: Part 1 was a focus group interview (n=8) to inform the development of the questionnaire, and Part 2 was a questionnaire (Web- and paper-based). All respondents (N=128) completed the questionnaire using the Internet. Parents frequently and habitually used the Internet and social media to gather information on their child's condition. These Web-based resources provide parents with a parent-to-parent support platform that allows them to share their experiences and information with other parents, which, the respondents considered, improved their knowledge and understanding of their child's condition. The respondents also reported that these resources positively impacted on their decision making, care, and management of their child's condition. However, they reported receiving mixed responses when wishing to engage and share with health care professionals their Internet and social media interactions and information outcomes. This study adds to the emerging body of research on the Internet use by parents of children with rare conditions to source information on their child's condition. The evolving and ever increasing parent-to-parent support systems via social media are impacting on parents' capacity to manage their children. Implications for practice include health care professionals' response to this knowledge and capacity shift, and the significance of these changes when interacting with parents. The key message of this study was that parents of children with rare conditions are habitual users of the Internet to source information about their children's conditions. Social media, especially Facebook, has an increasing role in the lives of these parents for information and support. Parents' interest in information gathering and sharing includes a desire for shared dialogue with health care professionals. ©Honor Nicholl, Catherine Tracey, Thelma Begley, Carole King, Aileen M Lynch. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 28.02.2017.

Information-seeking behavior changes in community-based teaching practices*†

PubMed Central

Byrnes, Jennifer A.; Kulick, Tracy A.; Schwartz, Diane G.

2004-01-01

A National Library of Medicine information access grant allowed for a collaborative project to provide computer resources in fourteen clinical practice sites that enabled health care professionals to access medical information via PubMed and the Internet. Health care professionals were taught how to access quality, cost-effective information that was user friendly and would result in improved patient care. Selected sites were located in medically underserved areas and received a computer, a printer, and, during year one, a fax machine. Participants were provided dial-up Internet service or were connected to the affiliated hospital's network. Clinicians were trained in how to search PubMed as a tool for practicing evidence-based medicine and to support clinical decision making. Health care providers were also taught how to find patient-education materials and continuing education programs and how to network with other professionals. Prior to the training, participants completed a questionnaire to assess their computer skills and familiarity with searching the Internet, MEDLINE, and other health-related databases. Responses indicated favorable changes in information-seeking behavior, including an increased frequency in conducting MEDLINE searches and Internet searches for work-related information. PMID:15243639

A Web-Based Decision Support System for Assessing Regional Water-Quality Conditions and Management Actions

USGS Publications Warehouse

Booth, N.L.; Everman, E.J.; Kuo, I.-L.; Sprague, L.; Murphy, L.

2011-01-01

The U.S. Geological Survey National Water Quality Assessment Program has completed a number of water-quality prediction models for nitrogen and phosphorus for the conterminous United States as well as for regional areas of the nation. In addition to estimating water-quality conditions at unmonitored streams, the calibrated SPAtially Referenced Regressions On Watershed attributes (SPARROW) models can be used to produce estimates of yield, flow-weighted concentration, or load of constituents in water under various land-use condition, change, or resource management scenarios. A web-based decision support infrastructure has been developed to provide access to SPARROW simulation results on stream water-quality conditions and to offer sophisticated scenario testing capabilities for research and water-quality planning via a graphical user interface with familiar controls. The SPARROW decision support system (DSS) is delivered through a web browser over an Internet connection, making it widely accessible to the public in a format that allows users to easily display water-quality conditions and to describe, test, and share modeled scenarios of future conditions. SPARROW models currently supported by the DSS are based on the modified digital versions of the 1:500,000-scale River Reach File (RF1) and 1:100,000-scale National Hydrography Dataset (medium-resolution, NHDPlus) stream networks. ?? 2011 American Water Resources Association. This article is a U.S. Government work and is in the public domain in the USA.

A decision-making process model of young online shoppers.

PubMed

Lin, Chin-Feng; Wang, Hui-Fang

2008-12-01

Based on the concepts of brand equity, means-end chain, and Web site trust, this study proposes a novel model called the consumption decision-making process of adolescents (CDMPA) to understand adolescents' Internet consumption habits and behavioral intention toward particular sporting goods. The findings of the CDMPA model can help marketers understand adolescents' consumption preferences and habits for developing effective Internet marketing strategies.

A Web-based system for the intelligent management of diabetic patients.

PubMed

Riva, A; Bellazzi, R; Stefanelli, M

1997-01-01

We describe the design and implementation of a distributed computer-based system for the management of insulin-dependent diabetes mellitus. The goal of the system is to support the normal activities of the physicians and patients involved in the care of diabetes by providing them with a set of automated services ranging from data collection and transmission to data analysis and decision support. The system is highly integrated with current practices in the management of diabetes, and it uses Internet technology to achieve high availability and ease of use. In particular, the user interaction takes place through dynamically generated World Wide Web pages, so that all the system's functions share an intuitive graphic user interface.

The web-surfing bariatic patient: the role of the internet in the decision-making process.

PubMed

Paolino, Luca; Genser, Laurent; Fritsch, Sylvie; De' Angelis, Nicola; Azoulay, Daniel; Lazzati, Andrea

2015-04-01

Health-related information on the Internet is constantly increasing, but its quality and accountability are difficult to assess. Patients browse the Net to get more information, but the impact of the Internet on their decisions about surgical techniques, referral centers, or surgeon choice are still not clear. This study aimed to describe the role of the Internet in the decision-making process of obese patients seeking bariatric surgery. Two hundred and twelve candidates for bariatric surgery were asked to answer a questionnaire evaluating their access to the Internet, the usefulness and trustworthiness of Internet-retrieved information, the verification of the information, and the role of the information in the decision-making process. Two hundred and twelve patients answered the questionnaire. Of these, 95.1% had access to the Internet and 77.8% reported having researched about bariatric surgery. Their main interests were the surgical techniques (81.4%) and other patients' experiences (72.3%). The favorite Web sites were those affiliated to public hospitals or edited by other patients. The accountability of the e-information was mainly evaluated by discussion with the general practitioner (GP) (83.0%) or family members and friends (46.8%). One patient in four decided to undergo bariatric surgery mainly based on e-information, while discussion about treatment options with the GP and the hospital reputation were taken into account in 77.8 and 51.7% of cases, respectively. Most patients seeking bariatric surgery search for health information online. E-information seems to have an important role in the decision-making process of patients who are candidates for bariatric surgery.

The online community based decision making support system for mitigating biased decision making

NASA Astrophysics Data System (ADS)

Kang, Sunghyun; Seo, Jiwan; Choi, Seungjin; Kim, Junho; Han, Sangyong

2016-10-01

As the Internet technology and social media advance, various information and opinions are shared and distributed through the online communities. However, the existence of implicit and explicit bias of opinions may have a potential influence on the outcomes. Compared to the importance of mitigating biased information, the study in this field is relatively young and does not address many important issues. In this paper we propose the noble approach to mitigate the biased opinions using conventional machine learning methods. The proposed method extracts the useful features such as inclination and sentiment of the community members. They are classified based on their previous behavior, and the propensity of the members is understood. This information on each community and its members is very useful and improve the ability to make an unbiased decision. The proposed method presented in this paper is shown to have the ability to assist optimal, fair and good decision making while also reducing the influence of implicit bias.

Final report.

DOT National Transportation Integrated Search

2017-02-14

This project report provides a descriptive overview of the architecture and design of wireless underground radio frequency smart sensors, data collection and Internet of Things (IOT) [8] transmission system and an SLR decision support system. The roa...

Internet Use by Parents of Children With Rare Conditions: Findings From a Study on Parents’ Web Information Needs

PubMed Central

Nicholl, Honor; Tracey, Catherine; Begley, Thelma; King, Carole

2017-01-01

Background Parents of children with rare conditions increasingly use the Internet to source information on their child’s condition. This study reports on part of a larger study whose overall aim was to identify the Internet use by parents when seeking information on their child’s rare condition, with the specific purpose of using the findings to aid in the development of a website specifically designed to meet the parents’ needs. It presents findings on why these parents use the Internet, the information and support content they source, and the impact these resources have on their capacity to care for and manage their child’s condition. Objective To (1) ascertain parents’ general Internet usage patterns, (2) identify the nature of the information parents most frequently searched for, and (3) determine the effect the Internet-sourced information had on parents of children with rare conditions. Methods Data collection was conducted in 2 parts: Part 1 was a focus group interview (n=8) to inform the development of the questionnaire, and Part 2 was a questionnaire (Web- and paper-based). All respondents (N=128) completed the questionnaire using the Internet. Results Parents frequently and habitually used the Internet and social media to gather information on their child’s condition. These Web-based resources provide parents with a parent-to-parent support platform that allows them to share their experiences and information with other parents, which, the respondents considered, improved their knowledge and understanding of their child’s condition. The respondents also reported that these resources positively impacted on their decision making, care, and management of their child’s condition. However, they reported receiving mixed responses when wishing to engage and share with health care professionals their Internet and social media interactions and information outcomes. Conclusions This study adds to the emerging body of research on the Internet use by parents of children with rare conditions to source information on their child’s condition. The evolving and ever increasing parent-to-parent support systems via social media are impacting on parents’ capacity to manage their children. Implications for practice include health care professionals’ response to this knowledge and capacity shift, and the significance of these changes when interacting with parents. The key message of this study was that parents of children with rare conditions are habitual users of the Internet to source information about their children’s conditions. Social media, especially Facebook, has an increasing role in the lives of these parents for information and support. Parents’ interest in information gathering and sharing includes a desire for shared dialogue with health care professionals. PMID:28246072

Role of the Internet in Care Initiation by People Living With HIV.

PubMed

Perazzo, Joseph; Haas, Stephen; Webel, Allison; Voss, Joachim

2017-02-01

People frequently use the internet to obtain information, including information about health, but we lack understanding of how people living with HIV (PLHIV) use the internet in their care and treatment decisions. In this secondary analysis, interviews with 23 individuals who initiated HIV care at an urban, Midwestern medical center and mentioned internet use were analyzed using qualitative content analysis to explore how they used the internet during the process of initiating HIV care. HIV care had been initiated by this sample from less than one month to three years post-diagnosis. Participants discussed the internet as a source of information about their diagnosis that influenced their care and treatment decisions. Five themes were predominant: (i) The internet alerted me to the possibility of HIV, (ii) the internet showed me a solution is available, (iii) the internet influenced my decisions about care, (iv) the internet empowered me to participate in my treatment decisions, and (v) the internet gave me hope for my future. The results suggest that the internet has the potential to provide information that can profoundly influence PLHIVs' acceptance of care and treatment decisions. Clinicians face a new reality in which patients use internet resources to obtain information and shape opinions about HIV treatment and care initiation decision-making. Guiding PLHIV in their selection of online resources is one approach to educating and empowering individuals as they cope with their diagnosis and contemplate decisions regarding HIV care and treatment. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Excessive Internet gaming and decision making: do excessive World of Warcraft players have problems in decision making under risky conditions?

PubMed

Pawlikowski, Mirko; Brand, Matthias

2011-08-15

The dysfunctional behavior of excessive Internet gamers, such as preferring the immediate reward (to play World of Warcraft) despite the negative long-term consequences may be comparable with the dysfunctional behavior in substance abusers or individuals with behavioral addictions, e.g. pathological gambling. In these disorders, general decision-making deficits have been demonstrated. Hence, the aim of the present work was to examine decision-making competences of excessive World of Warcraft players. Nineteen excessive Internet gamers (EIG) and a control group (CG) consisting of 19 non-gamers were compared with respect to decision-making abilities. The Game of Dice Task (GDT) was applied to measure decision-making under risky conditions. Furthermore psychological-psychiatric symptoms were assessed in both groups. The EIG showed a reduced decision-making ability in the GDT. Furthermore the EIG group showed a higher psychological-psychiatric symptomatology in contrast to the CG. The results indicate that the reduced decision-making ability of EIG is comparable with patients with other forms of behavioral addiction (e.g. pathological gambling), impulse control disorders or substance abusers. Thus, these results suggest that excessive Internet gaming may be based on a myopia for the future, meaning that EIG prefer to play World of Warcraft despite the negative long-term consequences in social or work domains of life. 2011 Elsevier Ltd. All rights reserved.

Dementia caregivers' responses to 2 Internet-based intervention programs.

PubMed

Marziali, Elsa; Garcia, Linda J

2011-02-01

The aim of this study was to examine the impact on dementia caregivers' experienced stress and health status of 2 Internet-based intervention programs. Ninety-one dementia caregivers were given the choice of being involved in either an Internet-based chat support group or an Internet-based video conferencing support group. Pre-post outcome measures focused on distress, health status, social support, and service utilization. In contrast to the Chat Group, the Video Group showed significantly greater improvement in mental health status. Also, for the Video Group, improvements in self-efficacy, neuroticism, and social support were associated with lower stress response to coping with the care recipient's cognitive impairment and decline in function. The results show that, of 2 Internet-based intervention programs for dementia caregivers, the video conferencing intervention program was more effective in improving mental health status and improvement in personal characteristics were associated with lower caregiver stress response.

Health literacy: a study of internet-based information on advance directives.

PubMed

Stuart, Peter

2017-11-28

The aim of this study was to evaluate the quality and value of web-based information on advance directives. Internet-based information on advance directives was selected because, if it is inaccurate or difficult to understand, patients risk making decisions about their care that may not be followed in practice. Two validated health information evaluation tools, the Suitability Assessment of Materials and DISCERN, and a focus group were used to assess credibility, user orientation and effectiveness. Only one of the 34 internet-based information items on advance directives reviewed fulfilled the study criteria and 30% of the sites were classed as unreadable. In terms of learning and informing, 79% of the sites were considered unsuitable. Using health literacy tools to evaluate internet-based health information highlights that often it is not at a functional literacy level and neither informs nor empowers users to make independent and valid healthcare decisions. ©2017 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

eHealth Literacy and Partner Involvement in Treatment Decision Making for Men With Newly Diagnosed Localized Prostate Cancer.

PubMed

Song, Lixin; Tatum, Kimberly; Greene, Giselle; Chen, Ronald C

2017-03-01

To examine how the eHealth literacy of partners of patients with newly diagnosed prostate cancer affects their involvement in decision making, and to identify the factors that influence their eHealth literacy.
. Cross-sectional exploratory study.
. North Carolina.
. 142 partners of men with newly diagnosed localized prostate cancer. 
. A telephone survey and descriptive and multiple linear regression analyses were used.
. The partners' eHealth literacy, involvement in treatment decision making, and demographics, and the health statuses of the patients and their partners. 
. Higher levels of eHealth literacy among partners were significantly associated with their involvement in getting a second opinion, their awareness of treatment options, and the size of the social network they relied on for additional information and support for treatment decision making for prostate cancer. The factor influencing eHealth literacy was the partners' access to the Internet for personal use, which explained some of the variance in eHealth literacy.
. This study described how partners' eHealth literacy influenced their involvement in treatment decision making for prostate cancer and highlighted the influencing factors (i.e., partners' access to the Internet for personal use).
. When helping men with prostate cancer and their partners with treatment decision making, nurses need to assess eHealth literacy levels to determine whether nonelectronically based education materials are needed and to provide clear instructions on how to use eHealth resources.

Keep in Touch (KIT): feasibility of using internet-based communication and information technology in palliative care.

PubMed

Guo, Qiaohong; Cann, Beverley; McClement, Susan; Thompson, Genevieve; Chochinov, Harvey Max

2017-05-06

Confinement to an in-patient hospital ward impairs patients' sense of social support and connectedness. Providing the means, through communication technology, for patients to maintain contact with friends and family can potentially improve well-being at the end of life by minimizing social isolation and facilitating social connection. This study aimed to explore the feasibility of introducing internet-based communication and information technologies for in-patients and their families and to describe their experience in using this technology. A cross-sectional survey design was used to describe patient and family member experiences in using internet-based communication technology and health care provider views of using such technology in palliative care. Participants included 13 palliative in-patients, 38 family members, and 14 health care providers. An iPad or a laptop computer with password-protected internet access was loaned to each patient and family member for about two weeks or they used their own electronic devices for the duration of the patient's stay. Quantitative and qualitative data were collected from patients, families, and health care providers to discern how patients and families used the technology, its ease of use and its impact. Descriptive statistics and paired sample t-tests were used to analyze quantitative data; qualitative data were analyzed using constant comparative techniques. Palliative patients and family members used the technology to keep in touch with family and friends, entertain themselves, look up information, or accomplish tasks. Most participants found the technology easy to use and reported that it helped them feel better overall, connected to others and calm. The availability of competent, respectful, and caring technical support personnel was highly valued by patients and families. Health care providers identified that computer technology helped patients and families keep others informed about the patient's condition, enabled sharing of important decisions and facilitated access to the outside world. This study confirmed the feasibility of offering internet-based communication and information technologies on palliative care in-patient units. Patients and families need to be provided appropriate technical support to ensure that the technology is used optimally to help them accomplish their goals.

A text-based data mining and toxicity prediction modeling system for a clinical decision support in radiation oncology: A preliminary study

NASA Astrophysics Data System (ADS)

Kim, Kwang Hyeon; Lee, Suk; Shim, Jang Bo; Chang, Kyung Hwan; Yang, Dae Sik; Yoon, Won Sup; Park, Young Je; Kim, Chul Yong; Cao, Yuan Jie

2017-08-01

The aim of this study is an integrated research for text-based data mining and toxicity prediction modeling system for clinical decision support system based on big data in radiation oncology as a preliminary research. The structured and unstructured data were prepared by treatment plans and the unstructured data were extracted by dose-volume data image pattern recognition of prostate cancer for research articles crawling through the internet. We modeled an artificial neural network to build a predictor model system for toxicity prediction of organs at risk. We used a text-based data mining approach to build the artificial neural network model for bladder and rectum complication predictions. The pattern recognition method was used to mine the unstructured toxicity data for dose-volume at the detection accuracy of 97.9%. The confusion matrix and training model of the neural network were achieved with 50 modeled plans (n = 50) for validation. The toxicity level was analyzed and the risk factors for 25% bladder, 50% bladder, 20% rectum, and 50% rectum were calculated by the artificial neural network algorithm. As a result, 32 plans could cause complication but 18 plans were designed as non-complication among 50 modeled plans. We integrated data mining and a toxicity modeling method for toxicity prediction using prostate cancer cases. It is shown that a preprocessing analysis using text-based data mining and prediction modeling can be expanded to personalized patient treatment decision support based on big data.

Online Hydrologic Impact Assessment Decision Support System using Internet and Web-GIS Capability

NASA Astrophysics Data System (ADS)

Choi, J.; Engel, B. A.; Harbor, J.

2002-05-01

Urban sprawl and the corresponding land use change from lower intensity uses, such as agriculture and forests, to higher intensity uses including high density residential and commercial has various long- and short-term environment impacts on ground water recharge, water pollution, and storm water drainage. A web-based Spatial Decision Support System, SDSS, for Web-based operation of long-term hydrologic impact modeling and analysis was developed. The system combines a hydrologic model, databases, web-GIS capability and HTML user interfaces to create a comprehensive hydrologic analysis system. The hydrologic model estimates daily direct runoff using the NRCS Curve Number technique and annual nonpoint source pollution loading by an event mean concentration approach. This is supported by a rainfall database with over 30 years of daily rainfall for the continental US. A web-GIS interface and a robust Web-based watershed delineation capability were developed to simplify the spatial data preparation task that is often a barrier to hydrologic model operation. The web-GIS supports browsing of map layers including hydrologic soil groups, roads, counties, streams, lakes and railroads, as well as on-line watershed delineation for any geographic point the user selects with a simple mouse click. The watershed delineation results can also be used to generate data for the hydrologic and water quality models available in the DSS. This system is already being used by city and local government planners for hydrologic impact evaluation of land use change from urbanization, and can be found at http://pasture.ecn.purdue.edu/~watergen/hymaps. This system can assist local community, city and watershed planners, and even professionals when they are examining impacts of land use change on water resources. They can estimate the hydrologic impact of possible land use changes using this system with readily available data supported through the Internet. This system provides a cost effective approach to serve potential users who require easy-to-use tools.

Improving healthcare services using web based platform for management of medical case studies.

PubMed

Ogescu, Cristina; Plaisanu, Claudiu; Udrescu, Florian; Dumitru, Silviu

2008-01-01

The paper presents a web based platform for management of medical cases, support for healthcare specialists in taking the best clinical decision. Research has been oriented mostly on multimedia data management, classification algorithms for querying, retrieving and processing different medical data types (text and images). The medical case studies can be accessed by healthcare specialists and by students as anonymous case studies providing trust and confidentiality in Internet virtual environment. The MIDAS platform develops an intelligent framework to manage sets of medical data (text, static or dynamic images), in order to optimize the diagnosis and the decision process, which will reduce the medical errors and will increase the quality of medical act. MIDAS is an integrated project working on medical information retrieval from heterogeneous, distributed medical multimedia database.

The Internet and Care Initiation by People Living with HIV

PubMed Central

Perazzo, Joseph; Haas, Stephen; Webel, Allison; Voss, Joachim

2017-01-01

Over the past 20 years, people increasingly use the Internet to obtain information, including information about health. Yet, we lack understanding of how people living with HIV (PLHIV) use the Internet in their care and treatment decisions. Interviews with 23 individuals who initiated HIV care at an urban, Midwestern medical center were analyzed to explore how they used the Internet during the process of initiating HIV care. The time frame of initiation of HIV care ranged from less than one month to a delay of three years post-diagnosis. Qualitative content analysis was conducted and revealed that the participants discussed the Internet as a source of information about their diagnosis that influenced their care and treatment decisions. Five predominate themes emerged: 1) The Internet Alerted me to the Possibility of HIV, 2) The Internet Showed me a Solution is Available, 3) The Internet Influenced my Decisions about Care, 4) The Internet Empowered me to Participate in my Treatment Decisions, and 5) The Internet Gave me Hope for my Future. The results suggest that the Internet has the potential to provide information that can profoundly influence PLHIVs acceptance of care and treatment decisions. Clinicians face a new reality in which patients use Internet resources to obtain information and shape opinions about HIV treatment and care initiation decision-making. Guiding PLHIV in their selection of online resources needs to be adopted as one approach to educating and empowering individuals as they cope with their diagnosis and contemplate decisions regarding HIV care and treatment. PMID:27686871

Design and Implementation of a Wireless Sensor and Actuator Network to Support the Intelligent Control of Efficient Energy Usage.

PubMed

Blanco, Jesús; García, Andrés; Morenas, Javier de Las

2018-06-09

Energy saving has become a major concern for the developed society of our days. This paper presents a Wireless Sensor and Actuator Network (WSAN) designed to provide support to an automatic intelligent system, based on the Internet of Things (IoT), which enables a responsible consumption of energy. The proposed overall system performs an efficient energetic management of devices, machines and processes, optimizing their operation to achieve a reduction in their overall energy usage at any given time. For this purpose, relevant data is collected from intelligent sensors, which are in-stalled at the required locations, as well as from the energy market through the Internet. This information is analysed to provide knowledge about energy utilization, and to improve efficiency. The system takes autonomous decisions automatically, based on the available information and the specific requirements in each case. The proposed system has been implanted and tested in a food factory. Results show a great optimization of energy efficiency and a substantial improvement on energy and costs savings.

Artificial Intelligence-Based Semantic Internet of Things in a User-Centric Smart City

PubMed Central

Guo, Kun; Lu, Yueming; Gao, Hui; Cao, Ruohan

2018-01-01

Smart city (SC) technologies can provide appropriate services according to citizens’ demands. One of the key enablers in a SC is the Internet of Things (IoT) technology, which enables a massive number of devices to connect with each other. However, these devices usually come from different manufacturers with different product standards, which confront interactive control problems. Moreover, these devices will produce large amounts of data, and efficiently analyzing these data for intelligent services. In this paper, we propose a novel artificial intelligence-based semantic IoT (AI-SIoT) hybrid service architecture to integrate heterogeneous IoT devices to support intelligent services. In particular, the proposed architecture is empowered by semantic and AI technologies, which enable flexible connections among heterogeneous devices. The AI technology can support very implement efficient data analysis and make accurate decisions on service provisions in various kinds. Furthermore, we also present several practical use cases of the proposed AI-SIoT architecture and the opportunities and challenges to implement the proposed AI-SIoT for future SCs are also discussed. PMID:29701679

Artificial Intelligence-Based Semantic Internet of Things in a User-Centric Smart City.

PubMed

Guo, Kun; Lu, Yueming; Gao, Hui; Cao, Ruohan

2018-04-26

Smart city (SC) technologies can provide appropriate services according to citizens’ demands. One of the key enablers in a SC is the Internet of Things (IoT) technology, which enables a massive number of devices to connect with each other. However, these devices usually come from different manufacturers with different product standards, which confront interactive control problems. Moreover, these devices will produce large amounts of data, and efficiently analyzing these data for intelligent services. In this paper, we propose a novel artificial intelligence-based semantic IoT (AI-SIoT) hybrid service architecture to integrate heterogeneous IoT devices to support intelligent services. In particular, the proposed architecture is empowered by semantic and AI technologies, which enable flexible connections among heterogeneous devices. The AI technology can support very implement efficient data analysis and make accurate decisions on service provisions in various kinds. Furthermore, we also present several practical use cases of the proposed AI-SIoT architecture and the opportunities and challenges to implement the proposed AI-SIoT for future SCs are also discussed.

INTERNET DEPENDENCE IN CHINESE HIGH SCHOOL STUDENTS: RELATIONSHIP WITH SEX, SELF-ESTEEM, AND SOCIAL SUPPORT.

PubMed

Zhang, Ruiping

2015-08-01

This cross-sectional study investigated the relationships among self-esteem, social support, and Internet dependence. A sample of young people aged between 15 and 18 years old (M age = 16.3 yr., SD = 0.7; 470 boys, 441 girls) completed measures of the Rosenberg Self-Esteem Scale, the Perceived Social Support Scale, and the Internet Dependence Test. According to the cognitive-behavioral model of problematic Internet use, social support should mediate the relationship between self-esteem and Internet dependence. Furthermore, based on previous research it was predicted that boys would score higher on Internet dependence than women. Support for this model was obtained. Internet dependent students were more likely to be boys. Self-esteem and social support were negatively correlated with Internet dependence. The relationship between self-esteem and Internet dependence was mediated by social support. Although the effect sizes were small, the findings of the present study are of significance in investigating adolescents' Internet dependence.

Web-of-Objects (WoO)-Based Context Aware Emergency Fire Management Systems for the Internet of Things

PubMed Central

Shamszaman, Zia Ush; Ara, Safina Showkat; Chong, Ilyoung; Jeong, Youn Kwae

2014-01-01

Recent advancements in the Internet of Things (IoT) and the Web of Things (WoT) accompany a smart life where real world objects, including sensing devices, are interconnected with each other. The Web representation of smart objects empowers innovative applications and services for various domains. To accelerate this approach, Web of Objects (WoO) focuses on the implementation aspects of bringing the assorted real world objects to the Web applications. In this paper; we propose an emergency fire management system in the WoO infrastructure. Consequently, we integrate the formation and management of Virtual Objects (ViO) which are derived from real world physical objects and are virtually connected with each other into the semantic ontology model. The charm of using the semantic ontology is that it allows information reusability, extensibility and interoperability, which enable ViOs to uphold orchestration, federation, collaboration and harmonization. Our system is context aware, as it receives contextual environmental information from distributed sensors and detects emergency situations. To handle a fire emergency, we present a decision support tool for the emergency fire management team. The previous fire incident log is the basis of the decision support system. A log repository collects all the emergency fire incident logs from ViOs and stores them in a repository. PMID:24531299

Web-of-Objects (WoO)-based context aware emergency fire management systems for the Internet of Things.

PubMed

Shamszaman, Zia Ush; Ara, Safina Showkat; Chong, Ilyoung; Jeong, Youn Kwae

2014-02-13

Recent advancements in the Internet of Things (IoT) and the Web of Things (WoT) accompany a smart life where real world objects, including sensing devices, are interconnected with each other. The Web representation of smart objects empowers innovative applications and services for various domains. To accelerate this approach, Web of Objects (WoO) focuses on the implementation aspects of bringing the assorted real world objects to the Web applications. In this paper; we propose an emergency fire management system in the WoO infrastructure. Consequently, we integrate the formation and management of Virtual Objects (ViO) which are derived from real world physical objects and are virtually connected with each other into the semantic ontology model. The charm of using the semantic ontology is that it allows information reusability, extensibility and interoperability, which enable ViOs to uphold orchestration, federation, collaboration and harmonization. Our system is context aware, as it receives contextual environmental information from distributed sensors and detects emergency situations. To handle a fire emergency, we present a decision support tool for the emergency fire management team. The previous fire incident log is the basis of the decision support system. A log repository collects all the emergency fire incident logs from ViOs and stores them in a repository.

Nurse-Moderated Internet-Based Support for New Mothers: Non-Inferiority, Randomized Controlled Trial.

PubMed

Sawyer, Michael G; Reece, Christy E; Bowering, Kerrie; Jeffs, Debra; Sawyer, Alyssa C P; Mittinty, Murthy; Lynch, John W

2017-07-24

Internet-based interventions moderated by community nurses have the potential to improve support offered to new mothers, many of whom now make extensive use of the Internet to obtain information about infant care. However, evidence from population-based randomized controlled trials is lacking. The aim of this study was to test the non-inferiority of outcomes for mothers and infants who received a clinic-based postnatal health check plus nurse-moderated, Internet-based group support when infants were aged 1-7 months as compared with outcomes for those who received standard care consisting of postnatal home-based support provided by a community nurse. The design of the study was a pragmatic, preference, non-inferiority randomized control trial. Participants were recruited from mothers contacted for their postnatal health check, which is offered to all mothers in South Australia. Mothers were assigned either (1) on the basis of their preference to clinic+Internet or home-based support groups (n=328), or (2) randomly assigned to clinic+Internet or home-based groups if they declared no strong preference (n=491). The overall response rate was 44.8% (819/1827). The primary outcome was parenting self-competence, as measured by the Parenting Stress Index (PSI) Competence subscale, and the Karitane Parenting Confidence Scale scores. Secondary outcome measures included PSI Isolation, Interpersonal Support Evaluation List-Short Form, Maternal Support Scale, Ages and Stages Questionnaire-Social-Emotional and MacArthur Communicative Development Inventory (MCDI) scores. Assessments were completed offline via self-assessment questionnaires at enrolment (mean child age=4.1 weeks, SD 1.3) and again when infants were aged 9, 15, and 21 months. Generalized estimating equations adjusting for post-randomization baseline imbalances showed that differences in outcomes between mothers in the clinic+Internet and home-based support groups did not exceed the pre-specified margin of inferiority (0.25 of a SD) on any outcome measure at any follow-up assessment, with the exception of MCDI scores assessing children's language development at 21 months for randomized mothers, and PSI Isolation scores at 9 months for preference mothers. Maternal and child outcomes from a clinic-based postnatal health check plus nurse-moderated Internet-based support were not inferior to those achieved by a universal home-based postnatal support program. Postnatal maternal and infant support using the Internet is a promising alternative to home-based universal support programs. Australian New Zealand Clinical Trials Registry Number (ANZCTR): ACTRN12613000204741; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=363712&isReview=true (Archived by WebCite at http://www.webcitation.org/6rZeCJ3k1). ©Michael G Sawyer, Christy E Reece, Kerrie Bowering, Debra Jeffs, Alyssa C P Sawyer, Murthy Mittinty, John W Lynch. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 24.07.2017.

Nurse-Moderated Internet-Based Support for New Mothers: Non-Inferiority, Randomized Controlled Trial

PubMed Central

Reece, Christy E; Bowering, Kerrie; Jeffs, Debra; Sawyer, Alyssa C P; Mittinty, Murthy; Lynch, John W

2017-01-01

Background Internet-based interventions moderated by community nurses have the potential to improve support offered to new mothers, many of whom now make extensive use of the Internet to obtain information about infant care. However, evidence from population-based randomized controlled trials is lacking. Objective The aim of this study was to test the non-inferiority of outcomes for mothers and infants who received a clinic-based postnatal health check plus nurse-moderated, Internet-based group support when infants were aged 1-7 months as compared with outcomes for those who received standard care consisting of postnatal home-based support provided by a community nurse. Methods The design of the study was a pragmatic, preference, non-inferiority randomized control trial. Participants were recruited from mothers contacted for their postnatal health check, which is offered to all mothers in South Australia. Mothers were assigned either (1) on the basis of their preference to clinic+Internet or home-based support groups (n=328), or (2) randomly assigned to clinic+Internet or home-based groups if they declared no strong preference (n=491). The overall response rate was 44.8% (819/1827). The primary outcome was parenting self-competence, as measured by the Parenting Stress Index (PSI) Competence subscale, and the Karitane Parenting Confidence Scale scores. Secondary outcome measures included PSI Isolation, Interpersonal Support Evaluation List–Short Form, Maternal Support Scale, Ages and Stages Questionnaire–Social-Emotional and MacArthur Communicative Development Inventory (MCDI) scores. Assessments were completed offline via self-assessment questionnaires at enrolment (mean child age=4.1 weeks, SD 1.3) and again when infants were aged 9, 15, and 21 months. Results Generalized estimating equations adjusting for post-randomization baseline imbalances showed that differences in outcomes between mothers in the clinic+Internet and home-based support groups did not exceed the pre-specified margin of inferiority (0.25 of a SD) on any outcome measure at any follow-up assessment, with the exception of MCDI scores assessing children’s language development at 21 months for randomized mothers, and PSI Isolation scores at 9 months for preference mothers. Conclusion Maternal and child outcomes from a clinic-based postnatal health check plus nurse-moderated Internet-based support were not inferior to those achieved by a universal home-based postnatal support program. Postnatal maternal and infant support using the Internet is a promising alternative to home-based universal support programs. Trial Registration Australian New Zealand Clinical Trials Registry Number (ANZCTR): ACTRN12613000204741; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=363712&isReview=true (Archived by WebCite at http://www.webcitation.org/6rZeCJ3k1) PMID:28739559

Performance Support in Internet Time: The State of the Practice.

ERIC Educational Resources Information Center

Gery, Gloria; Malcolm, Stan; Cichelli, Janet; Christensen, Hal; Raybould, Barry; Rosenberg, Marc J.

2000-01-01

Relates a discussion held via teleconference that addressed trends relating to performance support. Topics include computer-based training versus performance support; knowledge management; Internet and Web-based applications; dynamics and human activities; enterprise application integration; intrinsic performance support; and future possibilities.…

Evidence-based decision making and asthma in the internet age: the tools of the trade.

PubMed

Jadad, A R

2002-01-01

At the dawn of the Information Age, the practice of evidence-based decision making (EBDM) is still hindered by many important barriers related to the decision makers, to the evidence per se or to the health system. Some of these barriers, particularly those related to the distillation, dissemination and packaging of research evidence, could be overcome by recent and ongoing developments in portable/wearable computers, internet appliances, multimedia and wireless broadband internet traffic. This article describes specific EBDM-related tools, with emphasis on internet-enabled "how to" books; and tools to improve the quality of reporting research, to formulate questions; to search for evidence; to access journals, systematic reviews and guidelines; to interact with organizations promoting EBDM; and to tailor evidence to individual cases. However, thinking that all barriers to the practice of EBDM could be solved by fancy information technology is naïve. Barriers related to the generation, interpretation, integration and use of the evidence demand more complex and perhaps unfeasible solutions, as overcoming them will require substantial changes in the structure of the health system, in the politics of science and in the way in which humans think and behave.

Remote access to medical specialists: home care interactive patient management system

NASA Astrophysics Data System (ADS)

Martin, Peter J.; Draghic, Nicole; Wiesmann, William P.

1999-07-01

Diabetes management involves constant care and rigorous compliance. Glucose control is often difficult to maintain and onset of complications further compound health care needs. Status can be further hampered by geographic isolation from immediate medical infrastructures. The Home Care Interactive Patient Management System is an experimental telemedicine program that could improve chronic illness management through Internet-based applications. The goal of the system is to provide a customized, integrated approach to diabetes management to supplement and coordinate physician protocol while supporting routine patient activity, by supplying a set of customized automated services including health data collection, transmission, analysis and decision support.

Factors Related to Choosing between the Internet and a Financial Planner

ERIC Educational Resources Information Center

Son, Jiyeon

2012-01-01

In this dissertation, I aim to clarify the factors affecting a consumers' choice between the Internet and a financial planner for making saving and investment decisions, based on household production theory. Moreover, I explore the likelihood of an individual being an Internet user (vs. a non-user), a financial planner user (vs. a non-user),…

Collaborative Wideband Compressed Signal Detection in Interplanetary Internet

NASA Astrophysics Data System (ADS)

Wang, Yulin; Zhang, Gengxin; Bian, Dongming; Gou, Liang; Zhang, Wei

2014-07-01

As the development of autonomous radio in deep space network, it is possible to actualize communication between explorers, aircrafts, rovers and satellites, e.g. from different countries, adopting different signal modes. The first mission to enforce the autonomous radio is to detect signals of the explorer autonomously without disturbing the original communication. This paper develops a collaborative wideband compressed signal detection approach for InterPlaNetary (IPN) Internet where there exist sparse active signals in the deep space environment. Compressed sensing (CS) can be utilized by exploiting the sparsity of IPN Internet communication signal, whose useful frequency support occupies only a small portion of an entirely wide spectrum. An estimate of the signal spectrum can be obtained by using reconstruction algorithms. Against deep space shadowing and channel fading, multiple satellites collaboratively sense and make a final decision according to certain fusion rule to gain spatial diversity. A couple of novel discrete cosine transform (DCT) and walsh-hadamard transform (WHT) based compressed spectrum detection methods are proposed which significantly improve the performance of spectrum recovery and signal detection. Finally, extensive simulation results are presented to show the effectiveness of our proposed collaborative scheme for signal detection in IPN Internet. Compared with the conventional discrete fourier transform (DFT) based method, our DCT and WHT based methods reduce computational complexity, decrease processing time, save energy and enhance probability of detection.

Neural substrates of risky decision making in individuals with Internet addiction.

PubMed

Seok, Ji-Woo; Lee, Kyung Hwa; Sohn, Sunju; Sohn, Jin-Hun

2015-10-01

With the wide and rapid expansion of computers and smartphones, Internet use has become an essential part of life and an important tool that serves various purposes. Despite the advantages of Internet use, psychological and behavioral problems, including Internet addiction, have been reported. In response to growing concern, researchers have focused on the characteristics of Internet addicts. However, relatively little is known about the behavioral and neural mechanisms that underlie Internet addiction, especially with respect to risky decision making, which is an important domain frequently reported in other types of addictions. To examine the neural characteristics of decision making in Internet addicts, Internet addicts and healthy controls were scanned while they performed a financial decision-making task. Relative to healthy controls, Internet addicts showed (1) more frequent risky decision making; (2) greater activation in the dorsal anterior cingulate cortex and the left caudate nucleus, which are brain regions involved in conflict monitoring and reward, respectively; and (3) less activation in the ventrolateral prefrontal cortex, an area associated with cognitive control/regulation. These findings suggest that risky decision making may be an important behavioral characteristic of Internet addiction and that altered brain function in regions associated with conflict monitoring, reward and cognitive control/regulation might be critical biological risk factors for Internet addiction. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Distributed behavior model orchestration in cognitive internet of things solution

NASA Astrophysics Data System (ADS)

Li, Chung-Sheng; Darema, Frederica; Chang, Victor

2018-04-01

The introduction of pervasive and ubiquitous instrumentation within Internet of Things (IoT) leads to unprecedented real-time visibility (instrumentation), optimization and fault-tolerance of the power grid, traffic, transportation, water, oil & gas, to give some examples. Interconnecting those distinct physical, people, and business worlds through ubiquitous instrumentation, even though still in its embryonic stage, has the potential to create intelligent IoT solutions that are much greener, more efficient, comfortable, and safer. An essential new direction to materialize this potential is to develop comprehensive models of such systems dynamically interacting with the instrumentation in a feed-back control loop. We describe here opportunities in applying cognitive computing on interconnected and instrumented worlds (Cognitive Internet of Things-CIoT) and call out the system-of-systems trend among distinct but interdependent worlds, and Dynamic Data-Driven Application System (DDDAS)-based methods for advanced understanding, analysis, and real-time decision support capabilities with the accuracy of full-scale models.

Weighting Statistical Inputs for Data Used to Support Effective Decision Making During Severe Emergency Weather and Environmental Events

NASA Technical Reports Server (NTRS)

Gardner, Adrian

2010-01-01

National Aeronautical and Space Administration (NASA) weather and atmospheric environmental organizations are insatiable consumers of geophysical, hydrometeorological and solar weather statistics. The expanding array of internet-worked sensors producing targeted physical measurements has generated an almost factorial explosion of near real-time inputs to topical statistical datasets. Normalizing and value-based parsing of such statistical datasets in support of time-constrained weather and environmental alerts and warnings is essential, even with dedicated high-performance computational capabilities. What are the optimal indicators for advanced decision making? How do we recognize the line between sufficient statistical sampling and excessive, mission destructive sampling ? How do we assure that the normalization and parsing process, when interpolated through numerical models, yields accurate and actionable alerts and warnings? This presentation will address the integrated means and methods to achieve desired outputs for NASA and consumers of its data.

The role of social support on emotion dysregulation and Internet addiction among Chinese adolescents: A structural equation model.

PubMed

Mo, Phoenix K H; Chan, Virginia W Y; Chan, Samuel W; Lau, Joseph T F

2018-07-01

Internet addiction is prevalent among adolescents and is associated with various negative outcomes. Relatively few studies examined the role of emotion dysregulation and social support on Internet addiction in this population. The present examined the association between emotion dysregulation, social support, and Internet addiction among junior secondary school students in Hong Kong. The mediating role of emotion dysregulation and Internet use on the relationship between social support and Internet addiction and the gender difference in such association were also tested. A total of 862 junior secondary school students (grade 7 to 8) from 4 schools completed a cross-sectional survey. 10.9% scored above the cut-off for Internet addiction based on the Chen Internet Addiction Scale. Results from structural equation modeling revealed that social support was negatively related to emotion dysregulation and Internet usage, which in turn, were positively related to Internet addiction. Results from multi-group analysis by gender showed that the relationship between social support and emotion dysregulation, Internet usage, and Internet addiction, and those between emotion dysregulation and Internet addiction and between Internet usage and Internet addiction were stronger among female participants. Emotion dysregulation is a potential risk factor while social support is a potential protective factor for Internet addiction. The role of social support on emotion dysregulation and Internet addiction were stronger among female students. Gender-sensitive interventions on Internet Addiction for adolescents are warranted, such interventions should increase social support and improve emotion regulation. Copyright © 2018. Published by Elsevier Ltd.

Internet-Based Self-Help Career Assessments and Interventions: Challenges and Implications for Evidence-Based Career Counseling

ERIC Educational Resources Information Center

Gati, Itamar; Asulin-Peretz, Lisa

2011-01-01

A major characteristic of the 21st century with significant implications on career decision making is the growing prevalence of Information and Communication Technologies (ICTs). Challenges involving ICT-based self-assessment and self-help interventions aimed at facilitating career decision making are discussed. Specifically, this article focuses…

Evaluation of Internet-Based Interventions on Waist Circumference Reduction: A Meta-Analysis.

PubMed

Seo, Dong-Chul; Niu, Jingjing

2015-07-21

Internet-based interventions are more cost-effective than conventional interventions and can provide immediate, easy-to-access, and individually tailored support for behavior change. Waist circumference is a strong predictor of an increased risk for a host of diseases, such as hypertension, diabetes, and dyslipidemia, independent of body mass index. To date, no study has examined the effect of Internet-based lifestyle interventions on waist circumference change. This study aimed to systematically review the effect of Internet-based interventions on waist circumference change among adults. This meta-analysis reviewed randomized controlled trials (N=31 trials and 8442 participants) that used the Internet as a main intervention approach and reported changes in waist circumference. Internet-based interventions showed a significant reduction in waist circumference (mean change -2.99 cm, 95% CI -3.68 to -2.30, I(2)=93.3%) and significantly better effects on waist circumference loss (mean loss 2.38 cm, 95% CI 1.61-3.25, I(2)=97.2%) than minimal interventions such as information-only groups. Meta-regression results showed that baseline waist circumference, gender, and the presence of social support in the intervention were significantly associated with waist circumference reduction. Internet-based interventions have a significant and promising effect on waist circumference change. Incorporating social support into an Internet-based intervention appears to be useful in reducing waist circumference. Considerable heterogeneity exists among the effects of Internet-based interventions. The design of an intervention may have a significant impact on the effectiveness of the intervention.

Characterizing internet health information seeking strategies by socioeconomic status: a mixed methods approach.

PubMed

Perez, Susan L; Kravitz, Richard L; Bell, Robert A; Chan, Man Shan; Paterniti, Debora A

2016-08-09

The Internet is valuable for those with limited access to health care services because of its low cost and wealth of information. Our objectives were to investigate how the Internet is used to obtain health-related information and how individuals with differing socioeconomic resources navigate it when presented with a health decision. Study participants were recruited from public settings and social service agencies. Participants listened to one of two clinical scenarios - consistent with influenza or bacterial meningitis - and then conducted an Internet search. Screen-capture video software captured the Internet search. Participant Internet search strategies were analyzed and coded for pre- and post-Internet search guess at diagnosis and information seeking patterns. Individuals who did not have a college degree and were recruited from locations offering social services were categorized as "lower socioeconomic status" (SES); the remainder was categorized as "higher SES." Participants were 78 Internet health information seekers, ranging from 21-35 years of age, who experienced barriers to accessing health care services. Lower-SES individuals were more likely to use an intuitive, rather than deliberative, approach to Internet health information seeking. Lower- and higher-SES participants did not differ in the tendency to make diagnostic guesses based on Internet searches. Lower-SES participants were more likely than their higher-SES counterparts to narrow the scope of their search. Our findings suggest that individuals with different levels of socioeconomic status vary in the heuristics and search patterns they rely upon to direct their searches. The influence and use of credible information in the process of making a decision is associated with education and prior experiences with healthcare services. Those with limited resources may be disadvantaged when turning to the Internet to make a health decision.

Quality of online information on type 2 diabetes: a cross-sectional study.

PubMed

Weymann, Nina; Härter, Martin; Dirmaier, Jörg

2015-12-01

Evidence-based health information is a prerequisite for patients with type 2 diabetes to engage in self-management and to make informed medical decisions. The Internet is an important source of health information. In the present study, we systematically assessed formal quality, quality of decision support and usability of German and English language websites on type 2 diabetes. The search term 'type 2 diabetes' was entered in the two most popular search engines. Descriptive data on website quality are presented. Additionally, associations between website quality and affiliation (commercial vs. non-commercial), presence of the HON code quality seal and website traffic were explored. Forty-six websites were included. Most websites provided basic information necessary for decision-making, while only one website also provided decision support. Websites with a HON code had significantly better formal quality than websites without HON code. We found a highly significant correlation between usability and website traffic and a significant correlation between formal quality and website traffic. Most websites do not provide sufficient information to support patients in medical decision-making. Our finding that usability and website traffic are tightly associated is consistent with previous research indicating that design is the most important cue for users assessing website credibility. © The Author (2014). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Usability evaluation of the interactive Personal Patient Profile-Prostate decision support system with African American men.

PubMed

Jaja, Cheedy; Pares-Avila, Jose; Wolpin, Seth; Berry, Donna

2010-04-01

The Personal Patient Profile-Prostate (P4) program is an interactive Web-based decision support system that provides men with localized prostate cancer customized education and coaching with which to make the best personal treatment decision. This study assessed functionality and usability of the P4 program and identified problems in user-computer interaction in a sample of African American men. Usability testing was conducted with 12 community-dwelling African American adult men. The health status of participants was not known or collected by the research team. Each participant worked with the P4 program and provided simultaneous feedback using the "think aloud" technique. Handwritten field notes were collated and assigned to 3 standard coded categories. Aspects of P4 program usability was made based on common issues in the assigned categories. Summary statistics were derived for types and frequency of usability issues noted in the coded data. Twelve participants reported a total of 122 usability comments, with a mean of 9 usability comments. The most common usability issue by participant was completeness of information content, which comprised 53 (43%) of the total issues. Comprehensibility of text and graphics was second, comprising 51 (42%) of the total issues. This study provided initial inventory of usability issues for community African American men that may potentially interfere with application of the P4 system in the community setting and overall system usability, confirming the need for usability testing of a culturally appropriate Internet-based decision support system before community application.

The availability and effectiveness of tools supporting shared decision making in metastatic breast cancer care: a review.

PubMed

Spronk, Inge; Burgers, Jako S; Schellevis, François G; van Vliet, Liesbeth M; Korevaar, Joke C

2018-05-11

Shared decision-making (SDM) in the management of metastatic breast cancer care is associated with positive patient outcomes. In daily clinical practice, however, SDM is not fully integrated yet. Initiatives to improve the implementation of SDM would be helpful. The aim of this review was to assess the availability and effectiveness of tools supporting SDM in metastatic breast cancer care. Literature databases were systematically searched for articles published since 2006 focusing on the development or evaluation of tools to improve information-provision and to support decision-making in metastatic breast cancer care. Internet searches and experts identified additional tools. Data from included tools were extracted and the evaluation of tools was appraised using the GRADE grading system. The literature search yielded five instruments. In addition, two tools were identified via internet searches and consultation of experts. Four tools were specifically developed for supporting SDM in metastatic breast cancer, the other three tools focused on metastatic cancer in general. Tools were mainly applicable across the care process, and usable for decisions on supportive care with or without chemotherapy. All tools were designed for patients to be used before a consultation with the physician. Effects on patient outcomes were generally weakly positive although most tools were not studied in well-designed studies. Despite its recognized importance, only two tools were positively evaluated on effectiveness and are available to support patients with metastatic breast cancer in SDM. These tools show promising results in pilot studies and focus on different aspects of care. However, their effectiveness should be confirmed in well-designed studies before implementation in clinical practice. Innovation and development of SDM tools targeting clinicians as well as patients during a clinical encounter is recommended.

Grand Challenges in Clinical Decision Support v10

PubMed Central

Sittig, Dean F.; Wright, Adam; Osheroff, Jerome A.; Middleton, Blackford; Teich, Jonathan M.; Ash, Joan S.; Campbell, Emily; Bates, David W.

2008-01-01

There is a pressing need for high-quality, effective means of designing, developing, presenting, implementing, evaluating, and maintaining all types of clinical decision support capabilities for clinicians, patients and consumers. Using an iterative, consensus-building process we identified a rank-ordered list of the top 10 grand challenges in clinical decision support. This list was created to educate and inspire researchers, developers, funders, and policy-makers. The list of challenges in order of importance that they be solved if patients and organizations are to begin realizing the fullest benefits possible of these systems consists of: Improve the human-computer interface; Disseminate best practices in CDS design, development, and implementation; Summarize patient-level information; Prioritize and filter recommendations to the user; Create an architecture for sharing executable CDS modules and services; Combine recommendations for patients with co-morbidities; Prioritize CDS content development and implementation; Create internet-accessible clinical decision support repositories; Use freetext information to drive clinical decision support; Mine large clinical databases to create new CDS. Identification of solutions to these challenges is critical if clinical decision support is to achieve its potential and improve the quality, safety and efficiency of healthcare. PMID:18029232

Internet Use Frequency and Patient-Centered Care: Measuring Patient Preferences for Participation Using the Health Information Wants Questionnaire

PubMed Central

Wang, Mo; Feldman, Robert; Zhou, Le

2013-01-01

Background The Internet is bringing fundamental changes to medical practice through improved access to health information and participation in decision making. However, patient preferences for participation in health care vary greatly. Promoting patient-centered health care requires an understanding of the relationship between Internet use and a broader range of preferences for participation than previously measured. Objective To explore (1) whether there is a significant relationship between Internet use frequency and patients’ overall preferences for obtaining health information and decision-making autonomy, and (2) whether the relationships between Internet use frequency and information and decision-making preferences differ with respect to different aspects of health conditions. Methods The Health Information Wants Questionnaire (HIWQ) was administered to gather data about patients’ preferences for the (1) amount of information desired about different aspects of a health condition, and (2) level of decision-making autonomy desired across those same aspects. Results The study sample included 438 individuals: 226 undergraduates (mean age 20; SD 2.15) and 212 community-dwelling older adults (mean age 72; SD 9.00). A significant difference was found between the younger and older age groups’ Internet use frequencies, with the younger age group having significantly more frequent Internet use than the older age group (younger age group mean 5.98, SD 0.33; older age group mean 3.50, SD 2.00; t 436=17.42, P<.01). Internet use frequency was positively related to the overall preference rating (γ=.15, P<.05), suggesting that frequent Internet users preferred significantly more information and decision making than infrequent Internet users. The relationships between Internet use frequency and different types of preferences varied: compared with infrequent Internet users, frequent Internet users preferred more information but less decision making for diagnosis (γ=.57, P<.01); more information and more decision-making autonomy for laboratory test (γ=.15, P<.05), complementary and alternative medicine (γ=.32, P<.01), and self-care (γ=.15, P<.05); and less information but more decision-making autonomy for the psychosocial (γ=-.51, P<.01) and health care provider (γ=-.27, P<.05) aspects. No significant difference was found between frequent and infrequent Internet users in their preferences for treatment information and decision making. Conclusions Internet use frequency has a positive relationship with the overall preferences for obtaining health information and decision-making autonomy, but its relationship with different types of preferences varies. These findings have important implications for medical practice. PMID:23816979

An investigation of the effect of anecdotal information on the choice of a healthcare facility.

PubMed

Chalil Madathil, Kapil; Greenstein, Joel S

2018-07-01

This article includes two studies investigating the impact of anecdotal healthcare information from the Internet on healthcare decisions. The availability of anecdotal information on the Internet through social media and peer support groups has increased the risk of the dissemination of misleading information. The first study investigated the effect of demographics, quality of life, health status and public reports usage on the use of anecdotal healthcare information from the Internet. The second employed a 2 (anecdotal information presented as videos supporting and contradicting public report information) * 2 (phase of introduction of anecdotal information: early, late) between-subjects experimental design to investigate the consumer's choice between two health facilities, the level of confidence in the decision, the knowledge acquired and the workload experienced. The results from the first study found that age, gender, educational level, health status and public report usage were significant predictors of consumer use of anecdotal information on the Internet. The results from the second suggest that the probability of making the optimal choice was reduced by more than half when contradicting rather than supporting anecdotal information was presented first. The data from anecdotal information became the anchor points for developing an understanding of the healthcare situation, meaning initial perceptions did not change after the presentation of the more reliable public reports. Because of comprehension issues related to public reports, consumers may give more weight to anecdotal information found online. Thus, new approaches are needed to ensure the former is engaging for a wide range of healthcare consumers. Copyright © 2018 Elsevier Ltd. All rights reserved.

Interactive map communication: pilot study of the visual perceptions and preferences of public health practitioners.

PubMed

Koenig, A; Samarasundera, E; Cheng, T

2011-08-01

To conduct a pilot study into the comprehension and visualisation preferences of geographic information by public health practitioners (PHPs), particularly in the context of interactive, Internet-based atlases. Structured human-computer interaction interviews. Seven academia-based PHPs were interviewed as information service users based on a structured questionnaire to assess their understanding of geographic representations of morbidity data, and identify their visualisation preferences in a geographic information systems environment. Awareness of area-based deprivation indices and the Index of Multiple Deprivation 2007 health and disability domain was near-universal. However, novice users of disease maps had difficulties in interpreting data classifications, in understanding supplementary information in the form of box plots and histograms, and in making use of links between interactive tabular and cartographic information. Choices for colour plans when viewing maps showed little agreement between users, although pre-viewing comments showed preferences for red-blue diverging schema. PHPs new to geographic information would benefit from enhanced interpretive support documentation to meet their needs when using Internet-based, interactive public health atlases, which are rarely provided at such sites. Technical, software-related support alone is insufficient. Increased interaction between PHPs and mapmakers would be beneficial to maximise the potential of the current growth in interactive, electronic atlases, and improve geographic information support for public health decision-making and informing the wider public. Copyright © 2011 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

DXplain on the Internet.

PubMed

Barnett, G O; Famiglietti, K T; Kim, R J; Hoffer, E P; Feldman, M J

1998-01-01

DXplain, a computer-based medical education, reference and decision support system has been used by thousands of physicians and medical students on stand-alone systems and over communications networks. For the past two years, we have made DXplain available over the Internet in order to provide DXplain's knowledge and analytical capabilities as a resource to other applications within Massachusetts General Hospital (MGH) and at outside institutions. We describe and provide the user experience with two different protocols through which users can access DXplain through the World Wide Web (WWW). The first allows the user to have direct interaction with all the functionality of DXplain where the MGH server controls the interaction and the mode of presentation. In the second mode, the MGH server provides the DXplain functionality as a series of services, which can be called independently by the user application program.

Assessing Internet energy intensity: A review of methods and results

DOE Office of Scientific and Technical Information (OSTI.GOV)

Coroama, Vlad C., E-mail: vcoroama@gmail.com; Hilty, Lorenz M.; Empa, Swiss Federal Laboratories for Materials Science and Technology, Lerchenfeldstr. 5, 9014 St. Gallen

Assessing the average energy intensity of Internet transmissions is a complex task that has been a controversial subject of discussion. Estimates published over the last decade diverge by up to four orders of magnitude — from 0.0064 kilowatt-hours per gigabyte (kWh/GB) to 136 kWh/GB. This article presents a review of the methodological approaches used so far in such assessments: i) top–down analyses based on estimates of the overall Internet energy consumption and the overall Internet traffic, whereby average energy intensity is calculated by dividing energy by traffic for a given period of time, ii) model-based approaches that model all componentsmore » needed to sustain an amount of Internet traffic, and iii) bottom–up approaches based on case studies and generalization of the results. Our analysis of the existing studies shows that the large spread of results is mainly caused by two factors: a) the year of reference of the analysis, which has significant influence due to efficiency gains in electronic equipment, and b) whether end devices such as personal computers or servers are included within the system boundary or not. For an overall assessment of the energy needed to perform a specific task involving the Internet, it is necessary to account for the types of end devices needed for the task, while the energy needed for data transmission can be added based on a generic estimate of Internet energy intensity for a given year. Separating the Internet as a data transmission system from the end devices leads to more accurate models and to results that are more informative for decision makers, because end devices and the networking equipment of the Internet usually belong to different spheres of control. -- Highlights: • Assessments of the energy intensity of the Internet differ by a factor of 20,000. • We review top–down, model-based, and bottom–up estimates from literature. • Main divergence factors are the year studied and the inclusion of end devices. • We argue against extending the Internet system boundary beyond data transmission. • Decision-makers need data that differentiates between end devices and transmission.« less

Online support to facilitate the reintegration of students with brain injury: trials and errors.

PubMed

Verburg, Geb; Borthwick, Burt; Bennett, Bill; Rumney, Peter

2003-01-01

The reintegration of students after acquired/traumatic brain injury (ABI/TBI) continues to be fraught with difficulties. Presented are (1) case studies exploring the potential of online support for teachers of students with ABI after returning from a paediatric rehabilitation centre; (2) results of Internet-based courses about reintegrating students with ABI; (3) outcomes of videoconferencing-based and Internet email-based support; (4) development of an online support process that uses Questions and Answers as a quick and immediate resource for teachers. The authors recommend that a collaborative process be instituted, in order to generate a relatively small number of high quality online resources about re-integrating students into their school and community. A second recommendation focuses on the development of online support network which may be text or email based or which may use videoconferencing over the Internet. Such networks allow students with ABI to maintain contact with their family and friends in the home community and facilitate their reintegration. An Internet-based support structure also allows professionals to provide consultation, collaboration and continuing input.

Feasibility of Providing Web-Based Information to Breast Cancer Patients Prior to a Surgical Consult.

PubMed

Bruce, Jordan G; Tucholka, Jennifer L; Steffens, Nicole M; Mahoney, Jane E; Neuman, Heather B

2017-03-30

Patients facing decisions for breast cancer surgery commonly search the internet. Directing patients to high-quality websites prior to the surgeon consultation may be one way of supporting patients' informational needs. The objective was to test an approach for delivering web-based information to breast cancer patients. The implementation strategy was developed using the Replicating Effective Programs framework. Pilot testing measured the proportion that accepted the web-based information. A pre-consultation survey assessed whether the information was reviewed and the acceptability to stakeholders. Reasons for declining guided refinement to the implementation package. Eighty-two percent (309/377) accepted the web-based information. Of the 309 that accepted, 244 completed the pre-consultation survey. Participants were a median 59 years, white (98%), and highly educated (>50% with a college degree). Most patients who completed the questionnaire reported reviewing the website (85%), and nearly all found it helpful. Surgeons thought implementation increased visit efficiency (5/6) and would result in patients making more informed decisions (6/6). The most common reasons patients declined information were limited internet comfort or access (n = 36), emotional distress (n = 14), and preference to receive information directly from the surgeon (n = 7). Routine delivery of web-based information to breast cancer patients prior to the surgeon consultation is feasible. High stakeholder acceptability combined with the low implementation burden means that these findings have immediate relevance for improving care quality.

Disaster management: using Internet-based technology.

PubMed

Dimitruk, Paul

2007-01-01

Disasters impose operational challenges and substantial financial burdens on hospitals. Internet-based disaster management technology can help. This technology should: Capture, analyze, and track relevant data. Be available 24/7. Guide decision makers in setting up an incident command center and monitor the completion of jobs by ICC role. Provide assistance in areas that hospitals are not used to dealing with, e.g., chemical or bio-terror agents.

Internet Usage by Parents Prior to Seeking Care at a Pediatric Emergency Department: Observational Study

PubMed Central

2017-01-01

Background Little is known about how parents utilize medical information on the Internet prior to an emergency department (ED) visit. Objective The objective of the study was to determine the proportion of parents who accessed the Internet for medical information related to their child’s illness in the 24 hours prior to an ED visit (IPED), to identify the websites used, and to understand how the content contributed to the decision to visit the ED. Methods A 40-question interview was conducted with parents presenting to an ED within a freestanding children’s hospital. If parents reported IPED, the number and names of websites were documented. Parents indicated the helpfulness of Web-based content using a 100-mm visual analog scale and the degree to which it contributed to the decision to visit the ED using 5-point Likert-type responses. Results About 11.8 % (31/262) reported IPED (95% CI 7.3-5.3). Parents who reported IPED were more likely to have at least some college education (P=.04), higher annual household income (P=.001), and older children (P=.04) than those who did not report IPED. About 35% (11/31) could not name any websites used. Mean level of helpfulness of Web-based content was 62 mm (standard deviation, SD=25 mm). After Internet use, some parents (29%, 9/31) were more certain they needed to visit the ED, whereas 19% (6/31) were less certain. A majority (87%, 195/224) of parents who used the Internet stated that they would be somewhat likely or very likely to visit a website recommended by a physician. Conclusions Nearly 1 out of 8 parents presenting to an urban pediatric ED reported using the Internet in the 24 hours prior to the ED visit. Among privately insured, at least one in 5 parents reported using the Internet prior to visiting the ED. Web-based medical information often influences decision making regarding ED utilization. Pediatric providers should provide parents with recommendations for high-quality sources of health information available on the Internet. PMID:28958988

Architectural and Mobility Management Designs in Internet-Based Infrastructure Wireless Mesh Networks

ERIC Educational Resources Information Center

Zhao, Weiyi

2011-01-01

Wireless mesh networks (WMNs) have recently emerged to be a cost-effective solution to support large-scale wireless Internet access. They have numerous applications, such as broadband Internet access, building automation, and intelligent transportation systems. One research challenge for Internet-based WMNs is to design efficient mobility…

Internet-based individually versus group guided self-help treatment for social anxiety disorder: protocol of a randomized controlled trial.

PubMed

Schulz, Ava; Stolz, Timo; Berger, Thomas

2014-04-15

Social anxiety disorder (SAD) is one of the most common mental disorders and causes subjective suffering and economic burden worldwide. Although effective treatments are available, a lot of cases go untreated. Internet-based self-help is a low-threshold and flexible treatment alternative for SAD. Various studies have already shown that internet-based self-help can be effective to reduce social phobic symptoms significantly. Most of the interventions tested include therapist support, whereas the role of peer support within internet-based self-help has not yet been fully understood. There is evidence suggesting that patients' mutual exchange via integrated discussion forums can increase the efficacy of internet-based treatments. This study aims at investigating the added value of therapist-guided group support on the treatment outcome of internet-based self-help for SAD. The study is conducted as a randomized controlled trial. A total of 150 adults with a diagnosis of SAD are randomly assigned to either a waiting-list control group or one of the active conditions. The participants in the two active conditions use the same internet-based self-help program, either with individual support by a psychologist or therapist-guided group support. In the group guided condition, participants can communicate with each other via an integrated, protected discussion forum. Subjects are recruited via topic related websites and links; diagnostic status will be assessed with a telephone interview. The primary outcome variables are symptoms of SAD and diagnostic status after the intervention. Secondary endpoints are general symptomology, depression, quality of life, as well as the primary outcome variables 6 months later. Furthermore, process variables such as group processes, the change in symptoms and working alliance will be studied. The results of this study should indicate whether group-guided support could enhance the efficacy of an internet-based self-help treatment for SAD. This novel treatment format, if shown effective, could represent a cost-effective option and could further be modified to treat other conditions, as well. ISRCTN75894275.

Enhancing group cognitive-behavioral therapy for hoarding disorder with between-session Internet-based clinician support: A feasibility study.

PubMed

Ivanov, Volen Z; Enander, Jesper; Mataix-Cols, David; Serlachius, Eva; Månsson, Kristoffer N T; Andersson, Gerhard; Flygare, Oskar; Tolin, David; Rück, Christian

2018-02-07

Hoarding disorder (HD) is difficult to treat. In an effort to increase efficacy and engagement in cognitive-behavioral therapy (CBT), we developed and evaluated a novel intervention comprising group CBT combined with between-session Internet-based clinician support for people with HD. Twenty participants with HD received group CBT combined with an Internet-support system enabling therapist-participant communication between group sessions. The treatment was associated with a significant reduction on the Saving Inventory-Revised (SI-R) and a large effect size (Cohen's d = 1.57) was found at posttreatment. Treatment gains were maintained at the 3-month follow-up. Group attendance was high and no participants dropped out from treatment prematurely. Between-session motivational support from the therapist was most frequently mentioned as the main strength of the system. The results of this study support adding Internet-based clinician support to group CBT for HD to increase treatment adherence and, potentially, improve the overall efficacy of CBT. © 2018 Wiley Periodicals, Inc.

Building Internet-Based Electronic Performance Support for Teaching and Learning.

ERIC Educational Resources Information Center

Laffey, James M.; Musser, Dale

The College of Education, University of Missouri-Columbia is developing and testing a suite of tools that utilize the Internet and work as a system to support learning from field experiences. These tools are built to support preservice teachers, field-based mentors, and college faculty as they collaborate, engage in practice, document their…

Use of case-based reasoning to enhance intensive management of patients on insulin pump therapy.

