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PubMed2005

Use of the internet to obtain cancer information among cancer patients at an urban county hospital.

PURPOSE: To evaluate rates, predictors, and barriers to use of the Internet to obtain cancer information among a cohort of cancer patients at an urban county hospital. PATIENTS AND METHODS: Of 208 cancer patients approached, 200 patients completed a structured interview study examining Internet use, perceptions of the accuracy of Internet information, and barriers to use. RESULTS: Only 10% of participants reported using the Internet themselves to obtain cancer information. Another 21% reported exposure to Internet information through proxies. The most common barrier to Internet use cited was lack of Internet access, with 44% reporting that they would use the Internet to obtain cancer information if they had Internet access. Younger age and more years of formal education were significantly associated with Internet use, although race and income were not. Less education, African American race, and female sex were associated with lower estimates of the accuracy of Internet information. Fewer years of formal education was associated with increased likelihood of reporting confusion after reading Internet information. CONCLUSION: Very few cancer patients in this study of a cohort of generally disadvantaged individuals used the Internet themselves to obtain cancer information, although many more desired to do so. Significant opportunities for Web-based interventions aimed at improving cancer care outcomes in this population of cancer patients exist. However, further study will be needed to determine how to make such intervention accessible, trustworthy, and understandable to the disadvantaged.

Adult↗

PubMedDate not supplied

Impact of the internet on primary care staff in Glasgow.

BACKGROUND: The Government has invested pound 7 million (approx. $11.5 million) to connect all Primary Care Practices in Scotland to the National Health Service Intranet (NHSnet). This provides General Practitioners (GPs) and Practice Nurses with access to the Internet and a wealth of healthcare information of varying quality. OBJECTIVE: This study examines Primary Care Staff's use of the Internet, their views on the reliability of healthcare information available via the Internet, and their interaction with patients who have presented them with information downloaded from the Internet. METHODS: A postal questionnaire was distributed to a random sample of 300 GPs and 130 Practice Nurses throughout Glasgow. There was a response rate of 60%. RESULTS: Time restraints (20%) and concerns that they lack the necessary skills (17%) were highlighted as the most common reasons for not accessing the Internet. Sixty-nine per cent of GPs and 70% of Practice Nurses had looked at the Internet for healthcare information. Forty-eight per cent of GPs and 41% of Practice Nurses were concerned about the reliability of Internet information. Fifty-eight per cent of GPs and 34% of Practice Nurses have been approached by patients with Internet healthcare information. Sixty-five per cent of the information presented by patients was new to GPs. CONCLUSIONS: The majority of Primary Care Staff now have access to the Internet and use it to look up healthcare information. Almost half of GPs would consider referring their patients to the Internet for further information about their condition. Results highlight that the healthcare information downloaded from the Internet by patients is accurate, but patients have problems correctly interpreting this information. An increase in the use of home computers and free access to the Internet will see a continued increase in patients approaching GPs and Practice Nurses with healthcare information downloaded from the Internet.

Health Knowledge, Attitudes, Practice↗

PubMedDate not supplied

Use of the Internet by patients before and after cardiac surgery: telephone survey.

BACKGROUND: Little is known about to what extent patients who underwent medical treatment access the Internet and whether they benefit from consulting the Internet. OBJECTIVE: To understand if cardiopathic patients use the Internet for health-related information and whether they find retrieved information understandable and useful. METHODS: Telephone interviews, using a semi-structured questionnaire, were conducted with 82 patients who had undergone off-pump coronary-artery bypass grafting at the Center for Less Invasive and Robotic Heart Surgery in Buffalo, New York, USA. Study design was multidisciplinary, combining expertise of medical and communication science. Sources of medical information were identified (doctor, Internet, magazines, newspapers, television, radio, family members). Accessibility, quality, and readability of Internet medical information from the patients point of view were investigated. RESULTS: Out of 82 patients, 35 (35/82, 42.7%) were Internet users. Internet users had a significantly higher education level than Internet non-users (college education: 42.9% of users, 10.6% of non-users; P <.001). Among the Internet users, 18 (18/35, 51.4%) had used the Internet for retrieving medical information; 17 (17/35, 48.6%) had not. No statistically significant differences in demographic data were found when comparing these 2 sub-groups of patients. Family-members involvement was high (15/18, 83.3%). Internet medical information was rated helpful in most cases; readability was acceptable for only 3 patients (3/18, 16.7%). To improve on-line medical information, all patients interviewed suggested sites designed by their physicians. CONCLUSIONS: Although 1 in 5 patients in our sample has used the Internet to retrieve medical information, the majority of them experiences difficulties comprehending the information retrieved. Health-care providers should provide Internet medical information that is adequate for the non-medical public's needs.

