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Current experiences with internet telepathology and possible evolution in the next generation of Internet services.

The last five years experience has definitely demonstrated the possible applications of the Internet for telepathology. They may be listed as follows: (a) teleconsultation via multimedia e-mail; (b) teleconsultation via web-based tools; (c) distant education by means of World Wide Web; (d) virtual microscope management through Web and Java interfaces; (e) real-time consultations through Internet-based videoconferencing. Such applications have led to the recognition of some important limits of the Internet, when dealing with telemedicine: (i) no guarantees on the quality of service (QoS); (ii) inadequate security and privacy; (iii) for some countries, low bandwidth and thus low responsiveness for real-time applications. Currently, there are several innovations in the world of the Internet. Different initiatives have been aimed at an amelioration of the Internet protocols, in order to have quality of service, multimedia support, security and other advanced services, together with greater bandwidth. The forthcoming Internet improvements, although induced by electronic commerce, video on demand, and other commercial needs, are of real interest also for telemedicine, because they solve the limits currently slowing down the use of Internet. When such new services will be available, telepathology applications may switch from research to daily practice in a fast way.

Humans↗

Adverse drug reaction monitoring and the Internet: evaluation of the use of the Internet by French Pharmacovigilance Centres and a non-exhaustive survey of websites of interest for collecting information about adverse drug reaction.

The Internet, indisputably the most important source of information obtainable in real time, was long essentially the domain of researchers in the USA, but has now become more accessible to French Pharmacovigilance Centres (CRPV) and pharmaceutical companies. A questionnaire was sent to every CRPV to determine how the Internet was perceived in terms of pharmacovigilance activities and existing Websites of particular value to CRPVs were investigated. Analysis of the questionnaires revealed that 66.7 per cent of CRPVs are connected to the Internet but do not use it fully; 94 per cent of connected CRPVs use it essentially for access to a bibliographic database such as Medline (88 per cent), and none subscribes to discussion lists concerning alert messages on problems related to drugs and therapeutics. Non-connected CRPVs do not intend to use the Internet because of financial considerations, lack of time or the assumption that it is not beneficial in everyday situations. Apparently, many French CRPVs are not sufficiently aware of the importance of the Internet for professional purposes. A non-exhaustive list of sites on the Internet providing information likely to be of use to Pharmacovigilance Centres in their everyday activities is included. The Internet offers far greater possibilities than research for bibliographic references on Medline and could improve the manner in which pharmacovigilance is practised.

Adverse Drug Reaction Reporting Systems↗

[Development of internet addiction measurement scales and Korean internet addiction index].

OBJECTIVES: To develop measurement scales of Internet addiction, and propose a Korean Internet Addiction Index (K-IAI) and classification criteria for Internet addiction from the threshold scores developed. METHODS: The identification of the concept of "Internet addiction" was based on the literature review. To select the scales, an exploratory factor analysis was applied. A construct validation was tested by a confirmatory factor analysis (CFA) with a structured equation model (SEM). In testing the validity of the classification criteria, ANOVA and non-recursive models with SEM were applied. RESULTS: Out of 1,080 questionnaires distributed, 1,037 were returned,; a response rate of 96%. The Cronbach-alpha of all items was over 0.75. Using an exploratory factor analysis in the condition of a 6 factor constrain as the study model proposed, 23 of the initial 28 items were identified. In testing the discriminant and convergent validity of the selected 23 scales using CFA with SEM, the Internet addiction model explained about 93% of all variances of the data collected, and all the latent variables significantly explained the designated scales. A K-IAI was proposed using the T-scores of the sum of all factor averages. In the classification of users, the basic concept was a two-standard deviation approach of the K-IAI as the criteria of MMPI. The addiction group had a score > or =70 in the K-IAI, the pre-addiction group between > or =50 and <70, and the average user group <50. The Internet use times of the classified groups were statistically different in the ANOVA and multiple comparisons. CONCLUSIONS: The K-IAI is a reliable and valid instrument for measuring Internet addiction. Moreover, the taxonomy of the groups was also verified using various methods.

Behavior, Addictive↗

Predictors of women's Internet access and Internet health seeking.

