On-line health seeking activity of older adults: an integrative review of the literature

The internet is increasingly used to provide health information. Supporting older people to access on-line health information requires understanding their current usage and possible barriers and facilitators. Methods involved searching three databases. Inclusion criteria were: (i) articles published within 10 years; (ii) people aged >65; (iii) explored reasons for older people accessing on-line health information and (iv) in English. Eight articles met these criteria. Older people use on-line health information to learn about a disease, medication, treatment, or healthy living. Factors influencing usefulness of on-line health information included demographics, health status, trust in the information, lack of skills using the internet and attitudes of health professionals. Findings indicate that while older people access on-line health information there are barriers: Low trust, financial barriers, lack of familiarity with the internet and low health literacy levels. Implications for nursing include working in partnership with older people to assist them to identify appropriate on-line information.     

Prospective memory rehabilitation using smartphones in patients with TBI

Purpose: The aim of the present study was to investigate the effectiveness of a prospective memory aid that combines smartphones with Internet-based calendars among community-dwelling patients with traumatic brain injury.

Method: An uncontrolled pre- and post-assessment design was employed to study the use of unmodified, low-cost, off-the-shelf smartphones combined with Internet-calendars as a compensatory memory strategy in community-dwelling patients with traumatic brain injury. Thirteen participants received a 6-week group-based intervention with pre-, post- and 2-month follow-up-assessments by questionnaires and by daily assessment of target behaviors for 2-week periods.

Results: Participants reported significantly fewer retro- and prospective memory problems on questionnaires after the intervention and at follow-up with large effect sizes. The performance of target behaviors, however, improved insignificantly with moderate effect sizes. There were no changes in quality of life or symptoms of emotional distress.

Conclusions: This study adds to a growing body of evidence that smartphones are a useful compensatory aid in rehabilitation of prospective memory that should routinely be considered in rehabilitation of traumatic brain injury patients.

• Implication for rehabilitation

• Smartphones are easy-to-use and accessible assistive technology for compensatory memory rehabilitation to most traumatic brain injury patients.

• By using low-cost, off-the-shelf devices, the technology becomes available to a broader range of patients.

• By combining smartphones with Internet-based and cross-platform services (e.g., calendars, contacts) the participants are less device-dependent and less vulnerable to data loss.

• Smartphones should routinely be considered as compensatory aid in rehabilitation of prospective memory of traumatic brain injured patients.

     

Health literacy and the Internet: a study on the readability of Australian online health information

Objective: Almost 80% of Australian Internet users seek out health information online so the readability of this information is important. This study aimed to evaluate the readability of Australian online health information and determine if it matches the average reading level of Australians. Methods: Two hundred and fifty‐one web pages with information on 12 common health conditions were identified across sectors. Readability was assessed by the Flesch‐Kincaid (F‐K), Simple Measure of Gobbledygook (SMOG) and Flesch Reading Ease (FRE) formulas, with grade 8 adopted as the average Australian reading level. Results: The average reading grade measured by F‐K and SMOG was 10.54 and 12.12 respectively. The mean FRE was 47.54, a ‘difficult‐to‐read’ score. Only 0.4% of web pages were written at or below grade 8 according to SMOG. Information on dementia was the most difficult to read overall, while obesity was the most difficult among government websites. Conclusions and implications: The findings suggest that the readability of Australian health websites is above the average Australian levels of reading. A quantifiable guideline is needed to ensure online health information accommodates the reading needs of the general public to effectively use the Internet as an enabler of health literacy.     