PubMed

Schwartz, Frank L; Shubrook, Jay H; Marling, Cynthia R

2008-07-01

This study was conducted to develop case-based decision support software to improve glucose control in patients with type 1 diabetes mellitus (T1DM) on insulin pump therapy. While the benefits of good glucose control are well known, achieving and maintaining good glucose control remains a difficult task. Case-based decision support software may assist by recalling past problems in glucose control and their associated therapeutic adjustments. Twenty patients with T1DM on insulin pumps were enrolled in a 6-week study. Subjects performed self-glucose monitoring and provided daily logs via the Internet, tracking insulin dosages, work, sleep, exercise, meals, stress, illness, menstrual cycles, infusion set changes, pump problems, hypoglycemic episodes, and other events. Subjects wore a continuous glucose monitoring system at weeks 1, 3, and 6. Clinical data were interpreted by physicians, who explained the relationship between life events and observed glucose patterns as well as treatment rationales to knowledge engineers. Knowledge engineers built a prototypical system that contained cases of problems in glucose control together with their associated solutions. Twelve patients completed the study. Fifty cases of clinical problems and solutions were developed and stored in a case base. The prototypical system detected 12 distinct types of clinical problems. It displayed the stored problems that are most similar to the problems detected, and offered learned solutions as decision support to the physician. This software can screen large volumes of clinical data and glucose levels from patients with T1DM, identify clinical problems, and offer solutions. It has potential application in managing all forms of diabetes.

The adaptive decision-making, risky decision, and decision-making style of Internet gaming disorder.

PubMed

Ko, C-H; Wang, P-W; Liu, T-L; Chen, C-S; Yen, C-F; Yen, J-Y

2017-07-01

Persistent gaming, despite acknowledgment of its negative consequences, is a major criterion for individuals with Internet gaming disorder (IGD). This study evaluated the adaptive decision-making, risky decision, and decision-making style of individuals with IGD. We recruited 87 individuals with IGD and 87 without IGD (matched controls). All participants underwent an interview based on the Diagnostic and Statistical Manual of Mental Disorders (5th Edition) diagnostic criteria for IGD and completed an adaptive decision-making task; the Preference for Intuition and Deliberation Scale, Chen Internet Addiction Scale, and Barratt Impulsivity Scale were also assessed on the basis of the information from the diagnostic interviews. The results demonstrated that the participants in both groups tend to make more risky choices in advantage trials where their expected value (EV) was more favorable than those of the riskless choice. The tendency to make a risky choice in advantage trials was stronger among IGD group than that among controls. Participants of both groups made more risky choices in the loss domain, a risky option to loss more versus sure loss option, than they did in the gain domain, a risky option to gain more versus sure gain. Furthermore, the participants with IGD made more risky choices in the gain domain than did the controls. Participants with IGD showed higher and lower preferences for intuitive and deliberative decision-making styles, respectively, than controls and their preferences for intuition and deliberation were positively and negatively associated with IGD severity, respectively. These results suggested that individuals with IGD have elevated EV sensitivity for decision-making. However, they demonstrated risky preferences in the gain domain and preferred an intuitive rather than deliberative decision-making style. This might explain why they continue Internet gaming despite negative consequences. Thus, therapists should focus more on decision-making styles and promote deliberative thinking processes to mitigate the long-term negative consequences of IGD. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Application of Docker Swarm cluster for testing programs, developed for system of devices within paradigm of Internet of things

NASA Astrophysics Data System (ADS)

Shichkina, Y. A.; Kupriyanov, M. S.; Moldachev, S. O.

2018-05-01

Today, a description of various Internet devices very often appears on the Internet. For the efficient operation of the Industrial Internet of things, it is necessary to provide a modern level of data processing starting from getting them from devices ending with returning them to devices in a processed form. Current solutions of the Internet of Things are mainly focused on the development of centralized decisions, projecting the Internet of Things on the set of cloud-based platforms that are open, but limit the ability of participants of the Internet of Things to adapt these systems to their own problems. Therefore, it is often necessary to create specialized software for specific areas of the Internet of Things. This article describes the solution of the problem of virtualization of the system of devices based on the Docker system. This solution allows developers to test any software on any number of devices forming a mesh.

E-health and health care behaviour of parents of young children: a qualitative study

PubMed Central

van der Gugten, Anne C.; de Leeuw, Rob J. R. J.; Verheij, Theo J.M.; van der Ent, Cornelis K.; Kars, Marijke C.

2016-01-01

Objective Internet plays a huge role in providing information about health care problems. However, it is unknown how parents use and perceive the internet as a source of information and how this influences health care utilisation when it comes to common complaints in infants. The objective was to evaluate the perception parents have on the role of internet in providing health care information on common symptoms in infants and its effects on health care utilisation. Design A qualitative design was chosen. Setting and subjects Parents were recruited from a population-based birth-cohort and selected purposefully. Main outcome measures Semi-structured interviews were used to receive information of parentsʼ ideas. Thematic coding and constant comparison were used for interview transcript analysis. Results Ten parents were interviewed. Parents felt anxious and responsible when their child displayed common symptoms, and appeared to be in need of information. They tried to obtain information from relatives, but more so from the internet, because of its accessibility. Nevertheless, information found on the internet had several limitations, evoked new doubts and insecurity and although parents compared information from multiple sources, only the physician was able to take away the insecurity. The internet did not interfere in the decision to consult the physician. Conclusions Parents need information about their childrenʼs symptoms and the internet is a major resource. However, only physicians could take away their symptom-related doubts and insecurities and internet information did not play a role in parental decision making. Information gathered online may complement the information from physicians, rather than replace it. Key pointsInternet plays an increasing role in providing health care information but it is unknown how this influences health care utilisation.Our study suggests that:Parents need information about their children’s symptoms and the internet is a major resource.However, only physicians could take away their symptom-related doubts and insecurities.Internet information did not play a role in parental decision making. PMID:27063729

The Longitudinal Impact of an Internet Safety Decision Aid for Abused Women.

PubMed

Glass, Nancy E; Perrin, Nancy A; Hanson, Ginger C; Bloom, Tina L; Messing, Jill T; Clough, Amber S; Campbell, Jacquelyn C; Gielen, Andrea C; Case, James; Eden, Karen B

2017-05-01

Women experiencing intimate partner violence (IPV) navigate complex, dangerous decisions. Tailored safety information and safety planning, typically provided by domestic violence service providers, can prevent repeat IPV exposure and associated adverse health outcomes; however, few abused women access these services. The Internet represents a potentially innovative way to connect abused women with tailored safety planning resources and information. The purpose of this study was to compare safety and mental health outcomes at baseline, 6 months, and 12 months among abused women randomized to: (1) a tailored, Internet-based safety decision aid; or (2) control website (typical safety information available online). Multistate, community-based longitudinal RCT with one-to-one allocation ratio and blocked randomization. Data were collected March 2011-May 2013 and analyzed June-July 2015. Currently abused Spanish- or English-speaking women (N=720). A tailored Internet-based safety decision aid included priority-setting activities, risk assessment, and tailored feedback and safety plans. A control website offered typical safety information available online. Primary outcomes were decisional conflict, safety behaviors, and repeat IPV; secondary outcomes included depression and post-traumatic stress disorder. At 12 months, there were no significant group differences in IPV, depression, or post-traumatic stress disorder. Intervention women experienced significantly less decisional conflict after one use (β= -2.68, p=0.042) and greater increase in safety behaviors they rated as helpful from baseline to 12 months (12% vs 9%, p=0.033) and were more likely to have left the abuser (63% vs 53%, p=0.008). Women who left had higher baseline risk (14.9 vs 13.1, p=0.003) found more of the safety behaviors they tried helpful (61.1% vs 47.5%, p<0.001), and had greater reductions in psychological IPV ((11.69 vs 7.5, p=0.001) and sexual IPV (2.41 vs 1.25, p=0.001) than women who stayed. Internet-based safety planning represents a promising tool to reduce the public health impact of IPV. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Real-time Social Internet Data to Guide Forecasting Models

DOE Office of Scientific and Technical Information (OSTI.GOV)

Del Valle, Sara Y.

Our goal is to improve decision support by monitoring and forecasting events using social media, mathematical models, and quantifying model uncertainty. Our approach is real-time, data-driven forecasts with quantified uncertainty: Not just for weather anymore. Information flow from human observations of events through an Internet system and classification algorithms is used to produce quantitatively uncertain forecast. In summary, we want to develop new tools to extract useful information from Internet data streams, develop new approaches to assimilate real-time information into predictive models, validate approaches by forecasting events, and our ultimate goal is to develop an event forecasting system using mathematicalmore » approaches and heterogeneous data streams.« less

Information Technology (IT) Ethics: Training and Awareness Materials for the Department of the Navy

DTIC Science & Technology

2002-06-01

systems, organ transplantation and donation, artificial insemination , and in vitro fertilization. [Ref. 12] Yet another explanation could be that...multitude of ways, whether it be E-mail servers, workplace Internet access, decision support systems, or satellite links. The ubiquitous nature of

Deciding on PSA-screening - Quality of current consumer information on the Internet.

PubMed

Korfage, Ida J; van den Bergh, Roderick C N; Essink-Bot, Marie-Louise

2010-11-01

Given that screening for prostate cancer has the potential to reduce prostate cancer mortality at the expense of considerable overdiagnosis and overtreatment, the availability of core consumer information - correct, balanced and supportive of autonomous decision-making - is a must. We assessed the quality of consumer information available through the Internet per November 2009 and its possible contribution to informed decision-making by potential screenees. Consumer information on PSA-screening was sought through the Internet in November 2009. Materials had to be targeted at potential consumers, offered by not-for-profit organisations, released in 2005 or after, in English or Dutch. Per material 2 of the authors assessed independently from each other whether standardised pre-defined topics were addressed, whether the content was correct and which approach was taken towards the decision-making process about uptake. Twenty-three materials were included, of which 11 were released (shortly) after the results of 2 large randomized-controlled trials (RCTs) that evaluated the effectiveness of screening for prostate cancer had been published in March 2009. That a PSA-test result can be abnormal because of non-cancerous conditions (false positive) and that it may miss prostate cancer (false negative) was not addressed in 2/23 and 8/23 materials, respectively. The risk of overdiagnosis and overtreatment was not mentioned in 6 out of 23. PSA-screening was presented as a usual thing to do in some materials, whereas other materials emphasised the voluntary nature of PSA-screening ('it is your decision'). The content of 19/23 materials was considered sufficiently informative according to the pre-defined criteria, 12/23 materials were considered supportive of informed decision-making by men. Most materials of not-for-profit organizations supplied adequate information about PSA-screening, whilst the degree of persuasion towards uptake reflected variations in opinions on men's autonomy regarding their own health. Copyright © 2010 Elsevier Ltd. All rights reserved.

A systematic review of online resources to support patient decision-making for full-thickness rectal prolapse surgery.

PubMed

Fowler, G E; Baker, D M; Lee, M J; Brown, S R

2017-11-01

The internet is becoming an increasingly popular resource to support patient decision-making outside of the clinical encounter. The quality of online health information is variable and largely unregulated. The aim of this study was to assess the quality of online resources to support patient decision-making for full-thickness rectal prolapse surgery. This systematic review was registered on the PROSPERO database (CRD42017058319). Searches were performed on Google and specialist decision aid repositories using a pre-defined search strategy. Sources were analysed according to three measures: (1) their readability using the Flesch-Kincaid Reading Ease score, (2) DISCERN score and (3) International Patient Decision Aids Standards (IPDAS) minimum standards criteria score (IPDASi, v4.0). Overall, 95 sources were from Google and the specialist decision aid repositories. There were 53 duplicates removed, and 18 sources did not meet the pre-defined eligibility criteria, leaving 24 sources included in the full-text analysis. The mean Flesch-Kincaid Reading Ease score was higher than recommended for patient education materials (48.8 ± 15.6, range 25.2-85.3). Overall quality of sources supporting patient decision-making for full-thickness rectal prolapse surgery was poor (median DISCERN score 1/5 ± 1.18, range 1-5). No sources met minimum decision-making standards (median IPDASi score 5/12 ± 2.01, range 1-8). Currently, easily accessible online health information to support patient decision-making for rectal surgery is of poor quality, difficult to read and does not support shared decision-making. It is recommended that professional bodies and medical professionals seek to develop decision aids to support decision-making for full-thickness rectal prolapse surgery.

Internet Based Remote Operations

NASA Technical Reports Server (NTRS)

Chamberlain, James

1999-01-01

This is the Final Report for the Internet Based Remote Operations Contract, has performed payload operations research support tasks March 1999 through September 1999. These tasks support the GSD goal of developing a secure, inexpensive data, voice, and video mission communications capability between remote payload investigators and the NASA payload operations team in the International Space Station (ISS) era. AZTek has provided feedback from the NASA payload community by utilizing its extensive payload development and operations experience to test and evaluate remote payload operations systems. AZTek has focused on use of the "public Internet" and inexpensive, Commercial-off-the-shelf (COTS) Internet-based tools that would most benefit "small" (e.g., $2 Million or less) payloads and small developers without permanent remote operations facilities. Such projects have limited budgets to support installation and development of high-speed dedicated communications links and high-end, custom ground support equipment and software. The primary conclusions of the study are as follows: (1) The trend of using Internet technology for "live" collaborative applications such as telescience will continue. The GSD-developed data and voice capabilities continued to work well over the "public" Internet during this period. 2. Transmitting multiple voice streams from a voice-conferencing server to a client PC to be mixed and played on the PC is feasible. 3. There are two classes of voice vendors in the market: - Large traditional phone equipment vendors pursuing integration of PSTN with Internet, and Small Internet startups.The key to selecting a vendor will be to find a company sufficiently large and established to provide a base voice-conferencing software product line for the next several years.

Scientific publications: now a marketing decision?

USDA-ARS?s Scientific Manuscript database

Scientists have been publishing in journals related to their disciplines. Now with the advent of the internet, many more options are now available and scientific publication has become a marketing decision. Scientific journals are rated by "impact factor" which is based on the average number of cita...

Digital health care--the convergence of health care and the Internet.

PubMed

Frank, S R

2000-04-01

The author believes that interactive media (the Internet and the World Wide Web) and associated applications used to access those media (portals, browsers, specialized Web-based applications) will result in a substantial, positive, and measurable impact on medical care faster than any previous information technology or communications tool. Acknowledging the dynamic environment, the author classifies "pure" digital health care companies into three business service areas: content, connectivity, and commerce. Companies offering these services are attempting to tap into a host of different markets within the health care industry including providers, payers, pharmaceutical and medical products companies, employers, distributors, and consumers. As the fastest growing medium in history, and given the unique nature of health care information and the tremendous demand for content among industry professionals and consumers, the Internet offers a more robust and targeted direct marketing opportunity than traditional media. From the medical consumer's standpoint (i.e., the patient) the author sees the Internet as performing five critical functions: (1) Disseminate information, (2) Aid informed decision making, (3) Promote health, (4) Provide a means for information exchange and support--the community concept, and (5) Increase self-care and manage demand for health services, lowering direct medical costs. The author firmly submits the Web will provide overall benefits to the health care economy as health information consumers manage their own health problems that might not directly benefit from an encounter with a health professional. Marrying the Internet to other interactive technologies, including voice recognition systems and telephone-based triage lines among others, holds the promise of reducing unnecessary medical services.

Internet-Based Sources of Information Which Can Be Used to Study the Internationalization Process

ERIC Educational Resources Information Center

Danford, Gerard L.

2008-01-01

This review shows how the Internet can support learning about the process of internationalization. A description of how Internet-based sources of information can be used by students when investigating internationalization has not been made. However, the Internet and its role during a corporation's foreign market expansion has not been investigated…

Develop a Prototype Personal Health Record Application (PHR-A) that Captures Information About Daily Living Important for Diabetes and Provides Decision Support with Actionable Advice for Diabetes Self Care

DTIC Science & Technology

2012-10-01

higher  Java v5Apache Struts v2  Hibernate v2  C3PO  SQL*Net client / JDBC Database Server  Oracle 10.0.2 Desktop Client  Internet Explorer...for mobile Smartphones - A Java -based framework utilizing Apache Struts on the server - Relational database to handle data storage requirements B...technologies are as follows: Technology Use Requirements Java Application Provides the backend application software to drive the PHR-A 7 BEA Web

Use of computers and Internet among people with severe mental illnesses at peer support centers.

PubMed

Brunette, Mary F; Aschbrenner, Kelly A; Ferron, Joelle C; Ustinich, Lee; Kelly, Michael; Grinley, Thomas

2017-12-01

Peer support centers are an ideal setting where people with severe mental illnesses can access the Internet via computers for online health education, peer support, and behavioral treatments. The purpose of this study was to assess computer use and Internet access in peer support agencies. A peer-assisted survey assessed the frequency with which consumers in all 13 New Hampshire peer support centers (n = 702) used computers to access Internet resources. During the 30-day survey period, 200 of the 702 peer support consumers (28%) responded to the survey. More than 3 quarters (78.5%) of respondents had gone online to seek information in the past year. About half (49%) of respondents were interested in learning about online forums that would provide information and peer support for mental health issues. Peer support centers may be a useful venue for Web-based approaches to education, peer support, and intervention. Future research should assess facilitators and barriers to use of Web-based resources among people with severe mental illness in peer support centers. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Impaired anterior insular activation during risky decision making in young adults with internet gaming disorder.

PubMed

Lee, Deokjong; Lee, Junghan; Yoon, Kang Joon; Kee, Namkoong; Jung, Young-Chul

2016-05-25

Internet gaming disorder is defined as excessive and compulsive use of the internet to engage in games that leads to clinically significant psychosocial impairment. We tested the hypothesis that individuals with internet gaming disorder would be less sensitive to high-risk situations and show aberrant brain activation related to risk prediction processing. Young adults with internet gaming disorder underwent functional MRI while performing a risky decision-making task. The healthy control group showed stronger activations within the dorsal attention network and the anterior insular cortex, which were not found in the internet gaming disorder group. Our findings imply that young adults with internet gaming disorder show impaired anterior insular activation during risky decision making, which might make them vulnerable when they need to adapt new behavioral strategies in high-risk situations.

[Internet Use by Oncology Outpatients: Results of a Survey in Germany].

PubMed

Borges, Uirassu; Riese, Christoph; Baumann, Walter

2017-05-15

Objective Internet has become an important source of information for cancer patients regarding disease and treatment. A national survey was conducted to assess the importance of Internet in the routine care of cancer patients in Germany. Method The cross-sectional survey included 5,984 outpatients (56.7% female, M=64.3 years, SD=12). 3 groups were identified: Internet users, non-users whose families/friends did online research for them, and "complete" non-users. The data was analyzed using descriptive statistics and group comparisons. Results 1 patient in 2 used the Internet to research health-related information. Internet users considered this research to be helpful, felt better able to participate in health-related decisions, and less alone with their disease. However, the information found online contributed to a feeling of uncertainty. 72.5% of Internet users researched treatment options and 21.3% talked to their doctor about their research. Conclusion The Internet was shown to be an important source of information for cancer patients. For patients to be able to use Internet research meaningfully, it could be helpful that they receive support from their oncologist. © Georg Thieme Verlag KG Stuttgart · New York.

Fusion Analytics: A Data Integration System for Public Health and Medical Disaster Response Decision Support

PubMed Central

Passman, Dina B.

2013-01-01

Objective The objective of this demonstration is to show conference attendees how they can integrate, analyze, and visualize diverse data type data from across a variety of systems by leveraging an off-the-shelf enterprise business intelligence (EBI) solution to support decision-making in disasters. Introduction Fusion Analytics is the data integration system developed by the Fusion Cell at the U.S. Department of Health and Human Services (HHS), Office of the Assistant Secretary for Preparedness and Response (ASPR). Fusion Analytics meaningfully augments traditional public and population health surveillance reporting by providing web-based data analysis and visualization tools. Methods Fusion Analytics serves as a one-stop-shop for the web-based data visualizations of multiple real-time data sources within ASPR. The 24-7 web availability makes it an ideal analytic tool for situational awareness and response allowing stakeholders to access the portal from any internet-enabled device without installing any software. The Fusion Analytics data integration system was built using off-the-shelf EBI software. Fusion Analytics leverages the full power of statistical analysis software and delivers reports to users in a secure web-based environment. Fusion Analytics provides an example of how public health staff can develop and deploy a robust public health informatics solution using an off-the shelf product and with limited development funding. It also provides the unique example of a public health information system that combines patient data for traditional disease surveillance with manpower and resource data to provide overall decision support for federal public health and medical disaster response operations. Conclusions We are currently in a unique position within public health. One the one hand, we have been gaining greater and greater access to electronic data of all kinds over the last few years. On the other, we are working in a time of reduced government spending to support leveraging this data for decision support with robust analytics and visualizations. Fusion Analytics provides an opportunity for attendees to see how various types of data are integrated into a single application for population health decision support. It also can provide them with ideas of how they can use their own staff to create analyses and reports that support their public health activities.

The availability of health information system for decision-making with evidence-based medicine approach-a case study: Kermanshah, Iran.

PubMed

Safari, Ameneh; Safari, Yahya

2018-08-01

Evidence-based medicine (EBM) is defining proper and wise use of the best evidence in clinical decision for patient׳s care. This study have done with the aim of evaluating health information system for decision-making with EBM approach in educational hospital of Kermanshah city. The statistical population include all the specialist and specialty, and also head nurses of educational hospitals in Kermanshah city. The data collected by researcher made questionnaire. The content validities of the questionnaire were confirmed by experts to complete the questions of the questionnaire. Then, the reliability of the questionnaire was evaluated using the Cronbach׳s alpha coefficient. The results have showed that the accessibility rate to the internet sources is in desirable level. The results have showed that there was a significant difference at least in one group between the availability of hospital information system EBM establishment in terms of accessing to the internet based data, according to the academic major ( P = 0.021 ). The sufficiency of hospital information system in evidence-based medicine establishment in terms of necessary knowledge for implementing it according to the educational major have showed a significant statistical difference at least in one group ( P = 0.001 ). Kermanshah׳s hospital have a desirable condition in terms of accessibility to the internet sources, knowledge of EBM and its implementation which this have showed the availability of desirable platform for decision-making with the EBM approach. However, it is better to implement regulate educational periods for educating the doctors and nurses in order to reach practical implementation of the EBM approach.

Use of online health information to manage children's health care: a prospective study investigating parental decisions.

PubMed

Walsh, Anne M; Hamilton, Kyra; White, Katherine M; Hyde, Melissa K

2015-04-02

The use of the internet to access information is rapidly increasing; however, the quality of health information provided on various online sites is questionable. We aimed to examine the underlying factors that guide parents' decisions to use online information to manage their child's health care, a behaviour which has not yet been explored systematically. Parents (N = 391) completed a questionnaire assessing the standard theory of planned behaviour (TPB) measures of attitude, subjective norm, perceived behavioural control (PBC), and intention as well as the underlying TPB belief-based items (i.e., behavioural, normative, and control beliefs) in addition to a measure of perceived risk and demographic variables. Two months later, consenting parents completed a follow-up telephone questionnaire which assessed the decisions they had made regarding their use of online information to manage their child's health care during the previous 2 months. We found support for the TPB constructs of attitude, subjective norm, and PBC as well as the additional construct of perceived risk in predicting parents' intentions to use online information to manage their child's health care, with further support found for intentions, but not PBC, in predicting parents' behaviour. The results of the TPB belief-based analyses also revealed important information about the critical beliefs that guide parents' decisions to engage in this child health management behaviour. This theory-based investigation to understand parents' motivations and online information-seeking behaviour is key to developing recommendations and policies to guide more appropriate help-seeking actions among parents.

The potential of Web-based interventions for heart disease self-management: a mixed methods investigation.

PubMed

Kerr, Cicely; Murray, Elizabeth; Noble, Lorraine; Morris, Richard; Bottomley, Christian; Stevenson, Fiona; Patterson, David; Peacock, Richard; Turner, Indra; Jackson, Keith; Nazareth, Irwin

2010-12-02

Existing initiatives to support patient self-management of heart disease do not appear to be reaching patients most in need. Providing self-management programs over the Internet (web-based interventions) might help reduce health disparities by reaching a greater number of patients. However, it is unclear whether they can achieve this goal and whether their effectiveness might be limited by the digital divide. To explore the effectiveness of a web-based intervention in decreasing inequalities in access to self-management support in patients with coronary heart disease (CHD). Quantitative and qualitative methods were used to explore use made of a web-based intervention over a period of 9 months. Patients with CHD, with or without home Internet access or previous experience using the Internet, were recruited from primary care centers in diverse socioeconomic and ethnic areas of North London, UK. Patients without home Internet were supported in using the intervention at public Internet services. Only 10.6% of eligible patients chose to participate (N=168). Participants were predominantly Caucasian well-educated men, with greater proportions of male and younger CHD patients among participants than were registered at participating primary care practices. Most had been diagnosed with CHD a number of years prior to the study. Relatively few had been newly diagnosed or had experienced a cardiac event in the previous 5 years. Most had home Internet access and prior experience using the Internet. A greater use of the intervention was observed in older participants (for each 5-year age increase, OR 1.25 for no, low or high intervention use, 95% CI, 1.06-1.47) and in those that had home Internet access and prior Internet experience (OR 3.74, 95% CI, 1.52-9.22). Less use was observed in participants that had not recently experienced a cardiac event or diagnosis (≥ 5 years since cardiac event or diagnosis; OR 0.69, 95% CI, 0.50-0.95). Gender and level of education were not statistically related to level of use of the intervention. Data suggest that a recent cardiac event or diagnosis increased the need for information and advice in participants. However, participants that had been diagnosed several years ago showed little need for information and support. The inconvenience of public Internet access was a barrier for participants without home Internet access. The use of the intervention by participants with little or no Internet experience was limited by a lack of confidence with computers and discomfort with asking for assistance. It was also influenced by the level of participant need for information and by their perception of the intervention. The availability of a web-based intervention, with support for use at home or through public Internet services, did not result in a large number or all types of patients with CHD using the intervention for self-management support. The effectiveness of web-based interventions for patients with chronic diseases remains a significant challenge.

Emergence of a new consumer health informatics framework: introducing the healthcare organization.

PubMed

Reid, Paulette; Borycki, Elizabeth M

2011-01-01

Healthcare consumers are increasingly seeking reliable forms of health information on the Internet that can be used to support health related decision-making. Frameworks that have been developed and tested in the field of health informatics have attempted to describe the effects of the Internet upon the health care consumer and physician relationship. More recently, health care organizations are responding by providing information such as hospital wait lists or strategies for self-managing disease, and this information is being provided on organizational web-sites. The authors of this paper propose that current conceptualizations of the relationship between the Internet, physicians and patients are limited from a consumer informatics perspective and may need to be extended to include healthcare organizations.

Combining iGoogle and personal health records to create a prototype personal health application for diabetes self-management.

PubMed

Fonda, Stephanie J; Kedziora, Richard J; Vigersky, Robert A; Bursell, Sven-Erik

2010-05-01

The aim of this project is to create a prototype for a personal health application (PHA) for patients (i.e., consumers) with diabetes by employing a user-centered design process. This article describes the design process for and resulting architecture, workflow, and functionality of such a PHA. For the design process, we conducted focus groups with people who have diabetes (n = 21) to ascertain their needs for a PHA. We then developed a prototype in response to these needs, and through additional focus groups and step-by-step demonstrations for people with diabetes as well as healthcare providers, we obtained feedback about the prototype. The feedback led to changes in the PHA's presentation and function. Focus group participants said they wanted a tool that could give them timely, readily available information on how diabetes-related domains interact, how their behaviors affect them, and what to do next. Thus, the prototype PHA is Internet-based, retrieves data for diabetes self-management from a personal health record, displays those data using gadgets in the consumer's iGoogle page, and makes the data available to a decision-support component that provides lifestyle-oriented advice. Manipulation of the data enables consumers to anticipate the results of future actions and to see interrelationships. A user-centered design process resulted in a PHA that uses technology that is publicly available, employs a personal health record, and is Internet based. This PHA can provide the backbone for a decision support system that can bring together the cornerstones of diabetes self-management and integrate them into the life of the person with diabetes.

An education intervention to improve health literacy and decision making about supporting self-care among older Australians: a study protocol for a randomised controlled trial.

PubMed

Smith, Caroline A; Chang, Esther; Gallego, Gisselle; Balneaves, Lynda G

2017-09-26

Older Australians are high consumers of complementary and alternative medicines (CM). To help older people to take an active role in their health, we will develop and evaluate a novel educational intervention to support decision self-efficacy, and improve health literacy skills. The primary hypothesis is that participants receiving a web/DVD plus booklet intervention compared with a booklet-only group will demonstrate an increase in decision self-efficacy. This study is a randomised controlled trial. One hundred and sixty-eight people aged 65 years and older will be recruited from community settings comprising retirement villages and community groups, based in Sydney, Australia. Participants will be randomly allocated to either the education intervention delivered by the Internet or a DVD plus booklet versus a control group (booklet only). The primary outcome measure is CM decision self-efficacy. Secondary outcomes are health literacy, knowledge and attitudes, and change in health-seeking behaviour. Participants' views on the ease of using the resources, the length of the modules, the amount of information, and participant understanding of the modules will be assessed. Outcomes will be collected on completion of the intervention at 3 weeks, and at a 2-month follow up from trial entry. This trial has the potential to improve CM health literacy in older Australians. There are no educational resources designed to support decision self-efficacy and improve health literacy amongst older people related to CM. Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12616000135415 . Registered on 5 February 2016.

Performance measurement integrated information framework in e-Manufacturing

NASA Astrophysics Data System (ADS)

Teran, Hilaida; Hernandez, Juan Carlos; Vizán, Antonio; Ríos, José

2014-11-01

The implementation of Internet technologies has led to e-Manufacturing technologies becoming more widely used and to the development of tools for compiling, transforming and synchronising manufacturing data through the Web. In this context, a potential area for development is the extension of virtual manufacturing to performance measurement (PM) processes, a critical area for decision making and implementing improvement actions in manufacturing. This paper proposes a PM information framework to integrate decision support systems in e-Manufacturing. Specifically, the proposed framework offers a homogeneous PM information exchange model that can be applied through decision support in e-Manufacturing environment. Its application improves the necessary interoperability in decision-making data processing tasks. It comprises three sub-systems: a data model, a PM information platform and PM-Web services architecture. A practical example of data exchange for measurement processes in the area of equipment maintenance is shown to demonstrate the utility of the model.

76 FR 588 - Comment Request for Information Collection for Workforce Information Grants to States Application...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-05

...-making, support consultations with strategic partners, and leverage limited WI program grant resources... analysis, information disseminated via the Internet and other means to inform workforce investment decision-making. At the same time, ETA intends to retain a high level of state flexibility, and maintain the...

The internet as a source of information used by women after childbirth to meet their need for information: A web-based survey.

PubMed

Slomian, J; Bruyère, O; Reginster, J Y; Emonts, P

2017-05-01

the aims of this survey were: (a) to evaluate the need of information after childbirth and what questions do 'new' mothers ask themselves; (b) to assess why and how women use the Internet to meet their need of information; (c) to describe how the respondents evaluate the reliability of the information found; (d) to understand how the information found on the Internet affects women's decision-making; and (e) to appreciate how health professionals react to the information found by the women. this study used a large web-based survey that was widely broadcasted on various websites and social networks. belgian women who had a child under 2 years old and who agreed to participate were included in the study. 349 questionnaires were valid for analyses. After childbirth, 90.5% of women admitted to using the Internet to seek information about themselves or about their baby, regardless of socioeconomic status or age. There were various reasons for seeking information on the Internet, but the most frequent reason the women expressed was to find information 'on their own' (88.1%). The most searched for topic was breastfeeding. The women believed that the information was quite useful (82.7%) but they assigned an average score of 5.3 out of 10 for the quality of the information they found on the Internet. Approximately 80% of the women felt that the Internet helped them control a decision that they made 'a little', 'often' or 'very often'. Professionals are not always willing to talk about information found on the Internet with mothers. Therefore, many women believed that health professionals should suggest reliable Internet websites for new mothers. the integration of the Internet and new technologies could be a useful tool during postpartum management. Copyright © 2017 Elsevier Ltd. All rights reserved.

A transmission security framework for email-based telemedicine.

PubMed

Caffery, Liam J; Smith, Anthony C

2010-01-01

Encryption is used to convert an email message to an unreadable format thereby securing patient privacy during the transmission of the message across the Internet. Two available means of encryption are: public key infrastructure (PKI) used in conjunction with ordinary email and secure hypertext transfer protocol (HTTPS) used by secure web-mail applications. Both of these approaches have advantages and disadvantages in terms of viability, cost, usability and compliance. The aim of this study was develop an instrument to identify the most appropriate means of encrypting email communication for telemedicine. A multi-method approach was used to construct the instrument. Technical assessment and existing bodies of knowledge regarding the utility of PKI were analyzed, along with survey results from users of Queensland Health's Child and Youth Mental Health Service secure web-mail service. The resultant decision support model identified that the following conditions affect the choice of encryption technology: correspondent's risk perception, correspondent's identification to the security afforded by encryption, email-client used by correspondents, the tolerance to human error and the availability of technical resources. A decision support model is presented as a flow chart to identify the most appropriate encryption for a specific email-based telemedicine service.

Perspectives from the Patient and the Healthcare Professional in Multiple Sclerosis: Social Media and Participatory Medicine.

PubMed

Kantor, Daniel; Bright, Jeremy R; Burtchell, Jeri

2018-06-01

When faced with a diagnosis of multiple sclerosis (MS), patients often turn to the Internet and social media to find support groups, read about the experiences of other people affected by MS and seek their advice, and research their condition and treatment options to discuss with their healthcare professionals (HCPs). Here, we examine the use of social media and the Internet among patients with MS, considering its impact on patient empowerment and patient participation in treatment decision-making and MS research. These themes are exemplified with first-hand experiences of the patient author. We also explore the impact of the Internet and social media on the management of patients from the perspective of HCPs, including new opportunities for HCPs to engage in participatory medicine and to improve communication with and among patients. We consider both the benefits afforded to and the potential pitfalls faced by HCPs when interacting with their patients via these routes, and discuss potential concerns around privacy and confidentiality in the use of the Internet and social media in the clinical context. Communication online is driving the evolution of the patient-HCP relationship, and is empowering patients to participate more actively in the decision-making process relating to the provision of their health care. Funding Novartis Pharmaceuticals Corporation.

Parental Decision Making about Technology and Quality in Child Care Programs

ERIC Educational Resources Information Center

Rose, Katherine K.; Vittrup, Brigitte; Leveridge, Tinney

2013-01-01

Background: This study investigated parental decision making about non-parental child care programs based on the technological and quality components of the program, both child-focused and parent-focused. Child-focused variables related to children's access to technology such as computers, educational television programming, and the internet.…

An Internet-based program for depressive symptoms using human and automated support: a randomized controlled trial

PubMed Central

Mira, Adriana; Bretón-López, Juana; García-Palacios, Azucena; Quero, Soledad; Baños, Rosa María; Botella, Cristina

2017-01-01

Purpose The purpose of this study was to analyze the efficacy of an Internet-based program for depressive symptoms using automated support by information and communication technologies (ICTs) and human support. Patients and methods An Internet-based program was used to teach adaptive ways to cope with depressive symptoms and daily problems. A total of 124 participants who were experiencing at least one stressful event that caused interference in their lives, many of whom had clinically significant depressive symptoms, were randomly assigned into either an intervention group with ICT support (automated mobile phone messages, automated emails, and continued feedback through the program); an intervention group with ICT support plus human support (brief weekly support phone call without clinical content); or a waiting-list control. At pre-, post-, and 12-month follow-up, they completed depression, anxiety, positive and negative effect, and perceived stress measures. Results were analyzed using both intention-to-treat and completers data. The majority were women (67.7%), with a mean age of 35.6 years (standard deviation =9.7). Results The analysis showed that the two intervention groups improved significantly pre- to posttreatment, compared with the control group. Furthermore, improvements were maintained at the 12-month follow-up. Adherence and satisfaction with the program was high in both conditions. Conclusion The Internet-based program was effective and well accepted, with and without human support, showing that ICT-based automated support may be useful. It is essential to continue to study other ICT strategies for providing support. PMID:28408833

Web-based interventions for menopause: A systematic integrated literature review.

PubMed

Im, Eun-Ok; Lee, Yaelim; Chee, Eunice; Chee, Wonshik

2017-01-01

Advances in computer and Internet technologies have allowed health care providers to develop, use, and test various types of Web-based interventions for their practice and research. Indeed, an increasing number of Web-based interventions have recently been developed and tested in health care fields. Despite the great potential for Web-based interventions to improve practice and research, little is known about the current status of Web-based interventions, especially those related to menopause. To identify the current status of Web-based interventions used in the field of menopause, a literature review was conducted using multiple databases, with the keywords "online," "Internet," "Web," "intervention," and "menopause." Using these keywords, a total of 18 eligible articles were analyzed to identify the current status of Web-based interventions for menopause. Six themes reflecting the current status of Web-based interventions for menopause were identified: (a) there existed few Web-based intervention studies on menopause; (b) Web-based decision support systems were mainly used; (c) there was a lack of detail on the interventions; (d) there was a lack of guidance on the use of Web-based interventions; (e) counselling was frequently combined with Web-based interventions; and (f) the pros and cons were similar to those of Web-based methods in general. Based on these findings, directions for future Web-based interventions for menopause are provided. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Information search in health care decision-making: a study of word-of-mouth and internet information users.

PubMed

Snipes, Robin L; Ingram, Rhea; Jiang, Pingjun

2005-01-01

This paper investigates how individual consumers may differ in their information search behavior in health care decision-making. Results indicate that most consumers still use word-of-mouth as a primary information source for health care decisions. However, usage of the Internet is increasing. The results of this study indicate that consumers who are most likely to use the Internet for health care information are single, younger, and less educated, whereas consumers who are most likely to use word-of-mouth are middle-aged, married, with higher income and higher education. Surprisingly, no significant gender difference was found in information search behavior for health care decision-making. The results also suggest that consumers with the highest tendency to use word-of-mouth are also the lowest users of the Internet in health care decision-making. Implications of these findings are discussed.

Development of a GIService based on spatial data mining for location choice of convenience stores in Taipei City

NASA Astrophysics Data System (ADS)

Jung, Chinte; Sun, Chih-Hong

2006-10-01

Motivated by the increasing accessibility of technology, more and more spatial data are being made digitally available. How to extract the valuable knowledge from these large (spatial) databases is becoming increasingly important to businesses, as well. It is essential to be able to analyze and utilize these large datasets, convert them into useful knowledge, and transmit them through GIS-enabled instruments and the Internet, conveying the key information to business decision-makers effectively and benefiting business entities. In this research, we combine the techniques of GIS, spatial decision support system (SDSS), spatial data mining (SDM), and ArcGIS Server to achieve the following goals: (1) integrate databases from spatial and non-spatial datasets about the locations of businesses in Taipei, Taiwan; (2) use the association rules, one of the SDM methods, to extract the knowledge from the integrated databases; and (3) develop a Web-based SDSS GIService as a location-selection tool for business by the product of ArcGIS Server.

Logistics Response to the Industry 4.0: the Physical Internet

NASA Astrophysics Data System (ADS)

Maslarić, Marinko; Nikoličić, Svetlana; Mirčetić, Dejan

2016-11-01

Today's mankind and all human activities are constantly changing and evolving in response to changes in technology, social and economic environments and climate. Those changes drive a "new" way of manufacturing industry. That novelty could be described as the organization of production processes based on technology and devices autonomously communicating with each other along the value chain. Decision-makers have to address this novelty (usually named as Industry 4.0) and try to develop appropriate information systems, physical facilities, and different kind of technologies capable of meeting the future needs of economy. As a consequence, there is a need for new paradigms of the way freight is move, store, realize, and supply through the world (logistics system). One of the proposed solutions is the Physical Internet, concept of open global logistics system which completely redefines current supply chain configuration, business models, and value-creation patterns.However, further detailed research on this topic is much needed. This paper aims to provide a balanced review of the variety of views considered among professionals in the field of Physical Internet with the final aim to identify the biggest challenges (technological, societal, business paradigm) of proposed new logistics paradigm as a practical solution in supporting Industry 4.0.

Psychotropics without borders: ethics and legal implications of internet-based access to psychiatric medications.

PubMed

Klein, Carolina A

2011-01-01

Medical practitioners are revisiting many of the ethics and the legal implications surrounding the clinical frameworks within which we operate. In today's world, distinguishing between virtual and physical reality continues to be increasingly difficult. The physician may be found grappling with the decision of whether to continue to treat a patient who may be obtaining psychotropic medications through the Internet. This article approaches some of the clinical and legal implications and the ethics regarding the availability of prescription psychotropics over the Internet.

An Evaluation of Healthcare Information on the Internet: The Case of Colorectal Cancer Prevention

PubMed Central

Chen, Chia-Ching; Yamada, Tetsuji; Smith, John

2014-01-01

Health information, provided through the Internet, has recently received attention from consumers and healthcare providers as an efficient method of motivating people to get screened for colorectal cancer (CRC). In this study, the primary purpose was to investigate the extent to which consumers were better educated about CRC screening information because of the information available on the Internet. Another purpose was to identify how better-informed consumers, with reliable and trustworthy health information, were enabled to make sound decisions regarding CRC screening. The data used in this study was taken from the 2003 Health Information National Trends Survey. People aged 55 and older were classified based on their compliance with recommended CRC screening. The study applied the PRECEDE-PROCEED model to evaluate the effects of health information taken from the Internet regarding CRC screening. The credibility and reliance of cancer related information on the Internet was significantly associated with patient compliance to be screened for CRC. Experience and knowledge of Internet use had a significant impact on the utilization of CRC screening. This analysis suggests that the design and publishing websites concerning CRC should emphasize credibility and reliance. Websites providing information about CRC must also contain the most current information so that people are able to make educated decisions about CRC screening. PMID:24424284

Cloud-Based Data Sharing Connects Emergency Managers

NASA Technical Reports Server (NTRS)

2014-01-01

Under an SBIR contract with Stennis Space Center, Baltimore-based StormCenter Communications Inc. developed an improved interoperable platform for sharing geospatial data over the Internet in real time-information that is critical for decision makers in emergency situations.

Risk-taking and decision-making in youth: relationships to addiction vulnerability.

PubMed

Balogh, Kornelia N; Mayes, Linda C; Potenza, Marc N

2013-03-01

Decision-making and risk-taking behavior undergo developmental changes during adolescence. Disadvantageous decision-making and increased risk-taking may lead to problematic behaviors such as substance use and abuse, pathological gambling and excessive internet use. Based on MEDLINE searches, this article reviews the literature on decision-making and risk-taking and their relationship to addiction vulnerability in youth. Decision-making and risk-taking behaviors involve brain areas that undergoing developmental changes during puberty and young adulthood. Individual differences and peer pressure also relate importantly to decision-making and risk-taking. Brain-based changes in emotional, motivational and cognitive processing may underlie risk-taking and decision-making propensities in adolescence, making this period a time of heightened vulnerability for engagement in additive behaviors.

48 CFR 6105.505 - Decisions [Rule 505].

Code of Federal Regulations, 2010 CFR

2010-10-01

... agency and the affected employee, and information provided during conferences. The agency and the... addition, all Board decisions are posted weekly on the Internet. The Board's Internet address is: http...

Web-Based Medical Appointment Systems: A Systematic Review.

PubMed

Zhao, Peng; Yoo, Illhoi; Lavoie, Jaie; Lavoie, Beau James; Simoes, Eduardo

2017-04-26

Health care is changing with a new emphasis on patient-centeredness. Fundamental to this transformation is the increasing recognition of patients' role in health care delivery and design. Medical appointment scheduling, as the starting point of most non-urgent health care services, is undergoing major developments to support active involvement of patients. By using the Internet as a medium, patients are given more freedom in decision making about their preferences for the appointments and have improved access. The purpose of this study was to identify the benefits and barriers to implement Web-based medical scheduling discussed in the literature as well as the unmet needs under the current health care environment. In February 2017, MEDLINE was searched through PubMed to identify articles relating to the impacts of Web-based appointment scheduling. A total of 36 articles discussing 21 Web-based appointment systems were selected for this review. Most of the practices have positive changes in some metrics after adopting Web-based scheduling, such as reduced no-show rate, decreased staff labor, decreased waiting time, and improved satisfaction, and so on. Cost, flexibility, safety, and integrity are major reasons discouraging providers from switching to Web-based scheduling. Patients' reluctance to adopt Web-based appointment scheduling is mainly influenced by their past experiences using computers and the Internet as well as their communication preferences. Overall, the literature suggests a growing trend for the adoption of Web-based appointment systems. The findings of this review suggest that there are benefits to a variety of patient outcomes from Web-based scheduling interventions with the need for further studies. ©Peng Zhao, Illhoi Yoo, Jaie Lavoie, Beau James Lavoie, Eduardo Simoes. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 26.04.2017.

Teaching with the Internet: Lessons from the Classroom.

ERIC Educational Resources Information Center

Leu, Donald J., Jr.; Leu, Deborah Diadiun; Len, Katherine R.

This book is designed to give teachers ideas about how to effectively integrate the Internet into the classroom, based on teaching practices throughout the world. The book is organized three sections. The first section provides an introduction to Internet use and applications. Chapters include the potential of the Internet to support learning,…

Quantifying and Mapping Global Data Poverty.

PubMed

Leidig, Mathias; Teeuw, Richard M

2015-01-01

Digital information technologies, such as the Internet, mobile phones and social media, provide vast amounts of data for decision-making and resource management. However, access to these technologies, as well as their associated software and training materials, is not evenly distributed: since the 1990s there has been concern about a "Digital Divide" between the data-rich and the data-poor. We present an innovative metric for evaluating international variations in access to digital data: the Data Poverty Index (DPI). The DPI is based on Internet speeds, numbers of computer owners and Internet users, mobile phone ownership and network coverage, as well as provision of higher education. The datasets used to produce the DPI are provided annually for almost all the countries of the world and can be freely downloaded. The index that we present in this 'proof of concept' study is the first to quantify and visualise the problem of global data poverty, using the most recent datasets, for 2013. The effects of severe data poverty, particularly limited access to geoinformatic data, free software and online training materials, are discussed in the context of sustainable development and disaster risk reduction. The DPI highlights countries where support is needed for improving access to the Internet and for the provision of training in geoinfomatics. We conclude that the DPI is of value as a potential metric for monitoring the Sustainable Development Goals of the Sendai Framework for Disaster Risk Reduction.

The AgESGUI geospatial simulation system for environmental model application and evaluation

USDA-ARS?s Scientific Manuscript database

Practical decision making in spatially-distributed environmental assessment and management is increasingly being based on environmental process-based models linked to geographical information systems (GIS). Furthermore, powerful computers and Internet-accessible assessment tools are providing much g...

Status of the recommendations on the African cyberinfrastructure expressed by the scientific community written in 2007

NASA Astrophysics Data System (ADS)

Petitdidier, M.

2009-04-01

In today's Information Age, an effective cyber-infrastructure and Internet access underpins development and human welfare by strengthening education and training, expanding science, technology and innovation capability, opening up collaboration opportunities with the rest of the world, and generating the knowledge base for decision-making. Poor Internet connectivity prevents many countries in Africa, especially Sub-Saharan ones, from taking advantage of these opportunities. There are many initiatives from local, governmental, African, European and international organisations to promote, survey and fund networking. The eGY (electronic Geophysical Year) and Sharing Knowledge Foundation initiatives are based on African scientific communities, and are complementary of other initiatives. Their bottom-up role is twofold: firstly to motivate and support the scientists in each country (1) to ask their government or organisations for a better Internet for research and for education and (2) to organize themselves to welcome new technologies, secondly to promote a better cyber-infrastructure for their universities towards international organisations. In 2007 during the IHY workshop that gathered African scientists from 20 countries eGY provided the results of the questionnaire sent to all the participants to describe the status of internet in the Universities and Research institutes. Then recommendations were written. In 2007 Sharing the knowledge foundation organized a meeting devoted to internet and Grids in Africa. The participants, scientists, industrialists and members of NGO originating from 14 countries wrote also recommendations. In 2009 the presentation in this session of R.L.A Cottrell and U. Kalim will provide an overview of the evolution of the networking. In parallel to the improvement of internet the development of scientific collaboration among African countries and with Europe by using ICT was considered as an essential point. This presentation will be focused on the recommendations, different achievements and plans (see presentation in this section by V. Ardizzone et al.) .

Precision Agriculture Design Method Using a Distributed Computing Architecture on Internet of Things Context.

PubMed

Ferrández-Pastor, Francisco Javier; García-Chamizo, Juan Manuel; Nieto-Hidalgo, Mario; Mora-Martínez, José

2018-05-28

The Internet of Things (IoT) has opened productive ways to cultivate soil with the use of low-cost hardware (sensors/actuators) and communication (Internet) technologies. Remote equipment and crop monitoring, predictive analytic, weather forecasting for crops or smart logistics and warehousing are some examples of these new opportunities. Nevertheless, farmers are agriculture experts but, usually, do not have experience in IoT applications. Users who use IoT applications must participate in its design, improving the integration and use. In this work, different industrial agricultural facilities are analysed with farmers and growers to design new functionalities based on IoT paradigms deployment. User-centred design model is used to obtain knowledge and experience in the process of introducing technology in agricultural applications. Internet of things paradigms are used as resources to facilitate the decision making. IoT architecture, operating rules and smart processes are implemented using a distributed model based on edge and fog computing paradigms. A communication architecture is proposed using these technologies. The aim is to help farmers to develop smart systems both, in current and new facilities. Different decision trees to automate the installation, designed by the farmer, can be easily deployed using the method proposed in this document.

Perspectives from the Patient and the Healthcare Professional in Multiple Sclerosis: Social Media and Patient Education.

PubMed

Kantor, Daniel; Bright, Jeremy R; Burtchell, Jeri

2018-06-01

A diagnosis of multiple sclerosis (MS) is life-altering. Because the course of MS is heterogeneous, patients may face uncertainty in terms of long-term physical and cognitive challenges, potential loss of employment, and the risk of social isolation. Patients often turn to the Internet and social media for information about MS and its management, and to seek out fellow patients and support groups. Here, we examine the use of social media and the Internet among patients with MS, considering its impact on patient education. We consider the access that these conduits provide not only to other patients with MS but also to a wealth of disease-related information online. These themes are further illustrated with first-hand experiences of the patient author and her physician. We also explore the impact of the Internet and social media on the education and support of patients with MS from the healthcare professional's (HCP's) perspective, including opportunities for HCPs to promote disease education among their patients, and the advantages that arise from patients being better informed about their disease. The rise of the Internet and social media has changed the patient experience, helping patients to support each other, to educate themselves proactively about their condition, and to participate more actively in decisions relating to disease management than perhaps was the case historically. Funding Novartis Pharmaceuticals Corporation.

A Planning Framework for the Deployment of Innovative Information and Communication Technologies in Procurement

NASA Astrophysics Data System (ADS)

Alard, Robert; Gustafsson, Martin; Nienhaus, Jörg

The management of buyer-supplier relations is a major topic for many enterprises today. Modern Information and Communication Technologies (ICT) offer interesting perspectives on opportunities and implementation approaches. Today, logistics and procurement departments of numerous enterprises are evaluating the possibilities and opportunities of new ICT solutions and especially of internet-based electronic procurement solutions for the optimisation and re-engineering of their buyer-supplier relationships. Due to the highly innovative character of the new ICT solutions and the scarcely available operational examples in the industry, only little guidance exists to support responsible managers during the evaluation, planning and designing of internet-based electronic procurement solutions. This paper describes a framework for the strategic evaluation and planning of the deployment of internet-based procurement solutions for direct materials. The presented approach supports enterprises in the analysis of procurement objects and procurement structuring, in the definition and management of buyer-supplier-relationships, in the requirements analysis of ICT solutions as well as the assessment of the potential to support procurement with innovative ICT and internet-based electronic procurement solutions.

The Implementation of Internet Interventions for Depression: A Scoping Review.

PubMed

Drozd, Filip; Vaskinn, Linda; Bergsund, Hans Bugge; Haga, Silje Marie; Slinning, Kari; Bjørkli, Cato Alexander

2016-09-08

Depression is one of the most common mental health problems among adults, but effective treatments are not widely accessible. The Internet holds promise as a cost-effective and convenient delivery platform of interventions for depression. However, studies suggest that Internet interventions are not widely available in routine settings. The aim of this study was to review the literature and examine whether there are systematic differences in reporting of the various implementation components on Internet interventions for depression, and then to examine what is known about and is characteristic of the implementation of these Internet interventions in regular care settings. We performed a scoping review, drawing upon a broad range of the literature on Internet interventions for depression in regular care, and used the active implementation framework to extract data. Overall, the results suggested that knowledge about the implementation of Internet interventions for depression in regular care is limited. However, guided support from health professionals emphasizing program adherence and recruitment of end users to the interventions emerged as 2 main themes. We identified 3 additional themes among practitioners, including their qualifications, training, and supervision, but these were scarcely described in the literature. The competency drivers (ie, staff and user selection, training, and supervision) have received the most attention, while little attention has been given to organizational (ie, decision support, administration, and system intervention) and leadership drivers. Research has placed little emphasis on reporting on the implementation of interventions in practice. Leadership and organizational drivers, in particular, have been largely neglected. The results of this scoping review have implications for future research and efforts to successfully implement Internet interventions for depression in regular care.

The Implementation of Internet Interventions for Depression: A Scoping Review

PubMed Central

Vaskinn, Linda; Bergsund, Hans Bugge; Haga, Silje Marie; Slinning, Kari; Bjørkli, Cato Alexander

2016-01-01

Background Depression is one of the most common mental health problems among adults, but effective treatments are not widely accessible. The Internet holds promise as a cost-effective and convenient delivery platform of interventions for depression. However, studies suggest that Internet interventions are not widely available in routine settings. Objective The aim of this study was to review the literature and examine whether there are systematic differences in reporting of the various implementation components on Internet interventions for depression, and then to examine what is known about and is characteristic of the implementation of these Internet interventions in regular care settings. Methods We performed a scoping review, drawing upon a broad range of the literature on Internet interventions for depression in regular care, and used the active implementation framework to extract data. Results Overall, the results suggested that knowledge about the implementation of Internet interventions for depression in regular care is limited. However, guided support from health professionals emphasizing program adherence and recruitment of end users to the interventions emerged as 2 main themes. We identified 3 additional themes among practitioners, including their qualifications, training, and supervision, but these were scarcely described in the literature. The competency drivers (ie, staff and user selection, training, and supervision) have received the most attention, while little attention has been given to organizational (ie, decision support, administration, and system intervention) and leadership drivers. Conclusions Research has placed little emphasis on reporting on the implementation of interventions in practice. Leadership and organizational drivers, in particular, have been largely neglected. The results of this scoping review have implications for future research and efforts to successfully implement Internet interventions for depression in regular care. PMID:27608548

Internet TV set-top devices for web-based projects: smooth sailing or rough surfing?

PubMed Central

Johnson, K. B.; Ravert, R. D.; Everton, A.

1999-01-01

BACKGROUND: The explosion of projects utilizing the World Wide Web in the home environment offer a select group of patients a tremendous tool for information management and health-related support. However, many patients do not have ready access to the Internet in their homes. For these patients, Internet TV set-top devices may provide a low cost alternative to PC-based web browsers. METHODS: As a part of a larger descriptive study providing adolescents with access to an on-line support group, we investigated the feasibility of using an Internet TV set-top device for those patients in need of Internet access. RESULTS: Although the devices required some configuration before being installed in the home environment, they required a minimum of support and were well accepted by these patients. However, these patients used the Internet less frequently than their peers with home personal computers--most likely due to a lack of easy availability of the telephone or television at all times. CONCLUSION: Internet TV set-top devices represent a feasible alternative access to the World Wide Web for some patients. Any attempt to use these devices should, however, be coupled with education to all family members, and an attempt at providing a dedicated television and phone line. Images p537-a Figure 2 PMID:10566416

Internet TV set-top devices for web-based projects: smooth sailing or rough surfing?

PubMed

Johnson, K B; Ravert, R D; Everton, A

1999-01-01

The explosion of projects utilizing the World Wide Web in the home environment offer a select group of patients a tremendous tool for information management and health-related support. However, many patients do not have ready access to the Internet in their homes. For these patients, Internet TV set-top devices may provide a low cost alternative to PC-based web browsers. As a part of a larger descriptive study providing adolescents with access to an on-line support group, we investigated the feasibility of using an Internet TV set-top device for those patients in need of Internet access. Although the devices required some configuration before being installed in the home environment, they required a minimum of support and were well accepted by these patients. However, these patients used the Internet less frequently than their peers with home personal computers--most likely due to a lack of easy availability of the telephone or television at all times. Internet TV set-top devices represent a feasible alternative access to the World Wide Web for some patients. Any attempt to use these devices should, however, be coupled with education to all family members, and an attempt at providing a dedicated television and phone line.

Intranet usage and potential in acute care hospitals in the United States: survey-2000.

PubMed

Hatcher, M

2001-12-01

This paper provides the results of the Survey-2000 measuring Intranet and its potential in health care. The survey measured the levels of Internet and Intranet existence and usage in acute care hospitals. Business-to-business electronic commerce and electronic commerce for customers were measured. Since the Intranet was not studied in survey-1997, no comparisons could be made. Therefore the results were presented and discussed. The Intranet data were compared with the Internet data and statistically significant differences were presented and analyzed. This information will assist hospitals to plan Internet and Intranet technology. This is the third of three articles based upon the results of the Survey-2000. Readers are referred to prior articles by the author, which discusses the survey design and provides a tutorial on technology transfer in acute care hospitals.(1) The first article based upon the survey results discusses technology transfer, system design approaches, user involvement, and decision-making purposes. (2) The second article based upon the survey results discusses distribution of Internet usage and rating of Internet usage applied to specific applications. Homepages, advertising, and electronic commerce are discussed from an Internet perspective.

Internet use for prediagnosis symptom appraisal by colorectal cancer patients.

PubMed

Thomson, Maria D; Siminoff, Laura A; Longo, Daniel R

2012-10-01

This study explored the characteristics of colorectal cancer (CRC) patients who accessed Internet-based health information as part of their symptom appraisal process prior to consulting a health care provider. Newly diagnosed CRC patients who experienced symptoms prior to diagnosis were interviewed. Brief COPE was used to measure patient coping. Logistic and linear regressions were used to assess Internet use and appraisal delay. Twenty-five percent of the sample (61/242) consulted the Internet prior to visiting a health care provider. Internet use was associated with having private health insurance (odds ratio [OR] = 2.55; 95% confidence interval [CI] = 1.20-5.43) and experiencing elimination symptoms (OR = 1.43; 95% CI = 1.14-1.80) and was marginally associated with age (OR = 0.96; 95% CI = 0.93-0.99). Internet use was not related to delayed medical care seeking. Internet use did not influence decisions to seek medical care. The Internet provided a preliminary information resource for individuals who experienced embarrassing CRC symptoms, had private health insurance, and were younger.

The Development of Delta: Using Agile to Develop a Decision Aid for Pediatric Oncology Clinical Trial Enrollment.

PubMed

Robertson, Eden G; Wakefield, Claire E; Cohn, Richard J; O'Brien, Tracey; Ziegler, David S; Fardell, Joanna E

2018-05-04

The internet is increasingly being used to disseminate health information. Given the complexity of pediatric oncology clinical trials, we developed Delta, a Web-based decision aid to support families deciding whether or not to enroll their child with cancer in a clinical trial. This paper details the Agile development process of Delta and user testing results of Delta. Development was iterative and involved 5 main stages: a requirements analysis, planning, design, development, and user testing. For user testing, we conducted 13 eye-tracking analyses and think-aloud interviews with health care professionals (n=6) and parents (n=7). Results suggested that there was minimal rereading of content and a high level of engagement in content. However, there were some navigational problems. Participants reported high acceptability (12/13) and high usability of the website (8/13). Delta demonstrates the utility for the use of Agile in the development of a Web-based decision aid for health purposes. Our study provides a clear step-by-step guide to develop a Web-based psychosocial tool within the health setting. ©Eden G Robertson, Claire E Wakefield, Richard J Cohn, Tracey O'Brien, David S Ziegler, Joanna E Fardell. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 04.05.2018.

Quality of online information to support patient decision-making in breast cancer surgery.

PubMed

Bruce, Jordan G; Tucholka, Jennifer L; Steffens, Nicole M; Neuman, Heather B

2015-11-01

Breast cancer patients commonly use the internet as an information resource. Our objective was to evaluate the quality of online information available to support patients facing a decision for breast surgery. Breast cancer surgery-related queries were performed (Google and Bing), and reviewed for content pertinent to breast cancer surgery. The DISCERN instrument was used to evaluate websites' structural components that influence publication reliability and ability of information to support treatment decision-making. Scores of 4/5 were considered "good." 45 unique websites were identified. Websites satisfied a median 5/9 content questions. Commonly omitted topics included: having a choice between breast conservation and mastectomy (67%) and potential for 2nd surgery to obtain negative margins after breast conservation (60%). Websites had a median DISCERN score of 2.9 (range 2.0-4.5). Websites achieved higher scores on structural criteria (median 3.6 [2.1-4.7]), with 24% rated as "good." Scores on supporting decision-making questions were lower (2.6 [1.3-4.4]), with only 7% scoring "good." Although numerous breast cancer-related websites exist, most do a poor job providing women with essential information necessary to actively participate in decision-making for breast cancer surgery. Providing easily- accessible, high-quality online information has the potential to significantly improve patients' experiences with decision-making. © 2015 Wiley Periodicals, Inc.

Implementation of Internet-based preventive interventions for depression and anxiety: role of support? The design of a randomized controlled trial

PubMed Central

Donker, Tara; van Straten, Annemieke; Riper, Heleen; Marks, Isaac; Andersson, Gerhard; Cuijpers, Pim

2009-01-01

Background Internet-based self-help is an effective preventive intervention for highly prevalent disorders, such as depression and anxiety. It is not clear, however, whether it is necessary to offer these interventions with professional support or if they work without any guidance. In case support is necessary, it is not clear which level of support is needed. This study examines whether an internet-based self-help intervention with a coach is more effective than the same intervention without a coach in terms of clinical outcomes, drop-out and economic costs. Moreover, we will investigate which level of support by a coach is more effective compared to other levels of support. Methods In this randomized controlled trial, a total of 500 subjects (18 year and older) from the general population with mild to moderate depression and/or anxiety will be assigned to one of five conditions: (1) web-based problem solving through the internet (self-examination therapy) without a coach; (2) the same as 1, but with the possibility to ask help from a coach on the initiative of the respondent (on demand, by email); (3) the same as 1, but with weekly scheduled contacts initiated by a coach (once per week, by email); (4) weekly scheduled contacts initiated by a coach, but no web-based intervention; (5) information only (through the internet). The interventions will consist of five weekly lessons. Primary outcome measures are symptoms of depression and anxiety. Secondary outcome measures are drop-out from the intervention, quality of life, and economic costs. Other secondary outcome measures that may predict outcome are also studied, e.g. client satisfaction and problem-solving skills. Measures are taken at baseline (pre-test), directly after the intervention (post-test, five weeks after baseline), 3 months later, and 12 months later. Analysis will be conducted on the intention-to-treat sample. Discussion This study aims to provide more insight into the clinical effectiveness, differences in drop-out rate and costs between interventions with and without support, and in particular different levels of support. This is important to know in relation to the dissemination of internet-based self-help interventions. Trial Registration Nederlands Trial Register (NTR): TC1355 PMID:19635128

A reconsideration of the gendered mechanisms of support in online interactions about testicular implants: a discursive approach.

PubMed

Seymour-Smith, Sarah

2013-01-01

Researchers have observed gender differences in the frequency of emotion language used in cancer forums, with men more likely to seek medical information and women more likely to seek social and emotional support (Blank, Schmidt, Vangsness, Monteiro, & Santagata, 2010; Seale, Ziebland, & Charteris-Black, 2006). The aim of this article was to investigate Internet support groups to examine the support mechanisms that men employed when deciding whether or not to have a testicular implant. The four longest threads about prostheses were taken from four separate testicular cancer online support forums (totaling a number of 129 posts). A discursive approach (Edwards & Potter, 2001) was employed in order to consider what support mechanisms were employed by men. Findings illustrate that men employed a number of discursive strategies in "doing" support, including assessments, attending to issues of accountability, humor, providing alternative information, constructing decisions as personal choices, reconstituting normality, and sanctioning "emotional" talk. The psychological benefits of online homosocial support are discussed, and it is suggested that clinicians recommend Internet support groups to men with testicular cancer in order to start the psychological healing process. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Risk-taking and decision-making in youth: relationships to addiction vulnerability

PubMed Central

Balogh, Kornelia N.; Mayes, Linda C.; Potenza, Marc N.

2013-01-01

Background Decision-making and risk-taking behavior undergo developmental changes during adolescence. Disadvantageous decision-making and increased risk-taking may lead to problematic behaviors such as substance use and abuse, pathological gambling and excessive internet use. Methods Based on MEDLINE searches, this article reviews the literature on decision-making and risk-taking and their relationship to addiction vulnerability in youth. Results Decision-making and risk-taking behaviors involve brain areas that undergoing developmental changes during puberty and young adulthood. Individual differences and peer pressure also relate importantly to decision-making and risk-taking. Conclusions Brain-based changes in emotional, motivational and cognitive processing may underlie risk-taking and decision-making propensities in adolescence, making this period a time of heightened vulnerability for engagement in additive behaviors. PMID:24294500

Transitions from biomedical to recovery-oriented practices in mental health: a scoping review to explore the role of Internet-based interventions.

PubMed

Strand, Monica; Gammon, Deede; Ruland, Cornelia M

2017-04-07

The Internet is transforming mental health care services by increasing access to, and potentially improving the quality of, care. Internet-based interventions in mental health can potentially play a role in transitions from biomedical to recovery-oriented research and practices, but an overview of what this may entail, current work, and issues that need addressing, is lacking. The objective of this study is to describe Internet-based recovery-oriented interventions (referred to as e-recovery) and current research, and to identify gaps and issues relevant to advancing recovery research and practices through opportunities provided by the Internet. Five iterative stages of a scoping review framework were followed in searching and analyzing the literature. A recovery framework with four domains and 16 themes was used to deductively code intervention characteristics according to their support for recovery-oriented practices. Only Internet-based interventions used in conjunction with ongoing care were included. Twenty studies describing six e-recovery interventions were identified and originated in Australia, Finland, the Netherlands, Norway and USA. The domain supporting personal recovery was most clearly reflected in interventions, whereas the last three domains, i.e., promoting citizenship, organizational commitment and working relationship were less evident. Support for the formulation and follow-up of personal goals and preferences, and in accessing peer-support, were the characteristics shared by most interventions. Three of the six studies that employed a comparison group used randomization, and none presented definitive findings. None used recovery-oriented frameworks or specific recovery outcome measures. Four of the interventions were specific to a diagnosis. Research about how technologies might aid in illuminating and shaping recovery processes is in its formative stages. We recommend that future e-recovery research and innovation attend to four dimensions: evidence-supported interventions, new knowledge about personal recovery, values-based approaches and Internet as a facilitator for organizational transformation. The incremental changes facilitated by e-recovery may help propel a shift in mental health care toward recovery-oriented practices.

Electronic Data Collection Options for Practice-Based Research Networks

PubMed Central

Pace, Wilson D.; Staton, Elizabeth W.

2005-01-01

PURPOSE We wanted to describe the potential benefits and problems associated with selected electronic methods of collecting data within practice-based research networks (PBRNs). METHODS We considered a literature review, discussions with PBRN researchers, industry information, and personal experience. This article presents examples of selected PBRNs’ use of electronic data collection. RESULTS Collecting research data in the geographically dispersed PBRN environment requires considerable coordination to ensure completeness, accuracy, and timely transmission of the data, as well as a limited burden on the participants. Electronic data collection, particularly at the point of care, offers some potential solutions. Electronic systems allow use of transparent decision algorithms and improved data entry and data integrity. These systems may improve data transfer to the central office as well as tracking systems for monitoring study progress. PBRNs have available to them a wide variety of electronic data collection options, including notebook computers, tablet PCs, personal digital assistants (PDAs), and browser-based systems that operate independent of or over the Internet. Tablet PCs appear particularly advantageous for direct patient data collection in an office environment. PDAs work well for collecting defined data elements at the point of care. Internet-based systems work well for data collection that can be completed after the patient visit, as most primary care offices do not support Internet connectivity in examination rooms. CONCLUSIONS When planning to collect data electronically, it is important to match the electronic data collection method to the study design. Focusing an inappropriate electronic data collection method onto users can interfere with accurate data gathering and may also anger PBRN members. PMID:15928215

Electronic data collection options for practice-based research networks.

