K-core robustness in ecological and financial networks

In many real-world networks, the ability to withstand targeted or global attacks; extinctions; or shocks is vital to the survival of the network itself, and of dependent structures such as economies (for financial networks) or even the planet (for ecosystems). Previous attempts to characterise robustness include nestedness of mutualistic networks or exploration of degree distribution. In this work we present a new approach for characterising the stability and robustness of networks with all-positive interactions by studying the distribution of the k-shell of the underlying network. We find that high occupancy of nodes in the inner and outer k-shells and low occupancy in the middle shells of financial and ecological networks (yielding a "U-shape" in a histogram of k-shell occupancy) provide resilience against both local targeted and global attacks. Investigation of this highly-populated core gives insights into the nature of a network (such as sharp transitions in the core composition of the stock market from a mix of industries to domination by one or two in the mid-1990s) and allow predictions of future network stability, e.g., by monitoring populations of "core" species in an ecosystem or noting when stocks in the core-dominant sector begin to move in lock-step, presaging a dramatic move in the market. Moreover, this "U-shape" recalls core-periphery structure, seen in a wide range of networks including opinion and internet networks, suggesting that the "U-shaped" occupancy histogram and its implications for network health may indeed be universal.

Information Needs Assessment among Parents of Children with Cancer

Background: Parents of children with leukemia should be receiving an extensive amount of information about the care of their child; the aim of this study was to determine the parents’ information needs of children with leukemia. Methods: A cross-sectional study design was used to describe medical, physical, mental and lifestyle information needs among parents of children with leukemia. 209 parents of children diagnosed with leukemia in the west of Iran, during winter 2018, voluntarily participated in individual interviews. Data were analyzed by SPSS version 16 using t-test, One-way ANOVA and bivariate correlations statistical tests at 95% significant level. Results: The mean age of participants was 39.45 years [95% CI: 38.35, 40.55], ranged from 27 to 58 years. Participants achieved 55.6% score of information needs. There was a significant relationship between higher education level (P< 0.001), better economic status (P=0.008) and more family size member (P=0.003) with information needs. Conclusion: Findings suggest that parents of children with leukemia need the information to learn how to take care of their childhood and could be useful for guiding implementers to planning and implement effective programs to promotion information of parents towards children with cancer.

Augmenting geovisual analytics of social media data with heterogeneous information network mining-Cognitive plausibility assessment

This paper investigates the feasibility, from a user perspective, of integrating a heterogeneous information network mining (HINM) technique into SensePlace3 (SP3), a web-based geovisual analytics environment. The core contribution of this paper is a user study that determines whether an analyst with minimal background can comprehend the network data modeling metaphors employed by the resulting system, whether they can employ said metaphors to explore spatial data, and whether they can interpret the results of such spatial analysis correctly. This study confirms that all of the above is, indeed, possible, and provides empirical evidence about the importance of a hands-on tutorial and a graphical approach to explaining data modeling metaphors in the successful adoption of advanced data mining techniques. Analysis of outcomes of data exploration by the study participants also demonstrates the kinds of insights that a visual interface to HINM can enable. A second contribution is a realistic case study that demonstrates that our HINM approach (made accessible through a visual interface that provides immediate visual feedback for user queries), produces a clear and a positive difference in the outcome of spatial analysis. Although this study does not aim to validate HINM as a data modeling approach (there is considerable evidence for this in existing literature), the results of the case study suggest that HINM holds promise in the (geo)visual analytics domain as well, particularly when integrated into geovisual analytics applications. A third contribution is a user study protocol that is based on and improves upon the current methodological state of the art. This protocol includes a hands-on tutorial and a set of realistic data analysis tasks. Detailed evaluation protocols are rare in geovisual analytics (and in visual analytics more broadly), with most studies reviewed in this paper failing to provide sufficient details for study replication or comparison work.

Comparison of Health Communication Channels for Reaching Hispanics About Biobanking: a Pilot Trial

Cancer education is essential for improving cancer prevention and biobanking knowledge among racial-ethnic minorities, with the goal of increasing diversity and representativeness of biospecimen collections. However, little is known about the communication modalities for optimal delivery of information. We examined feasibility of recruitment and compared communication modalities for delivering cancer prevention and biobanking education to Hispanics. Communication modalities were evaluated using participation rates and change in knowledge, attitudes, self-efficacy, intention, receptivity, and trust. Enrollment in a biobanking registry was a behavioral outcome. Community members in Ponce, Puerto Rico and Tampa, Florida were recruited. Participants (N = 254) were randomized to one of three communication modalities: standard dissemination (mailed materials); enhanced dissemination (mailed materials plus follow-up call); and 'charla' (face-to-face group discussion). Participants completed questionnaires about their knowledge, attitudes, self-efficacy, intentions, receptivity, and trust regarding biobanking and cancer prevention pre- and post-intervention. Knowledge, attitudes, and self-efficacy were improved among all three modalities. Although the greatest increases in knowledge were observed when the information was delivered via charla, the charla had the lowest participation rate. The standard and enhanced dissemination modalities were more feasible for delivering cancer prevention and biobanking education to Hispanics. Lack of differences among the three modalities suggests culturally tailored education may be sufficient to capture the community's intention to participate in biobanking research, regardless of the delivery method for the education. Results from this study contribute to the limited knowledge regarding Hispanics knowledge and intentions for biospecimen collection, and in the future may improve participation in this underrepresented group.

Analysis of channel uncertainty in ARQ relay networks

Several power allocation algorithms for cooperative relay networks are presented in the literature. These contributions assume perfect channel knowledge and capacity achieving codes. However in practice, obtaining the channel state information at a relay or at the destination is an estimation problem and can generally not be error free. The investigation of the power allocation mechanism in a wireless network due to channel imperfections is important because it can severely degrade its performance regarding throughput and bit error rate. In this paper, the impact of imperfect channel state information on the power allocation of an adaptive relay network is investigated. Moreover, a framework including Automatic Repeat reQuest (ARQ) mechanism is provided to make the power allocation mechanism robust against these channel imperfections. For this framework, the end-to-end SNR is calculated considering imperfect channel knowledge using ARQ analytically. The goal is to emphasize the impact of imperfect channel knowledge on the power allocation mechanism. In this paper, the simulation results illustrate the impact of channel uncertainties on the average outage probability, throughput, and consumed sum power for different qualities of channel estimation. It is shown that the presented framework with ARQ is extremely robust against the channel imperfections.