A random, population-based sample of 431 women aged 18-74 in King County, Washington, USA, completed a survey module on Internet use and access. Level of mental health, level of general health perceptions, older age, and higher income predicted women's health-related Internet use. Participants without access reported various barriers to obtaining access; perceived lack of usefulness of the Internet as an information source and unfamiliarity with using this technology appear equally important reasons as financial cost for not adopting the Internet. Internet use motivators are complex; these findings have relevance to the design of Internet-based interventions.

Adolescent↗

In defense of the internet: the relationship between Internet communication and depression, loneliness, self-esteem, and perceived social support.

As more people connect to the Internet, researchers are beginning to examine the effects of Internet use on users' psychological health. Due in part to a study released by Kraut and colleagues in 1998, which concluded that Internet use is positively correlated with depression, loneliness, and stress, public opinion about the Internet has been decidedly negative. In contrast, the present study was designed to test the hypothesis that Internet usage can affect users beneficially. Participants engaged in five chat sessions with an anonymous partner. At three different intervals they were administered scales measuring depression, loneliness, self-esteem, and social support. Changes in their scores were tracked over time. Internet use was found to decrease loneliness and depression significantly, while perceived social support and self-esteem increased significantly.

Communication↗

The emerging relationship of psychology and the Internet: proposed guidelines for conducting Internet intervention research.

The Internet is rapidly developing into an important medium of communication in modern society, and both psychological research and therapeutic interventions are being increasingly conducted using this new communication medium. As therapeutic interventions using the Internet are becoming more prevalent, it is becoming increasingly important to conduct research on psychotherapeutic Internet interventions to assist in the development of an appropriate standard of practice regarding interventions using this new medium. In this article, we examine the Internet and the current psychological uses which are being initiated using this medium. Ethical concerns related to the psychological use of the Internet are discussed, and guidelines are proposed for the conduct of Internet intervention research.

Behavioral Research↗

Overcoming depression on the Internet (ODIN): a randomized controlled trial of an Internet depression skills intervention program.

BACKGROUND: Psychoeducational programs are increasingly being delivered over the Internet. We created an Internet-based, cognitive therapy, self-help program to be used as a stand-alone intervention for mild-to-moderate depression, or as an adjunct to traditional services for more severe depression. OBJECTIVE: To evaluate the effectiveness of a web-based intervention program to reduce depression in a randomized, controlled trial. METHODS: In a private, nonprofit health maintenance organization, we mailed recruitment brochures to two populations: depressed adults (n = 6994) who received traditional medical services for depression, and an age/gender matched sample of nondepressed adults (n = 6996). Participants consenting to the study were randomized to either the experimental Web site (n = 144), or a no-access control group (n = 155). Participants in both groups were free to obtain nonexperimental, usual care services for their depression. All participants completed an on-line version of the Center for Epidemiological Studies Depression Scale (CES-D) at enrollment and at 4-, 8-, 16- and 32-weeks after enrollment. Mean intake scores were in the severely depressed range. 74% of participants completed at least one follow-up assessment. Unfortunately, most intervention participants accessed the Internet site infrequently. RESULTS: We failed to find an effect for the Internet program across the entire sample. However, post-hoc, exploratory analyses revealed a modest effect among persons reporting low levels of depression at intake. CONCLUSIONS: The negative results might have resulted from infrequent patient use of the Internet site, or a more seriously depressed sample than the intervention was intended to help. Future studies should focus on recruiting persons with mild to moderate levels of depression, and on increasing participant use of the Internet site.

Adult↗

Measuring health beliefs on the Internet: A comparison of paper and Internet administrations of the Multidimensional Health Locus of Control Scale.

A growing number of studies have supported the use of unidimensional psychometric test instruments administered via the Internet; however, support for the use of multidimensional scales is weak. The present study compares paper and Internet administrations of the Multidimensional Health Locus of Control (MHLC) Scale (Wallston & Wallston, 1981). In terms of reliabilities and factor structures, the Internet data were found to be at least as good as the paper data. MHLC scores were comparable for paper and Internet administrations, although the Internet sample scored significantly lower on the Powerful Others subscale. Overall, the results show that administration of the MHLC Scale via the Internet can produce data comparable to that obtained by pen-and-paper methods. However, it is concluded that generalization of these findings beyond the psychometric test instrument and sampling procedures used here is not warranted.

