Community-Based Internet Access for People Living with HIV/AIDS

Abstract

The electronic information revolution has important implications for increasing access to health resources and improving health and quality of life for people living with chronic, life threatening illnesses. This article describes the establishment of a community based technology access center (CTAC) in an AIDS service organization. The goals of the CTAC were to increase Internet access among low-income and minority people living with HIV/AIDS. Results of an evaluation of CTAC utilization showed that the goals of increasing Internet access for this particular population were achieved. Content analysis of websites retrieved from CTAC computers indicated that CTAC users searched primarily for commercial, business-related, general resource, and entertainment functions. The CTAC was used less often for searching for health information and for social and supportive functions. Community-based CTACs housed within AIDS service organizations can increase Internet access and potentially improve the quality of life of people living with HIV/AIDS.     

Characteristics of analytically confirmed 3-MMC-related intoxications from the Swedish STRIDA project

Abstract

Background. 3-Methylmethcathinone (3-MMC) is a synthetic cathinone stimulant structurally related to the new psychoactive substance (NPS) mephedrone (4-methylmethcathinone, 4-MMC). We describe a case series of analytically confirmed intoxications involving 3-MMC presented to emergency departments in Sweden and included in the STRIDA project. Study design. Observational case series of consecutive patients with self-reported or suspected use of NPS presenting to hospitals in Sweden between August 2012 and March 2014. Methods. NPS analysis was performed by a liquid chromatography–mass spectrometry (MS)/MS method that is updated with new substances as they appear. Data on clinical features were collected during Poisons Information Centre consultations and retrieved from medical records. Results. 3-MMC was detected in 50 (6.4%) of the 786 cases included in the STRIDA project during the 20-month study period, with the peak occurring in August 2013. The age range of patients testing positive for 3-MMC was 17–49 years (median 24) and 76% of them were men. The 3-MMC concentration in serum ranged between 0.002 and 1.49 μg/mL (median, 0.091) and between 0.007 and 290 μg/mL (median, 3.05) in urine. Co-exposure to other NPS and/or traditional drugs was very common, and 3-MMC mono-intoxication was found in only 4 (8%) cases. The most frequent clinical features were tachycardia (48% of cases) and agitation (42%). Other features included a reduced level of consciousness (32%), dilated pupils (24%), hallucinations (20%), diaphoresis (12%), seizures (8%), and hyperthermia (6%). Most patients (60%) needed hospital care for only 1 day but in 8% for 3 days or longer. Conclusion. The majority of patients with analytically confirmed 3-MMC exposure had sympathomimetic features similar to those associated with mephedrone intoxication. However, the high incidence of co-exposure to other drugs makes the clinical interpretation difficult. Nevertheless, 3-MMC was associated with a high admittance rate to intensive care (30%), and detected in two cases with a fatal outcome, suggesting that 3-MMC is a harmful drug.     

JCHI EDITOR'S SELECT SITES

Abstract

A review of useful Internet sites on S-Adenosyl-L-Methionine or SAMe is presented. The Internet search engines become confused when attempting to locate material on SAMe because of the commonness of its name. Pending outcome of NCCAM's randomized controlled clinical trials, better insight into safety and efficacy of this relatively new alternative therapy should come to light.     

The curious case of cyberchondria: A longitudinal study on the reciprocal relationship between health anxiety and online health information seeking

The current study is the first to longitudinally investigate the reciprocal relationship between online health information seeking and health anxiety, i.e., cyberchondria. Expectations were that health anxious individuals who go online to find health information, experience an increase in health anxiety, which in turn will reinforce online seeking. A 4-wave longitudinal survey study among 5322 respondents aged 16–93 was conducted. Our results showed that individuals who are more health anxious than others, search online for health information more. Moreover, the results provided initial evidence for the expected reciprocal relationship between health anxiety and online health information seeking in respondents with non-clinical levels of health anxiety at the start of the study. However, this reciprocal relationship could not be found in a subsample of clinically health anxious individuals. Although for these individuals online health information seeking did not seem to exacerbate health anxiety levels, it might still serve as a maintaining factor of clinical health anxiety.     