Cardiac Care Facilities↗

PubMed2002

Unmet needs of primary care patients in using the Internet for health-related activities.

BACKGROUND: Millions of people use the Internet as a source for health information yet little is understood about the use of the Internet for other health-related activities. OBJECTIVE: We conducted the present study to understand, among primary care patients, the interest in and experience with using the Internet for a variety of health-related activities. METHODS: Cross-sectional survey in the setting of 4 community-based primary care practices in Rhode Island. A single self-administered questionnaire included the following: 14 items measuring interest in using the Internet for a variety of health-related purposes, demographics, self-reported health status, and self-reported health care quality. RESULTS: The survey was completed by 300 patients, 109 without access to the Internet and 191 with access to the Internet. Experiences with and attitudes about each of the health-related activities on the Internet varied widely across each activity. Regardless of access, patients were most interested in using the Internet for finding information about diseases and medications. However, patients with Internet access were more interested, compared to those without access, in each of the health-related activities on the Internet. Among patients with access to the Internet, the largest gap between interest and experience (the opportunity gap) was in using the Internet to investigate the quality of their care (eg, "find out if your health care provider was giving you all of the tests and treatments that you are due to have?") and administrative functions (eg, "schedule an appointment with your doctor?"). CONCLUSIONS: Much opportunity remains for developing health-related Internet Web sites to address the unmet needs of primary care patients.

Adolescent↗

PubMed2004

Health attitudes, health cognitions, and health behaviors among Internet health information seekers: population-based survey.

BACKGROUND: Using a functional theory of media use, this paper examines the process of health-information seeking in different domains of Internet use. OBJECTIVE: Based on an analysis of the 1999 HealthStyles data, this study was designed to demonstrate that people who gather information on the Internet are more health-oriented than non-users of Internet health information. METHODS: The Porter Novelli HealthStyles database, collected annually since 1995, is based on the results of nationally representative postal mail surveys. In 1999, 2636 respondents provided usable data for the HealthStyles database. Independent sample t-tests and logistic regression analyses were conducted. RESULTS: The results showed that individuals who searched for health information on the Internet were indeed more likely to be health-oriented than those who did not. Consumers who sought out medical information on the Internet reported higher levels of health-information orientation and healthy activities, as well as stronger health beliefs than those who did not search for medical news on the Internet. It was observed that those who reported searching for information about drugs and medications on the Internet held stronger health beliefs than the non-searchers. Comparison of individuals who reported seeking out information about specific diseases on the Internet with individuals who did not showed those who sought out disease-specific information on the Internet to be more health-oriented. Finally, consumers who sought out healthy lifestyle information on the Internet were more health conscious and more health-information oriented than those who did not. They were also more likely to hold stronger health-oriented beliefs and to engage in healthy activities. CONCLUSIONS: The results support the functional theory of Internet use. Internet searchers who used the Internet for a wide range of health purposes were typically more health oriented than non-searchers.

Age Factors↗

PubMed2006

Why are health care interventions delivered over the internet? A systematic review of the published literature.