Frictions or Mental Gaps: What’s Behind the Information We (Don’t) Use and When Do We Care?

Consumers suffer significant losses from not acting on available information. These losses stem from frictions such as search costs, switching costs, and rational inattention, as well as what we call mental gaps resulting from wrong priors/worldviews, or relevant features of a problem not being top of mind. Most research studying such losses does not empirically distinguish between these mechanisms. Instead, we show that most highly cited papers in this area presume one mechanism underlies consumer choices and assume away other potential explanations, or collapse many mechanisms together. We discuss the empirical difficulties that arise in distinguishing between different mechanisms, and some promising approaches for making progress in doing so. We also assess when it is more or less important for researchers to distinguish between these mechanisms. Approaches that seek to identify true value from demand, without specifying mechanisms behind this wedge, are most useful when researchers are interested in evaluating allocation policies that strongly steer consumers towards better options with regulation, traditional policy instruments, and defaults. On the other hand, understanding the precise mechanisms underlying consumer losses is essential to predicting the impact of mechanism policies aimed primarily at reducing specific frictions or mental gaps without otherwise steering consumers. We make the case that papers engaging with these questions empirically should be clear about whether their analyses distinguish between mechanisms behind poorly informed choices, and what that implies for the questions they can answer. We present examples from several empirical contexts to highlight these distinctions.

Search strategies of Wikipedia readers

The quest for information is one of the most common activity of human beings. Despite the the impressive progress of search engines, not to miss the needed piece of information could be still very tough, as well as to acquire specific competences and knowledge by shaping and following the proper learning paths. Indeed, the need to find sensible paths in information networks is one of the biggest challenges of our societies and, to effectively address it, it is important to investigate the strategies adopted by human users to cope with the cognitive bottleneck of finding their way in a growing sea of information. Here we focus on the case of Wikipedia and investigate a recently released dataset about users’ click on the English Wikipedia, namely the English Wikipedia Clickstream. We perform a semantically charged analysis to uncover the general patterns followed by information seekers in the multi-dimensional space of Wikipedia topics/categories. We discover the existence of well defined strategies in which users tend to start from very general, i.e., semantically broad, pages and progressively narrow down the scope of their navigation, while keeping a growing semantic coherence. This is unlike strategies associated to tasks with predefined search goals, namely the case of the Wikispeedia game. In this case users first move from the ‘particular’ to the ‘universal’ before focusing down again to the required target. The clear picture offered here represents a very important stepping stone towards a better design of information networks and recommendation strategies, as well as the construction of radically new learning paths.

"Forewarned and forearmed": Long-term childhood cancer survivors' and parents' information needs and implications for survivorship models of care

OBJECTIVE

This mixed-method study assessed 1) survivors' and parents' information needs; and 2) associations between unmet information needs and clinical and socio-demographic characteristics.

METHODS

Stage 1: CCS and parents of CCS, >5years post-diagnosis completed a questionnaire on information needs, overall health and perceived risk. Predictors for unmet information needs were assessed by multivariable regression. Stage 2: participants were interviewed in-depth on these topics.

RESULTS

Questionnaires were completed by 485 participants comprising 322 survivors (mean age: 26.7years, SD=7.9; time since diagnosis: 19.7years, SD=8.8) and 163 parents (child age: 12.9years, SD=2.4; time since diagnosis: 9.7years, SD=2.3), and complemented by 70 interviews. Survivors reported unmet information needs about late effects (57.5%) and parents for fertility issues (62.5%). Survivors had more unmet needs for medical information whereas parents had significantly more regarding sexual issues and lifestyle. Being a parent (p=0.001), dissatisfaction with follow-up care (p=0.003), lower overall health (p=0.014), higher perceived risk of late effects (p<0.001), and greater anxiety/depression (p<0.001) were significantly associated with more unmet needs.

CONCLUSION

Unmet information needs were common for survivors and parents of CCS.

PRACTICE IMPLICATIONS

Future efforts towards tailoring information on potential late effects, healthy lifestyles and follow-up care may help to address unmet information needs.

Patient activation and the use of information to support informed health decisions

OBJECTIVES

Patients and consumers make many choices that affect their health and their health care. Some of these decisions are informed by evidence, but many are not. A growing body of research indicates that those who are more activated or engaged in their health are more likely to seek out and use information to inform their health decisions. In this paper we review the evidence about patient activation and information seeking, health behaviors, and health outcomes. We also review what is known about how to increase patient activation, and how best to support patients who are at different levels of activation to use information to support their choices.

DISCUSSION

Strategies can be tailored to support and information for patients at different levels of activation. These strategies might be implemented in different clinical settings and situations, tailored and targeted approaches for care transitions, health coaching, and in the use of shared-decision-making.

CONCLUSIONS

Efforts to support informed consumer choices have largely been a 'one size fits all' approach. Understanding consumers, and trying to meet them where they are, is likely to be the focus of the 'next generation' of interventions to support informed consumer choices.

The association between educational resource utilization and knowledge/self-management among patients with Type 2 Diabetes in Pune, India

AIMS

Patients utilize a variety of sources to learn about their condition. This study assessed the association of these resources with patient knowledge, adherence, and physiologic outcomes.

METHODS

Adults with Type 2 diabetes recruited at an outpatient clinic in Pune, India provided IRB-approved consent and completed surveys measuring diabetes knowledge, self-management, and educational resource utilization. Lab values were obtained from the patient's medical record. Statistical analysis was conducted in SPSS to determine the association between educational resources and outcomes.