Adolescent↗

Medicine and the Internet. What can I learn from the Internet?

What is the Internet? The Internet is the biggest network of information resources the world has ever seen and is growing rapidly each day. The Internet and the World Wide Web (The Web) represent the first technology to fully integrate the communications found on bookshelves, magazine racks, catalog files, fax machines, symposiums, in television/radio studios and the common mail system into a global infrastructure with extraordinary capabilities to deliver timely health care information. Unlike conventional media like newspapers or television, the Internet provides rapid one-to-one communication between millions of individuals. Television and newspapers communicate from "a few" (the writers and advertisers) to "many" (the readership). On the Internet, everyone is a "peer," being both an information provider and consumer on a 24-hour, 7-day a week basis. This article will discuss ways you can use the Internet's information resources in your own personal and professional life.

Communication↗

The internet doctor and medical ethics. Ethical implications of the introduction of the Internet into medical encounters.

In this article, consultation via the Internet and the use of the Internet as a source of medical information is examined from an ethical point of view. It is argued that important ethical aspects of the clinical interaction, such as dialogue and trust will be difficult to realise in an Internet-consultation. Further, it is doubtful whether an Internet doctor will accept responsibility. However, medical information via the Internet can be a valuable resource for patients wanting to know more about their disease and, thus, it is a means to enhancing their autonomy.

Ethics, Medical↗

Internet resources for dentistry: computer, Internet, reference, and sites for enhancing personal productivity of the dental professional.

At the onset of the new millennium the Internet has become the new standard means of distributing information. In the last two to three years there has been an explosion of e-commerce with hundreds of new web sites being created every minute. For most corporate entities, a web site is as essential as the phone book listing used to be. Twenty years ago technologist directed how computer-based systems were utilized. Now it is the end users of personal computers that have gained expertise and drive the functionality of software applications. The computer, initially invented for mathematical functions, has transitioned from this role to an integrated communications device that provides the portal to the digital world. The Web needs to be used by healthcare professionals, not only for professional activities, but also for instant access to information and services "just when they need it." This will facilitate the longitudinal use of information as society continues to gain better information access skills. With the demand for current "just in time" information and the standards established by Internet protocols, reference sources of information may be maintained in dynamic fashion. News services have been available through the Internet for several years, but now reference materials such as online journals and digital textbooks have become available and have the potential to change the traditional publishing industry. The pace of change should make us consider Will Rogers' advice, "It isn't good enough to be moving in the right direction. If you are not moving fast enough, you can still get run over!" The intent of this article is to complement previous articles on Internet Resources published in this journal, by presenting information about web sites that present information on computer and Internet technologies, reference materials, news information, and information that lets us improve personal productivity. Neither the author, nor the Journal endorses any of the sites or products listed, but include these references and links as a matter of convenience for its readers.

Dentistry↗

[The Internet and medicine. II. Present status and perspectives in the use of the Internet in Medicine].

The authors present an account of all contemporary possibilities to use Internet in medicine. They summarize the advantages and disadvantages of electronic mail (E-mail) and give a list of services available via the World Wide WEb: the possibility to inspect more than seventy medical journals, consult books and specialized databases and acquire further medical training. They demonstrate actual possibilities how to use Internet in everyday medical practice. The authors present also data indicating the general scope of Internet and its application in medical sciences. In the conclusion the authors reflect on the future application of Internet and point out some risks which may interfere with or threaten in the near and remote future the use of Internet.

Humans↗

Surgery on the Internet. Part 1: The origins of the Internet.

The last few years have seen a dramatic increase in the size and use of the Internet; indeed recent figures estimate that the number of people with Internet access is increasing by up to 20 per cent monthly with over 30 million people now connected world wide. Many organisations, including The Royal College of Surgeons of England, now offer their own world wide web (WWW) sites. There are a number of areas and facilities on the Internet which are of particular interest to the surgeon; these include access to journals and textbooks, information of surgical units world-wide, e-mail and newsgroups discussing various surgical topics. The aim of this article, together with the two others in the series is to explain the steps necessary to get connected to the Internet and to illustrate some of the main areas of interest to the surgeon. This, the first of the articles will describe the origins of the Internet and the equipment and process required to get connected.