BACKGROUND: As Internet use grows, health interventions are increasingly being delivered online. Pioneering researchers are using the networking potential of the Internet, and several of them have evaluated these interventions. OBJECTIVE: The objective was to review the reasons why health interventions have been delivered on the Internet and to reflect on the work of the pioneers in this field in order to inform future research. METHODS: We conducted a qualitative systematic review of peer-reviewed evaluations of health interventions delivered to a known client/patient group using networked features of the Internet. Papers were reviewed for the reasons given for using the Internet, and these reasons were categorized. RESULTS: We included studies evaluating 28 interventions plus 9 interventions that were evaluated in pilot studies. The interventions were aimed at a range of health conditions. Reasons for Internet delivery included low cost and resource implications due to the nature of the technology; reducing cost and increasing convenience for users; reduction of health service costs; overcoming isolation of users; the need for timely information; stigma reduction; and increased user and supplier control of the intervention. A small number of studies gave the existence of Internet interventions as the only reason for undertaking an evaluation of this mode of delivery. CONCLUSIONS: One must remain alert for the unintended effects of Internet delivery of health interventions due to the potential for reinforcing the problems that the intervention was designed to help. Internet delivery overcomes isolation of time, mobility, and geography, but it may not be a substitute for face-to-face contact. Future evaluations need to incorporate the evaluation of cost, not only to the health service but also to users and their social networks. When researchers report the outcomes of Internet-delivered health care interventions, it is important that they clearly state why they chose to use the Internet, preferably backing up their decision with theoretical models and exploratory work. Evaluation of the effectiveness of a health care intervention delivered by the Internet needs to include comparison with more traditional modes of delivery to answer the following question: What are the added benefits or disadvantages of Internet use that are particular to this mode of delivery?

Delivery of Health Care↗

PubMed2002

[Internet in medicine--development and perspectives].

Internet is one of information technologies marking the transition from the second to the third millennium. The present role and expansion of Internet in medicine and healthcare is reviewed together with the perspective of further development. The beginning and initial expansion of the use of Internet in medicine are described. The World Wide Web (WWW or Web) is recognized as a major reason for this expansion, reaching a state described as a Web-pandemic. The rapid increase of the number of papers dealing with Internet in medical literature is presented as well as the appearance of several journals dedicated to Internet in medicine. First specialized symposia, among them MEDNET world conferences, are noted. First uses of Internet in medicine comprised databases, discussion groups, electronic newsletters, software archives and online public access catalogues. The appearance of the Web has led to a significant improvement of the Internet use in medicine, which is reflected in an exponential increase in the number of publications. It is noted that Internet allows "to do old things in new ways", but also "to do new things". It has become clear that the information revolution evoked by the internet shall leave a deep trace in medicine, as health information has become accessible to the public and ceased to be in exclusive control of health professionals. New medical fields--telemedicine and cybermedicine--appeared as the result of the development and global expansion of information and communication technologies, with cybermedicine dealing more specifically with the use of Internet. The advantages and disadvantages of cybermedicine are discussed, and major problems related to the quality of health information are highlighted. Several systems for quality criteria of health related Web-sites are described, indicating that Websites have to conform with the quality criteria such as transparency and honesty, accountability, privacy and data protection, currency, accountability and accessibility. A review of the development of the use of Internet in medicine in Croatia is given. It is ever more recognized worldwide that the Internet is capable to create conditions for partnership between patients and clinicians. In concluding remarks, the reasons are given for a sooner access to the Internet and its daily use in healthcare activity.

Croatia↗

PubMed2006

Adolescents' use of the Internet: a controversial, coming-of-age resource.

Emerging research on adolescents and the Internet should be thoughtfully considered, especially with respect to the influence of Internet activities on mental health and psychiatric conditions. A given Internet site may have content that would be helpful to one, have no effect on another, and be harmful to yet an-other adolescent. The effect on the adolescent would in part be determined by the site itself and the way in which it provides information and interactivity, and in part on the characteristics of the particular adolescent. It will be necessary to employ diverse approaches to keep current the information on how adolescents use the Internet, as well as to understand how it affects them. Rather than rely on focus groups and self-report surveys, researchers should examine adolescent Internet use with naturalistic methods that will provide quantitative and qualitative data regarding this new domain. Additionally, researchers can use experimental designs to explore how Internet experiences or exposure to online information affects health knowledge, attitudes, and behaviors. Because adolescents rely on the Internet for both its content and technology,youth caregivers and advocates should continue to research and study this medium. The efficacy of delivering Internet-based therapies and prevention pro-grams should be studied. Mental health organizations should remain vigilant,monitoring and helping to improve websites [7]. Parents should also be aware of their adolescents' online activities, so it may be necessary for health practitioners to educate parents about what is available and occurring on line. Lastly, youth need to be better informed on how to best use the Internet. We take for granted that adolescents are savvy users of this technology, when it is not yet fully known how young people make use of the Internet and how they incorporate information from the Internet into their lives. Online media literacy skills are necessary and should be developed among the very young to make the best use of the Internet.

