YouTube as a Source of Patient Information Regarding Placenta Accreta Spectrum.

OBJECTIVE: As the awareness of the accompanying morbidity of placenta accreta spectrum (PAS) has increased over recent decades. We sought to analyze the precision and reliability of the currently available content regarding PAS on YouTube. STUDY DESIGN: A YouTube search was performed on June 17, 2019 by using the search terms "placenta accreta," "PAS," and "invasive placentation." Search results were sorted by relevance, and up to 200 videos per search term were systematically evaluated by four independent reviewers. A quality assessment checklist relating to aspects of PAS was developed with a Likert's scale from 0 to 12 points to quantify video content. Videos were classified as poor educational quality (grade 0 to ≤4), moderate quality (grade >4-8), and high quality (grade >8-12). RESULTS: Of the 318 videos identified, 99 videos met inclusion criteria. The majority of videos (61.6%) were produced by a professional source, that is, appearing to be from a hospital, university, or educational service. Of the remaining videos, 16.2% were classified as personal, that is, posted from personal YouTube accounts and depicting a personal or family member experience, and 22.2% were classified as other. The majority of the "other" category consisted of news segments and short clips from talk shows. Overall, 60.6% of videos were of poor educational quality, 32.3% were of moderate quality, and 7.1% were deemed high quality. All seven of the high-quality videos were produced by a professional source and intended for an audience of medical professionals. There were neither high-quality videos intended for the general public nor the likely affected and relevant patient population. CONCLUSION: This study suggests that the currently available videos on YouTube regarding PAS are poor educational sources for patients seeking information, and demonstrates a need for high-quality content videos produced by medical professionals specifically focused on meeting the needs of patient population. KEY POINTS: · Awareness of the accompanying morbidity of placenta accreta spectrum has increased over recent decades.. · YouTube videos are poor educational sources for patients seeking information regarding PAS.. · YouTube videos and all social media warrant improvements regarding patient's information..

YouTube as a Source of Patient Information for Prenatal Repair of Myelomeningocele.

OBJECTIVE: With the increasing interest in fetal repair of myelomeningoceles (MMCs) over the last decade, it is reasonable to anticipate the need for high quality and accessible educational materials for patients. Patients often look to the internet for details regarding medical topics and specifically to YouTube for informative health-related videos. This study aims to analyze the content and shortcomings of currently available videos on YouTube regarding prenatal repair of MMCs. STUDY DESIGN: A YouTube search was performed on December 15, 2018, using the terms "fetoscopic surgery for neural tube defect" and "fetal surgery for neural tube defect." The first 50 videos from each search were sorted by relevance and evaluated for video source (i.e., professional, personal, or other), target audience (medical professionals or general public), general descriptive statistics (i.e., video length, number of views, number of comments), and for five areas of content determined by the authors to constitute basic patient information regarding a surgical procedure: (1) procedure details, (2) eligibility criteria, (3) alternatives to surgery, (4) surgical risks, and (5) success rate. Accuracy of videos was not assessed. RESULTS: Of the 16 videos that met inclusion criteria, only 1 discussed fetoscopic surgery. The majority (62.5%) of videos were produced by a professional source and 81.3% were targeted toward the general public rather than medical professionals. Of the 16 videos, 10 (62.5%) included details regarding the surgery, 3 (18.8%) discussed eligibility criteria, and 8 (50.0%) mentioned alternatives to surgery. Additionally, seven videos (43.8%) discussed risks of the procedure and six (37.5%) included surgical success rate. CONCLUSION: Only 2 of the 16 videos included all five areas of content that were evaluated, and both were in regard to open fetal repair. This study not only calls attention to the initial shortcomings of YouTube videos regarding fetal surgery for neural tube defects but also demonstrates the need for further investigation and more comprehensive analysis.

Infantile Pyknocytosis: An Uncommon Cause of Newborn Hemolytic Anemia.

Infantile pyknocytosis is a rare cause of neonatal hemolytic anemia, which presents in the first few weeks of life. We report a classic case of infantile pyknocytosis that presented to our institution with rebound hyperbilirubinemia after receiving phototherapy. The infant was found to have a hemoglobin of 5.8 g/dL, requiring a total of 15 mL/kg of red blood cells (in 2 separate transfusions) before discharge. The diagnosis was ultimately made by a review of the peripheral blood smear. We review the literature and suggest pediatricians consider infantile pyknocytosis on their differential when hemolytic anemia presents in the newborn period.

