社会力量参与公立互联网医院建设激励与约束机制研究

社会力量具备相应的经济基础和技术条件,对于公立互联网医院体系建设具有积极的促进作用。但是实践中仍然存在商业模式不完善、监管制度不健全等问题。基于经济学契约理论要义,提出在坚持激励与约束机制并举、平衡公私益关系的前提下,通过完善医保政策、构建互联网医疗服务价格分类管理机制来促进社会力量向医疗服务公益性目标回归,并通过构建完善的监督体制来约束部分社会力量的盲目逐利性行为。     

Digital navigators to implement smartphone and digital tools in care

While smartphone apps and other digital health tools have the clear potential to increase both quality of and access to care, actual successful implementation remains limited. Challenges often encountered in seeking to use apps in care include selecting safe/effective tools, spending clinical time troubleshooting technology instead of discussing health matters, and lack of time to check and review constant streams of data these digital tools can produce. In this ‘From Research to Clinical Practice’ piece, we focus on how a new care team member, the digital navigator, can help overcome these barriers through conducting evidence-based app evaluation to help in selecting the right apps, troubleshooting technology outside of visits to improve the therapeutic alliance during, and finally summarizing digital data to facilitate clinical care that focus on actionable data.     

Cyberchondria in First Year Medical Students of Yogyakarta

Abstract

Cyberchondria is a relatively new term addressing health anxiety associated with online information. Research data is scarce, as most instruments measuring anxiety do not consider online behavior an important factor. Medical students are arguably assumed to have frequent health anxieties, i.e. “medical student syndrome.” Moreover, they are exposed to large amounts of information. We aimed to measure the level of cyberchondria severity of first-year medical students. First-year medical students of the regular program at Universitas Gadjah Mada completed self-reported instruments (the Cyberchondria Severity Scale (CSS) and the Beck Anxiety Inventory (BAI)). Cut off was determined using ROC analysis to find the best score that corresponded to BAI cut off of 16. Data were analyzed using chi square and t-tests to analyze any differences between gender. Respondents were 162 students, 54 males and 108 females, with mean age 18.18-year-old ± 0.696. Based on ROC analysis, cut off of 75.5 corresponded with BAI score of 16. Mean CSS score was 70.73 ± 16.292. There was no significant difference of CSS scores between genders. Based on the analysis of individual items, compared to male students, female students more frequently searched for physical symptoms on the Internet, and afterwards, consulted the results with a General Practitioner (GP), discussed with a GP, or went to other specialists; and thus, more frequently required reassurance after online search. In contrast, male students more frequently had difficulty relaxing after searching online for physical symptoms. We concluded that there was no difference of overall cyberchondria severity score, but there were slight but significant differences of online behavior between genders.     

Hair hormones in male youth with internet gaming disorder

Objectives: Internet gaming disorder (IGD) is associated with altered physiological reactivity to psychosocial stress. Findings from a previous study on alterations of basal hypothalamic–pituitary–adrenal (HPA) axis functioning, indexed by differences in hair hormone levels (i.e., cortisol) in IGD patients compared to matched controls, were limited by a small sample size.

Methods: Following the protocol of the previous study, male patients with IGD (n?=?31) and controls (n?=?31) matched for age, educational status and smoking were recruited. Sociodemographic and clinical characteristics were assessed using structured interviews and self-reports. Hair samples were taken for the analysis of cortisol, cortisone, testosterone, progesterone, dehydroepiandrosterone (DHEA), and corticosterone.

Results: Groups showed no significant differences on cortisol (d?=??0.10, 95%CI (?0.60; 0.40)), cortisone (d?=??0.10, 95%CI (?0.60; 0.40)), testosterone (d?=??0.00, 95%CI (?0.51; 0.51)), progesterone (d?=??0.46, 95%CI (?0.96; 0.05)), DHEA (d?=??0.04, 95%CI (?0.54; 0.47)) or corticosterone (d?=??0.19, 95%CI (?0.69; 0.32)). Associations between hair hormone concentrations, symptom severity and sociodemographic variables were weak and did not survive correction for multiple testing.

Conclusions: Unlike other psychiatric disorders, effects of IGD and associated psychopathology on basal HPA axis functioning, indexed by hair hormone levels, are negligible. Future studies need to rule out potential effects of sex, age and long-term pathology on these findings.     

A cross-national comparison of the Twitter feeds of popular alcohol brands in India and Australia

Aims: To evaluate (i) the types of techniques alcohol marketers utilise to facilitate user engagement with content on leading Indian and Australian Twitter alcohol brand pages and (ii) the extent to which users engage with this content in two diverse national contexts.

Methods: The 10 alcohol brands per country with the greatest Twitter presence were identified based on the number of ‘followers’. Number of tweets, photos, and videos were collected and the type of content noted for each brand between 1 January 2016 and 29 February 2016. The data were analysed via an inductive coding approach using NVivo10.

Results: In total, the brands had accumulated up to 150,386 followers (Indian: 110,032; Australian: 40,354). The techniques utilised were a mix of those that differed by country (e.g. India: sexually suggestive content versus Australia: posts related to the brand’s tradition or heritage) and generic approaches (e.g. alcohol sponsorship of sport, music, and fashion; offering consumption suggestions; organising competitions; giveaways; and use of memes).

Conclusions: The flexibility of Twitter, which complements traditional marketing, allows brands to adapt and deliver their online alcohol content in specific national contexts and to capitalise on the cultural meanings users invoke in their interactions with the brands.     

YouTube as a source of medical information on the novel coronavirus 2019 disease (COVID-19) pandemic

ABSTRACT

Media coverage on coronavirus disease 2019 (COVID-19) has been extensive, yet large gaps remain in our understanding of the role of social media platforms during worldwide health crisis. The purpose of this study was to assess the most viewed YouTube videos on COVID-19 for medical content. We coded video characteristics, source, and medical content of the 113 most-widely viewed videos about COVID-19. Seventy-nine (69.9%) videos were classified as useful, and 10 (8.8%) videos were classified as misleading. Independent users were more likely to post misleading videos than useful videos (60.0% vs 21.5%, P?=?0.009). News agencies were more likely to post useful videos than misleading videos (72.2% vs 40.0%, P?=?0.039). Useful videos were more likely to present any information on prevalence or incidence (79.7% vs 20.0%, P?<?0.001), as well as information on outcomes or prognosis (84.8% vs 30.0%, P?<?0.001) compared to misleading videos. The World Health Organization contributed one useful video (1.3%), while no videos from the Center for Disease Control were included. Although YouTube generally is a useful source of medical information on the COVID-19 pandemic, increased efforts to disseminate accurate information from reputable sources is desired to help mitigate disease spread and decrease unnecessary panic in the general population.     

ROCCIPI技术框架下智慧医院建设的问题识别及分析

建设智慧医院旨在以患者为中心,通过智慧化途径向患者提供便捷化、个性化的医疗卫生服务,改善患者就医体验。文章采用ROCCIPI技术框架,就规则、机会、能力、交流、利益、过程和意识七个方面对我国医院智慧化建设进行深入分析,为现代化医院建设提供一定参考。