COVID-19–Related Internet Search Patterns Among People in the United States: Exploratory Analysis

Background The internet is a well-known source of information that patients use to better inform their opinions and to guide their conversations with physicians during clinic visits. The novelty of the recent COVID-19 outbreak has led patients to turn more frequently to the internet to gather more information and to alleviate their concerns about the virus. Objective The aims of the study were to (1) determine the most commonly searched phrases related to COVID-19 in the United States and (2) identify the sources of information for these web searches. Methods Search terms related to COVID-19 were entered into Google. Questions and websites from Google web search were extracted to a database using customized software. Each question was categorized into one of 6 topics: clinical signs and symptoms, treatment, transmission, cleaning methods, activity modification, and policy. Additionally, the websites were categorized according to source: World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), non-CDC government, academic, news, and other media. Results In total, 200 questions and websites were extracted. The most common question topic was transmission (n=63, 31.5%), followed by clinical signs and symptoms (n=54, 27.0%) and activity modification (n=31, 15.5%). Notably, the clinical signs and symptoms category captured questions about myths associated with the disease, such as whether consuming alcohol stops the coronavirus. The most common websites provided were maintained by the CDC, the WHO, and academic medical organizations. Collectively, these three sources accounted for 84.0% (n=168) of the websites in our sample. Conclusions In the United States, the most commonly searched topics related to COVID-19 were transmission, clinical signs and symptoms, and activity modification. Reassuringly, a sizable majority of internet sources provided were from major health organizations or from academic medical institutions.

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COVID-19–Related Internet Search Patterns Among People in the United States: Exploratory Analysis (Preprint)

10.2196/preprints.22407 ◽

2020 ◽

Author(s):

Tony S Shen ◽

Aaron Z Chen ◽

Patawut Bovonratwet ◽

Carol L Shen ◽

Edwin P Su

Keyword(s):

United States ◽

Web Search ◽

Clinical Signs ◽

Signs And Symptoms ◽

The United States ◽

World Health ◽

The Internet ◽

Sources Of Information ◽

Academic Medical ◽

Clinical Signs And Symptoms

BACKGROUND The internet is a well-known source of information that patients use to better inform their opinions and to guide their conversations with physicians during clinic visits. The novelty of the recent COVID-19 outbreak has led patients to turn more frequently to the internet to gather more information and to alleviate their concerns about the virus. OBJECTIVE The aims of the study were to (1) determine the most commonly searched phrases related to COVID-19 in the United States and (2) identify the sources of information for these web searches. METHODS Search terms related to COVID-19 were entered into Google. Questions and websites from Google web search were extracted to a database using customized software. Each question was categorized into one of 6 topics: clinical signs and symptoms, treatment, transmission, cleaning methods, activity modification, and policy. Additionally, the websites were categorized according to source: World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), non-CDC government, academic, news, and other media. RESULTS In total, 200 questions and websites were extracted. The most common question topic was transmission (n=63, 31.5%), followed by clinical signs and symptoms (n=54, 27.0%) and activity modification (n=31, 15.5%). Notably, the clinical signs and symptoms category captured questions about myths associated with the disease, such as whether consuming alcohol stops the coronavirus. The most common websites provided were maintained by the CDC, the WHO, and academic medical organizations. Collectively, these three sources accounted for 84.0% (n=168) of the websites in our sample. CONCLUSIONS In the United States, the most commonly searched topics related to COVID-19 were transmission, clinical signs and symptoms, and activity modification. Reassuringly, a sizable majority of internet sources provided were from major health organizations or from academic medical institutions.

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Lyme Disease: An Overview

Hospital Pharmacy ◽

10.1177/001857870003500211 ◽

2000 ◽

Vol 35 (2) ◽

pp. 156-161 ◽

Cited By ~ 1

Author(s):

Jean G. Dib ◽

Horatio B. Fung ◽

Raquel M. Tiu

Keyword(s):

United States ◽

Nervous System ◽

Lyme Disease ◽

Skin Lesion ◽

Erythema Migrans ◽

Clinical Signs ◽

Signs And Symptoms ◽

The United States ◽

Disease Treatment ◽

Clinical Signs And Symptoms

Lyme disease is the most common tick-borne illness in the United States. It occurs most commonly in areas that foster and harbor the deer tick. The number of reported cases of Lyme disease in the United States has increased steadily since 1982. The tick transmits an infection of the spirochete Borrelia burgdorferi that typically manifests as a localized skin lesion and erythema migrans. If left untreated, infection may lead to localized arthritis, heartblock, and/or disease of the nervous system. The diagnosis of Lyme disease is made primarily from clinical signs and symptoms that are suggestive of the disease. Treatment includes 10 to 27 days of antibiotics depending on stage of the disease. Vaccines for the prevention of Lyme disease are now licensed and the trend of increasing incidence of Lyme disease will likely be reversed.