Computer Communication Networks↗

Internet communities for recruitment of cancer patients into an Internet survey: a discussion paper.

The purpose of this paper is to provide future directions for the usage of Internet communities (ICs) for recruitment of research participants based on issues raised in an Internet survey among 132 cancer patients. About 317 general and 233 ethnic-specific Internet Cancer Support Groups and 1588 ethnic-specific ICs were contacted to recruit cancer patients. Research staff recorded issues and wrote memos during the recruitment process. The written memos and records were later analyzed using content analysis. The issues included: (a) difficulty in identifying appropriate ICs and potential participants, (b) meta-tags, (c) dominant white and women groups, (d) dynamics inside ICs, (e) difficulty in trust building, and (f) potential selection bias. The findings suggest that researchers thoroughly review the ICs' information, be recognizant of potential gender and ethnic issues and current trends in Internet interaction, and consider potential selection bias.

Attitude to Computers↗

Internet experts' planning of explanations for laypersons: a Web experimental approach in the Internet domain.

How flexible are Internet experts in taking the perspective of laypersons? A Web experimental approach is presented that examines the Internet experts' perspective taking in planning explanations for laypersons. The Internet was the topic to be communicated and it also provided the means to implement the experimental method. Participants rated how extensively they would treat some specific concepts when explaining a topic such as the WWW. Independent variables were the addressee's intention, their level of domain knowledge, and the importance of the concepts to be evaluated. The results show that the experts preferred planning strategies that integrated all three types of information. Though their planning decisions were mainly guided by conceptual constraints, the Internet experts also took into account information about the addressee's intention and prior knowledge.

Adult↗

Consulting the Internet before visit to general practice. Patients' use of the Internet and other sources of health information.

OBJECTIVES: To describe where patients in Danish general practice get information about health and disease, particularly how patients prepare for a visit to their GP, with special reference to use of the lnternet. DESIGN: Structured interviews. SETTING: Four Danish general PATIENTS: 93 consecutive patients after visiting their GP. MAIN OUTCOME MEASURES: The patient's report about we of the Internet and different mass media in preparation for the consultation. RESULTS: Only two patients never looked for health information. Of all patients, 20% had used the Internet to get health information, 8% because of the current visit, i.e. a third of all with Internet access had used it because of the current visit. Women used the sources of information more than men did. Personal contact with family, friends or neighbours was the most commonly used source. CONCLUSION: The Internet is used in direct preparation for a visit to the general practitioner. The vast majority of patients use the mass media for information. In general practice, the main source of information on a health-related subject is personal contact with family and friends.

Denmark↗

Internet blues revisited: replication and extension of an Internet paradox study.

This study is a replication of the Kraut et al. Internet paradox study designed to set guidelines for harmless Internet usage, without any potential for personal damage. The present study produced two main results: The first is a partial confirmation of the general response pattern found by Kraut et al. (i.e., that younger individuals tend to use the Internet to a higher degree and that they experience a lesser degree of psychological well-being). The second main result, however, contradicts the interpretation by Kraut et al. of the causal relationship between Internet usage and psychological well-being.

Adolescent↗

"On the Internet no one knows I'm an introvert": extroversion, neuroticism, and Internet interaction.

Social communication is one of the most common reasons for using the Internet. This paper examines how the personality characteristics of the user affect the meaning and importance of Internet social interaction in comparison with "real life," face-to-face interactions. Forty subjects all of whom were familiar with using "chat" participated in this study. After a at" session, they were instructed to answer several questionnaires. It was found that introverted and neurotic people locate their "real me" on the Internet, while extroverts and nonneurotic people locate their "real me" through traditional social interaction. The implications of our results for understanding the user-net interaction, the "real-me" location, extroversion, neuroticism, and Internet interaction, and the treatment of social phobics are examined.

Adult↗