Adolescent↗

PubMed2007

Perceptions and behaviour of access of the Internet: a study of women attending a breast screening service in Sydney, Australia.

OBJECTIVES: To describe the perceptions and behaviour in accessing health information from the Internet by women attending a BreastScreen, New South Wales (NSW) Service in Northern Sydney. DESIGN: Cross-sectional study. SETTING: A BreastScreen NSW Service in Northern Sydney. MAIN OUTCOME MEASURES: Behaviour and perceptions of accessing of the Internet for breast health and screening information and other related health information. PARTICIPANTS: Four hundred and fifteen women aged > or =40 years who had a screening mammogram at a BreastScreen NSW Service in Northern Sydney. Data were collected from 1 October to 22 December 2004 (study interval). RESULTS: Four hundred and sixty-one eligible women were invited to participate in the study and of these 415 women agreed to participate in the study (participation rate=90%). Of the 415 women enrolled in the cohort, 80% (333/415) of women accessed the Internet in general and 62% (205/333) of the women who accessed the Internet also accessed health related information from the Internet, but only 7% of the total women accessed breast health and screening information from the Internet. Two hundred and eighty (70%) women in the cohort expressed their intention to access the Internet if they were diagnosed with breast cancer. Age (OR=0.94; 95% CI=0.91-0.97), marital status (OR=2.65; 95% CI=1.45-4.83), educational status (OR=3.26; 95% CI=1.77-6.02) and behavioural intention of accessing the Internet if diagnosed with breast cancer (OR=3.31; 95% CI=1.83-5.98) were found to be associated with access of Internet for general information. Furthermore, behavioural intention (OR=2.43; 95% CI=1.30-4.55), rating of computer skills as 'average' (OR=0.42; 95% CI=0.22-0.79) and 'not good to poor' (OR=0.23; 95% CI=0.11-0.49) were found to be associated with access of health related information from the Internet. CONCLUSIONS: Information searching from the Internet is common among women having a screening mammogram. There is potential to provide guidance to women regarding accessing the BreastScreen NSW website and other reliable sources of Internet information on breast health, breast screening and cancer-related information.

Aged↗

PubMed2005

Internet-based monitoring of asthma: a long-term, randomized clinical study of 300 asthmatic subjects.

BACKGROUND: Experience from other fields of internal medicine shows that Internet-based technology can be used to monitor various diseases. The new technology handles complex calculation programs easily, and it is a unique way of communicating. These advantages might be used in optimizing the treatment for asthmatic subjects because undertreatment is a common problem found in European asthmatic subjects. OBJECTIVE: We sought to investigate the outcome of monitoring and treatment using a physician-managed online interactive asthma monitoring tool and to assess whether the outcome differs from that of monitoring and treatment in an outpatient respiratory clinic or in primary care. METHODS: Three hundred asthmatic subjects were randomized to 3 parallel groups in a 6-month prospective study: (1) Internet-based monitoring (n = 100); (2) specialist monitoring (n = 100); and (3) general practitioner (GP) monitoring (n = 100). All the patients were examined on entry into the study and after 6 months of treatment. RESULTS: The treatment and monitoring with the Internet-based management tool lead to significantly better improvement in the Internet group than in the other 2 groups regarding asthma symptoms (Internet vs specialist: odds ratio of 2.64, P = .002; Internet vs GP: odds ratio of 3.26; P < .001), quality of life (Internet vs specialist: odds ratio of 2.21, P = .03; Internet vs GP: odds ratio of 2.10, P = .04), lung function (Internet vs specialist: odds ratio of 3.26, P = .002; Internet vs GP: odds ratio of 4.86, P < .001), and airway responsiveness (Internet vs GP: odds ratio of 3.06, P = .02). CONCLUSION: When physicians and patients used an interactive Internet-based asthma monitoring tool, better asthma control was achieved.

Adolescent↗

PubMedDate not supplied

[Frequency and utility of internet use by orthopaedic patients].