RESULTS

We enrolled 82 patients with a mean age of 58.3 years. The most commonly used resource was books/pamphlets. The use of television and books/pamphlets as sources of information was significantly associated with greater knowledge and self-management. Use of books and pamphlets and peers with diabetes was associated with lower fasting and postprandial blood glucose. Regression analyses controlling for age, gender, and years with diabetes revealed that use of newspapers and magazines, books and pamphlets, and television were predictors of overall diabetes knowledge and nutrition knowledge. The use of television as a source of information was a predictor of the hours exercised per week.

CONCLUSIONS

Resources such as books and pamphlets, newspapers and magazines, and television are common ways that people with diabetes learn about their medical conditions. The use of television as a source of information predicted the greatest number of positive outcomes among patients, followed by use of books and pamphlets. These methods should be further explored in order to understand how their benefit may be maximized for patients.

Do Content and Format Affect Older Consumers’ Use of Comparative Information in a Medicare Health Plan Choice? Results from a Controlled Experiment

We assessed the efficacy of materials that integrated comparative information on cost, benefits, and quality for employer-based retiree health plans and Medicare Advantage plans in a randomized experiment to test the impact of content and format. Results indicate that older consumers who received the intervention materials found the materials easier to use, gained greater knowledge about Medicare from them, were more likely to value comparative quality information, were more likely to select higher quality plans, and were more likely to choose a plan that reflected the dimensions they found most important compared to older consumers receiving the control materials.

Analysis of Internet Information on Lateral Lumbar Interbody Fusion

Lateral lumbar interbody fusion (LLIF) is a surgical technique that is being increasingly used. The authors' objective was to examine information on the Internet pertaining to the LLIF technique. An analysis was conducted of publicly accessible websites pertaining to LLIF. The following search engines were used: Google (www.google.com), Bing (www.bing.com), and Yahoo (www.yahoo.com). DuckDuckGo (www.duckduckgo.com) was an additional search engine used due to its emphasis on generating accurate and consistent results while protecting searchers' privacy and reducing advertisements. The top 35 websites providing information on LLIF from the 4 search engines were identified. A total of 140 websites were evaluated. Each web-site was categorized based on authorship (academic, private, medical industry, insurance company, other) and content of information. Using the search term lateral lumbar interbody fusion, 174,000 Google results, 112,000 Yahoo results, and 112,000 Bing results were obtained. DuckDuckGo does not display the number of results found for a search. From the top 140 websites collected from each website, 78 unique websites were identified. Websites were authored by a private medical group in 46.2% of the cases, an academic medical group in 26.9% of the cases, and the biomedical industry in 5.1% of the cases. Sixty-eight percent of websites reported indications, and 24.4% reported contraindications. Benefits of LLIF were reported by 69.2% of websites. Thirty-six percent of websites reported complications of LLIF. Overall, the quality of information regarding LLIF on the Internet is poor. Spine surgeons and spine societies can assist in improving the quality of the information on the Internet regarding LLIF. [Orthopedics. 2016; 39(4):e701-e707.].

Informed Patients and the Internet

This article investigates how individuals’ use of the Internet for finding health information may affect the relationship between health professionals and patients. It explores people's rationales for searching for information online, the information selection process and the implications for doctor–patient interactions. Qualitative interviews were conducted by email with 31 health information seekers. Study findings show the importance of the ‘everyday’ in orientating health information searches and of personal experience in navigating a multiplicity of online sources. Interviewees emphasize the primary role of the doctor–patient relationship for delivering health and medical information, their Internet searches complementing rather than opposing professional expertise.

Teen Smoking Cessation Help Via the Internet: A Survey of Search Engines

The objective of this study was to assess Web sites related to teen smoking cessation on the Internet. Seven Internet search engines were searched using the keywords teen quit smoking. The top 20 hits from each search engine were reviewed and categorized. The keywords teen quit smoking produced between 35 and 400,000 hits depending on the search engine. Of 140 potential hits, 62% were active, unique sites; 85% were listed by only one search engine; and 40% focused on cessation. Findings suggest that legitimate on-line smoking cessation help for teens is constrained by search engine choice and the amount of time teens spend looking through potential sites. Resource listings should be updated regularly. Smoking cessation Web sites need to be picked up on multiple search engine searches. Further evaluation of smoking cessation Web sites need to be conducted to identify the most effective help for teens.

Health Promotion Directory: Development, Distribution, and Utilization

In response to repeated questions from older adults in the community about health resources, a health promotion directory was created. To enhance the development and distribution of the directory, the authors reviewed the literature and received input from unpaid consultants—both health professionals and a diverse group of older adults. To assess the utilization of the directory, the authors obtained a purposive sample, comparing 43 African American older adults, with low income and educational levels, with 118 mostly Anglo American (96%) older adults with a higher educational level. The African American group members were significantly more likely to contact one of the resources listed in the health directory. This may be due to a variety of factors, including the increased contact time that the authors had spent with these older adults or the greater need that older adults with low income and education levels may have for the information in the directory.

How do junior medical officers use online information resources? A survey

BACKGROUND

Online information resources function dually as important learning tools and sources of the latest evidence-based recommendations for junior medical officers (JMOs). However, little is currently known about how JMOs utilise this information when providing care for their patients. This study aimed to examine the usage and experience of online information resources amongst JMOs in South Australia to ascertain (i) the type of resources accessed, (ii) the frequency, (iii) the intended purpose, and (iv) the perceived reliability.

METHODS

A survey instrument using multiple choices, five-point Likert scales and free-text comments was developed and distributed through SurveyMonkey to South Australian JMOs between 1 May 2014 and 30 June 2014.

RESULTS

Of the 142 surveyed, 100 JMOs (70.4%) used online information resources as their first approach over all other resources available. JMOs overwhelmingly (94.4%, n = 134) used online information resources at least once per day, with the most frequent purpose for use being information regarding prescription medication (82.4%, n = 117, reported 'very frequent' use). JMOs stated online resources were necessary to perform their work and, of the different types of information accessed, they rated peer-reviewed resources as the most reliable.

CONCLUSIONS

JMOs strongly rely upon online clinical information in their everyday practice. Importantly, provision of these resources assists JMOs in their education and clinical performance.