Patient education,engagement and shared decision making: APM patients need to have skin in the game

Total joint replacement remains a highly cost-effective procedure with the potential to improve patient’s quality of life and long-term health. Bundled payment programs require increased alignment between hospitals, surgeons, and patients in order to obtain improved outcomes. Many of the desired care processes and steps needed to cost-effectively achieve the optimal outcome require active patient participation. Therefore, patient engagement throughout the entire episode is critical and efforts to improve and maximize that are needed. Shared decision-making combined with an accurate portrayal of patient risk and the benefits of risk factor modification are discussed.     

Problematic internet use (PIU): Associations with the impulsive-compulsive spectrum. An application of machine learning in psychiatry

Problematic internet use is common, functionally impairing, and in need of further study. Its relationship with obsessive-compulsive and impulsive disorders is unclear. Our objective was to evaluate whether problematic internet use can be predicted from recognised forms of impulsive and compulsive traits and symptomatology. We recruited volunteers aged 18 and older using media advertisements at two sites (Chicago USA, and Stellenbosch, South Africa) to complete an extensive online survey. State-of-the-art out-of-sample evaluation of machine learning predictive models was used, which included Logistic Regression, Random Forests and Naïve Bayes. Problematic internet use was identified using the Internet Addiction Test (IAT). 2006 complete cases were analysed, of whom 181 (9.0%) had moderate/severe problematic internet use. Using Logistic Regression and Naïve Bayes we produced a classification prediction with a receiver operating characteristic area under the curve (ROC-AUC) of 0.83 (SD 0.03) whereas using a Random Forests algorithm the prediction ROC-AUC was 0.84 (SD 0.03) [all three models superior to baseline models p < 0.0001]. The models showed robust transfer between the study sites in all validation sets [p < 0.0001]. Prediction of problematic internet use was possible using specific measures of impulsivity and compulsivity in a population of volunteers. Moreover, this study offers proof-of-concept in support of using machine learning in psychiatry to demonstrate replicability of results across geographically and culturally distinct settings.     

Usage d’Internet chez les millennials : qu’en dit la littérature ?

The use of Internet and social media is the most common activity today for teenagers and young adults. Today, the question is not how much time is spent online but from how long does it become pathological or from what age can one be online without it being too young. A large part of the social and emotional development takes place on the Internet for the younger generation. Internet offers them a portal for their distraction and communication with advantages but also risks. Given the magnitude of this phenomenon, we conducted a literature review in order to take stock of the current situation of Internet use for adolescents/young adults concerning cyber addiction, particularly those related to social media and video games as well as its psychiatric comorbidities and its psychological impact. We also looked for literature on the issues of self-representation, its implications for privacy and loss of self-esteem, cyberbullying and sleep disorders. Young people are at risk of living negative experiences more than parents tend to realize. Internet and social media are a topical subject that is of great interest to be explored in connection with sociological, psychological and psychiatric issues. Clinical consequences already are felt with the presence of comorbidities and addictions in psychiatry but also the presence of physical consequences in pediatrics.     

互联网远程管理对社区高血压患者治疗依从性影响的研究进展

高血压是严重危害人类健康的慢性病之一，全球范围内有较高的发病率和致死率，且控制率低，尤其在欠发达国家和地区。有效的高血压管理是提高患者治疗依从性和影响血压控制率的关键。随着互联网在全世界的发展，传统基于医生诊室管理高血压患者治疗依从性的模式在发生改变，本文综合探讨了国内外互联网远程管理对高血压患者治疗依从性的影响，分析得出互联网远程管理对高血压患者治疗依从性在健康教育、经济、医患沟通、随访等方面存在优势，但存在使用障碍、数据不准确、研究证据有限、安全性可靠性不能保证等挑战与不足，并提出展望，以期将互联网远程管理更好地应用于社区高血压患者的管理。     

Health Information for Gay Men on the Internet

Summary

The groundbreaking publication in April 2001 of the Healthy People 2010 Companion Document for Lesbian, Gay, Bisexual and Transgender Health supplement to the nation's Healthy People 2010 prevention agenda marked a crucial milestone for gay men, as well as other sexual minorities in the United States. Based on work done by the Gay and Lesbian Medical Association and scholars at Columbia University, this policy document outlined the most pressing health concerns for Lesbian, Gay, Bisexual and Transgender (LGBT) people. This article identifies those health concerns specific to gay men, and provides a review of highly select Web resources targeting this population.