AIM: We assessed to what degree orthopaedic patients use the internet as an information platform and how these patients rate the information they obtain over the World Wide Web (WWW). METHODS: 450 consecutive patients consulting the out-patient department of our university clinic for the first time anonymously filled out a three-page questionnaire. Apart from clinical and sociodemographic data, the questionnaire addressed aspects such as the availability of computers and internet. Also, questions concerning the use and interpretation of medical information freely available on the WWW were asked. RESULTS: 402 questionnaires were evaluated. 54 % of the patients stated that they readily had access to the internet. Of the remaining patients without internet access, 19 % planned the installation in the near future. The prevalence of the use of the WWW of patients in the age group up to 40 years was 72 % and in patients over 40 years only 49 %. Compared with internet non-users, internet users were younger (p < 0.001), more frequently men (p < 0.05), and of a higher education level (p < 0.001). 68 % used the internet on a regular basis with regard to queries concerning their health and well being. More than every third patient (38 %) had consulted the internet about the specific orthopaedic ailment prior to seeking advice in our clinic. Almost half of the patients judged the previous treatment to be partially in accordance with the information obtained from the internet. 86 % considered the information obtained over the WWW as helpful or very helpful. 85 % would recommend other patients to use the internet for information concerning their orthopaedic complaint. 65 % of all patients objected to an orthopaedic on-line consultation via internet. CONCLUSION: The internet seems to be an important source of information for orthopaedic patients. The prevalence concerning the use of the WWW is particularly high in younger, well educated patients.

Access to Information↗

PubMed2006

Internet gambling: an emerging concern in family practice medicine?

BACKGROUND: Gambling problems are rarely brought to the attention of family practice physicians, but pathological gambling can be associated with poor emotional and physical health. Recent availability and easy accessibility of Internet gambling may be associated with pathological gambling status, and Internet gambling may confer health risks. OBJECTIVE: This study evaluated the prevalence of Internet gambling, its association with pathological gambling, and the relationship between Internet gambling and health status among patients attending medical and dental clinics. METHODS: The South Oaks Gambling Screen and Short Form 12 were administered to 1414 adults in waiting areas of clinics. RESULTS: Only 6.9% of respondents reported ever gambling on the Internet, with 2.8% indicating frequent Internet wagering. Almost two-thirds (65.9%) of regular Internet gamblers were classified as probable pathological gamblers, compared with 29.8% of ever-Internet gamblers and 7.6% of non-Internet gamblers. Internet gambling was associated with poor mental and physical health, and this association remained significant even after controlling for age, gender, site and pathological gambling status. CONCLUSIONS: These data suggest that Internet gambling is linked to pathological gambling and is independently associated with poor health. Family practice physicians should consider referring patients who gamble on the Internet for further treatment.

Adult↗

PubMed2001

Seeking sex on the Internet and sexual risk behaviour among gay men using London gyms.

OBJECTIVE: To examine the association between seeking sex on the Internet and sexual risk behaviour among gay men in London. METHODS: In January-February 2000, gay men in London gyms were asked to complete self-administered questionnaires concerning use of the Internet, history of sexually transmitted diseases (STD) and recent unprotected anal intercourse (UAI). Internet sex seekers were compared with other men, also with Internet access, who did not seek sex in this way. RESULTS: Of 743 gay men included in the analysis (121 HIV-positive, 465 HIV-negative, 157 never-tested), 80.9% (601) had access to the Internet. Among those who had access, 34.4% (207) had used the Internet to find a sexual partner; this did not vary significantly by HIV status (P = 0.3). Internet sex seekers were more likely to have had an STD (HIV-negative men, 26.9 versus 17.5%, P = 0.04) or gonorrhoea (HIV-positive men, 22.2 versus 5.8%, P = 0.04) in the previous year than other men with Internet access. HIV-negative Internet sex seekers were also more likely to report non-concordant UAI in the previous 3 months [23.1 versus 11.8%; adjusted odds ratio (aOR), 1.9; 95% confidence interval (CI), 1.2--3.5; P = 0.01]. HIV-positive Internet sex seekers were more likely to report UAI with another positive man (37.8 versus 7.4%; aOR, 7.9; 95% CI, 1.8--34.6; P = 0.006). CONCLUSION: Seeking sex on the Internet was associated with recent STD and high-risk sexual behaviour among HIV-positive and -negative gay men in London. The contribution of seeking sex on the Internet to the recent increase in high-risk behaviour among London gay men merits further investigation.

Adult↗

PubMed2006

Characteristics of recently HIV-infected men who use the Internet to find male sex partners and sexual practices with those partners.