Approaches for describing and communicating overall uncertainty in toxicity characterizations: U.S. Environmental Protection Agency's Integrated Risk Information System (IRIS) as a case study

Single point estimates of human health hazard/toxicity values such as a reference dose (RfD) are generally used in chemical hazard and risk assessment programs for assessing potential risks associated with site- or use-specific exposures. The resulting point estimates are often used by risk managers for regulatory decision-making, including standard setting, determination of emission controls, and mitigation of exposures to chemical substances. Risk managers, as well as stakeholders (interested and affected parties), often have limited information regarding assumptions and uncertainty factors in numerical estimates of both hazards and risks. Further, the use of different approaches for addressing uncertainty, which vary in transparency, can lead to a lack of confidence in the scientific underpinning of regulatory decision-making. The overarching goal of this paper, which was developed from an invited participant workshop, is to offer five approaches for presenting toxicity values in a transparent manner in order to improve the understanding, consideration, and informed use of uncertainty by risk assessors, risk managers, and stakeholders. The five approaches for improving the presentation and communication of uncertainty are described using U.S. Environmental Protection Agency's (EPA's) Integrated Risk Information System (IRIS) as a case study. These approaches will ensure transparency in the documentation, development, and use of toxicity values at EPA, the Agency for Toxic Substances and Disease Registry (ATSDR), and other similar assessment programs in the public and private sector. Further empirical testing will help to inform the approaches that will work best for specific audiences and situations.

Monitoring the web to support vaccine coverage: results of two years of the portal VaccinarSì

OBJECTIVES

The increasingly widespread use of the Internet by the population to collect information regarding health and medical treatments and the circulation of many non-scientific documents on the effectiveness and safety of vaccines has led the Italian Society of Hygiene (SItI), in 2013, to promote a portal to provide scientific information that is verified and easily understood to counteract the rampant misinformation on health treatments and combat the phenomenon of vaccine hesitancy.

METHODS

The project was launched in May 2013 and provides a portal with six main sections (vaccine preventable diseases, registered vaccines, benefits and risks of vaccination, against misinformation, pros & cons and travel immunizations) and other headings that relate to scientific events, comics and news coverage concerning vaccines. The contents are validated and evaluated by a scientific committee of high profile scientists and experts in computer-mediated communication.

RESULTS

In the first two years of activity, the portal has published more than 250 web pages on all aspects related to vaccinations. The number of individual users was 860,411, with a constant increase over time. Of these, about 21.7% returned to the website at least once. The total visits in 24 months were 1,099,670, with a total page count of 2,530,416. The frequency of contact was almost exclusively Italian (95.6%), with a higher proportion of males (54.1%) and younger age groups (25-34 years, 33.5%, and18-24 years, 27.5%). The data also show a significant position of the website in the major web search engines. The website has been certified by the Health On the Net Foundation. It is connected with the main social networks and it has recently opened its first regional section (Veneto).

CONCLUSIONS

The strong, progressive increase in web contacts, the involvement of several institutional bodies, and the appreciation of various stakeholders give an absolutely positive assessment of the first two years of the VaccinarSì project. The success of the website suggests future developments, with updates, sections devoted to regional problems, in-depth news analysis, and international expansion. The authors conclude that initiatives like this are to be implemented and constitute an effective way to counteract vaccine hesitancy.

Library and information services: impact on patient care quality

PURPOSE

The purpose of this paper is to explore library and information service impact on patient care quality.

DESIGN/METHODOLOGY/APPROACH

A large-scale critical incident survey of physicians and residents at 56 library sites serving 118 hospitals in the USA and Canada. Respondents were asked to base their answers on a recent incident in which they had used library resources to search for information related to a specific clinical case.

FINDINGS

Of 4,520 respondents, 75 percent said that they definitely or probably handled patient care differently using information obtained through the library. In a multivariate analysis, three summary clinical outcome measures were used as value and impact indicators: first, time saved; second, patient care changes; and third, adverse events avoided. The outcomes were examined in relation to four information access methods: first, asking librarian for assistance; second, performing search in a physical library; third, searching library's web site; or fourth, searching library resources on an institutional intranet. All library access methods had consistently positive relationships with the clinical outcomes, providing evidence that library services have a positive impact on patient care quality.

ORIGINALITY/VALUE

Electronic collections and services provided by the library and the librarian contribute to patient care quality.

Progress of the European Assistive Technology Information Network

The European Assistive Technology Information Network (EASTIN), launched in 2005 as the result of a collaborative EU project, provides information on Assistive Technology products and related material through the website www.eastin.eu. In the past few years several advancements have been implemented on the EASTIN website thanks to the contribution of EU funded projects, including a multilingual query processing component for supporting non expert users, a user rating and comment facility, and a detailed taxonomy for the description of ICT based assistive products. Recently, within the framework of the EU funded project Cloud4All, the EASTIN information system has also been federated with the Unified Listing of assistive products, one of the building blocks of the Global Public Inclusive Infrastructure initiative.

Examining the relationships between resources and online health information seeking among patients with chronic diseases and healthy people

The Internet is increasingly used as an important source of health and medical-related information for people with chronic diseases. It is recognized that online health information seeking (OHIS) is influenced by individuals' multi-dimensional factors, such as demographics, socio-economic factors, perceptions of the Internet, and health conditions. This study applies the conservation of resource theory to examine relationships between various multi-dimensional factors, daily challenges, and OHIS depending on individuals' health conditions. The data used in this study was taken from the U.S. Health Tracking Survey (2012). In this study, Internet users aged 18 and older were classified into patients (N = 518) and healthy people (N = 677) based on their health status related to chronic diseases. Multiple regression analysis was used to examine the relationships between multi-dimensional factors (resources), self-rated health, and OHIS. Patients' various resources (e.g., age, income, education, having a smartphone, and health tracking) significantly predicted their self-rated health and OHIS; in addition, self-rated health significantly mediated the relationships between focal resources and OHIS. However, the mediating effects of self-rated health were not found in healthy people.