PubMed

Pace, Wilson D; Staton, Elizabeth W

2005-01-01

We wanted to describe the potential benefits and problems associated with selected electronic methods of collecting data within practice-based research networks (PBRNs). We considered a literature review, discussions with PBRN researchers, industry information, and personal experience. This article presents examples of selected PBRNs' use of electronic data collection. Collecting research data in the geographically dispersed PBRN environment requires considerable coordination to ensure completeness, accuracy, and timely transmission of the data, as well as a limited burden on the participants. Electronic data collection, particularly at the point of care, offers some potential solutions. Electronic systems allow use of transparent decision algorithms and improved data entry and data integrity. These systems may improve data transfer to the central office as well as tracking systems for monitoring study progress. PBRNs have available to them a wide variety of electronic data collection options, including notebook computers, tablet PCs, personal digital assistants (PDAs), and browser-based systems that operate independent of or over the Internet. Tablet PCs appear particularly advantageous for direct patient data collection in an office environment. PDAs work well for collecting defined data elements at the point of care. Internet-based systems work well for data collection that can be completed after the patient visit, as most primary care offices do not support Internet connectivity in examination rooms. When planning to collect data electronically, it is important to match the electronic data collection method to the study design. Focusing an inappropriate electronic data collection method onto users can interfere with accurate data gathering and may also anger PBRN members.

The role of the internet on patient knowledge management, education, and decision-making.

PubMed

Ilic, Dragan

2010-01-01

E-health encompasses a broad range of health disciplines that use the Internet and associated technologies to deliver information and health services. Traditionally, patients have relied on the healthcare professional to provide relevant medical information to inform decision making on diagnosis and therapy. Patient education in the past has consisted of independently collated health information, disseminated predominantly in written and video formats. Greater accessibility to the Internet has provides a novel method for patients to access health information and play a greater role in decisions ultimately affecting their health. However, patients' ability to access, understand, and integrate this knowledge with their healthcare professional influences the extent to which such technologies are effective. This article provides an overview of the impact of the Internet on patient knowledge management, education, and its subsequent impact upon the medical decision-making process between the patient and clinician.

Online health information seeking: the influence of age, information trustworthiness, and search challenges.

PubMed

Miller, Lisa M Soederberg; Bell, Robert A

2012-04-01

The Internet holds great potential to support information gathering and decision making surrounding health education and self-care. Older adults, however, underutilize the Internet for health information searches relative to younger adults. The goal of the present study was to examine age differences in the role of trust and ease of search in predicting whether or not individuals use (adopters) or do notuse (nonadopters) the Internet to search for health information. We used logistic regressions todetermine whether there were age differences in the extent to which trust and ease of search predicted online health information searches within a nationally-representative sample of 3796 adults from the Health Information National Trends Survey (HINTS). Adopters were more trusting of Internet health informationthan nonadopters. However, a significant age by trust interaction indicated that this difference increased in magnitude with age, a pattern that held even after controlling for demographic and health variables. Older adults may benefit from special instructions designed to boost Internet trust, for example, learning how to distinguish between high and low quality health-related websites.

The fact and the fiction: A prospective study of internet forum discussions on vaginal breech birth.

PubMed

Petrovska, Karolina; Sheehan, Athena; Homer, Caroline S E

2017-04-01

Women with a breech baby late in pregnancy may use the internet to gather information to assist in decision-making for birth. The aim of this study was to examine how women use English language internet discussion forums to find out information about vaginal breech birth and to increase understanding of how vaginal breech birth is perceived among women. A descriptive qualitative study of internet discussion forums was undertaken. Google alerts were created with the search terms "breech birth" and "breech". Alerts were collected for a one-year period (January 2013-December 2013). The content of forum discussions was analysed using thematic analysis. A total of 50 forum discussions containing 382 comments were collected. Themes that arose from the data were: Testing the waters-which way should I go?; Losing hope for the chance of a normal birth; Seeking support for options-who will listen to me?; Considering vaginal breech birth-a risky choice?; Staying on the 'safe side'-caesarean section as a guarantee; Exploring the positive potential for vaginal breech birth. Women search online for information about vaginal breech birth in an attempt to come to a place in their decision-making where they feel comfortable with their birth plan. This study highlights the need for clinicians to provide comprehensive, unbiased information on the risks and benefits of all options for breech birth to facilitate informed decision-making for the woman. This will contribute to improving the woman's confidence in distinguishing between "the fact and the fiction" of breech birth discussions online. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Hydra: A web-based system for cardiovascular analysis, diagnosis and treatment.

PubMed

Novo, J; Hermida, A; Ortega, M; Barreira, N; Penedo, M G; López, J E; Calvo, C

2017-02-01

Cardiovascular (CV) risk stratification is a highly complex process involving an extensive set of clinical trials to support the clinical decision-making process. There are many clinical conditions (e.g. diabetes, obesity, stress, etc.) that can lead to the early diagnosis or establishment of cardiovascular disease. In order to determine all these clinical conditions, a complete set of clinical patient analyses is typically performed, including a physical examination, blood analysis, electrocardiogram, blood pressure (BP) analysis, etc. This article presents a web-based system, called Hydra, which integrates a full and detailed set of services and functionalities for clinical decision support in order to help and improve the work of clinicians in cardiovascular patient diagnosis, risk assessment, treatment and monitoring over time. Hydra integrates a number of different services: a service for inputting all the information gathered by specialists (physical examination, habits, BP, blood analysis, electrocardiogram, etc.); a tool to automatically determine the CV risk stratification, including well-known standard risk stratification tables; and, finally, various tools to incorporate, analyze and graphically present the records of the ambulatory BP monitoring that provides BP analysis over a given period of time (24 or 48 hours). In addition, the platform presents a set of reports derived from all the information gathered from the patient in order to support physicians in their clinical decisions. Hydra was tested and validated in a real domain. In particular, internal medicine specialists at the Hypertension Unit of the Santiago de Compostela University Hospital (CHUS) validated the platform and used it in different clinical studies to demonstrate its utility. It was observed that the platform increased productivity and accuracy in the assessment of patient data yielding a cost reduction in clinical practice. This paper proposes a complete platform that includes different services for cardiovascular clinical decision support. It was also run as a web-based application to facilitate its use by clinicians, who can access the platform from any remote computer with Internet access. Hydra also includes different automated methods to facilitate the physicians' work and avoid potential errors in the analysis of patient data. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Data-mining to build a knowledge representation store for clinical decision support. Studies on curation and validation based on machine performance in multiple choice medical licensing examinations.

PubMed

Robson, Barry; Boray, Srinidhi

2016-06-01

Extracting medical knowledge by structured data mining of many medical records and from unstructured data mining of natural language source text on the Internet will become increasingly important for clinical decision support. Output from these sources can be transformed into large numbers of elements of knowledge in a Knowledge Representation Store (KRS), here using the notation and to some extent the algebraic principles of the Q-UEL Web-based universal exchange and inference language described previously, rooted in Dirac notation from quantum mechanics and linguistic theory. In a KRS, semantic structures or statements about the world of interest to medicine are analogous to natural language sentences seen as formed from noun phrases separated by verbs, prepositions and other descriptions of relationships. A convenient method of testing and better curating these elements of knowledge is by having the computer use them to take the test of a multiple choice medical licensing examination. It is a venture which perhaps tells us almost as much about the reasoning of students and examiners as it does about the requirements for Artificial Intelligence as employed in clinical decision making. It emphasizes the role of context and of contextual probabilities as opposed to the more familiar intrinsic probabilities, and of a preliminary form of logic that we call presyllogistic reasoning. Copyright © 2016 Elsevier Ltd. All rights reserved.

A work-centered cognitively based architecture for decision support: the work-centered infomediary layer (WIL) model

NASA Astrophysics Data System (ADS)

Zachary, Wayne; Eggleston, Robert; Donmoyer, Jason; Schremmer, Serge

2003-09-01

Decision-making is strongly shaped and influenced by the work context in which decisions are embedded. This suggests that decision support needs to be anchored by a model (implicit or explicit) of the work process, in contrast to traditional approaches that anchor decision support to either context free decision models (e.g., utility theory) or to detailed models of the external (e.g., battlespace) environment. An architecture for cognitively-based, work centered decision support called the Work-centered Informediary Layer (WIL) is presented. WIL separates decision support into three overall processes that build and dynamically maintain an explicit context model, use the context model to identify opportunities for decision support and tailor generic decision-support strategies to the current context and offer them to the system-user/decision-maker. The generic decision support strategies include such things as activity/attention aiding, decision process structuring, work performance support (selective, contextual automation), explanation/ elaboration, infosphere data retrieval, and what if/action-projection and visualization. A WIL-based application is a work-centered decision support layer that provides active support without intent inferencing, and that is cognitively based without requiring classical cognitive task analyses. Example WIL applications are detailed and discussed.

Internet-based support for the production of holographic stereograms

NASA Astrophysics Data System (ADS)

Gustafsson, Jonny

1998-03-01

Holographic hard-copy techniques suffers from a lack of availability for ordinary users of computer graphics. The production of holograms usually requires special skills as well as expensive equipment which means that the direct production cost will be high for an ordinary user with little or no knowledge in holography. Here it is shown how a system may be created in which the users of computer graphics can do all communication with a holography studio through a Java-based web browser. This system will facilitate for the user to understand the technique of holographic stereograms, make decisions about angles, views, lighting etc., previsualizing the end result, as well as automatically submit the 3D-data to the producer of the hologram. A prototype system has been built which uses internal scripting in VRML.

An Overview of Internet biosurveillance

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hartley, David M.; Nelson, Noele P.; Arthur, Ray

Internet biosurveillance utilizes unstructured data from diverse Web-based sources to provide early warning and situational awareness of public health threats. The scope of source coverage ranges from local based media in the vernacular to international media in widely read languages. Internet biosurveillance is a timely modality available to government and public health officials, health care workers, and the public and private sector, serving as a real-time complementary approach to traditional indicator-based public health disease surveillance methods. Internet biosurveillance also supports the broader activity of epidemic intelligence. This review covers the current state of the field of Internet biosurveillance and providesmore » a perspective on the future of the field.« less

VineSens: An Eco-Smart Decision-Support Viticulture System

PubMed Central

Pérez-Expósito, Josman P.; Fernández-Caramés, Tiago M.; Fraga-Lamas, Paula; Castedo, Luis

2017-01-01

This article presents VineSens, a hardware and software platform for supporting the decision-making of the vine grower. VineSens is based on a wireless sensor network system composed by autonomous and self-powered nodes that are deployed throughout a vineyard. Such nodes include sensors that allow us to obtain detailed knowledge on different viticulture processes. Thanks to the use of epidemiological models, VineSens is able to propose a custom control plan to prevent diseases like one of the most feared by vine growers: downy mildew. VineSens generates alerts that warn farmers about the measures that have to be taken and stores the historical weather data collected from different spots of the vineyard. Such data can then be accessed through a user-friendly web-based interface that can be accessed through the Internet by using desktop or mobile devices. VineSens was deployed at the beginning in 2016 in a vineyard in the Ribeira Sacra area (Galicia, Spain) and, since then, its hardware and software have been tested to prevent the development of downy mildew, showing during its first season that the system can led to substantial savings, to decrease the amount of phytosanitary products applied, and, as a consequence, to obtain a more ecologically sustainable and healthy wine. PMID:28245619

VineSens: An Eco-Smart Decision-Support Viticulture System.

PubMed

Pérez-Expósito, Josman P; Fernández-Caramés, Tiago M; Fraga-Lamas, Paula; Castedo, Luis

2017-02-25

This article presents VineSens, a hardware and software platform for supporting the decision-making of the vine grower. VineSens is based on a wireless sensor network system composed by autonomous and self-powered nodes that are deployed throughout a vineyard. Such nodes include sensors that allow us to obtain detailed knowledge on different viticulture processes. Thanks to the use of epidemiological models, VineSens is able to propose a custom control plan to prevent diseases like one of the most feared by vine growers: downy mildew. VineSens generates alerts that warn farmers about the measures that have to be taken and stores the historical weather data collected from different spots of the vineyard. Such data can then be accessed through a user-friendly web-based interface that can be accessed through the Internet by using desktop or mobile devices. VineSens was deployed at the beginning in 2016 in a vineyard in the Ribeira Sacra area (Galicia, Spain) and, since then, its hardware and software have been tested to prevent the development of downy mildew, showing during its first season that the system can led to substantial savings, to decrease the amount of phytosanitary products applied, and, as a consequence, to obtain a more ecologically sustainable and healthy wine.

High-end clinical domain information systems for effective healthcare delivery.

PubMed

Mangalampalli, Ashish; Rama, Chakravarthy; Muthiyalian, Raja; Jain, Ajeet K

2007-01-01

The Electronic Health Record (EHR) provides doctors with a quick, reliable, secure, real-time and user-friendly source of all relevant patient data. The latest information system technologies, such as Clinical Data Warehouses (CDW), Clinical Decision-Support (CDS) systems and data-mining techniques (Online Analytical Processing (OLAP) and Online Transactional Processing (OLTP)), are used to maintain and utilise patient data intelligently, based on the users' requirements. Moreover, clinical trial reports for new drug approvals are now being submitted electronically for faster and easier processing. Also, information systems are used in educating patients about the latest developments in medical science through the internet and specially configured kiosks in hospitals and clinics.

Digital disease detection: A systematic review of event-based internet biosurveillance systems.

PubMed

O'Shea, Jesse

2017-05-01

Internet access and usage has changed how people seek and report health information. Meanwhile,infectious diseases continue to threaten humanity. The analysis of Big Data, or vast digital data, presents an opportunity to improve disease surveillance and epidemic intelligence. Epidemic intelligence contains two components: indicator based and event-based. A relatively new surveillance type has emerged called event-based Internet biosurveillance systems. These systems use information on events impacting health from Internet sources, such as social media or news aggregates. These systems circumvent the limitations of traditional reporting systems by being inexpensive, transparent, and flexible. Yet, innovations and the functionality of these systems can change rapidly. To update the current state of knowledge on event-based Internet biosurveillance systems by identifying all systems, including current functionality, with hopes to aid decision makers with whether to incorporate new methods into comprehensive programmes of surveillance. A systematic review was performed through PubMed, Scopus, and Google Scholar databases, while also including grey literature and other publication types. 50 event-based Internet systems were identified, including an extraction of 15 attributes for each system, described in 99 articles. Each system uses different innovative technology and data sources to gather data, process, and disseminate data to detect infectious disease outbreaks. The review emphasises the importance of using both formal and informal sources for timely and accurate infectious disease outbreak surveillance, cataloguing all event-based Internet biosurveillance systems. By doing so, future researchers will be able to use this review as a library for referencing systems, with hopes of learning, building, and expanding Internet-based surveillance systems. Event-based Internet biosurveillance should act as an extension of traditional systems, to be utilised as an additional, supplemental data source to have a more comprehensive estimate of disease burden. Copyright © 2017 Elsevier B.V. All rights reserved.

A survey of Internet utilization among patients with cancer.

PubMed

Castleton, Kimra; Fong, Thomas; Wang-Gillam, Andrea; Waqar, Muhammad A; Jeffe, Donna B; Kehlenbrink, Lisa; Gao, Feng; Govindan, Ramaswamy

2011-08-01

Recently published articles have established that a substantial number of cancer patients utilize the Internet to gather information about their respective diagnoses. The challenges for medical providers include understanding the prevalence and characteristics of patients using the Internet, reasons for Internet use, and the effectiveness of currently available websites in providing useful health-related information to patients. Adults with cancer were asked to complete a self-administered, anonymous, 21-item questionnaire upon registration at the Alvin J. Siteman Cancer Center at the Washington University School of Medicine. There were 500 respondents (mean age 58 years (range 18-90), 83% Caucasian and 15% African-American). Three hundred ninety-eight participants (80%) reported access to the Internet, and 315 (63%) reported searching for information about cancer on the Internet. Patients accessing the Internet for cancer information were younger than those who did not (median age 56 vs. 63 years; p < 0.001). Internet usage for cancer information also differed by race (p < 0.0001) and education (p < 0.0001). Among patients who searched the Internet for cancer information, 13.3% of patients had their decisions towards treatments affected or changed, and 11.4% of patients had their choice in physicians affected or changed because of Internet use; 23.5% of patients sought information on clinical trials, and 9.5% of patients were influenced or changed their decision regarding clinical trial enrollment due to Internet information. Approximately two thirds of patients with cancer used the Internet to obtain information about their disease. Factors affecting Internet use for cancer information included age, race, and education. Clinical decisions can be affected by Internet use.

An Evaluation of Internet-Based CAD Collaboration Tools

ERIC Educational Resources Information Center

Smith, Shana Shiang-Fong

2004-01-01

Due to the now widespread use of the Internet, most companies now require computer aided design (CAD) tools that support distributed collaborative design on the Internet. Such CAD tools should enable designers to share product models, as well as related data, from geographically distant locations. However, integrated collaborative design…

78 FR 38227 - Connect America Fund

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-26

... different per- location support amounts based on the existing level of Internet access ($550 for homes with low-speed Internet access and $775, as in the first round, for homes with only dial-up access), and... Internet access. We adopt a process for challenges to the eligibility of specific areas where price cap...

Physician Evaluation of Internet Health Information on Proton Therapy for Prostate Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shah, Anand, E-mail: as4351@columbia.edu; Department of Radiation Oncology, Columbia University Medical Center, New York, New York; Paly, Jonathan J.

Purpose: Many patients considering prostate cancer (PCa) treatment options report seeking proton beam therapy (PBT) based in part on information readily available on the Internet. There is, however, potential for considerable variation in Internet health information (IHI). We thus evaluated the characteristics, quality, and accuracy of IHI on PBT for PCa. Methods and Materials: We undertook a qualitative research study using snowball-purposive sampling in which we evaluated the top 50 Google search results for “proton prostate cancer.” Quality was evaluated on a 5-point scale using the validated 15-question DISCERN instrument. Accuracy was evaluated by comparing IHI with the best availablemore » evidence. Results: Thirty-seven IHI websites were included in the final sample. These websites most frequently were patient information/support resources (46%), were focused exclusively on PBT (51%), and had a commercial affiliation (38%). There was a significant difference in quality according to the type of IHI. Substantial inaccuracies were noted in the study sample compared with best available or contextual evidence. Conclusions: There are shortcomings in quality and accuracy in consumer-oriented IHI on PBT for PCa. Providers must be prepared to educate patients how to critically evaluate IHI related to PBT for PCa to best inform their treatment decisions.« less

The Importance of Earth Observations and Data Collaboration within Environmental Intelligence Supporting Arctic Research

NASA Technical Reports Server (NTRS)

Casas, Joseph

2017-01-01

Within the IARPC Collaboration Team activities of 2016, Arctic in-situ and remote earth observations advanced topics such as :1) exploring the role for new and innovative autonomous observing technologies in the Arctic; 2) advancing catalytic national and international community based observing efforts in support of the National Strategy for the Arctic Region; and 3) enhancing the use of discovery tools for observing system collaboration such as the U.S. National Oceanic and Atmospheric Administration (NOAA) Arctic Environmental Response Management Application (ERMA) and the U.S. National Aeronautics and Space Administration (NASA) Arctic Collaborative Environment (ACE) project geo reference visualization decision support and exploitation internet based tools. Critical to the success of these earth observations for both in-situ and remote systems is the emerging of new and innovative data collection technologies and comprehensive modeling as well as enhanced communications and cyber infrastructure capabilities which effectively assimilate and dissemination many environmental intelligence products in a timely manner. The Arctic Collaborative Environment (ACE) project is well positioned to greatly enhance user capabilities for accessing, organizing, visualizing, sharing and producing collaborative knowledge for the Arctic.

Ethical practice in internet research involving vulnerable people: lessons from a self-harm discussion forum study (SharpTalk).

PubMed

Sharkey, Siobhan; Jones, Ray; Smithson, Janet; Hewis, Elaine; Emmens, Tobit; Ford, Tamsin; Owens, Christabel

2011-12-01

The internet is widely used for health information and support, often by vulnerable people. Internet-based research raises both familiar and new ethical problems for researchers and ethics committees. While guidelines for internet-based research are available, it is unclear to what extent ethics committees use these. Experience of gaining research ethics approval for a UK study (SharpTalk), involving internet-based discussion groups with young people who self-harm and health professionals is described. During ethical review, unsurprisingly, concerns were raised about the vulnerability of potential participants. These were dominated by the issue of anonymity, which also affected participant safety and consent. These ethical problems are discussed, and our solutions, which included: participant usernames specific to the study, a closed website, private messaging facilities, a direct contact email to researchers, information about forum rules displayed on the website, a 'report' button for participants, links to online support, and a discussion room for forum moderators. This experience with SharpTalk suggests that an approach to ethics, which recognises the relational aspects of research with vulnerable people, is particularly useful for internet-based health research. The solutions presented here can act as guidance for researchers developing proposals and for ethics committees reviewing them.

Conventional Cognitive Behavioral Therapy Facilitated by an Internet-Based Support System: Feasibility Study at a Psychiatric Outpatient Clinic.

PubMed

Månsson, Kristoffer Nt; Klintmalm, Hugo; Nordqvist, Ragnar; Andersson, Gerhard

2017-08-24

Cognitive behavioral therapies have been shown to be effective for a variety of psychiatric and somatic disorders, but some obstacles can be noted in regular psychiatric care; for example, low adherence to treatment protocols may undermine effects. Treatments delivered via the Internet have shown promising results, and it is an open question if the blend of Internet-delivered and conventional face-to-face cognitive behavioral therapies may help to overcome some of the barriers of evidence-based treatments in psychiatric care. We evaluated the feasibility of an Internet-based support system at an outpatient psychiatric clinic in Sweden. For instance, the support system made it possible to send messages and share information between the therapist and the patient before and after therapy sessions at the clinic. Nine clinical psychologists participated and 33 patients were enrolled in the current study. We evaluated the usability and technology acceptance after 12 weeks of access. Moreover, clinical data on common psychiatric symptoms were assessed before and after the presentation of the support system. In line with our previous study in a university setting, the Internet-based support system has the potential to be feasible also when delivered in a regular psychiatric setting. Notably, some components in the system were less frequently used. We also found that patients improved on common outcome measures for depressive and anxious symptoms (effect sizes, as determined by Cohen d, ranged from 0.20-0.69). This study adds to the literature suggesting that modern information technology could be aligned with conventional face-to-face services. ©Kristoffer NT Månsson, Hugo Klintmalm, Ragnar Nordqvist, Gerhard Andersson. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 24.08.2017.

Health-Related Internet Use in People With Cancer: Results From a Cross-Sectional Study in Two Outpatient Clinics in Sweden.

PubMed

Mattsson, Susanne; Olsson, Erik Martin Gustaf; Johansson, Birgitta; Carlsson, Maria

2017-05-15

The access to various forms of support during the disease trajectory is crucial for people with cancer. The provision and use of Internet health services is increasing, and it is important to further investigate the preferences and demographical characteristics of its users. Investigating the uptake and perceived value of Internet health services is a prerequisite to be able to meet the needs in the targeted group. The objective of this study was to investigate health-related Internet use among people with cancer. The health online support questionnaire (HOSQ), examining the incentives for health-related Internet support use, was administered in two Swedish outpatient hospital clinics. Of the 350 copies of the questionnaire handed out, 285 (81.4%) were returned, answered by persons with cancer who had completed treatment or were under active surveillance or another medical treatment. A total of 215 (76.2%, 215/282) participants reported Internet use since being diagnosed with cancer. Internet-users were younger (P<.001), more likely to have a partner (P=.03), and had a higher level of education than nonusers (P<.001). The most common health-related activity on the Internet was searching for information (77.2%, 166/215), and users searched significantly more immediately after diagnosis compared with later on (P<.001). Use of My Healthcare Contacts was considered the most valuable Internet activity. Having a university degree (P ˂.001) and being younger in age (P=.01) were associated with a significantly higher frequency of health- related Internet use. People with cancer turn to the Internet for informational support that enables them to influence their care and to stay in touch with friends and relatives. Demographical differences regarding the uptake of Web-based support remains. This indicates a need for research on how to bridge this digital gap. By learning more about the use of health-related support on the Web among people with cancer, adequate support can be offered and potential strain reduced. ©Susanne Mattsson, Erik Martin Gustaf Olsson, Birgitta Johansson, Maria Carlsson. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 15.05.2017.

Guided and unguided internet-based vestibular rehabilitation versus usual care for dizzy adults of 50 years and older: a protocol for a three-armed randomised trial

PubMed Central

van der Wouden, Johannes C; Bosmans, Judith E; Smalbrugge, Martin; van Diest, Willianne; Essery, Rosie; Yardley, Lucy; van der Horst, Henriëtte E; Maarsingh, Otto R

2017-01-01

Introduction Dizziness is a common symptom in general practice with a high prevalence among older adults. The most common cause of dizziness in general practice is peripheral vestibular disease. Vestibular rehabilitation (VR) is a safe and effective treatment for peripheral vestibular disease that entails specific exercises to maximise the central nervous system compensation for the effects of vestibular pathology. An internet-based VR intervention has recently been shown to be safe and effective. Online interventions are low cost and easily accessible, but prone to attrition and non-adherence. A combination of online and face-to-face therapy, known as blended care, may balance these advantages and disadvantages. Methods and analysis A single-blind, three-arm, randomised controlled trial among patients aged 50 years and over presenting with dizziness of vestibular origin in general practice will be performed. In this study, we will compare the clinical and cost-effectiveness of stand-alone internet-based VR and internet-based VR with physiotherapeutic support (‘blended care’) with usual care during 6 months of follow-up. We will use a translated Dutch version of a British online VR intervention. Randomisation will be stratified by dizziness severity. The primary outcome measure is the Vertigo Symptoms Scale—Short Form. Intention-to-treat analysis will be performed, adjusting for confounders. The economic evaluation will be conducted from a societal perspective. We will perform an additional analysis on the data to identify predictors of successful treatment in the same population to develop a clinical decision rule for general practitioners. Ethics and dissemination The ethical committee of the VU University Medical Center approved ethics and dissemination of the study protocol. The insights and results of this study will be widely disseminated through international peer-reviewed journals and conference presentations. Trial registration number Pre-results, NTR5712. PMID:28110290

Quantifying and Mapping Global Data Poverty

PubMed Central

2015-01-01

Digital information technologies, such as the Internet, mobile phones and social media, provide vast amounts of data for decision-making and resource management. However, access to these technologies, as well as their associated software and training materials, is not evenly distributed: since the 1990s there has been concern about a "Digital Divide" between the data-rich and the data-poor. We present an innovative metric for evaluating international variations in access to digital data: the Data Poverty Index (DPI). The DPI is based on Internet speeds, numbers of computer owners and Internet users, mobile phone ownership and network coverage, as well as provision of higher education. The datasets used to produce the DPI are provided annually for almost all the countries of the world and can be freely downloaded. The index that we present in this ‘proof of concept’ study is the first to quantify and visualise the problem of global data poverty, using the most recent datasets, for 2013. The effects of severe data poverty, particularly limited access to geoinformatic data, free software and online training materials, are discussed in the context of sustainable development and disaster risk reduction. The DPI highlights countries where support is needed for improving access to the Internet and for the provision of training in geoinfomatics. We conclude that the DPI is of value as a potential metric for monitoring the Sustainable Development Goals of the Sendai Framework for Disaster Risk Reduction. PMID:26560884

Electronic health record meets digital library: a new environment for achieving an old goal.

PubMed

Humphreys, B L

2000-01-01

Linking the electronic health record to the digital library is a Web-era reformulation of the long-standing informatics goal of seamless integration of automated clinical data and relevant knowledge-based information to support informed decisions. The spread of the Internet, the development of the World Wide Web, and converging format standards for electronic health data and digital publications make effective linking increasingly feasible. Some existing systems link electronic health data and knowledge-based information in limited settings or limited ways. Yet many challenging informatics research problems remain to be solved before flexible and seamless linking becomes a reality and before systems become capable of delivering the specific piece of information needed at the time and place a decision must be made. Connecting the electronic health record to the digital library also requires positive resolution of important policy issues, including health data privacy, government encouragement of high-speed communications, electronic intellectual property rights, and standards for health data and for digital libraries. Both the research problems and the policy issues should be important priorities for the field of medical informatics.

Electronic Health Record Meets Digital Library

PubMed Central

Humphreys, Betsy L.

2000-01-01

Linking the electronic health record to the digital library is a Web-era reformulation of the long-standing informatics goal of seamless integration of automated clinical data and relevant knowledge-based information to support informed decisions. The spread of the Internet, the development of the World Wide Web, and converging format standards for electronic health data and digital publications make effective linking increasingly feasible. Some existing systems link electronic health data and knowledge-based information in limited settings or limited ways. Yet many challenging informatics research problems remain to be solved before flexible and seamless linking becomes a reality and before systems become capable of delivering the specific piece of information needed at the time and place a decision must be made. Connecting the electronic health record to the digital library also requires positive resolution of important policy issues, including health data privacy, government envouragement of high-speed communications, electronic intellectual property rights, and standards for health data and for digital libraries. Both the research problems and the policy issues should be important priorities for the field of medical informatics. PMID:10984463

Application of a web-based Decision Support System in risk management

NASA Astrophysics Data System (ADS)

Aye, Zar Chi; Jaboyedoff, Michel; Derron, Marc-Henri

2013-04-01

Increasingly, risk information is widely available with the help of advanced technologies such as earth observation satellites, global positioning technologies, coupled with hazard modeling and analysis, and geographical information systems (GIS). Even though it exists, no effort will be put into action if it is not properly presented to the decision makers. These information need to be communicated clearly and show its usefulness so that people can make better informed decision. Therefore, communicating available risk information has become an important challenge and decision support systems have been one of the significant approaches which can help not only in presenting risk information to the decision makers but also in making efficient decisions while reducing human resources and time needed. In this study, the conceptual framework of an internet-based decision support system is presented to highlight its importance role in risk management framework and how it can be applied in case study areas chosen. The main purpose of the proposed system is to facilitate the available risk information in risk reduction by taking into account of the changes in climate, land use and socio-economic along with the risk scenarios. It allows the users to formulate, compare and select risk reduction scenarios (mainly for floods and landslides) through an enhanced participatory platform with diverse stakeholders' involvement in the decision making process. It is based on the three-tier (client-server) architecture which integrates web-GIS plus DSS functionalities together with cost benefit analysis and other supporting tools. Embedding web-GIS provides its end users to make better planning and informed decisions referenced to a geographical location, which is the one of the essential factors in disaster risk reduction programs. Different risk reduction measures of a specific area (local scale) will be evaluated using this web-GIS tool, available risk scenarios obtained from Probabilistic Risk Assessment (PRA) model and the knowledge collected from experts. The visualization of the risk reduction scenarios can also be shared among the users on the web to support the on-line participatory process. In addition, cost-benefit ratios of the different risk reduction scenarios can be prepared in order to serve as inputs for high-level decision makers. The most appropriate risk reduction scenarios will be chosen using Multi-Criteria Evaluation (MCE) method by weighting different parameters according to the preferences and criteria defined by the users. The role of public participation has been changing from one-way communication between authorities, experts, stakeholders and citizens towards more intensive two-way interaction. Involving the affected public and interest groups can enhance the level of legitimacy, transparency, and confidence in the decision making process. Due to its important part in decision making, online participatory tool is included in the DSS in order to allow the involved stakeholders interactively in risk reduction and be aware of the existing vulnerability conditions of the community. Moreover, it aims to achieve a more transparent and better informed decision-making process. The system is under in progress and the first tools implemented will be presented showing the wide possibilities of new web technologies which can have a great impact on the decision making process. It will be applied in four pilot areas in Europe: French Alps, North Eastern Italy, Romania and Poland. Nevertheless, the framework will be designed and implemented in a way to be applicable in any other regions.

Internet interventions to support lifestyle modification for diabetes management: a systematic review of the evidence.

PubMed

Cotter, Alexander P; Durant, Nefertiti; Agne, April A; Cherrington, Andrea L

2014-01-01

The Internet presents a widely accessible, 24-h means to promote chronic disease management. The objective of this review is to identify studies that used Internet based interventions to promote lifestyle modification among adults with type 2 diabetes. We searched PubMed using the terms: [internet, computer, phone, smartphone, mhealth, mobile health, web based, telehealth, social media, text messages] combined with [diabetes management and diabetes control] through January 2013. Studies were included if they described an Internet intervention, targeted adults with type 2 diabetes, focused on lifestyle modification, and included an evaluation component with behavioral outcomes. Of the 2803 papers identified, nine met inclusion criteria. Two studies demonstrated improvements in diet and/or physical activity and two studies demonstrated improvements in glycemic control comparing web-based intervention with control. Successful studies were theory-based, included interactive components with tracking and personalized feedback, and provided opportunities for peer support. Website utilization declined over time in all studies that reported on it. Few studies focused on high risk, underserved populations. Web-based strategies provide a viable option for facilitating diabetes self-management. Future research is needed on the use of web-based interventions in underserved communities and studies examining website utilization patterns and engagement over time. © 2014 Elsevier Inc. All rights reserved.

Patients' acceptance of Internet-based home asthma telemonitoring.

PubMed

Finkelstein, J; Hripcsak, G; Cabrera, M R

1998-01-01

We studied asthma patients from a low-income inner-city community without previous computer experience. The patients were given portable spirometers to perform spirometry tests and palmtop computers to enter symptoms in a diary, to exchange messages with physician and to review test results. The self-testing was performed at home on a daily basis. The results were transmitted to the hospital information system immediately after completion of each test. Physician could review results using an Internet Web browser from any location. A constantly active decision support server monitored all data traffic and dispatched alerts when certain clinical conditions were met. Seventeen patients, out of 19 invited, agreed to participate in the study and have been monitored for three weeks. They have been surveyed then using standardized questionnaire. Most of the patients (82.4%) characterized self-testing procedures as "not complicated at all." In 70.6% of cases self-testing did not interfere with usual activities, and 82.4% of patients felt the self-testing required a "very little" amount of their time. All patients stated that it is important for them to know that the results can be reviewed by professional staff in a timely manner. However, only 29.5% of patients reviewed their results at least once a week at home independently. The majority of the patients (94.1%) were strongly interested in using home asthma telemonitoring in the future. We concluded that Internet-based home asthma telemonitoring can be successfully implemented in the group of patients without previous computer background.

Year 1 Evaluation of Nebraska's Statewide Plan: Connecting Schools to the Internet.

ERIC Educational Resources Information Center

Topp, Neal W.; Grandgenett, Neal

1996-01-01

Reviews activities in the first year of a Nebraska plan to connect K-12 schools to the Internet, including: installing UNIX-based computers; developing a statewide training program; hiring; distributing support materials; and devising a formative evaluation process. Trends in teacher and student Internet use and eight projects in classroom…

The Use of the Internet for Business: The Experience of Early Adopters in Singapore.

ERIC Educational Resources Information Center

Soh, Christina; Mah, Quee Yong; Gan, Fong Jek; Chew, Daniel; Reid, Edna

1997-01-01

A survey of Singapore-based firms in computer/information technology, hospitality, manufacturing, retail, travel, publishing, and banking/finance that use the Internet for business found that most of the respondents use the Internet for marketing and advertising, customer service and support, information gathering, and, to a lesser degree,…

A Web-Based Earth-Systems Knowledge Portal and Collaboration Platform

NASA Astrophysics Data System (ADS)

D'Agnese, F. A.; Turner, A. K.

2010-12-01

In support of complex water-resource sustainability projects in the Great Basin region of the United States, Earth Knowledge, Inc. has developed several web-based data management and analysis platforms that have been used by its scientists, clients, and public to facilitate information exchanges, collaborations, and decision making. These platforms support accurate water-resource decision-making by combining second-generation internet (Web 2.0) technologies with traditional 2D GIS and web-based 2D and 3D mapping systems such as Google Maps, and Google Earth. Most data management and analysis systems use traditional software systems to address the data needs and usage behavior of the scientific community. In contrast, these platforms employ more accessible open-source and “off-the-shelf” consumer-oriented, hosted web-services. They exploit familiar software tools using industry standard protocols, formats, and APIs to discover, process, fuse, and visualize earth, engineering, and social science datasets. Thus, they respond to the information needs and web-interface expectations of both subject-matter experts and the public. Because the platforms continue to gather and store all the contributions of their broad-spectrum of users, each new assessment leverages the data, information, and expertise derived from previous investigations. In the last year, Earth Knowledge completed a conceptual system design and feasibility study for a platform, which has a Knowledge Portal providing access to users wishing to retrieve information or knowledge developed by the science enterprise and a Collaboration Environment Module, a framework that links the user-access functions to a Technical Core supporting technical and scientific analyses including Data Management, Analysis and Modeling, and Decision Management, and to essential system administrative functions within an Administrative Module. The over-riding technical challenge is the design and development of a single technical platform that is accessed through a flexible series of knowledge portal and collaboration environment styles reflecting the information needs and user expectations of a diverse community of users. Recent investigations have defined the information needs and expectations of the major end-users and also have reviewed and assessed a wide variety of modern web-based technologies. Combining these efforts produced design specifications and recommendations for the selection and integration of web- and client-based tools. When fully developed, the resulting platform will: -Support new, advanced information systems and decision environments that take full advantage of multiple data sources and platforms; -Provide a distribution network tailored to the timely delivery of products to a broad range of users that are needed to support applications in disaster management, resource management, energy, and urban sustainability; -Establish new integrated multiple-user requirements and knowledge databases that support researchers and promote infusion of successful technologies into existing processes; and -Develop new decision support strategies and presentation methodologies for applied earth science applications to reduce risk, cost, and time.

Supporting a caring fatherhood in cyberspace - an analysis of communication about caring within an online forum for fathers.

PubMed

Eriksson, Henrik; Salzmann-Erikson, Martin

2013-03-01

Today's parents seek out social support on the Internet. A key motivation behind the choice to go online is the need for more experience based information. In recent years, new fathers have increasingly taken on an active parental role. Men's support for their caring activities for infants on the Internet needs attention. The aim was to describe communication about caring activities for infants among men who visited an Internet-based forum for fathers and elaborate on the dimensions of support available in the forum. An archival and cross-sectional observational forum study was undertaken using principles for conducting ethnographic research online: "nethnography". A total of 1203 pages of data from an Internet forum for fathers were gathered and analysed. Support for a caring fatherhood in cyberspace can be understood as fathers' communicating encouragement, confirmation and advice. The findings show that important ways of providing support through the forum included a reciprocal sharing of concerns - how to be a better father - in relation to caring for an infant. Concerns for their child's well-being and shared feelings of joy and distress in everyday life were recurrent supportive themes in the communication. Information gained from contacting others in similar situations is one important reason for the fathers' use of the Internet. Support offered in this kind of forum can be considered as a complement to formal support. Professionals can use it to provide choices for fathers who are developing themselves as caregivers without downplaying the parental support offered by formal health care regimes. FURTHER RESEARCH: Online support will probably be one of the main supporting strategies for fathers in Scandinavia. Caring and nursing researchers need to closely monitor support activities that develop, and over time, as these ill likely become an important source of support for people. © 2012 The Authors. Scandinavian Journal of Caring Sciences © 2012 Nordic College of Caring Science.

Modeling IoT-Based Solutions Using Human-Centric Wireless Sensor Networks

PubMed Central

Monares, Álvaro; Ochoa, Sergio F.; Santos, Rodrigo; Orozco, Javier; Meseguer, Roc

2014-01-01

The Internet of Things (IoT) has inspired solutions that are already available for addressing problems in various application scenarios, such as healthcare, security, emergency support and tourism. However, there is no clear approach to modeling these systems and envisioning their capabilities at the design time. Therefore, the process of designing these systems is ad hoc and its real impact is evaluated once the solution is already implemented, which is risky and expensive. This paper proposes a modeling approach that uses human-centric wireless sensor networks to specify and evaluate models of IoT-based systems at the time of design, avoiding the need to spend time and effort on early implementations of immature designs. It allows designers to focus on the system design, leaving the implementation decisions for a next phase. The article illustrates the usefulness of this proposal through a running example, showing the design of an IoT-based solution to support the first responses during medium-sized or large urban incidents. The case study used in the proposal evaluation is based on a real train crash. The proposed modeling approach can be used to design IoT-based systems for other application scenarios, e.g., to support security operatives or monitor chronic patients in their homes. PMID:25157549

Modeling IoT-based solutions using human-centric wireless sensor networks.

PubMed

Monares, Álvaro; Ochoa, Sergio F; Santos, Rodrigo; Orozco, Javier; Meseguer, Roc

2014-08-25

The Internet of Things (IoT) has inspired solutions that are already available for addressing problems in various application scenarios, such as healthcare, security, emergency support and tourism. However, there is no clear approach to modeling these systems and envisioning their capabilities at the design time. Therefore, the process of designing these systems is ad hoc and its real impact is evaluated once the solution is already implemented, which is risky and expensive. This paper proposes a modeling approach that uses human-centric wireless sensor networks to specify and evaluate models of IoT-based systems at the time of design, avoiding the need to spend time and effort on early implementations of immature designs. It allows designers to focus on the system design, leaving the implementation decisions for a next phase. The article illustrates the usefulness of this proposal through a running example, showing the design of an IoT-based solution to support the first responses during medium-sized or large urban incidents. The case study used in the proposal evaluation is based on a real train crash. The proposed modeling approach can be used to design IoT-based systems for other application scenarios, e.g., to support security operatives or monitor chronic patients in their homes.

Health-Related Internet Use in People With Cancer: Results From a Cross-Sectional Study in Two Outpatient Clinics in Sweden

PubMed Central

Olsson, Erik Martin Gustaf; Johansson, Birgitta; Carlsson, Maria

2017-01-01

Background The access to various forms of support during the disease trajectory is crucial for people with cancer. The provision and use of Internet health services is increasing, and it is important to further investigate the preferences and demographical characteristics of its users. Investigating the uptake and perceived value of Internet health services is a prerequisite to be able to meet the needs in the targeted group. Objective The objective of this study was to investigate health-related Internet use among people with cancer. Methods The health online support questionnaire (HOSQ), examining the incentives for health-related Internet support use, was administered in two Swedish outpatient hospital clinics. Of the 350 copies of the questionnaire handed out, 285 (81.4%) were returned, answered by persons with cancer who had completed treatment or were under active surveillance or another medical treatment. Results A total of 215 (76.2%, 215/282) participants reported Internet use since being diagnosed with cancer. Internet-users were younger (P<.001), more likely to have a partner (P=.03), and had a higher level of education than nonusers (P<.001). The most common health-related activity on the Internet was searching for information (77.2%, 166/215), and users searched significantly more immediately after diagnosis compared with later on (P<.001). Use of My Healthcare Contacts was considered the most valuable Internet activity. Having a university degree (P ˂.001) and being younger in age (P=.01) were associated with a significantly higher frequency of health- related Internet use. Conclusions People with cancer turn to the Internet for informational support that enables them to influence their care and to stay in touch with friends and relatives. Demographical differences regarding the uptake of Web-based support remains. This indicates a need for research on how to bridge this digital gap. By learning more about the use of health-related support on the Web among people with cancer, adequate support can be offered and potential strain reduced. PMID:28506959

Command and Control of Space Assets Through Internet-Based Technologies Demonstrated

NASA Technical Reports Server (NTRS)

Foltz, David A.

2002-01-01

The NASA Glenn Research Center successfully demonstrated a transmission-control-protocol/ Internet-protocol- (TCP/IP) based approach to the command and control of onorbit assets over a secure network. This is a significant accomplishment because future NASA missions will benefit by using Internet-standards-based protocols. Benefits of this Internet-based space command and control system architecture include reduced mission costs and increased mission efficiency. The demonstration proved that this communications architecture is viable for future NASA missions. This demonstration was a significant feat involving multiple NASA organizations and industry. Phillip Paulsen, from Glenn's Project Development and Integration Office, served as the overall project lead, and David Foltz, from Glenn's Satellite Networks and Architectures Branch, provided the hybrid networking support for the required Internet connections. The goal was to build a network that would emulate a connection between a space experiment on the International Space Station and a researcher accessing the experiment from anywhere on the Internet, as shown. The experiment was interfaced to a wireless 802.11 network inside the demonstration area. The wireless link provided connectivity to the Tracking and Data Relay Satellite System (TDRSS) Internet Link Terminal (TILT) satellite uplink terminal located 300 ft away in a parking lot on top of a panel van. TILT provided a crucial link in this demonstration. Leslie Ambrose, NASA Goddard Space Flight Center, provided the TILT/TDRSS support. The TILT unit transmitted the signal to TDRS 6 and was received at the White Sands Second TDRSS Ground Station. This station provided the gateway to the Internet. Coordination also took place at the White Sands station to install a Veridian Firewall and automated security incident measurement (ASIM) system to the Second TDRSS Ground Station Internet gateway. The firewall provides a trusted network for the simulated space experiment. A second Internet connection at the demonstration area was implemented to provide Internet connectivity to a group of workstations to serve as platforms for controlling the simulated space experiment. Installation of this Internet connection was coordinated with an Internet service provider (ISP) and local NASA Johnson Space Center personnel. Not only did this TCP/IP-based architecture prove that a principal investigator on the Internet can securely command and control on-orbit assets, it also demonstrated that valuable virtual testing of planned on-orbit activities can be conducted over the Internet prior to actual deployment in space.

Development of an Undergraduate Course--Internet-Based Instrumentation and Control

ERIC Educational Resources Information Center

Zhuang, Hanqi; Morgera, Salvatore D.

2007-01-01

The objective, strategy, and implementation details of a new undergraduate course, Internet-based Instrumentation and Control, are presented. The course has a companion laboratory that is supported by the National Science Foundation and industry. The combination is offered to senior-level undergraduate engineering students interested in sensing,…

The Internet as a research site: establishment of a web-based longitudinal study of the nursing and midwifery workforce in three countries.

PubMed

Huntington, Annette; Gilmour, Jean; Schluter, Philip; Tuckett, Anthony; Bogossian, Fiona; Turner, Catherine

2009-06-01

The aim of this paper is to describe the development of a web-based longitudinal research project, The Nurses and Midwives e-cohort Study. The Internet has only recently been used for health research. However, web-based methodologies are increasingly discussed as significant and inevitable developments in research as Internet access and use rapidly increases worldwide. In 2006, a longitudinal web-based study of nurses and midwives workforce participation patterns, health and wellbeing, and lifestyle choices was established. Participating countries are Australia, New Zealand and the United Kingdom. Data collection is handled through a dedicated website using a range of standardized tools combined into one comprehensive questionnaire. Internet-specific data collection and a range of recruitment and retention strategies have been developed for this study. Internet-based technology can support the maintenance of cohorts across multiple countries and jurisdictions to explore factors influencing workforce participation. However, barriers to widespread adoption of web-based approaches include website development costs, the need for fast broadband connection for large data collection instruments, and varying degrees of Internet and computer literacy in the nursing and midwifery workforce. Many of the issues reported in this paper are transitional in nature at a time of rapid technological development. The development of on-line methods and tools is a major and exciting development in the world of research. Research via the world-wide web can support international collaborations across borders and cultures.

The development and application of a decision support system for land management in the Lake Tahoe Basin—The Land Use Simulation Model

USGS Publications Warehouse

Forney, William M.; Oldham, I. Benson; Crescenti, Neil

2013-01-01

This report describes and applies the Land Use Simulation Model (LUSM), the final modeling product for the long-term decision support project funded by the Southern Nevada Public Land Management Act and developed by the U.S. Geological Survey’s Western Geographic Science Center for the Lake Tahoe Basin. Within the context of the natural-resource management and anthropogenic issues of the basin and in an effort to advance land-use and land-cover change science, this report addresses the problem of developing the LUSM as a decision support system. It includes consideration of land-use modeling theory, fire modeling and disturbance in the wildland-urban interface, historical land-use change and its relation to active land management, hydrologic modeling and the impact of urbanization as related to the Lahontan Regional Water Quality Control Board’s recently developed Total Maximum Daily Load report for the basin, and biodiversity in urbanizing areas. The LUSM strives to inform land-management decisions in a complex regulatory environment by simulating parcel-based, land-use transitions with a stochastic, spatially constrained, agent-based model. The tool is intended to be useful for multiple purposes, including the multiagency Pathway 2007 regional planning effort, the Tahoe Regional Planning Agency (TRPA) Regional Plan Update, and complementary research endeavors and natural-resource-management efforts. The LUSM is an Internet-based, scenario-generation decision support tool for allocating retired and developed parcels over the next 20 years. Because USGS staff worked closely with TRPA staff and their “Code of Ordinances” and analyzed datasets of historical management and land-use practices, this report accomplishes the task of providing reasonable default values for a baseline scenario that can be used in the LUSM. One result from the baseline scenario for the model suggests that all vacant parcels could be allocated within 12 years. Results also include: assessment of model functionality, brief descriptions of the 7 basic output tables, assessment of the rate of change in land-use allocation pools over time, locations and amounts of the spatially explicit probabilities of land-use transitions by real estate commodity, and analysis of the state change from today’s existing land cover to potential land uses in the future. Assumptions and limitations of the model are presented. This report concludes with suggested next steps to support the continued utility of the LUSM and additional research avenues.

The experiential health information processing model: supporting collaborative web-based patient education

PubMed Central

O'Grady, Laura A; Witteman, Holly; Wathen, C Nadine

2008-01-01

Background First generation Internet technologies such as mailing lists or newsgroups afforded unprecedented levels of information exchange within a variety of interest groups, including those who seek health information. With emergence of the World Wide Web many communication applications were ported to web browsers. One of the driving factors in this phenomenon has been the exchange of experiential or anecdotal knowledge that patients share online, and there is emerging evidence that participation in these forums may be having an impact on people's health decision making. Theoretical frameworks supporting this form of information seeking and learning have yet to be proposed. Results In this article, we propose an adaptation of Kolb's experiential learning theory to begin to formulate an experiential health information processing model that may contribute to our understanding of online health information seeking behaviour in this context. Conclusion An experiential health information processing model is proposed that can be used as a research framework. Future research directions include investigating the utility of this model in the online health information seeking context, studying the impact of collaborating in these online environments on patient decision making and on health outcomes are provided. PMID:19087353

The experiential health information processing model: supporting collaborative web-based patient education.

PubMed

O'Grady, Laura A; Witteman, Holly; Wathen, C Nadine

2008-12-16

First generation Internet technologies such as mailing lists or newsgroups afforded unprecedented levels of information exchange within a variety of interest groups, including those who seek health information. With emergence of the World Wide Web many communication applications were ported to web browsers. One of the driving factors in this phenomenon has been the exchange of experiential or anecdotal knowledge that patients share online, and there is emerging evidence that participation in these forums may be having an impact on people's health decision making. Theoretical frameworks supporting this form of information seeking and learning have yet to be proposed. In this article, we propose an adaptation of Kolb's experiential learning theory to begin to formulate an experiential health information processing model that may contribute to our understanding of online health information seeking behaviour in this context. An experiential health information processing model is proposed that can be used as a research framework. Future research directions include investigating the utility of this model in the online health information seeking context, studying the impact of collaborating in these online environments on patient decision making and on health outcomes are provided.

Authoritative knowledge, evidence-based medicine, and behavioral pediatrics.

PubMed

Kennell, J H

1999-12-01

Evidence-based medicine is the conscientious and judicious use of current best knowledge in making decisions about the care of individual patients, often from well-designed, randomized, controlled trials. Authoritative medicine is the traditional approach to learning and practicing medicine, but no one authority has comprehensive scientific knowledge. Archie Cochrane proposed that every medical specialty should compile a list of all of the randomized, controlled trials within its field to be available for those who wish to know what treatments are effective. This was done first for obstetrics by a group collecting and critically analyzing all of the randomized trials and then indicating procedures every mother should have and those that no mother should have. Support during labor was used as an example. Similar groups are now active in almost all specialties, with information available on the Internet in the Cochrane Database of Systematic Reviews. Developmental-behavioral pediatrics should be part of this movement to evidence-based medicine.

Study on generation investment decision-making considering multi-agent benefit for global energy internet

NASA Astrophysics Data System (ADS)

Li, Pai; Huang, Yuehui; Jia, Yanbing; Liu, Jichun; Niu, Yi

2018-02-01

Abstract . This article has studies on the generation investment decision in the background of global energy interconnection. Generation investment decision model considering the multiagent benefit is proposed. Under the back-ground of global energy Interconnection, generation investors in different clean energy base not only compete with other investors, but also facing being chosen by the power of the central area, therefor, constructing generation investment decision model considering multiagent benefit can be close to meet the interests demands. Using game theory, the complete information game model is adopted to solve the strategies of different subjects in equilibrium state.

Home monitoring and decision support for international liver transplant children.

PubMed

Song, Bianying; Schulze, Mareike; Goldschmidt, Imeke; Haux, Reinhold; Baumann, Ulrich; Marschollek, Michael

2013-01-01

Complications may occur after a liver transplantation, therefore proper monitoring and care in the post-operation phase plays a very important role. Sometimes, monitoring and care for patients from abroad is difficult due to a variety of reasons, e.g., different care facilities. The objective of our research for this paper is to design, implement and evaluate a home monitoring and decision support infrastructure for international children who underwent liver transplant operation. A point-of-care device and the PedsQL questionnaire were used in patients' home environment for measuring the blood parameters and assessing quality of life. By using a tablet PC and a specially developed software, the measured results were able to be transmitted to the health care providers via internet. So far, the developed infrastructure has been evaluated with four international patients/families transferring 38 records of blood test. The evaluation showed that the home monitoring and decision support infrastructure is technically feasible and is able to give timely alarm in case of abnormal situation as well as may increase parent's feeling of safety for their children.

The Internet and the Banks' Strategic Distribution Channel Decisions.

ERIC Educational Resources Information Center

Mols, Niels Peter

1998-01-01

Discusses two strategic distribution channel decisions facing banks, one regarding whether to target the Internet banking segment of customers versus the branch banking segment, and the other regarding the geographical area banks aim to serve. Future distribution channels, the change process, and local, national, and international strategies are…

Online Social Engagement by Cancer Patients: A Clinic-Based Patient Survey

PubMed Central

Wallner, Lauren

2016-01-01

Background The Internet is commonly used as a source of health information, but little is known about the Internet practices specific to cancer patients. Objective To understand cancer patients’ use of the Internet as an informational resource and for social support. Methods The researchers conducted a survey of 1282 patients at a comprehensive cancer center to assess frequency of Internet access and online behaviors. Results Of the cancer patients surveyed, 1096 (85.49%) had Internet access; of those with Internet access, 953 (86.95%) reported going online at least weekly, and 747 (68.16%) reported daily online activity. Grouping Internet users by their level of online social engagement revealed that out of 1096 users, 331 (30.20%) had not sought out social connections online, 227 (20.71%) had read about experiences from other cancer patients, 410 (37.41%) had also written about their personal experiences, and 128 (11.68%) had participated in a formal online group for cancer patients. Increased online social engagement was associated with an increased perception that the Internet was useful for social support. Conclusions Internet use among cancer patients was common, and most patients reported that they found useful information about their cancer diagnosis online. Cancer patients who actively posted or shared content perceived more social support from the Internet than those who used the Internet solely as an informational resource or to read about other cancer patients’ experiences. Physicians have a great opportunity to direct users to quality health information on the Web. PMID:28410186

The Internet and Academics' Workload and Work-Family Balance

ERIC Educational Resources Information Center

Heijstra, Thamar M.; Rafnsdottir, Gudbjorg Linda

2010-01-01

The aim of this article is to analyse whether the Internet and other ICT technologies support a work-family balance amongst academics. The study is based on 20 in-depth interviews with academics in Iceland and analysed according to the Grounded Theory Approach. This study challenges the notion that the Internet, as part of ICT technology, makes it…

Internet-based Modeling, Mapping, and Analysis for the Greater Everglades (IMMAGE; Version 1.0): web-based tools to assess the impact of sea level rise in south Florida

USGS Publications Warehouse

Hearn, Paul; Strong, David; Swain, Eric; Decker, Jeremy

2013-01-01

South Florida's Greater Everglades area is particularly vulnerable to sea level rise, due to its rich endowment of animal and plant species and its heavily populated urban areas along the coast. Rising sea levels are expected to have substantial impacts on inland flooding, the depth and extent of surge from coastal storms, the degradation of water supplies by saltwater intrusion, and the integrity of plant and animal habitats. Planners and managers responsible for mitigating these impacts require advanced tools to help them more effectively identify areas at risk. The U.S. Geological Survey's (USGS) Internet-based Modeling, Mapping, and Analysis for the Greater Everglades (IMMAGE) Web site has been developed to address these needs by providing more convenient access to projections from models that forecast the effects of sea level rise on surface water and groundwater, the extent of surge and resulting economic losses from coastal storms, and the distribution of habitats. IMMAGE not only provides an advanced geographic information system (GIS) interface to support decision making, but also includes topic-based modules that explain and illustrate key concepts for nontechnical users. The purpose of this report is to familiarize both technical and nontechnical users with the IMMAGE Web site and its various applications.

PDM and the Internet: A Look at Product Management and Its Internet Opportunities.

ERIC Educational Resources Information Center

Mendel, Alan

1997-01-01

Discusses the impact of internet technology on product data management (PDM) vendor's and the users' purchasing decisions. Internet users anticipate graphical user interface (GUI) and two-way communication which allow users to enter and modify data as well as access it. Examines PDM and the Internet: price and performance, the World Wide Web,…

Internet-based interventions for the prevention and treatment of depression in people living in developing countries: A systematic review.

PubMed

Martínez, Pablo; Rojas, Graciela; Martínez, Vania; Lara, María Asunción; Pérez, J Carola

2018-07-01

Internet-based interventions for depression may be a valuable resource to reduce the treatment gap for those living in developing countries. However, evidence comes mainly from developed countries. This systematic review summarized the evidence on preventive or therapeutic Internet-based interventions for depression for people who reside in developing countries. CINAHL, EMBASE, PubMed, SciELO Citation Indexes, the Journal of Medical Internet Research, and the Telemedicine and e-Health journal, were searched up to June 2017, to identify feasibility or effectiveness studies of preventive or therapeutic Internet-based interventions for depression, with or without human support. Studies included subjects residing in developing countries, and were published in English or Spanish. Study protocols were included. Risk of bias and/or quality of the reporting of the studies included was assessed. Five feasibility studies, aimed at the prevention of depression, and a study protocol were included in this systematic review. Reports came mostly from the Americas (n = 4). Internet-based interventions aimed at the prevention of depression presented low levels of human support, were useful and acceptable to their users, and require further design refinements to improve their use and retention. No gray literature was searched or included in this systematic review. Searches were limited to English and Spanish languages. Internet-based interventions aimed at the prevention of depression in people who reside in developing countries are in an early phase of development, limiting the generalizability of the results. Future studies must employ persuasive designs to improve user retention, incorporating larger samples and a control group to conclusively determine feasibility. Copyright © 2018 Elsevier B.V. All rights reserved.

SmallTool - a toolkit for realizing shared virtual environments on the Internet

NASA Astrophysics Data System (ADS)

Broll, Wolfgang

1998-09-01

With increasing graphics capabilities of computers and higher network communication speed, networked virtual environments have become available to a large number of people. While the virtual reality modelling language (VRML) provides users with the ability to exchange 3D data, there is still a lack of appropriate support to realize large-scale multi-user applications on the Internet. In this paper we will present SmallTool, a toolkit to support shared virtual environments on the Internet. The toolkit consists of a VRML-based parsing and rendering library, a device library, and a network library. This paper will focus on the networking architecture, provided by the network library - the distributed worlds transfer and communication protocol (DWTP). DWTP provides an application-independent network architecture to support large-scale multi-user environments on the Internet.

Components and Outcomes of Internet-Based Interventions for Caregivers of Older Adults: Systematic Review.

PubMed

Guay, Cassioppée; Auger, Claudine; Demers, Louise; Mortenson, W Ben; Miller, William C; Gélinas-Bronsard, Dominique; Ahmed, Sara

2017-09-19

When trying to access interventions to improve their well-being and quality of life, family caregivers face many challenges. Internet-based interventions provide new and accessible opportunities to remotely support them and can contribute to reducing their burden. However, little is known about the link existing between the components, the use of behavior change techniques, and the outcomes of these Internet-based interventions. This study aimed to provide an update on the best available evidence about the efficacy of Internet-based interventions for caregivers of older adults. Specifically, the components and the use of behavior change techniques and how they impact on the efficacy of the intervention were sought. A systematic review searched primary source studies published between 2000 and 2015. Included studies were scored with a high level of evidence by independent raters using the GRADE criteria and reported caregiver-specific outcomes about interventions delivered through the Internet for caregivers of people aged 50 years and older. A narrative synthesis identified intervention components (eg, content, multimedia use, interactive online activities, and provision of support), behavior change techniques, and caregiver outcomes (eg, effects on stressors, mediators, and psychological health). The risk of bias within the included studies was assessed. A total of 2338 articles were screened and 12 studies describing 10 Internet-based interventions were identified. Seven of these interventions led to statistically significant improvements in caregiver outcomes (eg, reducing depression or anxiety, n=4). These efficacious interventions used interactive components, such as online exercises and homework (n=4) or questionnaires on health status (n=2) and five of them incorporated remote human support, either by professionals or peers. The most frequently used behavior change techniques included in efficacious interventions were provision of social support (n=6) and combinations of instructions to guide behavior change and barrier identification (n=5). The design and aim of the included studies did not permit determining exactly which component and/or behavior change technique was more efficacious in producing positive outcomes in caregivers. The risk for selection bias was low for all the studies, and low to high for performance, detection, and attrition biases. In sum, Internet-based interventions that incorporate professional and social support, and provide instructions to change behavior and problem solve in an interactive manner appear to lead to positive outcomes in caregivers. Studies isolating the specific effect of components are needed to improve our understanding of the underlying mechanism of action. ©Cassioppée Guay, Claudine Auger, Louise Demers, W Ben Mortenson, William C Miller, Dominique Gélinas-Bronsard, Sara Ahmed. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 19.09.2017.

Supporting Students' Learning and Socioscientific Reasoning About Climate Change—the Effect of Computer-Based Concept Mapping Scaffolds

NASA Astrophysics Data System (ADS)

Eggert, Sabina; Nitsch, Anne; Boone, William J.; Nückles, Matthias; Bögeholz, Susanne

2017-02-01

Climate change is one of the most challenging problems facing today's global society (e.g., IPCC 2013). While climate change is a widely covered topic in the media, and abundant information is made available through the internet, the causes and consequences of climate change in its full complexity are difficult for individuals, especially non-scientists, to grasp. Science education is a field which can play a crucial role in fostering meaningful education of students to become climate literate citizens (e.g., NOAA 2009; Schreiner et al., 41, 3-50, 2005). If students are, at some point, to participate in societal discussions about the sustainable development of our planet, their learning with respect to such issues needs to be supported. This includes the ability to think critically, to cope with complex scientific evidence, which is often subject to ongoing inquiry, and to reach informed decisions on the basis of factual information as well as values-based considerations. The study presented in this paper focused on efforts to advance students in (1) their conceptual understanding about climate change and (2) their socioscientific reasoning and decision making regarding socioscientific issues in general. Although there is evidence that "knowledge" does not guarantee pro-environmental behavior (e.g. Schreiner et al., 41, 3-50, 2005; Skamp et al., 97(2), 191-217, 2013), conceptual, interdisciplinary understanding of climate change is an important prerequisite to change individuals' attitudes towards climate change and thus to eventually foster climate literate citizens (e.g., Clark et al. 2013). In order to foster conceptual understanding and socioscientific reasoning, a computer-based learning environment with an embedded concept mapping tool was utilized to support senior high school students' learning about climate change and possible solution strategies. The evaluation of the effect of different concept mapping scaffolds focused on the quality of student-generated concept maps, as well as on students' test performance with respect to conceptual knowledge as well as socioscientific reasoning and socioscientific decision making.

Components and Outcomes of Internet-Based Interventions for Caregivers of Older Adults: Systematic Review

PubMed Central

Auger, Claudine; Demers, Louise; Mortenson, W Ben; Miller, William C; Gélinas-Bronsard, Dominique; Ahmed, Sara

2017-01-01

Background When trying to access interventions to improve their well-being and quality of life, family caregivers face many challenges. Internet-based interventions provide new and accessible opportunities to remotely support them and can contribute to reducing their burden. However, little is known about the link existing between the components, the use of behavior change techniques, and the outcomes of these Internet-based interventions. Objective This study aimed to provide an update on the best available evidence about the efficacy of Internet-based interventions for caregivers of older adults. Specifically, the components and the use of behavior change techniques and how they impact on the efficacy of the intervention were sought. Methods A systematic review searched primary source studies published between 2000 and 2015. Included studies were scored with a high level of evidence by independent raters using the GRADE criteria and reported caregiver-specific outcomes about interventions delivered through the Internet for caregivers of people aged 50 years and older. A narrative synthesis identified intervention components (eg, content, multimedia use, interactive online activities, and provision of support), behavior change techniques, and caregiver outcomes (eg, effects on stressors, mediators, and psychological health). The risk of bias within the included studies was assessed. Results A total of 2338 articles were screened and 12 studies describing 10 Internet-based interventions were identified. Seven of these interventions led to statistically significant improvements in caregiver outcomes (eg, reducing depression or anxiety, n=4). These efficacious interventions used interactive components, such as online exercises and homework (n=4) or questionnaires on health status (n=2) and five of them incorporated remote human support, either by professionals or peers. The most frequently used behavior change techniques included in efficacious interventions were provision of social support (n=6) and combinations of instructions to guide behavior change and barrier identification (n=5). The design and aim of the included studies did not permit determining exactly which component and/or behavior change technique was more efficacious in producing positive outcomes in caregivers. The risk for selection bias was low for all the studies, and low to high for performance, detection, and attrition biases. Conclusions In sum, Internet-based interventions that incorporate professional and social support, and provide instructions to change behavior and problem solve in an interactive manner appear to lead to positive outcomes in caregivers. Studies isolating the specific effect of components are needed to improve our understanding of the underlying mechanism of action. PMID:28928109

Preferences for Depression Treatment Including Internet-Based Interventions: Results From a Large Sample of Primary Care Patients

PubMed Central

Dorow, Marie; Löbner, Margrit; Pabst, Alexander; Stein, Janine; Riedel-Heller, Steffi G.

2018-01-01

Background: To date, little is known about treatment preferences for depression concerning new media. This study aims to (1) investigate treatment preferences for depression including internet-based interventions and (2) examine subgroup differences concerning age, gender and severity of depression as well as patient-related factors associated with treatment preferences. Methods: Data were derived from the baseline assessment of the @ktiv-trial. Depression treatment preferences were assessed from n = 641 primary care patients with mild to moderate depression regarding the following treatments: medication, psychotherapy, combined treatment, alternative treatment, talking to friends and family, exercise, self-help literature, and internet-based interventions. Depression severity was specified by GPs according to ICD-10 criteria. Ordinal logistic regression models were conducted to identify associated factors of treatment preferences. Results: Patients had a mean age of 43.9 years (SD = 13.8) and more than two thirds (68.6%) were female. About 43% of patients had mild depression while 57% were diagnosed with moderate depression. The majority of patients reported strong preferences for psychotherapy, talking to friends and family, and exercise. About one in five patients was very likely to consider internet-based interventions in case of depression. Younger patients expressed significantly stronger treatment preferences for psychotherapy and internet-based interventions than older patients. The most salient factors associated with treatment preferences were the patients' education and perceived self-efficacy. Conclusions: Patients with depression report individually different treatment preferences.Our results underline the importance of shared decision-making within primary care. Future studies should investigate treatment preferences for different types of internet-based interventions. PMID:29867605

Variation Among Internet Based Calculators in Predicting Spontaneous Resolution of Vesicoureteral Reflux

PubMed Central

Routh, Jonathan C.; Gong, Edward M.; Cannon, Glenn M.; Yu, Richard N.; Gargollo, Patricio C.; Nelson, Caleb P.

