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Frontiers in Public Health 2024Digital health literacy (DHL) is a key competency for individuals' daily decisions toward their health behavior and wellbeing. While there is much focus on health...
INTRODUCTION
Digital health literacy (DHL) is a key competency for individuals' daily decisions toward their health behavior and wellbeing. While there is much focus on health literacy (HL) among the general population, teachers have been rarely addressed. Given the shortages in the teaching workforce in Europe and the impact of demanding working conditions on their health, it is important to address DHL in teachers. This paper examines the DHL of primary and secondary teachers and its associations with sociodemographic and school-related factors.
METHODS
An online cross-sectional study was conducted with 1,600 German primary and secondary school teachers between October and December 2022. To assess DHL, the Digital Health Literacy Instrument (DHLI) including seven subscales was used. Statistical analyses were conducted on item and subscale level and an overall DHL score was calculated. Next to descriptive analyses, bivariate and regression analyses were conducted to explore potential associations with sociodemographic and school-related factors.
RESULTS
The frequency of difficulty in using digital health information varied across DHL dimensions and was greatest for (70.9%) and (40.0%). In multivariate analysis, females more often reported a sufficient ability of (OR = 1.61, CI = 1.05-2.48), while males more often reported a sufficient ability to (OR = 0.45, CI = 0.27-0.75). Teachers with leadership positions more often reported a sufficient ability in (OR = 1.78, CI = 1.07-2.98). Regarding the ability to of online health-related information, no associations with a predictor variable were found.
DISCUSSION
The results suggest that it is important to examine the individual dimensions of DHL and their distinct associations with sociodemographic and school-level factors, rather than just to rely on the overall level of DHL. The differential patterns identified in this study suggest a greater intervention need for teachers from higher age groups, primary and secondary general schools, and those without leadership roles. However, based on the limited predictive power of the variables included, further individual and school-level factors and their potential association with DHL should be investigated in the future. The promotion of DHL should be integrated into both teacher education and in-service training.
Topics: Humans; School Teachers; Male; Female; Health Literacy; Cross-Sectional Studies; Adult; Middle Aged; Germany; Surveys and Questionnaires; Schools
PubMed: 38912263
DOI: 10.3389/fpubh.2024.1334263 -
Risk Management and Healthcare Policy 2024Growing cyberattacks have made it more challenging to maintain healthcare information system (HIS) security in medical institutes, especially for hospitals that provide...
BACKGROUND
Growing cyberattacks have made it more challenging to maintain healthcare information system (HIS) security in medical institutes, especially for hospitals that provide patient portals to access patient information, such as electronic health record (EHR).
OBJECTIVE
This work aims to evaluate the patient portal security risk of Taiwan's EEC (EMR Exchange Center) member hospitals and analyze the association between patient portal security, hospital location, contract category and hospital type.
METHODS
We first collected the basic information of EEC member hospitals, including hospital location, contract category and hospital type. Then, the patient portal security of individual hospitals was evaluated by a well-known vulnerability scanner, UPGUARD, to assess website if vulnerable to high-level attacks such as denial of service attacks or ransomware attacks. Based on their UPSCAN scores, hospitals were classified into four security ratings: absolute low risk, low to medium risk, medium to high risk and high risk. Finally, the associations between security rating, contract category and hospital type were analyzed using chi-square tests.
RESULTS
We surveyed a total of 373 EEC member hospitals. Among them, 20 hospital patient portals were rated as "absolute low risk", 104 hospital patient portals as "low to medium risk", 99 hospital patient portals as "medium to high risk" and 150 hospital patient portals as "high risk". Further investigation revealed that the patient portal security of EEC member hospitals was significantly associated with the contract category and hospital type (<0.001).
CONCLUSION
The analysis results showed that large-scale hospitals generally had higher security levels, implying that the security of low-tier and small-scale hospitals may warrant reinforcement or strengthening. We suggest that hospitals should pay attention to the security risk assessment of their patient portals to preserve patient information privacy.
PubMed: 38910900
DOI: 10.2147/RMHP.S463408 -
Proceedings (Baylor University. Medical... 2024Colorectal cancer (CRC) presents significant mortality risks, underscoring the urgency of timely diagnosis and intervention. Advanced stages of CRC are managed through...