Link prediction in complex networks: a mutual information perspective

Topological properties of networks are widely applied to study the link-prediction problem recently. Common Neighbors, for example, is a natural yet efficient framework. Many variants of Common Neighbors have been thus proposed to further boost the discriminative resolution of candidate links. In this paper, we reexamine the role of network topology in predicting missing links from the perspective of information theory, and present a practical approach based on the mutual information of network structures. It not only can improve the prediction accuracy substantially, but also experiences reasonable computing complexity.

Cancer survivors' use of numerous information sources for cancer-related information: does more matter?

A large proportion of the 14 million cancer survivors in the USA are actively seeking health information. This study builds on the informed- and shared-decision making literature, examining cancer survivors' health information seeking behaviors to (1) quantify the number of health information sources used; (2) create a demographic profile of patients who report seeking cancer information from numerous sources versus fewer sources in five areas: cancer information overall, disease/treatment, self-care/management, health services, and work/finances; and (3) examine whether seeking cancer information from numerous sources is associated with self-efficacy, fear of recurrence, perceptions of information seeking difficulty, and resultant patient-provider communication. Data came from a survey of post-treatment cancer survivors (N = 501) who responded to a mailed questionnaire about health information seeking. Participants were divided into two groups using a median split: those who sought health information from more than five sources (numerous source seekers) and those that sought information from less than five sources (fewer source seekers). Multivariable logistic regression was used to model differential information seeking behaviors and outcomes for numerous versus fewer source seekers. On average, survivors sought cancer-related information from five different sources. Numerous source seekers were more likely to be women, have higher levels of education, and report fewer problems with cancer information-seeking. Overall, numerous source seekers were no more or less likely to discuss information with their providers or bring conflicting information to their providers. Understanding the characteristics, behaviors, and experiences of survivors who seek cancer-related information from numerous sources can contribute to informed decision making and patient-centered care.

The Value of Library and Information Services in Nursing and Patient Care

Libraries are a primary resource for evidence-based practice. This study, using a critical incident survey administered to 6,788 nurses at 118 hospitals, sought to explore the influence of nurses' use of library resources on both nursing and patient outcomes. In this article, the authors describe the background events motivating this study, the survey methods used, and the study results. They also discuss their findings, noting that use of library resources showed consistently positive relationships with changing advice given to patients, handling patient care differently, avoiding adverse events, and saving time. The authors discuss the study limitations and conclude that the availability and use of library and information resources and services had a positive impact on nursing and patient outcomes, and that nurse managers play an important role both by encouraging nurses to use evidence-based library resources and services and by supporting the availability of these resources in healthcare settings.

Determinants of modern family planning use among women of reproductive age in the Nkwanta district of Ghana: a case-control study

BACKGROUND

Average contraceptive prevalence rate in the Nkwanta district of Ghana was estimated to be 6.2% relative to the national average at the time, of 19%. While several efforts had been made to improve family planning in the country, the district still had very low use of modern family planning methods. This study sought to determine the factors that influenced modern family planning use in general and specifically, the factors that determined the consistently low use of modern family planning methods in the district.

METHODS

A case-control study was conducted in the Nkwanta district of Ghana to determine socio-economic, socio-cultural and service delivery factors influencing family planning usage. One hundred and thirty cases and 260 controls made up of women aged 15-49 years were interviewed using structured questionnaires. A logistic regression was fitted.

RESULTS

Awareness and knowledge of modern family planning methods were high among cases and controls (over 90%). Lack of formal education among women, socio-cultural beliefs and spousal communication were found to influence modern family planning use. Furthermore, favourable opening hours of the facilities and distance to health facilities influenced the use of modern contraceptives.

CONCLUSION

While modern family planning seemed to be common knowledge among these women, actual use of such contraceptives was limited. There is need to improve use of modern family planning methods in the district. In addition to providing health facilities and consolidating close-to-client service initiatives in the district, policies directed towards improving modern family planning method use need to consider the influence of formal education. Promoting basic education, especially among females, will be a crucial step as the district is faced with high levels of school dropout and illiteracy rates.

Personal cancer knowledge and information seeking through PRISM: the planned risk information seeking model

This study retested PRISM, a model of risk information seeking, and found that it is applicable to the context of cancer risk communication. The study, which used an online sample of 928 U.S. adults, also tested the effect of additional variables on that model and found that the original model better fit the data. Among the strongest predictors of cancer information seeking were seeking-related subjective norms, attitude toward seeking, perceived knowledge insufficiency, and affective risk response. Furthermore, risk perception was a strong predictor of an affective risk response. The authors suggest that, given the robustness across studies, the path between seeking-related subjective norms and seeking intention is ready to be implemented in communication practice.

Why do people Google epilepsy? An infodemiological study of online behavior for epilepsy-related search terms

Millions of people worldwide use the Internet daily as a source of health information. Google is the most popular search engine and is used by patients and physicians to search for online health-related information. This study aimed to evaluate changes in web search behavior occurring in English-speaking countries over time for terms related to epilepsy and epileptic seizures. Using Google Trends, data on global search queries for the terms "epilepsy", "seizure", and "seizures" between January 2004 and September 2013 were analyzed. The reduction over time in search queries for the term "epilepsy" (and, to a lesser extent, "seizures") was counterbalanced by an increased trend in searches for the term "seizure". Most terms associated with the search queries were related to symptoms of seizures, especially tonic-clonic seizures, and to seizures occurring in children. Three peaks in search volume over the period studied corresponded to news of celebrities having seizures. The volume of searches for the term "epilepsy SUDEP" was found to be enormously increased over time. Most people appear to use search engines to look for terms related to epilepsy to obtain information on seizure symptoms, possibly to aid initial self-diagnosis. Fears and worries about epileptic seizures and news on celebrities with epilepsy seem to be major factors that influence online search behavior.

Disparities in human papillomavirus vaccine awareness among U.S. parents of preadolescents and adolescents

BACKGROUND

Improved parental awareness of human papillomavirus (HPV) vaccines could increase uptake of vaccines early in the life course, thereby reducing adolescents' later risk for HPV infection and cancer. As such, we sought to determine factors related to parental awareness of HPV vaccines, using a nationally representative population-based sample.