2010-01-01

Purpose An increasing number of parents and practitioners use the Internet for health related purposes, and an increasing number of models are available on the Internet for predicting spontaneous resolution rates for children with vesi-coureteral reflux. We sought to determine whether currently available Internet based calculators for vesicoureteral reflux resolution produce systematically different results. Materials and Methods Following a systematic Internet search we identified 3 Internet based calculators of spontaneous resolution rates for children with vesicoureteral reflux, of which 2 were academic affiliated and 1 was industry affiliated. We generated a random cohort of 100 hypothetical patients with a wide range of clinical characteristics and entered the data on each patient into each calculator. We then compared the results from the calculators in terms of mean predicted resolution probability and number of cases deemed likely to resolve at various cutoff probabilities. Results Mean predicted resolution probabilities were 41% and 36% (range 31% to 41%) for the 2 academic affiliated calculators and 33% for the industry affiliated calculator (p = 0.02). For some patients the calculators produced markedly different probabilities of spontaneous resolution, in some instances ranging from 24% to 89% for the same patient. At thresholds greater than 5%, 10% and 25% probability of spontaneous resolution the calculators differed significantly regarding whether cases would resolve (all p < 0.0001). Conclusions Predicted probabilities of spontaneous resolution of vesicoureteral reflux differ significantly among Internet based calculators. For certain patients, particularly those with a lower probability of spontaneous resolution, these differences can significantly influence clinical decision making. PMID:20172550

The role of health information sources in decision-making among Hispanic mothers during their children’s first 1000 days of life

PubMed Central

Criss, Shaniece; Woo Baidal, Jennifer A.; Goldman, Roberta E.; Perkins, Meghan; Cunningham, Courtney; Taveras, Elsie M.

2015-01-01

Objective This qualitative research aimed to explore how health information sources inform decision-making among Hispanic mothers during their children’s first 1000 days of life (conception-age 24 months), and to generate appropriate health information sources and communication strategies for future interventions. Methods We conducted 7 focus groups with 49 Hispanic women who were pregnant or had children < 2 years old. Domains included interpersonal and media sources, source trustworthiness, dealing with contradictory information, and how information affects decision-making. We used immersion/crystallization process for analysis. Results Trusted health information sources included health care providers, female and male family members, BabyCenter.com and other Internet sources, selected social media, and television. Some immigrant women reported preferring the Internet citing less established local support networks. Women highlighted the importance of validating health information through checking multiple sources for consistency and resolving contradictory information. Mothers expressed interest in receiving reliable website links from healthcare professionals and outreach to extended family. Conclusion Cultural factors, including immigration status, are important in understanding the use of health information sources and their role in decision-making about pregnancy and child health among Hispanic mothers. Healthcare providers and public health professionals should consider Hispanic mothers health information environment and provide culturally-relevant communication strategies and interventions during this high information-seeking time period. PMID:26122256

Decision Facilitator for Launch Operations using Intelligent Agents

NASA Technical Reports Server (NTRS)

Thirumalainambi, Rajkumar; Bardina, Jorge

2005-01-01

Launch operations require millions of micro-decisions which contribute to the macro decision of 'Go/No-Go' for a launch. Knowledge workers"(such as managers and technical professionals) need information in a timely precise manner as it can greatly affect mission success. The intelligent agent (web search agent) uses the words of a hypertext markup language document which is connected through the internet. The intelligent agent's actions are to determine if its goal of seeking a website containing a specified target (e.g., keyword or phrase), has been met. There are few parameters that should be defined for the keyword search like "Go" and "No-Go". Instead of visiting launch and range decision making servers individually, the decision facilitator constantly connects to all servers, accumulating decisions so the final decision can be decided in a timely manner. The facilitator agent uses the singleton design pattern, which ensures that only a single instance of the facilitator agent exists at one time. Negotiations could proceed between many agents resulting in a final decision. This paper describes details of intelligent agents and their interaction to derive an unified decision support system.

Internet based HIV prevention research targeting rural MSM: feasibility, acceptability, and preliminary efficacy

PubMed Central

Williams, M. L.; Daniel, C. M.; Clayton, S.

2008-01-01

Internet delivered primary prevention interventions for HIV risk reduction present significant challenges. Changing lifestyle behaviors, such as beginning to use condoms, is difficult and men seeking dates on line may want to avoid thinking about HIV risk which may lead to low initiation and high dropout rates. Many Internet delivered HIV risk reduction programs have mimicked face-to-face outreach programs, failing to take advantage of the Internet’s capabilities or did not conduct evaluation. This study focuses on examining the feasibility, acceptability, and efficacy of an Internet delivered HIV risk reduction program for rural men who have sex with men (MSM). The program included online recruiting, three intervention modules, each with two sessions, online questionnaires. The intervention was developed based on iterative research and the Information-Motivation-Behavioral skills model. Participants (N = 475) were randomly assigned to one of six module orders and data were collected automatically at pre-test and after each module. Data supports the feasibility and acceptability of the program as demonstrated by good retention and rapid program completion. Knowledge, self-efficacy, outcome expectancies and motivation increase in a dose response fashion. Post-intervention behavior changes included reduced anal sex and significant increases in condom use. Limitations include a short follow-up period, a predominantly young white rural sample, and the lack of an attention control. Overall the results of the study provide support for the efficacy of Internet-based interventions to reduce risk of HIV infection. Results also support traditional research methods to evaluate HIV prevention programs delivered exclusively through the Internet. PMID:18770021

Enabling Real-time Water Decision Support Services Using Model as a Service

NASA Astrophysics Data System (ADS)

Zhao, T.; Minsker, B. S.; Lee, J. S.; Salas, F. R.; Maidment, D. R.; David, C. H.

2014-12-01

Through application of computational methods and an integrated information system, data and river modeling services can help researchers and decision makers more rapidly understand river conditions under alternative scenarios. To enable this capability, workflows (i.e., analysis and model steps) are created and published as Web services delivered through an internet browser, including model inputs, a published workflow service, and visualized outputs. The RAPID model, which is a river routing model developed at University of Texas Austin for parallel computation of river discharge, has been implemented as a workflow and published as a Web application. This allows non-technical users to remotely execute the model and visualize results as a service through a simple Web interface. The model service and Web application has been prototyped in the San Antonio and Guadalupe River Basin in Texas, with input from university and agency partners. In the future, optimization model workflows will be developed to link with the RAPID model workflow to provide real-time water allocation decision support services.

Implementing Internet-Based Self-Care Programs in Primary Care: Qualitative Analysis of Determinants of Practice for Patients and Providers.

PubMed

Hermes, Eric; Burrone, Laura; Perez, Elliottnell; Martino, Steve; Rowe, Michael

2018-05-18

Access to evidence-based interventions for common mental health conditions is limited due to geographic distance, scheduling, stigma, and provider availability. Internet-based self-care programs may mitigate these barriers. However, little is known about internet-based self-care program implementation in US health care systems. The objective of this study was to identify determinants of practice for internet-based self-care program use in primary care by eliciting provider and administrator perspectives on internet-based self-care program implementation. The objective was explored through qualitative analysis of semistructured interviews with primary care providers and administrators from the Veterans Health Administration. Participants were identified using a reputation-based snowball design. Interviews focused on identifying determinants of practice for the use of internet-based self-care programs at the point of care in Veterans Health Administration primary care. Qualitative analysis of transcripts was performed using thematic coding. A total of 20 physicians, psychologists, social workers, and nurses participated in interviews. Among this group, internet-based self-care program use was relatively low, but support for the platform was assessed as relatively high. Themes were organized into determinants active at patient and provider levels. Perceived patient-level determinants included literacy, age, internet access, patient expectations, internet-based self-care program fit with patient experiences, interest and motivation, and face-to-face human contact. Perceived provider-level determinants included familiarity with internet-based self-care programs, changes to traditional care delivery, face-to-face human contact, competing demands, and age. This exploration of perspectives on internet-based self-care program implementation among Veterans Health Administration providers and administrators revealed key determinants of practice, which can be used to develop comprehensive strategies for the implementation of internet-based self-care programs in primary care settings. ©Eric Hermes, Laura Burrone, Elliottnell Perez, Steve Martino, Michael Rowe. Originally published in JMIR Mental Health (http://mental.jmir.org), 18.05.2018.

HIV-infected women’s perspectives on the use of the Internet for social support: A potential role for online group-based interventions

PubMed Central

Blackstock, Oni J.; Shah, Pooja A.; Haughton, Lorlette J.; Horvath, Keith J.; Cunningham, Chinazo O.

2015-01-01

While the development and implementation of HIV-related online interventions has expanded, few have been tailored for women or have leveraged Web 2.0’s capabilities to provide social support. We conducted semi-structured interviews with 27 women with HIV at an urban community health center to understand their perspectives on the potential role of the Internet and the use of an online group format to provide social support. Data were analyzed using the constant comparative method. We identified six themes: a need for groups and increased sense of connectedness, convenience and accessibility, trust as a precondition for participating, online groups as a potential facilitator or barrier to expression, limited digital access and literacy, and privacy concerns. Overall, women were highly supportive of online group-based interventions but acknowledged the need for increased digital access and Internet navigation training. Hybrid (in-person and online) interventions may be most useful for women with HIV. PMID:25749532

The forum as a friend: parental mental illness and communication on open Internet forums.

PubMed

Widemalm, My; Hjärthag, Fredrik

2015-10-01

The aim of this study was to identify how daughters or sons to parents suffering from mental illness perceive their situation. The objective was to provide new knowledge based on what they communicate on open Internet forums. The sample consisted of forum posts written by individuals who reported that they had mentally ill parents. Data collection comprised 301 comments from 35 forum threads on 5 different Swedish Internet forums, and predetermined inclusion criteria were used. Data were analyzed qualitatively using thematic analysis. The analysis generated four themes: "Caregiver burden," "Knowledge seeking," "Support from the forum," and "Frustration and powerlessness over health care." The results showed that parents' mental illness affected the forum writers on several levels, and they often felt stigmatized. The writers often lacked knowledge of their parents' mental illness and sought out Internet forums for information and support from peers in similar situations. The psychiatric care given to the parents was a source of dissatisfaction among the forum writers, who often felt that their parents did not receive adequate care. This study shows that fear of stigmatization and perceived lack of care and support caused forum writers to anonymously seek out Internet forums for information and support from others with similar experiences. The role of social support and the attractiveness of anonymity and availability typical for open Internet forums ought to be considered by health care professionals and researchers when developing new ways for providing support for children or adolescents with a mentally ill parent.

The impact of the Internet on cancer outcomes.

PubMed

Eysenbach, Gunther

2003-01-01

Each day, more than 12.5 million health-related computer searches are conducted on the World Wide Web. Based on a meta-analysis of 24 published surveys, the author estimates that in the developed world, about 39% of persons with cancer are using the Internet, and approximately 2.3 million persons living with cancer worldwide are online. In addition, 15% to 20% of persons with cancer use the Internet "indirectly" through family and friends. Based on a comprehensive review of the literature, the available evidence on how persons with cancer are using the Internet and the effect of Internet use on persons with cancer is summarized. The author distinguishes four areas of Internet use: communication (electronic mail), community (virtual support groups), content (health information on the World Wide Web), and e-commerce. A conceptual framework summarizing the factors involved in a possible link between Internet use and cancer outcomes is presented, and future areas for research are highlighted.

Sifting Through It All: Characterizing Melanoma Patients' Utilization of the Internet as an Information Source.

PubMed

Hamilton, Sarah Nicole; Scali, Elena P; Yu, Irene; Gusnowski, Eva; Ingledew, Paris-Ann

2015-09-01

This study describes how melanoma patients used the Internet as a melanoma information source and how it impacted their clinical encounter and treatment decision. From 2010 to 2013, melanoma patients were invited to complete a 23-question paper survey with open- and close-ended questions. Thirty-one of the 62 patients approached completed the survey. The majority (90 %) of respondents used the Internet as a melanoma information source. Most (90 %) had used the search engine Google. The most commonly searched topics were melanoma treatment (96 %), screening (64 %), and prevention (64 %). While most respondents (85 %) found the Internet was a useful melanoma information source, over half (54 %) found melanoma websites at least somewhat difficult to understand. Many (78 %) believed it increased their understanding of their diagnosis, 71 % thought it influenced their treatment decision, and 59 % felt it impacted their specialist consultation. This study informs health care professionals that many melanoma patients search the Internet for information regarding their diagnosis and that it may impact their disease understanding and treatment decisions.

A validation of well-being and happiness surveys for administration via the Internet.

PubMed

Howell, Ryan T; Rodzon, Katrina S; Kurai, Mark; Sanchez, Amy H

2010-08-01

Internet research is appealing because it is a cost- and time-efficient way to access a large number of participants; however, the validity of Internet research for important subjective well-being (SWB) surveys has not been adequately assessed. The goal of the present study was to validate the Satisfaction With Life Scale (SWLS; Diener, Emmons, Larsen, & Griffin, 1985), the Positive and Negative Affect Schedule (PANAS-X; Watson & Clark, 1994), and the Subjective Happiness Scale (SHS; Lyubomirsky & Lepper, 1999) for use on the Internet. This study compared the quality of data collected using paper-based (paper-and-pencil version in a lab setting), computer-based (Web-based version in a lab setting), and Internet (Web-based version on a computer of the participant's choosing) surveys for these three measures of SWB. The paper-based and computer-based experiment recruited two college student samples; the Internet experiments recruited a college student sample and an adult sample responding to ads on different social-networking Web sites. This study provides support for the reliability, validity, and generalizability of the Internet format of the SWLS, PANAS-X, and SHS. Across the three experiments, the results indicate that the computer-based and Internet surveys had means, standard deviations, reliabilities, and factor structures that were similar to those of the paper-based versions. The discussion examines the difficulty of higher attrition for the Internet version, the need to examine reverse-coded items in the future, and the possibility that unhappy individuals are more likely to participate in Internet surveys of SWB.

Elements of an integrated health monitoring framework

NASA Astrophysics Data System (ADS)

Fraser, Michael; Elgamal, Ahmed; Conte, Joel P.; Masri, Sami; Fountain, Tony; Gupta, Amarnath; Trivedi, Mohan; El Zarki, Magda

2003-07-01

Internet technologies are increasingly facilitating real-time monitoring of Bridges and Highways. The advances in wireless communications for instance, are allowing practical deployments for large extended systems. Sensor data, including video signals, can be used for long-term condition assessment, traffic-load regulation, emergency response, and seismic safety applications. Computer-based automated signal-analysis algorithms routinely process the incoming data and determine anomalies based on pre-defined response thresholds and more involved signal analysis techniques. Upon authentication, appropriate action may be authorized for maintenance, early warning, and/or emergency response. In such a strategy, data from thousands of sensors can be analyzed with near real-time and long-term assessment and decision-making implications. Addressing the above, a flexible and scalable (e.g., for an entire Highway system, or portfolio of Networked Civil Infrastructure) software architecture/framework is being developed and implemented. This framework will network and integrate real-time heterogeneous sensor data, database and archiving systems, computer vision, data analysis and interpretation, physics-based numerical simulation of complex structural systems, visualization, reliability & risk analysis, and rational statistical decision-making procedures. Thus, within this framework, data is converted into information, information into knowledge, and knowledge into decision at the end of the pipeline. Such a decision-support system contributes to the vitality of our economy, as rehabilitation, renewal, replacement, and/or maintenance of this infrastructure are estimated to require expenditures in the Trillion-dollar range nationwide, including issues of Homeland security and natural disaster mitigation. A pilot website (http://bridge.ucsd.edu/compositedeck.html) currently depicts some basic elements of the envisioned integrated health monitoring analysis framework.

Online support for individuals with spinal cord injuries: An ethnographic investigation

PubMed Central

O'Riley, Alisa A.; Rose, Jon; Dalal, Brinda

2014-01-01

Background Although social support is an important protective factor for individuals with spinal cord injuries (SCIs), individuals often encounter significant barriers to obtaining support after experiencing a SCI. It has been suggested that the Internet may serve to help individuals with disabilities overcome common barriers in obtaining support, yet research examining the efficacy of Internet-based support for individuals with SCI has been mixed. Objective To develop a more nuanced understanding of how individuals with SCI can or might use the Internet for support. Design Using an ethnographic approach, we conducted semi-structured interviews with nine individuals with SCI to explore perceived needs and barriers to information-seeking and online support. Setting Participants were recruited from Veterans Administration medical center outpatient and inpatient units providing specialty care to individuals with SCIs and from a community SCI Center of Excellence. Results Individuals with SCI gain emotional, problem-focused, and reciprocal support from online sources. Conclusions Online resources can provide important opportunities for social support for individuals with SCI. PMID:24090378

Prevalence and characteristics of smokers interested in internet-based smoking cessation interventions: cross-sectional findings from a national household survey.

PubMed

Brown, Jamie; Michie, Susan; Raupach, Tobias; West, Robert

2013-03-18

An accurate and up-to-date estimate of the potential reach of Internet-based smoking cessation interventions (ISCIs) would improve calculations of impact while an understanding of the characteristics of potential users would facilitate the design of interventions. This study reports the prevalence and the sociodemographic, smoking, and Internet-use characteristics of smokers interested in using ISCIs in a nationally representative sample. Data were collected using cross-sectional household surveys of representative samples of adults in England. Interest in trying an Internet site or "app" that was proven to help with stopping smoking was assessed in 1128 adult smokers in addition to sociodemographic characteristics, dependence, motivation to quit, previous attempts to quit smoking, Internet and handheld computer access, and recent types of information searched online. Of a representative sample of current smokers, 46.6% (95% CI 43.5%-49.6%) were interested in using an Internet-based smoking cessation intervention. In contrast, only 0.3% (95% CI 0%-0.7%) of smokers reported having used such an intervention to support their most recent quit attempt within the past year. After adjusting for all other background characteristics, interested smokers were younger (OR=0.98, 95% CI 0.97-0.99), reported stronger urges (OR=1.29, 95% CI 1.10-1.51), were more motivated to quit within 3 months (OR=2.16, 95% CI 1.54-3.02), and were more likely to have made a quit attempt in the past year (OR=1.76, 95% CI 1.30-2.37), access the Internet at least weekly (OR=2.17, 95% CI 1.40-3.36), have handheld computer access (OR=1.65, 95% CI 1.22-2.24), and have used the Internet to search for online smoking cessation information or support in past 3 months (OR=2.82, 95% CI 1.20-6.62). There was no association with social grade. Almost half of all smokers in England are interested in using online smoking cessation interventions, yet fewer than 1% have used them to support a quit attempt in the past year. Interest is not associated with social grade but is associated with being younger, more highly motivated, more cigarette dependent, having attempted to quit recently, having regular Internet and handheld computer access, and having recently searched for online smoking cessation information and support.

Environmental stewardship practices of veterinary professionals and educators related to use and disposal of pharmaceuticals and personal care products.

PubMed

Lam, Jennifer; Chan, Samuel S; Conway, Flaxen D L; Stone, David

2018-03-01

OBJECTIVE To document the environmental stewardship practices (decisions and actions regarding use and disposal) of pet and human pharmaceuticals and personal care products (PPCPs) among pet-owning veterinary-care professionals (practicing veterinarians, veterinary students, and veterinary technicians and trainees) and environmental educators. DESIGN Internet-based cross-sectional survey. SAMPLE 191 pet owners (103 veterinary-care professionals and 88 environmental educators). PROCEDURES Study participants were recruited by means of a 2-part internet survey distributed to veterinary-care professional and environmental educator networks of individuals residing in Washington state, Oregon, and southern California. Survey questions addressed motivators for environmental stewardship practices (ie, decisions and actions regarding use and disposal of pet and human PPCPs). RESULTS Data were collected from 191 respondents; the response rate for individuals who self-selected to opt in was 78% (191/246). Of the 191 respondents, 42 (22%) stored pet pharmaceuticals indefinitely. The most common disposal method was the garbage (88/191 [46%]). Veterinary-care professionals counseled clients infrequently regarding environmental stewardship practices for PPCPs. Fifty-five percent (105/191) of all respondents preferred more environmentally friendly and clinically effective PPCPs. CONCLUSIONS AND CLINICAL RELEVANCE Results of the present survey emphasized the urgent need for improved educational resources to minimize environmental contamination from improper disposal of PPCPs. Environmental and economic motivations among pet owners in the veterinary-care and education professions indicate further opportunities for outreach and institutional support.

Comorbidity of Internet use disorder and attention deficit hyperactivity disorder: Two adult case-control studies.

PubMed

Bielefeld, Martin; Drews, Marion; Putzig, Inken; Bottel, Laura; Steinbüchel, Toni; Dieris-Hirche, Jan; Szycik, Gregor R; Müller, Astrid; Roy, Mandy; Ohlmeier, Martin; Theodor Te Wildt, Bert

2017-12-01

Objectives There is good scientific evidence that attention deficit hyperactivity disorder (ADHD) is both a predictor and a comorbidity of addictive disorders in adulthood. These associations not only focus on substance-related addictions but also on behavioral addictions like gambling disorder and Internet use disorder (IUD). For IUD, systematic reviews have identified ADHD as one of the most prevalent comorbidities besides depressive and anxiety disorders. Yet, there is a need to further understand the connections between both disorders to derive implications for specific treatment and prevention. This is especially the case in adult clinical populations where little is known about these relations so far. This study was meant to further investigate this issue in more detail based on the general hypothesis that there is a decisive intersection of psychopathology and etiology between IUD and ADHD. Methods Two case-control samples were examined at a university hospital. Adult ADHD and IUD patients ran through a comprehensive clinical and psychometrical workup. Results We found support for the hypothesis that ADHD and IUD share psychopathological features. Among patients of each group, we found substantial prevalence rates of a comorbid ADHD in IUD and vice versa. Furthermore, ADHD symptoms were positively associated with media use times and symptoms of Internet addiction in both samples. Discussion Clinical practitioners should be aware of the close relationships between the two disorders both diagnostically and therapeutically. When it comes to regain control over one's Internet use throughout treatment and rehabilitation, a potential shift of addiction must be kept in mind on side of practitioners and patients.

General Formalism of Decision Making Based on Theory of Open Quantum Systems

NASA Astrophysics Data System (ADS)

Asano, M.; Ohya, M.; Basieva, I.; Khrennikov, A.

2013-01-01

We present the general formalism of decision making which is based on the theory of open quantum systems. A person (decision maker), say Alice, is considered as a quantum-like system, i.e., a system which information processing follows the laws of quantum information theory. To make decision, Alice interacts with a huge mental bath. Depending on context of decision making this bath can include her social environment, mass media (TV, newspapers, INTERNET), and memory. Dynamics of an ensemble of such Alices is described by Gorini-Kossakowski-Sudarshan-Lindblad (GKSL) equation. We speculate that in the processes of evolution biosystems (especially human beings) designed such "mental Hamiltonians" and GKSL-operators that any solution of the corresponding GKSL-equation stabilizes to a diagonal density operator (In the basis of decision making.) This limiting density operator describes population in which all superpositions of possible decisions has already been resolved. In principle, this approach can be used for the prediction of the distribution of possible decisions in human populations.

Pathway Linking Internet Health Information Seeking to Better Health: A Moderated Mediation Study.

PubMed

Jiang, Shaohai; Street, Richard L

2017-08-01

The Internet increasingly has been recognized as an important medium with respect to population health. However, little is known about the mechanisms that underlie the potential impact of health-related Internet use on health outcomes. Based on the three-stage model of health promotion using interactive media, this study empirically tested a moderated mediation pathway model. Results showed that the effect of Internet health information seeking on three health outcomes (general, emotional, and physical) was completely mediated by respondents' access to social support resources. In addition, users' online health information seeking experience positively moderated this mediation path. The findings have significant theoretical and practical implications for the design of Internet-based health promotion resources to improve health outcomes.

Internet Sex Ads for MSM and Partner Selection Criteria: The Potency of Race/Ethnicity Online

PubMed Central

Paul, Jay P.; Ayala, George; Choi, Kyung-Hee

2009-01-01

The explosive growth in Internet use by MSM to find sexual partners has been noted in the research literature. However, little attention has been given to the impact of participating in this online sexual marketplace for MSM of color, despite race/ethnicity as a frequently used selection criterion in personal ads or profiles. Six focus group discussions [n=50], and 35 in-depth qualitative interviews were conducted with African American, Latino, Asian and Pacific Islander MSM in Los Angeles, which included discussion of their use of Internet sites to meet/interact with other MSM. Men reported race/ethnicity as a pervasive and powerful factor in facilitating or derailing Internet-mediated sexual encounters. The racialized interactions that MSM of color reported ranged from simple expressions of race-based preferences to blatantly discriminatory/hostile interactions and often demeaning race-based sexual objectification. Experiences of rejection and a perceived hierarchy of value in the sexual market based on race had definite costs for these MSM using these online sites. Furthermore, the private and solitary nature of seeking partners online meant that there was little to buffer the corrosive aspects of those negative experiences. These online dynamics have implications for the power balance in Internet-mediated sexual liaisons, including sexual decision-making and sexual risk. PMID:21322176

Primary Care Provider Views About Usefulness and Dissemination of a Web-Based Depression Treatment Information Decision Aid.

PubMed

Beaulac, Julie; Westmacott, Robin; Walker, John R; Vardanyan, Gohar

2016-06-08

Decisions related to mental health are often complex, problems often remain undetected and untreated, information unavailable or not used, and treatment decisions frequently not informed by best practice or patient preferences. The objective of this paper was to obtain the opinions of health professionals working in primary health care settings about a Web-based information decision aid (IDA) for patients concerning treatment options for depression and the dissemination of the resources in primary care settings. Participants were recruited from primary care clinics in Winnipeg and Ottawa, Canada, and included 48 family physicians, nurses, and primary care staff. The study design was a qualitative framework analytic approach of 5 focus groups. Focus groups were conducted during regular staff meetings, were digitally recorded, and transcripts created. Analysis involved a content and theme analysis. Seven key themes emerged including the key role of the primary care provider, common questions about treatments, treatment barriers, sources of patient information, concern about quality and quantity of available information, positive opinions about the IDA, and disseminating the IDA. The most common questions mentioned were about medication and side effects and alternatives to medication. Patients have limited access to alternative treatment options owing to cost and availability. Practitioners evaluated the IDA positively. The resources were described as useful, supportive of providers' messages, and accessible for patients. There was unanimous consensus that information needs to be available electronically through the Internet.

Selling Internet Service: An Ancient Art Form on a New Canvas.

ERIC Educational Resources Information Center

Maloff, Joel H.

1992-01-01

The Internet, no longer solely the domain of scientists and network engineers, is expanding rapidly to serve a diverse community of business professionals. Those marketing Internet services to these decision makers must practice the ancient art of salesmanship in a complex technological environment. Crucial is knowledge of Internet opportunities,…

Physiological markers of biased decision-making in problematic Internet users.

PubMed

Nikolaidou, Maria; Fraser, Danaë Stanton; Hinvest, Neal

2016-09-01

Background and aims Addiction has been reliably associated with biased emotional reactions to risky choices. Problematic Internet use (PIU) is a relatively new concept and its classification as an addiction is debated. Implicit emotional responses were measured in individuals expressing nonproblematic and problematic Internet behaviors while they made risky/ambiguous decisions to explore whether they showed similar responses to those found in agreed-upon addictions. Methods The design of the study was cross sectional. Participants were adult Internet users (N = 72). All testing took place in the Psychophysics Laboratory at the University of Bath, UK. Participants were given the Iowa Gambling Task (IGT) which provides an index of an individual's ability to process and learn probabilities of reward and loss. Integration of emotions into current decision-making frameworks is vital for optimal performance on the IGT and thus, skin conductance responses (SCRs) to reward, punishment, and in anticipation of both were measured to assess emotional function. Results Performance on the IGT did not differ between the groups of Internet users. However, problematic Internet users expressed increased sensitivity to punishment as revealed by stronger SCRs to trials with higher punishment magnitude. Discussion and conclusions PIU seems to differ on behavioral and physiological levels with other addictions. However, our data imply that problematic Internet users were more risk-sensitive, which is a suggestion that needs to be incorporated into in any measure and, potentially, any intervention for PIU.

Internet Technology on Spacecraft

NASA Technical Reports Server (NTRS)

Rash, James; Parise, Ron; Hogie, Keith; Criscuolo, Ed; Langston, Jim; Powers, Edward I. (Technical Monitor)

2000-01-01

The Operating Missions as Nodes on the Internet (OMNI) project has shown that Internet technology works in space missions through a demonstration using the UoSAT-12 spacecraft. An Internet Protocol (IP) stack was installed on the orbiting UoSAT-12 spacecraft and tests were run to demonstrate Internet connectivity and measure performance. This also forms the basis for demonstrating subsequent scenarios. This approach provides capabilities heretofore either too expensive or simply not feasible such as reconfiguration on orbit. The OMNI project recognized the need to reduce the risk perceived by mission managers and did this with a multi-phase strategy. In the initial phase, the concepts were implemented in a prototype system that includes space similar components communicating over the TDRS (space network) and the terrestrial Internet. The demonstration system includes a simulated spacecraft with sample instruments. Over 25 demonstrations have been given to mission and project managers, National Aeronautics and Space Administration (NASA), Department of Defense (DoD), contractor technologists and other decisions makers, This initial phase reached a high point with an OMNI demonstration given from a booth at the Johnson Space Center (JSC) Inspection Day 99 exhibition. The proof to mission managers is provided during this second phase with year 2000 accomplishments: testing the use of Internet technologies onboard an actual spacecraft. This was done with a series of tests performed using the UoSAT-12 spacecraft. This spacecraft was reconfigured on orbit at very low cost. The total period between concept and the first tests was only 6 months! On board software was modified to add an IP stack to support basic IP communications. Also added was support for ping, traceroute and network timing protocol (NTP) tests. These tests show that basic Internet functionality can be used onboard spacecraft. The performance of data was measured to show no degradation from current approaches. The cost to implement is much less than current approaches due to the availability of highly reliable and standard Internet tools. Use of standard Internet applications onboard reduces the risk of obsolescence inherent in custom protocols due to extremely wide use across all domains. These basic building blocks provide the framework for building onboard software to support direct user communication with payloads including payload control. Other benefits are payload to payload communication from dissimilar spacecraft, constellations of spacecraft, and reconfigurability on orbit. This work is funded through contract with the National Aeronautics and Space Administration (NASA) Goddard Space Flight Center (GSFC).

The Healthcare Administrator's Associate: an experiment in distributed healthcare information systems.

PubMed Central

Fowler, J.; Martin, G.

1997-01-01

The Healthcare Administrator's Associate is a collection of portable tools designed to support analysis of data retrieved via the Internet from diverse distributed healthcare information systems by means of the InfoSleuth system of distributed software agents. Development of these tools is part of an effort to enhance access to diverse and geographically distributed healthcare data in order to improve the basis upon which administrative and clinical decisions are made. PMID:9357686

An Analysis of Some Variables Affecting the Internet Dependency Level of Turkish Adolescents by Using Decision Tree Methods

ERIC Educational Resources Information Center

Kayri, Murat; Gunuc, Selim

2010-01-01

Internet dependency is going to expand into social life in wide area whereas it has been accepted as a pathological and psychological disease. Knowing the basic effects of internet dependency is an inevitable approach to use the internet technology healthy. In this study, internet dependency levels of 754 students were examined with the Internet…

Colorado Late Cenozoic Fault and Fold Database and Internet Map Server: User-friendly technology for complex information

USGS Publications Warehouse

Morgan, K.S.; Pattyn, G.J.; Morgan, M.L.

2005-01-01

Internet mapping applications for geologic data allow simultaneous data delivery and collection, enabling quick data modification while efficiently supplying the end user with information. Utilizing Web-based technologies, the Colorado Geological Survey's Colorado Late Cenozoic Fault and Fold Database was transformed from a monothematic, nonspatial Microsoft Access database into a complex information set incorporating multiple data sources. The resulting user-friendly format supports easy analysis and browsing. The core of the application is the Microsoft Access database, which contains information compiled from available literature about faults and folds that are known or suspected to have moved during the late Cenozoic. The database contains nonspatial fields such as structure type, age, and rate of movement. Geographic locations of the fault and fold traces were compiled from previous studies at 1:250,000 scale to form a spatial database containing information such as length and strike. Integration of the two databases allowed both spatial and nonspatial information to be presented on the Internet as a single dataset (http://geosurvey.state.co.us/pubs/ceno/). The user-friendly interface enables users to view and query the data in an integrated manner, thus providing multiple ways to locate desired information. Retaining the digital data format also allows continuous data updating and quick delivery of newly acquired information. This dataset is a valuable resource to anyone interested in earthquake hazards and the activity of faults and folds in Colorado. Additional geologic hazard layers and imagery may aid in decision support and hazard evaluation. The up-to-date and customizable maps are invaluable tools for researchers or the public.

Collaboration via E-Mail and Internet Relay Chat: Understanding Time and Technology.

ERIC Educational Resources Information Center

Duin, Ann Hill; Archee, Ray

1996-01-01

Examines how college students working across distances used e-mail and Internet Relay Chat (IRC) to facilitate their collaboration and decision-making processes. Finds that students came to a decision more quickly using e-mail than with IRC, and when IRC was slow, students reverted to a series of rapid-fire e-mail messages. (RS)

The Development of a Nurse-Led Internet-Based Learning and Self-care Program for Cancer Patients With Symptoms of Anxiety and Depression-A Part of U-CARE.

PubMed

Hauffman, Anna; Alfonsson, Sven; Mattsson, Susanne; Forslund, Marina; Bill-Axelson, Anna; Nygren, Peter; Johansson, Birgitta

Having access to information about the disease and being encouraged to participate in self-care activities may reduce anxiety and depression symptoms in cancer patients. Internet-based interventions may be one way to support effective self-care strategies to improve emotional well-being and health-related quality of life. The aim of this study was to describe the development and acceptance of an Internet-based program intended to support cancer patients with anxiety and depression symptoms. A structured collaboration between patients, clinicians, and researchers was used to develop a theory- and evidence-based interactive health communication application (IHCA) based on Orem's self-care deficit nursing theory with influences from Bandura's social learning theory and psychoeducation. The result is an IHCA described as a Nurse-led, Internet-based Learning and Self-care program that helps patients to perform self-care using different types of material in interaction with patients and healthcare staff. The acceptance of the program is consistent with the results of similar studies. Collaboration between patients, clinicians, and researchers seems to be a fruitful approach in the development of an IHCA aiming to support cancer patients' self-care strategies. Well-designed intervention studies are needed to evaluate the effects of the IHCA. This article suggests a theoretical foundation for an IHCA and allows researchers and healthcare providers to take part in the discussion regarding format and content of IHCAs.

AdaBoost-based algorithm for network intrusion detection.

PubMed

Hu, Weiming; Hu, Wei; Maybank, Steve

2008-04-01

Network intrusion detection aims at distinguishing the attacks on the Internet from normal use of the Internet. It is an indispensable part of the information security system. Due to the variety of network behaviors and the rapid development of attack fashions, it is necessary to develop fast machine-learning-based intrusion detection algorithms with high detection rates and low false-alarm rates. In this correspondence, we propose an intrusion detection algorithm based on the AdaBoost algorithm. In the algorithm, decision stumps are used as weak classifiers. The decision rules are provided for both categorical and continuous features. By combining the weak classifiers for continuous features and the weak classifiers for categorical features into a strong classifier, the relations between these two different types of features are handled naturally, without any forced conversions between continuous and categorical features. Adaptable initial weights and a simple strategy for avoiding overfitting are adopted to improve the performance of the algorithm. Experimental results show that our algorithm has low computational complexity and error rates, as compared with algorithms of higher computational complexity, as tested on the benchmark sample data.

[Attendance for Using Internet-Based Support After Inpatient Treatment - A Cross-Sectional Survey].

PubMed

Frank, Fabian; Gräder, Nicola; Dahlmann, Hannah; Berger, Mathias; Hölzel, Lars

2018-05-01

Examination of the attendance for using internet-based measures after inpatient treatment. Cross-sectional-survey in former inpatients (N = 247). 44.9 % are willing to use measures via videoconference, 34.7 % via Chat, 50.0 % via E-Mail and 38.0 % as onlinetherapy. Attendance is lower in older age groups. Benefits regarding the introduced measures are seen mainly in the flexibility and disadvantages in the impersonal character. A relevant share of especially younger patients is willing to use internet-based measures. © Georg Thieme Verlag KG Stuttgart · New York.

Internet embeddedness: links with online health information seeking, expectancy value/quality of health information websites, and Internet usage patterns.

PubMed

Leung, Louis

2008-10-01

To see how the Internet is actually embedded in our lives, this exploratory study examines how Internet users search the Web for important information, especially health or medical information, to make critical decisions, and the perception of how intimately our lives are embedded in the Internet intersects with patterns of health information seeking online and the expected quality of health information websites. Data from a probability sample of 569 Internet users found four types of commonly sought health information clusters online which included information on (a) health improvement, (b) medical treatment, (c) family health, and (d) health issues that are difficult to talk about. Results also show that behavior or behavioral intentions in health information seeking are in fact either a function of value expectancy or the evaluation of health information websites. More importantly, people who often go to the Internet for health information and have high expectations of the value and quality of health information websites (especially in terms of reliability, relevance/context, and interaction) tend to be those who are more likely to perceive the Internet as playing an important role in life decisions or rate the Internet as more embedded in their lives.

Manufacturing process and material selection in concurrent collaborative design of MEMS devices

NASA Astrophysics Data System (ADS)

Zha, Xuan F.; Du, H.

2003-09-01

In this paper we present knowledge of an intensive approach and system for selecting suitable manufacturing processes and materials for microelectromechanical systems (MEMS) devices in concurrent collaborative design environment. In the paper, fundamental issues on MEMS manufacturing process and material selection such as concurrent design framework, manufacturing process and material hierarchies, and selection strategy are first addressed. Then, a fuzzy decision support scheme for a multi-criteria decision-making problem is proposed for estimating, ranking and selecting possible manufacturing processes, materials and their combinations. A Web-based prototype advisory system for the MEMS manufacturing process and material selection, WebMEMS-MASS, is developed based on the client-knowledge server architecture and framework to help the designer find good processes and materials for MEMS devices. The system, as one of the important parts of an advanced simulation and modeling tool for MEMS design, is a concept level process and material selection tool, which can be used as a standalone application or a Java applet via the Web. The running sessions of the system are inter-linked with webpages of tutorials and reference pages to explain the facets, fabrication processes and material choices, and calculations and reasoning in selection are performed using process capability and material property data from a remote Web-based database and interactive knowledge base that can be maintained and updated via the Internet. The use of the developed system including operation scenario, use support, and integration with an MEMS collaborative design system is presented. Finally, an illustration example is provided.

Supporting virtual enterprise design by a web-based information model

NASA Astrophysics Data System (ADS)

Li, Dong; Barn, Balbir; McKay, Alison; de Pennington, Alan

2001-10-01

Development of IT and its applications have led to significant changes in business processes. To pursue agility, flexibility and best service to customers, enterprises focus on their core competence and dynamically build relationships with partners to form virtual enterprises as customer driven temporary demand chains/networks. Building the networked enterprise needs responsively interactive decisions instead of a single-direction partner selection process. Benefits and risks in the combination should be systematically analysed, and aggregated information about value-adding abilities and risks of networks needs to be derived from interactions of all partners. In this research, a hierarchical information model to assess partnerships for designing virtual enterprises was developed. Internet technique has been applied to the evaluation process so that interactive decisions can be visualised and made responsively during the design process. The assessment is based on the process which allows each partner responds to requirements of the virtual enterprise by planning its operational process as a bidder. The assessment is then produced by making an aggregated value to represent prospect of the combination of partners given current bidding. Final design is a combination of partners with the greatest total value-adding capability and lowest risk.

Impaired decision-making and impulse control in Internet gaming addicts: evidence from the comparison with recreational Internet game users.

PubMed

Wang, Yifan; Wu, Lingdan; Wang, Lingxiao; Zhang, Yifen; Du, Xiaoxia; Dong, Guangheng

2017-11-01

Although Internet games have been proven to be addictive, only a few game players develop online gaming addiction. A large number of players play online games recreationally without being addicted to it. These individuals are defined as recreational Internet gaming users (RGU). So far, no research has investigated decision-making and impulse control in RGU. In the current study, we used delay discounting (DD) task and probabilistic discounting (PD) task to examine decision-making and impulse control in 20 healthy controls, 20 subjects with Internet gaming disorder (IGD) and 23 RGU during fMRI scanning. At the behavioral level, RGU showed lower DD rate and higher PD rate than subjects with IGD and there was no significant difference between RGU and healthy controls on the DD and PD rates. At the neural level, RGU showed increased neural response in the parahippocampal gyrus, the anterior cingulate cortex, the medial frontal gyrus and the inferior frontal gyrus as compared with subjects with IGD. These brain regions may play an important role in preventing RGU from developing addiction. The results suggest that the RGU are capable of inhibiting impulse due to additional cognitive endeavor and the subjects with IGD have deficit in decision-making and impulsive control, which are associated with brain dysfunction. © 2016 Society for the Study of Addiction.

RHAPSODY - Internet-based support for caregivers of people with young onset dementia: program design and methods of a pilot study.

PubMed

Kurz, Alexander; Bakker, Christian; Böhm, Markus; Diehl-Schmid, Janine; Dubois, Bruno; Ferreira, Catarina; Gage, Heather; Graff, Caroline; Hergueta, Thierry; Jansen, Sabine; Jones, Bridget; Komar, Alexander; de Mendonça, Alexandre; Metcalfe, Anna; Milecka, Katrina; Millenaar, Joany; Orrung Wallin, Anneli; Oyebode, Jan; Schneider-Schelte, Helga; Saxl, Susanna; de Vugt, Marjolein

2016-12-01

Young Onset Dementia (YOD), defined by first symptoms of cognitive or behavioral decline occurring before the age of 65 years, is relatively rare compared to dementia of later onset, but it is associated with diagnostic difficulty and heavy burden on affected individuals and their informal carers. Existing health and social care structures rarely meet the needs of YOD patients. Internet-based interventions are a novel format of delivering health-related education, counseling, and support to this vulnerable yet underserved group. The RHAPSODY (Research to Assess Policies and Strategies for Dementia in the Young) project is a European initiative to improve care for people with YOD by providing an internet-based information and skill-building program for family carers. The e-learning program focuses on managing problem behaviors, dealing with role change, obtaining support, and looking after oneself. It will be evaluated in a pilot study in three countries using a randomized unblinded design with a wait-list control group. Participants will be informal carers of people with dementia in Alzheimer's disease or behavioral-variant Frontotemporal degeneration with an onset before the age of 65 years. The primary outcome will be caregiving self-efficacy after 6 weeks of program use. As secondary outcomes, caregivers' stress and burden, carer health-related quality of life, caring-related knowledge, patient problem behaviors, and user satisfaction will be assessed. Program utilization will be monitored and a health-economic evaluation will also be performed. The RHAPSODY project will add to the evidence on the potential and limitations of a conveniently accessible, user-friendly, and comprehensive internet-based intervention as an alternative for traditional forms of counseling and support in healthcare, aiming to optimize care and support for people with YOD and their informal caregivers.

General Vulnerability and Exposure Profile to Tsunami in Puerto Rico

NASA Astrophysics Data System (ADS)

Ruiz, R.; Huérfano-Moreno, V.

2012-12-01

The Puerto Rico archipelago, located in the seismically active Caribbean region, has been directly affected by tsunamis in the last two centuries. The M 7.3 tsunamigenic earthquake, which occurred on October 11, 1918, caused $29 million in damage, death of 116 people and 100 residents were reported as missing. Presently, deficiencies on urban planning have induced an increase on the number of vulnerable people living inside the tsunami flood areas. Tsunami-prone areas have been delimited for Puerto Rico based on numerical tsunami modeling. However, the demographic, social and physical (e.g. critical and essential facilities) characteristics of these areas have not been documented in detail. We are conducting a municipality and community-level tsunami vulnerability and exposure study using Geographical Information System (GIS) tool. The results of our study are being integrated into the Puerto Rico Disaster Decision Support Tool (DDST). The DDST is a tool that brings access, at no cost, to a variety of updated geo-referenced information for Puerto Rico. This tool provides internet-based scalable maps that will aid emergency managers and decision-makers on their responsibilities and will improve Puerto Rico communities' resilience against tsunami hazard. This project aims to provide an initial estimate of Puerto Rico vulnerability and exposure to tsunami and brings to the community a technological tool that will help increase their awareness of this hazard and to assist them on their decisions.

Social media use by orthodontic patients.

PubMed

Henzell, M; Knight, A; Antoun, J S; Farella, M

2013-12-01

Internet-based social media sites have recently surged in popularity and are often used to share thoughts and seek support about health issues. The aim of this study was to investigate how orthodontic patients use Internet-based social media sites to share their treatment-related experiences and attitudes towards braces. A secondary objective was to investigate whether an online or mobile application would be considered helpful in improving co-operation with the use of orthodontic appliances. Patients visiting the orthodontic clinic at the University of Otago were asked to participate in a cross-sectional survey that sought details of their Internet-based social media use and their thoughts about the development of a reminder application. The sample comprised 130 orthodontic patients, with a mean age of 17.2 (SD 6.9) and a nearly equal sex distribution (52.3% were female). Internet-based social media sites were used by 80.8%, with Facebook being the most popular. Some 13.3% of the sample had posted comments about braces on these social media sites. Only 6.7% had considered obtaining information about orthodontic treatment from Internet-based social media sites, with the majority (81%) preferring to seek this information directly from their orthodontist. Nearly two-thirds of those who had difficulty remembering to wear their orthodontic appliances reported that a reminder application on their phone would be beneficial. A large proportion of orthodontic patients use Internet-based social media sites, although only a few currently use them to post about treatment-related topics. Social media sites may provide a useful channel of communication for patients seeking support. Further research is needed to evaluate the use of phone reminder applications in orthodontics.

Technology and Curriculum Standards: How Well Do Internet-Based Learning Games Support Common Core Standards for Mathematics?

ERIC Educational Resources Information Center

Bingham, Teri; Ray, Jan

2013-01-01

In an effort to keep up with the new generation of digital learners, educators are integrating multiple forms of technology into their teaching, including online learning game applications. The purpose of this study was to determine the degree to which internet-based learning game applications selected by preservice teachers were aligned with the…

The roles of social factor and internet self-efficacy in nurses' web-based continuing learning.

PubMed

Chiu, Yen-Lin; Tsai, Chin-Chung

2014-03-01

This study was conducted to explore the relationships among social factor, Internet self-efficacy and attitudes toward web-based continuing learning in a clinical nursing setting. The participants recruited were 244 in-service nurses from hospitals in Taiwan. Three instruments were used to assess their perceptions of social factor, Internet self-efficacy (including basic and advanced Internet self-efficacy) and attitudes toward web-based continuing learning (including perceived usefulness, perceived ease of use, affection and behavior). Structural equation modeling (SEM) was utilized to identify the hypothesized structural model. The results of this study support that social factor is a significant factor correlated to Internet self-efficacy and attitudes toward web-based continuing learning (including perceived usefulness, perceived ease of use and affection). In addition, nurses' basic Internet self-efficacy plays a key role in attitudes including perceived usefulness, perceived ease of use and affection. However, advanced self-efficacy was not correlated to any of the attitudes. The behavior dimension was not linked to social factor or Internet self-efficacy, but was linked to perceived ease of use and affection. Copyright © 2013 Elsevier Ltd. All rights reserved.

Research on web-based decision support system for sports competitions

NASA Astrophysics Data System (ADS)

Huo, Hanqiang

2010-07-01

This paper describes the system architecture and implementation technology of the decision support system for sports competitions, discusses the design of decision-making modules, management modules and security of the system, and proposes the development idea of building a web-based decision support system for sports competitions.

Effects of an internet intervention on mothers' psychological, parenting, and health care utilization outcomes.

PubMed

Hudson, Diane Brage; Campbell-Grossman, Christie; Hertzog, Melody

2012-01-01

The purpose of this pilot study was to test the effects of an Internet-based intervention, the New Mothers Network, on single, low-income, adolescent, African American mothers' psychological, parenting, and health care utilization outcomes. The study was based on social support theory. For mothers in the Intervention Group, MSNTV™ was installed in subjects' homes and connected to the Internet. Data were collected at 1 week, 6 weeks, 3 months, and 6 months following the infant's birth. For infant health services utilization, 70.6% of those in the Control Group took their infant to the emergency room at least once during the study compared to 35.7% of mothers in the Intervention Group. The New Mothers Network allowed mothers to share their experiences and acquire information from nurses about caring for themselves and their infants. The New Mothers Network Web site is well poised for nursing driven social support intervention via the Internet, even though access devices are evolving over time.

Patient internet use surrounding cancer clinical trials: clinician perceptions and responses

PubMed Central

Simon, Christian; Schramm, Sarah; Hillis, Stephen

2010-01-01

Clinician perceptions of patient internet use related to clinical trials are not well documented. This exploratory study surveyed how cancer care providers at one NCI-designated cancer center viewed patient internet use surrounding cancer trials, including whether it affected patient decision making regarding trial enrollment. The sample included 20 oncologists (59%) and 14 (41%) nurses (n=34). Most clinicians (n=26; 76%) perceived the internet as having an effect on whether or not patients decided to enroll in a cancer trial. Two thirds (n=17; 65%) felt that this effect was positive, including in terms of enhancing patient knowledge of, access to, and enrollment in trials. Clinicians were asked if they ever discussed with their patients the topic of going online to find out more about cancer trials. Over half (n=18; 58%) who responded (n=31) to this item said yes; the rest (n=13; 42%) said no. The majority (n=10; 77%) in the “no” category were among those who reported that the internet had an effect on patient decision making. These data provisionally suggest that clinicians may see the internet as having mostly a positive effect on patient decision making about cancer trials, but that their communication efforts with patients do not always logically follow from this perception. Provider-patient discussion about internet use may be an opportunity for clinicians to contribute to improved patient knowledge of and enrollment in cancer trials. More research is needed to confirm and explain the gap between clinician perception and communication regarding trial-related internet use by cancer patients. PMID:20227523

Automated Pollution Control

NASA Technical Reports Server (NTRS)

1997-01-01

Patterned after the Cassini Resource Exchange (CRE), Sholtz and Associates established the Automated Credit Exchange (ACE), an Internet-based concept that automates the auctioning of "pollution credits" in Southern California. An early challenge of the Jet Propulsion Laboratory's Cassini mission was allocating the spacecraft's resources. To support the decision-making process, the CRE was developed. The system removes the need for the science instrument manager to know the individual instruments' requirements for the spacecraft resources. Instead, by utilizing principles of exchange, the CRE induces the instrument teams to reveal their requirements. In doing so, they arrive at an efficient allocation of spacecraft resources by trading among themselves. A Southern California RECLAIM air pollution credit trading market has been set up using same bartering methods utilized in the Cassini mission in order to help companies keep pollution and costs down.

Health-Related Internet Use by Children and Adolescents: Systematic Review

PubMed Central

Kwon, Misol

2018-01-01

Background The internet is widely used by children and adolescents, who generally have a high level of competency with technology. Thus, the internet has become a great resource for supporting youth self-care and health-related services. However, few studies have explored adolescents’ internet use for health-related matters. Objective The objective of this systematic literature review was to examine the phenomenon of children and adolescents’ health-related internet use and to identify gaps in the research. Methods A total of 19 studies were selected from a search of major electronic databases: PubMed, Cumulative Index of Nursing and Allied Health Literature, and PsycINFO using the following search terms: “health-related internet use,” “eHealth,” “Internet use for health-related purpose,” “Web-based resource,” “health information seeking,” and “online resource,” combined with “child,” “adolescent,” “student,” “youth,” and “teen.” The children’s and adolescents’ ages were limited to 24 years and younger. The search was conducted from September 2015 to October 2017. The studies identified to contain youth (<24 years) health-related internet use were all published in peer-reviewed journals in the past 10 years; these studies examined general internet use seeking health care services, resources, information, or using the internet for health promotion and self-care. Studies were excluded if they explored the role of the internet as a modality for surveys, recruitment, or searching for relevant literature without specifically aiming to study participants’ health-related internet use; focused solely on quality assurance for specific websites; or were designed to test a specific internet-based intervention. Results Interesting patterns in adolescents’ health-related internet use, such as seeking preventative health care and specific information about medical issues, were identified. Quantitative studies reported rates of the internet use and access among youth, and the purpose and patterns of health-related internet use among youth were identified. A major objective of health-related internet use is to gain information, but there are inconsistencies in adolescents’ perceptions of health-related internet use. Conclusions This study’s findings provide important information on how youth seek information and related support systems for their health care on the internet. The conceptual and methodological limitations of the identified studies, such as the lack of a theoretical background and unrepresentative samples, are discussed, and gaps within the studies are identified for future research. This review also suggests important features for potential Web-based health interventions for children and adolescents. PMID:29615385

Representativeness of two sampling procedures for an internet intervention targeting cancer-related distress: a comparison of convenience and registry samples.

PubMed

Owen, Jason E; Bantum, Erin O'Carroll; Criswell, Kevin; Bazzo, Julie; Gorlick, Amanda; Stanton, Annette L

2014-08-01

Internet interventions often rely on convenience sampling, yet convenience samples may differ in important ways from systematic recruitment approaches. The purpose of this study was to evaluate potential demographic, medical, and psychosocial differences between Internet-recruited and registry-recruited cancer survivors in an Internet-based intervention. Participants were recruited from a cancer registry (n = 80) and via broad Internet outreach efforts (n = 160). Participants completed a set of self-report questionnaires, and both samples were compared to a population-based sample of cancer survivors (n = 5,150). The Internet sample was younger, better educated, more likely to be female, had longer time since diagnosis, and had more advanced stage of disease (p's < .001), and the registry-sample was over-represented by men and those with prostate or other cancer types (p's < .001). The Internet sample also exhibited lower quality of life and social support and greater mood disturbance (p's < .001). Understanding how convenience and systematic samples differ has important implications for external validity and potential for dissemination of Internet-based interventions.

A cognitive-behavioral model of Internet gaming disorder: theoretical underpinnings and clinical implications.

PubMed

Dong, Guangheng; Potenza, Marc N

2014-11-01

Cognitive contributions to the behaviors observed in substance and non-substance addictions have been investigated and characterized. Based on models of drug addictions and the extant literature on Internet gaming disorder (IGD), we propose a cognitive-behavioral model for conceptualizing IGD. The model focuses on three domains and their roles in addictive behaviors. The three domains include motivational drives related to reward-seeking and stress-reduction, behavioral control relating to executive inhibition, and decision-making that involves weighing the pros and cons of engaging in motivated behaviors. Based on this model, we propose how behavioral therapies might target these domains in the treatment of IGD. Copyright © 2014 Elsevier Ltd. All rights reserved.

Integration of Dynamic Models in Range Operations

NASA Technical Reports Server (NTRS)

Bardina, Jorge; Thirumalainambi, Rajkumar

2004-01-01

This work addresses the various model interactions in real-time to make an efficient internet based decision making tool for Shuttle launch. The decision making tool depends on the launch commit criteria coupled with physical models. Dynamic interaction between a wide variety of simulation applications and techniques, embedded algorithms, and data visualizations are needed to exploit the full potential of modeling and simulation. This paper also discusses in depth details of web based 3-D graphics and applications to range safety. The advantages of this dynamic model integration are secure accessibility and distribution of real time information to other NASA centers.

Adherence predictors in an Internet-based Intervention program for depression.

PubMed

Castro, Adoración; López-Del-Hoyo, Yolanda; Peake, Christian; Mayoral, Fermín; Botella, Cristina; García-Campayo, Javier; Baños, Rosa María; Nogueira-Arjona, Raquel; Roca, Miquel; Gili, Margalida

2018-05-01

Internet-delivered psychotherapy has been demonstrated to be effective in the treatment of depression. Nevertheless, the study of the adherence in this type of the treatment reported divergent results. The main objective of this study is to analyze predictors of adherence in a primary care Internet-based intervention for depression in Spain. A multi-center, three arm, parallel, randomized controlled trial was conducted with 194 depressive patients, who were allocated in self-guided or supported-guided intervention. Sociodemographic and clinical characteristics were gathered using a case report form. The Mini international neuropsychiatric interview diagnoses major depression. Beck Depression Inventory was used to assess depression severity. The visual analogic scale assesses the respondent's self-rated health and Short Form Health Survey was used to measure the health-related quality of life. Age results a predictor variable for both intervention groups (with and without therapist support). Perceived health is a negative predictor of adherence for the self-guided intervention when change in depression severity was included in the model. Change in depression severity results a predictor of adherence in the support-guided intervention. Our findings demonstrate that in our sample, there are differences in sociodemographic and clinical variables between active and dropout participants and we provide adherence predictors in each intervention condition of this Internet-based program for depression (self-guided and support-guided). It is important to point that further research in this area is essential to improve tailored interventions and to know specific patients groups can benefit from these interventions.

Physiological markers of biased decision-making in problematic Internet users

PubMed Central

Nikolaidou, Maria; Fraser, Danaë Stanton

2016-01-01

Background and aims Addiction has been reliably associated with biased emotional reactions to risky choices. Problematic Internet use (PIU) is a relatively new concept and its classification as an addiction is debated. Implicit emotional responses were measured in individuals expressing nonproblematic and problematic Internet behaviors while they made risky/ambiguous decisions to explore whether they showed similar responses to those found in agreed-upon addictions. Methods The design of the study was cross sectional. Participants were adult Internet users (N = 72). All testing took place in the Psychophysics Laboratory at the University of Bath, UK. Participants were given the Iowa Gambling Task (IGT) which provides an index of an individual’s ability to process and learn probabilities of reward and loss. Integration of emotions into current decision-making frameworks is vital for optimal performance on the IGT and thus, skin conductance responses (SCRs) to reward, punishment, and in anticipation of both were measured to assess emotional function. Results Performance on the IGT did not differ between the groups of Internet users. However, problematic Internet users expressed increased sensitivity to punishment as revealed by stronger SCRs to trials with higher punishment magnitude. Discussion and conclusions PIU seems to differ on behavioral and physiological levels with other addictions. However, our data imply that problematic Internet users were more risk-sensitive, which is a suggestion that needs to be incorporated into in any measure and, potentially, any intervention for PIU. PMID:27554505

Taking It Online, and Making It Pay.

ERIC Educational Resources Information Center

Online & CD-ROM Review, 1996

1996-01-01

Discusses taking content online and payment models online based on sessions at the 1996 Internet World International conference in London (England). Highlights include publishers' decisions to reproduce materials on the World Wide Web; designing Web sites; guidelines for online content; online pricing; and the pros and cons of charging online…

Development of a culturally appropriate computer-delivered tailored Internet-based health literacy intervention for Spanish-dominant Hispanics living with HIV.

PubMed

Jacobs, Robin J; Caballero, Joshua; Ownby, Raymond L; Kane, Michael N

2014-11-30

Low health literacy is associated with poor medication adherence in persons with human immunodeficiency virus (HIV), which can lead to poor health outcomes. As linguistic minorities, Spanish-dominant Hispanics (SDH) face challenges such as difficulties in obtaining and understanding accurate information about HIV and its treatment. Traditional health educational methods (e.g., pamphlets, talking) may not be as effective as delivering through alternate venues. Technology-based health information interventions have the potential for being readily available on desktop computers or over the Internet. The purpose of this research was to adapt a theoretically-based computer application (initially developed for English-speaking HIV-positive persons) that will provide linguistically and culturally appropriate tailored health education to Spanish-dominant Hispanics with HIV (HIV + SDH). A mixed methods approach using quantitative and qualitative interviews with 25 HIV + SDH and 5 key informants guided by the Information-Motivation-Behavioral (IMB) Skills model was used to investigate cultural factors influencing medication adherence in HIV + SDH. We used a triangulation approach to identify major themes within cultural contexts relevant to understanding factors related to motivation to adhere to treatment. From this data we adapted an automated computer-based health literacy intervention to be delivered in Spanish. Culture-specific motivational factors for treatment adherence in HIV + SDH persons that emerged from the data were stigma, familismo (family), mood, and social support. Using this data, we developed a culturally and linguistically adapted a tailored intervention that provides information about HIV infection, treatment, and medication related problem solving skills (proven effective in English-speaking populations) that can be delivered using touch-screen computers, tablets, and smartphones to be tested in a future study. Using a theoretically-grounded Internet-based eHealth education intervention that builds on knowledge and also targets core cultural determinants of adherence may prove a highly effective approach to improve health literacy and medication decision-making in this group.

A comparative evaluation of the effect of Internet-based CME delivery format on satisfaction, knowledge and confidence.

PubMed

Curran, Vernon R; Fleet, Lisa J; Kirby, Fran

2010-01-29

Internet-based instruction in continuing medical education (CME) has been associated with favorable outcomes. However, more direct comparative studies of different Internet-based interventions, instructional methods, presentation formats, and approaches to implementation are needed. The purpose of this study was to conduct a comparative evaluation of two Internet-based CME delivery formats and the effect on satisfaction, knowledge and confidence outcomes. Evaluative outcomes of two differing formats of an Internet-based CME course with identical subject matter were compared. A Scheduled Group Learning format involved case-based asynchronous discussions with peers and a facilitator over a scheduled 3-week delivery period. An eCME On Demand format did not include facilitated discussion and was not based on a schedule; participants could start and finish at any time. A retrospective, pre-post evaluation study design comparing identical satisfaction, knowledge and confidence outcome measures was conducted. Participants in the Scheduled Group Learning format reported significantly higher mean satisfaction ratings in some areas, performed significantly higher on a post-knowledge assessment and reported significantly higher post-confidence scores than participants in the eCME On Demand format that was not scheduled and did not include facilitated discussion activity. The findings support the instructional benefits of a scheduled delivery format and facilitated asynchronous discussion in Internet-based CME.

The effectiveness of loyalty rewards to promote the use of an Internet-based heart health program.

PubMed

Liu, Sam; Hodgson, Corinne; Zbib, Ahmad M; Payne, Ada Y M; Nolan, Robert P

2014-07-02

Internet-based health programs have been shown to be effective in reducing risk for cardiovascular disease. However, their rates of enrollment and engagement remain low. It is currently unclear whether rewards from established loyalty programs can serve as a conditioned stimulus to improve the use of a freely available Internet-based program. The objectives of the study were to (1) examine enrollment rates and levels of engagement with the My Health eSupport program between a Conditioned Reward group and a Control group, and (2) investigate the influence of loyalty rewards and participant characteristics on levels of enrollment and program engagement. The study sample (n=142,726) consisted of individuals who were offered enrollment in an Internet-based health intervention (My Health eSupport) after completing the Heart&Stroke Risk Assessment on the Heart and Stroke Foundation website. My Health eSupport programs provided encouragement and tips for lifestyle change. This is a free, self-guided, fully automated program that proactively delivers tailored email messages at 2-week intervals based on the participant's stage of motivational "readiness" and priority for lifestyle change. Participants in the Conditioned Reward group were offered a single exposure of 20 loyalty reward points from the Air Miles loyalty program for completing the Heart&Stroke Risk Assessment (10 reward points) and enrolling in the Internet-based program (10 reward points). Meanwhile, no rewards were given to the Control group participants. All data were collected between February 1, 2011 and February 10, 2012. In total, 51.38% (73,327/142,726) of individuals in the Conditioned Reward group and 48.62% (69,399/142,726) of individuals in the Control group completed the Heart&Stroke Risk Assessment. Subsequently, significantly more individuals from the Conditioned Reward group (52.96%, 38,835/73,327) enrolled in the My Health eSupport program than Controls (4.07%, 2826/69,399). Regression analyses indicated that individuals were 27.9 times (95% CI 26.4-29.4; P<.001) more likely to join the My Health eSupport program when presented with loyalty rewards controlling for gender, age, education, ethnicity, employment, and number of modifiable risk factors. However, ongoing engagement level was low in both groups and it was not influenced by loyalty rewards. Instead, individuals were more likely to engage with the My Health eSupport program if they were greater than 60 years of age (OR 12.56, 95% CI 5.66-27.8; P<.001), were female (OR 1.27, 95% CI 1.09-1.46; P=.002), or had one or more modifiable risk factors (OR 1.38, 95% CI 1.31-1.45; P<.001). Our findings suggest that a single exposure of loyalty rewards may be used to encourage individuals to enroll in an Internet-based preventative health program, but additional strategies are required to maintain engagement level. Future studies need to examine the schedules of loyalty reward reinforcement on the long-term engagement level of Internet-based health programs.

The Effectiveness of Loyalty Rewards to Promote the Use of an Internet-Based Heart Health Program

PubMed Central

Liu, Sam; Hodgson, Corinne; Zbib, Ahmad M; Payne, Ada YM

2014-01-01

Background Internet-based health programs have been shown to be effective in reducing risk for cardiovascular disease. However, their rates of enrollment and engagement remain low. It is currently unclear whether rewards from established loyalty programs can serve as a conditioned stimulus to improve the use of a freely available Internet-based program. Objective The objectives of the study were to (1) examine enrollment rates and levels of engagement with the My Health eSupport program between a Conditioned Reward group and a Control group, and (2) investigate the influence of loyalty rewards and participant characteristics on levels of enrollment and program engagement. Methods The study sample (n=142,726) consisted of individuals who were offered enrollment in an Internet-based health intervention (My Health eSupport) after completing the Heart&Stroke Risk Assessment on the Heart and Stroke Foundation website. My Health eSupport programs provided encouragement and tips for lifestyle change. This is a free, self-guided, fully automated program that proactively delivers tailored email messages at 2-week intervals based on the participant’s stage of motivational “readiness” and priority for lifestyle change. Participants in the Conditioned Reward group were offered a single exposure of 20 loyalty reward points from the Air Miles loyalty program for completing the Heart&Stroke Risk Assessment (10 reward points) and enrolling in the Internet-based program (10 reward points). Meanwhile, no rewards were given to the Control group participants. All data were collected between February 1, 2011 and February 10, 2012. Results In total, 51.38% (73,327/142,726) of individuals in the Conditioned Reward group and 48.62% (69,399/142,726) of individuals in the Control group completed the Heart&Stroke Risk Assessment. Subsequently, significantly more individuals from the Conditioned Reward group (52.96%, 38,835/73,327) enrolled in the My Health eSupport program than Controls (4.07%, 2826/69,399). Regression analyses indicated that individuals were 27.9 times (95% CI 26.4-29.4; P<.001) more likely to join the My Health eSupport program when presented with loyalty rewards controlling for gender, age, education, ethnicity, employment, and number of modifiable risk factors. However, ongoing engagement level was low in both groups and it was not influenced by loyalty rewards. Instead, individuals were more likely to engage with the My Health eSupport program if they were greater than 60 years of age (OR 12.56, 95% CI 5.66-27.8; P<.001), were female (OR 1.27, 95% CI 1.09-1.46; P=.002), or had one or more modifiable risk factors (OR 1.38, 95% CI 1.31-1.45; P<.001). Conclusions Our findings suggest that a single exposure of loyalty rewards may be used to encourage individuals to enroll in an Internet-based preventative health program, but additional strategies are required to maintain engagement level. Future studies need to examine the schedules of loyalty reward reinforcement on the long-term engagement level of Internet-based health programs. PMID:24989982

From guideline modeling to guideline execution: defining guideline-based decision-support services.