Colorectal cancer (CRC) presents significant mortality risks, underscoring the urgency of timely diagnosis and intervention. Advanced stages of CRC are managed through chemotherapy, targeted therapy, immunotherapy, radiotherapy, and surgery. Immunotherapy, while effective in bolstering the immune system against cancer cells, often carries toxic side effects, including colitis. This study aimed to evaluate the incidence of colitis in patients with metastatic CRC (mCRC) undergoing various immunotherapy treatments. Through a systematic search of Google Scholar and PubMed databases from inception until November 2023, nine relevant studies were identified. Subgroup analyses revealed a higher incidence of colitis, particularly in patients treated with anti-cytotoxic T-lymphocyte-associated molecule-4 (anti-CTLA-4) and combination therapies compared to monotherapy with programmed cell death receptor-1 (PD-1) or programmed cell death ligand receptor-1 (PDL-1) inhibitors. Notably, naive-treated metastatic CRC patients exhibited elevated colitis incidences compared to those previously treated. In conclusion, anti-CTLA-4 and combination therapies, such as nivolumab plus ipilimumab, were associated with increased colitis occurrences in metastatic CRC patients, highlighting the need for vigilant monitoring and management strategies, especially in immunotherapy-naive individuals.
PubMed: 38910824
DOI: 10.1080/08998280.2024.2342723 -
BMJ Open Jun 2024Sub-Saharan Africa (SSA) regions have the highest burden of cervical cancer (CC), accounting for nearly a quarter of global mortality. Many women in SSA are reluctant to...
INTRODUCTION
Sub-Saharan Africa (SSA) regions have the highest burden of cervical cancer (CC), accounting for nearly a quarter of global mortality. Many women in SSA are reluctant to access CC screening because they are uncomfortable exposing their private parts to healthcare providers. The perception of women who have experienced self-sampling in SSA is yet to be reviewed. This scoping review will explore the literature on the perception and attitude of women towards methods of collecting cervicovaginal samples for human papillomavirus (HPV) testing in SSA.
METHODS AND ANALYSIS
An extensive search using the Arksey and O'Malley framework will be conducted. The search criteria will be limited to original research conducted in community or clinical settings in SSA within the last 10 years. Four databases, namely, PUBMED, Cochrane, African Journals Online and Google Scholar, will be searched. Two independent persons (UIAB and DOO) will screen the titles and abstracts and later full texts using population, intervention, comparison and outcome criteria. IOMB will serve as a tiebreaker whenever there is no agreement on the choice of eligibility criteria. The screening process will be presented using Preferred Reporting Items for Systematic Reviews and Meta-Analyses for the scoping review flow format. The descriptive analysis of eligible studies for scoping reviews will be summarised. We will describe themes of attitude and perception covering pain, embarrassment, privacy and comfortability, willingness to self-sample, anxiety and confidence.
ETHICS AND DISSEMINATION
This is a scoping review protocol and does not require ethical approval. Findings from this review will be disseminated through peer-reviewed publications, the production of policy briefs, and presentations at local and international conferences.
Topics: Humans; Female; Africa South of the Sahara; Papillomavirus Infections; Uterine Cervical Neoplasms; Specimen Handling; Research Design; Early Detection of Cancer; Vaginal Smears; Papillomaviridae; Review Literature as Topic; Mass Screening; Human Papillomavirus Viruses
PubMed: 38910004
DOI: 10.1136/bmjopen-2024-085408 -
Journal of the American Medical... Jun 2024This article proposes a framework for examining the ethical and legal concerns for using artificial intelligence (AI) in post-acute and long-term care (PA-LTC). It...
This article proposes a framework for examining the ethical and legal concerns for using artificial intelligence (AI) in post-acute and long-term care (PA-LTC). It argues that established frameworks on health, AI, and the law should be adapted to specific care contexts. For residents in PA-LTC, their social, psychological, and mobility needs should act as a gauge for examining the benefits and risks of integrating AI into their care. Using those needs as a gauge, 4 areas of particular concern are identified. First, the threat that AI poses to the autonomy of residents can undermine their core needs. Second, how discrimination and bias in algorithmic decision-making can undermine Medicare coverage for PA-LTC, causing doctors' recommendations to be ignored and denying residents the care they are entitled to. Third, privacy rules concerning data use may undermine developers' ability to train accurate AI systems, limiting their usefulness in PA-LTC contexts. Fourth, the importance of obtaining consent before AI is used and discussions about how that care should continue if there are concerns about an ongoing decline in cognition. Together, these considerations elevate existing frameworks and adapt them to the context-specific case of PA-LTC. It is hoped that future research will examine the legal implications of these matters in each of these specific cases.
