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.     

A systematic review of internet-based self-help therapeutic interventions to improve distress and disease-control among adults with chronic health conditions

The evidence base of internet-based self-help interventions has been rapidly growing for mental health conditions over the past decade. However, to date a systematic review of the application of this technology to chronic health conditions has not been reported. The objective of the present review was to therefore critically appraise the research on the efficacy of internet self-help interventions for distress and disease outcomes in adults with physical health complaints. Electronic searches were conducted in Embase, CINAHL, MEDLINE and PsychINFO, and reference lists were examined. Twenty four studies met inclusion criteria, covering 8 health conditions. Across health conditions, consistent evidence was obtained that online therapeutic interventions were efficacious in improving disease-symptoms and control, with the exception of diabetes. Mixed evidence was obtained for distress outcomes: 3 health conditions demonstrated consistent benefit (irritable bowel syndrome, tinnitus, and one heterogeneous chronic illness population); one condition obtained moderate support (chronic pain); while results were not promising for diabetes. The limited research conducted among epilepsy, cancer, and chronic fatigue precluded conclusions from being drawn. Few studies met all methodological quality criteria. This review demonstrates that internet-based self-help interventions hold guarded promise in the amelioration of distress and disease-control, and further research implications are discussed.     

What makes Internet addicts continue playing online even when faced by severe negative consequences? Possible explanations from an fMRI study

In this study, we designed a continuous wins-and-losses task to monitor the mental activities during decision-making and their effects on subsequent decisions in Internet addiction disorder (IAD) subjects. In behavioral performance, IAD subjects show longer response time, lower repeat rate and greater Stroop effect than healthy controls. In neuroimaging results, IAD subjects show increased brain activities in the inferior frontal cortex, insula, anterior cingulate cortex and decreased activation in the caudate and posterior cingulate cortex after continuous wins than healthy controls. In addition, IAD subjects show increased brain activities in the inferior frontal gyrus and decreased brain activation in the posterior cingulate cortex after continuous losses. Thus, we concluded that IAD subjects engage more cognitive activities to finish the decision-making task. As a result, they cannot sufficiently focus on the executive function during this process. They also do not pay adequate attention to considering previous selections and relevant outcomes during decision-making.     

Using the Internet for information about breast cancer: A questionnaire-based study

Objectives

To identify the proportion of breast cancer patients that used the Internet for breast cancer information; to classify patterns of use based on patient demographics; and to evaluate whether using the Internet for this purpose was beneficial or problematic. Also to recognize whether a specific demographic group was more likely to experience problems when using the Internet for breast cancer information.

Methods

A 10-item questionnaire was given to patients who attended the breast unit at the University Hospital of South Manchester between May and June 2011 following breast cancer treatment within the last 5 years.

Results

200 questionnaires were completed. 50.5% of patients had used the Internet for breast cancer information, with younger (p < 0.001) patients with a higher household income (p < 0.001) being most likely to do so. The majority (73%) found it beneficial; however 31% had experienced problems. Ethnicity affected the likelihood of experiencing problems with white patients encountering fewer problems (25%) than non-white patients (64%) (p = 0.008).

Conclusion

A significant proportion of breast cancer patients will encounter difficulties when using the Internet for breast cancer information, particularly those from ethnic minorities.

Practice implications

Health professionals need to include a discussion about Internet use in consultations with breast cancer patients.