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Sources of Information About Gestational Weight Gain, Diet, and Exercise Among Brazilian Immigrant Women Living in the United States: A Cross-Sectional Study

Public Health Nutrition ◽

10.1017/s1368980021001798 ◽

2021 ◽

pp. 1-41

Author(s):

Ana Cristina Lindsay ◽

Qun Le ◽

Denise Lima Nogueira ◽

Márcia M. T. Machado ◽

Mary L. Greaney

Keyword(s):

United States ◽

Weight Gain ◽

Gestational Weight Gain ◽

The United States ◽

The Internet ◽

Sources Of Information ◽

Cross Sectional ◽

Gestational Weight ◽

Diet And Exercise ◽

First Time

Abstract Objectives: The objective of this study was to assess sources of information about gestational weight gain (GWG), diet, and exercise among first-time pregnant Brazilian women in the United States (US). Design: Cross-sectional survey. Setting: Massachusetts, United States. Participants: First-time pregnant Brazilian women. Results: Eighty-six women, the majority of whom were immigrants (96.5%) classified as having low-acculturation levels (68%), participated in the study. Approximately two-thirds of respondents had sought information about GWG (72.1%), diet (79.1%), and exercise (74.4%) via the internet. Women classified as having low acculturation levels were more likely to seek information about GWG via the internet (OR = 7.55; 95% CI: 1.41, 40.26) than those with high acculturation levels after adjusting for age and receiving information about GWG from healthcare provider (doctor or midwife). Moreover, many respondents reported seeking information about GWG (67%), diet (71%), and exercise (52%) from family and friends. Women who self-identified as being overweight pre-pregnancy were less likely to seek information about diet (OR = 0.32; 95% CI: 0.11, 0.93) and exercise (OR = 0.33; 95% CI: 0.11, 0.96) from family and friends than those who self-identified being normal weight pre-pregnancy. Conclusions: This is the first study to assess sources of information about GWG, diet, and exercise among pregnant Brazilian immigrants in the US. Findings have implications for the design of interventions and suggest the potential of mHealth intervention as low-cost, easy access option for delivering culturally and linguistically tailored evidence-based information about GWG incorporating behavioral change practices to this growing immigrant group.

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Advances in Medical Genetics: Huntington Disease

Pediatrics in Review ◽

10.1542/pir.9.1.13 ◽

1987 ◽

Vol 9 (1) ◽

pp. 13-14

Author(s):

Frederick Hecht

Keyword(s):

Molecular Genetics ◽

Huntington Disease ◽

Age Of Onset ◽

Late Onset ◽

Clinical Signs ◽

Signs And Symptoms ◽

The United States ◽

Medical Genetics ◽

Clinical Signs And Symptoms ◽

Huntington Chorea

Medical genetics is currently enjoying a time of exploration and discovery. Huntington disease has long been of interest in adult medicine. The onset of clinical signs and symptoms is usually delayed until midadulthood. It may seem strange in this context to focus on Huntington disease, but advances in molecular genetics have brought Huntington disease into the purview of pediatrics. These advances in molecular genetics make it possible to detect Huntington disease in a preclinical stage at or even before birth. The molecular approach does not replace prior approaches to Huntington disease but is synergistic and provides a model of the new genetics. Huntington disease is synonymous with Huntington chorea. It is named after George Huntington who, like his father and grandfather before him, studied the disease in families on Long Island, NY. Huntington disease is a more common hereditary disorder than phenylketonuria, which occurs in one of about 10,000 newborns in the United States. By contrast, about one in 2,000 persons is at risk for Huntington disease. Although most cases start clinically in midadulthood, usually between 35 and 42 years of age, there is great variability in age of onset. About 3% of cases are diagnosed as juvenile Huntington disease before the age of 15 years. Late onset is well known after 50 years of age.