PubMed: 38909630
DOI: 10.1016/j.jamda.2024.105105 -
BMC Medical Research Methodology Jun 2024Generating synthetic patient data is crucial for medical research, but common approaches build up on black-box models which do not allow for expert verification or...
BACKGROUND
Generating synthetic patient data is crucial for medical research, but common approaches build up on black-box models which do not allow for expert verification or intervention. We propose a highly available method which enables synthetic data generation from real patient records in a privacy preserving and compliant fashion, is interpretable and allows for expert intervention.
METHODS
Our approach ties together two established tools in medical informatics, namely OMOP as a data standard for electronic health records and Synthea as a data synthetization method. For this study, data pipelines were built which extract data from OMOP, convert them into time series format, learn temporal rules by 2 statistical algorithms (Markov chain, TARM) and 3 algorithms of causal discovery (DYNOTEARS, J-PCMCI+, LiNGAM) and map the outputs into Synthea graphs. The graphs are evaluated quantitatively by their individual and relative complexity and qualitatively by medical experts.
RESULTS
The algorithms were found to learn qualitatively and quantitatively different graph representations. Whereas the Markov chain results in extremely large graphs, TARM, DYNOTEARS, and J-PCMCI+ were found to reduce the data dimension during learning. The MultiGroupDirect LiNGAM algorithm was found to not be applicable to the problem statement at hand.
CONCLUSION
Only TARM and DYNOTEARS are practical algorithms for real-world data in this use case. As causal discovery is a method to debias purely statistical relationships, the gradient-based causal discovery algorithm DYNOTEARS was found to be most suitable.
Topics: Humans; Algorithms; Electronic Health Records; Markov Chains; Medical Informatics
PubMed: 38909216
DOI: 10.1186/s12874-024-02257-8 -
Scientific Reports Jun 2024Access to individual-level health data is essential for gaining new insights and advancing science. In particular, modern methods based on artificial intelligence rely...
Access to individual-level health data is essential for gaining new insights and advancing science. In particular, modern methods based on artificial intelligence rely on the availability of and access to large datasets. In the health sector, access to individual-level data is often challenging due to privacy concerns. A promising alternative is the generation of fully synthetic data, i.e., data generated through a randomised process that have similar statistical properties as the original data, but do not have a one-to-one correspondence with the original individual-level records. In this study, we use a state-of-the-art synthetic data generation method and perform in-depth quality analyses of the generated data for a specific use case in the field of nutrition. We demonstrate the need for careful analyses of synthetic data that go beyond descriptive statistics and provide valuable insights into how to realise the full potential of synthetic datasets. By extending the methods, but also by thoroughly analysing the effects of sampling from a trained model, we are able to largely reproduce significant real-world analysis results in the chosen use case.
Topics: Humans; Longitudinal Studies; Data Analysis; Artificial Intelligence
PubMed: 38909025
DOI: 10.1038/s41598-024-62102-2 -
JMIR MHealth and UHealth Jun 2024Hospital apps are increasingly being adopted in many countries, especially since the start of the COVID-19 pandemic. Web-based hospitals can provide valuable medical...
BACKGROUND
Hospital apps are increasingly being adopted in many countries, especially since the start of the COVID-19 pandemic. Web-based hospitals can provide valuable medical services and enhanced accessibility. However, increasing concerns about personal information (PI) and strict legal compliance requirements necessitate privacy assessments for these platforms. Guided by the theory of contextual integrity, this study investigates the regulatory compliance of privacy policies for internet hospital apps in the mainland of China.
OBJECTIVE
In this paper, we aim to evaluate the regulatory compliance of privacy policies of internet hospital apps in the mainland of China and offer recommendations for improvement.
METHODS
We obtained 59 internet hospital apps on November 7, 2023, and reviewed 52 privacy policies available between November 8 and 23, 2023. We developed a 3-level indicator scale based on the information processing activities, as stipulated in relevant regulations. The scale comprised 7 level-1 indicators, 26 level-2 indicators, and 70 level-3 indicators.