基于自组网和物联网的医疗设备综合管理系统设计与实现

目的:针对传统医疗设备管理系统电子信息化方面的不足,设计一种新的基于自组网和物联网技术医疗设备综合管理系统,以提高医院对医疗设备的管理效率。方法:引入自组网和云计算网络技术,实现各个管理系统模块之间快速无缝链接,并提供完善的操作手册和设备状态等信息。结果:该系统采用了新型监控和无线组网技术,具有监控医院所有医疗仪器设备的运行状况,并记录和统计各种运行信息,实现对医院所有医疗仪器设备的管理、跟踪和统计等功能;此外,提供的手册可以方便地检查仪器设备的健康状态,以便于维护和维修。结论:基于自组网和物联网技术医疗设备综合管理系统,通过实际部署使用,验证了该系统的成熟性和可靠性,可以大幅提高医疗设备的使用效率。     

Research: Ageing,social capital and the Internet: Findings from an exploratory study of Australian ‘silver surfers’

Objective: To document the sociodemographic characteristics and online use patterns of older Australian Internet users as part of an exploratory study of the relationship between Internet communication and access to social capital in later life. Methods: A purposive sample of 154 Internet users aged 55 years or older and not employed full time completed an electronic survey about their social characteristics and patterns of Internet use. A subsample of 30 participated in follow‐up in‐depth interviews. Results: The majority of participants comprised married, home‐owning, English‐speaking women and men in good health. They made extensive use of the communication and information functions of the Internet to supplement and enhance their connections with friends and family and their engagement with wider social networks. Conclusion: Policy development should be informed by better understanding of the potential and limitations of the Internet as a tool for generating and sustaining social capital in old age.     

Randomised controlled non-inferiority trial with 3-year follow-up of internet-delivered versus face-to-face group cognitive behavioural therapy for depression

Background

Guided internet-delivered cognitive behaviour therapy (ICBT) has been found to be effective in the treatment of mild to moderate depression, but there have been no direct comparisons with the more established group-based CBT with a long-term follow-up.

Method

Participants with mild to moderate depression were recruited from the general population and randomized to either guided ICBT (n=33) or to live group treatment (n=36). Measures were completed before and after the intervention to assess depression, anxiety, and quality of life. Follow-ups were conducted at one-year and three-year after the treatment had ended.

Results

Data were analysed on an intention-to-treat basis using linear mixed-effects regression analysis. Results on the self-rated version of the Montgomery–Åsberg Depression Scale showed significant improvements in both groups across time indicating non-inferiority of guided ICBT, and there was even a tendency for the guided ICBT group to be superior to group-based CBT at three year follow-up. Within-group effect sizes for the ICBT condition at post-treatment showed a Cohen′s d=1.46, with a similar large effect at 3-year follow-up, d=1.78. For the group CBT the corresponding within-group effects were d=0.99 and d=1.34, respectively.

Limitations

The study was small with two active treatments and there was no placebo or credible control condition.

Conclusions

Guided ICBT is at least as effective as group-based CBT and long-term effects can be sustained up to 3 years after treatment.     

Resting-state beta and gamma activity in Internet addiction

Internet addiction is the inability to control one's use of the Internet and is related to impulsivity. Although a few studies have examined neurophysiological activity as individuals with Internet addiction engage in cognitive processing, no information on spontaneous EEG activity in the eyes-closed resting-state is available. We investigated resting-state EEG activities in beta and gamma bands and examined their relationships with impulsivity among individuals with Internet addiction and healthy controls. Twenty-one drug-naïve patients with Internet addiction (age: 23.33 ± 3.50 years) and 20 age-, sex-, and IQ-matched healthy controls (age: 22.40 ± 2.33 years) were enrolled in this study. Severity of Internet addiction was identified by the total score on Young's Internet Addiction Test. Impulsivity was measured with the Barratt Impulsiveness Scale-11 and a stop-signal task. Resting-state EEG during eyes closed was recorded, and the absolute/relative power of beta and gamma bands was analyzed. The Internet addiction group showed high impulsivity and impaired inhibitory control. The generalized estimating equation showed that the Internet-addiction group showed lower absolute power on the beta band than did the control group (estimate = − 3.370, p < 0.01). On the other hand, the Internet-addiction group showed higher absolute power on the gamma band than did the control group (estimate = 0.434, p < 0.01). These EEG activities were significantly associated with the severity of Internet addiction as well as with the extent of impulsivity. The present study suggests that resting-state fast-wave brain activity is related to the impulsivity characterizing Internet addiction. These differences may be neurobiological markers for the pathophysiology of Internet addiction.