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Typical and atypical clinical signs and symptoms of myocardial infarction and delayed seeking of professional care among blacks

American Journal of Critical Care ◽

10.4037/ajcc1997.6.1.7 ◽

1997 ◽

Vol 6 (1) ◽

pp. 7-13 ◽

Cited By ~ 28

Author(s):

HO Lee

Keyword(s):

Myocardial Infarction ◽

Chest Pain ◽

Clinical Signs ◽

Signs And Symptoms ◽

The United States ◽

United States Department ◽

Manual Search ◽

Black Patients ◽

Definitive Therapy ◽

Clinical Signs And Symptoms

BACKGROUND: Despite the fact that the effectiveness of thrombolytic therapy for acute myocardial infarction is inversely related to the time between the onset of signs and symptoms and definitive therapy, long delays in seeking treatment have been reported consistently. A variety of reasons for the delays have been suggested. Because such delays are associated with longer hospital stays and higher mortality and morbidity, interventions that reduce delays are especially important. PURPOSE: To examine research on patients with myocardial infarction who delay seeking professional treatment and the factors related to the delay, and to review studies indicating that black patients have premonitory clinical signs and symptoms of myocardial infarction and changes in the structure and function of the cardiovascular system that are different from those in whites. METHODS: Studies were reviewed by using MEDLINE and by doing a manual search of relevant research journals in cardiovascular, nursing, and behavioral medicine published since 1970. Data published by the United States Department of Health and Human Services and the Agency for Health Care Policy and Research were also reviewed. RESULTS: Although the lengths of the delays have varied considerably, blacks have generally experienced longer delays than whites between acute onset of signs and symptoms of myocardial infarction and arrival at the emergency department. Studies show that black patients have a lower incidence of classic chest pain or discomfort but an increased incidence of dyspnea, whereas white patients are much more likely to complain of chest pain. CONCLUSION: Culturally sensitive public education about typical and atypical premonitory clinical signs and symptoms of myocardial infarction and the significance of early treatment of myocardial infarction in blacks is needed.

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Phosphodiesterase Inhibitors: Could They Be Beneficial for the Treatment of COVID-19?

International Journal of Molecular Sciences ◽

10.3390/ijms21155338 ◽

2020 ◽

Vol 21 (15) ◽

pp. 5338 ◽

Cited By ~ 4

Author(s):

Mauro Giorgi ◽

Silvia Cardarelli ◽

Federica Ragusa ◽

Michele Saliola ◽

Stefano Biagioni ◽

...

Keyword(s):

Clinical Signs ◽

Clinical Manifestations ◽

Phosphodiesterase Inhibitors ◽

Signs And Symptoms ◽

World Health ◽

Pde Inhibitors ◽

Clinical Signs And Symptoms ◽

Hydrolyzing Enzymes ◽

Health Organization ◽

Restrictive Measures

In March 2020, the World Health Organization declared the severe acute respiratory syndrome corona virus 2 (SARS-CoV2) infection to be a pandemic disease. SARS-CoV2 was first identified in China and, despite the restrictive measures adopted, the epidemic has spread globally, becoming a pandemic in a very short time. Though there is growing knowledge of the SARS-CoV2 infection and its clinical manifestations, an effective cure to limit its acute symptoms and its severe complications has not yet been found. Given the worldwide health and economic emergency issues accompanying this pandemic, there is an absolute urgency to identify effective treatments and reduce the post infection outcomes. In this context, phosphodiesterases (PDEs), evolutionarily conserved cyclic nucleotide (cAMP/cGMP) hydrolyzing enzymes, could emerge as new potential targets. Given their extended distribution and modulating role in nearly all organs and cellular environments, a large number of drugs (PDE inhibitors) have been developed to control the specific functions of each PDE family. These PDE inhibitors have already been used in the treatment of pathologies that show clinical signs and symptoms completely or partially overlapping with post-COVID-19 conditions (e.g., thrombosis, inflammation, fibrosis), while new PDE-selective or pan-selective inhibitors are currently under study. This review discusses the state of the art of the different pathologies currently treated with phosphodiesterase inhibitors, highlighting the numerous similarities with the disorders linked to SARS-CoV2 infection, to support the hypothesis that PDE inhibitors, alone or in combination with other drugs, could be beneficial for the treatment of COVID-19.