METHODS

We examined data on 5735 parents of preadolescents and adolescents aged 8 to 17 years from the 2010 National Health Interview Survey. Parents were asked if they had ever heard of HPV vaccines or shots. Multivariable logistic regression analyses were used to examine the odds of parental awareness of HPV vaccines, controlling for relevant covariates.

RESULTS

Most US parents (62.6%) heard of HPV vaccines. Multivariable results revealed parents of children who were older, female, and insured were more likely to have heard of HPV vaccines; parents who were female, white (non-Hispanic), English speakers, born in the United States, married or living with a partner, more educated, and had higher income were also more likely to be aware of HPV vaccines. Notably, parents of children who had a well-child checkup in the last 12 months were significantly more likely to have heard of HPV vaccines (odds ratio, 1.23; 95% confidence interval, 1.04-1.46).

CONCLUSIONS

Given the significant disparities in parental awareness of HPV vaccines, improving access to preventive pediatric health care could offer an opportunity to increase parental awareness. In addition, public health efforts that provide culturally sensitive information in a variety of languages may be an effective way to reach vulnerable groups.

Analysis of the patients and physicians connection network on an online health information platform

Social network applications have gained popularity in the health domain as they bring health information seekers (patients and alike) and medication advice providers (physicians and other relevant actors) together. By employing a network science perspective, this research is aimed to understand an information network establishing connections among and between information seekers and providers. We found that such a connection network surfaces most of the essential characteristics of a typical complex network. Furthermore, a detailed structural analysis shows some intriguing relations and connection behaviours in the network. Implications of the findings are discussed from the perspectives of medical informatics and social network analysis.

Multicultural media outreach: increasing cancer information coverage in minority communities

Ethnic media can serve as an opportunity for cancer education and outreach to minority communities. The National Cancer Institute developed the Multicultural Media Outreach (MMO) program which utilizes an integrated approach of both traditional and social media to disseminate evidence-based cancer education information for minority communities. The MMO program is the contact point for multicultural media outlets seeking evidence-based cancer information, education materials, minority spokespersons, and news tailored to minority communities affected by cancer health disparities. MMO developed Lifelines®, a cancer education series that addresses cancer prevention, treatment, survivorship, clinical trials, and other cancer-related topics for African American, Hispanic, Asian American, American Indian, and Alaska Native audiences. Lifelines® content is disseminated through traditional media (radio, print, and television) as well as social media (web, Twitter, YouTube, and RSS feed). This article describes the MMO program and lessons learned to date.

Management of scientific information with Google Drive

BACKGROUND

The amount and diversity of scientific publications requires a modern management system. By "management" we mean the process of gathering interesting information for the purpose of reading and archiving for quick access in future clinical practice and research activity. In the past, such system required physical existence of a library, either institutional or private. Nowadays in an era dominated by electronic information, it is natural to migrate entire systems to a digital form.

AIM OF THE STUDY

In the following paper we describe the structure and functions of an individual electronic library system (IELiS) for the management of scientific publications based on the Google Drive service.

MATERIAL AND METHODS

Architecture of the system. Architecture system consists of a central element and peripheral devices. Central element of the system is virtual Google Drive provided by Google Inc. Physical elements of the system include: tablet with Android operating system and a personal computer, both with internet access. Required software includes a program to view and edit files in PDF format for mobile devices and another to synchronize the files.

RESULTS

Functioning of the system. The first step in creating a system is collection of scientific papers in PDF format and their analysis. This step is performed most frequently on a tablet. At this stage, after being read, the papers are cataloged in a system of folders and subfolders, according to individual demands. During this stage, but not exclusively, the PDF files are annotated by the reader. This allows the user to quickly track down interesting information in review or research process. Modification of the document title is performed at this stage, as well. Second element of the system is creation of a mirror database in the Google Drive virtual memory. Modified and cataloged papers are synchronized with Google Drive. At this stage, a fully functional scientific information electronic library becomes available online. The third element of the system is a periodic two-way synchronization of data between Google Drive and tablet, as occasional modification of the files with annotation or recataloging may be performed at both locations.

CONCLUSIONS

The system architecture is designed to gather, catalog and analyze scientific publications. All steps are electronic, eliminating paper forms. Indexed files are available for re-reading and modification. The system allows for fast access to full-text search with additional features making research easier. Team collaboration is also possible with full control of user privileges. Particularly important is the safety of collected data. In our opinion, the system exceeds many commercially available applications in terms of functionality and versatility.

Standardized assessment of walking capacity after spinal cord injury: the European network approach

OBJECTIVES

After a spinal cord injury (SCI), walking function is an important outcome measure for rehabilitation and new treatment interventions. The current status of four walking capacity tests that are applied to SCI subjects is presented: the revised walking index for spinal cord injury (WISCI II), the 6 minute walk test (6MinWT), 10 meter walk test (10MWT) and the timed up and go (TUG) test. Then, we investigated which categories of the WISCI II apply to SCI subjects who participated in the European Multicenter Study of Human Spinal Cord Injury (EM-SCI), and the relationship between the 10MWT and the TUG.

METHODS

In the EM-SCI, the walking tests were applied 2 weeks and 1, 3, 6 and 12 months after SCI. We identified the WISCI II categories that applied to the EM-SCI subjects at each time point and quantified the relationship between the 10MWT and the TUG using Spearman's correlation coefficients (rho) and linear regression.

RESULTS

Five WISCI II categories applied to 71% of the EM-SCI subjects with walking ability, while 11 items applied to 11% of the subjects. The 10MWT correlated excellently with the TUG at each time point (rho>0.80). However, this relationship changed over time. One year after SCI, the time needed to accomplish the TUG was 1.25 times greater than the 10MWT time.

DISCUSSION

Some categories of the WISCI II appear to be redundant, while some discriminate to an insufficient degree. In addition, there appear to be ceiling effects, which limit its usefulness. The relationship between the 10MWT and TUG is high, but changes over time. We suggest that, at present, the 10MWT appears to be the best tool to assess walking capacity in SCI subjects. Additional valuable information is provided by assessing the needs for walking aids or personal assistance. To ensure comparability of study results, proposals for standardized instructions are presented.

