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

PURPOSE OF REVIEW

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 FINDINGS

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.

SUMMARY

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.

An evolutionary examination of telemedicine: a health and computer-mediated communication perspective

Telemedicine, the use of advanced communication technologies in the healthcare context, has a rich history and a clear evolutionary course. In this paper, the authors identify telemedicine as operationally defined, the services and technologies it comprises, the direction telemedicine has taken, along with its increased acceptance in the healthcare communities. The authors also describe some of the key pitfalls warred with by researchers and activists to advance telemedicine to its full potential and lead to an unobstructed team of technicians to identify telemedicine's diverse utilities. A discussion and future directions section is included to provide fresh ideas to health communication and computer-mediated scholars wishing to delve into this area and make a difference to enhance public understanding of this field.

Detecting intra-fraction motion in patients undergoing radiation treatment using a low-cost wireless accelerometer

The utility of a novel, high-precision, non-intrusive, wireless, accelerometer-based patient orientation monitoring system (APOMS) in determining orientation change in patients undergoing radiation treatment is reported here. Using this system a small wireless accelerometer sensor is placed on a patient’s skin, broadcasting its orientation to the receiving station connected to a PC in the control area. A threshold-based algorithm is developed to identify the exact amount of the patient’s head orientation change. Through real-time measurements, an audible alarm can alert the radiation therapist if the user-defined orientation threshold is violated. Our results indicate that, in spite of its low-cost and simplicity, the APOMS is highly sensitive and offers accurate measurements. Furthermore, the APOMS is patient friendly, vendor neutral, and requires minimal user training. The versatile architecture of the APOMS makes it potentially suitable for variety of applications, including study of correlation between external and internal markers during Image-Guided Radiation Therapy (IGRT), with no major changes in hardware setup or algorithm.

A New Era in Clinical Communications: A Report on the Past Year's Work at NEHTA

Across Australia there is a groundswell of support for a better more connected healthcare system. More than 80 per cent of Australians are in favour of electronic health records and the sector is increasingly aware of the safety and quality benefits that e-health can deliver. On behalf of the governments of Australia, the National E-Health Transition Authority (NEHTA) is developing a national e-health infrastructure that will underpin the success of a connected healthcare system. This involves a body of work that includes clinical terminologies, unique healthcare identification and the development and recommendation of standards for the safe transmission and access of healthcare information. Read an update of NEHTA's work and progress in 2008.

[Questionnaire to evaluate health web sites according to European criteria]

OBJECTIVES

To design a questionnaire to evaluate compliance with quality criteria on health web sites and to analyse its reliability.

DESIGN

A descriptive study on the reliability of a questionnaire.

PARTICIPANTS

Twenty web sites on health topics.

SETTING

Internet.

MAIN MEASUREMENTS

The questionnaire was based on analysis of content of the criteria of the e-Europe 2002 code of conduct, comparing these with the criteria underlying the AMA, the Summit code and the e-Health Code of Ethics regulations and current directives. The dimensions studied were transparency, absence of conflicts of interest, authorship, data protection, updating, accountability, and accessibility. A preliminary questionnaire was drawn up for a pilot test conducted by 3 researchers for 20 web sites, its reliability was appraised, adjustments were made and the definitive questionnaire was designed. Reliability was evaluated again for 26 web sites evaluated by 3 researchers. To evaluate concordance in the answers of the participants, Cohen's Kappa index with a 95% confidence level was used.

RESULTS

All the quality directives of e-Europe 2002, the European regulations and relevant points from other questionnaires were included in the questionnaire designed. Reliability was acceptable (kappa > or = 0.60) for 12 of the 18 quality criteria included. The least concordant aspects of the questionnaire were information update (kappa = 0.310) and accessibility (search for contents and access for persons with disability).

CONCLUSIONS

Reliability of the questionnaire designed was acceptable.