RESULTS
The mean compliance score of the 52 assessed apps was 73/100 (SD 22.4%), revealing a varied spectrum of compliance. Sensitive PI protection compliance (mean 73.9%, SD 24.2%) lagged behind general PI protection (mean 90.4%, SD 14.7%), with only 12 apps requiring separate consent for processing sensitive PI (mean 73.9%, SD 24.2%). Although most apps (n=41, 79%) committed to supervising subcontractors, only a quarter (n=13, 25%) required users' explicit consent for subcontracting activities. Concerning PI storage security (mean 71.2%, SD 29.3%) and incident management (mean 71.8%, SD 36.6%), half of the assessed apps (n=27, 52%) committed to bear corresponding legal responsibility, whereas fewer than half (n=24, 46%) specified the security level obtained. Most privacy policies stated the PI retention period (n=40, 77%) and instances of PI deletion or anonymization (n=41, 79%), but fewer (n=20, 38.5%) committed to prompt third-party PI deletion. Most apps delineated various individual rights, but only a fraction addressed the rights to obtain copies (n=22, 42%) or to refuse advertisement based on automated decision-making (n=13, 25%). Significant deficiencies remained in regular compliance audits (mean 11.5%, SD 37.8%), impact assessments (mean 13.5%, SD 15.2%), and PI officer disclosure (mean 48.1%, SD 49.3%).
CONCLUSIONS
Our analysis revealed both strengths and significant shortcomings in the compliance of internet hospital apps' privacy policies with relevant regulations. As China continues to implement internet hospital apps, it should ensure the informed consent of users for PI processing activities, enhance compliance levels of relevant privacy policies, and fortify PI protection enforcement across the information processing stages.
Topics: China; Humans; Mobile Applications; Computer Security; COVID-19; Confidentiality; Internet; Pandemics
PubMed: 38904994
DOI: 10.2196/55061 -
Frontiers in Digital Health 2024With advancements in communication technologies and internet connectivity, avatar robots for children who cannot attend school in person due to illness or disabilities...
INTRODUCTION
With advancements in communication technologies and internet connectivity, avatar robots for children who cannot attend school in person due to illness or disabilities have become more widespread. Introducing these technologies to the classroom aims to offer possibilities of social and educational inclusion. While implementation is still at an experimental level, several of these avatars have already been introduced as a marketable service. However, various obstacles impede widespread acceptance.
METHODS
In our explorative qualitative case study we conducted semi-structured interviews with eight individuals involved in the implementation of the avatar robots AV1 in Germany and eleven participants involved with implementing OriHime in Japan. We analyzed and compared implementation processes, application areas, access and eligibility, and the potential and limitations of avatars at schools.
RESULTS
We identified structural similarities and differences in both countries. In the German cases the target is defined as temporary use for children who cannot attend school in person because of childhood illness, with the clear goal of returning to school. Whereas in Japan OriHime is also implemented for children with physical or developmental disabilities, or who cannot attend school in person for other reasons.
DISCUSSION
Our study suggests that avatar technologies bear high potential for children to stay socially and educationally connected. Yet, structures need establishing that grant equal access to avatar technologies. These include educational board regulations, budgets for funding avatar technologies and making them accessible to the public, and privacy protection standards that are adequate, yet do not create implementation hurdles that are too high. Furthermore, guidelines or training sessions on technical, educational and psychosocial aspects of including avatar technologies in the classroom for teachers are important for successful implementation. Since our Japanese cases suggest that expanding the area of application beyond childhood illness is promising, further research on the benefits for different groups is needed.
PubMed: 38904032
DOI: 10.3389/fdgth.2024.1273415 -
Frontiers in Artificial Intelligence 2024The prevention of crime is a multifaceted challenge with legal, political, and cultural implications. Surveillance technologies play a crucial role in assisting law...
The prevention of crime is a multifaceted challenge with legal, political, and cultural implications. Surveillance technologies play a crucial role in assisting law enforcement and other relevant parties in this mission. Drones, cameras, and wiretaps are examples of such devices. As their use increases, it becomes essential to address related challenges involving various stakeholders and consider cultural, political, and legal aspects. The objective of this study was to analyze the impact of surveillance technologies and identify commonalities and differences in perspectives among social media users and researchers. Data extraction was performed from two platforms: Scopus (for academic research papers) and platform X (formerly known as Twitter). The dataset included 88,989 tweets and 4,874 research papers. Topic modeling, an unsupervised machine learning approach, was applied to analyze the content. The research results revealed that privacy received little attention across the datasets, indicating its relatively low prominence. The military applications and their usage have been documented in academic research articles as well as tweets. Based on the empirical evidence, it seems that contemporary surveillance technology may be accurately described as possessing a bi-directional nature, including both sousveillance and surveillance, which aligns with Deleuzian ideas on the Panopticon. The study's findings also indicate that there was a greater level of interest in actual applications of surveillance technologies as opposed to more abstract concepts like ethics and privacy.
PubMed: 38903156
DOI: 10.3389/frai.2024.1406361