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Telehealth in the Context of COVID-19: Changing Perspectives in Australia, the United Kingdom, and the United States

Journal of Medical Internet Research ◽

10.2196/19264 ◽

2020 ◽

Vol 22 (6) ◽

pp. e19264 ◽

Cited By ~ 31

Author(s):

Malcolm Fisk ◽

Anne Livingstone ◽

Sabrina Winona Pit

Keyword(s):

United States ◽

United Kingdom ◽

Health Services ◽

Older People ◽

Health Care Providers ◽

The United States ◽

World Health ◽

Care Providers ◽

Sources Of Information ◽

The United Kingdom

Background On March 12, 2020, the World Health Organization declared the coronavirus disease (COVID-19) outbreak a pandemic. On that date, there were 134,576 reported cases and 4981 deaths worldwide. By March 26, 2020, just 2 weeks later, reported cases had increased four-fold to 531,865, and deaths increased five-fold to 24,073. Older people are both major users of telehealth services and are more likely to die as a result of COVID-19. Objective This paper examines the extent that Australia, the United Kingdom, and the United States, during the 2 weeks following the pandemic announcement, sought to promote telehealth as a tool that could help identify COVID-19 among older people who may live alone, be frail, or be self-isolating, and give support to or facilitate the treatment of people who are or may be infected. Methods This paper reports, for the 2-week period previously mentioned and immediately prior, on activities and initiatives in the three countries taken by governments or their agencies (at national or state levels) together with publications or guidance issued by professional, trade, and charitable bodies. Different sources of information are drawn upon that point to the perceived likely benefits of telehealth in fighting the pandemic. It is not the purpose of this paper to draw together or analyze information that reflects growing knowledge about COVID-19, except where telehealth is seen as a component. Results The picture that emerges for the three countries, based on the sources identified, shows a number of differences. These differences center on the nature of their health services, the extent of attention given to older people (and the circumstances that can relate to them), the different geographies (notably concerned with rurality), and the changes to funding frameworks that could impact these. Common to all three countries is the value attributed to maintaining quality safeguards in the wider context of their health services but where such services are noted as sometimes having precluded significant telehealth use. Conclusions The COVID-19 pandemic is forcing changes and may help to establish telehealth more firmly in its aftermath. Some of the changes may not be long-lasting. However, the momentum is such that telehealth will almost certainly find a stronger place within health service frameworks for each of the three countries and is likely to have increased acceptance among both patients and health care providers.

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Assessment of Health Information About COVID-19 Prevention on the Internet: Infodemiological Study

JMIR Public Health and Surveillance ◽

10.2196/18717 ◽

2020 ◽

Vol 6 (2) ◽

pp. e18717 ◽

Cited By ~ 52

Author(s):

Ignacio Hernández-García ◽

Teresa Giménez-Júlvez

Keyword(s):

Public Health ◽

United States ◽

Digital Media ◽

Health Information ◽

The United States ◽

World Health ◽

The Internet ◽

Health Organizations ◽

Public Health Organizations ◽

Google Search

Background The internet is a large source of health information and has the capacity to influence its users. However, the information found on the internet often lacks scientific rigor, as anyone may upload content. This factor is a cause of great concern to scientific societies, governments, and users. Objective The objective of our study was to investigate the information about the prevention of coronavirus disease 2019 (COVID-19) on the internet. Methods On February 29, 2020, we performed a Google search with the terms “Prevention coronavirus,” “Prevention COVID-19,” “Prevención coronavirus,” and “Prevención COVID-19”. A univariate analysis was performed to study the association between the type of authorship, country of publication, and recommendations to avoid COVID-19 according to the World Health Organization (WHO). Results In total, 80 weblinks were reviewed. Most of them were produced in the United States and Spain (n=58, 73%) by digital media sources and official public health organizations (n=60, 75%). The most mentioned WHO preventive measure was “wash your hands frequently” (n=65, 81%). A less frequent recommendation was to “stay home if you feel unwell” (n=26, 33%). The analysis by type of author (official public health organizations versus digital media) revealed significant differences regarding the recommendation to wear a mask when you are healthy only if caring for a person with suspected COVID-19 (odds ratio [OR] 4.39). According to the country of publication (Spain versus the United States), significant differences were detected regarding some recommendations such as “wash your hands frequently” (OR 9.82), “cover your mouth and nose with your bent elbow or tissue when you cough or sneeze” (OR 4.59), or “stay home if you feel unwell” (OR 0.31). Conclusions It is necessary to urge and promote the use of the websites of official public health organizations when seeking information on COVID-19 preventive measures on the internet. In this way, users will be able to obtain high-quality information more frequently, and such websites may improve their accessibility and positioning, given that search engines justify the positioning of links obtained in a search based on the frequency of access to them.