[Promotion of health rights in Peru: an approach from the perspective of The Peruvian National Health Authority]. / Promoción de los derechos en salud en Perú: una aproximación desde la perspectiva de acción de la Superintendencia Nacional de Salud.

In Peru, The National Health Authority (SUSALUD) is granted the responsibility to promote, protect and defend the health rights of every citizen. However, in the Peruvian Health System (PHS) there exists an insufficient culture of health rights, a low level of knowledge of health rights by the population, and a limited degree of cooperation between users, providers and funders. In light of this limited popular participation in the health rights of the citizenry, it has been necessary for SUSALUD to pursue various activities in order to promote the exercise of health rights by Peruvians. Among the strategies implemented are the development of Organized Boards of Users (OBU) and a Program of Integrated Actions for the Promotion of Health Rights (PIAPHI). The aim of both interventions is to increase the level of trust between citizens and government, which fosters and strengthens the capacity of citizens to pursue their health rights. In this article we begin with a brief presentation on the state of knowledge, attitudes and practices of users of the health system regarding their rights. Then we explain both programs, their goals and procedures, and a general description of their activities. Also, some indicators of process and some results are presented along with discussion and future prospects. We believe that the gradual implementation of the OBU and PIAPHI programs will enhance the participation of Peruvians in their health system, and will contribute positively to their empowerment and the pursuit of their health rights.

Promoción de los derechos en salud en Perú: una aproximación desde la perspectiva de acción de la Superintendencia Nacional de Salud / Promotion of health rights in Peru: an approach from the perspective of The Peruvian National Health Authority

RESUMEN En Perú, la Superintendencia Nacional de Salud (SUSALUD) tiene la responsabilidad de promover, proteger y defender los derechos en salud (DES) de cada peruano. No obstante, la existencia de una cultura deficiente en materia de DES, el escaso conocimiento de la población sobre sus DES, las reducidas acciones de cooperación entre usuarios, prestadores y financiadores, así como, la restringida participación ciudadana, son condiciones frecuentes en el sistema de salud peruano (SSP). Ese contexto ha demandado la puesta en marcha de distintas acciones por parte de SUSALUD, dentro de las cuales se encuentran el desarrollo de las juntas de usuarios de los servicios de salud (JUS) y del Programa de Acciones Integradas para la Promoción de los Derechos en Salud (PAIPDES-SUSALUD). Ambas intervenciones pretenden incrementar el grado de confianza entre la ciudadanía y el Estado, lo cual amplía y fortalece las competencias para el ejercicio de los DES por parte de los ciudadanos. El presente artículo parte con una exposición breve acerca del estado de los conocimientos, actitudes y prácticas de los usuarios de los servicios de salud del SSP respecto a los DES. Luego, se explican de modo global ambos programas, presentándose sus objetivos y pautas generales, una descripción genérica de sus contenidos; asimismo, se exhiben algunos indicadores de proceso y resultado, para, finalmente, ofrecer una discusión y perspectivas sobre el particular. Se considera que la implementación gradual de las JUS y el PAIDPDES-SUSALUD impulsan la consolidación de la participación social en salud en el SSP y contribuyen favorablemente al empoderamiento del ciudadano como constituyente clave en la arena de los DES en Perú.

ABSTRACT In Peru, The National Health Authority (SUSALUD) is granted the responsibility to promote, protect and defend the health rights of every citizen. However, in the Peruvian Health System (PHS) there exists an insufficient culture of health rights, a low level of knowledge of health rights by the population, and a limited degree of cooperation between users, providers and funders. In light of this limited popular participation in the health rights of the citizenry, it has been necessary for SUSALUD to pursue various activities in order to promote the exercise of health rights by Peruvians. Among the strategies implemented are the development of Organized Boards of Users (OBU) and a Program of Integrated Actions for the Promotion of Health Rights (PIAPHI). The aim of both interventions is to increase the level of trust between citizens and government, which fosters and strengthens the capacity of citizens to pursue their health rights. In this article we begin with a brief presentation on the state of knowledge, attitudes and practices of users of the health system regarding their rights. Then we explain both programs, their goals and procedures, and a general description of their activities. Also, some indicators of process and some results are presented along with discussion and future prospects. We believe that the gradual implementation of the OBU and PIAPHI programs will enhance the participation of Peruvians in their health system, and will contribute positively to their empowerment and the pursuit of their health rights.