PubMed Central

Tu, S. W.; Musen, M. A.

2000-01-01

We describe our task-based approach to defining the guideline-based decision-support services that the EON system provides. We categorize uses of guidelines in patient-specific decision support into a set of generic tasks--making of decisions, specification of work to be performed, interpretation of data, setting of goals, and issuance of alert and reminders--that can be solved using various techniques. Our model includes constructs required for representing the knowledge used by these techniques. These constructs form a toolkit from which developers can select modeling solutions for guideline task. Based on the tasks and the guideline model, we define a guideline-execution architecture and a model of interactions between a decision-support server and clients that invoke services provided by the server. These services use generic interfaces derived from guideline tasks and their associated modeling constructs. We describe two implementations of these decision-support services and discuss how this work can be generalized. We argue that a well-defined specification of guideline-based decision-support services will facilitate sharing of tools that implement computable clinical guidelines. PMID:11080007

Should DSM-V Designate “Internet Addiction” a Mental Disorder?

PubMed Central

2009-01-01

There is considerable controversy with respect to so-called internet addiction and whether it ought to be reified as a diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. The relationship between “addiction” and various compulsive or impulsive behaviors is also a source of confusion. Some psychiatrists have argued that internet addiction shows the features of excessive use, withdrawal phenomena, tolerance, and negative repercussions that characterize many substance use disorders; however, there are few physiological data bearing on these claims. It is not clear whether internet addiction usually represents a manifestation of an underlying disorder, or is truly a discrete disease entity. The frequent appearance of internet addiction in the context of numerous comorbid conditions raises complex questions of causality. In order to make nosological decisions regarding internet addiction, we require a more general model of what counts as “disease,” and as a specific disease. Based on a model emphasizing intrinsic suffering and incapacity, as well as data regarding course, prognosis, temporal stability, and response to treatment, it appears premature to consider internet addiction as a discrete disease entity. However, growing research suggests that some individuals with internet addiction are at significant risk and merit our professional care and treatment. Carefully controlled studies are required to settle these controversies. PMID:19724746

The ANU WellBeing study: a protocol for a quasi-factorial randomised controlled trial of the effectiveness of an Internet support group and an automated Internet intervention for depression

PubMed Central

2010-01-01

Background Recent projections suggest that by the year 2030 depression will be the primary cause of disease burden among developed countries. Delivery of accessible consumer-focused evidenced-based services may be an important element in reducing this burden. Many consumers report a preference for self-help modes of delivery. The Internet offers a promising modality for delivering such services and there is now evidence that automated professionally developed self-help psychological interventions can be effective. By contrast, despite their popularity, there is little evidence as to the effectiveness of Internet support groups which provide peer-to-peer mutual support. Methods/Design Members of the community with elevated psychological distress were randomised to receive one of the following: (1) Internet Support Group (ISG) intervention, (2) a multi-module automated psychoeducational and skills Internet Training Program (ITP), (3) a combination of the ISG and ITP, or (4) an Internet Attention Control website (IAC) comprising health and wellbeing information and question and answer modules. Each intervention was 12 weeks long. Assessments were conducted at baseline, post-intervention, 6 and 12 months to examine depressive symptoms, social support, self-esteem, quality of life, depression literacy, stigma and help-seeking for depression. Participants were recruited through a screening postal survey sent to 70,000 Australians aged 18 to 65 years randomly selected from four rural and four metropolitan regions in Australia. Discussion To our knowledge this study is the first randomised controlled trial of the effectiveness of a depression ISG. Trial registration Current Controlled Trials ISRCTN65657330. PMID:20211025

Developing an evidence-based curriculum designed to help psychiatric nurses learn to use computers and the Internet.

PubMed

Koivunen, Marita; Välimäki, Maritta; Jakobsson, Tiina; Pitkänen, Anneli

2008-01-01

This article describes the systematic process in which an evidence-based approach was used to develop a curriculum designed to support the computer and Internet skills of nurses in psychiatric hospitals in Finland. The pressure on organizations to have skilled and motivated nurses who use modern information and communication technology in health care organizations has increased due to rapid technology development at the international and national levels. However, less frequently has the development of those computer education curricula been based on evidence-based knowledge. First, we identified psychiatric nurses' learning experiences and barriers to computer use by examining written essays. Second, nurses' computer skills were surveyed. Last, evidence from the literature was scrutinized to find effective methods that can be used to teach and learn computer use in health care. This information was integrated and used for the development process of an education curriculum designed to support nurses' computer and Internet skills.

Patient expectations in internet-based self-help for social anxiety.

PubMed

Boettcher, Johanna; Renneberg, Babette; Berger, Thomas

2013-01-01

A number of controlled trials have demonstrated the efficacy of Internet-based cognitive-behaviour therapy for treating social anxiety disorder (SAD). However, little is known about what makes those interventions work. The current trial focuses on patient expectations as one common mechanism of change. The study examines whether patients' expectancy predicts outcome, adherence, and dropout in an unguided Internet-based self-help programme for SAD. Data of 109 participants in a 10-week self-help programme for SAD were analysed. Social anxiety measures were administered prior to the intervention, at week 2, and after the intervention. Expectancy was assessed at week 2. Patient expectations were a significant predictor of change in social anxiety (β = - .35 to - .40, all p < .003). Patient expectations also predicted treatment adherence (β = .27, p = .02). Patients with higher expectations showed more adherence and better outcome. Dropout was not predicted by expectations. The effect of positive expectations on outcome was mediated by early symptom change (from week 0 to week 2). Results suggest that positive outcome expectations have a beneficial effect on outcome in Internet-based self-help for SAD. Furthermore, patient expectations as early process predictors could be used to inform therapeutic decisions such as stepping up patients to guided or face-to-face treatment options.

Design, development, and evaluation of an interactive simulator for engineering ethics education (SEEE).

PubMed

Chung, Christopher A; Alfred, Michael

2009-06-01

Societal pressures, accreditation organizations, and licensing agencies are emphasizing the importance of ethics in the engineering curriculum. Traditionally, this subject has been taught using dogma, heuristics, and case study approaches. Most recently a number of organizations have sought to increase the utility of these approaches by utilizing the Internet. Resources from these organizations include on-line courses and tests, videos, and DVDs. While these individual approaches provide a foundation on which to base engineering ethics, they may be limited in developing a student's ability to identify, analyze, and respond to engineering ethics situations outside of the classroom environment. More effective approaches utilize a combination of these types of approaches. This paper describes the design and development of an internet based interactive Simulator for Engineering Ethics Education. The simulator places students in first person perspective scenarios involving different types of ethical situations. Students must gather data, assess the situation, and make decisions. This requires students to develop their own ability to identify and respond to ethical engineering situations. A limited comparison between the internet based interactive simulator and conventional internet web based instruction indicates a statistically significant improvement of 32% in instructional effectiveness. The simulator is currently being used at the University of Houston to help fulfill ABET requirements.

Performance evaluation of the machine learning algorithms used in inference mechanism of a medical decision support system.

PubMed

Bal, Mert; Amasyali, M Fatih; Sever, Hayri; Kose, Guven; Demirhan, Ayse

2014-01-01

The importance of the decision support systems is increasingly supporting the decision making process in cases of uncertainty and the lack of information and they are widely used in various fields like engineering, finance, medicine, and so forth, Medical decision support systems help the healthcare personnel to select optimal method during the treatment of the patients. Decision support systems are intelligent software systems that support decision makers on their decisions. The design of decision support systems consists of four main subjects called inference mechanism, knowledge-base, explanation module, and active memory. Inference mechanism constitutes the basis of decision support systems. There are various methods that can be used in these mechanisms approaches. Some of these methods are decision trees, artificial neural networks, statistical methods, rule-based methods, and so forth. In decision support systems, those methods can be used separately or a hybrid system, and also combination of those methods. In this study, synthetic data with 10, 100, 1000, and 2000 records have been produced to reflect the probabilities on the ALARM network. The accuracy of 11 machine learning methods for the inference mechanism of medical decision support system is compared on various data sets.

Next Generation Integrated Environment for Collaborative Work Across Internets

DOE Office of Scientific and Technical Information (OSTI.GOV)

Harvey B. Newman

2009-02-24

We are now well-advanced in our development, prototyping and deployment of a high performance next generation Integrated Environment for Collaborative Work. The system, aimed at using the capability of ESnet and Internet2 for rapid data exchange, is based on the Virtual Room Videoconferencing System (VRVS) developed by Caltech. The VRVS system has been chosen by the Internet2 Digital Video (I2-DV) Initiative as a preferred foundation for the development of advanced video, audio and multimedia collaborative applications by the Internet2 community. Today, the system supports high-end, broadcast-quality interactivity, while enabling a wide variety of clients (Mbone, H.323) to participate in themore » same conference by running different standard protocols in different contexts with different bandwidth connection limitations, has a fully Web-integrated user interface, developers and administrative APIs, a widely scalable video network topology based on both multicast domains and unicast tunnels, and demonstrated multiplatform support. This has led to its rapidly expanding production use for national and international scientific collaborations in more than 60 countries. We are also in the process of creating a 'testbed video network' and developing the necessary middleware to support a set of new and essential requirements for rapid data exchange, and a high level of interactivity in large-scale scientific collaborations. These include a set of tunable, scalable differentiated network services adapted to each of the data streams associated with a large number of collaborative sessions, policy-based and network state-based resource scheduling, authentication, and optional encryption to maintain confidentiality of inter-personal communications. High performance testbed video networks will be established in ESnet and Internet2 to test and tune the implementation, using a few target application-sets.« less

Is E-health Progressing Faster Than E-health Researchers?

PubMed Central

2006-01-01

Formal Internet interventions exist in a broad context of diverse online health resources, which share elements in common like information, advice and peer support. However, most online health resources are not created by healthcare professionals. Internet interventions need to be designed to “compete” in that wider context. The democratization of production and distribution is central to the transformative effect of the Internet on society, yet potentially conflicts with healthcare’s need for an evidence base and safe practice. This is a core challenge for healthcare on the Internet. PMID:17032640

Effect of social support on depression of internet addicts and the mediating role of loneliness.

PubMed

He, Fei; Zhou, Qin; Li, Jing; Cao, Rong; Guan, Hao

2014-01-01

Many studies have determined the existence of an extremely close association between Internet addiction and depression. However, the reasons for the depression of Internet addicts have not been fully investigated. This cross-sectional study aims to explore the factors that influence depression among Internet addicts. A total of 162 male Internet addicts completed the Emotional and Social Loneliness Scale, Multidimensional Scale of Perceived Social Support, and Self-Rating Depression Scale. Loneliness and lack of social support are significantly correlated with depression among Internet addicts. Structural Equation Modeling results indicate that social support partially mediates loneliness and depression. Both social support and loneliness were negatively associated with depression of Internet addicts whereas loneliness plays a mediating role between social support and depression.

Patient behavior and the benefits of artificial intelligence: the perils of "dangerous" literacy and illusory patient empowerment.

PubMed

Schulz, Peter J; Nakamoto, Kent

2013-08-01

Artificial intelligence can provide important support of patient health. However, limits to realized benefits can arise as patients assume an active role in their health decisions. Distinguishing the concepts of health literacy and patient empowerment, we analyze conditions that bias patient use of the Internet and limit access to and impact of artificial intelligence. Improving health literacy in the face of the Internet requires significant guidance. Patients must be directed toward the appropriate tools and also provided with key background knowledge enabling them to use the tools and capitalize on the artificial intelligence technology. Benefits of tools employing artificial intelligence to promote health cannot be realized without recognizing and addressing the patients' desires, expectations, and limitations that impact their Internet behavior. In order to benefit from artificial intelligence, patients need a substantial level of background knowledge and skill in information use-i.e., health literacy. It is critical that health professionals respond to patient search for information on the Internet, first by guiding their search to relevant, authoritative, and responsive sources, and second by educating patients about how to interpret the information they are likely to encounter. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Seeking Health Information and Support Online: Does It Differ as a Function of Engagement in Risky Health Behaviors? Evidence From the Health Information National Trends Survey

PubMed Central

Brown, Jamie; Gardner, Benjamin; Smith, Samuel George

2014-01-01

Background The Internet is an important tool to deliver health behavior interventions, yet little is known about Internet access and use of health-related information, or support, by the intended intervention recipients. Objective Our aim was to evaluate whether health-related Internet use differed as a function of common health-risk behaviors (excessive alcohol consumption, smoking, low fruit/vegetable intake, inactive/sedentary lifestyle, unprotected sun exposure, or obesity). Methods Sociodemographic, health behavior characteristics, and information on Internet access and use were assessed in the nationally representative US Health Information National Trends Survey (HINTS) 4. Data from 3911 participants collated in 2011/12 were included. Results Of the 78.2% (95% CI 76.1-80.1) of participants who had ever accessed the Internet, approximately three-quarters (78.2%, 95% CI 75.4-80.7) had obtained health-related information online last year. About half had used the Internet as the first source of health-related information (47.8%, 95% CI 44.8-50.7) or to access behavioral support (56.9%, 95% CI 53.7-60.0) in the last year. Adjusting for sociodemographic determinants of going online (being younger, white, female, with at least college education) revealed few differences in Internet access and use between health-risk behaviors. Participants with inadequate sun protection were less likely to access the Internet (OR 0.59, 95% CI 0.04-0.88) and those with low fruit/vegetable intake were less likely to have gone online to obtain health-related information last year (OR 0.60, 95% CI 0.45-0.80). Smokers in particular were likely to use the Internet to obtain behavioral support (OR 1.90, 95% CI 1.35-2.68). Conclusions Internet access and use to obtain health-related information and support is widespread and mostly independent of engagement in various health-risk behaviors. However, those with low fruit/vegetable intake or inadequate sun-protective behaviors may be more difficult to reach with Internet-based interventions. In addition, when developing online health promotions, relevant sociodemographic determinants of Internet use need to be targeted to maximize their impact. PMID:25380308

Implementation of workflow engine technology to deliver basic clinical decision support functionality.

PubMed

Huser, Vojtech; Rasmussen, Luke V; Oberg, Ryan; Starren, Justin B

2011-04-10

Workflow engine technology represents a new class of software with the ability to graphically model step-based knowledge. We present application of this novel technology to the domain of clinical decision support. Successful implementation of decision support within an electronic health record (EHR) remains an unsolved research challenge. Previous research efforts were mostly based on healthcare-specific representation standards and execution engines and did not reach wide adoption. We focus on two challenges in decision support systems: the ability to test decision logic on retrospective data prior prospective deployment and the challenge of user-friendly representation of clinical logic. We present our implementation of a workflow engine technology that addresses the two above-described challenges in delivering clinical decision support. Our system is based on a cross-industry standard of XML (extensible markup language) process definition language (XPDL). The core components of the system are a workflow editor for modeling clinical scenarios and a workflow engine for execution of those scenarios. We demonstrate, with an open-source and publicly available workflow suite, that clinical decision support logic can be executed on retrospective data. The same flowchart-based representation can also function in a prospective mode where the system can be integrated with an EHR system and respond to real-time clinical events. We limit the scope of our implementation to decision support content generation (which can be EHR system vendor independent). We do not focus on supporting complex decision support content delivery mechanisms due to lack of standardization of EHR systems in this area. We present results of our evaluation of the flowchart-based graphical notation as well as architectural evaluation of our implementation using an established evaluation framework for clinical decision support architecture. We describe an implementation of a free workflow technology software suite (available at http://code.google.com/p/healthflow) and its application in the domain of clinical decision support. Our implementation seamlessly supports clinical logic testing on retrospective data and offers a user-friendly knowledge representation paradigm. With the presented software implementation, we demonstrate that workflow engine technology can provide a decision support platform which evaluates well against an established clinical decision support architecture evaluation framework. Due to cross-industry usage of workflow engine technology, we can expect significant future functionality enhancements that will further improve the technology's capacity to serve as a clinical decision support platform.

The over-optimistic portrayal of life-supporting treatments in newspapers and on the Internet: a cross-sectional study using extra-corporeal membrane oxygenation as an example.

PubMed

Chen, Yen-Yuan; Chen, Likwang; Kao, Yu-Hui; Chu, Tzong-Shinn; Huang, Tien-Shang; Ko, Wen-Je

2014-08-01

Extra-corporeal membrane oxygenation has been introduced to clinical practice for several decades. It is unclear how internet and newspapers portray the use of extra-corporeal membrane oxygenation. This study were: (1) to quantify the coverage of extra-corporeal membrane oxygenation use in newspapers and on the Internet; (2) to describe the characteristics of extra-corporeal membrane oxygenation users presented in newspaper articles and the Internet web pages in comparison with those shown in extra-corporeal membrane oxygenation studies in Taiwan; and (3) to examine the survival rates of extra-corporeal membrane oxygenation users presented in newspaper articles and the Internet web pages in comparison with those in Taiwan and in the Extracorporeal Life Support Registry Report International Summary for January 2014. All issues of Taiwan's four major newspapers from 2006 to 2010 were reviewed. In October 2011, a search of Internet web pages was performed based on the subjects of "yeh-ko-mo" (extra-corporeal membrane oxygenation in Traditional Chinese), "ECMO", and "extra-corporeal membrane oxygenation." All the Internet web pages and newspaper articles recounting the use of extra-corporeal membrane oxygenation were reviewed. The information, such as patient characteristic and the status at hospital discharge, was collected. The survival rate of extra-corporeal membrane oxygenation use shown on the Internet (83.97%) was significantly higher than all the survival rates reported in Taiwan's literature (p < .01) and in the Extracorporeal Life Support Registry Report International Summary for January 2014 (p < .01). In addition, the survival rate of extra-corporeal membrane oxygenation use shown in newspapers (61.54%) was significantly higher than the average survival rate (43%) reported in Taiwan's literature, the pediatric average survival rate (51%), and the adult average survival rate (47%) in the Extracorporeal Life Support Registry Report International Summary for January 2014. Internet and newspapers both showed over-optimistic survival to hospital discharge for patients sustained by extra-corporeal membrane oxygenation. Internet was more likely to provide optimistic information for aggressive life-supporting treatments such as extra-corporeal membrane oxygenation than newspapers as indicated by survival to hospital discharge.

Internet support groups for suicide survivors: a new mode for gaining bereavement assistance.

PubMed

Feigelman, William; Gorman, Bernard S; Beal, Karyl Chastain; Jordan, John R

2008-01-01

Taken among parents who sustained the loss of a child to suicide this study explores the participation of parents in Internet support groups, comparing their demographic and loss-related characteristics (N = 104) to other parent survivors participating in face-to-face support groups (N = 297). Contrary to expectations that Internet affiliates would be concentrated in under-served rural areas, we found similar levels of urban, suburban, small city and rural residents in both Internet and face-to-face subsamples. Bivariate and multivariate analyses suggested several important factors contributing to interest in Internet grief support including: 24/7 availability and opportunities to invest more time into this type of support group experience. Compared to their face-to-face group counterparts, Internet affiliates experienced greater suicide stigmatization from their families and other associates. Unable to find ready comfort and support from their personal communities, Internet users-and especially highly depressed survivors-sought and obtained valuable help from the Internet support resource.

Optical burst switching for the next generation Optical Internet

NASA Astrophysics Data System (ADS)

Yoo, Myungsik

2000-11-01

In recent years, Internet Protocol (IP) over Wavelength Division Multiplexing (WDM) networks for the next generation Internet (or the so-called Optical Internet) have received enormous attention. There are two main drivers for an Optical Internet. One is the explosion of Internet traffic, which seems to keep growing exponentially. The other driver is the rapid advance in the WDM optical networking technology. In this study, key issues in the optical (WDM) layer will be investigated. As a novel switching paradigm for Optical Internet, Optical Burst Switching (OBS) is discussed. By leveraging the attractive properties of optical communications and at the same time, taking into account its limitations, OBS can combine the best of optical circuit-switching and packet/cell switching. The general concept of JET-based OBS protocol is described, including offset time and delayed reservation. In the next generation Optical Internet, one must address how to support Quality of Service (QoS) at the WDM layer since current IP provides only best effort services. The offset-time- based QoS scheme is proposed as a way of supporting QoS at the WDM layer. Unlike existing QoS schemes, offset- time-based QoS scheme does not mandate the use of buffer to differentiate services. For the bufferless WDM switch, the performance of offset- time-based QoS scheme is evaluated in term of blocking probability. In addition, the extra offset time required for class isolation is quantified and the theoretical bounds on blocking probability are analyzed. The offset-time-based scheme is applied to WDM switch with limited fiber delay line (FDL) buffer. We evaluate the effect of having a FDL buffer on the QoS performance of the offset-time-based scheme in terms of the loss probability and queuing delay of bursts. Finally, in order to dimension the network resources in Optical Internet backbone networks, the performance of the offset-time-based QoS scheme is evaluated for the multi-hop case. In particular, we consider very high performance Backbone Network Service (vBNS) backbone network. Various policies such as drop, retransmission, deflection routing and buffering are considered for performance evaluation. The performance results obtained under these policies are compared to decide the most efficient policy for the WDM backbone network.

Guided Act and Feel Indonesia (GAF-ID) - Internet-based behavioral activation intervention for depression in Indonesia: study protocol for a randomized controlled trial.

PubMed

Arjadi, Retha; Nauta, Maaike H; Scholte, Willem F; Hollon, Steven D; Chowdhary, Neerja; Suryani, Angela O; Bockting, Claudi L H

2016-09-17

Depression is a leading cause of disease burden across the world. However, in low-middle income countries (LMICs), access to mental health services is severely limited because of the insufficient number of mental health professionals available. The WHO initiated the Mental Health Gap Action Program (mhGAP) aiming to provide a coherent strategy for closing the gap between what is urgently needed and what is available in LMICs. Internet-based treatment is a promising strategy that can be made available to a large number of people now that Internet access is increasing rapidly throughout the world. The present study will investigate whether such an Internet-based treatment for depression is effective in Indonesia. An Internet-based behavioral activation treatment, with support by lay counselors who will provide online feedback on the assignments and supportive phone contact to encourage participants to work in the program (Guided Act and Feel Indonesia/GAF-ID), is compared to an online-delivered minimal psychoeducation without any support (psychoeducation/PE). Initial assessment for inclusion is based on a Patient Health Questionnaire-9 (PHQ-9) score of at least 10 and meeting criteria for major depressive disorder or persistent depressive disorder as assessed using the Structured Clinical Interview for DSM-5 (SCID-5). Participants with depression (N = 312) will be recruited and randomly assigned to GAF-ID or PE. Overall assessments will be done at baseline, post intervention (10 weeks from baseline) and follow-ups (3 months and 6 months from baseline). The primary outcome is the reduction of depression symptoms as measured by the PHQ-9 after 10 weeks from baseline. To our knowledge, this is the first study in Indonesia that examines the effectiveness of an Internet-based intervention for depression in a randomized controlled trial. The hope is that it can serve as a starting point for bridging the mental health gap in Indonesia and other LMICs. Nederlands Trial Register ( www.trialregister.nl ): NTR5920 , registered on 1 July 2016.

A grounded theory of Internet and social media use by young people who use augmentative and alternative communication (AAC).

PubMed

Hynan, Amanda; Goldbart, Juliet; Murray, Janice

2015-01-01

This paper presents a conceptual grounded theory for how young people with a diagnosis of cerebral palsy who use augmentative and alternative communication (AAC), perceive using the Internet and social media. The aims of the research were to understand and contextualise their perceptions of access and use and explore implications for self-representation and social participation; to date literature on this topic is limited. A constructivist grounded theory research approach concurrently collected and analysed interview data from 25 participants (aged 14-24 years) who use AAC and additional sources. A conceptual grounded theory was developed around an emergent core category that showed young people who use AAC have a clear desire to use the Internet and social media. This was underpinned by eight supporting categories: reported use, described support, online challenges, access technology, speech generating device (SGD) issues, self-determination, self-representation and online social ties. The conceptual grounded theory supports understanding of facilitators and challenges to use of the Internet and social media by young people with a diagnosis of cerebral palsy who use AAC. The grounded theory illustrates how the desire to use the Internet and social media is based upon perceived benefits for enriching social relationships and enhancing opportunities for self-representation and self-determination that are synonymous with identified antecedents for community-based social inclusion. Some of the participants are engaging with the Internet and social media through collaborative practice and the implications for how this phenomenon may impact on orthographic literacy and the personal care workforce are raised.

Understanding the information needs of public health practitioners: a literature review to inform design of an interactive digital knowledge management system.

PubMed

Revere, Debra; Turner, Anne M; Madhavan, Ann; Rambo, Neil; Bugni, Paul F; Kimball, AnnMarie; Fuller, Sherrilynne S

2007-08-01

The need for rapid access to information to support critical decisions in public health cannot be disputed; however, development of such systems requires an understanding of the actual information needs of public health professionals. This paper reports the results of a literature review focused on the information needs of public health professionals. The authors reviewed the public health literature to answer the following questions: (1) What are the information needs of public health professionals? (2) In what ways are those needs being met? (3) What are the barriers to meeting those needs? (4) What is the role of the Internet in meeting information needs? The review was undertaken in order to develop system requirements to inform the design and development of an interactive digital knowledge management system. The goal of the system is to support the collection, management, and retrieval of public health documents, data, learning objects, and tools. The search method extended beyond traditional information resources, such as bibliographic databases, tables of contents (TOC), and bibliographies, to include information resources public health practitioners routinely use or have need to use--for example, grey literature, government reports, Internet-based publications, and meeting abstracts. Although few formal studies of information needs and information-seeking behaviors of public health professionals have been reported, the literature consistently indicated a critical need for comprehensive, coordinated, and accessible information to meet the needs of the public health workforce. Major barriers to information access include time, resource reliability, trustworthiness/credibility of information, and "information overload". Utilizing a novel search method that included the diversity of information resources public health practitioners use, has produced a richer and more useful picture of the information needs of the public health workforce than other literature reviews. There is a critical need for public health digital knowledge management systems designed to reflect the diversity of public health activities, to enable human communications, and to provide multiple access points to critical information resources. Public health librarians and other information specialists can serve a significant role in helping public health professionals meet their information needs through the development of evidence-based decision support systems, human-mediated expert searching and training in the use information retrieval systems.

Web-services-based spatial decision support system to facilitate nuclear waste siting

NASA Astrophysics Data System (ADS)

Huang, L. Xinglai; Sheng, Grant

2006-10-01

The availability of spatial web services enables data sharing among managers, decision and policy makers and other stakeholders in much simpler ways than before and subsequently has created completely new opportunities in the process of spatial decision making. Though generally designed for a certain problem domain, web-services-based spatial decision support systems (WSDSS) can provide a flexible problem-solving environment to explore the decision problem, understand and refine problem definition, and generate and evaluate multiple alternatives for decision. This paper presents a new framework for the development of a web-services-based spatial decision support system. The WSDSS is comprised of distributed web services that either have their own functions or provide different geospatial data and may reside in different computers and locations. WSDSS includes six key components, namely: database management system, catalog, analysis functions and models, GIS viewers and editors, report generators, and graphical user interfaces. In this study, the architecture of a web-services-based spatial decision support system to facilitate nuclear waste siting is described as an example. The theoretical, conceptual and methodological challenges and issues associated with developing web services-based spatial decision support system are described.

Fathers sharing about early parental support in health-care - virtual discussions on an Internet forum.

PubMed

Salzmann-Erikson, Martin; Eriksson, Henrik

2013-07-01

Becoming a father is a life changing event and this transition is associated with various emotions. Educational activities aimed at new parents are important in healthcare parental support (HCPS). HCPS has been critiqued for its predominant focus on mothers, while the needs of fathers seem to have been downplayed. As a result, fathers often turn to Internet-based forums for support. As virtual discussions and mutual support among fathers take place in cyberspace, it is important to monitor these forums to observe the ways in which the fathers discuss HCPS. The aim of this study is to explore the ways in which new fathers visiting an Internet-based forum for fathers communicated their experiences of HCPS. A netnographic method consisting of six steps was used to gather and analyse the data. The findings show that fathers shared with one another their experiences of the attitudes expressed by HCPS workers as well as their own attitudes towards HCPS. The attitudes of HCPS workers that were directed towards the fathers were perceived as highly personal and individual, while fathers described their attitudes towards the HCPS in general terms, towards HCPS as a system. Overall, the fathers described HCPS as a valuable confirmatory support that eased their worries concerning sudden infant death syndrome (SIDS), colic, weight gain, fever and teething. Although the fathers expressed gratitude towards HCPS, they also shared their negative experiences, such as feeling invisible, disregarded and insulted. In fact, the twofold attitudes that exist in the relationship between the fathers and HCPS can act as a barrier rather than being a confirmatory support. We recommend that HCPS adopts a broader approach using more targeted and strategic didactic methods for supporting fathers in the growth of their own personal awareness, as such an approach would offer a competitive and professional alternative to the support offered in informal experience-based Internet forums. © 2013 Blackwell Publishing Ltd.

Characterizing the Processes for Navigating Internet Health Information Using Real-Time Observations: A Mixed-Methods Approach.

PubMed

Perez, Susan L; Paterniti, Debora A; Wilson, Machelle; Bell, Robert A; Chan, Man Shan; Villareal, Chloe C; Nguyen, Hien Huy; Kravitz, Richard L

2015-07-20

Little is known about the processes people use to find health-related information on the Internet or the individual characteristics that shape selection of information-seeking approaches. Our aim was to describe the processes by which users navigate the Internet for information about a hypothetical acute illness and to identify individual characteristics predictive of their information-seeking strategies. Study participants were recruited from public settings and agencies. Interested individuals were screened for eligibility using an online questionnaire. Participants listened to one of two clinical scenarios—consistent with influenza or bacterial meningitis—and then conducted an Internet search. Screen-capture video software captured Internet search mouse clicks and keystrokes. Each step of the search was coded as hypothesis testing (etiology), evidence gathering (symptoms), or action/treatment seeking (behavior). The coded steps were used to form a step-by-step pattern of each participant's information-seeking process. A total of 78 Internet health information seekers ranging from 21-35 years of age and who experienced barriers to accessing health care services participated. We identified 27 unique patterns of information seeking, which were grouped into four overarching classifications based on the number of steps taken during the search, whether a pattern consisted of developing a hypothesis and exploring symptoms before ending the search or searching an action/treatment, and whether a pattern ended with action/treatment seeking. Applying dual-processing theory, we categorized the four overarching pattern classifications as either System 1 (41%, 32/78), unconscious, rapid, automatic, and high capacity processing; or System 2 (59%, 46/78), conscious, slow, and deliberative processing. Using multivariate regression, we found that System 2 processing was associated with higher education and younger age. We identified and classified two approaches to processing Internet health information. System 2 processing, a methodical approach, most resembles the strategies for information processing that have been found in other studies to be associated with higher-quality decisions. We conclude that the quality of Internet health-information seeking could be improved through consumer education on methodical Internet navigation strategies and the incorporation of decision aids into health information websites.

Characterizing the Processes for Navigating Internet Health Information Using Real-Time Observations: A Mixed-Methods Approach

PubMed Central

Paterniti, Debora A; Wilson, Machelle; Bell, Robert A; Chan, Man Shan; Villareal, Chloe C; Nguyen, Hien Huy; Kravitz, Richard L

2015-01-01

Background Little is known about the processes people use to find health-related information on the Internet or the individual characteristics that shape selection of information-seeking approaches. Objective Our aim was to describe the processes by which users navigate the Internet for information about a hypothetical acute illness and to identify individual characteristics predictive of their information-seeking strategies. Methods Study participants were recruited from public settings and agencies. Interested individuals were screened for eligibility using an online questionnaire. Participants listened to one of two clinical scenarios—consistent with influenza or bacterial meningitis—and then conducted an Internet search. Screen-capture video software captured Internet search mouse clicks and keystrokes. Each step of the search was coded as hypothesis testing (etiology), evidence gathering (symptoms), or action/treatment seeking (behavior). The coded steps were used to form a step-by-step pattern of each participant’s information-seeking process. A total of 78 Internet health information seekers ranging from 21-35 years of age and who experienced barriers to accessing health care services participated. Results We identified 27 unique patterns of information seeking, which were grouped into four overarching classifications based on the number of steps taken during the search, whether a pattern consisted of developing a hypothesis and exploring symptoms before ending the search or searching an action/treatment, and whether a pattern ended with action/treatment seeking. Applying dual-processing theory, we categorized the four overarching pattern classifications as either System 1 (41%, 32/78), unconscious, rapid, automatic, and high capacity processing; or System 2 (59%, 46/78), conscious, slow, and deliberative processing. Using multivariate regression, we found that System 2 processing was associated with higher education and younger age. Conclusions We identified and classified two approaches to processing Internet health information. System 2 processing, a methodical approach, most resembles the strategies for information processing that have been found in other studies to be associated with higher-quality decisions. We conclude that the quality of Internet health-information seeking could be improved through consumer education on methodical Internet navigation strategies and the incorporation of decision aids into health information websites. PMID:26194787

Big-Data Based Decision-Support Systems to Improve Clinicians' Cognition.

PubMed

Roosan, Don; Samore, Matthew; Jones, Makoto; Livnat, Yarden; Clutter, Justin

2016-01-01

Complex clinical decision-making could be facilitated by using population health data to inform clinicians. In two previous studies, we interviewed 16 infectious disease experts to understand complex clinical reasoning. For this study, we focused on answers from the experts on how clinical reasoning can be supported by population-based Big-Data. We found cognitive strategies such as trajectory tracking, perspective taking, and metacognition has the potential to improve clinicians' cognition to deal with complex problems. These cognitive strategies could be supported by population health data, and all have important implications for the design of Big-Data based decision-support tools that could be embedded in electronic health records. Our findings provide directions for task allocation and design of decision-support applications for health care industry development of Big data based decision-support systems.

Big-Data Based Decision-Support Systems to Improve Clinicians’ Cognition

PubMed Central

Roosan, Don; Samore, Matthew; Jones, Makoto; Livnat, Yarden; Clutter, Justin

2016-01-01

Complex clinical decision-making could be facilitated by using population health data to inform clinicians. In two previous studies, we interviewed 16 infectious disease experts to understand complex clinical reasoning. For this study, we focused on answers from the experts on how clinical reasoning can be supported by population-based Big-Data. We found cognitive strategies such as trajectory tracking, perspective taking, and metacognition has the potential to improve clinicians’ cognition to deal with complex problems. These cognitive strategies could be supported by population health data, and all have important implications for the design of Big-Data based decision-support tools that could be embedded in electronic health records. Our findings provide directions for task allocation and design of decision-support applications for health care industry development of Big data based decision-support systems. PMID:27990498

The Internet's Impact on Policy Evaluation: Information Compression and Credibility

ERIC Educational Resources Information Center

Bozeman, Barry

2004-01-01

As with all media, the Internet structures and frames information, rewarding some information search and decision behaviors while punishing others and, thereby, strongly influences evaluation research results and possibilities. Now that the Internet is for many evaluators the information medium of choice, the impacts of the medium on evaluation…

Dig That Site: Exploring Archaeology, History, and Civilization on the Internet.

ERIC Educational Resources Information Center

Garfield, Gary M.; McDonough, Suzanne

This book combines the excitement of the Internet with conventional learning resources to explore early civilizations and cultures. This approach encourages independent student research, problem solving, and decision making while bringing together the fascination of archaeology with the Internet and hands-on learning activities. Students learn the…

Internet Policy Handbook for Libraries. Neal-Schuman NetGuide Series.

ERIC Educational Resources Information Center

Smith, Mark

This book is intended to guide library administrators--directors and departmental managers in public, school, and academic libraries--through the many complex decisions inherent in managing public Internet access. The handbook systematically deals with each possible element of an Internet policy. It identifies the options available at each…

A review of decision support, risk communication and patient information tools for thrombolytic treatment in acute stroke: lessons for tool developers

PubMed Central

2013-01-01

Background Tools to support clinical or patient decision-making in the treatment/management of a health condition are used in a range of clinical settings for numerous preference-sensitive healthcare decisions. Their impact in clinical practice is largely dependent on their quality across a range of domains. We critically analysed currently available tools to support decision making or patient understanding in the treatment of acute ischaemic stroke with intravenous thrombolysis, as an exemplar to provide clinicians/researchers with practical guidance on development, evaluation and implementation of such tools for other preference-sensitive treatment options/decisions in different clinical contexts. Methods Tools were identified from bibliographic databases, Internet searches and a survey of UK and North American stroke networks. Two reviewers critically analysed tools to establish: information on benefits/risks of thrombolysis included in tools, and the methods used to convey probabilistic information (verbal descriptors, numerical and graphical); adherence to guidance on presenting outcome probabilities (IPDASi probabilities items) and information content (Picker Institute Checklist); readability (Fog Index); and the extent that tools had comprehensive development processes. Results Nine tools of 26 identified included information on a full range of benefits/risks of thrombolysis. Verbal descriptors, frequencies and percentages were used to convey probabilistic information in 20, 19 and 18 tools respectively, whilst nine used graphical methods. Shortcomings in presentation of outcome probabilities (e.g. omitting outcomes without treatment) were identified. Patient information tools had an aggregate median Fog index score of 10. None of the tools had comprehensive development processes. Conclusions Tools to support decision making or patient understanding in the treatment of acute stroke with thrombolysis have been sub-optimally developed. Development of tools should utilise mixed methods and strategies to meaningfully involve clinicians, patients and their relatives in an iterative design process; include evidence-based methods to augment interpretability of textual and probabilistic information (e.g. graphical displays showing natural frequencies) on the full range of outcome states associated with available options; and address patients with different levels of health literacy. Implementation of tools will be enhanced when mechanisms are in place to periodically assess the relevance of tools and where necessary, update the mode of delivery, form and information content. PMID:23777368

The World Wide Web: a review of an emerging internet-based technology for the distribution of biomedical information.

PubMed Central

Lowe, H J; Lomax, E C; Polonkey, S E

1996-01-01

The Internet is rapidly evolving from a resource used primarily by the research community to a true global information network offering a wide range of databases and services. This evolution presents many opportunities for improved access to biomedical information, but Internet-based resources have often been difficult for the non-expert to develop and use. The World Wide Web (WWW) supports an inexpensive, easy-to-use, cross-platform, graphic interface to the Internet that may radically alter the way we retrieve and disseminate medical data. This paper summarizes the Internet and hypertext origins of the WWW, reviews WWW-specific technologies, and describes current and future applications of this technology in medicine and medical informatics. The paper also includes an appendix of useful biomedical WWW servers. PMID:8750386

Measuring nursing essential contributions to quality patient care outcomes.

PubMed

Wolgast, Kelly A; Taylor, Katherine; Garcia, Dawn; Watkins, Miko

2011-01-01

Workload Management System for Nursing (WMSN) is a core Army Medical Department business system that has provided near real-time, comprehensive nursing workload and manpower data for decision making at all levels for over 25 years. The Army Manpower Requirements and Documentation Agency populates data from WMSN into the Manpower Staffing Standards System (Inpatient module within Automated Staffing Assessment Model). The current system, Workload Management System for Nursing Internet (WMSNi), is an interim solution that requires additional functionalities for modernization and integration at the enterprise level. The expanding missions and approved requirements for WMSNi support strategic initiatives on the Army Medical Command balanced scorecard and require continued sustainment for multiple personnel and manpower business processes for both inpatient and outpatient nursing care. This system is currently being leveraged by the TRICARE Management Activity as an interim multiservice solution, and is being used at 24 Army medical treatment facilities. The evidenced-based information provided to Army decision makers through the methods used in the WMSNi will be essential across the Army Medical Command throughout the system's life cycle.

Research use of the AIDA www.2aida.org diabetes software simulation program: a review-part 1. decision support testing and neural network training.

PubMed

Lehmann, Eldon D

2003-01-01

The purpose of this two-part review is to overview research use of the AIDA diabetes software simulator. AIDA is a diabetes computer program that permits the interactive simulation of plasma insulin and blood glucose profiles for teaching, demonstration, and self-learning purposes. It has been made freely available, without charge, on the Internet as a noncommercial contribution to continuing diabetes education. Since its launch in 1996 over 300,000 visits have been logged at the main AIDA Website-www.2aida.org-and over 60,000 copies of the AIDA program have been downloaded free-of-charge. This review describes research projects and ventures, undertaken for the most part by other research workers in the diabetes computing field, that have made use of the freeware AIDA software. Relevant research work was identified in three main ways: (i) by personal (e-mail/written) communications from researchers, (ii) via the ISI Web of Science citation database to identify published articles that referred to AIDA-related papers, and (iii) via searches on the Internet. In a number of cases research students who had sought advice about AIDA, and diabetes computing in general, provided copies of their research dissertations/theses upon the completion of their projects. The two reviews highlight some of the many and varied research projects that have made use of the AIDA diabetes simulation software to date. A wide variety of diabetes computing topics have been addressed. In Part 1 of the review, these range from testing decision support prototypes to training artificial neural networks. In Part 2 of the review, issues surrounding dietary assessments, developing new diabetes models, and performance monitoring of closed-loop insulin delivery devices are considered. Overall, research projects making use of AIDA have been identified in Australia, Italy, South Korea, the United Kingdom, and the United States. These reviews confirm an unexpected but useful benefit of distributing medical software, like AIDA, for free via the Internet-demonstrating how it is possible to have a synergistic benefit with other researchers-facilitating their own research projects in related medical fields. The reviews highlight a variety of these projects that have benefited from the free availability of the AIDA diabetes software simulator. In a number of cases these other research projects simply would not have been possible without unrestricted access to the AIDA software and/or technical descriptions of its workings. In addition, some specific common themes begin to emerge from the research ventures that have been reviewed. These include the use of simulated blood glucose data from the AIDA program for preliminary computerlab-based testing of other decision support prototypes. Issues surrounding such use of simulated data for separate prototype testing are discussed further in Part 2 of the review.

[Direct-to-consumer genetic testing through Internet: marketing, ethical and social issues].

PubMed

Ducournau, Pascal; Gourraud, Pierre-Antoine; Rial-Sebbag, Emmanuelle; Bulle, Alexandre; Cambon-Thomsen, Anne

2011-01-01

We probably did not anticipate all the consequences of the direct to consumer genetic tests on Internet, resulting from the combined skills of communication and genomic advances. What are the commercial strategies used by the companies offering direct-to-consumer genetic tests on Internet and what are the different social expectations on which they focus? Through a quantitative and qualitative analysis of the web sites offering such tests, it seems that these companies target a triple market based on: the "healthism" which raises health and hygiene to the top of the social values; the contemporary demands of the users to become actual actors of health decisions; and finally on the need for bio-social relationships. These three commercial strategies underlie various ethical and societal issues justifying a general analysis.

Modeling the Mental Health Practice Change Preferences of Educators: A Discrete-Choice Conjoint Experiment.

PubMed

Cunningham, Charles E; Barwick, Melanie; Short, Kathy; Chen, Yvonne; Rimas, Heather; Ratcliffe, Jenna; Mielko, Stephanie

2014-01-01

Schools are sometimes slow to adopt evidence-based strategies for improving the mental health outcomes of students. This study used a discrete-choice conjoint experiment to model factors influencing the decision of educators to adopt strategies for improving children's mental health outcomes. A sample of 1,010 educators made choices between hypothetical mental health practice change strategies composed by systematically varying the four levels of 16 practice change attributes. Latent class analysis yielded two segments with different practice change preferences. Both segments preferred small-group workshops, conducted by engaging experts, teaching skills applicable to all students. Participants expressed little interest in Internet options. The support of colleagues, administrators, and unions exerted a strong influence on the practice change choices of both segments. The Change Ready segment, 77.1 % of the sample, was more intent on adopting new strategies to improve the mental health of students. They preferred that schools, rather than the provincial ministry of education, make practice change decisions, coaching was provided to all participants, and participants received post-training follow-up sessions. The Demand Sensitive segment (22.9 %) was less intent on practice change. They preferred that individual teachers make practice change decisions, recommended discretionary coaching, and chose no post-training follow-up support. This study emphasizes the complex social, organizational, and policy context within which educators make practice change decisions. Efforts to disseminate strategies to improve the mental health outcomes of students need to be informed by the preferences of segments of educators who are sensitive to different dimensions of the practice change process. In the absence of a broad consensus of educators, administrators, and unions, potentially successful practice changes are unlikely to be adopted.

Decision-making for risky gains and losses among college students with Internet gaming disorder.

PubMed

Yao, Yuan-Wei; Chen, Pin-Ru; Li, Song; Wang, Ling-Jiao; Zhang, Jin-Tao; Yip, Sarah W; Chen, Gang; Deng, Lin-Yuan; Liu, Qin-Xue; Fang, Xiao-Yi

2015-01-01

Individuals with Internet gaming disorder (IGD) tend to exhibit disadvantageous risky decision-making not only in their real life but also in laboratory tasks. Decision-making is a complex multifaceted function and different cognitive processes are involved in decision-making for gains and losses. However, the relationship between impaired decision-making and gain versus loss processing in the context of IGD is poorly understood. The main aim of the present study was to separately evaluate decision-making for risky gains and losses among college students with IGD using the Cups task. Additionally, we further examined the effects of outcome magnitude and probability level on decision-making related to risky gains and losses respectively. Sixty college students with IGD and 42 matched healthy controls (HCs) participated. Results indicated that IGD subjects exhibited generally greater risk taking tendencies than HCs. In comparison to HCs, IGD subjects made more disadvantageous risky choices in the loss domain (but not in the gain domain). Follow-up analyses indicated that the impairment was associated to insensitivity to changes in outcome magnitude and probability level for risky losses among IGD subjects. In addition, higher Internet addiction severity scores were associated with percentage of disadvantageous risky options in the loss domain. These findings emphasize the effect of insensitivity to losses on disadvantageous decisions under risk in the context of IGD, which has implications for future intervention studies.

A Middleware with Comprehensive Quality of Context Support for the Internet of Things Applications

PubMed Central

Gomes, Berto de Tácio Pereira; Muniz, Luiz Carlos Melo; dos Santos, Davi Viana; Lopes, Rafael Fernandes; Coutinho, Luciano Reis; Carvalho, Felipe Oliveira; Endler, Markus

2017-01-01

Context aware systems are able to adapt their behavior according to the environment in which the user is. They can be integrated into an Internet of Things (IoT) infrastructure, allowing a better perception of the user’s physical environment by collecting context data from sensors embedded in devices known as smart objects. An IoT extension called the Internet of Mobile Things (IoMT) suggests new scenarios in which smart objects and IoT gateways can move autonomously or be moved easily. In a comprehensive view, Quality of Context (QoC) is a term that can express quality requirements of context aware applications. These requirements can be those related to the quality of information provided by the sensors (e.g., accuracy, resolution, age, validity time) or those referring to the quality of the data distribution service (e.g, reliability, delay, delivery time). Some functionalities of context aware applications and/or decision-making processes of these applications and their users depend on the level of quality of context available, which tend to vary over time for various reasons. Reviewing the literature, it is possible to verify that the quality of context support provided by IoT-oriented middleware systems still has limitations in relation to at least four relevant aspects: (i) quality of context provisioning; (ii) quality of context monitoring; (iii) support for heterogeneous device and technology management; (iv) support for reliable data delivery in mobility scenarios. This paper presents two main contributions: (i) a state-of-the-art survey specifically aimed at analyzing the middleware with quality of context support and; (ii) a new middleware with comprehensive quality of context support for Internet of Things Applications. The proposed middleware was evaluated and the results are presented and discussed in this article, which also shows a case study involving the development of a mobile remote patient monitoring application that was developed using the proposed middleware. This case study highlights how middleware components were used to meet the quality of context requirements of the application. In addition, the proposed middleware was compared to other solutions in the literature. PMID:29292791

A Middleware with Comprehensive Quality of Context Support for the Internet of Things Applications.

PubMed

Gomes, Berto de Tácio Pereira; Muniz, Luiz Carlos Melo; da Silva E Silva, Francisco José; Dos Santos, Davi Viana; Lopes, Rafael Fernandes; Coutinho, Luciano Reis; Carvalho, Felipe Oliveira; Endler, Markus

2017-12-08

Context aware systems are able to adapt their behavior according to the environment in which the user is. They can be integrated into an Internet of Things (IoT) infrastructure, allowing a better perception of the user's physical environment by collecting context data from sensors embedded in devices known as smart objects. An IoT extension called the Internet of Mobile Things (IoMT) suggests new scenarios in which smart objects and IoT gateways can move autonomously or be moved easily. In a comprehensive view, Quality of Context (QoC) is a term that can express quality requirements of context aware applications. These requirements can be those related to the quality of information provided by the sensors (e.g., accuracy, resolution, age, validity time) or those referring to the quality of the data distribution service (e.g, reliability, delay, delivery time). Some functionalities of context aware applications and/or decision-making processes of these applications and their users depend on the level of quality of context available, which tend to vary over time for various reasons. Reviewing the literature, it is possible to verify that the quality of context support provided by IoT-oriented middleware systems still has limitations in relation to at least four relevant aspects: (i) quality of context provisioning; (ii) quality of context monitoring; (iii) support for heterogeneous device and technology management; (iv) support for reliable data delivery in mobility scenarios. This paper presents two main contributions: (i) a state-of-the-art survey specifically aimed at analyzing the middleware with quality of context support and; (ii) a new middleware with comprehensive quality of context support for Internet of Things Applications. The proposed middleware was evaluated and the results are presented and discussed in this article, which also shows a case study involving the development of a mobile remote patient monitoring application that was developed using the proposed middleware. This case study highlights how middleware components were used to meet the quality of context requirements of the application. In addition, the proposed middleware was compared to other solutions in the literature.

How do eHealth Programs for Adolescents With Depression Work? A Realist Review of Persuasive System Design Components in Internet-Based Psychological Therapies

PubMed Central

McGrath, Patrick J

2017-01-01

Background Major depressive disorders are common among adolescents and can impact all aspects of their daily life. Traditional therapies, cognitive behavioral therapy (CBT), and interpersonal psychotherapy (IPT) have been delivered face-to-face. However, Internet-based (online) delivery of these therapies is emerging as an option for adolescents. Internet-based CBT and IPT involve therapeutic content, interaction between the user and the system, and different technological features embedded into the online program (eg, multimedia). Studies of Internet-based CBT and IPT for adolescent depression differ on all three aspects, and variable, positive therapy effects have been reported. A better understanding of the treatment conditions that influence therapy outcomes is important to designing and evaluating these novel therapies. Objective Our aim was to examine the technological and program delivery features of Internet-based CBT and IPT for adolescent depression and to document their potential relation to treatment outcomes and program use. Methods We performed a realist synthesis. We started with an extensive search of published and gray literature. We included intervention studies that evaluated Internet-based CBT or IPT for adolescent depression. We included mixed-methods and qualitative studies, theoretical papers, and policy/implementation documents if they included a focus on how Internet-based psychological therapy is proposed to work for adolescents with depression/depressive symptoms. We used the Mixed-Methods Appraisal Tool to assess the methodological quality of studies. We used the Persuasive System Design (PSD) model as a framework for data extraction and analysis to examine how Internet-based CBT and IPT, as technology-based systems, influence the attitudes and behaviors of system users. PSD components described for the therapies were linked to reported outcomes using a cross-case comparison method and thematic synthesis. Results We identified 19 Internet-based CBT programs in 59 documents. Of those, 71% (42/59) were of moderate to high quality. The PSD features surface credibility (competent “look and feel”), dialogue support (online program + in-person support), liking and similarity (esthetics and content appeal to adolescent users), the reduction and tunneling of therapeutic content (reducing online content into simple tasks, guiding users), and use of self-monitoring were present in therapies that resulted in improved therapy engagement, satisfaction, and adherence, as well as symptom and functional impairments. Conclusions When incorporated into Internet-based CBT for adolescent depression, PSD features may improve adolescent adherence, satisfaction, and depression-related outcomes. Testing of these features using hypothesis-driven dismantling approaches is recommended to advance our understanding of how these features contribute to therapy effectiveness. PMID:28793983

Innovation in sexually transmitted disease and HIV prevention: internet and mobile phone delivery vehicles for global diffusion.

PubMed

Swendeman, Dallas; Rotheram-Borus, Mary Jane

2010-03-01

Efficacious behavioral interventions and practices have not been universally accepted, adopted, or diffused by policy makers, administrators, providers, advocates, or consumers. Biomedical innovations for sexually transmitted disease (STD) and HIV prevention have been embraced but their effectiveness is hindered by behavioral factors. Behavioral interventions are required to support providers and consumers for adoption and diffusion of biomedical innovations, protocol adherence, and sustained prevention for other STDs. Information and communication technology such as the Internet and mobile phones can deliver behavioral components for STD/HIV prevention and care to more people at less cost. Recent innovations in STD/HIV prevention with information and communication technology-mediated behavioral supports include STD/HIV testing and partner interventions, behavioral interventions, self-management, and provider care. Computer-based and Internet-based behavioral STD/HIV interventions have demonstrated efficacy comparable to face-to-face interventions. Mobile phone STD/HIV interventions using text-messaging are being broadly utilized but more work is needed to demonstrate efficacy. Electronic health records and care management systems can improve care, but interventions are needed to support adoption. Information and communication technology is rapidly diffusing globally. Over the next 5-10 years smart-phones will be broadly disseminated, connecting billions of people to the Internet and enabling lower cost, highly engaging, and ubiquitous STD/HIV prevention and treatment support interventions.

Prefrontal Control and Internet Addiction: A Theoretical Model and Review of Neuropsychological and Neuroimaging Findings

PubMed Central

Brand, Matthias; Young, Kimberly S.; Laier, Christian

2014-01-01

Most people use the Internet as a functional tool to perform their personal goals in everyday-life such as making airline or hotel reservations. However, some individuals suffer from a loss of control over their Internet use resulting in personal distress, symptoms of psychological dependence, and diverse negative consequences. This phenomenon is often referred to as Internet addiction. Only Internet Gaming Disorder has been included in the appendix of the DSM-5, but it has already been argued that Internet addiction could also comprise problematic use of other applications with cybersex, online relations, shopping, and information search being Internet facets at risk for developing an addictive behavior. Neuropsychological investigations have pointed out that certain prefrontal functions in particular executive control functions are related to symptoms of Internet addiction, which is in line with recent theoretical models on the development and maintenance of the addictive use of the Internet. Control processes are particularly reduced when individuals with Internet addiction are confronted with Internet-related cues representing their first choice use. For example, processing Internet-related cues interferes with working memory performance and decision making. Consistent with this, results from functional neuroimaging and other neuropsychological studies demonstrate that cue-reactivity, craving, and decision making are important concepts for understanding Internet addiction. The findings on reductions in executive control are consistent with other behavioral addictions, such as pathological gambling. They also emphasize the classification of the phenomenon as an addiction, because there are also several similarities with findings in substance dependency. The neuropsychological and neuroimaging results have important clinical impact, as one therapy goal should enhance control over the Internet use by modifying specific cognitions and Internet use expectancies. PMID:24904393

Prefrontal control and internet addiction: a theoretical model and review of neuropsychological and neuroimaging findings.

PubMed

Brand, Matthias; Young, Kimberly S; Laier, Christian

2014-01-01

Most people use the Internet as a functional tool to perform their personal goals in everyday-life such as making airline or hotel reservations. However, some individuals suffer from a loss of control over their Internet use resulting in personal distress, symptoms of psychological dependence, and diverse negative consequences. This phenomenon is often referred to as Internet addiction. Only Internet Gaming Disorder has been included in the appendix of the DSM-5, but it has already been argued that Internet addiction could also comprise problematic use of other applications with cybersex, online relations, shopping, and information search being Internet facets at risk for developing an addictive behavior. Neuropsychological investigations have pointed out that certain prefrontal functions in particular executive control functions are related to symptoms of Internet addiction, which is in line with recent theoretical models on the development and maintenance of the addictive use of the Internet. Control processes are particularly reduced when individuals with Internet addiction are confronted with Internet-related cues representing their first choice use. For example, processing Internet-related cues interferes with working memory performance and decision making. Consistent with this, results from functional neuroimaging and other neuropsychological studies demonstrate that cue-reactivity, craving, and decision making are important concepts for understanding Internet addiction. The findings on reductions in executive control are consistent with other behavioral addictions, such as pathological gambling. They also emphasize the classification of the phenomenon as an addiction, because there are also several similarities with findings in substance dependency. The neuropsychological and neuroimaging results have important clinical impact, as one therapy goal should enhance control over the Internet use by modifying specific cognitions and Internet use expectancies.

Reasons Why Young Women Accept or Decline Fertility Preservation After Cancer Diagnosis.

PubMed

Hershberger, Patricia E; Sipsma, Heather; Finnegan, Lorna; Hirshfeld-Cytron, Jennifer

2016-01-01

To understand young women's reasons for accepting or declining fertility preservation after cancer diagnosis to aid in the development of theory regarding decision making in this context. Qualitative descriptive. Participants' homes or other private location. Twenty-seven young women (mean age, 29 years) diagnosed with cancer and eligible for fertility preservation. Recruitment was conducted via the Internet and in fertility centers. Participants completed demographic questionnaires and in-depth semi-structured interviews. Tenets of grounded theory guided an inductive and deductive analysis. Young women's reasons for deciding whether to undergo fertility preservation were linked to four theoretical dimensions: Cognitive Appraisals, Emotional Responses, Moral Judgments, and Decision Partners. Women who declined fertility preservation described more reasons in the Cognitive Appraisals dimension, including financial cost and human risks, than women who accepted. In the Emotional Responses dimension, most women who accepted fertility preservation reported a strong desire for biological motherhood, whereas women who declined tended to report a strong desire for surviving cancer. Three participants who declined reported reasons linked to the Moral Judgments dimension, and most participants were influenced by Decision Partners, including husbands, boyfriends, parents, and clinicians. The primary reason on which many but not all participants based decisions related to fertility preservation was whether the immediate emphasis of care should be placed on surviving cancer or securing options for future biological motherhood. Nurses and other clinicians should base education and counseling on the four theoretical dimensions to effectively support young women with cancer. Copyright © 2016 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

Reasons Why Young Women Accept or Decline Fertility Preservation Following Cancer Diagnosis

PubMed Central

Hershberger, Patricia E.; Sipsma, Heather; Finnegan, Lorna; Hirshfeld-Cytron, Jennifer

2015-01-01

Objective To understand young women’s reasons for accepting or declining fertility preservation following cancer diagnosis to aid in the development of theory regarding decision making in this context. Design Qualitative descriptive. Setting Participants’ homes or other private location. Participants Twenty-seven young women (mean age = 29 years) diagnosed with cancer and eligible for fertility preservation. Methods Recruitment was conducted via the Internet and in fertility centers. Participants completed demographic questionnaires and in-depth semi-structured interviews. Tenets of grounded theory guided an inductive and deductive analysis. Results Young women’s reasons for deciding whether to undergo fertility preservation were linked to four theoretical dimensions: Cognitive Appraisals, Emotional Responses, Moral Judgments, and Decision Partners. Women who declined fertility preservation described more reasons in the Cognitive Appraisals dimension, including financial cost and human risks, than women who accepted. In the Emotional Responses dimension, most women who accepted fertility preservation reported a strong desire for biological motherhood, whereas women who declined tended to report a strong desire for surviving cancer. Three participants who declined reported reasons linked to the Moral Judgments dimension, and the majority were influenced by Decision Partners, including husbands, boyfriends, parents, and clinicians. Conclusion The primary reason upon which many but not all participants based decisions related to fertility preservation was whether the immediate emphasis of care should be placed on surviving cancer or securing options for future biological motherhood. Nurses and other clinicians should base education and counseling on the four theoretical dimensions to effectively support young women with cancer. PMID:26815806

How do patients between the age of 65 and 75 use a web-based decision aid for treatment choice in localized prostate cancer?

PubMed

Schrijvers, Jessie; Vanderhaegen, Joke; Van Poppel, Hendrik; Haustermans, Karin; Van Audenhove, Chantal

2013-08-01

This study was designed to evaluate the use of a web-based decision aid by a 65plus patient group in their decision-making process for treatment of localized prostate cancer. Of particular interest was the use of technology features such as patients' statements, comparative tables, and a values clarification tool. One hundred men from the University Hospital of Leuven campus, Gasthuisberg, were invited to use the web-based decision aid in their decision-making process. Twenty-six men were excluded based on non- or limited use of the decision aid. Of the remaining 74 men, user specifications, decision aid surfing characteristics by means of web-log data, and especially the use of technology features were analyzed. Men spent on average 30 minutes on the web-based decision aid. Most time was spent on the pages with information on treatment options. These pages were also most frequently accessed. The use of the feature 'comparative tables' was the highest, followed by the 'values clarification tool'. According to age (<70 or >70 years) differences were observed for the time spent on the decision aid, the pages accessed, and the use of the technology features. Despite concerns about the usability of a web-based decision aid for elderly patients, these results indicated that the majority of 65plus persons with good internet skills use a web-based decision aid as well as its incorporated technology features. © 2013 Wiley Publishing Asia Pty Ltd and Chinese Cochrane Center, West China Hospital of Sichuan University.

Analysis of Internet information on the controversial X-Stop device.

PubMed

Anderson, Joshua T; Sullivan, T Barrett; Ahn, Uri M; Ahn, Nicholas U

2014-10-01

The Internet is frequently used by patients to aid in medical decision making. Multiple studies display the Internet's ineffectiveness in presenting high-quality information regarding surgical procedures and devices. With recent reports of unacceptably high complication rates and poor outcomes with the X-Stop device, it is important that online information is comprehensive and accurate. This study is the first to examine Internet information on the controversial X-Stop. To determine how accurately public information over the Internet portrays the existing primary literature on the X-Stop, how extensively the X-Stop is characterized online, and how patient decision making could foreseeably be affected. This cross-sectional study analyzed publicly available Internet information, including videos on the web site YouTube regarding the X-Stop device. No patients were involved in this study. No specific outcome measures were used. Search engines Google, Yahoo, and Bing were used to identify 105 web sites providing information on the X-Stop. Videos on the web site YouTube were included. Web sites were categorized based on the authorship. Each site was analyzed for the provision of appropriate patient inclusion and exclusion criteria, surgical and nonsurgical treatment alternatives, purported benefits, common complications, peer-reviewed literature citations, and descriptions/diagrams of the procedure. Data were evaluated for each authorship subgroup and the entire group of sites. Forty-three percent of sites were authored by a private medical group, 4% by an academic medical group, 16% by an insurance company, 9% by a biomedical industry, 10% by news sources, and 19% by other. Thirty-one percent of web sites and 11% of sites authored by private medical groups contained references to peer-reviewed literature. Fifty-six percent of web sites reported patient inclusion criteria, whereas 33% reported exclusion criteria. Benefits and complications were reported within 91% and 23% of sites, respectively. Surgical and nonsurgical treatment options were mentioned within 59% and 61% of web sites, respectively. Our study demonstrates the Internet's ineffectiveness in reporting quality information on the X-Stop. Information was often incomplete and potentially misleading. Significant controversy exists within primary literature regarding the safety and efficacy of the X-Stop. Yet, publicly available Internet information largely provided misinformation and did not reflect any such controversy. This raises the concern that such information lends itself more toward patient recruitment than patient education. Medical professionals need to know how this may affect their patients' decision making. Copyright © 2014 Elsevier Inc. All rights reserved.

Web-Based Tools for Data Visualization and Decision Support for South Asia

NASA Astrophysics Data System (ADS)

Jones, N.; Nelson, J.; Pulla, S. T.; Ames, D. P.; Souffront, M.; David, C. H.; Zaitchik, B. F.; Gatlin, P. N.; Matin, M. A.

2017-12-01

The objective of the NASA SERVIR project is to assist developing countries in using information provided by Earth observing satellites to assess and manage climate risks, land use, and water resources. We present a collection of web apps that integrate earth observations and in situ data to facilitate deployment of data and water resources models as decision-making tools in support of this effort. The interactive nature of web apps makes this an excellent medium for creating decision support tools that harness cutting edge modeling techniques. Thin client apps hosted in a cloud portal eliminates the need for the decision makers to procure and maintain the high performance hardware required by the models, deal with issues related to software installation and platform incompatibilities, or monitor and install software updates, a problem that is exacerbated for many of the regional SERVIR hubs where both financial and technical capacity may be limited. All that is needed to use the system is an Internet connection and a web browser. We take advantage of these technologies to develop tools which can be centrally maintained but openly accessible. Advanced mapping and visualization make results intuitive and information derived actionable. We also take advantage of the emerging standards for sharing water information across the web using the OGC and WMO approved WaterML standards. This makes our tools interoperable and extensible via application programming interfaces (APIs) so that tools and data from other projects can both consume and share the tools developed in our project. Our approach enables the integration of multiple types of data and models, thus facilitating collaboration between science teams in SERVIR. The apps developed thus far by our team process time-varying netCDF files from Earth observations and large-scale computer simulations and allow visualization and exploration via raster animation and extraction of time series at selected points and/or regions.

Introduction to Decision Support Systems for Risk Based Management of Contaminated Sites

EPA Science Inventory

A book on Decision Support Systems for Risk-based Management of contaminated sites is appealing for two reasons. First, it addresses the problem of contaminated sites, which has worldwide importance. Second, it presents Decision Support Systems (DSSs), which are powerful comput...

Energy Efficient, Cross-Layer Enabled, Dynamic Aggregation Networks for Next Generation Internet

NASA Astrophysics Data System (ADS)

Wang, Michael S.

Today, the Internet traffic is growing at a near exponential rate, driven predominately by data center-based applications and Internet-of-Things services. This fast-paced growth in Internet traffic calls into question the ability of the existing optical network infrastructure to support this continued growth. The overall optical networking equipment efficiency has not been able to keep up with the traffic growth, creating a energy gap that makes energy and cost expenditures scale linearly with the traffic growth. The implication of this energy gap is that it is infeasible to continue using existing networking equipment to meet the growing bandwidth demand. A redesign of the optical networking platform is needed. The focus of this dissertation is on the design and implementation of energy efficient, cross-layer enabled, dynamic optical networking platforms, which is a promising approach to address the exponentially growing Internet bandwidth demand. Chapter 1 explains the motivation for this work by detailing the huge Internet traffic growth and the unsustainable energy growth of today's networking equipment. Chapter 2 describes the challenges and objectives of enabling agile, dynamic optical networking platforms and the vision of the Center for Integrated Access Networks (CIAN) to realize these objectives; the research objectives of this dissertation and the large body of related work in this field is also summarized. Chapter 3 details the design and implementation of dynamic networking platforms that support wavelength switching granularity. The main contribution of this work involves the experimental validation of deep cross-layer communication across the optical performance monitoring (OPM), data, and control planes. The first experiment shows QoS-aware video streaming over a metro-scale test-bed through optical power monitoring of the transmission wavelength and cross-layer feedback control of the power level. The second experiment extends the performance monitoring capabilities to include real-time monitoring of OSNR and polarization mode dispersion (PMD) to enable dynamic wavelength switching and selective restoration. Chapter 4 explains the author?s contributions in designing dynamic networking at the sub-wavelength switching granularity, which can provide greater network efficiency due to its finer granularity. To support dynamic switching, regeneration, adding/dropping, and control decisions on each individual packet, the cross-layer enabled node architecture is enhanced with a FPGA controller that brings much more precise timing and control to the switching, OPM, and control planes. Furthermore, QoS-aware packet protection and dynamic switching, dropping, and regeneration functionalities were experimentally demonstrated in a multi-node network. Chapter 5 describes a technique to perform optical grooming, a process of optically combining multiple incoming data streams into a single data stream, which can simultaneously achieve greater bandwidth utilization and increased spectral efficiency. In addition, an experimental demonstration highlighting a fully functioning multi-node, agile optical networking platform is detailed. Finally, a summary and discussion of future work is provided in Chapter 6. The future of the Internet is very exciting, filled with not-yet-invented applications and services driven by cloud computing and Internet-of-Things. The author is cautiously optimistic that agile, dynamically reconfigurable optical networking is the solution to realizing this future.