OBJECTIVE: To examine (1) characteristics of recently HIV-infected men who have sex with men (MSM) who find sex partners through the Internet and (2) differences in characteristics of and sexual behaviors practiced with Internet partners as compared to other partner types. METHODS: From May 2002 to 2005, a computer-assisted self-interview was administered to 194 recently HIV-infected MSM in southern California. MSM who used the Internet to find sex partners were compared with those who did not report Internet use, and partners found from the Internet were compared with those who were found from other venues using chi analyses, t tests, logistic regression, and generalized estimating equations. RESULTS: Seventy percent of participants reported using the Internet to find partners in the prior 3 months. In multivariate analysis, Internet users as compared to non-Internet users reported higher education levels (some college vs. high school: odds ratio [OR] = 5.04; P < 0.01 and college or greater vs. high school: OR = 9.61; P = 0.01), were more likely to be white (OR = 2.16; P = 0.04), reported more partners in the prior 3 months (OR = 1.05; P = 0.04), were more likely to have had sexual contact with all their last 3 partners after HIV diagnosis (OR = 3.43; P < 0.01), and were more likely to report that all their last 3 partners were HIV-negative (OR = 3.35; P = 0.02), but none were main partners (OR = 2.36; P = 0.02). When compared with partners who were found in other venues, Internet partners were less likely to be main partners (OR = 0.52; P < 0.01) and were more likely to be younger (OR = 0.98; P = 0.05), to be HIV-negative (OR = 1.88; P = 0.02), and to become sex partners after HIV diagnosis (OR = 1.58; P = 0.03). CONCLUSIONS: The Internet is a popular venue for recently HIV-infected MSM to find partners, many of whom are HIV-negative. Because finding sex partners through the Internet occurs after HIV diagnosis, the Internet could be a valuable target for new HIV prevention strategies.

Adult↗

PubMedDate not supplied

Internet and computer access and use for health information in an underserved community.

BACKGROUND: The "digital divide" is the gap between those with access to information tools such as the Internet and those without access. The gap has been described by income, education, age, and race. Little information exists on computer and Internet access and use for health information by parents, particularly among populations of low income and low education level. OBJECTIVE: To describe computer and Internet access and use, including health information retrieval, among low-income, urban, African American caregivers (parents). DESIGN: Cross-sectional survey administered in pediatric waiting rooms of urban community-based health centers in a low-income area. PARTICIPANTS: Caregivers of pediatric outpatients. MAIN OUTCOME MEASURES: Access to computers, Internet access, and use of Internet for health information. RESULTS: In 2003, among 260 African Americans who completed surveys, 58% had a computer and 41% had home Internet access. Fifty-two percent had used the Internet for finding health information. Ninety-three percent agreed or strongly agreed that there is useful health information on the Internet. Ninety-two percent agreed or strongly agreed that they would want to talk with a medical professional about health information on the Internet. Sixty-five percent of respondents had no additional schooling after high school. Annual household income was <US 24,999 dollars for 57%. Computer use and Internet access were significantly higher in caregivers with higher education and income. CONCLUSIONS: Most pediatric patients' families have home computers and believe there is useful health information on the Internet, even among low-income and traditionally underserved populations. Most would like to discuss Internet-based health information with their providers.

Adolescent↗

PubMedDate not supplied

Ethical challenges of medicine and health on the Internet: a review.

Knowledge and capabilities, particularly of a new technology or in a new area of study, frequently develop faster than the guidelines and principles needed for practitioners to practice ethically in the new arena; this is particularly true in medicine. The blending of medicine and healthcare with e-commerce and the Internet raises many questions involving what sort of ethical conduct should be expected by practitioners and developers of the medical Internet. Some of the early pioneers in medical and healthcare Web sites pushed the ethical boundaries with questionable, even unethical, practices. Many involved with the medical Internet are now working to reestablish patient and consumer trust by establishing guidelines to determine how the fundamentals of the medical code of ethical conduct can best be adapted for the medical/healthcare Internet. Ultimately, all those involved in the creation, maintenance, and marketing of medical and healthcare Web sites should be required to adhere to a strict code of ethical conduct, one that has been fairly determined by an impartial international organization with reasonable power to regulate the code. This code could also serve as a desirable, recognizable label-of-distinction for ethical Web sites within the medical and healthcare Internet community. One challenge for those involved with the medical and healthcare Internet will be to determine what constitutes "Medical Internet Ethics" or "Healthcare Internet Ethics," since the definition of medical ethics can vary from country to country. Therefore, the emerging field of Medical/ Healthcare Internet Ethics will require careful thought and insights from an international collection of ethicists in many contributing areas. This paper is a review of the current status of the evolving field of Medical/Healthcare Internet Ethics, including proposed definitions and identification of many diverse areas that may ultimately contribute to this multidisciplinary field. The current role that medicine and health play in the growing area of Internet communication and commerce and many of the ethical challenges raised by the Internet for the medical community are explored and some possible ways to address these ethical challenges are postulated.

