#Healthcare: Patient and Family Uses and Perceptions of Health Care Social Media.

BACKGROUND/INTRODUCTION: Although social media is becoming a primary resource for information and support in all aspects of life, including health care, limited information is available describing social media use in parents whose child undergoes surgical care. OBJECTIVES/AIMS: The aims of this study were to describe how patients/families use social media to address health care needs and understand their perceptions of social media privacy and reliability. METHODS: A descriptive survey of 39 questions, both fixed choice and open ended, was distributed to a convenience sample of parents during their child's preoperative visit. Descriptive statistics were used to summarize fixed-choice responses. Content analysis was used to assess open-ended responses and comments. RESULTS: A total of 205 completed surveys were available for review. Overall, 195 (95.6%) reported using social media, with 70 (35%) using social media up to 5 times a day and another 61 (30.5%) using it 6 to 40 times a day. Respondents used social media for medical information (122/60.1%), to make health care decisions (53/26.5%), after a diagnosis (104/52%), after a medical visit (88/44%), and to update friends and family (129/65.5%). Most respondents were undecided (111/58.1%) when asked how reliable medical information was on social media sites, with 33 (17.3%) believing medical information to be "reliable to very reliable" on social media sites. Among the 61 comments received, 4 themes emerged: Spectrum of Social Media Use, Social Media and Health Care Interaction, Social Media as a Source of Support and Peer Experience, and Reliability of Social Media. DISCUSSION: Most respondents utilized social media for health care information while reporting feeling undecided on the reliability of the information. Understanding the multiple ways patients and families utilize social media provides health care members opportunities to discuss medical information, inform health care decision making, and support patient and family needs.

Twelve-Month Follow-Up to a Fully Automated Internet-Based Cognitive Behavior Therapy Intervention for Rural Adults With Depression Symptoms: Single-Arm Longitudinal Study.

BACKGROUND: Internet-based cognitive behavior therapy (iCBT) interventions have the potential to help individuals with depression, regardless of time and location. Yet, limited information exists on the longer-term (>6 months) effects of iCBT and adherence to these interventions. OBJECTIVE: The primary aim of this study was to evaluate the longitudinal (12 months) effectiveness of a fully automated, self-guided iCBT intervention called Thrive, designed to enhance engagement with a rural population of adults with depression symptoms. The secondary aim was to determine whether the program adherence enhanced the effectiveness of the Thrive intervention. METHODS: We analyzed data from 181 adults who used the Thrive intervention. Using self-reports, participants were evaluated at baseline, 8 weeks, 6 months, and 12 months for the primary outcome of depression symptom severity using the Patient Health Questionnaire-9 (PHQ-9) scale and secondary outcome measures, namely, the Generalized Anxiety Disorder Scale-7 (GAD-7) scores, Work and Social Adjustment Scale (WSAS) scores, Conner-Davidson Resilience Scale-10 (CD-RISC-10) scores, and suicidal ideation (ninth item of the PHQ-9 scale) scores. The Thrive program adherence was measured using the numbers of program logins, page views, and lessons completed. RESULTS: The assessment response rates for 8-week, 6-month, and 12-month outcomes were 58.6% (106/181), 50.3% (91/181), and 51.4% (93/181), respectively. By 8 weeks, significant improvements were observed for all outcome measures. These improvements were maintained at 12 months with mean reductions in severities of depression (mean -6.5; P<.001) and anxiety symptoms (mean -4.3; P<.001). Improvements were also observed in work and social functioning (mean -6.9; P<.001) and resilience (mean 4.3; P<.001). Marked decreases were observed in suicidal ideation (PHQ-9 ninth item score >1) at 6 months (16.5%) and 12 months (17.2%) compared to baseline (39.8%) (P<.001). In regard to the program adherence, cumulative counts of page views and lessons completed were significantly related to lower PHQ-9, GAD-7, and WSAS scores and higher CD-RISC-10 scores (all P values <.001 with an exception of page views with WSAS for which P value was .02). CONCLUSIONS: The Thrive intervention was effective at reducing depression and anxiety symptom severity and improving functioning and resilience among a population of adults from mostly rural communities in the United States. These gains were maintained at 1 year. Program adherence, measured by the number of logins and lessons completed, indicates that users who engage more with the program benefit more from the intervention. TRIAL REGISTRATION: ClinicalTrials.gov NCT03244878; https://clinicaltrials.gov/ct2/show/NCT03244878.

Correction: Twelve-Month Follow-Up to a Fully Automated Internet-Based Cognitive Behavior Therapy Intervention for Rural Adults With Depression Symptoms: Single-Arm Longitudinal Study.

[This corrects the article DOI: 10.2196/21336.].

Pausing With the Gauze: Inhibition of Temporary Pacemakers by Radiofrequency Scan During Cardiac Surgery.