Drugs on the internet, part III: tobacco and smoking on the web

This study examines the types of tobacco- and smoking-related websites that are available on the Internet. The search terms used were nicotine, tobacco, and cigarette. These terms were searched in the engines Google and Yahoo as well as video-sharing website YouTube and analyzed based on the search engine results pages (SERPs) that were produced. The results returned the following categories of websites: health information and news, smoking cessation, product ads/sales, history of tobacco and smoking, prosmoking/pleasure, smoking prevention/control, and miscellaneous. Results showed fluctuations in the number of search engine results by search term and date. There also was variable quality and availability of informative resources for Internet users due to lack of quality control criteria and regulation.

A longitudinal study on engagement with dieting information as a predictor of dieting behavior among adults diagnosed with cancer

OBJECTIVE

This study explores cancer survivors' engagement with information about dieting to control weight from doctors, interpersonal, and media sources and examines whether engagement from these sources impacts subsequent dieting behavior.

METHODS

A total of 1128 respondents diagnosed with colorectal, breast, or prostate cancers were surveyed over three years following their cancer diagnoses. Using weighted logistic regression analyses, the authors predicted the odds of dieting based on earlier information engagement with sources, controlling for dieting in the previous year and confounders.

RESULTS

Participants reported talking with doctors more frequently (37%) than seeking or scanning from interpersonal and media sources about dieting (15-22%). Seeking from interpersonal and media sources, and discussion with physicians, significantly predicted dieting behavior. In addition, discussions with physicians increased the odds of subsequent dieting behavior by 2.32 times (95% CI: 1.50-3.61; p=.002), over and above the effects of other information engagement.

CONCLUSION

Cancer survivors reported engaging with a variety of information sources about dieting. Engagement with doctors and information-seeking from interpersonal or media sources predicted cancer survivors' dieting behavior a year later.

PRACTICE IMPLICATIONS

The results may inform strategies to encourage and empower cancer survivors to engage with information about healthy lifestyle changes for promoting long-term health.

Evaluation of the Dutch AIDS STI information helpline: differential outcomes of telephone versus online counseling

OBJECTIVE

Health information helplines have an important function in health education, prevention and counseling. Information and help services are increasingly provided online. This study focuses on the differences and similarities between online help services and telephone services.

METHODS

The telephone service of the Dutch AIDS STI helpline was compared to its e-mail equivalent. After consulting the helpline service, both callers and e-mailers (N(tot) = 455) were asked to participate in a survey that evaluated their background characteristics, contacting reasons, and satisfaction with the specific service and information received. The survey also included questions regarding the advice received from the helpline. A follow-up measure 4 weeks after the baseline survey evaluated to what extent clients acted upon the advice.

RESULTS

The study shows that both services are positively evaluated and are equally persuasive in their counseling. Differences between callers and e-mailers were found regarding background characteristics, content of the consultation, satisfaction, and the advice received.

CONCLUSION

It can be concluded that online health information services are an important addition to, but not a replacement for, the traditional telephone helplines.

PRACTICE IMPLICATIONS

In order to provide an optimal health service to a wide public, both online and telephone counseling should be offered.

Adventures in data citation: sorghum genome data exemplifies the new gold standard

Scientific progress is driven by the availability of information, which makes it essential that data be broadly, easily and rapidly accessible to researchers in every field. In addition to being good scientific practice, provision of supporting data in a convenient way increases experimental transparency and improves research efficiency by reducing unnecessary duplication of experiments. There are, however, serious constraints that limit extensive data dissemination. One such constraint is that, despite providing a major foundation of data to the advantage of entire community, data producers rarely receive the credit they deserve for the substantial amount of time and effort they spend creating these resources. In this regard, a formal system that provides recognition for data producers would serve to incentivize them to share more of their data. The process of data citation, in which the data themselves are cited and referenced in journal articles as persistently identifiable bibliographic entities, is a potential way to properly acknowledge data output. The recent publication of several sorghum genomes in Genome Biology is a notable first example of good data citation practice in the field of genomics and demonstrates the practicalities and formatting required for doing so. It also illustrates how effective use of persistent identifiers can augment the submission of data to the current standard scientific repositories.

Outcomes of online support and resources for cancer survivors: a systematic literature review

OBJECTIVE

This study aims to review systematically the available literature on health outcomes of online cancer support and resources.

METHODS

We searched major databases with the following selection criteria: (1) empirical study on use of online support or resources by cancer survivors, (2) reporting effects or outcomes of online support or resources, (3) focusing on adult cancer survivors, and (4) peer-reviewed articles published by 2010.

RESULTS

A total of 24 studies (37 articles) were included in the review. Most studies were focused on breast cancer survivors and had small sample sizes. Fifteen studies employed a cross-sectional design including eight qualitative studies. Only five studies used pre-post design, and four employed RCT design. The outcome measures have focused on psychosocial effects; most studies reported positive effects, although none of the RCT studies reported significant outcomes.

CONCLUSION

Existing studies of online cancer support and resources have demonstrated preliminary but inconclusive evidence for positive outcomes. We call for additional studies with rigorous study designs and the inclusion of more diverse participants and cancer conditions.

PRACTICE IMPLICATIONS

Connecting diverse cancer survivors to culturally appropriate, evidence-based online support and resources is a strategy to enhance health outcomes.

The Italian Helpdesk under the Regulation (EC) No. 1272/2008 (CLP): three-year activity and experience (2009-2011)

INTRODUCTION

The Regulation (EC) No. 1272/2008 on classification, labelling and packaging of substances and mixtures (CLP) sets further obligations for manufacturers, importers, distributors, downstream users of substances either on their own or in mixtures. According to the European mandate, each Member State has constituted its National Helpdesk to provide advice to the interested parties on their duties under this Regulation. In Italy, the contact point for questions has been established at the National Centre for Chemical Substances of the Istituto Superiore di Sanità.