Web-assisted tobacco interventions: empowering change in the global fight for the public's (e)Health.

PubMed

Norman, Cameron D; McIntosh, Scott; Selby, Peter; Eysenbach, Gunther

2008-11-25

Tobacco control in the 21(st) century faces many of the same challenges as in the past, but in different contexts, settings and enabled by powerful new tools including those delivered by information and communication technologies via computer, videocasts, and mobile handsets to the world. Building on the power of electronic networks, Web-assisted tobacco interventions (WATI) provide a vehicle for delivering tobacco prevention, cessation, social support and training opportunities on-demand and direct to practitioners and the public alike. The Framework Convention on Tobacco Control, the world's first global public health treaty, requires that all nations develop comprehensive tobacco control strategies that include provision of health promotion information, population interventions, and decision-support services. WATI research and development has evolved to provide examples of how eHealth can address all of these needs and provide exemplars for other areas of public health to follow. This paper discusses the role of WATI in supporting tobacco control and introduces a special issue of the Journal of Medical Internet Research that broadens the evidence base and provides illustrations of how new technologies can support health promotion and population health overall, empowering change and ushering in a new era of public eHealth.

Web-Based Medical Appointment Systems: A Systematic Review

PubMed Central

Zhao, Peng; Lavoie, Jaie; Lavoie, Beau James; Simoes, Eduardo

2017-01-01

Background Health care is changing with a new emphasis on patient-centeredness. Fundamental to this transformation is the increasing recognition of patients' role in health care delivery and design. Medical appointment scheduling, as the starting point of most non-urgent health care services, is undergoing major developments to support active involvement of patients. By using the Internet as a medium, patients are given more freedom in decision making about their preferences for the appointments and have improved access. Objective The purpose of this study was to identify the benefits and barriers to implement Web-based medical scheduling discussed in the literature as well as the unmet needs under the current health care environment. Methods In February 2017, MEDLINE was searched through PubMed to identify articles relating to the impacts of Web-based appointment scheduling. Results A total of 36 articles discussing 21 Web-based appointment systems were selected for this review. Most of the practices have positive changes in some metrics after adopting Web-based scheduling, such as reduced no-show rate, decreased staff labor, decreased waiting time, and improved satisfaction, and so on. Cost, flexibility, safety, and integrity are major reasons discouraging providers from switching to Web-based scheduling. Patients’ reluctance to adopt Web-based appointment scheduling is mainly influenced by their past experiences using computers and the Internet as well as their communication preferences. Conclusions Overall, the literature suggests a growing trend for the adoption of Web-based appointment systems. The findings of this review suggest that there are benefits to a variety of patient outcomes from Web-based scheduling interventions with the need for further studies. PMID:28446422

The internet and the physician-patient relationship.

PubMed

Sechrest, Randale C

2010-10-01

Since the emergence of the public Internet in the early 1990s, the healthcare industry has been struggling to understand how best to utilize this resource. During the last decade there has been an increase in both the interest and participation by healthcare providers in the Internet space, but many observers continue to push for more development of healthcare resources to better support the provider-patient relationship. This paper will review the historical development of the Internet, the core concepts that have driven the emergence and evolution of the Internet as a mass medium of information exchange, and how the healthcare industry can harness the Internet to improve the provider patient relationship. WHERE ARE WE NOW?: The healthcare industry continues to lag behind other industries that have been transformed by the Internet. Numerous industries including travel, real estate, retail sales, and banking have migrated both comprehensive information resources and transactions to the Internet in order to improve efficiency and customer satisfaction. That same process is occurring now in the healthcare industry. Credible and comprehensive Information resources are beginning to mature. Transactions are still in their infancy, reflecting a continued concern about privacy and security. WHERE DO WE NEED TO GO?: We need to improve information resources to educate and inform patients. Improving the availability and credibility of information resources will empower patients to make better healthcare decisions and I contend will ultimately reduce the cost of delivering care. HOW DO WE GET THERE?: Orthopaedists must first recognize the value of information resources to the patient. Effective communication with patients is a critical component of providing healthcare services. All healthcare providers should reflect on the importance of developing an effective communications strategy for their own practice and consider the benefits of participating in efforts by professional organizations to improve existing information resources.

Distributed Web-Based Expert System for Launch Operations

NASA Technical Reports Server (NTRS)

Bardina, Jorge E.; Thirumalainambi, Rajkumar

2005-01-01

The simulation and modeling of launch operations is based on a representation of the organization of the operations suitable to experiment of the physical, procedural, software, hardware and psychological aspects of space flight operations. The virtual test bed consists of a weather expert system to advice on the effect of weather to the launch operations. It also simulates toxic gas dispersion model, and the risk impact on human health. Since all modeling and simulation is based on the internet, it could reduce the cost of operations of launch and range safety by conducting extensive research before a particular launch. Each model has an independent decision making module to derive the best decision for launch.

Online Career Guidance: Does Knowledge Equate to Power for High School Students?

ERIC Educational Resources Information Center

Galliott, Natal'ya

2017-01-01

The provision of online career information and guidance is becoming more popular among career counselling practitioners and policy makers targeting the postschool transitions of youth. Internet-based career exploration and guidance systems provide convenience and economy to both individuals confronted with career decision making as well as those…

Reducing Aversion to Side Effects in Preventive Medical Treatment Decisions

ERIC Educational Resources Information Center

Waters, Erika A.; Weinstein, Neil D.; Colditz, Graham A.; Emmons, Karen M.

2007-01-01

Laypeople tend to be overly sensitive to side effects of treatments that prevent illness, possibly leading them to refuse beneficial therapies. This Internet-based study attempted to reduce such side effect aversion by adding graphic displays to the numerical risk probabilities. It also explored whether graphics reduce side effect aversion by…

Decision Support Systems and the Conflict Model of Decision Making: A Stimulus for New Computer-Assisted Careers Guidance Systems.

ERIC Educational Resources Information Center

Ballantine, R. Malcolm

Decision Support Systems (DSSs) are computer-based decision aids to use when making decisions which are partially amenable to rational decision-making procedures but contain elements where intuitive judgment is an essential component. In such situations, DSSs are used to improve the quality of decision-making. The DSS approach is based on Simon's…

Nip, Tuck and Click: Medical Tourism and the Emergence of Web-Based Health Information

PubMed Central

Lunt, Neil; Hardey, Mariann; Mannion, Russell

2010-01-01

An emerging trend is what has become commonly known as ‘Medical Tourism’ where patients travel to overseas destinations for specialised surgical treatments and other forms of medical care. With the rise of more affordable cross-border travel and rapid technological developments these movements are becoming more commonplace. A key driver is the platform provided by the internet for gaining access to healthcare information and advertising. There has been relatively little attention given to the role and impact of web-based information to inform Medical Tourism decisions. This article provides a brief overview of the most recent development in Medical Tourism and examines how this is linked to the emergence of specialized internet web sites. It produces a summary of the functionality of medical tourist sites, and situates Medical Tourism informatics within the broader literatures relating to information search, information quality and decision-making. This paper is both a call to strengthen the empirical evidence in this area, and also to advocate integrating Medical Tourism research within a broader conceptual framework. PMID:20517465

Nip, tuck and click: medical tourism and the emergence of web-based health information.

PubMed

Lunt, Neil; Hardey, Mariann; Mannion, Russell

2010-02-12

An emerging trend is what has become commonly known as 'Medical Tourism' where patients travel to overseas destinations for specialised surgical treatments and other forms of medical care. With the rise of more affordable cross-border travel and rapid technological developments these movements are becoming more commonplace. A key driver is the platform provided by the internet for gaining access to healthcare information and advertising. There has been relatively little attention given to the role and impact of web-based information to inform Medical Tourism decisions.This article provides a brief overview of the most recent development in Medical Tourism and examines how this is linked to the emergence of specialized internet web sites. It produces a summary of the functionality of medical tourist sites, and situates Medical Tourism informatics within the broader literatures relating to information search, information quality and decision-making.This paper is both a call to strengthen the empirical evidence in this area, and also to advocate integrating Medical Tourism research within a broader conceptual framework.

How do eHealth Programs for Adolescents With Depression Work? A Realist Review of Persuasive System Design Components in Internet-Based Psychological Therapies.

PubMed

Wozney, Lori; Huguet, Anna; Bennett, Kathryn; Radomski, Ashley D; Hartling, Lisa; Dyson, Michele; McGrath, Patrick J; Newton, Amanda S

2017-08-09

Major depressive disorders are common among adolescents and can impact all aspects of their daily life. Traditional therapies, cognitive behavioral therapy (CBT), and interpersonal psychotherapy (IPT) have been delivered face-to-face. However, Internet-based (online) delivery of these therapies is emerging as an option for adolescents. Internet-based CBT and IPT involve therapeutic content, interaction between the user and the system, and different technological features embedded into the online program (eg, multimedia). Studies of Internet-based CBT and IPT for adolescent depression differ on all three aspects, and variable, positive therapy effects have been reported. A better understanding of the treatment conditions that influence therapy outcomes is important to designing and evaluating these novel therapies. Our aim was to examine the technological and program delivery features of Internet-based CBT and IPT for adolescent depression and to document their potential relation to treatment outcomes and program use. We performed a realist synthesis. We started with an extensive search of published and gray literature. We included intervention studies that evaluated Internet-based CBT or IPT for adolescent depression. We included mixed-methods and qualitative studies, theoretical papers, and policy/implementation documents if they included a focus on how Internet-based psychological therapy is proposed to work for adolescents with depression/depressive symptoms. We used the Mixed-Methods Appraisal Tool to assess the methodological quality of studies. We used the Persuasive System Design (PSD) model as a framework for data extraction and analysis to examine how Internet-based CBT and IPT, as technology-based systems, influence the attitudes and behaviors of system users. PSD components described for the therapies were linked to reported outcomes using a cross-case comparison method and thematic synthesis. We identified 19 Internet-based CBT programs in 59 documents. Of those, 71% (42/59) were of moderate to high quality. The PSD features surface credibility (competent "look and feel"), dialogue support (online program + in-person support), liking and similarity (esthetics and content appeal to adolescent users), the reduction and tunneling of therapeutic content (reducing online content into simple tasks, guiding users), and use of self-monitoring were present in therapies that resulted in improved therapy engagement, satisfaction, and adherence, as well as symptom and functional impairments. When incorporated into Internet-based CBT for adolescent depression, PSD features may improve adolescent adherence, satisfaction, and depression-related outcomes. Testing of these features using hypothesis-driven dismantling approaches is recommended to advance our understanding of how these features contribute to therapy effectiveness. ©Lori Wozney, Anna Huguet, Kathryn Bennett, Ashley D Radomski, Lisa Hartling, Michele Dyson, Patrick J McGrath, Amanda S Newton. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 09.08.2017.

Prevalence of Internet addiction and its association with social support and other related factors among adolescents in China.

PubMed

Wu, Xiao-Shuang; Zhang, Zhi-Hua; Zhao, Feng; Wang, Wen-Jing; Li, Yi-Feng; Bi, Linda; Qian, Zhen-Zhong; Lu, Shan-Shan; Feng, Fang; Hu, Cai-Yun; Gong, Feng-Feng; Sun, Ye-Huan

2016-10-01

A cross-sectional study design was applied amongst a random sample (n = 10158) of Chinese adolescents. Self-completed questionnaires, including demographic characteristics, Internet use situation, Youth Internet Addiction Test, Youth Social Support Rating Scale and Zung Self-rating Depression Scale were utilized to examine the study objectives. Among the study population, the prevalence rate of Internet addiction was 10.4%, with 1038 (10.2%) moderately and 21 (0.2%) severely addicted to the Internet. Results from the multivariate logistic regression analyses suggested that a variety of related factors have significant effects on Internet addiction (parental control, per capita annual household income, academic performance, the access to Internet, online activities). The correlation coefficients showed that Internet addiction was negatively correlated with social support and positively associated with depression. Social support had a significant negative predictive effect on Internet addiction. The mediating effect of depression between social support and Internet addiction was remarkable. Copyright © 2016 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Assessment of response consistency and respective participant profiles in the Internet-based NutriNet-Santé Cohort.

PubMed

Andreeva, Valentina A; Galan, Pilar; Julia, Chantal; Castetbon, Katia; Kesse-Guyot, Emmanuelle; Hercberg, Serge

2014-04-01

Whereas the feasibility and effectiveness of Internet-based epidemiologic research have been established, methodological support for the quality of such data is still accumulating. We aimed to identify sociodemographic differences among members of a French cohort according to willingness to provide part of one's 15-digit national identification number (personal Social Security number (PSSN)) and to assess response consistency based on information reported on the sociodemographic questionnaire and that reflected in the PSSN. We studied 100,118 persons enrolled in an Internet-based prospective cohort study, the NutriNet-Santé Study, between 2009 and 2013. Persons aged 18 years or more who resided in France and had Internet access were eligible for enrollment. The sociodemographic profiles of participants with discordant data were compared against those of participants with concordant data via 2-sided polytomous logistic regression. In total, 84,442 participants (84.3%) provided the first 7 digits of their PSSN, and among them 5,141 (6.1%) had discordant data. Our multivariate analysis revealed differences by sex, age, education, and employment as regards response consistency patterns. The results support the quality of sociodemographic data obtained online from a large and diverse volunteer sample. The quantitative description of participant profiles according to response consistency patterns could inform future methodological work in e-epidemiology.

Systematic Review of Medical Informatics-Supported Medication Decision Making.

PubMed

Melton, Brittany L

2017-01-01

This systematic review sought to assess the applications and implications of current medical informatics-based decision support systems related to medication prescribing and use. Studies published between January 2006 and July 2016 which were indexed in PubMed and written in English were reviewed, and 39 studies were ultimately included. Most of the studies looked at computerized provider order entry or clinical decision support systems. Most studies examined decision support systems as a means of reducing errors or risk, particularly associated with medication prescribing, whereas a few studies evaluated the impact medical informatics-based decision support systems have on workflow or operations efficiency. Most studies identified benefits associated with decision support systems, but some indicate there is room for improvement.

Decreased functional connectivity of insula-based network in young adults with internet gaming disorder.

PubMed

Zhang, Yanzhen; Mei, Wei; Zhang, John X; Wu, Qiulin; Zhang, Wei

2016-09-01

The insula is a region that integrates interoception and drug urges, but little is known about its role in behavioral addiction such as internet addiction. We investigated insula-based functional connectivity in participants with internet gaming disorder (IGD) and healthy controls (HC) using resting-state functional MRI. The right and left insula subregions (posterior, ventroanterior, and dorsoanterior) were used as seed regions in a connectivity analysis. Compared with the HC group, the IGD group showed decreased functional connectivity between left posterior insula and bilateral supplementary motor area and middle cingulated cortex, between right posterior insula and right superior frontal gyrus, and decreased functional integration between insular subregions. The finding of reduced functional connectivity between the interoception and the motor/executive control regions is interpreted to reflect reduced ability to inhibit motor responses to internet gaming or diminished executive control over craving for internet gaming in IGD. The results support the hypothesis that IGD is associated with altered insula-based network, similar to substance addiction such as smoking.

An Internet-based self-help treatment for fear of public speaking: a controlled trial.

PubMed

Botella, C; Gallego, M J; Garcia-Palacios, A; Guillen, V; Baños, R M; Quero, S; Alcañiz, M

2010-08-01

This study offers data about the efficacy of "Talk to Me," an Internet-based telepsychology program for the treatment of fear of public speaking that includes the most active components in cognitive-behavior therapy (CBT) for social phobia (exposure and cognitive therapies). One hundred twenty-seven participants with social phobia were randomly assigned to three experimental conditions: (a) an Internet-based self-administered program; (b) the same program applied by a therapist; (c) a waiting-list control group. Results showed that both treatment conditions were equally efficacious. In addition, Talk to Me and the same treatment applied by a therapist were more efficacious than the waiting-list condition. Treatment gains were maintained at 1-year follow-up. The results from this study support the utility of Internet-delivered CBT programs in order to reach a higher number of people who could benefit from CBT. Internet-delivered CBT programs could also play a valuable role in the dissemination of CBT.

Recommendations for a culturally relevant Internet-based tool to promote physical activity among overweight young African American women, Alabama, 2010-2011.

PubMed

Durant, Nefertiti H; Joseph, Rodney P; Cherrington, Andrea; Cuffee, Yendelela; Knight, BernNadette; Lewis, Dwight; Allison, Jeroan J

2014-01-16

Innovative approaches are needed to promote physical activity among young adult overweight and obese African American women. We sought to describe key elements that African American women desire in a culturally relevant Internet-based tool to promote physical activity among overweight and obese young adult African American women. A mixed-method approach combining nominal group technique and traditional focus groups was used to elicit recommendations for the development of an Internet-based physical activity promotion tool. Participants, ages 19 to 30 years, were enrolled in a major university. Nominal group technique sessions were conducted to identify themes viewed as key features for inclusion in a culturally relevant Internet-based tool. Confirmatory focus groups were conducted to verify and elicit more in-depth information on the themes. Twenty-nine women participated in nominal group (n = 13) and traditional focus group sessions (n = 16). Features that emerged to be included in a culturally relevant Internet-based physical activity promotion tool were personalized website pages, diverse body images on websites and in videos, motivational stories about physical activity and women similar to themselves in size and body shape, tips on hair care maintenance during physical activity, and online social support through social media (eg, Facebook, Twitter). Incorporating existing social media tools and motivational stories from young adult African American women in Internet-based tools may increase the feasibility, acceptability, and success of Internet-based physical activity programs in this high-risk, understudied population.

Dementia Prevention: optimizing the use of observational data for personal, clinical, and public health decision-making.

PubMed

Dacks, Penny A; Andrieu, Sandrine; Blacker, Deborah; Carman, Aaron J; Green, Allan M; Grodstein, Francine; Henderson, Victor W; James, Bryan D; Lane, Rachel F; Lau, Joseph; Lin, Pei-Jung; Reeves, Barnaby C; Shah, Raj C; Vellas, Bruno; Yaffe, Kristine; Yurko-Mauro, Karin; Shineman, Diana W; Bennett, David A; Fillit, Howard M

2014-02-01

Worldwide, over 35 million people suffer from Alzheimer's disease and related dementias. This number is expected to triple over the next 40 years. How can we improve the evidence supporting strategies to reduce the rate of dementia in future generations? The risk of dementia is likely influenced by modifiable factors such as exercise, cognitive activity, and the clinical management of diabetes and hypertension. However, the quality of evidence is limited and it remains unclear whether specific interventions to reduce these modifiable risk factors can, in turn, reduce the risk of dementia. Although randomized controlled trials are the gold-standard for causality, the majority of evidence for long-term dementia prevention derives from, and will likely continue to derive from, observational studies. Although observational research has some unavoidable limitations, its utility for dementia prevention might be improved by, for example, better distinction between confirmatory and exploratory research, higher reporting standards, investment in effectiveness research enabled by increased data-pooling, and standardized exposure and outcome measures. Informed decision-making by the general public on low-risk health choices that could have broad potential benefits could be enabled by internet-based tools and decision-aids to communicate the evidence, its quality, and the estimated magnitude of effect.

A comparative evaluation of the effect of internet-based CME delivery format on satisfaction, knowledge and confidence

PubMed Central

2010-01-01

Background Internet-based instruction in continuing medical education (CME) has been associated with favorable outcomes. However, more direct comparative studies of different Internet-based interventions, instructional methods, presentation formats, and approaches to implementation are needed. The purpose of this study was to conduct a comparative evaluation of two Internet-based CME delivery formats and the effect on satisfaction, knowledge and confidence outcomes. Methods Evaluative outcomes of two differing formats of an Internet-based CME course with identical subject matter were compared. A Scheduled Group Learning format involved case-based asynchronous discussions with peers and a facilitator over a scheduled 3-week delivery period. An eCME On Demand format did not include facilitated discussion and was not based on a schedule; participants could start and finish at any time. A retrospective, pre-post evaluation study design comparing identical satisfaction, knowledge and confidence outcome measures was conducted. Results Participants in the Scheduled Group Learning format reported significantly higher mean satisfaction ratings in some areas, performed significantly higher on a post-knowledge assessment and reported significantly higher post-confidence scores than participants in the eCME On Demand format that was not scheduled and did not include facilitated discussion activity. Conclusions The findings support the instructional benefits of a scheduled delivery format and facilitated asynchronous discussion in Internet-based CME. PMID:20113493

The Duality of Information Policy Debates: The Case of the Internet Governance Forum

ERIC Educational Resources Information Center

Epstein, Dmitry

2012-01-01

This project focuses on the dynamics of the Internet Governance Forum (IGF) as a non-binding multistakeholder debate about information policymaking. Using the theory of structuration and critical discourse analysis, I explore how the nation-state-centric and the internet-community-centric perceptions of authority and approaches to decision-making…

Reading on the Internet: Realizing and Constructing Potential Texts

ERIC Educational Resources Information Center

Cho, Byeong-Young; Afflerbach, Peter

2015-01-01

Successful Internet reading requires making strategic decisions about what texts to read and a sequence for reading them, all in accordance with readers' goals. In this paper, we describe the process of realizing and constructing potential texts as an important and critical part of successful Internet reading and use verbal report data to…

Case analysis online: a strategic management case model for the health industry.

PubMed

Walsh, Anne; Bearden, Eithne

2004-01-01

Despite the plethora of methods and tools available to support strategic management, the challenge for health executives in the next century will relate to their ability to access and interpret data from multiple and intricate communication networks. Integrated digital networks and satellite systems will expand the scope and ease of sharing information between business divisions, and networked systems will facilitate the use of virtual case discussions across universities. While the internet is frequently used to support clinical decisions in the healthcare industry, few executives rely upon the internetfor strategic analysis. Although electronic technologies can easily synthesize data from multiple information channels, research as well as technical issues may deter their application in strategic analysis. As digital models transform access to information, online models may become increasingly relevant in designing strategic solutions. While there are various pedagogical models available to support the strategic management process, this framework was designed to enhance strategic analysis through the application of technology and electronic research. A strategic analysis framework, which incorporated internet research and case analysis in a strategic managementcourse, is described alongwith design and application issues that emerged during the case analysis process.

ENergy and Power Evaluation Program

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1996-11-01

In the late 1970s, national and international attention began to focus on energy issues. Efforts were initiated to design and test analytical tools that could be used to assist energy planners in evaluating energy systems, particularly in developing countries. In 1984, the United States Department of Energy (DOE) commissioned Argonne National Laboratory`s Decision and Information Sciences Division (DIS) to incorporate a set of analytical tools into a personal computer-based package for distribution in developing countries. The package developed by DIS staff, the ENergy and Power Evaluation Program (ENPEP), covers the range of issues that energy planners must face: economic development,more » energy demand projections, supply-and-demand balancing, energy system expansion, and environmental impact analysis. Following the original DOE-supported development effort, the International Atomic Energy Agency (IAEA), with the assistance from the US Department of State (DOS) and the US Department of Energy (DOE), provided ENPEP training, distribution, and technical support to many countries. ENPEP is now in use in over 60 countries and is an international standard for energy planning tools. More than 500 energy experts have been trained in the use of the entire ENPEP package or some of its modules during the international training courses organized by the IAEA in collaboration with Argonne`s Decision and Information Sciences (DIS) Division and the Division of Educational Programs (DEP). This report contains the ENPEP program which can be download from the internet. Described in this report is the description of ENPEP Program, news, forums, online support and contacts.« less

The Ability of the United States Federal Radiological Monitoring and Assessment Center to Collect and Disseminate Environmental Measurements during Radiological Emergencies

DOE Office of Scientific and Technical Information (OSTI.GOV)

Craig Marianno and James Essex

The Federal Radiological Monitoring and Assessment Center (FRMAC) is the United States’ response organization for radiological emergencies. The FRMAC is structured as an operations center and employs the combined resources of several federal agencies to respond to any disaster resulting in the release of radioactivity. The mission of the FRMAC is to support state and local authorities in the gathering of environmental data using an array of survey equipment ranging from alpha probes, beta/gamma probes, and high-purity germanium (HPGe) spectroscopy to the gathering of physical samples. Once collected, the data are projected on maps to assist public officials make protectivemore » action decisions. In addition to the accumulation of data, it is the legal obligation of the FRMAC to keep archival records of all data points and their actions. During an event, it is conceivable that hundreds to thousands of sample points will be recorded over a relatively short time. It is in the interest of the federal government and public that the information collected be put to the best use as fast as possible. Toward this end, the Remote Sensing Laboratory, working under the direction of the United States Department of Energy’s National Nuclear Security Administration, is investigating the use of several technologies that will accelerate data flow from field teams to the FRMAC and, finally, distribution of data to decision makers and the public. Not only can finished data products be viewed through the internet, but the actual collection of data via “real-time” telemetry can be viewed using this same method. Data from the field will be transferred directly to the FRMAC using the MCPD (multi-path communication device). This base station receives the survey information from the field teams via Bluetooth and instantly investigates the best communication pathway to transfer data to the FRMAC. Possible paths include standalone radio, commercial cellular networks (GPRS and CDMA) and satellite. Once inside the FRMAC, this information is transferred to the pertinent divisions for review, data storage, and eventual display on map products. The internet is also a powerful communications tool being utilized by the FRMAC. Using a secure internet connection, field team location and data collection can be viewed live-time by any computer attached to the internet. Similarly, survey information from our fixed-wing aircraft can be viewed while the mission is being flown. All accumulated data and maps generated in the FRMAC are disseminated on a web page through the secure FRMAC web site. Several new data communication processes are being investigated to aid the FRMAC. Each of these provides an important tool to efficiently collect, record and disseminate environmental measurements to FRMAC scientists and decision makers. The ultimate goal of these processes is to improve the flow of protection decisions and information to the public.« less

Effects of outcome on the covariance between risk level and brain activity in adolescents with internet gaming disorder.

PubMed

Qi, Xin; Yang, Yongxin; Dai, Shouping; Gao, Peihong; Du, Xin; Zhang, Yang; Du, Guijin; Li, Xiaodong; Zhang, Quan

2016-01-01

Individuals with internet gaming disorder (IGD) often have impaired risky decision-making abilities, and IGD-related functional changes have been observed during neuroimaging studies of decision-making tasks. However, it is still unclear how feedback (outcomes of decision-making) affects the subsequent risky decision-making in individuals with IGD. In this study, twenty-four adolescents with IGD and 24 healthy controls (HCs) were recruited and underwent functional magnetic resonance imaging while performing the balloon analog risk task (BART) to evaluate the effects of prior outcomes on brain activity during subsequent risky decision-making in adolescents with IGD. The covariance between risk level and activation of the bilateral ventral medial prefrontal cortex, left inferior frontal cortex, right ventral striatum (VS), left hippocampus/parahippocampus, right inferior occipital gyrus/fusiform gyrus and right inferior temporal gyrus demonstrated interaction effects of group by outcome ( P  < 0.05, AlphaSim correction). The regions with interactive effects were defined as ROI, and ROI-based intergroup comparisons showed that the covariance between risk level and brain activation was significantly greater in adolescents with IGD compared with HCs after a negative outcome occurred ( P  < 0.05). Our results indicated that negative outcomes affected the covariance between risk level and activation of the brain regions related to value estimation (prefrontal cortex), anticipation of rewards (VS), and emotional-related learning (hippocampus/parahippocampus), which may be one of the underlying neural mechanisms of disadvantageous risky decision-making in adolescents with IGD.

Home care decision support using an Arden engine--merging smart home and vital signs data.

PubMed

Marschollek, Michael; Bott, Oliver J; Wolf, Klaus-H; Gietzelt, Matthias; Plischke, Maik; Madiesh, Moaaz; Song, Bianying; Haux, Reinhold

2009-01-01

The demographic change with a rising proportion of very old people and diminishing resources leads to an intensification of the use of telemedicine and home care concepts. To provide individualized decision support, data from different sources, e.g. vital signs sensors and home environmental sensors, need to be combined and analyzed together. Furthermore, a standardized decision support approach is necessary. The aim of our research work is to present a laboratory prototype home care architecture that integrates data from different sources and uses a decision support system based on the HL7 standard Arden Syntax for Medical Logical Modules. Data from environmental sensors connected to a home bus system are stored in a data base along with data from wireless medical sensors. All data are analyzed using an Arden engine with the medical knowledge represented in Medical Logic Modules. Multi-modal data from four different sensors in the home environment are stored in a single data base and are analyzed using an HL7 standard conformant decision support system. Individualized home care decision support must be based on all data available, including context data from smart home systems and medical data from electronic health records. Our prototype implementation shows the feasibility of using an Arden engine for decision support in a home setting. Our future work will include the utilization of medical background knowledge for individualized decision support, as there is no one-size-fits-all knowledge base in medicine.

Implementation of workflow engine technology to deliver basic clinical decision support functionality

PubMed Central

2011-01-01

Background Workflow engine technology represents a new class of software with the ability to graphically model step-based knowledge. We present application of this novel technology to the domain of clinical decision support. Successful implementation of decision support within an electronic health record (EHR) remains an unsolved research challenge. Previous research efforts were mostly based on healthcare-specific representation standards and execution engines and did not reach wide adoption. We focus on two challenges in decision support systems: the ability to test decision logic on retrospective data prior prospective deployment and the challenge of user-friendly representation of clinical logic. Results We present our implementation of a workflow engine technology that addresses the two above-described challenges in delivering clinical decision support. Our system is based on a cross-industry standard of XML (extensible markup language) process definition language (XPDL). The core components of the system are a workflow editor for modeling clinical scenarios and a workflow engine for execution of those scenarios. We demonstrate, with an open-source and publicly available workflow suite, that clinical decision support logic can be executed on retrospective data. The same flowchart-based representation can also function in a prospective mode where the system can be integrated with an EHR system and respond to real-time clinical events. We limit the scope of our implementation to decision support content generation (which can be EHR system vendor independent). We do not focus on supporting complex decision support content delivery mechanisms due to lack of standardization of EHR systems in this area. We present results of our evaluation of the flowchart-based graphical notation as well as architectural evaluation of our implementation using an established evaluation framework for clinical decision support architecture. Conclusions We describe an implementation of a free workflow technology software suite (available at http://code.google.com/p/healthflow) and its application in the domain of clinical decision support. Our implementation seamlessly supports clinical logic testing on retrospective data and offers a user-friendly knowledge representation paradigm. With the presented software implementation, we demonstrate that workflow engine technology can provide a decision support platform which evaluates well against an established clinical decision support architecture evaluation framework. Due to cross-industry usage of workflow engine technology, we can expect significant future functionality enhancements that will further improve the technology's capacity to serve as a clinical decision support platform. PMID:21477364

Flexible distributed architecture for semiconductor process control and experimentation

NASA Astrophysics Data System (ADS)

Gower, Aaron E.; Boning, Duane S.; McIlrath, Michael B.

1997-01-01

Semiconductor fabrication requires an increasingly expensive and integrated set of tightly controlled processes, driving the need for a fabrication facility with fully computerized, networked processing equipment. We describe an integrated, open system architecture enabling distributed experimentation and process control for plasma etching. The system was developed at MIT's Microsystems Technology Laboratories and employs in-situ CCD interferometry based analysis in the sensor-feedback control of an Applied Materials Precision 5000 Plasma Etcher (AME5000). Our system supports accelerated, advanced research involving feedback control algorithms, and includes a distributed interface that utilizes the internet to make these fabrication capabilities available to remote users. The system architecture is both distributed and modular: specific implementation of any one task does not restrict the implementation of another. The low level architectural components include a host controller that communicates with the AME5000 equipment via SECS-II, and a host controller for the acquisition and analysis of the CCD sensor images. A cell controller (CC) manages communications between these equipment and sensor controllers. The CC is also responsible for process control decisions; algorithmic controllers may be integrated locally or via remote communications. Finally, a system server images connections from internet/intranet (web) based clients and uses a direct link with the CC to access the system. Each component communicates via a predefined set of TCP/IP socket based messages. This flexible architecture makes integration easier and more robust, and enables separate software components to run on the same or different computers independent of hardware or software platform.

Gender differences in relationships of actual and virtual social support to Internet addiction mediated through depressive symptoms among college students in Taiwan.

PubMed

Yeh, Yu-Chun; Ko, Huei-Chen; Wu, Jo Yung-Wei; Cheng, Chung-Ping

2008-08-01

This study examined gender differences in the relationships of actual and virtual social support to Internet addiction mediated through depressive symptoms among college students in Taiwan. Results revealed that in females, both actual and virtual social support directly predicted Internet addiction or were mediated through depressive symptoms. However, in males, while Internet addiction was predicted by virtual social support directly or indirectly mediated through depressive symptoms, the link of actual social support to Internet addiction was only mediated through depressive symptoms. Furthermore, in both genders, lower actual social support and higher virtual social support were associated with higher depressive symptoms.

Internet and Cell Phone Based Smoking Cessation Programs among Adolescents

ERIC Educational Resources Information Center

Mehta, Purvi; Sharma, Manoj

2010-01-01

Smoking cessation among adolescents is a salient public health issue, as it can prevent the adoption of risky health behaviors and reduce negative impacts on health. Self-efficacy, household and social support systems, and perceived benefits are some important cessation determinants. With the popular use of the Internet and cell phone usage among…

A Meta-Data Driven Approach to Searching for Educational Resources in a Global Context.

ERIC Educational Resources Information Center

Wade, Vincent P.; Doherty, Paul

This paper presents the design of an Internet-enabled search service that supports educational resource discovery within an educational brokerage service. More specifically, it presents the design and implementation of a metadata-driven approach to implementing the distributed search and retrieval of Internet-based educational resources and…

An Overview and Analysis of Mobile Internet Protocols in Cellular Environments.

ERIC Educational Resources Information Center

Chao, Han-Chieh

2001-01-01

Notes that cellular is the inevitable future architecture for the personal communication service system. Discusses the current cellular support based on Mobile Internet Protocol version 6 (Ipv6) and points out the shortfalls of using Mobile IP. Highlights protocols especially for mobile management schemes which can optimize a high-speed mobile…

Let Our Voices Be Heard: Qualitative Analysis of an Internet Discussion Board

ERIC Educational Resources Information Center

de Vries, Sabina Remmers; Valadez, Albert A.

2008-01-01

This article addresses an online discussion board referencing a domestic violence related murder trial. Findings from qualitative analyses based on narrative and grounded theory suggest that online discussion boards can help survivors of domestic violence to tell their stories and support each other. The perceived anonymity of Internet discussion…

A Web-Based Tool to Support Data-Based Early Intervention Decision Making

ERIC Educational Resources Information Center

Buzhardt, Jay; Greenwood, Charles; Walker, Dale; Carta, Judith; Terry, Barbara; Garrett, Matthew

2010-01-01

Progress monitoring and data-based intervention decision making have become key components of providing evidence-based early childhood special education services. Unfortunately, there is a lack of tools to support early childhood service providers' decision-making efforts. The authors describe a Web-based system that guides service providers…

Social support and social interaction ties on internet addiction: integrating online and offline contexts.

PubMed

Wang, Edward Shih-Tse; Wang, Michael Chih-Hung

2013-11-01

This study explores the relationship between social support and social interaction ties on Internet addiction by integrating both online and offline social encounters. A total of 1,642 members of online social communities participated in this research, for which structural equation modeling was used for analysis. The findings show that social support is positively associated with social interaction ties in both online and offline contexts. In addition, online social support and online social interaction ties are positively associated with Internet addiction, whereas offline social support and social interaction ties on Internet addiction are negatively associated. This finding has important implications not only for understanding the cause of Internet addiction but also for understanding the diminishing Internet addiction due to social support and social interaction ties.

Characteristics and help-seeking behaviors of Internet gamblers based on most problematic mode of gambling.

PubMed

Hing, Nerilee; Russell, Alex Myles Thomas; Gainsbury, Sally Melissa; Blaszczynski, Alex

2015-01-07

Previous studies of problem Internet gamblers have failed to distinguish whether their problem gambling relates to Internet or land-based gambling modes. Therefore, characteristics and help-seeking behaviors of people whose gambling problems relate specifically to Internet gambling are unknown, but could inform the optimal alignment of treatment and support services with the needs and preferences of problem gamblers. This study aimed to compare (1) characteristics of problem Internet gamblers and problem land-based gamblers and (2) uptake of different types and modes of help between problem Internet gamblers and problem land-based gamblers. Hypothesis 1 was that problem Internet gamblers are less likely to seek help. Hypothesis 2 was that problem Internet gamblers are more likely to use online modes of help. A sample of 620 respondents meeting criteria for problem gambling was drawn from an online survey of 4594 Australian gamblers. Respondents were recruited through advertisements on gambling and gambling help websites, Facebook, and Google. Measures consisted of gambling participation; proportion of gambling on the Internet; most problematic mode of gambling; help seeking from 11 different sources of formal help, informal help, and self-help for gambling problems; psychological distress (Kessler 6); problem gambling severity (Problem Gambling Severity Index, PGSI); and demographics. Problem Internet gamblers were significantly more likely than problem land-based gamblers to be male (χ(2) 1=28.3, P<.001, φ=0.21), younger (t616.33=4.62, P<.001, d=0.37), have lower psychological distress (χ(2) 1=5.4, P=.02, φ=0.09), and experience problems with sports and race wagering (χ(2) 4=228.5, P<.001, φ=0.61). Uptake of help was significantly lower among problem Internet compared to problem land-based gamblers (χ(2) 1=6.9, P<.001, φ=0.11), including from face-to-face services, gambling helplines, online groups, self-exclusion from land-based venues, family or friends, and self-help strategies. Both problem Internet and problem land-based gamblers had similarly low use of online help. However, problem land-based gamblers (37.6%, 126/335) were significantly more likely to have sought land-based formal help compared to problem Internet gamblers (23.5%, 67/285; χ(2) 1=14.3, P<.001, φ=0.15). The findings suggest that more targeted and innovative efforts may be needed to increase use of gambling help by problem Internet gamblers. Alternatively, their lower PGSI and K6 scores suggest Internet problem gamblers may have less need for gambling-related help. This is the first known study to classify problem Internet gamblers as those whose problem gambling specifically relates to Internet gambling. Further research is needed to better understand why help-seeking rates are lower among Internet problem gamblers.

General and health-related Internet use among an urban, community-based sample of HIV-positive women: implications for intervention development.

PubMed

Blackstock, Oni J; Haughton, Lorlette J; Garner, Ruby Y; Horvath, Keith J; Norwood, Chris; Cunningham, Chinazo O

2015-01-01

Internet-based HIV interventions are increasingly common, although little focus has been on HIV-positive women. To understand the feasibility of using the Internet to deliver behavioral interventions to HIV-positive women, we sought to describe patterns of Internet use for general and health-related purposes and to explore differences between Internet-using and non-using women. From February 2014 to April 2014, 103 women were recruited at six community-based organizations in the Bronx, NY that provide services to HIV-positive persons. Women completed a 30-minute interview and answered a brief survey of socio-demographic factors, risk behavior and clinical characteristics. We performed χ(2) and Kruskal-Wallis tests to compare Internet users and non-users. Sixty-one percent of participants were current Internet users, most of whom used a personal electronic device (e.g., cellphone/smartphone) to access the Internet. While higher proportions of Internet users were passively engaged (e.g., signed up to receive email updates [42.9%] or watched an online video [58.7%] for health-related purposes), smaller proportions (12.7-15.9%) were involved in more interactive activities such as posting comments, questions, or information about health-related issues in an online discussion or a blog. A majority of Internet non-users (60.0%) expressed interest in going online. Lack of computer or Internet access (37.5%) and Internet navigation skills (37.5%) were the primary reasons for non-use. Compared with non-users, Internet users were more likely to be younger, to have higher socioeconomic status, and to report low health-related social support. Despite having a lower proportion of Internet users in our study than the general population, Internet-using women in our study had relatively high levels of online engagement and went online for both general and health-related purposes. However, Internet-based interventions targeting HIV-positive women will likely need to include providing computer and/or Internet access as well as training participants in how to navigate the Internet.

General and health-related Internet use among an urban, community-based sample of HIV-positive women: implications for intervention development

PubMed Central

Blackstock, Oni J.; Haughton, Lorlette J.; Garner, Ruby Y.; Horvath, Keith J.; Norwood, Chris; Cunningham, Chinazo O.

2015-01-01

Internet-based HIV interventions are increasingly common, although little focus has been on HIV-positive women. To understand the feasibility of using the Internet to deliver behavioral interventions to HIV-positive women, we sought to describe patterns of Internet use for general and health-related purposes and to explore differences between Internet-using and non-using women. From February 2014 to April 2014, 103 women were recruited at six community-based organizations in the Bronx, NY that provide services to HIV-positive persons. Women completed a 30-minute interview and answered a brief survey of socio-demographic factors, risk behavior and clinical characteristics. We performed χ2 and Kruskal-Wallis tests to compare Internet users and non-users. Sixty-one percent of participants were current Internet users, most of whom used a personal electronic device (e.g., cellphone/smartphone) to access the Internet. While higher proportions of Internet users were passively engaged (e.g., signed up to receive email updates [42.9%] or watched an online video [58.7%] for health-related purposes), smaller proportions (12.7–15.9%) were involved in more interactive activities such as posting comments, questions, or information about health-related issues in an online discussion or a blog. A majority of Internet non-users (60.0%) expressed interest in going online. Lack of computer or Internet access (37.5%) and Internet navigation skills (37.5%) were the primary reasons for non-use. Compared with non-users, Internet users were more likely to be younger, to have higher socioeconomic status, and to report low health-related social support. Despite having a lower proportion of Internet users in our study than the general population, Internet-using women in our study had relatively high levels of online engagement and went online for both general and health-related purposes. However, Internet-based interventions targeting HIV-positive women will likely need to include providing computer and/or Internet access as well as training participants in how to navigate the Internet. PMID:25411825

Impact of patient access to Internet health records on glaucoma medication: randomized controlled trial.

PubMed

Kashiwagi, Kenji; Tsukahara, Shigeo

2014-01-15

Glaucoma is one of the leading causes of blindness. Reduction of intraocular pressure is the only proven way to prevent progression of glaucomatous optic neuropathy. The majority of glaucoma patients need to use antiglaucoma ophthalmic solutions over the course of their life. Thus, good adherence and persistency of glaucoma treatment are important factors for better glaucoma care. The purpose of this study was to investigate the impact of an Internet-based glaucoma care support system on glaucoma medication use. Patients were randomly divided into two groups. The non-Internet access (NIA) group consisted of patients who had access to the Internet-based glaucoma care support system during the 4-year period only when they were examined by ophthalmologists. The Internet access (IA) group consisted of patients who had the same Internet-based glaucoma care support system access as the NIA group for the first 2 years following enrollment but who were also given free access to the glaucoma care support system for the remaining 2 years. Changes in glaucoma medication use were investigated. In total, 81 patients in the IA group and 90 patients in the NIA group satisfied the study protocol. The number of antiglaucoma ophthalmic solutions used during the study period significantly increased in the NIA group (P<.03) but not in the IA group. The percentages of patients with unchanged, increased, and decreased antiglaucoma ophthalmic solution use during the study period were 61.1% (55/90), 17.8% (16/90), and 3.3% (3/90), respectively, in the NIA group, and 56.8% (46/81), 8.6% (7/81), and 13.6% (11/81), respectively, in the IA group (P<.001). Internet access significantly shifted from an increasing intraocular pressure trend to a decreasing trend in the IA group (P=.002) among the patients who did not have any medication changes. Allowing patients to browse their medical data may reduce the use and improve the effectiveness of glaucoma medication. UMIN-CTR Clinical Trial Number: UMIN000006982; https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&type=summary&recptno=R000008238&language=E (Archived by WebCite at http://www.webcitation.org/6MRPQeEAv).

An overview of biomedical literature search on the World Wide Web in the third millennium.

PubMed

Kumar, Prince; Goel, Roshni; Jain, Chandni; Kumar, Ashish; Parashar, Abhishek; Gond, Ajay Ratan

2012-06-01

Complete access to the existing pool of biomedical literature and the ability to "hit" upon the exact information of the relevant specialty are becoming essential elements of academic and clinical expertise. With the rapid expansion of the literature database, it is almost impossible to keep up to date with every innovation. Using the Internet, however, most people can freely access this literature at any time, from almost anywhere. This paper highlights the use of the Internet in obtaining valuable biomedical research information, which is mostly available from journals, databases, textbooks and e-journals in the form of web pages, text materials, images, and so on. The authors present an overview of web-based resources for biomedical researchers, providing information about Internet search engines (e.g., Google), web-based bibliographic databases (e.g., PubMed, IndMed) and how to use them, and other online biomedical resources that can assist clinicians in reaching well-informed clinical decisions.

An Internationally Consented Standard for Nursing Process-Clinical Decision Support Systems in Electronic Health Records.

PubMed

Müller-Staub, Maria; de Graaf-Waar, Helen; Paans, Wolter

2016-11-01

Nurses are accountable to apply the nursing process, which is key for patient care: It is a problem-solving process providing the structure for care plans and documentation. The state-of-the art nursing process is based on classifications that contain standardized concepts, and therefore, it is named Advanced Nursing Process. It contains valid assessments, nursing diagnoses, interventions, and nursing-sensitive patient outcomes. Electronic decision support systems can assist nurses to apply the Advanced Nursing Process. However, nursing decision support systems are missing, and no "gold standard" is available. The study aim is to develop a valid Nursing Process-Clinical Decision Support System Standard to guide future developments of clinical decision support systems. In a multistep approach, a Nursing Process-Clinical Decision Support System Standard with 28 criteria was developed. After pilot testing (N = 29 nurses), the criteria were reduced to 25. The Nursing Process-Clinical Decision Support System Standard was then presented to eight internationally known experts, who performed qualitative interviews according to Mayring. Fourteen categories demonstrate expert consensus on the Nursing Process-Clinical Decision Support System Standard and its content validity. All experts agreed the Advanced Nursing Process should be the centerpiece for the Nursing Process-Clinical Decision Support System and should suggest research-based, predefined nursing diagnoses and correct linkages between diagnoses, evidence-based interventions, and patient outcomes.

Knowledge of and Attitudes Toward Evidence-Based Guidelines for and Against Clinical Preventive Services: Results from a National Survey.

PubMed

Lantz, Paula M; Evans, W Douglas; Mead, Holly; Alvarez, Carmen; Stewart, Lisa

2016-03-01

Both the underuse and overuse of clinical preventive services relative to evidence-based guidelines are a public health concern. Informed consumers are an important foundation of many components of the Affordable Care Act, including coverage mandates for proven clinical preventive services recommended by the US Preventive Services Task Force. Across sociodemographic groups, however, knowledge of and positive attitudes toward evidence-based guidelines for preventive care are extremely low. Given the demonstrated low levels of consumers' knowledge of and trust in guidelines, coupled with their strong preference for involvement in preventive care decisions, better education and decision-making support for evidence-based preventive services are greatly needed. Both the underuse and overuse of clinical preventive services are a serious public health problem. The goal of our study was to produce population-based national data that could assist in the design of communication strategies to increase knowledge of and positive attitudes toward evidence-based guidelines for clinical preventive services (including the US Preventive Services Task Force, USPSTF) and to reduce uncertainty among patients when guidelines change or are controversial. In late 2013 we implemented an Internet-based survey of a nationally representative sample of 2,529 adults via KnowledgePanel, a probability-based survey panel of approximately 60,000 adults, statistically representative of the US noninstitutionalized population. African Americans, Hispanics, and those with less than a high school education were oversampled. We then conducted descriptive statistics and multivariable logistic regression analysis to identify the prevalence of and sociodemographic characteristics associated with key knowledge and attitudinal variables. While 36.4% of adults reported knowing that the Affordable Care Act requires insurance companies to cover proven preventive services without cost sharing, only 7.7% had heard of the USPSTF. Approximately 1 in 3 (32.6%) reported trusting that a government task force would make fair guidelines for preventive services, and 38.2% believed that the government uses guidelines to ration health care. Most of the respondents endorsed the notion that research/scientific evidence and expert medical opinion are important for the creation of guidelines and that clinicians should follow guidelines based on evidence. But when presented with patient vignettes in which a physician made a guideline-based recommendation against a cancer-screening test, less than 10% believed that this recommendation alone, without further dialogue and/or the patient's own research, was sufficient to make such a decision. Given these demonstrated low levels of knowledge and mistrust regarding guidelines, coupled with a strong preference for shared decision making, better consumer education and decision supports for evidence-based guidelines for clinical preventive services are greatly needed. © 2016 Milbank Memorial Fund.

Personality traits as predictors of intentions to seek online information about STDs and HIV/AIDS among junior and senior college students in Taiwan.

PubMed

Lu, Hung-Yi; Palmgreen, Philip C; Zimmerman, Rick S; Lane, Derek R; Alexander, Linda J

2006-10-01

The purpose of this cross-sectional study is to examine how personality traits such as sensation- seeking and impulsive decision-making affect Taiwanese college students' intentions to seek online information about sexually transmitted diseases (STDs) and human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS). Five hundred thirty-five (n = 535) junior and senior college students in Taiwan were recruited and completed self-report questionnaires. This study found high sensation-seekers were more likely to seek information about STDs and HIV/AIDS on the Internet than low sensation-seekers. Impulsive decision-makers were less likely than rational decision-makers to seek information about STDs and HIV/AIDS on the Internet. These findings suggest that personality needs to be considered as an exploratory factor which potentially influences intentions to seek STD and HIV/AIDS information on the Internet among Taiwanese college students.

The Chicago Public Schools (CPS)/University of Chicago (UC) Internet Project (CUIP)

NASA Astrophysics Data System (ADS)

Richardson, D.; Rebull, L. M.; Munoz-Franco, L.; Jay, M. J.; Burke, R. D.; Fenstermacher, K. D.; Lenz, D. D.; MacNaught, H.; Marks, M. D.; Murphy, J.; Thomas, C.; York, D. G.; Anderson, D.; Chisom, Y.; Dynis, R.; Letts, J.; Lewis, E.; Harris, E.; Segneri, L.

1998-01-01

The Chicago Public Schools (CPS)/University of Chicago (UC) Internet Project (CUIP) is a collaborative pilot project among the UC, CPS Central Administration, and 24 public schools in the Woodlawn, Hyde Park/ South Kenwood, and North Kenwood/Oakland neighborhoods. Our primary goal is connecting these schools to the Internet, emphasizing the continued support of the schools and their teachers after the computers and connections are in place. We work with principals, department heads, and individual teachers to create and nurture a self-sustaining computer culture that will both maintain the network systems and incorporate the technology into the curriculum. We also encourage the schools to take advantage of ther new connectivity by collaborating and sharing resources among themselves. Formal interactions are fostered with museums and research centers, locally and nationally. CUIP is committed to supporting these schools as they use the Internet to enhance student learning. CUIP's goals include: providing T-1 internet connectivity to 24 local schools, supporting the technology coordinator in each school in order to ensure continuous Internet connectivity, and developing effective technology plans, including technology upgrades; nurturing and supporting teachers interested in incorporating technology in their classroom; fostering an environment in which the students can acquire a wide range of comptuer skills appropriate to the current job market; and fostering similar community-based efforts, around Chicago and the nation. CUIP's milestones include: internet service connected to 12 schools; technology interns placed in some CUIP schools in collaboration with Governors State University; email provided to more than half of the 660 teachers in connected schools; and World Wide Web for Teachers, a summer class on curriculum uses of the Web, taught by CUIP staff to 23 of over 100 public school teacher applicants.

Utilization of Internet Protocol-Based Voice Systems in Remote Payload Operations

NASA Technical Reports Server (NTRS)

Chamberlain, jim; Bradford, Bob; Best, Susan; Nichols, Kelvin

2002-01-01

Due to limited crew availability to support science and the large number of experiments to be operated simultaneously, telescience is key to a successful International Space Station (ISS) science program. Crew, operations personnel at NASA centers, and researchers at universities and companies around the world must work closely together to per orm scientific experiments on-board ISS. The deployment of reliable high-speed Internet Protocol (IP)-based networks promises to greatly enhance telescience capabilities. These networks are now being used to cost-effectively extend the reach of remote mission support systems. They reduce the need for dedicated leased lines and travel while improving distributed workgroup collaboration capabilities. NASA has initiated use of Voice over Internet Protocol (VoIP) to supplement the existing mission voice communications system used by researchers at their remote sites. The Internet Voice Distribution System (IVoDS) connects remote researchers to mission support "loopsll or conferences via NASA networks and Internet 2. Researchers use NODS software on personal computers to talk with operations personnel at NASA centers. IVoDS also has the ;capability, if authorized, to allow researchers to communicate with the ISS crew during experiment operations. NODS was developed by Marshall Space Flight Center with contractors & Technology, First Virtual Communications, Lockheed-Martin, and VoIP Group. NODS is currently undergoing field-testing with full deployment for up to 50 simultaneous users expected in 2002. Research is being performed in parallel with IVoDS deployment for a next-generation system to qualitatively enhance communications among ISS operations personnel. In addition to the current voice capability, video and data/application-sharing capabilities are being investigated. IVoDS technology is also being considered for mission support systems for programs such as Space Launch Initiative and Homeland Defense.

Parent's use of the Internet in the search for healthcare information and subsequent impact on the doctor-patient relationship.

PubMed

Harvey, S; Memon, A; Khan, R; Yasin, F

2017-11-01

The Internet is an unavoidable source of healthcare information. This information, both reliable and unreliable, has previously been shown to influence carer's decisions. Our aim was to evaluate this information seeking behavior among parents and its subsequent potential impact on the doctor-patient relationship. We undertook a cross-sectional questionnaire-based survey of paediatric outpatients. Enrollment took place over 4 weeks in March 2015. There were no inclusion or exclusion criteria and enrollment was voluntary. In total 100 questionnaires were completed. General Practitioners were the most common source of healthcare information. The Internet ranked third as a reliable source of healthcare information. The Internet was commonly used as an educational resource to learn about causes, treatment, and medications. A significant percentage of our population expressed concern regarding Internet information reliability. A small percentage of parents were concerned that disclosing Internet usage may worsen the relationship with their doctor. Parents showed a willingness to learn about diseases and treatments, and felt that the Internet was a good resource to do so. This study shows that open discussion about Internet usage between parents and doctors is not common and carers feel at risk of judgment should they admit to Internet usage. The Internet should be seen as a positive adjunct to patient education which can improve understanding, thus strengthening the doctor-patient relationship. The Internet will never replace the role of healthcare professionals but must be seen as an integral part of a multi-disciplinary approach.

Funding Decisions for Newborn Screening: A Comparative Review of 22 Decision Processes in Europe

PubMed Central

Fischer, Katharina Elisabeth; Rogowski, Wolf Henning

2014-01-01

Decision-makers need to make choices to improve public health. Population-based newborn screening (NBS) is considered as one strategy to prevent adverse health outcomes and address rare disease patients’ needs. The aim of this study was to describe key characteristics of decisions for funding new NBS programmes in Europe. We analysed past decisions using a conceptual framework. It incorporates indicators that capture the steps of decision processes by health care payers. Based on an internet survey, we compared 22 decisions for which answers among two respondents were validated for each observation. The frequencies of indicators were calculated to elicit key characteristics. All decisions resulted in positive, mostly unrestricted funding. Stakeholder participation was diverse focusing on information provision or voting. Often, decisions were not fully transparent. Assessment of NBS technologies concentrated on expert opinion, literature review and rough cost estimates. Most important appraisal criteria were effectiveness (i.e., health gain from testing for the children being screened), disease severity and availability of treatments. Some common and diverging key characteristics were identified. Although no evidence of explicit healthcare rationing was found, processes may be improved in respect of transparency and scientific rigour of assessment. PMID:24852389

Semantic Clinical Guideline Documents

PubMed Central

Eriksson, Henrik; Tu, Samson W.; Musen, Mark

2005-01-01

Decision-support systems based on clinical practice guidelines can support physicians and other health-care personnel in the process of following best practice consistently. A knowledge-based approach to represent guidelines makes it possible to encode computer-interpretable guidelines in a formal manner, perform consistency checks, and use the guidelines directly in decision-support systems. Decision-support authors and guideline users require guidelines in human-readable formats in addition to computer-interpretable ones (e.g., for guideline review and quality assurance). We propose a new document-oriented information architecture that combines knowledge-representation models with electronic and paper documents. The approach integrates decision-support modes with standard document formats to create a combined clinical-guideline model that supports on-line viewing, printing, and decision support. PMID:16779037

Computer and Internet Interventions to Optimize Listening and Learning for People With Hearing Loss: Accessibility, Use, and Adherence.

PubMed

Ferguson, Melanie; Henshaw, Helen

2015-09-01

The aim of this research forum article was to examine accessibility, use, and adherence to computerized and online interventions for people with hearing loss. Four intervention studies of people with hearing loss were examined: 2 auditory training studies, 1 working memory training study, and 1 study of multimedia educational support. A small proportion (approximately 15%) of participants had never used a computer, which may be a barrier to the accessibility of computer and Internet-based interventions. Computer competence was not a factor in intervention use or adherence. Computer skills and Internet access influenced participant preference for the delivery method of the multimedia educational support program. It is important to be aware of current barriers to computer and Internet-delivered interventions for people with hearing loss. However, there is a clear need to develop and future-proof hearing-related applications for online delivery.

The relation between Internet and social media use and the demographic and clinical parameters, quality of life, depression, cognitive function and sleep quality in hemodialysis patients: social media and hemodialysis.

PubMed

Afsar, Baris

2013-01-01

There are very few studies in the literature investigating the Internet use in hemodialysis (HD) patients. However, no study examined the relationship between Internet and social media use and quality of life, depression, cognitive function and sleep problems in HD patients. The study is cross-sectional in design. All patients underwent history taking; physical examination; laboratory analysis and quality of life (by a short form of the Medical Outcomes Study), depression (by the Beck Depression Inventory), cognitive function (by the Standardized Mini Mental State Examination) and sleep problems (by the Pittsburgh Sleep Quality Index) evaluation. In total, 134 HD patients (male/female: 73/61, age: 53.0 ± 13.4 years) were included. Patients with mail, Facebook and Twitter accounts were younger, were less depressive, had better quality of life, had higher cognitive function and were more educated compared to patients who did not have these accounts. Patients with Internet-based research about their disease were less depressive, had better quality of life and sleep quality, had higher cognitive function and were more educated compared to patients who did not have Internet-based research. Internet and social media use was closely related with quality of life, depression, cognitive function and education in HD patients. Studies are needed on whether Internet use under the supervision of health care professionals will improve clinical outcomes, adherence, quality of life, depression and decision making in HD patients. Copyright © 2013 Elsevier Inc. All rights reserved.

Implementing training and support, financial reimbursement, and referral to an internet-based brief advice program to improve the early identification of hazardous and harmful alcohol consumption in primary care (ODHIN): study protocol for a cluster randomized factorial trial.

PubMed

Keurhorst, Myrna N; Anderson, Peter; Spak, Fredrik; Bendtsen, Preben; Segura, Lidia; Colom, Joan; Reynolds, Jillian; Drummond, Colin; Deluca, Paolo; van Steenkiste, Ben; Mierzecki, Artur; Kłoda, Karolina; Wallace, Paul; Newbury-Birch, Dorothy; Kaner, Eileen; Gual, Toni; Laurant, Miranda G H

2013-01-24

The European level of alcohol consumption, and the subsequent burden of disease, is high compared to the rest of the world. While screening and brief interventions in primary healthcare are cost-effective, in most countries they have hardly been implemented in routine primary healthcare. In this study, we aim to examine the effectiveness and efficiency of three implementation interventions that have been chosen to address key barriers for improvement: training and support to address lack of knowledge and motivation in healthcare providers; financial reimbursement to compensate the time investment; and internet-based counselling to reduce workload for primary care providers. In a cluster randomized factorial trial, data from Catalan, English, Netherlands, Polish, and Swedish primary healthcare units will be collected on screening and brief advice rates for hazardous and harmful alcohol consumption. The three implementation strategies will be provided separately and in combination in a total of seven intervention groups and compared with a treatment as usual control group. Screening and brief intervention activities will be measured at baseline, during 12 weeks and after six months. Process measures include health professionals' role security and therapeutic commitment of the participating providers (SAAPPQ questionnaire). A total of 120 primary healthcare units will be included, equally distributed over the five countries. Both intention to treat and per protocol analyses are planned to determine intervention effectiveness, using random coefficient regression modelling. Effective interventions to implement screening and brief interventions for hazardous alcohol use are urgently required. This international multi-centre trial will provide evidence to guide decision makers.

Internet-based medical education: a realist review of what works, for whom and in what circumstances

PubMed Central

2010-01-01

Background Educational courses for doctors and medical students are increasingly offered via the Internet. Despite much research, course developers remain unsure about what (if anything) to offer online and how. Prospective learners lack evidence-based guidance on how to choose between the options on offer. We aimed to produce theory driven criteria to guide the development and evaluation of Internet-based medical courses. Methods Realist review - a qualitative systematic review method whose goal is to identify and explain the interaction between context, mechanism and outcome. We searched 15 electronic databases and references of included articles, seeking to identify theoretical models of how the Internet might support learning from empirical studies which (a) used the Internet to support learning, (b) involved doctors or medical students; and (c) reported a formal evaluation. All study designs and outcomes were considered. Using immersion and interpretation, we tested theories by considering how well they explained the different outcomes achieved in different educational contexts. Results 249 papers met our inclusion criteria. We identified two main theories of the course-in-context that explained variation in learners' satisfaction and outcomes: Davis's Technology Acceptance Model and Laurillard's model of interactive dialogue. Learners were more likely to accept a course if it offered a perceived advantage over available non-Internet alternatives, was easy to use technically, and compatible with their values and norms. 'Interactivity' led to effective learning only if learners were able to enter into a dialogue - with a tutor, fellow students or virtual tutorials - and gain formative feedback. Conclusions Different modes of course delivery suit different learners in different contexts. When designing or choosing an Internet-based course, attention must be given to the fit between its technical attributes and learners' needs and priorities; and to ways of providing meaningful interaction. We offer a preliminary set of questions to aid course developers and learners consider these issues. PMID:20122253

Pregnancy eHealth and mHealth: user proportions and characteristics of pregnant women using Web-based information sources-a cross-sectional study.

PubMed

Wallwiener, Stephanie; Müller, Mitho; Doster, Anne; Laserer, Wolfgang; Reck, Corinna; Pauluschke-Fröhlich, Jan; Brucker, Sara Y; Wallwiener, Christian W; Wallwiener, Markus

2016-11-01

To analyze the current proportions and characteristics of women using Internet (eHealth) and smartphone (mHealth) based sources of information during pregnancy and to investigate the influence, this information-seeking behavior has on decision-making. A cross-sectional study was conducted at two major German university hospitals. Questionnaires covering socio-demographic data, medical data and details of Internet, and smartphone application use were administered to 220 pregnant women. Data analysis utilized descriptive statistics and multiple regression analysis. 50.7 % of pregnant women were online information seekers. 22.4 % used an mHealth pregnancy application. Women using eHealth information showed no specific profile, while women using mHealth applications proved to be younger, were more likely to be in their first pregnancy, felt less healthy, and were more likely to be influenced by the retrieved information. Stepwise backward regression analysis explained 25.8 % of the variance of mHealth use. 80.5 % of cases were classified correctly by the identified predictors. All types of Web-based information correlated significantly with decision-making during pregnancy. Pregnant women frequently use the Internet and smartphone applications as a source of information. While Web usage was a common phenomenon, this study revealed specific characteristics of mHealth users during pregnancy. Improved, medically accurate smartphone applications might provide a way to specifically target the mHealth user group. As user influenceability was of major relevance to all types of information, all medical content should be carefully reviewed by a multidisciplinary board of medical specialists.

Neural Affective Mechanisms Predict Market-Level Microlending

PubMed Central

Genevsky, Alexander; Knutson, Brian

2015-01-01

Humans sometimes share with others whom they may never meet or know, in violation of the dictates of pure self-interest. Research has not established which neuropsychological mechanisms support lending decisions, nor whether their influence extends to markets involving significant financial incentives. In two studies, we found that neural affective mechanisms influence the success of requests for microloans. In a large Internet database of microloan requests (N = 13,500), we found that positive affective features of photographs promoted the success of those requests. We then established that neural activity (i.e., in the nucleus accumbens) and self-reported positive arousal in a neuroimaging sample (N = 28) predicted the success of loan requests on the Internet, above and beyond the effects of the neuroimaging sample’s own choices (i.e., to lend or not). These findings suggest that elicitation of positive arousal can promote the success of loan requests, both in the laboratory and on the Internet. They also highlight affective neuroscience’s potential to probe neuropsychological mechanisms that drive microlending, enhance the effectiveness of loan requests, and forecast market-level behavior. PMID:26187248

Adaptation of a Knowledge-Based Decision-Support System in the Tactical Environment.

DTIC Science & Technology

1981-12-01

002-04-6411S1CURITY CL All PICATION OF 1,416 PAGE (00HIR Onto ea0aOW .L10 *GU9WVC 4bGSI.CAYON S. Voss 10466lVka t... OftesoE ’ making decisons . The...noe..aaw Ad tdlalttt’ IV 680011 MMib) Artificial Intelligence; Decision-Support Systems; Tactical Decision- making ; Knowledge-based Decision-support...tactical information to assist tactical commanders in making decisions. The system, TAC*, for "Tactical Adaptable Consultant," incorporates a database

Internet trials: participant experiences and perspectives.

PubMed

Mathieu, Erin; Barratt, Alexandra; Carter, Stacy M; Jamtvedt, Gro

2012-10-23

Use of the Internet to conduct randomised controlled trials is increasing, and provides potential to increase equity of access to medical research, increase the generalisability of trial results and decrease the costs involved in conducting large scale trials. Several studies have compared response rates, completeness of data, and reliability of surveys using the Internet and traditional methods, but very little is known about participants' attitudes towards Internet-based randomised trials or their experience of participating in an Internet-based trial. To obtain insights into the experiences and perspectives of participants in an Internet-based randomised controlled trial, their attitudes to the use of the Internet to conduct medical research, and their intentions regarding future participation in Internet research. All English speaking participants in a recently completed Internet randomised controlled trial were invited to participate in an online survey. 1246 invitations were emailed. 416 participants completed the survey between May and October 2009 (33% response rate). Reasons given for participating in the Internet RCT fell into 4 main areas: personal interest in the research question and outcome, ease of participation, an appreciation of the importance of research and altruistic reasons. Participants' comments and reflections on their experience of participating in a fully online trial were positive and less than half of participants would have participated in the trial had it been conducted using other means of data collection. However participants identified trade-offs between the benefits and downsides of participating in Internet-based trials. The main trade-off was between flexibility and convenience - a perceived benefit - and a lack connectedness and understanding - a perceived disadvantage. The other tradeoffs were in the areas of: ease or difficulty in use of the Internet; security, privacy and confidentiality issues; perceived benefits and disadvantages for researchers; technical aspects of using the Internet; and the impact of Internet data collection on information quality. Overall, more advantages were noted by participants, consistent with their preference for this mode of research over others. The majority of participants (69%) would prefer to participate in Internet-based research compared to other modes of data collection in the future. Participants in our survey would prefer to participate in Internet-based trials in the future compared to other ways of conducting trials. From the participants' perspective, participating in Internet-based trials involves trade-offs. The central trade-off is between flexibility and convenience - a perceived benefit - and lack of connectedness and understanding - a perceived disadvantage. Strategies to maintain the convenience of the Internet while increasing opportunities for participants to feel supported, well-informed and well-understood would seem likely to increase the acceptability of Internet-based trials.