BACKGROUND: Radiofrequency identification (RFID) detection systems are used to detect retained surgical sponges and may cause electromagnetic interference (EMI), altering intended function of cardiac pacing systems. Three pediatric patients requiring temporary pacing for postoperative atrioventricular block experienced transient inhibition of ventricular pacing during the use of RFID detection system. Bench testing was performed to evaluate the mechanism of pacemaker inhibition. METHODS: Impedance of temporary pacing wires was obtained using a pacing system analyzer. Temporary pacemakers (Medtronic 5388, Medtronic 5392, and Biotronik Reocor D) at nominal settings (VVI 120 bpm, output 10 mA) were attached at the ventricular terminal to temporary pacing wires and a resistor for sham impedance in physiologic range. An RFID detection system and wand (RF Assure, model 200) or mat was tested over wires. Induced current and voltages were recorded via an oscilloscope attached to lead terminals. Inhibition of pacing was determined for the following variables: distance from wires, sham impedance, and programmed sensitivity. RESULTS: In bench testing, the RFID system induced a stereotyped EMI signal in temporary pacing wires with peak root-mean-square voltage demonstrating an exponential decay relationship with increasing distance from pacing wires. Induced voltages overlapped with normal sensing range of temporary pacemakers, resulting in pacemaker inhibition at nominal settings (ventricular sensitivity 2.0 mV, distance from wand <23 cm). Increasing height, decreasing device sensitivity, or increasing sham impedance (at fixed sensitivity) attenuated EMI and inhibition for all 3 temporary pacemakers used and with the automated RFID detection mat in place of the wand. Programming pacemakers asynchronously prevented inhibition. CONCLUSIONS: Normal operation of RFID detection systems may cause inhibition of temporary pacing systems consistent with oversensing from EMI. Precaution should be taken, including considering pacing asynchronously to avoid effects of inhibition.

Assessing accuracy of measurements for a Wingate Test using the Taguchi method.

The purpose of this study was to establish the effects of four variables on the results obtained for a Wingate Anaerobic Test (WAnT). This study used a 30 second WAnT and compared data collection and analysed in different ways in order to form conclusions as to the relative importance of the variables on the results. Data was collected simultaneously by a commercially available software correction system manufactured by Cranlea Ltd., (Birmingham, England) system and an alternative method of data collection which involves the direct measurement of the flywheel velocity and the brake force. Data was compared using a design of experiments technique, the Taguchi method. Four variables were examined - flywheel speed, braking force, moment of inertia of the flywheel, and time intervals over which the work and power were calculated. The choice of time interval was identified as the most influential variable on the results. While the other factors have an influence on the results, the decreased time interval over which the data is averaged gave 9.8% increase in work done, 40.75% increase in peak power and 13.1% increase in mean power.

Accurate assessment of work done and power during a Wingate anaerobic test.

A Monark cycle ergometer is used in physiological studies to measure work done and power. In this paper, the accuracy of a Monark rope-braked cycle ergometer was examined for a Wingate anaerobic test (WAnT). The traditional method of determining brake torque fails to take into account rope-brake theory and, as the brake torque is used to determine the moment of inertia of the flywheel, a second error is introduced into the calculation to determine the work done or power. In this study, the rope tensions were measured to determine the actual brake torque. A deceleration test was carried out to determine the moment of inertia of the system. The work done by subjects of different masses was calculated for various accelerations and it was found that the traditional calculations overestimate work done and power by between 12% and 14.7%.

Determination of aerobic work and power on a rope-braked cycle ergometer by direct measurement.

The purpose of this study was to compare the power and work outputs of a cycle ergometer using the manufacturer's guidelines, with calculations using direct flywheel velocity and brake torque. A further aim was to compare the values obtained with those supplied by the manufacturer. A group of 10 male participants were asked to pedal a Monark 824E ergometer at a constant cadence of 60 r/min for a period of 3 min against a resistive mass of 3 kg. The flywheel velocity was measured using a tachometer. The brake force was determined by measuring the tension in the rope on either side of the flywheel. The calculated mean power was 147.45 +/- 6.5 W compared with the Monark value of 183 +/- 3.7 W. The difference between the methods for power estimation was 18% and was statistically significant (p < 0.01). The mean work done by the participants during the 3 min period was found to be 26 460 +/- 1145 J compared with the Monark value of 33,067 +/- 648 J (p < 0.01). The Monark formulae currently used to determine the power and work done by a participant overestimates the actual values required to overcome the resistance. There findings have far-reaching implications in the physiological assessment of athletic, sedentary, and diseased populations.

Mechanics of a rope-braked cycle ergometer flywheel and its use for physiological measurement.

The cycle ergometer is one of the main tools used by physiologists in studies involving the measurement of work or power against physiological criteria. The current mechanical analysis of a Monark 824E rope-braked ergometer is based on a simplified approach. In this study a detailed analysis of the system is adopted to increase understanding. The mechanics of the ergometer flywheel are explained using data generated experimentally and the detailed components of the values of work that comprise the total work done by a subject are discussed. The total work done by a subject in 2.5 minutes at a speed of 60 rpm against a brake mass of 3 kg was 23,034 J compared with the value of 27,000 J that normally would be attributed using the traditional calculations. This 15% difference is mainly due to the incorrect assumption that the brake load is the force due to the basket mass.