Animals↗

PubMed2004

Sex differences in youth-reported depressive symptomatology and unwanted internet sexual solicitation.

BACKGROUND: As the number of youths using the Internet regularly increase, so too does the number of youths potentially vulnerable to negative experiences online. Clinicians, policy makers, and parents need to better understand the Internet and factors related to positive and negative experiences online. OBJECTIVE: Primarily to investigate the association between youth-reported depressive symptomatology and unwanted Internet sexual solicitation and secondarily to identify sex differences in related characteristics of affected youth. METHODS: Data from the Youth Internet Safety Survey were analyzed to investigate the association between reported depressive symptomatology and unwanted Internet sexual solicitation. The Youth Internet Safety Survey was a nationally-representative, cross-sectional telephone survey. Youth participants (N = 1501) were English speakers between the ages of 10 and 17 years who had accessed the Internet at least 6 times in the previous 6 months and had resided in the household for at least 2 weeks in the previous year. Eighty-two percent of contacted households agreed to participate. Each participant was asked to indicate whether any of the 9 symptoms of major depression defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) had been present within the previous month. Logistic regression was used to estimate the odds of reporting an unwanted sexual solicitation online for youths with mild or major depressive symptomatology versus no symptomatology. A parsimonious, multivariate model of significant youth characteristics was identified separately for males and females. RESULTS: Youths who report major depressive-like symptoms were 3.5 times more likely (odds ratio, 3.54; 95% confidence interval, 2.19-5.71) to also report an unwanted sexual solicitation online compared to youths with mild/no symptomatology. After adjusting for significant Internet and psychosocial characteristics, male Internet users who report major depressive-like symptomatology were 2.5 times more likely to also indicate an unwanted Internet solicitation (adjusted odds ratio, 2.72; 95% CI, 1.15-6.40); significant differences were not observed among otherwise-similar females. Further, among youths reporting an Internet solicitation (N = 283), youths with major depressive-like symptomatology were twice as likely to report feeling emotionally distressed by the incident compared to youths with mild/no symptomatology (odds ratio, 2.27; 95% CI, 1.03-5.02). CONCLUSIONS: While the majority of youths report positive experiences online, some youths may be more vulnerable to negative experiences. Cross-sectional results indicate that the report of depressive symptomatology is significantly related to the concurrent report of an unwanted Internet sexual solicitation, especially for young males. Future research should focus on parsing out the temporality of events and identifying additional populations of vulnerable youths online.

Adolescent↗

PubMed2004

Internet use among high school students in Ankara, Turkey.

OBJECTIVE: Internet use has grown considerably in recent years throughout the world, particularly among young people. This study aimed at assessing Internet use among high school students. METHODS: This is a cross-sectional epidemiological study involving 246 students in 7 classes representing first, second, and third year students (754 persons) at a high school in Ankara, Turkey during March 2001. An Internet use questionnaire comprising 34 questions was used. RESULTS: It was found that 86.5% of the students used the Internet at home. The mean daily Internet use was 2.5 hours during vacation, and less while school was in session. Although 86.5% of students with computers at home had Internet connections, approximately half of the students reported that they had frequently gone to Internet cafe's. CONCLUSION: Significant differences between boys and girls were found in terms of hours spent on the Internet and purpose of use, and changes over time in hours spent. "Daily" and "weekly" Internet use is more frequent among boys than girls. Boys visit cyber-sex sites more than girls. Those whose weekly Internet use was 4 hours or more were found to have been using the Internet for 36 months or more; they had irregular eating habits, and their relatives complained more frequently on the amount of time they spent on the Internet.

Adolescent↗