FUNCTIONS

The responders of the Italian CLP Helpdesk process the requests that have been submitted by the dedicated website. Applicants are asked to complete the form with all the required information. The Helpdesk staff also take part in the European network of CLP, REACH and ECHA Helpdesks together with the European Commission and other parties, that is the HelpNet.

RESULTS

The present paper describes the results of the three-year activity of the Italian CLP Helpdesk (2009-2011).

Discussions of cancer clinical trials with the National Cancer Institute's Cancer Information Service

Clinical trials are essential for the development of new and effective treatments for cancer; however, participation rates are low. One reason for this is lack of knowledge about clinical trials. This study assessed how often clinical trials are discussed on calls to National Cancer Institute's Cancer Information Service (CIS). The authors quantitatively analyzed 283,094 calls to the CIS (1-800-4-CANCER) over 3 years (2006-2008). They calculated descriptive statistics and multivariate regressions to determine whether specific caller characteristics are associated with the presence of a clinical trials discussion. In addition, 2 focus groups were conducted with CIS information specialists (n=12) to provide insight into the findings. The authors found that approximately 9.3% of CIS calls discussed clinical trials, with higher percentages for patients (12.5%) and family members (15.4%). Calls with Hispanics, Blacks, and Spanish speakers were less likely to include a conversation. For all cancers, patients who are in treatment or experiencing a recurrence were statistically significantly more likely to discuss clinical trials. CIS information specialists reported callers' limited knowledge of clinical trials. The CIS has the unique ability to make a substantial effect in educating patients about clinical trials as an option in cancer treatment and care.

Lingering questions and doubts: online information-seeking of support forum members following their medical visits

OBJECTIVE

To examine the prevalence and predictors of patients' post-appointment online health information-seeking and the reasons behind their information searches.

METHODS

Survey of 274 Internet support community members who had been seen by a physician within 30 days. The questionnaire included measures of trust in the physician, health worries, changes in amount of worrying following the visit, online health information-seeking, and standard demographic and visit characteristics.

RESULTS

A majority of respondents (68%) went online in search of information after their visits. In a logistic regression analysis, going online was associated with lower trust (P=.002), greater worrying (P=.049), and becoming more (P=.024) or less worried (P=.05) by the visit. Among those who went online, the most common reasons for doing so were sheer curiosity (71%) and disappointment with some aspect of the physician's behavior (32%).

CONCLUSION

Patients in this online forum routinely turned to the Internet after their medical visits, but were especially likely to do so when trust in the physician was low, anxieties were high, and the visit altered (for better or worse) their anxiety levels.

PRACTICE IMPLICATIONS

Since many patients seek online information after their appointments, physicians should suggest credible websites suited to the circumstances of each patient.

Class, race, ethnicity and information needs in post-treatment cancer patients

OBJECTIVE

Health information-seeking behaviors (HISBs) are associated with active participation in cancer care decisions which, in turn, may positively impact health outcomes. The goal of this study was to develop a taxonomy of topics for which post-treatment cancer patients sought information, and to explore HISB patterns by sociodemographic factors and cancer type.

METHODS

We examined how health information seeking is associated with social determinants in a survey of 521 post-treatment cancer patients.

RESULTS

Four major topics of interest were found: disease/treatment, self-care management, health services, and work/finance. Assessment of the relationship between social determinants and these four topics showed associations for (1) HISBs on disease/treatment topics decreased with age and increased with education; (2) HISBs on self-care management increased with education and varied by cancer type; (3) HISBs on health services increased with education; and (4) HISBs on work/finance decreased with age and wealth, but increased with debt.

CONCLUSION

These results demonstrate one pathway through which social determinants may drive communication inequalities, which may result in increased disparities in health outcomes.

PRACTICE IMPLICATIONS

Further exploration of the relationship between social determinants and information-seeking among post-treatment cancer patients may contribute to the development of strategies to reduce health disparities.

Rural-urban differences in discussions of cancer treatment clinical trials

OBJECTIVE

Compare the characteristics of rural and urban callers to NCI's Cancer Information Service (CIS), and explore the association of geographic location and discussion of cancer clinical trials.

METHODS

Using CIS call data from 2006 to 2008, we assigned a rural or urban designation to caller ZIP codes using Rural-Urban Commuting Area Codes. Calls which discussed clinical trials were analyzed using univariate and multivariate analyses.

RESULTS

The CIS received 227,579 calls from 2006 to 2008 where geographic location could be determined. Overall, 10.3% of calls included a discussion of clinical trials; there were significantly more discussions among urban dwellers than rural individuals (10.5% versus 9.4%, respectively). Multivariate regression analyses supported the univariate findings. In addition, compared to other callers, patients (OR 5.58 [95% CI: 4.88, 6.39]) and family and friends (6.26 [5.48, 71.5]) were significantly more likely to discuss clinical trials.

CONCLUSION

Urban callers were more likely than their rural counterparts to discuss cancer treatment trials, placing individuals living in rural areas at a disadvantage in learning about and communicating with their providers about possible participation in clinical trials.

PRACTICE IMPLICATIONS

Through its multiple access points, the CIS can serve as an important source of clinical trials information for rural cancer patients, family members, and providers.

Inquiring minds acquiring wellness: uses of online and offline sources for health information

Variation in ability to access and use health information is a key pathway through which social status may impact health. Digital media offer new opportunities for health information seeking, potentially lowering barriers to such content. Using a data set with nuanced information about what sources a diverse group of college students consults for different types of health material, coupled with detailed measures of Internet experiences, this article explores factors related to where young adults turn for health content. Results suggest considerable sex differences in practices across sources of health information. We also find differences in Hispanic students' actions based on parents' country of origin across sources. Finally, challenging assumptions about the universal savvy of young adults, findings suggest that those who are more highly skilled with the Internet are more likely to use it for health information seeking, and Internet experiences are especially important for explaining who turns to online discussions in this realm. Our findings not only contribute to a better understanding of health information seeking and health inequality, but also point to possible sites of intervention to ameliorate health disparities.