Internet trials: participant experiences and perspectives

PubMed Central

2012-01-01

Background Use of the Internet to conduct randomised controlled trials is increasing, and provides potential to increase equity of access to medical research, increase the generalisability of trial results and decrease the costs involved in conducting large scale trials. Several studies have compared response rates, completeness of data, and reliability of surveys using the Internet and traditional methods, but very little is known about participants’ attitudes towards Internet-based randomised trials or their experience of participating in an Internet-based trial. Objective To obtain insights into the experiences and perspectives of participants in an Internet-based randomised controlled trial, their attitudes to the use of the Internet to conduct medical research, and their intentions regarding future participation in Internet research. Methods All English speaking participants in a recently completed Internet randomised controlled trial were invited to participate in an online survey. Results 1246 invitations were emailed. 416 participants completed the survey between May and October 2009 (33% response rate). Reasons given for participating in the Internet RCT fell into 4 main areas: personal interest in the research question and outcome, ease of participation, an appreciation of the importance of research and altruistic reasons. Participants’ comments and reflections on their experience of participating in a fully online trial were positive and less than half of participants would have participated in the trial had it been conducted using other means of data collection. However participants identified trade-offs between the benefits and downsides of participating in Internet-based trials. The main trade-off was between flexibility and convenience – a perceived benefit – and a lack connectedness and understanding – a perceived disadvantage. The other tradeoffs were in the areas of: ease or difficulty in use of the Internet; security, privacy and confidentiality issues; perceived benefits and disadvantages for researchers; technical aspects of using the Internet; and the impact of Internet data collection on information quality. Overall, more advantages were noted by participants, consistent with their preference for this mode of research over others. The majority of participants (69%) would prefer to participate in Internet-based research compared to other modes of data collection in the future. Conclusion Participants in our survey would prefer to participate in Internet-based trials in the future compared to other ways of conducting trials. From the participants’ perspective, participating in Internet-based trials involves trade-offs. The central trade-off is between flexibility and convenience – a perceived benefit – and lack of connectedness and understanding – a perceived disadvantage. Strategies to maintain the convenience of the Internet while increasing opportunities for participants to feel supported, well-informed and well-understood would seem likely to increase the acceptability of Internet-based trials. PMID:23092116

EMDS users guide (version 2.0): knowledge-based decision support for ecological assessment.

Treesearch

Keith M. Reynolds

1999-01-01

The USDA Forest Service Pacific Northwest Research Station in Corvallis, Oregon, has developed the ecosystem management decision support (EMDS) system. The system integrates the logical formalism of knowledge-based reasoning into a geographic information system (GIS) environment to provide decision support for ecological landscape assessment and evaluation. The...

The over-optimistic portrayal of life-supporting treatments in newspapers and on the Internet: a cross-sectional study using extra-corporeal membrane oxygenation as an example

PubMed Central

2014-01-01

Background Extra-corporeal membrane oxygenation has been introduced to clinical practice for several decades. It is unclear how internet and newspapers portray the use of extra-corporeal membrane oxygenation. This study were: (1) to quantify the coverage of extra-corporeal membrane oxygenation use in newspapers and on the Internet; (2) to describe the characteristics of extra-corporeal membrane oxygenation users presented in newspaper articles and the Internet web pages in comparison with those shown in extra-corporeal membrane oxygenation studies in Taiwan; and (3) to examine the survival rates of extra-corporeal membrane oxygenation users presented in newspaper articles and the Internet web pages in comparison with those in Taiwan and in the Extracorporeal Life Support Registry Report International Summary for January 2014. Methods All issues of Taiwan’s four major newspapers from 2006 to 2010 were reviewed. In October 2011, a search of Internet web pages was performed based on the subjects of “yeh-ko-mo” (extra-corporeal membrane oxygenation in Traditional Chinese), “ECMO”, and “extra-corporeal membrane oxygenation.” All the Internet web pages and newspaper articles recounting the use of extra-corporeal membrane oxygenation were reviewed. The information, such as patient characteristic and the status at hospital discharge, was collected. Results The survival rate of extra-corporeal membrane oxygenation use shown on the Internet (83.97%) was significantly higher than all the survival rates reported in Taiwan’s literature (p < .01) and in the Extracorporeal Life Support Registry Report International Summary for January 2014 (p < .01). In addition, the survival rate of extra-corporeal membrane oxygenation use shown in newspapers (61.54%) was significantly higher than the average survival rate (43%) reported in Taiwan’s literature, the pediatric average survival rate (51%), and the adult average survival rate (47%) in the Extracorporeal Life Support Registry Report International Summary for January 2014. Conclusions Internet and newspapers both showed over-optimistic survival to hospital discharge for patients sustained by extra-corporeal membrane oxygenation. Internet was more likely to provide optimistic information for aggressive life-supporting treatments such as extra-corporeal membrane oxygenation than newspapers as indicated by survival to hospital discharge. PMID:25081491

Pilot Program for the Development of Classification and Accuracy Assessment Methods and Improved Accessibility for Landsat and Related GIS Data and Technology Transfer of These Methods to State and Local Governments

NASA Technical Reports Server (NTRS)

Limp, W. Fredrick

1996-01-01

This project has a single, comprehensive objective that is manifested in many tangible products and impacts throughout the state and the mid-south region. The primary objective or mission of this project is to expose the broadest possible cross-section of public sector decision makers responsible for developing and maintaining policy at the state, local and national levels, private sector professionals and students to the power, flexibility and utility of sensor based imagery and the mapping and interpretive products that are derived from these digital geodata. In accomplishing this mission this project has worked to provide hands-on exposure and training to primary and secondary teachers; developed and distributed instructional materials to students across the state; created an on-line archive of satellite images and related geographic data; implemented a service that enables users throughout the region and around the world to develop customized mapping products suitable for visualization and/or decision support from the comfort of their classroom or office via an internet connection to our facility; extended the use of sensor based imagery in natural resource management and commercial applications through a range of pilot research initiatives, demonstrations, presentations and professional papers.

Design of a randomized controlled trial of Internet-based cognitive behavioral therapy for treatment-induced menopausal symptoms in breast cancer survivors.

PubMed

Atema, Vera; van Leeuwen, Marieke; Oldenburg, Hester S A; Retèl, Valesca; van Beurden, Marc; Hunter, Myra S; Aaronson, Neil K

2016-11-25

Menopausal symptoms are common and may be particularly severe in younger women who undergo treatment-induced menopause. Medications to reduce menopausal symptoms are either contra-indicated or have bothersome side effects. Previous studies have demonstrated that face-to-face cognitive behavioral therapy (CBT) is effective in alleviating menopausal symptoms in women with breast cancer. However, compliance with face-to-face CBT programs can be problematic. A promising approach is to use the Internet to make this form of CBT more accessible and feasible for patients. This study is evaluating the efficacy and cost-effectiveness of an Internet-based CBT program, with or without therapist guidance, in alleviating or reducing the severity of menopausal symptoms. In a multicenter, randomized controlled trial we are evaluating the efficacy of two Internet-based CBT programs in alleviating or reducing the impact of menopausal symptoms, and particularly hot flushes and night sweats, in breast cancer survivors who have experienced a treatment-induced menopause. Secondary outcomes include sexual functioning, sleep quality, hot flush frequency, psychological distress, health-related quality of life and cost-effectiveness. We will recruit 248 women who will be randomized to either a therapist guided or a self-management version of the 6-week Internet-based CBT program, or to a usual care, waiting list control group. Self-administered questionnaires are completed at baseline (T0), and at 10 weeks (T1) and 24 weeks (T2) post-randomization. Internet-based CBT is a potentially useful treatment for reducing menopausal symptoms in breast cancer survivors. This study will provide evidence on the efficacy and cost-effectiveness of such an Internet-based CBT program, with or without therapist support. If demonstrated to be efficacious and cost-effective, the availability of such structured supportive intervention programs will be a welcome addition to standard medical treatment offered to cancer patients with treatment-induced menopause. The study is retrospectively registered at ClinicalTrials.gov on January 26th 2016 ( NCT02672189 ).

Educating the patient for health care communication in the age of the world wide web: a qualitative study.

PubMed

Woodward-Kron, Robyn; Connor, Melanie; Schulz, Peter J; Elliott, Kristine

2014-02-01

Communication skills teaching in medical education has yet to acknowledge the impact of the Internet on physician-patient communication. The authors present a conceptual model showing the variables influencing how and to what extent physicians and patients discuss Internet-sourced health information as part of the consultation with the purpose of educating the patient. A study exploring the role physicians play in patient education mediated through health information available on the Internet provided the foundation for the conceptual model. Twenty-one physicians participated in semistructured interviews between 2011 and 2013. Participants were from Australia and Switzerland, whose citizens demonstrate different degrees of Internet usage and who differ culturally and ethnically. The authors analyzed the interviews thematically and iteratively. The themes as well as their interrelationships informed the components of the conceptual model. The intrinsic elements of the conceptual model are the physician, the patient, and Internet based health information. The extrinsic variables of setting, time, and communication activities as well as the quality, availability, and usability of the Internet-based health information influenced the degree to which physicians engaged with, and were engaged by, their patients about Internet-based health information. The empirically informed model provides a means of understanding the environment, enablers, and constraints of discussing Internet-based health information, as well as the benefits for patients' understanding of their health. It also provides medical educators with a conceptual tool to engage and support physicians in their activities of communicating health information to patients.

Validating TOEFL[R] iBT Speaking and Setting Score Requirements for ITA Screening

ERIC Educational Resources Information Center

Xi, Xiaoming

2007-01-01

Although the primary use of the speaking section of the Test of English as a Foreign Language Internet-based test (TOEFL[R] iBT Speaking) is to inform admissions decisions at English medium universities, it may also be useful as an initial screening measure for international teaching assistants (ITAs). This study provides criterion-related…

Evaluation of Web-Based Ostomy Patient Support Resources.

PubMed

Pittman, Joyce; Nichols, Thom; Rawl, Susan M

To evaluate currently available, no-cost, Web-based patient support resources designed for those who have recently undergone ostomy surgery. Descriptive, correlational study using telephone survey. The sample comprised 202 adults who had ostomy surgery within the previous 24 months in 1 of 5 hospitals within a large healthcare organization in the Midwestern United States. Two of the hospitals were academic teaching hospitals, and 3 were community hospitals. The study was divided into 2 phases: (1) gap analysis of 4 Web sites (labeled A-D) based on specific criteria; and (2) telephone survey of individuals with an ostomy. In phase 1, a comprehensive checklist based on best practice standards was developed to conduct the gap analysis. In phase 2, data were collected from 202 participants by trained interviewers via 1-time structured telephone interviews that required approximately 30 minutes to complete. Descriptive analyses were performed, along with correlational analysis of relationships among Web site usage, acceptability and satisfaction, demographic characteristics, and medical history. Gap analysis revealed that Web site D, managed by a patient advocacy group, received the highest total content score of 155/176 (88%) and the highest usability score of 31.7/35 (91%). Two hundred two participants completed the telephone interview, with 96 (48%) reporting that they used the Internet as a source of information. Sixty participants (30%) reported that friends or family member had searched the Internet for ostomy information on their behalf, and 148 (75%) indicated they were confident they could get information about ostomies on the Internet. Of the 90 participants (45%) who reported using the Internet to locate ostomy information, 73 (82%) found the information on the Web easy to understand, 28 (31%) reported being frustrated during their search for information, 24 (27%) indicated it took a lot of effort to get the information they needed, and 39 (43%) were concerned about the quality of the information. Web-based patient support resources may be a cost-effective approach to providing essential ostomy information, self-management training, and support. Additional research is needed to examine the efficacy of Web-based patient support interventions to improve ostomy self-management knowledge, skills, and outcomes for patients.

Reducing Cultural Barriers via Internet Courses

ERIC Educational Resources Information Center

Xing, Minjie; Spencer, Ken

2008-01-01

A Web-based learning environment has been developed to support students from China who are studying in the UK and are confronted by many cultural barriers, which may impede their academic studies. The electronic environment incorporates a number of approaches to support learning, ranging from a simple text-based presentation to more active…

The Development and Application of Distance Learning Courses on the Internet.

ERIC Educational Resources Information Center

Fuks, Hugo; Gerosa, Marco Aurelio; Lucena, Carlos Jose Pereira de

2002-01-01

Presents the methodology, results, and difficulties encountered in the development and delivery of a course through the Internet at a university in Rio de Janeiro. Provides a model for group work, including group discussions; and shows how a Web-based environment can be used to provide support and to facilitate cooperative learning. (Author/LRW)

The use of video-based patient education for shared decision-making in the treatment of prostate cancer.

PubMed

Gomella, L G; Albertsen, P C; Benson, M C; Forman, J D; Soloway, M S

2000-08-01

Increased consumerism, patient empowerment, and autonomy are creating a health care revolution. In recent years, the public has become better informed and more sophisticated. An extraordinary amount of treatment advice from books, the media, and the Internet is available to patients today, although much of it is confusing or conflicting. Consequently, the traditional, paternalistic doctor-patient relationship is yielding to a more consumerist one. The new dynamic is based on a participatory ethic and a change in the balance of power. This shared decision-making creates a true partnership between professionals and patients, in which each contributes equally to decisions about treatment or care. Evidence suggests that in diseases such as prostate cancer, where there may be a number of appropriate treatment options for a particular patient, shared decision-making may lead to improved clinical and quality-of-life outcomes. This article explores the evolving relationship between the physician and patient, the pros and cons of shared decision-making, and the use of video technology in the clinical setting. The authors review the use of medical decision aids, including a video-based educational program called CHOICES, in the treatment of prostate cancer and other diseases.

Technology Use Among Patients in a Nonurban Southern U.S. HIV Clinic in 2015

PubMed Central

Waldman, Ava Lena; Ritterband, Lee; Dillingham, Rebecca; Bullock, Linda; Ingersoll, Karen S.

2016-01-01

Abstract Background: Behavioral interventions can be delivered over the Internet, but nonurban subpopulations living with HIV may still have inadequate Internet access to make this feasible. Methods: We report on a survey conducted in 2015 among 150 patients receiving care at a university-based Infectious Disease Clinic serving a nonurban and rural population in central Virginia. Our aim was to determine the rate of computer, tablet, and smartphone usage, as well as Internet access, to inform the delivery of a novel intervention using Internet and mobile technology. Results: The participants' mean age was 46; 111 patients used computers, 101 used smartphones, and 41 used tablets. The results showed that 87% of patients had Internet access. Of those, 49 reported daily Internet use, while 18% reported weekly Internet use, and 33% reported less frequent Internet use. Conclusions: The survey study data suggest that Internet access among nonurban and rural patients with HIV is adequate to support trials testing Internet-delivered interventions. It is time to develop and deliver Internet interventions tailored for this often isolated subpopulation. PMID:27123688

Internet peer support for individuals with psychiatric disabilities: A randomized controlled trial.

PubMed

Kaplan, Katy; Salzer, Mark S; Solomon, Phyllis; Brusilovskiy, Eugene; Cousounis, Pamela

2011-01-01

Despite the prevalence of Internet support groups for individuals with mental illnesses little is known about the potential benefits, or harm, of participating in such groups. Therefore, this randomized controlled trial sought to determine the impact of unmoderated, unstructured Internet peer support, similar to what is naturally occurring on the Internet, on the well-being of individuals with psychiatric disabilities. Three hundred individuals resident in the USA diagnosed with a Schizophrenia Spectrum or an Affective Disorder were randomized into one of three conditions: experimental Internet peer support via a listserv, experimental Internet peer support via a bulletin board, or a control condition. Three measurement time points, baseline, 4- and 12 months post-baseline, assessed well-being by examining measures of recovery, quality of life, empowerment, social support, and distress. Time × group interactions in the repeated measures ANOVA showed no differences between conditions on the main outcomes. Post-hoc repeated measures ANOVAs found that those individuals who participated more in Internet peer support reported higher levels of distress than those with less or no participation (p = 0.03). Those who reported more positive experiences with the Internet peer support group also reported higher levels of psychological distress than those reporting less positive experiences (p = 0.01). Study results therefore do not support the hypothesis that participation in an unmoderated, unstructured Internet listserv or bulletin board peer support group for individuals with psychiatric disabilities enhances well-being. Counterintuitive findings demonstrating those who report more positive experiences also experienced higher levels of distress are discussed but we also point to the need for additional research. Future research should explore the various structures, formats, and interventions of Internet support, as well as the content and quality of interactions. Knowledge generated from such research can help to inform policies and guidelines for safely navigating online resources and supports to gain maximum benefit. Copyright © 2010 Elsevier Ltd. All rights reserved.

Current experiences with internet telepathology and possible evolution in the next generation of Internet services.

PubMed

Della Mea, V; Beltrami, C A

2000-01-01

The last five years experience has definitely demonstrated the possible applications of the Internet for telepathology. They may be listed as follows: (a) teleconsultation via multimedia e-mail; (b) teleconsultation via web-based tools; (c) distant education by means of World Wide Web; (d) virtual microscope management through Web and Java interfaces; (e) real-time consultations through Internet-based videoconferencing. Such applications have led to the recognition of some important limits of the Internet, when dealing with telemedicine: (i) no guarantees on the quality of service (QoS); (ii) inadequate security and privacy; (iii) for some countries, low bandwidth and thus low responsiveness for real-time applications. Currently, there are several innovations in the world of the Internet. Different initiatives have been aimed at an amelioration of the Internet protocols, in order to have quality of service, multimedia support, security and other advanced services, together with greater bandwidth. The forthcoming Internet improvements, although induced by electronic commerce, video on demand, and other commercial needs, are of real interest also for telemedicine, because they solve the limits currently slowing down the use of Internet. When such new services will be available, telepathology applications may switch from research to daily practice in a fast way.

Feasibility of Internet-based Parent Training for Low-income Parents of Young Children.

PubMed

McGoron, Lucy; Hvizdos, Erica; Bocknek, Erika L; Montgomery, Erica; Ondersma, Steven J

2018-01-01

Parent training programs promote positive parenting and benefit low-income children, but are rarely used. Internet-based delivery may help expand the reach of parent training programs, although feasibility among low-income populations is still unclear. We examined the feasibility of internet-based parent training, in terms of internet access/use and engagement, through two studies. In Study 1, 160 parents recruited from Women, Infants, and Children (WIC) centers completed a brief paper survey regarding internet access and use (all parents received government aid). We found high levels of access, openness, and comfort with the internet and internet-enabled devices. In Study 2, a pilot study, we assessed use of an online parenting program in a project with a sample of 89 predominately low-income parents (75% received government aid). Parents learned about a new, online parenting program (the "5-a-Day Parenting Program") and provided ratings of level of interest and program use 2-weeks and 4-weeks later. Local website traffic was also monitored. At baseline, parents were very interested in using the web-based program, and the majority of parents (69.6%) reported visiting the website at least once. However, in-depth use was rare (only 9% of parents reported frequent use of the online program). Results support the feasibility of internet-based parent training for low-income parents, as most parent were able to use the program and were interested in doing so. However, results also suggest the need to develop strategies to promote in-depth program use.

Uncertainty and probability in wildfire management decision support: An example from the United States [Chapter 4

Treesearch

Matthew Thompson; David Calkin; Joe H. Scott; Michael Hand

2017-01-01

Wildfire risk assessment is increasingly being adopted to support federal wildfire management decisions in the United States. Existing decision support systems, specifically the Wildland Fire Decision Support System (WFDSS), provide a rich set of probabilistic and risk‐based information to support the management of active wildfire incidents. WFDSS offers a wide range...

Feasibility of e-Health Interventions on Smoking Cessation among Vietnamese Active Internet Users

PubMed Central

Tran, Bach Xuan; Le, Xuan Thanh Thi; Nguyen, Phuong Ngoc; Le, Quynh Ngoc Hoang; Mai, Hue Thi; Nguyen, Huong Lan Thi; Le, Huong Thi; Tran, Tung Thanh; Latkin, Carl A.; Zhang, Melvyn W.B.; Ho, Roger C.M.

2018-01-01

Introduction: Although e-health interventions are widely implemented as a supportive measure to smoking cessation, there is a lack of evidence in the feasibility of its application among Vietnamese youths, which is considered to be one of the most frequent internet using populations. This study assessed the quitting attempts among smokers and their preference and willingness to pay for smartphone-based cessation supporting applications in a sample of active internet users approached. Methods: A total of 1082 participants were recruited for the online-based survey from August to October 2015 in Vietnam. Information on sociodemographic characteristics, health information seeking behaviors on the internet, smoking status, quitting attempts and willingness to pay for smartphone-based cessation supporting applications were collected. Multivariate logistic regression was used to determine the associated factors with current smoking and willingness to pay for the smoking cessation application. Results: About 11% of participants were current smokers while 73.4% had attempted to quit smoking. Only 26.8% of the individuals indicated that they were willing to utilize a smartphone application to assist them in quitting. Participants who were male, had partners/spouse and lived at other places were more likely to smoke cigarette. Meanwhile, people who spent 50–70% of their online time to read health information were less likely to smoke. Results also show that living with family and never sharing health information on the internet were negatively associated with a participant’s willingness to pay for the smartphone application. Meanwhile, people who highly trusted health information were more likely to be willing to pay for the application. Conclusions: This prevalence of smoking and associated factors can provide potential indicators for creating several public health interventions in the new environment with the increasing development of information technology. This study implies that in order to expand the coverage of smoking cessation interventions, we recommend the integration of e-health interventions with clinical- or telephone-based conventional models by providing smartphone applications and information on the internet from reliable sources. PMID:29361694

Recommendations for a Culturally Relevant Internet-Based Tool to Promote Physical Activity Among Overweight Young African American Women, Alabama, 2010–2011

PubMed Central

Joseph, Rodney P.; Cherrington, Andrea; Cuffee, Yendelela; Knight, BernNadette; Lewis, Dwight; Allison, Jeroan J.

2014-01-01

Introduction Innovative approaches are needed to promote physical activity among young adult overweight and obese African American women. We sought to describe key elements that African American women desire in a culturally relevant Internet-based tool to promote physical activity among overweight and obese young adult African American women. Methods A mixed-method approach combining nominal group technique and traditional focus groups was used to elicit recommendations for the development of an Internet-based physical activity promotion tool. Participants, ages 19 to 30 years, were enrolled in a major university. Nominal group technique sessions were conducted to identify themes viewed as key features for inclusion in a culturally relevant Internet-based tool. Confirmatory focus groups were conducted to verify and elicit more in-depth information on the themes. Results Twenty-nine women participated in nominal group (n = 13) and traditional focus group sessions (n = 16). Features that emerged to be included in a culturally relevant Internet-based physical activity promotion tool were personalized website pages, diverse body images on websites and in videos, motivational stories about physical activity and women similar to themselves in size and body shape, tips on hair care maintenance during physical activity, and online social support through social media (eg, Facebook, Twitter). Conclusion Incorporating existing social media tools and motivational stories from young adult African American women in Internet-based tools may increase the feasibility, acceptability, and success of Internet-based physical activity programs in this high-risk, understudied population. PMID:24433625

SMARTDIAB: a communication and information technology approach for the intelligent monitoring, management and follow-up of type 1 diabetes patients.

PubMed

Mougiakakou, Stavroula G; Bartsocas, Christos S; Bozas, Evangelos; Chaniotakis, Nikos; Iliopoulou, Dimitra; Kouris, Ioannis; Pavlopoulos, Sotiris; Prountzou, Aikaterini; Skevofilakas, Marios; Tsoukalis, Alexandre; Varotsis, Kostas; Vazeou, Andrianni; Zarkogianni, Konstantia; Nikita, Konstantina S

2010-05-01

SMARTDIAB is a platform designed to support the monitoring, management, and treatment of patients with type 1 diabetes mellitus (T1DM), by combining state-of-the-art approaches in the fields of database (DB) technologies, communications, simulation algorithms, and data mining. SMARTDIAB consists mainly of two units: 1) the patient unit (PU); and 2) the patient management unit (PMU), which communicate with each other for data exchange. The PMU can be accessed by the PU through the internet using devices, such as PCs/laptops with direct internet access or mobile phones via a Wi-Fi/General Packet Radio Service access network. The PU consists of an insulin pump for subcutaneous insulin infusion to the patient and a continuous glucose measurement system. The aforementioned devices running a user-friendly application gather patient's related information and transmit it to the PMU. The PMU consists of a diabetes data management system (DDMS), a decision support system (DSS) that provides risk assessment for long-term diabetes complications, and an insulin infusion advisory system (IIAS), which reside on a Web server. The DDMS can be accessed from both medical personnel and patients, with appropriate security access rights and front-end interfaces. The DDMS, apart from being used for data storage/retrieval, provides also advanced tools for the intelligent processing of the patient's data, supporting the physician in decision making, regarding the patient's treatment. The IIAS is used to close the loop between the insulin pump and the continuous glucose monitoring system, by providing the pump with the appropriate insulin infusion rate in order to keep the patient's glucose levels within predefined limits. The pilot version of the SMARTDIAB has already been implemented, while the platform's evaluation in clinical environment is being in progress.

Dissemination of a Web-Based Tool for Supporting Health Insurance Plan Decisions (Show Me Health Plans): Cross-Sectional Observational Study.

PubMed

Zhao, Jingsong; Mir, Nageen; Ackermann, Nicole; Kaphingst, Kimberly A; Politi, Mary C

2018-06-20

The rate of uninsured people has decreased dramatically since the Affordable Care Act was passed. To make an informed decision, consumers need assistance to understand the advantages and disadvantages of health insurance plans. The Show Me Health Plans Web-based decision support tool was developed to improve the quality of health insurance selection. In response to the promising effectiveness of Show Me Health Plans in a randomized controlled trial (RCT) and the growing need for Web-based health insurance decision support, the study team used expert recommendations for dissemination and implementation, engaged external stakeholders, and made the Show Me Health Plans tool available to the public. The purpose of this study was to implement the public dissemination of the Show Me Health Plans tool in the state of Missouri and to evaluate its impact compared to the RCT. This study used a cross-sectional observational design. Dissemination phase users were compared with users in the RCT study across the same outcome measures. Time spent using the Show Me Health Plans tool, knowledge, importance rating of 9 health insurance features, and intended plan choice match with algorithm predictions were examined. During the dissemination phase (November 2016 to January 2017), 10,180 individuals visited the SMHP website, and the 1069 users who stayed on the tool for more than one second were included in our analyses. Dissemination phase users were more likely to live outside St. Louis City or County (P<.001), were less likely to be below the federal poverty level (P<.001), and had a higher income (P=.03). Overall, Show Me Health Plans users from St. Louis City or County spent more time on the Show Me Health Plans tool than those from other Missouri counties (P=.04); this association was not observed in the RCT. Total time spent on the tool was not correlated with knowledge scores, which were associated with lower poverty levels (P=.009). The users from the RCT phase were more likely to select an insurance plan that matched the tool's recommendations (P<.001) compared with the dissemination phase users. The study suggests that a higher income population may be more likely to seek information and online help when making a health insurance plan decision. We found that Show Me Health Plans users in the dissemination phase were more selective in the information they reviewed. This study illustrates one way of disseminating and implementing an empirically tested Web-based decision aid tool. Distributing Web-based tools is feasible and may attract a large number of potential users, educate them on basic health insurance information, and make recommendations based on personal information and preference. However, using Web-based tools may differ according to the demographics of the general public compared to research study participants. ©Jingsong Zhao, Nageen Mir, Nicole Ackermann, Kimberly A Kaphingst, Mary C Politi. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 20.06.2018.

Understanding Instructional Support Needs of Emerging Internet Users for Web-Based Information Seeking

ERIC Educational Resources Information Center

Gupta, Naman K.; Penstein Rosé, Carolyn

2010-01-01

As the wealth of information available on the Web increases, Web-based information seeking becomes a more and more important skill for supporting both formal education and lifelong learning. However, Web-based information access poses hurdles that must be overcome by certain student populations, such as low English competency users, low literacy…

Internet-based interventions for smoking cessation.

PubMed

Taylor, Gemma M J; Dalili, Michael N; Semwal, Monika; Civljak, Marta; Sheikh, Aziz; Car, Josip

2017-09-04

Tobacco use is estimated to kill 7 million people a year. Nicotine is highly addictive, but surveys indicate that almost 70% of US and UK smokers would like to stop smoking. Although many smokers attempt to give up on their own, advice from a health professional increases the chances of quitting. As of 2016 there were 3.5 billion Internet users worldwide, making the Internet a potential platform to help people quit smoking. To determine the effectiveness of Internet-based interventions for smoking cessation, whether intervention effectiveness is altered by tailoring or interactive features, and if there is a difference in effectiveness between adolescents, young adults, and adults. We searched the Cochrane Tobacco Addiction Group Specialised Register, which included searches of MEDLINE, Embase and PsycINFO (through OVID). There were no restrictions placed on language, publication status or publication date. The most recent search was conducted in August 2016. We included randomised controlled trials (RCTs). Participants were people who smoked, with no exclusions based on age, gender, ethnicity, language or health status. Any type of Internet intervention was eligible. The comparison condition could be a no-intervention control, a different Internet intervention, or a non-Internet intervention. To be included, studies must have measured smoking cessation at four weeks or longer. Two review authors independently assessed and extracted data. We extracted and, where appropriate, pooled smoking cessation outcomes of six-month follow-up or more, reporting short-term outcomes narratively where longer-term outcomes were not available. We reported study effects as a risk ratio (RR) with a 95% confidence interval (CI).We grouped studies according to whether they (1) compared an Internet intervention with a non-active control arm (e.g. printed self-help guides), (2) compared an Internet intervention with an active control arm (e.g. face-to-face counselling), (3) evaluated the addition of behavioural support to an Internet programme, or (4) compared one Internet intervention with another. Where appropriate we grouped studies by age. We identified 67 RCTs, including data from over 110,000 participants. We pooled data from 35,969 participants.There were only four RCTs conducted in adolescence or young adults that were eligible for meta-analysis.Results for trials in adults: Eight trials compared a tailored and interactive Internet intervention to a non-active control. Pooled results demonstrated an effect in favour of the intervention (RR 1.15, 95% CI 1.01 to 1.30, n = 6786). However, statistical heterogeneity was high (I 2 = 58%) and was unexplained, and the overall quality of evidence was low according to GRADE. Five trials compared an Internet intervention to an active control. The pooled effect estimate favoured the control group, but crossed the null (RR 0.92, 95% CI 0.78 to 1.09, n = 3806, I 2 = 0%); GRADE quality rating was moderate. Five studies evaluated an Internet programme plus behavioural support compared to a non-active control (n = 2334). Pooled, these studies indicated a positive effect of the intervention (RR 1.69, 95% CI 1.30 to 2.18). Although statistical heterogeneity was substantial (I 2 = 60%) and was unexplained, the GRADE rating was moderate. Four studies evaluated the Internet plus behavioural support compared to active control. None of the studies detected a difference between trial arms (RR 1.00, 95% CI 0.84 to 1.18, n = 2769, I 2 = 0%); GRADE rating was moderate. Seven studies compared an interactive or tailored Internet intervention, or both, to an Internet intervention that was not tailored/interactive. Pooled results favoured the interactive or tailored programme, but the estimate crossed the null (RR 1.10, 95% CI 0.99 to 1.22, n = 14,623, I 2 = 0%); GRADE rating was moderate. Three studies compared tailored with non-tailored Internet-based messages, compared to non-tailored messages. The tailored messages produced higher cessation rates compared to control, but the estimate was not precise (RR 1.17, 95% CI 0.97 to 1.41, n = 4040), and there was evidence of unexplained substantial statistical heterogeneity (I 2 = 57%); GRADE rating was low.Results should be interpreted with caution as we judged some of the included studies to be at high risk of bias. The evidence from trials in adults suggests that interactive and tailored Internet-based interventions with or without additional behavioural support are moderately more effective than non-active controls at six months or longer, but there was no evidence that these interventions were better than other active smoking treatments. However some of the studies were at high risk of bias, and there was evidence of substantial statistical heterogeneity. Treatment effectiveness in younger people is unknown.

A modular approach to disease registry design: successful adoption of an internet-based rare disease registry.

PubMed

Bellgard, Matthew I; Macgregor, Andrew; Janon, Fred; Harvey, Adam; O'Leary, Peter; Hunter, Adam; Dawkins, Hugh

2012-10-01

There is a need to develop Internet-based rare disease registries to support health care stakeholders to deliver improved quality patient outcomes. Such systems should be architected to enable multiple-level access by a range of user groups within a region or across regional/country borders in a secure and private way. However, this functionality is currently not available in many existing systems. A new approach to the design of an Internet-based architecture for disease registries has been developed for patients with clinical and genetic data in geographical disparate locations. The system addresses issues of multiple-level access by key stakeholders, security and privacy. The system has been successfully adopted for specific rare diseases in Australia and is open source. The results of this work demonstrate that it is feasible to design an open source Internet-based disease registry system in a scalable and customizable fashion and designed to facilitate interoperability with other systems. © 2012 Wiley Periodicals, Inc.

WEB-GIS Decision Support System for CO2 storage

NASA Astrophysics Data System (ADS)

Gaitanaru, Dragos; Leonard, Anghel; Radu Gogu, Constantin; Le Guen, Yvi; Scradeanu, Daniel; Pagnejer, Mihaela

2013-04-01

Environmental decision support systems (DSS) paradigm evolves and changes as more knowledge and technology become available to the environmental community. Geographic Information Systems (GIS) can be used to extract, assess and disseminate some types of information, which are otherwise difficult to access by traditional methods. In the same time, with the help of the Internet and accompanying tools, creating and publishing online interactive maps has become easier and rich with options. The Decision Support System (MDSS) developed for the MUSTANG (A MUltiple Space and Time scale Approach for the quaNtification of deep saline formations for CO2 storaGe) project is a user friendly web based application that uses the GIS capabilities. MDSS can be exploited by the experts for CO2 injection and storage in deep saline aquifers. The main objective of the MDSS is to help the experts to take decisions based large structured types of data and information. In order to achieve this objective the MDSS has a geospatial objected-orientated database structure for a wide variety of data and information. The entire application is based on several principles leading to a series of capabilities and specific characteristics: (i) Open-Source - the entire platform (MDSS) is based on open-source technologies - (1) database engine, (2) application server, (3) geospatial server, (4) user interfaces, (5) add-ons, etc. (ii) Multiple database connections - MDSS is capable to connect to different databases that are located on different server machines. (iii)Desktop user experience - MDSS architecture and design follows the structure of a desktop software. (iv)Communication - the server side and the desktop are bound together by series functions that allows the user to upload, use, modify and download data within the application. The architecture of the system involves one database and a modular application composed by: (1) a visualization module, (2) an analysis module, (3) a guidelines module, and (4) a risk assessment module. The Database component is build by using the PostgreSQL and PostGIS open source technology. The visualization module allows the user to view data of CO2 injection sites in different ways: (1) geospatial visualization, (2) table view, (3) 3D visualization. The analysis module will allow the user to perform certain analysis like Injectivity, Containment and Capacity analysis. The Risk Assessment module focus on the site risk matrix approach. The Guidelines module contains the methodologies of CO2 injection and storage into deep saline aquifers guidelines.

Knowledge-Based Information Management in Decision Support for Ecosystem Management

Treesearch

Keith Reynolds; Micahel Saunders; Richard Olson; Daniel Schmoldt; Michael Foster; Donald Latham; Bruce Miller; John Steffenson; Lawrence Bednar; Patrick Cunningham

1995-01-01

The Pacific Northwest Research Station (USDA Forest Service) is developing a knowledge-based information management system to provide decision support for watershed analysis in the Pacific Northwest region of the U.S. The decision support system includes: (1) a GIS interface that allows users to graphically navigate to specific provinces and watersheds and display a...

Integrating DXplain into a clinical information system using the World Wide Web.

PubMed

Elhanan, G; Socratous, S A; Cimino, J J

1996-01-01

The World Wide Web(WWW) offers a cross-platform environment and standard protocols that enable integration of various applications available on the Internet. The authors use the Web to facilitate interaction between their Web-based Clinical Information System and a decision-support system-DXplain, at the Massachusetts General Hospital-using local architecture and Common Gateway Interface programs. The current application translates patients laboratory test results into DXplain's terms to generate diagnostic hypotheses. Two different access methods are utilized for this model; Hypertext Transfer Protocol (HTTP) and TCP/IP function calls. While clinical aspects cannot be evaluated as yet, the model demonstrates the potential of Web-based applications for interaction and integration and how local architecture, with a controlled vocabulary server, can further facilitate such integration. This model serves to demonstrate some of the limitations of the current WWW technology and identifies issues such as control over Web resources and their utilization and liability issues as possible obstacles for further integration.

Induced attitude change on online gaming among adolescents: an application of the less-leads-to-more effect.

PubMed

Chiou, Wen-Bin

2008-04-01

The negative impact of Internet use on adolescents has received much popular attention and has also become a popular research topic. How to induce adolescent players to change their attitudes toward online gaming is one of the most important issues in online gaming addiction. The present study is based on the less-leads-to-more effect of dissonance theory. Experimental research was conducted to examine the effects of rewards and decision freedom on attitude change toward online gaming among adolescents considered at risk for addiction. The results supported predictions based on external justification in dissonance theory. Specifically, fewer rewards produced greater attitude change toward online gaming in the condition of personal freedom of choice after participants exhibited attitude-discrepant behavior. However, the less-leads-to-more effect was not prominent in the condition without personal freedom of choice. Adopting a reward strategy to induce game players to disengage online gaming is discussed.

Internet use, online information seeking and knowledge among third molar patients attending public dental services.

PubMed

Hanna, K; Sambrook, P; Armfield, J M; Brennan, D S

2017-09-01

While Australians are searching the internet for third molar (TM) information, the usefulness of online sources may be questioned due to quality variation. This study explored: (i) internet use, online information-seeking behaviour among TM patients attending public dental services; and (ii) whether patients' TM knowledge scores are associated with the level of internet use and eHealth Literacy Scale (eHEALS) scores. Baseline survey data from the 'Engaging Patients in Decision-Making' study were used. Variables included: sociodemographics, internet access status, online information-seeking behaviour, eHEALS, the Control Preferences Scale (CPS) and TM knowledge. Participants (N = 165) were mainly female (73.8%), aged 19-25 years (42.4%) and had 'secondary school or less' education (58.4%). A majority (N = 79, 52.7%) had sought online dental information which was associated with active decisional control preference (odds ratio = 3.1, P = 0.034) and higher educational attainment (odds ratio = 2.7, P = 0.040). TM knowledge scores were not associated with either the level of internet use (F (2,152) = 2.1, P = 0.094, χ 2 = 0.0310) or the eHEALS scores (r = 0.147, P = 0.335). 'The internet-prepared patient' phenomena exists among public TM patients and was explained by preference for involvement in decision-making. However, internet use was not associated with better TM knowledge. Providing TM patients with internet guidance may be an opportunity to improve TM knowledge. © 2017 Australian Dental Association.

"I just googled and read everything": Exploring breast cancer survivors' use of the internet to find information on complementary medicine.

PubMed

Holmes, Michelle M; Bishop, Felicity L; Calman, Lynn

2017-08-01

Breast cancer survivors often turn to the internet as an information resource when deciding whether to use complementary and alternative medicine (CAM) but their use of online CAM-related resources is poorly understood. The objective was to explore breast cancer survivors' use of the internet when making decisions about CAM use. A purposive sample of 11 breast cancer survivors (mean age=56) completed a quantitative questionnaire and a qualitative telephone interview. The theory of planned behaviour (TPB) was used to guide interview questions. Framework analysis and descriptive statistics were used. United Kingdom. All participants found information on CAM using the internet and used some form of CAM after their diagnosis. Themes from the interviews went beyond the standard definitions of the TPB areas. Despite the lack of approval from their social network and healthcare team, participants used the internet to find information on CAM. Further, participants' cancer diagnosis changed their needs, transforming how they perceived and experienced the internet CONCLUSIONS: Participants' use of the internet was more complex than can easily be explained by the TPB and was inherently connected to the experience of self-management for the consequences of cancer and its treatment. As breast cancer survivors may not disclose their use of the internet to their healthcare team, healthcare professionals need to be aware that the information available on the internet plays a factor in the decision-making process to use CAM. Copyright © 2017 Elsevier Ltd. All rights reserved.

A two-stage clinical decision support system for early recognition and stratification of patients with sepsis: an observational cohort study.

PubMed

Amland, Robert C; Lyons, Jason J; Greene, Tracy L; Haley, James M

2015-10-01

To examine the diagnostic accuracy of a two-stage clinical decision support system for early recognition and stratification of patients with sepsis. Observational cohort study employing a two-stage sepsis clinical decision support to recognise and stratify patients with sepsis. The stage one component was comprised of a cloud-based clinical decision support with 24/7 surveillance to detect patients at risk of sepsis. The cloud-based clinical decision support delivered notifications to the patients' designated nurse, who then electronically contacted a provider. The second stage component comprised a sepsis screening and stratification form integrated into the patient electronic health record, essentially an evidence-based decision aid, used by providers to assess patients at bedside. Urban, 284 acute bed community hospital in the USA; 16,000 hospitalisations annually. Data on 2620 adult patients were collected retrospectively in 2014 after the clinical decision support was implemented. 'Suspected infection' was the established gold standard to assess clinical decision support clinimetric performance. A sepsis alert activated on 417 (16%) of 2620 adult patients hospitalised. Applying 'suspected infection' as standard, the patient population characteristics showed 72% sensitivity and 73% positive predictive value. A postalert screening conducted by providers at bedside of 417 patients achieved 81% sensitivity and 94% positive predictive value. Providers documented against 89% patients with an alert activated by clinical decision support and completed 75% of bedside screening and stratification of patients with sepsis within one hour from notification. A clinical decision support binary alarm system with cross-checking functionality improves early recognition and facilitates stratification of patients with sepsis.

The bioethics discussion forum--an implementation of an Internet-based bioethics information analysis resource.

PubMed Central

Derse, A. R.; Krogull, S. R.

1995-01-01

Ethical analysis is crucial to decision making in biomedicine and health care, necessitating both rapid access to diffusely disseminated sources of information pertinent to bioethics and promotion of analysis in the field of bioethics through a resource for information analysis. We developed the Bioethics Discussion Forum, an Internet-based information analysis resource, in order to supplement the Bioethics Online Service with an interactive information medium to meet the demand for such an interactive resource. The Bioethics Discussion Forum has shown promise for information analysis, providing an arena for the review and discussion of complex bioethical information, establishing a connection nationally and internationally among individuals with high levels of expertise in bioethics, and providing a template for future interactive informatics services. PMID:8563245

Launching a virtual decision lab: development and field-testing of a web-based patient decision support research platform.

PubMed

Hoffman, Aubri S; Llewellyn-Thomas, Hilary A; Tosteson, Anna N A; O'Connor, Annette M; Volk, Robert J; Tomek, Ivan M; Andrews, Steven B; Bartels, Stephen J

2014-12-12

Over 100 trials show that patient decision aids effectively improve patients' information comprehension and values-based decision making. However, gaps remain in our understanding of several fundamental and applied questions, particularly related to the design of interactive, personalized decision aids. This paper describes an interdisciplinary development process for, and early field testing of, a web-based patient decision support research platform, or virtual decision lab, to address these questions. An interdisciplinary stakeholder panel designed the web-based research platform with three components: a) an introduction to shared decision making, b) a web-based patient decision aid, and c) interactive data collection items. Iterative focus groups provided feedback on paper drafts and online prototypes. A field test assessed a) feasibility for using the research platform, in terms of recruitment, usage, and acceptability; and b) feasibility of using the web-based decision aid component, compared to performance of a videobooklet decision aid in clinical care. This interdisciplinary, theory-based, patient-centered design approach produced a prototype for field-testing in six months. Participants (n = 126) reported that: the decision aid component was easy to use (98%), information was clear (90%), the length was appropriate (100%), it was appropriately detailed (90%), and it held their interest (97%). They spent a mean of 36 minutes using the decision aid and 100% preferred using their home/library computer. Participants scored a mean of 75% correct on the Decision Quality, Knowledge Subscale, and 74 out of 100 on the Preparation for Decision Making Scale. Completing the web-based decision aid reduced mean Decisional Conflict scores from 31.1 to 19.5 (p < 0.01). Combining decision science and health informatics approaches facilitated rapid development of a web-based patient decision support research platform that was feasible for use in research studies in terms of recruitment, acceptability, and usage. Within this platform, the web-based decision aid component performed comparably with the videobooklet decision aid used in clinical practice. Future studies may use this interactive research platform to study patients' decision making processes in real-time, explore interdisciplinary approaches to designing web-based decision aids, and test strategies for tailoring decision support to meet patients' needs and preferences.

Characteristics and Help-Seeking Behaviors of Internet Gamblers Based on Most Problematic Mode of Gambling

PubMed Central

2015-01-01

Background Previous studies of problem Internet gamblers have failed to distinguish whether their problem gambling relates to Internet or land-based gambling modes. Therefore, characteristics and help-seeking behaviors of people whose gambling problems relate specifically to Internet gambling are unknown, but could inform the optimal alignment of treatment and support services with the needs and preferences of problem gamblers. Objective This study aimed to compare (1) characteristics of problem Internet gamblers and problem land-based gamblers and (2) uptake of different types and modes of help between problem Internet gamblers and problem land-based gamblers. Hypothesis 1 was that problem Internet gamblers are less likely to seek help. Hypothesis 2 was that problem Internet gamblers are more likely to use online modes of help. Methods A sample of 620 respondents meeting criteria for problem gambling was drawn from an online survey of 4594 Australian gamblers. Respondents were recruited through advertisements on gambling and gambling help websites, Facebook, and Google. Measures consisted of gambling participation; proportion of gambling on the Internet; most problematic mode of gambling; help seeking from 11 different sources of formal help, informal help, and self-help for gambling problems; psychological distress (Kessler 6); problem gambling severity (Problem Gambling Severity Index, PGSI); and demographics. Results Problem Internet gamblers were significantly more likely than problem land-based gamblers to be male (χ2 1=28.3, P<.001, φ=0.21), younger (t 616.33=4.62, P<.001, d=0.37), have lower psychological distress (χ2 1=5.4, P=.02, φ=0.09), and experience problems with sports and race wagering (χ2 4=228.5, P<.001, φ=0.61). Uptake of help was significantly lower among problem Internet compared to problem land-based gamblers (χ2 1=6.9, P<.001, φ=0.11), including from face-to-face services, gambling helplines, online groups, self-exclusion from land-based venues, family or friends, and self-help strategies. Both problem Internet and problem land-based gamblers had similarly low use of online help. However, problem land-based gamblers (37.6%, 126/335) were significantly more likely to have sought land-based formal help compared to problem Internet gamblers (23.5%, 67/285; χ2 1=14.3, P<.001, φ=0.15). Conclusions The findings suggest that more targeted and innovative efforts may be needed to increase use of gambling help by problem Internet gamblers. Alternatively, their lower PGSI and K6 scores suggest Internet problem gamblers may have less need for gambling-related help. This is the first known study to classify problem Internet gamblers as those whose problem gambling specifically relates to Internet gambling. Further research is needed to better understand why help-seeking rates are lower among Internet problem gamblers. PMID:25567672

76 FR 50926 - Civilian Board of Contract Appeals; Rules of Procedure of the Civilian Board of Contract Appeals...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-17

... working hours, they may be transmitted at any time from any location with Internet access. This amendment... Internet address for the Board. In addition, section 6101.5(c) is amended to correct an error in printing... [Rule 25]. (a) * * * (1) * * * In addition, all Board decisions are posted weekly on the Internet. The...

Development of transportation asset management decision support tools : final report.

DOT National Transportation Integrated Search

2017-08-09

This study developed a web-based prototype decision support platform to demonstrate the benefits of transportation asset management in monitoring asset performance, supporting asset funding decisions, planning budget tradeoffs, and optimizing resourc...

Design and realization of tourism spatial decision support system based on GIS

NASA Astrophysics Data System (ADS)

Ma, Zhangbao; Qi, Qingwen; Xu, Li

2008-10-01

In this paper, the existing problems of current tourism management information system are analyzed. GIS, tourism as well as spatial decision support system are introduced, and the application of geographic information system technology and spatial decision support system to tourism management and the establishment of tourism spatial decision support system based on GIS are proposed. System total structure, system hardware and software environment, database design and structure module design of this system are introduced. Finally, realization methods of this systemic core functions are elaborated.

CorRECTreatment: A Web-based Decision Support Tool for Rectal Cancer Treatment that Uses the Analytic Hierarchy Process and Decision Tree

PubMed Central

Karakülah, G.; Dicle, O.; Sökmen, S.; Çelikoğlu, C.C.

2015-01-01

Summary Background The selection of appropriate rectal cancer treatment is a complex multi-criteria decision making process, in which clinical decision support systems might be used to assist and enrich physicians’ decision making. Objective The objective of the study was to develop a web-based clinical decision support tool for physicians in the selection of potentially beneficial treatment options for patients with rectal cancer. Methods The updated decision model contained 8 and 10 criteria in the first and second steps respectively. The decision support model, developed in our previous study by combining the Analytic Hierarchy Process (AHP) method which determines the priority of criteria and decision tree that formed using these priorities, was updated and applied to 388 patients data collected retrospectively. Later, a web-based decision support tool named corRECTreatment was developed. The compatibility of the treatment recommendations by the expert opinion and the decision support tool was examined for its consistency. Two surgeons were requested to recommend a treatment and an overall survival value for the treatment among 20 different cases that we selected and turned into a scenario among the most common and rare treatment options in the patient data set. Results In the AHP analyses of the criteria, it was found that the matrices, generated for both decision steps, were consistent (consistency ratio<0.1). Depending on the decisions of experts, the consistency value for the most frequent cases was found to be 80% for the first decision step and 100% for the second decision step. Similarly, for rare cases consistency was 50% for the first decision step and 80% for the second decision step. Conclusions The decision model and corRECTreatment, developed by applying these on real patient data, are expected to provide potential users with decision support in rectal cancer treatment processes and facilitate them in making projections about treatment options. PMID:25848413

CorRECTreatment: a web-based decision support tool for rectal cancer treatment that uses the analytic hierarchy process and decision tree.

PubMed

Suner, A; Karakülah, G; Dicle, O; Sökmen, S; Çelikoğlu, C C

2015-01-01

The selection of appropriate rectal cancer treatment is a complex multi-criteria decision making process, in which clinical decision support systems might be used to assist and enrich physicians' decision making. The objective of the study was to develop a web-based clinical decision support tool for physicians in the selection of potentially beneficial treatment options for patients with rectal cancer. The updated decision model contained 8 and 10 criteria in the first and second steps respectively. The decision support model, developed in our previous study by combining the Analytic Hierarchy Process (AHP) method which determines the priority of criteria and decision tree that formed using these priorities, was updated and applied to 388 patients data collected retrospectively. Later, a web-based decision support tool named corRECTreatment was developed. The compatibility of the treatment recommendations by the expert opinion and the decision support tool was examined for its consistency. Two surgeons were requested to recommend a treatment and an overall survival value for the treatment among 20 different cases that we selected and turned into a scenario among the most common and rare treatment options in the patient data set. In the AHP analyses of the criteria, it was found that the matrices, generated for both decision steps, were consistent (consistency ratio<0.1). Depending on the decisions of experts, the consistency value for the most frequent cases was found to be 80% for the first decision step and 100% for the second decision step. Similarly, for rare cases consistency was 50% for the first decision step and 80% for the second decision step. The decision model and corRECTreatment, developed by applying these on real patient data, are expected to provide potential users with decision support in rectal cancer treatment processes and facilitate them in making projections about treatment options.

Geospatial Data Fusion and Multigroup Decision Support for Surface Water Quality Management

NASA Astrophysics Data System (ADS)

Sun, A. Y.; Osidele, O.; Green, R. T.; Xie, H.

2010-12-01

Social networking and social media have gained significant popularity and brought fundamental changes to many facets of our everyday life. With the ever-increasing adoption of GPS-enabled gadgets and technology, location-based content is likely to play a central role in social networking sites. While location-based content is not new to the geoscience community, where geographic information systems (GIS) are extensively used, the delivery of useful geospatial data to targeted user groups for decision support is new. Decision makers and modelers ought to make more effective use of the new web-based tools to expand the scope of environmental awareness education, public outreach, and stakeholder interaction. Environmental decision processes are often rife with uncertainty and controversy, requiring integration of multiple sources of information and compromises between diverse interests. Fusing of multisource, multiscale environmental data for multigroup decision support is a challenging task. Toward this goal, a multigroup decision support platform should strive to achieve transparency, impartiality, and timely synthesis of information. The latter criterion often constitutes a major technical bottleneck to traditional GIS-based media, featuring large file or image sizes and requiring special processing before web deployment. Many tools and design patterns have appeared in recent years to ease the situation somewhat. In this project, we explore the use of Web 2.0 technologies for “pushing” location-based content to multigroups involved in surface water quality management and decision making. In particular, our granular bottom-up approach facilitates effective delivery of information to most relevant user groups. Our location-based content includes in-situ and remotely sensed data disseminated by NASA and other national and local agencies. Our project is demonstrated for managing the total maximum daily load (TMDL) program in the Arroyo Colorado coastal river basin in Texas. The overall design focuses on assigning spatial information to decision support elements and on efficiently using Web 2.0 technologies to relay scientific information to the nonscientific community. We conclude that (i) social networking, if appropriately used, has great potential for mitigating difficulty associated with multigroup decision making; (ii) all potential stakeholder groups should be involved in creating a useful decision support system; and (iii) environmental decision support systems should be considered a must-have, instead of an optional component of TMDL decision support projects. Acknowledgment: This project was supported by NASA grant NNX09AR63G.

Lessons Learned About Public Health from Online Crowd Surveillance

PubMed Central

Merchant, Raina; Ungar, Lyle

2013-01-01

Abstract The Internet has forever changed the way people access information and make decisions about their healthcare needs. Patients now share information about their health at unprecedented rates on social networking sites such as Twitter and Facebook and on medical discussion boards. In addition to explicitly shared information about health conditions through posts, patients reveal data on their inner fears and desires about health when searching for health-related keywords on search engines. Data are also generated by the use of mobile phone applications that track users' health behaviors (e.g., eating and exercise habits) as well as give medical advice. The data generated through these applications are mined and repackaged by surveillance systems developed by academics, companies, and governments alike to provide insight to patients and healthcare providers for medical decisions. Until recently, most Internet research in public health has been surveillance focused or monitoring health behaviors. Only recently have researchers used and interacted with the crowd to ask questions and collect health-related data. In the future, we expect to move from this surveillance focus to the “ideal” of Internet-based patient-level interventions where healthcare providers help patients change their health behaviors. In this article, we highlight the results of our prior research on crowd surveillance and make suggestions for the future. PMID:25045598

LESSONS LEARNED ABOUT PUBLIC HEALTH FROM ONLINE CROWD SURVEILLANCE.

PubMed

Hill, Shawndra; Merchant, Raina; Ungar, Lyle

2013-09-10

The Internet has forever changed the way people access information and make decisions about their healthcare needs. Patients now share information about their health at unprecedented rates on social networking sites such as Twitter and Facebook and on medical discussion boards. In addition to explicitly shared information about health conditions through posts, patients reveal data on their inner fears and desires about health when searching for health-related keywords on search engines. Data are also generated by the use of mobile phone applications that track users' health behaviors (e.g., eating and exercise habits) as well as give medical advice. The data generated through these applications are mined and repackaged by surveillance systems developed by academics, companies, and governments alike to provide insight to patients and healthcare providers for medical decisions. Until recently, most Internet research in public health has been surveillance focused or monitoring health behaviors. Only recently have researchers used and interacted with the crowd to ask questions and collect health-related data. In the future, we expect to move from this surveillance focus to the "ideal" of Internet-based patient-level interventions where healthcare providers help patients change their health behaviors. In this article, we highlight the results of our prior research on crowd surveillance and make suggestions for the future.

Alcohol Consumption Decisions among Nonabusing Drinkers Diagnosed with Hepatitis C: An Exploratory Sequential Mixed Methods Study

PubMed Central

Stoller, Eleanor Palo; Webster, Noah J.; Blixen, Carol E.; McCormick, Richard A.; Hund, Andrew J.; Perzynski, Adam T.; Kanuch, Stephanie W.; Thomas, Charles L.; Kercher, Kyle; Dawson, Neal V.

2009-01-01

Most studies of decisions to curtail alcohol consumption reflect experiences of abusing drinkers. We employ an exploratory sequential research design to explore the applicability of this research to the experience of nonabusing drinkers advised to curtail alcohol consumption after a Hepatitis C diagnosis. A qualitative component identified 17 new decision factors not reflected in an inventory of factors based on synthesis of existing scales. We triangulated qualitative data by supplementing semi-structured interviews with Internet postings. A quantitative component estimated prevalence and association with current drinking of these new decision factors. Patients who quit drinking tended to attribute post-diagnosis drinking to occasional triggers, whereas patients who were still drinking were more likely to endorse rationales not tied to specific triggers. PMID:20046861

Toward theoretical understanding of the fertility preservation decision-making process: examining information processing among young women with cancer.

PubMed

Hershberger, Patricia E; Finnegan, Lorna; Altfeld, Susan; Lake, Sara; Hirshfeld-Cytron, Jennifer

2013-01-01

Young women with cancer now face the complex decision about whether to undergo fertility preservation. Yet little is known about how these women process information involved in making this decision. The purpose of this article is to expand theoretical understanding of the decision-making process by examining aspects of information processing among young women diagnosed with cancer. Using a grounded theory approach, 27 women with cancer participated in individual, semistructured interviews. Data were coded and analyzed using constant-comparison techniques that were guided by 5 dimensions within the Contemplate phase of the decision-making process framework. In the first dimension, young women acquired information primarily from clinicians and Internet sources. Experiential information, often obtained from peers, occurred in the second dimension. Preferences and values were constructed in the third dimension as women acquired factual, moral, and ethical information. Women desired tailored, personalized information that was specific to their situation in the fourth dimension; however, women struggled with communicating these needs to clinicians. In the fifth dimension, women offered detailed descriptions of clinician behaviors that enhance or impede decisional debriefing. Better understanding of theoretical underpinnings surrounding women's information processes can facilitate decision support and improve clinical care.

Preserving the Finger Lakes for the Future: A Prototype Decision Support System for Water Resource Management, Open Space, and Agricultural Protection

NASA Technical Reports Server (NTRS)

Brower, Robert

2003-01-01

As described herein, this project has progressed well, with the initiation or completion of a number of program facets at programmatic, technical, and inter-agency levels. The concept of the Virtual Management Operations Center has taken shape, grown, and has been well received by parties from a wide variety of agencies and organizations in the Finger Lakes region and beyond. As it has evolved in design and functionality, and to better illustrate its current focus for this project, it has been given the expanded name of Watershed Virtual Management Operations Center (W-VMOC). It offers the advanced, compelling functionality of interactive 3D visualization interfaced with 2D mapping, all accessed via Internet or virtually any kind of distributed computer network. This strong foundation will allow the development of a Decision Support System (DSS) with anticipated enhanced functionality to be applied to the myriad issues involved in the wise management of the Finger Lakes region.

Internet-based patient self-care: the next generation of health care delivery.

PubMed

Forkner-Dunn, June

2003-01-01

The United States health care system is an outdated model in need of fundamental change. As part of this change, the system must explore and take advantage of the potential benefits of the "e-revolution," a phenomenon that includes everyday use of the Internet by the general public. During 2002, an estimated 100 million Americans will have obtained information--including health information--from the Web as a basis for making decisions. The Internet is thus an influential force; and, as such, this medium could have a revolutionary role in retooling the trillion-dollar United States health care industry to improve patient self-management, patient satisfaction, and health outcomes. As a group, physicians use the Internet more than do many other sectors of the general adult population. However, physicians have not received sufficient information to convince them that they can provide higher-quality care by using the Internet; indeed, few studies have assessed the Internet's value for improving patients' medical self-management and health behavior, as well as their clinical outcomes and relationships with health care practitioners. New e-technology formats introduced to the growing consumer movement will drive the next generation of self-care by allowing patients to manage their own health conveniently and proficiently.

Modeling and Simulation of Shuttle Launch and Range Operations

NASA Technical Reports Server (NTRS)

Bardina, Jorge; Thirumalainambi, Rajkumar

2004-01-01

The simulation and modeling test bed is based on a mockup of a space flight operations control suitable to experiment physical, procedural, software, hardware and psychological aspects of space flight operations. The test bed consists of a weather expert system to advise on the effect of weather to the launch operations. It also simulates toxic gas dispersion model, impact of human health risk, debris dispersion model in 3D visualization. Since all modeling and simulation is based on the internet, it could reduce the cost of operations of launch and range safety by conducting extensive research before a particular launch. Each model has an independent decision making module to derive the best decision for launch.

Internet-based self-management offers an opportunity to achieve better asthma control in adolescents.

PubMed

van der Meer, Victor; van Stel, Henk F; Detmar, Symone B; Otten, Wilma; Sterk, Peter J; Sont, Jacob K

2007-07-01

Internet and short message service are emerging tools for chronic disease management in adolescents, but few data exist on the barriers to and benefits of internet-based asthma self-management. Our objective was to reveal the barriers and benefits perceived by adolescents with well-controlled and poorly controlled asthma to current and internet-based asthma management. Ninety-seven adolescents with mild-to-moderate persistent asthma monitored their asthma control on a designated Web site. After 4 weeks, 35 adolescents participated in eight focus groups. Participants were stratified in terms of age, gender, and asthma control level. We used qualitative and quantitative methods to analyze the written focus group transcripts. Limited self-efficacy to control asthma was a significant barrier to current asthma management in adolescents with poor asthma control (65%) compared to adolescents with good asthma control (17%; p < 0.01). The former group revealed the following several benefits from internet-based asthma self-management: feasible electronic monitoring; easily accessible information; e-mail communication; and use of an electronic action plan. Personal benefits included the ability to react to change and to optimize asthma control. Patients with poor asthma control were able and ready to incorporate internet-based asthma self-management for a long period of time (65%), whereas patients with good control were not (11%; p < 0.01). Our findings reveal a need for the support of self-management in adolescents with poorly controlled asthma that can be met by the application of novel information and communication technologies. Internet-based self-management should therefore target adolescents with poor asthma control.

An intelligent tele-healthcare environment offering person-centric and wellness-maintenance services.

PubMed

Abidi, S S

2001-06-01

Worldwide healthcare delivery trends are undergoing a subtle paradigm shift--patient centered services as opposed to provider centered services and wellness maintenance as opposed to illness management. In this paper we present a Tele-Healthcare project TIDE--Tele-Healthcare Information and Diagnostic Environment. TIDE manifests an 'intelligent' healthcare environment that aims to ensure lifelong coverage of person-specific health maintenance decision-support services--i.e., both wellness maintenance and illness management services--ubiquitously available via the Internet/WWW. Taking on an all-encompassing health maintenance role--spanning from wellness to illness issues--the functionality of TIDE involves the generation and delivery of (a) Personalized, Pro-active, Persistent, Perpetual, and Present wellness maintenance services, and (b) remote diagnostic services for managing noncritical illnesses. Technically, TIDE is an amalgamation of diverse computer technologies--Artificial Intelligence, Internet, Multimedia, Databases, and Medical Informatics--to implement a sophisticated healthcare delivery infostructure.

IRIS Toxicological Review of Dichloromethane (Methylene ...

EPA Pesticide Factsheets

EPA has finalized the Toxicological Review of Dichloromethane (Methylene Chloride): In support of the Integrated Risk Information System (IRIS). Now final, this assessment may be used by EPA’s program and regional offices to inform decisions to protect human health. This document presents background information and justification for the Intergrated Risk Information System (IRIS) Summary of the hazard and dose-response assessment of dichloromethane. IRIS Summaries may include oral reference dose (RfD) and inhalation reference concentration (RfC) values for chronic and other exposure durations, and a carcinogencity assessment. Internet/NCEA web site

Land Cover Applications, Landscape Dynamics, and Global Change

USGS Publications Warehouse

Tieszen, Larry L.

2007-01-01

The Land Cover Applications, Landscape Dynamics, and Global Change project at U.S. Geological Survey (USGS) Center for Earth Resources Observation and Science (EROS) seeks to integrate remote sensing and simulation models to better understand and seek solutions to national and global issues. Modeling processes related to population impacts, natural resource management, climate change, invasive species, land use changes, energy development, and climate mitigation all pose significant scientific opportunities. The project activities use remotely sensed data to support spatial monitoring, provide sensitivity analyses across landscapes and large regions, and make the data and results available on the Internet with data access and distribution, decision support systems, and on-line modeling. Applications support sustainable natural resource use, carbon cycle science, biodiversity conservation, climate change mitigation, and robust simulation modeling approaches that evaluate ecosystem and landscape dynamics.

Research on the business QoS and trustworthy and controllable strategies mechanism for energy internet

NASA Astrophysics Data System (ADS)

Zhang, Geng; Lu, Meiling; Zhang, Dahua; Zhou, Liang; Li, Likang

2017-01-01

Energy internet is a kind of power sharing network, which can realize the bidirectional flow of energy information on the basis of the existing power grid. It puts forward higher requirements for reliability and controllability of information communication, and all kinds of business QoS of the backbone network. So the research of business QoS and trustworthy and controllable strategies mechanism have an important significance for the development of energy internet. This paper mainly studies how to use the software defined network (SDN) to achieve business QoS, and provide QoS support for all kinds of business of the energy internet. Combined with the current development situation of the energy internet in our country, this paper researches the trustworthy and controllable strategies mechanism for energy internet, and proposes the transition scheme of the IPv6 credible network architecture based on SDN. This coordinates the contradiction between the growing demand for energy internet applications and the limitations of the energy internet technology itself.

Health Information Obtained From the Internet and Changes in Medical Decision Making: Questionnaire Development and Cross-Sectional Survey.

PubMed

Chen, Yen-Yuan; Li, Chia-Ming; Liang, Jyh-Chong; Tsai, Chin-Chung

2018-02-12

The increasing utilization of the internet has provided a better opportunity for people to search online for health information, which was not easily available to them in the past. Studies reported that searching on the internet for health information may potentially influence an individual's decision making to change her health-seeking behaviors. The objectives of this study were to (1) develop and validate 2 questionnaires to estimate the strategies of problem-solving in medicine and utilization of online health information, (2) determine the association between searching online for health information and utilization of online health information, and (3) determine the association between online medical help-seeking and utilization of online health information. The Problem Solving in Medicine and Online Health Information Utilization questionnaires were developed and implemented in this study. We conducted confirmatory factor analysis to examine the structure of the factor loadings and intercorrelations for all the items and dimensions. We employed Pearson correlation coefficients for examining the correlations between each dimension of the Problem Solving in Medicine questionnaire and each dimension of the Online Health Information Utilization questionnaire. Furthermore, we conducted structure equation modeling for examining the possible linkage between each of the 6 dimensions of the Problem Solving in Medicine questionnaire and each of the 3 dimensions of the Online Health Information Utilization questionnaire. A total of 457 patients participated in this study. Pearson correlation coefficients ranged from .12 to .41, all with statistical significance, implying that each dimension of the Problem Solving in Medicine questionnaire was significantly associated with each dimension of the Online Health Information Utilization questionnaire. Patients with the strategy of online health information search for solving medical problems positively predicted changes in medical decision making (P=.01), consulting with others (P<.001), and promoting self-efficacy on deliberating the online health information (P<.001) based on the online health information they obtained. Present health care professionals have a responsibility to acknowledge that patients' medical decision making may be changed based on additional online health information. Health care professionals should assist patients' medical decision making by initiating as much dialogue with patients as possible, providing credible and convincing health information to patients, and guiding patients where to look for accurate, comprehensive, and understandable online health information. By doing so, patients will avoid becoming overwhelmed with extraneous and often conflicting health information. Educational interventions to promote health information seekers' ability to identify, locate, obtain, read, understand, evaluate, and effectively use online health information are highly encouraged. ©Yen-Yuan Chen, Chia-Ming Li, Jyh-Chong Liang, Chin-Chung Tsai. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 12.02.2018.