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Assessment of Health Information About COVID-19 Prevention on the Internet: Infodemiological Study (Preprint)

10.2196/preprints.18717 ◽

2020 ◽

Cited By ~ 1

Author(s):

Ignacio Hernández-García ◽

Teresa Giménez-Júlvez

Keyword(s):

Public Health ◽

United States ◽

Digital Media ◽

Health Information ◽

The United States ◽

World Health ◽

The Internet ◽

Health Organizations ◽

Public Health Organizations ◽

Google Search

BACKGROUND The internet is a large source of health information and has the capacity to influence its users. However, the information found on the internet often lacks scientific rigor, as anyone may upload content. This factor is a cause of great concern to scientific societies, governments, and users. OBJECTIVE The objective of our study was to investigate the information about the prevention of coronavirus disease 2019 (COVID-19) on the internet. METHODS On February 29, 2020, we performed a Google search with the terms “Prevention coronavirus,” “Prevention COVID-19,” “Prevención coronavirus,” and “Prevención COVID-19”. A univariate analysis was performed to study the association between the type of authorship, country of publication, and recommendations to avoid COVID-19 according to the World Health Organization (WHO). RESULTS In total, 80 weblinks were reviewed. Most of them were produced in the United States and Spain (n=58, 73%) by digital media sources and official public health organizations (n=60, 75%). The most mentioned WHO preventive measure was “wash your hands frequently” (n=65, 81%). A less frequent recommendation was to “stay home if you feel unwell” (n=26, 33%). The analysis by type of author (official public health organizations versus digital media) revealed significant differences regarding the recommendation to wear a mask when you are healthy only if caring for a person with suspected COVID-19 (odds ratio [OR] 4.39). According to the country of publication (Spain versus the United States), significant differences were detected regarding some recommendations such as “wash your hands frequently” (OR 9.82), “cover your mouth and nose with your bent elbow or tissue when you cough or sneeze” (OR 4.59), or “stay home if you feel unwell” (OR 0.31). CONCLUSIONS It is necessary to urge and promote the use of the websites of official public health organizations when seeking information on COVID-19 preventive measures on the internet. In this way, users will be able to obtain high-quality information more frequently, and such websites may improve their accessibility and positioning, given that search engines justify the positioning of links obtained in a search based on the frequency of access to them.

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Telehealth in the Context of COVID-19: Changing Perspectives in Australia, the United Kingdom, and the United States (Preprint)

10.2196/preprints.19264 ◽

2020 ◽

Author(s):

Malcolm Fisk ◽

Anne Livingstone ◽

Sabrina Winona Pit

Keyword(s):

United States ◽

United Kingdom ◽

Health Services ◽

Older People ◽

Health Care Providers ◽

The United States ◽

World Health ◽

Care Providers ◽

Sources Of Information ◽

The United Kingdom

BACKGROUND On March 12, 2020, the World Health Organization declared the coronavirus disease (COVID-19) outbreak a pandemic. On that date, there were 134,576 reported cases and 4981 deaths worldwide. By March 26, 2020, just 2 weeks later, reported cases had increased four-fold to 531,865, and deaths increased five-fold to 24,073. Older people are both major users of telehealth services and are more likely to die as a result of COVID-19. OBJECTIVE This paper examines the extent that Australia, the United Kingdom, and the United States, during the 2 weeks following the pandemic announcement, sought to promote telehealth as a tool that could help identify COVID-19 among older people who may live alone, be frail, or be self-isolating, and give support to or facilitate the treatment of people who are or may be infected. METHODS This paper reports, for the 2-week period previously mentioned and immediately prior, on activities and initiatives in the three countries taken by governments or their agencies (at national or state levels) together with publications or guidance issued by professional, trade, and charitable bodies. Different sources of information are drawn upon that point to the perceived likely benefits of telehealth in fighting the pandemic. It is not the purpose of this paper to draw together or analyze information that reflects growing knowledge about COVID-19, except where telehealth is seen as a component. RESULTS The picture that emerges for the three countries, based on the sources identified, shows a number of differences. These differences center on the nature of their health services, the extent of attention given to older people (and the circumstances that can relate to them), the different geographies (notably concerned with rurality), and the changes to funding frameworks that could impact these. Common to all three countries is the value attributed to maintaining quality safeguards in the wider context of their health services but where such services are noted as sometimes having precluded significant telehealth use. CONCLUSIONS The COVID-19 pandemic is forcing changes and may help to establish telehealth more firmly in its aftermath. Some of the changes may not be long-lasting. However, the momentum is such that telehealth will almost certainly find a stronger place within health service frameworks for each of the three countries and is likely to have increased acceptance among both patients and health care providers.

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