[Biomedical publications in Spain on debate (II): the on-going 'revolutions' and their application to neurological journals].

PubMed

González de Dios, J; Sempere, A P; Aleixandre-Benavent, R

To debate about the application of on-going 'revolutions' in medical knowledge to Spanish neurological journals in the 21st century. This article reviews the current status of five revolutions in the field of health sciences, in general, and in neurological sciences, in particular: 1) the knowledge revolution: to translate the scientific investigation to the patient, with knowledge needs-driven research agenda with founder commissioning research to answer questions posed by clinicians, managers and patients, and systematic and critical appraisal reviews as the creator of quality improved knowledge; 2) the evidence based medicine revolution: the pyramid information of '4S', with systems (guidelines and computerized decision support systems), synopses (secondary journals), syntheses (systematic reviews and meta-analysis) and studies (original studies published in journals); 3) the web revolution: the possibility of dissemination of biomedical documentation by means of the Internet network are producing changes in the traditional way of conceiving scientific publication; the Internet represents a great advantage for investigation and also for clinical practice, since it permits free, universal access to databases and the interchange of texts, images and videos; 4) the open access revolution: to take full control over all operations related to the process of publish (to create, publish, communicate, distribute, reproduce and transform) with no need of any intermediaries, and to transform fundamental aspects concerning the circulation of knowledge, its use and availability; and 5) the librarian revolution: the project of a Virtual Health Library in Spain as a tool to access and disseminate scientific and technical knowledge on health through the Internet.

Protocol Architecture Model Report

NASA Technical Reports Server (NTRS)

Dhas, Chris

2000-01-01

NASA's Glenn Research Center (GRC) defines and develops advanced technology for high priority national needs in communications technologies for application to aeronautics and space. GRC tasked Computer Networks and Software Inc. (CNS) to examine protocols and architectures for an In-Space Internet Node. CNS has developed a methodology for network reference models to support NASA's four mission areas: Earth Science, Space Science, Human Exploration and Development of Space (REDS), Aerospace Technology. This report applies the methodology to three space Internet-based communications scenarios for future missions. CNS has conceptualized, designed, and developed space Internet-based communications protocols and architectures for each of the independent scenarios. The scenarios are: Scenario 1: Unicast communications between a Low-Earth-Orbit (LEO) spacecraft inspace Internet node and a ground terminal Internet node via a Tracking and Data Rela Satellite (TDRS) transfer; Scenario 2: Unicast communications between a Low-Earth-Orbit (LEO) International Space Station and a ground terminal Internet node via a TDRS transfer; Scenario 3: Multicast Communications (or "Multicasting"), 1 Spacecraft to N Ground Receivers, N Ground Transmitters to 1 Ground Receiver via a Spacecraft.

Innovation in the North: are health service providers ready for the uptake of an internet-based chronic disease management platform?

PubMed

Tillotson, Sherri; Lear, Scott; Araki, Yuriko; Horvat, Dan; Prkachin, Ken; Bates, Joanna; Balka, Ellen

2009-01-01

Remote and rural regions in Canada are faced with unique challenges in the delivery of primary health services. The purpose of this study was to understand how patients and healthcare professionals in northern British Columbia might make use of the Internet to manage cardiovascular diseases. The study used a qualitative methodology. Eighteen health professionals and 6 patients were recruited for a semi-structured interview that explored their experience in managing patients with cardiovascular disease and their opinions and preferences about the use of the Internet in chronic disease management. Key findings from the data suggest that a) use of the Internet helps to maintain continuity of care while a patient moves through various stages of care, b) the Internet may possibly be used as an educational tool in chronic disease self-management, c) there is a need for policy development to support Internet-based consultation processes, and d) while health providers endorse the notion of electronic advancement in their practice, the need for secure and stable electronic systems is essential.

Connecting Children Internationally for Science Instruction: Using the Internet to Support Learning about Lunar Phases

ERIC Educational Resources Information Center

Smith, Walter S.; Cheon, Jongpil; Jabri, Faiza; Reynolds, Stephen; Zebedi, Amira

2012-01-01

This study investigated the effect on children's science understanding of Internet-based instruction in which children from around the world in grades 4 to 8 observed the Moon for several weeks and then shared their lunar data internationally to find global patterns in the Moon's behavior. Students in two American and one Australian class took the…

Using the internet to understand angler behavior in the information age

USGS Publications Warehouse

Martin, Dustin R.; Pracheil, Brenda M.; DeBoer, Jason A.; Wilde, Gene R.; Pope, Kevin L.

2012-01-01

Declining participation in recreational angling is of great concern to fishery managers because fishing license sales are an important revenue source for protection of aquatic resources. This decline is frequently attributed, in part, to increased societal reliance on electronics. Internet use by anglers is increasing and fishery managers may use the Internet as a unique means to increase angler participation. We examined Internet search behavior using Google Insights for Search, a free online tool that summarizes Google searches from 2004 to 2011 to determine (1) trends in Internet search volume for general fishing related terms and (2) the relative usefulness of terms related to angler recruitment programs across the United States. Though search volume declined for general fishing terms (e.g., fishing, fishing guide), search volume increased for social media and recruitment terms (e.g., fishing forum, family fishing) over the 7-year period. We encourage coordinators of recruitment programs to capitalize on anglers’ Internet usage by considering Internet search patterns when creating web-based information. Careful selection of terms used in web-based information to match those currently searched by potential anglers may help to direct traffic to state agency websites that support recruitment efforts.

A knowledge-based decision support system for payload scheduling

NASA Technical Reports Server (NTRS)

Floyd, Stephen; Ford, Donnie

1988-01-01

The role that artificial intelligence/expert systems technologies play in the development and implementation of effective decision support systems is illustrated. A recently developed prototype system for supporting the scheduling of subsystems and payloads/experiments for NASA's Space Station program is presented and serves to highlight various concepts. The potential integration of knowledge based systems and decision support systems which has been proposed in several recent articles and presentations is illustrated.

Assessing internet-based information used to aid patient decision-making about surgery for perianal Crohn's fistula.

PubMed

Marshall, J H; Baker, D M; Lee, M J; Jones, G L; Lobo, A J; Brown, S R

2017-06-01

Decision-making in perianal Crohn's fistula (pCD) is preference sensitive. Patients use the internet to access healthcare information. The aim of this study was to assess the online information and patient decision aids relating to surgery for pCD. A search of Google™ and the Decision Aids Library Inventory (DALI) was performed using a predefined search strategy. Patient-focussed sources providing information about pCD surgery were included in the analysis. Written health information was assessed using the International Patient Decision Aids Standards (IPDAS) and DISCERN criteria. The readability of the source content was assessed using the Flesch-Kincaid score. Of the 201 sources found, 187 were excluded, leaving 14 sources for analysis. Three sources were dedicated to pCD, and six sources mentioned pCD-specific outcomes. The most common surgical intervention reported was seton insertion (n = 13). The least common surgical intervention reported was proctectomy (n = 1). The mean IPDAS and DISCERN scores were 4.43 ± 1.65 out of 12 (range = 2-8) and 2.93 ± 0.73 out of 5 (range = 1-5), respectively. The mean reading ease was US college standard. We found no patient decision aids relating to surgery for pCD. The online sources relating to surgery for pCD are few, and their quality is poor, as seen in the low IPDAS and DISCERN scores. Less than half of the sources mentioned pCD-specific outcomes, and three sources were solely dedicated to providing information on pCD. Healthcare professionals should look to create a patient tool to assist decision-making in pCD.

Convergent Technologies in Distance Learning Delivery.

ERIC Educational Resources Information Center

Wheeler, Steve

1999-01-01

Describes developments in British education in distance learning technologies. Highlights include networking the rural areas; communication, community, and paradigm shifts; digital compression techniques and telematics; Web-based material delivered over the Internet; system flexibility; social support; learning support; videoconferencing; and…

Dr Google Is Here to Stay but Health Care Professionals Are Still Valued: An Analysis of Health Care Consumers' Internet Navigation Support Preferences.

PubMed

Lee, Kenneth; Hoti, Kreshnik; Hughes, Jeffery David; Emmerton, Lynne

2017-06-14

The Internet offers great opportunities for consumers to be informed about their health. However, concerns have been raised regarding its impact on the traditional health consumer-health professional relationship. Our recent survey of 400 Australian adults identified that over half of consumers required some form of navigational support in locating appropriate Web-based health information. We propose that support provided by health professionals would be preferred by consumers; this preference is regardless of whether consumers have a need for navigational support. Secondary analysis of the survey dataset is presented here to quantify consumer-reported support preferences and barriers when navigating Web-based health information. We aimed to quantitatively identify consumers' support preferences for locating Web-based health information and their barriers when navigating Web-based health information. We also aimed to compare such preferences and barriers between consumers identified as needing and not needing support when locating Web-based health information. Chi-square (χ 2 ) tests identified whether each listed support preference differed between subgroups of consumers classified as needing (n=205, 51.3%) or not needing (n=195, 48.8%) navigational support; degree of association, via phi coefficient (φ) tests, were also considered to ascertain the likely practical significance of any differences. This was repeated for each listed barrier. Free-text responses regarding additional support preferences were descriptively analyzed and compared with the quantitative findings to provide a richer understanding of desired support for health information searches. Of the 400 respondents, the most preferred mode of navigational support was involvement of health professionals; this was reported by participants identified as needing and not needing navigational support. While there was a significant difference between groups, the degree of association was small (χ 2 1 [N=400]=13.2; P<.001; φ=.18). Qualitative data from the free-text responses supported consumers' desire for health professional involvement. The two most commonly reported barriers when navigating desired Web-based health information were (1) volume of available information and (2) inconsistency of information between sources; these were reported by participants with and without a need for navigational support. While participants identified with a need for navigational support were more likely to report volume (χ 2 1 [N=387]= 4.40; P=.04; φ=.11) and inconsistency of information (χ 2 1 [N=387]= 16.10, P<.001, φ=.20) as barriers, the degrees of association were small to moderate. Despite concerns in the literature that the popularity of the Internet could compromise the health consumer-health professional relationship, our findings suggest the contrary. Our findings showed that health professionals were found to be the most commonly preferred mode of navigational support, even among consumers classified as not needing navigational support. Further research into how health professionals could assist consumers with Web-based health information seeking could strengthen the health consumer-health professional relationship amidst the growing use of "Dr Google." ©Kenneth Lee, Kreshnik Hoti, Jeffery David Hughes, Lynne Emmerton. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 14.06.2017.

Clinical decision support provided within physician order entry systems: a systematic review of features effective for changing clinician behavior.

PubMed

Kawamoto, Kensaku; Lobach, David F

2003-01-01

Computerized physician order entry (CPOE) systems represent an important tool for providing clinical decision support. In undertaking this systematic review, our objective was to identify the features of CPOE-based clinical decision support systems (CDSSs) most effective at modifying clinician behavior. For this review, two independent reviewers systematically identified randomized controlled trials that evaluated the effectiveness of CPOE-based CDSSs in changing clinician behavior. Furthermore, each included study was assessed for the presence of 14 CDSS features. We screened 10,023 citations and included 11 studies. Of the 10 studies comparing a CPOE-based CDSS intervention against a non-CDSS control group, 7 reported a significant desired change in professional practice. Moreover, meta-regression analysis revealed that automatic provision of the decision support was strongly associated with improved professional practice (adjusted odds ratio, 23.72; 95% confidence interval, 1.75-infiniti). Thus, we conclude that automatic provision of decision support is a critical feature of successful CPOE-based CDSS interventions.

Model-driven methodology for rapid deployment of smart spaces based on resource-oriented architectures.

PubMed

Corredor, Iván; Bernardos, Ana M; Iglesias, Josué; Casar, José R

2012-01-01

Advances in electronics nowadays facilitate the design of smart spaces based on physical mash-ups of sensor and actuator devices. At the same time, software paradigms such as Internet of Things (IoT) and Web of Things (WoT) are motivating the creation of technology to support the development and deployment of web-enabled embedded sensor and actuator devices with two major objectives: (i) to integrate sensing and actuating functionalities into everyday objects, and (ii) to easily allow a diversity of devices to plug into the Internet. Currently, developers who are applying this Internet-oriented approach need to have solid understanding about specific platforms and web technologies. In order to alleviate this development process, this research proposes a Resource-Oriented and Ontology-Driven Development (ROOD) methodology based on the Model Driven Architecture (MDA). This methodology aims at enabling the development of smart spaces through a set of modeling tools and semantic technologies that support the definition of the smart space and the automatic generation of code at hardware level. ROOD feasibility is demonstrated by building an adaptive health monitoring service for a Smart Gym.

A randomized, controlled proof-of-concept trial of an Internet-based, therapist-assisted self-management treatment for posttraumatic stress disorder.

PubMed

Litz, Brett T; Engel, Charles C; Bryant, Richard A; Papa, Anthony

2007-11-01

The authors report an 8-week randomized, controlled proof-of-concept trial of a new therapist-assisted, Internet-based, self-management cognitive behavior therapy versus Internet-based supportive counseling for posttraumatic stress disorder (PTSD). Service members with PTSD from the attack on the Pentagon on September 11th or the Iraq War were randomly assigned to self-management cognitive behavior therapy (N=24) or supportive counseling (N=21). The dropout rate was similar to regular cognitive behavior therapy (30%) and unrelated to treatment arm. In the intent-to-treat group, self-management cognitive behavior therapy led to sharper declines in daily log-on ratings of PTSD symptoms and global depression. In the completer group, self-management cognitive behavior therapy led to greater reductions in PTSD, depression, and anxiety scores at 6 months. One-third of those who completed self-management cognitive behavior therapy achieved high-end state functioning at 6 months. Self-management cognitive behavior therapy may be a way of delivering effective treatment to large numbers with unmet needs and barriers to care.

The INTERNET and the business of oil and gas

DOE Office of Scientific and Technical Information (OSTI.GOV)

Erlewine, K.

1995-12-31

The INTERNET, from a commercial oil and gas viewpoint, represents a unique medium for distributing information about products and services to potential clients, for establishing contact and communicating with new and existent clients and for providing both technical and marketing support to client-bases. Currently, there are several hurdles to doing business on the INTERNET which are client-driven. Most professionals in oil and gas are extremely busy and don`t have time to navigate the {open_quotes}web{close_quotes}, and the rate of online literacy in oil and gas is relatively low.

Public participation GIS: a method for identifying ecosystems services

USGS Publications Warehouse

Brown, Greg; Montag, Jessica; Lyon, Katie

2012-01-01

This study evaluated the use of an Internet-based public participation geographic information system (PPGIS) to identify ecosystem services in Grand County, Colorado. Specific research objectives were to examine the distribution of ecosystem services, identify the characteristics of participants in the study, explore potential relationships between ecosystem services and land use and land cover (LULC) classifications, and assess the methodological strengths and weakness of the PPGIS approach for identifying ecosystem services. Key findings include: (1) Cultural ecosystem service opportunities were easiest to identify while supporting and regulatory services most challenging, (2) participants were highly educated, knowledgeable about nature and science, and have a strong connection to the outdoors, (3) some LULC classifications were logically and spatially associated with ecosystem services, and (4) despite limitations, the PPGIS method demonstrates potential for identifying ecosystem services to augment expert judgment and to inform public or environmental policy decisions regarding land use trade-offs.

On the Design of a Comprehensive Authorisation Framework for Service Oriented Architecture (SOA)

DTIC Science & Technology

2013-07-01

Authentication Server AZM Authorisation Manager AZS Authorisation Server BP Business Process BPAA Business Process Authorisation Architecture BPAD Business...Internet Protocol Security JAAS Java Authentication and Authorisation Service MAC Mandatory Access Control RBAC Role Based Access Control RCA Regional...the authentication process, make authorisation decisions using application specific access control functions that results in the practice of

Information Seeking Behaviour of Parents of Paediatric Patients for Clinical Decision Making: The Central Role of Information Literacy in a Participatory Setting

ERIC Educational Resources Information Center

Kostagiolas, Petros; Martzoukou, Konstantina; Georgantzi, Georgia; Niakas, Dimitris

2013-01-01

Introduction: This study investigated the information seeking behaviour and needs of parents of paediatric patients and their motives for seeking Internet-based information. Method: A questionnaire survey of 121 parents was conducted in a paediatric clinic of a Greek university hospital. Analysis: The data were analysed using SPSS; descriptive…

Current Experiences with Internet Telepathology and Possible Evolution in the Next Generation of Internet Services

PubMed Central

Della Mea, V.; Beltrami, C. A.

2000-01-01

The last five years experience has definitely demonstrated the possible applications of the Internet for telepathology. They may be listed as follows: (a) teleconsultation via multimedia e‐mail; (b) teleconsultation via web‐based tools; (c) distant education by means of World Wide Web; (d) virtual microscope management through Web and Java interfaces; (e) real‐time consultations through Internet‐based videoconferencing. Such applications have led to the recognition of some important limits of the Internet, when dealing with telemedicine: (i) no guarantees on the quality of service (QoS); (ii) inadequate security and privacy; (iii) for some countries, low bandwidth and thus low responsiveness for real‐time applications. Currently, there are several innovations in the world of the Internet. Different initiatives have been aimed at an amelioration of the Internet protocols, in order to have quality of service, multimedia support, security and other advanced services, together with greater bandwidth. The forthcoming Internet improvements, although induced by electronic commerce, video on demand, and other commercial needs, are of real interest also for telemedicine, because they solve the limits currently slowing down the use of Internet. When such new services will be available, telepathology applications may switch from research to daily practice in a fast way. PMID:11339559

LandCaRe DSS--an interactive decision support system for climate change impact assessment and the analysis of potential agricultural land use adaptation strategies.

PubMed

Wenkel, Karl-Otto; Berg, Michael; Mirschel, Wilfried; Wieland, Ralf; Nendel, Claas; Köstner, Barbara

2013-09-01

Decision support to develop viable climate change adaptation strategies for agriculture and regional land use management encompasses a wide range of options and issues. Up to now, only a few suitable tools and methods have existed for farmers and regional stakeholders that support the process of decision-making in this field. The interactive model-based spatial information and decision support system LandCaRe DSS attempts to close the existing methodical gap. This system supports interactive spatial scenario simulations, multi-ensemble and multi-model simulations at the regional scale, as well as the complex impact assessment of potential land use adaptation strategies at the local scale. The system is connected to a local geo-database and via the internet to a climate data server. LandCaRe DSS uses a multitude of scale-specific ecological impact models, which are linked in various ways. At the local scale (farm scale), biophysical models are directly coupled with a farm economy calculator. New or alternative simulation models can easily be added, thanks to the innovative architecture and design of the DSS. Scenario simulations can be conducted with a reasonable amount of effort. The interactive LandCaRe DSS prototype also offers a variety of data analysis and visualisation tools, a help system for users and a farmer information system for climate adaptation in agriculture. This paper presents the theoretical background, the conceptual framework, and the structure and methodology behind LandCaRe DSS. Scenario studies at the regional and local scale for the two Eastern German regions of Uckermark (dry lowlands, 2600 km(2)) and Weißeritz (humid mountain area, 400 km(2)) were conducted in close cooperation with stakeholders to test the functionality of the DSS prototype. The system is gradually being transformed into a web version (http://www.landcare-dss.de) to ensure the broadest possible distribution of LandCaRe DSS to the public. The system will be continuously developed, updated and used in different research projects and as a learning and knowledge-sharing tool for students. The main objective of LandCaRe DSS is to provide information on the complex long-term impacts of climate change and on potential management options for adaptation by answering "what-if" type questions. Copyright © 2013 Elsevier Ltd. All rights reserved.

The use of the Dutch Self-Sufficiency Matrix (SSM-D) to inform allocation decisions to public mental health care for homeless people.

PubMed

Lauriks, Steve; de Wit, Matty A S; Buster, Marcel C A; Fassaert, Thijs J L; van Wifferen, Ron; Klazinga, Niek S

2014-10-01

The current study set out to develop a decision support tool based on the Self-Sufficiency Matrix (Dutch version; SSM-D) for the clinical decision to allocate homeless people to the public mental health care system at the central access point of public mental health care in Amsterdam, The Netherlands. Logistic regression and receiver operating characteristic-curve analyses were used to model professional decisions and establish four decision categories based on SSM-D scores from half of the research population (Total n = 612). The model and decision categories were found to be accurate and reliable in predicting professional decisions in the second half of the population. Results indicate that the decision support tool based on the SSM-D is useful and feasible. The method to develop the SSM-D as a decision support tool could be applied to decision-making processes in other systems and services where the SSM-D has been implemented, to further increase the utility of the instrument.

The development of internet based ship design support system for small and medium sized shipyards

NASA Astrophysics Data System (ADS)

Shin, Sung-Chul; Lee, Soon-Sup; Kang, Dong-Hoon; Lee, Kyung-Ho

2012-03-01

In this paper, a prototype of ship basic planning system is implemented for the small and medium sized shipyards based on the internet technology and concurrent engineering concept. The system is designed from the user requirements. Consequently, standardized development environment and tools are selected. These tools are used for the system development to define and evaluate core application technologies. The system will contribute to increasing competitiveness of small and medium sized shipyards in the 21st century industrial en-vironment.

Toward Predicting Social Support Needs in Online Health Social Networks.

PubMed

Choi, Min-Je; Kim, Sung-Hee; Lee, Sukwon; Kwon, Bum Chul; Yi, Ji Soo; Choo, Jaegul; Huh, Jina

2017-08-02

While online health social networks (OHSNs) serve as an effective platform for patients to fulfill their various social support needs, predicting the needs of users and providing tailored information remains a challenge. The objective of this study was to discriminate important features for identifying users' social support needs based on knowledge gathered from survey data. This study also provides guidelines for a technical framework, which can be used to predict users' social support needs based on raw data collected from OHSNs. We initially conducted a Web-based survey with 184 OHSN users. From this survey data, we extracted 34 features based on 5 categories: (1) demographics, (2) reading behavior, (3) posting behavior, (4) perceived roles in OHSNs, and (5) values sought in OHSNs. Features from the first 4 categories were used as variables for binary classification. For the prediction outcomes, we used features from the last category: the needs for emotional support, experience-based information, unconventional information, and medical facts. We compared 5 binary classifier algorithms: gradient boosting tree, random forest, decision tree, support vector machines, and logistic regression. We then calculated the scores of the area under the receiver operating characteristic (ROC) curve (AUC) to understand the comparative effectiveness of the used features. The best performance was AUC scores of 0.89 for predicting users seeking emotional support, 0.86 for experience-based information, 0.80 for unconventional information, and 0.83 for medical facts. With the gradient boosting tree as our best performing model, we analyzed the strength of individual features in predicting one's social support need. Among other discoveries, we found that users seeking emotional support tend to post more in OHSNs compared with others. We developed an initial framework for automatically predicting social support needs in OHSNs using survey data. Future work should involve nonsurvey data to evaluate the feasibility of the framework. Our study contributes to providing personalized social support in OHSNs. ©Min-Je Choi, Sung-Hee Kim, Sukwon Lee, Bum Chul Kwon, Ji Soo Yi, Jaegul Choo, Jina Huh. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 02.08.2017.

Internet-based self-management plus education compared with usual care in asthma: a randomized trial.

PubMed

van der Meer, Victor; Bakker, Moira J; van den Hout, Wilbert B; Rabe, Klaus F; Sterk, Peter J; Kievit, Job; Assendelft, Willem J J; Sont, Jacob K

2009-07-21

The Internet may support patient self-management of chronic conditions, such as asthma. To evaluate the effectiveness of Internet-based asthma self-management. Randomized, controlled trial. 37 general practices and 1 academic outpatient department in the Netherlands. 200 adults with asthma who were treated with inhaled corticosteroids for 3 months or more during the previous year and had access to the Internet. Asthma-related quality of life at 12 months (minimal clinically significant difference of 0.5 on the 7-point scale), asthma control, symptom-free days, lung function, and exacerbations. Participants were randomly assigned by using a computer-generated permuted block scheme to Internet-based self-management (n = 101) or usual care (n = 99). The Internet-based self-management program included weekly asthma control monitoring and treatment advice, online and group education, and remote Web communications. Asthma-related quality of life improved by 0.56 and 0.18 points in the Internet and usual care groups, respectively (adjusted between-group difference, 0.38 [95% CI, 0.20 to 0.56]). An improvement of 0.5 point or more occurred in 54% and 27% of Internet and usual care patients, respectively (adjusted relative risk, 2.00 [CI, 1.38 to 3.04]). Asthma control improved more in the Internet group than in the usual care group (adjusted difference, -0.47 [CI, -0.64 to -0.30]). At 12 months, 63% of Internet patients and 52% of usual care patients reported symptom-free days in the previous 2 weeks (adjusted absolute difference, 10.9% [CI, 0.05% to 21.3%]). Prebronchodilator FEV1 changed with 0.24 L and -0.01 L for Internet and usual care patients, respectively (adjusted difference, 0.25 L [CI, 0.03 to 0.46 L]). Exacerbations did not differ between groups. The study was unblinded and lasted only 12 months. Internet-based self-management resulted in improvements in asthma control and lung function but did not reduce exacerbations, and improvement in asthma-related quality of life was slightly less than clinically significant. Netherlands Organization for Health Research and Development, ZonMw, and Netherlands Asthma Foundation.

How can Smartphone-Based Internet Data Support Animal Ecology Fieldtrip?

NASA Astrophysics Data System (ADS)

Kurniawan, I. S.; Tapilow, F. S.; Hidayat, T.

2017-09-01

Identification and classification skills must be owned by the students. In animal ecology course, the identification and classification skills are necessary to study animals. This experimental study aims to describe the identification and classification skills of students on animal ecology field trip to studying various bird species using smartphone-based internet data. Using Involving 63 students divided into 7 groups for each observation station. Data of birds were sampled using line transect method (5000 meters/station). The results showed the identification and classification skills of students are in sufficient categories. Most students have difficulties because of the limitations of data on the internet about birds. In general, students support the use of smartphones in field trip activities. The results of this study can be used as a reference for the development of learning using smartphones in the future by developing application about birds. The outline, smartphones can be used as a method of alternative learning but needs to be developed for some special purposes.

Facilitation of Goal-Setting and Follow-Up in an Internet Intervention for Health and Wellness

NASA Astrophysics Data System (ADS)

Kaipainen, Kirsikka; Mattila, Elina; Kinnunen, Marja-Liisa; Korhonen, Ilkka

Chronic work-related stress and insufficient recovery from workload can gradually lead to problems with mental and physical health. Resources in healthcare are limited especially for preventive treatment, but low-cost support can be provided by Internet-based behavior change interventions. This paper describes the design of an Internet intervention which supports working-age people in managing and preventing stress-related health and wellness problems. The intervention is designed for early prevention and aims to motivate individuals to take responsibility for their own well-being. It allows them to choose the approach to take to address personally significant issues, while guiding them through the process. The first iteration of the intervention was evaluated with three user groups and subsequently improved based on the user experiences to be more persuasive, motivating and better suited for independent use. Goal setting and follow-up were especially enhanced, tunneled structure improved, and the threshold of use lowered.

Swarm-based medicine.

PubMed

Putora, Paul Martin; Oldenburg, Jan

2013-09-19

Occasionally, medical decisions have to be taken in the absence of evidence-based guidelines. Other sources can be drawn upon to fill in the gaps, including experience and intuition. Authorities or experts, with their knowledge and experience, may provide further input--known as "eminence-based medicine". Due to the Internet and digital media, interactions among physicians now take place at a higher rate than ever before. With the rising number of interconnected individuals and their communication capabilities, the medical community is obtaining the properties of a swarm. The way individual physicians act depends on other physicians; medical societies act based on their members. Swarm behavior might facilitate the generation and distribution of knowledge as an unconscious process. As such, "swarm-based medicine" may add a further source of information to the classical approaches of evidence- and eminence-based medicine. How to integrate swarm-based medicine into practice is left to the individual physician, but even this decision will be influenced by the swarm.

Style-based classification of Chinese ink and wash paintings

NASA Astrophysics Data System (ADS)

Sheng, Jiachuan; Jiang, Jianmin

2013-09-01

Following the fact that a large collection of ink and wash paintings (IWP) is being digitized and made available on the Internet, their automated content description, analysis, and management are attracting attention across research communities. While existing research in relevant areas is primarily focused on image processing approaches, a style-based algorithm is proposed to classify IWPs automatically by their authors. As IWPs do not have colors or even tones, the proposed algorithm applies edge detection to locate the local region and detect painting strokes to enable histogram-based feature extraction and capture of important cues to reflect the styles of different artists. Such features are then applied to drive a number of neural networks in parallel to complete the classification, and an information entropy balanced fusion is proposed to make an integrated decision for the multiple neural network classification results in which the entropy is used as a pointer to combine the global and local features. Evaluations via experiments support that the proposed algorithm achieves good performances, providing excellent potential for computerized analysis and management of IWPs.

A decision-based perspective for the design of methods for systems design

NASA Technical Reports Server (NTRS)

Mistree, Farrokh; Muster, Douglas; Shupe, Jon A.; Allen, Janet K.

1989-01-01

Organization of material, a definition of decision based design, a hierarchy of decision based design, the decision support problem technique, a conceptual model design that can be manufactured and maintained, meta-design, computer-based design, action learning, and the characteristics of decisions are among the topics covered.

Minimally Invasive Spine Surgery: Analyzing Internet-based Education Material.

PubMed

Bryant, Jessica; Mohan, Rohith; Koottappillil, Brian; Wong, Kevin; Yi, Paul H

2018-04-01

This is a cross-sectional study. The purpose of this study is to evaluate the content of information available on the Internet regarding minimally invasive spine surgery (MISS). Patients look to the Internet for quick and accessible information on orthopedic procedures to help guide their personal decision making process regarding the care they receive. However, the quality of internet-based orthopedic education material varies significantly with respect to accuracy and readability. The top 50 results were generated from each of 3 search engines (Google, Yahoo!, and Bing) using the search term "minimally invasive spine surgery." Results were categorized by authorship type and evaluated for their description of key factors such as procedural benefits, risks, and techniques. Comparisons between search engines and between authorship types were done using the Freeman-Halton extension for the Fisher exact test. The content of websites certified by Health on the Net Foundation (HONcode) was compared with those not HONcode certified. Of the 150 websites and videos, only 26% were authored by a hospital or university, whereas 50% were by a private physician or clinic. Most resources presented some benefits of MISS (84%, 126/150), but only 17% presented risks of the procedure (26/150). Almost half of all resources described the technique of MISS, but only 27% had thorough descriptions that included visual representations while 26% failed to describe the procedure. Only 12 results were HONcode certified, and 10 (83%) of these were authored by a medical industry company. Internet-based resources on MISS provide inconsistent content and tend to emphasize benefits of MISS over risks.

Patients' and Surgeons' Perceptions of Social Media's Role in the Decision Making for Primary Aesthetic Breast Augmentation.

PubMed

Montemurro, Paolo; Cheema, Mubashir; Hedén, Per

2018-02-09

Social media (SoMe) has evolved to be a platform that patients use to seek information prior to an operation, share perioperative and postoperative journey, provide feedback, offer and receive support. While there have been studies looking at the evolution and usage of SoMe either by patients or by surgeons, there is no information that compares its usefulness for both the groups. The aim of this study was to compare the view held by patients and surgeons, towards social media and other internet resources, in relation to one commonly performed operation. A questionnaire was presented to 648 consecutive patients who attended our clinic for consultation for primary breast augmentation from September 2016 to March 2017. A separate "surgeons' questionnaire" was answered by a group of 138 plastic surgeons who either worked in our clinic, had previously done fellowship with us or were visiting the clinic. All 138 surgeons and 648 patients responded to the questionnaire. 91.4% of patients said that they had searched online and 61.4% had searched in specific online groups for information on breast augmentation. 88.9% of patients had specifically looked for clinical photographs and 73.4% had specifically searched for unfavorable reviews of the surgeon. In comparison, 72.5% of surgeons thought that over three quarters of patients gather information on the internet while only 20.3% thought that over three-quarters of patients use social media for their information. 52.5% of surgeons have noticed that social media affected their consultations. With the evolution of Internet and related technologies, the role of social media continues to increase. While patients use social media to help make their decision, it is not the only deciding factor. Surgeons appear to underestimate the patients' use of these technologies. There is concern in each group about the amount of inaccurate information on the social media. This underlines the importance of providing factual, evidence-based information to the patients. © 2018 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com

Using the Internet for psychological research: personality testing on the World Wide Web.

PubMed

Buchanan, T; Smith, J L

1999-02-01

The Internet is increasingly being used as a medium for psychological research. To assess the validity of such efforts, an electronic version of Gangestad & Snyder's (1985) revised self-monitoring questionnaire was placed at a site on the World Wide Web. In all, 963 responses were obtained through the Internet and these were compared with those from a group of 224 undergraduates who completed a paper-and-pencil version. Comparison of model fit indices obtained through confirmatory factor analyses indicated that the Internet-mediated version had similar psychometric properties to its conventional equivalent and compared favourably as a measure of self-monitoring. Reasons for possible superiority of Internet data are discussed. Results support the notion that Web-based personality assessment is possible, but stringent validation of test instruments is urged.

Web-Assisted Tobacco Interventions: Empowering Change in the Global Fight for the Public’s (e)Health

PubMed Central

McIntosh, Scott; Selby, Peter; Eysenbach, Gunther

2008-01-01

Tobacco control in the 21st century faces many of the same challenges as in the past, but in different contexts, settings and enabled by powerful new tools including those delivered by information and communication technologies via computer, videocasts, and mobile handsets to the world. Building on the power of electronic networks, Web-assisted tobacco interventions (WATI) provide a vehicle for delivering tobacco prevention, cessation, social support and training opportunities on-demand and direct to practitioners and the public alike. The Framework Convention on Tobacco Control, the world’s first global public health treaty, requires that all nations develop comprehensive tobacco control strategies that include provision of health promotion information, population interventions, and decision-support services. WATI research and development has evolved to provide examples of how eHealth can address all of these needs and provide exemplars for other areas of public health to follow. This paper discusses the role of WATI in supporting tobacco control and introduces a special issue of the Journal of Medical Internet Research that broadens the evidence base and provides illustrations of how new technologies can support health promotion and population health overall, empowering change and ushering in a new era of public eHealth. PMID:19033147

Data access and decision tools for coastal water resources ...

EPA Pesticide Factsheets

US EPA has supported the development of numerous models and tools to support implementation of environmental regulations. However, transfer of knowledge and methods from detailed technical models to support practical problem solving by local communities and watershed or coastal management organizations remains a challenge. We have developed the Estuary Data Mapper (EDM) to facilitate data discovery, visualization and access to support environmental problem solving for coastal watersheds and estuaries. EDM is a stand-alone application based on open-source software which requires only internet access for operation. Initially, development of EDM focused on delivery of raw data streams from distributed web services, ranging from atmospheric deposition to hydrologic, tidal, and water quality time series, estuarine habitat characteristics, and remote sensing products. We have transitioned to include access to value-added products which provide end-users with results of future scenario analysis, facilitate extension of models across geographic regions, and/or promote model interoperability. Here we present three examples: 1) the delivery of input data for the development of seagrass models across estuaries, 2) scenarios illustrating the implications of riparian buffer management (loss or restoration) for stream thermal regimes and fish communities, and 3) access to hydrology model outputs to foster connections across models at different scales, ultimately feeding

Integrating psychological theory into the design of an online intervention for sexual health: the sexunzipped website.

PubMed

Carswell, Kenneth; McCarthy, Ona; Murray, Elizabeth; Bailey, Julia V

2012-11-19

The Internet can provide a confidential and convenient medium for sexual health promotion for young people. This paper describes the development of an interactive, theory-based website (Sexunzipped) aimed at increasing safe sexual behavior of young people, as well as an outline of the evaluation protocol. The website focuses on safer sex, relationships, and sexual pleasure. An overview of the site is provided, including a description of the theoretical constructs which form the basis of the site development. An integrated behavioral model was chosen as the guiding theory for the Sexunzipped intervention. A randomized trial design will be used to evaluate the site quantitatively. The content of the site is described in detail with examples of the main content types: information pages, quizzes, and decision-making activities. We describe the protocol for quantitative evaluation of the website using a randomized trial design and discuss the principal challenges involved in developing the site, including the challenge of balancing the requirements of theory with young people's views on website content and design. Considerations for future interventions are discussed. Developing an online behavior-change intervention is costly and time consuming. Given the large public health potential, the cost involved in developing online interventions, and the need for attractive design, future interventions may benefit from collaborating with established sites that already have a user base, a brand, and a strong Internet presence. It is vital to involve users in decisions about intervention content, design, and features, paying attention to aspects that will attract and retain users' interest. A central challenge in developing effective Internet-based interventions for young people is to find effective ways to operationalize theory in ways that address the views and perspectives of young people.

Integrating Psychological Theory Into the Design of an Online Intervention for Sexual Health: The Sexunzipped Website

PubMed Central

2012-01-01

Background The Internet can provide a confidential and convenient medium for sexual health promotion for young people. Objective This paper describes the development of an interactive, theory-based website (Sexunzipped) aimed at increasing safe sexual behavior of young people, as well as an outline of the evaluation protocol. Methods The website focuses on safer sex, relationships, and sexual pleasure. An overview of the site is provided, including a description of the theoretical constructs which form the basis of the site development. An integrated behavioral model was chosen as the guiding theory for the Sexunzipped intervention. A randomized trial design will be used to evaluate the site quantitatively. Results The content of the site is described in detail with examples of the main content types: information pages, quizzes, and decision-making activities. We describe the protocol for quantitative evaluation of the website using a randomized trial design and discuss the principal challenges involved in developing the site, including the challenge of balancing the requirements of theory with young people’s views on website content and design. Conclusions Considerations for future interventions are discussed. Developing an online behavior-change intervention is costly and time consuming. Given the large public health potential, the cost involved in developing online interventions, and the need for attractive design, future interventions may benefit from collaborating with established sites that already have a user base, a brand, and a strong Internet presence. It is vital to involve users in decisions about intervention content, design, and features, paying attention to aspects that will attract and retain users’ interest. A central challenge in developing effective Internet-based interventions for young people is to find effective ways to operationalize theory in ways that address the views and perspectives of young people. PMID:23612122

SANDS: a service-oriented architecture for clinical decision support in a National Health Information Network.

PubMed

Wright, Adam; Sittig, Dean F

2008-12-01

In this paper, we describe and evaluate a new distributed architecture for clinical decision support called SANDS (Service-oriented Architecture for NHIN Decision Support), which leverages current health information exchange efforts and is based on the principles of a service-oriented architecture. The architecture allows disparate clinical information systems and clinical decision support systems to be seamlessly integrated over a network according to a set of interfaces and protocols described in this paper. The architecture described is fully defined and developed, and six use cases have been developed and tested using a prototype electronic health record which links to one of the existing prototype National Health Information Networks (NHIN): drug interaction checking, syndromic surveillance, diagnostic decision support, inappropriate prescribing in older adults, information at the point of care and a simple personal health record. Some of these use cases utilize existing decision support systems, which are either commercially or freely available at present, and developed outside of the SANDS project, while other use cases are based on decision support systems developed specifically for the project. Open source code for many of these components is available, and an open source reference parser is also available for comparison and testing of other clinical information systems and clinical decision support systems that wish to implement the SANDS architecture. The SANDS architecture for decision support has several significant advantages over other architectures for clinical decision support. The most salient of these are:

Development and Validation of the Online Social Support for Smokers Scale

PubMed Central

Papandonatos, George D; Kang, Hakmook; Moreno, Jose L; Abrams, David B

2011-01-01

Background Social networks play an important role in smoking. Provision of social support during cessation is a cornerstone of treatment. Online social networks for cessation are ubiquitous and represent a promising modality for smokers to receive and provide the support necessary for cessation. There are no existing measures specific to online social support for smoking cessation. Objective The objective was to develop a measure of social support to be used in online smoking cessation treatment research. Methods Initial items for the Online Social Support for Smokers Scale (OS4) were based on existing theory and scales delineated in various taxonomies. Preliminary field analysis (N = 73) was conducted on 23 initial items to optimize the scale. Further development was conducted on a refined 15-item scale in the context of a large randomized trial of Internet and telephone cessation treatment with follow-ups at 3, 6, 12, and 18 months. In all, 1326 participants were randomized to an enhanced Internet arm that included a large online social network; psychometric analyses employed 3-month follow-up data from those reporting use of the enhanced Internet intervention at least once (n = 873). Items were subjected to a factor analysis, and the internal consistency reliability of the scale was examined along with construct and criterion validity. Other measures used in the study included demographics, nicotine dependence, partner support for cessation, general social support, social integration, stress, depression, health status, online community use, Internet use behaviors, intervention satisfaction, and 30-day point prevalence abstinence. Results The final 12-item OS4 scale demonstrated high internal consistency reliability (Cronbach alphas .86-.89) across demographic and smoking strata of interest. The OS4 also demonstrated good construct and criterion validity, with the directionality of the observed associations providing support for most a priori hypotheses. Significant Pearson correlations were observed between the OS4 and the Partner Interaction Questionnaire (PIQ) Positive subscale (ρ = .24, P < .001). As hypothesized, participants with the highest OS4 scores were more likely to have actively participated in the enhanced Internet community and to have high levels of satisfaction with the enhanced Internet intervention. In logistic regression analyses, the OS4 was highly predictive of 30-day point-prevalence abstinence at 6, 12, and 18 months (all P values <.001). The odds of abstinence at 6 months rose by 48% for each standard unit increase in online social support (95% confidence interval [CI] 1.17 - 1.71), dropping only slightly to 37% at 12 and 18 months (95% CI 1.17 - 1.59). Conclusions The OS4 is a brief, reliable, and valid instrument for measuring online social support for smoking cessation. Results should be replicated and extended, but this study suggests the OS4 can be used to advance theory, understand mechanisms, and potentially help to improve the tailoring of Internet-based smoking cessation treatments. It can also inspire development of similar measures for other online health-related intervention research. Trial registration Clinicaltrials.gov #NCT00282009; http://clinicaltrials.gov/ct2/show/NCT00282009 (Archived by WebCite at http://www.webcitation.org/60XNj3xM6) PMID:21955465

Information Expensiveness Perceived by Vietnamese Patients with Respect to Healthcare Provider's Choice.

PubMed

Quan-Hoang, Vuong

2016-10-01

Patients have to acquire information to support their decision on choosing a suitable healthcare provider. But in developing countries like Vietnam, accessibility issues remain an obstacle, thus adversely affect both quality and costliness of healthcare information. Vietnamese use both sources from health professionals and friends/relatives, especially when quality of the Internet-based cheaper sources appear to be still questionable. The search of information from both professionals and friends/relatives incurs some cost, which can be viewed as low or high depending low or high accessibility to the sources. These views potentially affect their choices. To investigate the effects that medical/health services information on perceived expensiveness of patients' labor costs. Two related objectives are a) establishing empirical relations between accessibility to sources and expensiveness; and, b) probabilistic trends of probabilities for perceived expensiveness. There is evidence for established relations among the variables "Convexp" and "Convrel" (all p's < 0.01), indicating that both information sources (experts and friends/relatives) have influence on patients perception of information expensiveness. The use of experts source tends to increase the probability of perceived expensiveness. a) Probabilistic trends show Vietnamese patients have propensity to value healthcare information highly and do not see it as "expensive"; b) The majority of Vietnamese households still take non-professional advices at their own risks; c) There is more for the public healthcare information system to do to reduce costliness and risk of information. The Internet-based health service users communities cannot replace this system.

Preferences regarding targeted education and risk assessment in people with a family history of major depressive disorder.

PubMed

Quinn, Veronica; Meiser, Bettina; Wilde, Alex; Cousins, Zoe; Barlow-Stewart, Kristine; Mitchell, Philip B; Schofield, Peter R

2014-10-01

Genetic testing for susceptibility to major depressive disorder (MDD) is not available for clinical use at present. Given this, family history remains the best predictor for development of MDD, and family-history-based risk assessment and information about familial aspects of MDD may be useful to clients at increased risk for MDD attending for genetic counseling. This study uses a mixed-methods design to assess the information needs and preferences of people at increased familial risk for MDD. Telephone interviews were conducted with 23 individuals, who had at least one first-degree relative with MDD and were recruited through advertisements placed on depression education websites. The most preferred way to access depression information was via the internet (87 % of participants), although this preference may have been due to the internet-based recruitment method. The second most preferred dissemination strategy (56 %) was face-to-face delivery through a health professional, including genetic counselors. Individuals reported a need for information about etiology and development of MDD, reproductive decision-making, early detection of symptoms and risk-reducing strategies. Nearly all participants expressed an interest in risk assessment. The present study found evidence of a high level of interest for information targeted to people at increased familial risk for MDD. Genetic counselors are likely to be called upon increasingly to provide supportive counseling to assist clients at increased familial risk in interpreting and contextualizing such information once it becomes available.

[Information technologies: new partners in treating diabetes].

PubMed

Colombet, I; Chatellier, G

2001-10-15

The management of chronic diseases such as diabetes is becoming a crucial issue in developed countries. Innovative communication technologies should now be included as new partners in the health care system. These technologies can help both in managing patients and measuring quality of care. Internet-based health promotion programs may improve compliance with treatment. Decision systems are available on the Net to help patients monitoring their diet and insulin doses. The use of electronic medical record shared on Internet may help both physicians and patients to monitor on the long term the effect of interventions. It is now time to perform appropriate trials to determine, beside other interventions, the precise role of innovative communication technologies in diabetes management.

Anticipating Stock Market Movements with Google and Wikipedia

NASA Astrophysics Data System (ADS)

Moat, Helen Susannah; Curme, Chester; Stanley, H. Eugene; Preis, Tobias

Many of the trading decisions that have led to financial crises are captured by vast, detailed stock market datasets. Here, we summarize two of our recent studies which investigate whether Internet usage data contain traces of attempts to gather information before such trading decisions were taken. By analyzing changes in how often Internet users searched for financially related information on Google (Preis et al., Sci Rep 3:1684, 2013) and Wikipedia (Moat et al., Sci Rep 3:1801, 2013), patterns are found that may be interpreted as "early warning signs" of stock market moves. Our results suggest that online data may allow us to gain new insight into early information gathering stages of economic decision making.

IT/IS plus E: exploring the need for e-integration

NASA Astrophysics Data System (ADS)

Miele, Renato; Gunasekaran, Angappa; Yusuf, Yahaya Y.

2000-10-01

The change in IT/IS strategy is about the Internet becoming a major part of the corporate environment and driving decisions more and more. Companies of all sizes and industries can fully engage employees, customers and partners to capitalize upon the new Internet economy. They can optimize supply chains, managing strategic relationships, reducing time to market, sharing vital information, and increasing productivity and shareholder value. Remaining competitive in today's rapidly changing global marketplace requires fast action. The problem is now how much, how soon, and what kind of Internet based components are essential for companies to be successful, and how the adoption of E-Integration can become a critical component of company's survival in an increasingly competitive environment. How information, knowledge and innovation processes can drive business success are fundamental notions for the information- based economy, which have been extensively researched and confirmed throughout the IT revolution. The new capabilities to use the Internet to supply large amounts of relevant information from multiple internal and external sources give the possibility to move from isolate Information Systems toward an integrated environment in every business organization. The article addresses how E-Integration must link together data from multiple sources, providing a seamless system, fully interoperable with pre-existing IT environment, totally scalable and upgradeable.

Can Cyberloafing and Internet Addiction Affect Organizational Information Security?

PubMed

Hadlington, Lee; Parsons, Kathryn

2017-09-01

Researchers have noted potential links between Internet addiction, the use of work computers for nonwork purposes and an increased risk of threat to the organization from breaches in cybersecurity. However, much of this research appears conjectural in nature and lacks clear empirical evidence to support such claims. To fill this knowledge gap, a questionnaire-based study explored the link between cyberloafing, Internet addiction, and information security awareness (ISA). A total of 338 participants completed an online questionnaire, which comprised of the Online Cognition Scale, Cyberloafing Scale, and the Human Aspects of Information Security Questionnaire. Participants who reported higher Internet addiction and cyberloafing tendencies had lower ISA, and Internet addiction and cyberloafing predicted a significant 45 percent of the variance in ISA. Serious cyberloafing, such as the propensity to visit adult websites and online gambling, was shown to be the significant predictor for poorer ISA. Implications for organizations and recommendations to reduce or manage inappropriate Internet use are discussed.

[Development of a service on line advice and information technology management for health].

PubMed

Berrospi Polo, Victor; Rodriguez Abad, Juan; Bobadilla Aguilar, Juan; Di Liberto Moreno, Carlos; Díaz Arroyo, Cecilia; Rafael Quipan, Carlos

2015-10-01

To validate an advisory service and online information technology management for health and helps to make assessment and acquisition processes an informed medical equipment according to the market and the needs of the health institutions. Internet via a technological solution supported ona data base containing systematic and updated information on technical specifications of 25 compared medical equipment, the same reference prices, list of suppliers, agents and / or producers and technical standards are developed. The"virtual" technical assistance was made with the support of a team of specialists in Health Technology Management, the decision makers in the planning, evaluation and procurement of biomedical equipment. The validation of the service was conducted by involving specialists in the field of Health Technology Management, from different disciplines and institutions who worked in health, public and private. They used the service for a period of time to verify its feasibility of use as well as its usefulness for their planning, evaluation and procurement of biomedical equipment. To these experts we applied a survey before and after them about the software developed in this project. We found that it is common to use the internet to search for information on medical equipment.Also,an increase on the view that the application will help in procurement of biomedical equipment(40% to 78%) was observed, it will improve the information system(40% to 89%) and communication among physicians,nurses, planners, engineers and other professionals involved in this process(20% to 78%). There is a need for a technological tool available with such features contribute to technology management in Peru.

Teaching adolescents about changing bodies: Randomized controlled trial of an Internet puberty education and body dissatisfaction prevention program.

PubMed

Cousineau, Tara M; Franko, Debra L; Trant, Meredith; Rancourt, Diana; Ainscough, Jessica; Chaudhuri, Anamika; Brevard, Julie

2010-09-01

This study tested the efficacy of an Internet-based prevention program, Trouble on the Tightrope: In Search of Skateboard Sam, on pubertal knowledge, body esteem, and self-esteem. One hundred and ninety participants (mean age 11.6 years) were randomized to either an intervention or attention placebo control condition and were assessed at baseline, after three Internet-based sessions, and at 3-month follow-up. Although the primary hypotheses were not supported, exploratory moderator analyses indicated that the intervention was beneficial for select students. Specifically, pubertal status moderated the effects on weight-related body esteem and several domains of self-esteem, resulting in positive effects for participants in the intervention group who had begun puberty. Gender differences were found on self-esteem subscales, indicating more robust effects for girls than boys. Tailored Internet programs based on personal characteristics such as gender and pubertal status may be a fruitful area for future research with adolescents. Copyright © 2010 Elsevier Ltd. All rights reserved.

Generic Divide and Conquer Internet-Based Computing

NASA Technical Reports Server (NTRS)

Follen, Gregory J. (Technical Monitor); Radenski, Atanas

2003-01-01

The growth of Internet-based applications and the proliferation of networking technologies have been transforming traditional commercial application areas as well as computer and computational sciences and engineering. This growth stimulates the exploration of Peer to Peer (P2P) software technologies that can open new research and application opportunities not only for the commercial world, but also for the scientific and high-performance computing applications community. The general goal of this project is to achieve better understanding of the transition to Internet-based high-performance computing and to develop solutions for some of the technical challenges of this transition. In particular, we are interested in creating long-term motivation for end users to provide their idle processor time to support computationally intensive tasks. We believe that a practical P2P architecture should provide useful service to both clients with high-performance computing needs and contributors of lower-end computing resources. To achieve this, we are designing dual -service architecture for P2P high-performance divide-and conquer computing; we are also experimenting with a prototype implementation. Our proposed architecture incorporates a master server, utilizes dual satellite servers, and operates on the Internet in a dynamically changing large configuration of lower-end nodes provided by volunteer contributors. A dual satellite server comprises a high-performance computing engine and a lower-end contributor service engine. The computing engine provides generic support for divide and conquer computations. The service engine is intended to provide free useful HTTP-based services to contributors of lower-end computing resources. Our proposed architecture is complementary to and accessible from computational grids, such as Globus, Legion, and Condor. Grids provide remote access to existing higher-end computing resources; in contrast, our goal is to utilize idle processor time of lower-end Internet nodes. Our project is focused on a generic divide and conquer paradigm and on mobile applications of this paradigm that can operate on a loose and ever changing pool of lower-end Internet nodes.

The anatomy of decision support during inpatient care provider order entry (CPOE): Empirical observations from a decade of CPOE experience at Vanderbilt

PubMed Central

Miller, Randolph A.; Waitman, Lemuel R.; Chen, Sutin; Rosenbloom, S. Trent

2006-01-01

The authors describe a pragmatic approach to the introduction of clinical decision support at the point of care, based on a decade of experience in developing and evolving Vanderbilt’s inpatient “WizOrder” care provider order entry (CPOE) system. The inpatient care setting provides a unique opportunity to interject CPOE-based decision support features that restructure clinical workflows, deliver focused relevant educational materials, and influence how care is delivered to patients. From their empirical observations, the authors have developed a generic model for decision support within inpatient CPOE systems. They believe that the model’s utility extends beyond Vanderbilt, because it is based on characteristics of end-user workflows and on decision support considerations that are common to a variety of inpatient settings and CPOE systems. The specific approach to implementing a given clinical decision support feature within a CPOE system should involve evaluation along three axes: what type of intervention to create (for which the authors describe 4 general categories); when to introduce the intervention into the user’s workflow (for which the authors present 7 categories), and how disruptive, during use of the system, the intervention might be to end-users’ workflows (for which the authors describe 6 categories). Framing decision support in this manner may help both developers and clinical end-users plan future alterations to their systems when needs for new decision support features arise. PMID:16290243

[Effects of an empowerment education program in the prevention of internet games addiction in middle school students].

PubMed

Joo, Aeran; Park, Inhyae

2010-04-01

The purpose of this study was to determine effects of an empowerment education program (EEP) on internet games addiction, empowerment, and stress in middle school students. The EEP used in this study was based on the Freire's Empowerment Education Model. The research design of this study was a non-equivalent control group pretest-posttest design for 48 middle school students, who were conveniently assigned to an experimental group or a control group. The data were collected from May 29 to June 19, 2005. Data were analyzed using SPSS/PC program with frequencies, X(2)-test, Fisher exact test, t-test, mean, standard deviation and ANCOVA. 1) The first hypothesis that, "the experimental group would have higher empowerment scores than the control group." was supported. 2) The second hypothesis that, "the experimental group would have lower internet games addiction scores than the control group." was supported. 3) The third hypothesis that, "the experimental group would have lower stress scores than the control group." was supported. We suggest, therefore, that the EEP should be used with adolescent to help them control their stress, internet games addiction and to increase their empowerment.

Cybermediation in the Tourism and Travel Industries

NASA Astrophysics Data System (ADS)

Killion, Les

Travel and tourism are second only to pornography in adopting Internet-based technologies to intermediate between those supplying the total travel experience, and those seeking to satisfy leisure needs by engaging in tourism. From Thomas Cook in the 1800s, traditional ‘travel trade networks’ have provided the components of the travel experience: transport, accommodation and attractions. However, the Internet has encouraged customer self-service, and on-going debate regarding the future of traditional travel trade intermediaries. The intermediation debate suggests the emergence of ‘hybrid’ intermediation systems combining customer self-service with face-to-face customer contacts characteristic of traditional travel agents. A focus group investigation identified profiles and motives of customers using the Internet to make holiday arrangements. Potential cost savings are a primary motivation for customer self-service. Using the Internet for travel and tourism is becoming commonplace among older travellers as well as younger people. In gathering information before making holiday decisions, potential tourists also engage in a Web 2.0 environment where family and friends, not established intermediaries, provide reliable and authentic information via their individual blogs.

Computers and the internet: tools for youth empowerment.

PubMed

Valaitis, Ruta K

2005-10-04

Youth are often disenfranchised in their communities and may feel they have little voice. Since computers are an important aspect of youth culture, they may offer solutions to increasing youth participation in communities. This qualitative case study investigated the perceptions of 19 (predominantly female) inner-city school youth about their use of computers and the Internet in a school-based community development project. Youth working with public health nurses in a school-based community development project communicated with local community members using computer-mediated communication, surveyed peers online, built websites, searched for information online, and prepared project materials using computers and the Internet. Participant observation, semistructured interviews, analysis of online messages, and online- and paper-based surveys were used to gather data about youth's and adults' perceptions and use of the technologies. Constant comparison method and between-method triangulation were used in the analysis to satisfy the existence of themes. Not all youth were interested in working with computers. Some electronic messages from adults were perceived to be critical, and writing to adults was intimidating for some youth. In addition, technical problems were experienced. Despite these barriers, most youth perceived that using computers and the Internet reduced their anxiety concerning communication with adults, increased their control when dealing with adults, raised their perception of their social status, increased participation within the community, supported reflective thought, increased efficiency, and improved their access to resources. Overall, youth perceived computers and the Internet to be empowering tools, and they should be encouraged to use such technology to support them in community initiatives.

Computers and the Internet: Tools for Youth Empowerment

PubMed Central

2005-01-01

Background Youth are often disenfranchised in their communities and may feel they have little voice. Since computers are an important aspect of youth culture, they may offer solutions to increasing youth participation in communities. Objective This qualitative case study investigated the perceptions of 19 (predominantly female) inner-city school youth about their use of computers and the Internet in a school-based community development project. Methods Youth working with public health nurses in a school-based community development project communicated with local community members using computer-mediated communication, surveyed peers online, built websites, searched for information online, and prepared project materials using computers and the Internet. Participant observation, semistructured interviews, analysis of online messages, and online- and paper-based surveys were used to gather data about youth’s and adults’ perceptions and use of the technologies. Constant comparison method and between-method triangulation were used in the analysis to satisfy the existence of themes. Results Not all youth were interested in working with computers. Some electronic messages from adults were perceived to be critical, and writing to adults was intimidating for some youth. In addition, technical problems were experienced. Despite these barriers, most youth perceived that using computers and the Internet reduced their anxiety concerning communication with adults, increased their control when dealing with adults, raised their perception of their social status, increased participation within the community, supported reflective thought, increased efficiency, and improved their access to resources. Conclusions Overall, youth perceived computers and the Internet to be empowering tools, and they should be encouraged to use such technology to support them in community initiatives. PMID:16403715

Multi-criteria clinical decision support: A primer on the use of multiple criteria decision making methods to promote evidence-based, patient-centered healthcare.

PubMed

Dolan, James G

2010-01-01

Current models of healthcare quality recommend that patient management decisions be evidence-based and patient-centered. Evidence-based decisions require a thorough understanding of current information regarding the natural history of disease and the anticipated outcomes of different management options. Patient-centered decisions incorporate patient preferences, values, and unique personal circumstances into the decision making process and actively involve both patients along with health care providers as much as possible. Fundamentally, therefore, evidence-based, patient-centered decisions are multi-dimensional and typically involve multiple decision makers.Advances in the decision sciences have led to the development of a number of multiple criteria decision making methods. These multi-criteria methods are designed to help people make better choices when faced with complex decisions involving several dimensions. They are especially helpful when there is a need to combine "hard data" with subjective preferences, to make trade-offs between desired outcomes, and to involve multiple decision makers. Evidence-based, patient-centered clinical decision making has all of these characteristics. This close match suggests that clinical decision support systems based on multi-criteria decision making techniques have the potential to enable patients and providers to carry out the tasks required to implement evidence-based, patient-centered care effectively and efficiently in clinical settings.The goal of this paper is to give readers a general introduction to the range of multi-criteria methods available and show how they could be used to support clinical decision-making. Methods discussed include the balance sheet, the even swap method, ordinal ranking methods, direct weighting methods, multi-attribute decision analysis, and the analytic hierarchy process (AHP).

Multi-criteria clinical decision support: A primer on the use of multiple criteria decision making methods to promote evidence-based, patient-centered healthcare

PubMed Central

Dolan, James G.

2010-01-01

Current models of healthcare quality recommend that patient management decisions be evidence-based and patient-centered. Evidence-based decisions require a thorough understanding of current information regarding the natural history of disease and the anticipated outcomes of different management options. Patient-centered decisions incorporate patient preferences, values, and unique personal circumstances into the decision making process and actively involve both patients along with health care providers as much as possible. Fundamentally, therefore, evidence-based, patient-centered decisions are multi-dimensional and typically involve multiple decision makers. Advances in the decision sciences have led to the development of a number of multiple criteria decision making methods. These multi-criteria methods are designed to help people make better choices when faced with complex decisions involving several dimensions. They are especially helpful when there is a need to combine “hard data” with subjective preferences, to make trade-offs between desired outcomes, and to involve multiple decision makers. Evidence-based, patient-centered clinical decision making has all of these characteristics. This close match suggests that clinical decision support systems based on multi-criteria decision making techniques have the potential to enable patients and providers to carry out the tasks required to implement evidence-based, patient-centered care effectively and efficiently in clinical settings. The goal of this paper is to give readers a general introduction to the range of multi-criteria methods available and show how they could be used to support clinical decision-making. Methods discussed include the balance sheet, the even swap method, ordinal ranking methods, direct weighting methods, multi-attribute decision analysis, and the analytic hierarchy process (AHP) PMID:21394218

The Role of Geoscience Information in Reducing Catastrophic Loss Using a Web-Based Economics Experiment

USGS Publications Warehouse

Bernknopf, Richard L.; Brookshire, David S.; Ganderton, Philip T.

2003-01-01

What role can geoscience information play in the assessment of risk and the value of insurance, especially for natural hazard type risks? In an earlier, related paper Ganderton and others (2000) provided subjects with relatively simple geoscience information concerning natural hazard-type risks. Their research looked at how subjects purchase insurance when faced with relatively low probability but high loss risks of the kind that characterize natural hazards and now, increasingly, manmade disasters. They found evidence to support the expected utility theory (definitions of economics terms can be found in a glossary at the end of report), yet there remained the implication that subjects with excessive aversion to risk were willing to pay considerably more for insurance than the actuarially fair price plus any reasonable risk premium. Here, we report the results of additional experiments that provide further support for the basic postulates of expected utility theory. However, these new experiments add considerably to the decision environment facing subjects by offering an option to purchase geoscientific information that would assist them when calculating expected losses from hazards more accurately. Using an Internet-based mechanism to present information and gather data in an experimental setting, this research provided subjects with considerable textual and graphical information, and time to process it. Over a period of three months, almost 400 subjects participated in on-line experiments that generated approximately 22,000 usable data points for the empirical analysis discussed in this report. In the design of the experiment, we modeled the decisions to purchase (1) a detailed map giving subjects more information regarding the distribution of losses from a hazard and (2) insurance to indemnify them from any losses should they occur. On the basis of this design, we find strong evidence in support of the expected utility theory. Many of the findings reinforce those found in the early, similar study (Ganderton and others, 2000). However, this research also finds interactions between the decision to become better informed and the decision to insure. We chose an empirical framework that allows for both explicit and implicit (unobservable) correlations between the two decisions. The results suggest that at the end of the computer game subjects recognize the benefits of greater geoscience information. They take advantage of it, but are sensitive to its cost. When subjects use the more detailed information, they are more likely to purchase insurance when it offers a net benefit.

Emotional first aid for a suicide crisis: comparison between Telephonic hotline and internet.

PubMed

Gilat, Itzhak; Shahar, Golan

2007-01-01

The telephone and the internet have become popular sources of psychological help in various types of distress, including a suicide crisis. To gain more insight into the unique features of these media, we compared characteristics of calls to three technologically mediated sources of help that are part of the volunteer-based Israeli Association for Emotional First Aid (ERAN): Telephonic hotline (n = 4426), personal chat (n = 373) and an asynchronous online support group (n = 954). Threats of suicide were much more frequent among participants in the asynchronous support group than the telephone and personal chat. These findings encourage further research into suicide-related interpersonal exchanges in asynchronous online support groups.

High order GPS base station support for Rhode Island

DOT National Transportation Integrated Search

2001-09-01

The University of Rhode Island (URI) upgraded its Global Positioning System (GPS) Base Station to provide round-the-clock Internet access to survey-grade (+/- 2 cm accuracy) reference files using a web-based data distribution system. In August 2000, ...

Direction to an Internet Support Group Compared With Online Expressive Writing for People With Depression And Anxiety: A Randomized Trial.

PubMed

Dean, Jeremy; Potts, Henry Ww; Barker, Chris

2016-05-17

Depression and anxiety are common, often comorbid, conditions, and Internet support groups for them are well used. However, little rigorous research has been conducted on the outcome of these groups. This study aimed to evaluate the efficacy of an Internet support group in reducing depression and anxiety, and increasing social support and life satisfaction. A randomized trial compared direction to an existing Internet support group for depression and anxiety with an online expressive writing condition. A total of 863 (628 female) United Kingdom, United States, and Canadian volunteers were recruited via the Internet. Online, self-report measures of depression, anxiety, social support, and satisfaction with life were administered at baseline, 3, and 6 months. All four outcomes - depression, anxiety, social support, and satisfaction with life - improved over the 6 months of the study (all P <.001). There was no difference in outcome between the two conditions: participants responded similarly to the expressive writing and the Internet support group. Engagement with the Internet support group was low, it had high 6-month attrition (692/795, 87%) and low adherence, and it received mixed and often negative feedback. The main problems reported were a lack of comfort and connection with others, negative social comparisons, and the potential for receiving bad advice. Expressive writing had lower attrition (194/295, 65%) and participants reported that it was more acceptable. Until further evidence accumulates, directing people with depression and anxiety to Internet support groups cannot be recommended. On the other hand, online expressive writing seems to have potential, and its use for people with depression and anxiety warrants further investigation. Clinicaltrials.gov NCT01149265; https://clinicaltrials.gov/ct2/show/NCT01149265 (Archived by WebCite at http://www.webcitation.org/6hYISlNFT).

Evaluating a Web-Based MMR Decision Aid to Support Informed Decision-Making by UK Parents: A Before-and-After Feasibility Study

ERIC Educational Resources Information Center

Jackson, Cath; Cheater, Francine M.; Peacock, Rose; Leask, Julie; Trevena, Lyndal

2010-01-01

Objective: The objective of this feasibility study was to evaluate the acceptability and potential effectiveness of a web-based MMR decision aid in supporting informed decision-making for the MMR vaccine. Design: This was a prospective before-and-after evaluation. Setting: Thirty parents of children eligible for MMR vaccination were recruited from…

Autonomous Congestion Control in Delay-Tolerant Networks

NASA Technical Reports Server (NTRS)

Burleigh, Scott C.; Jennings, Esther H.

2005-01-01

Congestion control is an important feature that directly affects network performance. Network congestion may cause loss of data or long delays. Although this problem has been studied extensively in the Internet, the solutions for Internet congestion control do not apply readily to challenged network environments such as Delay Tolerant Networks (DTN) where end-to-end connectivity may not exist continuously and latency can be high. In DTN, end-to-end rate control is not feasible. This calls for congestion control mechanisms where the decisions can be made autonomously with local information only. We use an economic pricing model and propose a rule-based congestion control mechanism where each router can autonomously decide on whether to accept a bundle (data) based on local information such as available storage and the value and risk of accepting the bundle (derived from historical statistics).