The Health and Retirement Study: Analysis of Associations Between Use of the Internet for Health Information and Use of Health Services at Multiple Time Points

BACKGROUND The use of the internet for health information among older people is receiving increasing attention, but how it is associated with chronic health conditions and health service use at concurrent and subsequent time points using nationally representative data is less known. OBJECTIVE This study aimed to determine whether the use of the internet for health information is associated with health service utilization and whether the association is affected by specific health conditions. METHODS The study used data collected in a technology module from a nationally representative sample of community-dwelling older Americans aged 52 years and above from the 2012 Health and Retirement Study (HRS; N=991). Negative binomial regressions were used to examine the association between use of Web-based health information and the reported health service uses in 2012 and 2014. Analyses included additional covariates adjusting for predisposing, enabling, and need factors. Interactions between the use of the internet for health information and chronic health conditions were also tested. RESULTS A total of 48.0% (476/991) of Americans aged 52 years and above reported using Web-based health information. The use of Web-based health information was positively associated with the concurrent reports of doctor visits, but not over 2 years. However, an interaction of using Web-based health information with diabetes showed that users had significantly fewer doctor visits compared with nonusers with diabetes at both times. CONCLUSIONS The use of the internet for health information was associated with higher health service use at the concurrent time, but not at the subsequent time. The interaction between the use of the internet for health information and diabetes was significant at both time points, which suggests that health-related internet use may be associated with fewer doctor visits for certain chronic health conditions. Results provide some insight into how Web-based health information may provide an alternative health care resource for managing chronic conditions.

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Use of TanDEM-X and SRTM-C Data for Detection of Deforestation Caused by Bark Beetle in Central European Mountains

Remote Sensing ◽

10.3390/rs13153042 ◽

2021 ◽

Vol 13 (15) ◽

pp. 3042

Author(s):

Kateřina Gdulová ◽

Jana Marešová ◽

Vojtěch Barták ◽

Marta Szostak ◽

Jaroslav Červenka ◽

...

Keyword(s):

Bark Beetle ◽

Synergistic Effects ◽

Canopy Height ◽

Surface Model ◽

Multiple Time ◽

Central European ◽

Time Points ◽

Bohemian Forest ◽

Multiple Time Points ◽

Surrounding Areas

The availability of global digital elevation models (DEMs) from multiple time points allows their combination for analysing vegetation changes. The combination of models (e.g., SRTM and TanDEM-X) can contain errors, which can, due to their synergistic effects, yield incorrect results. We used a high-resolution LiDAR-derived digital surface model (DSM) to evaluate the accuracy of canopy height estimates of the aforementioned global DEMs. In addition, we subtracted SRTM and TanDEM-X data at 90 and 30 m resolutions, respectively, to detect deforestation caused by bark beetle disturbance and evaluated the associations of their difference with terrain characteristics. The study areas covered three Central European mountain ranges and their surrounding areas: Bohemian Forest, Erzgebirge, and Giant Mountains. We found that vertical bias of SRTM and TanDEM-X, relative to the canopy height, is similar with negative values of up to −2.5 m and LE90s below 7.8 m in non-forest areas. In forests, the vertical bias of SRTM and TanDEM-X ranged from −0.5 to 4.1 m and LE90s from 7.2 to 11.0 m, respectively. The height differences between SRTM and TanDEM-X show moderate dependence on the slope and its orientation. LE90s for TDX-SRTM differences tended to be smaller for east-facing than for west-facing slopes, and varied, with aspect, by up to 1.5 m in non-forest areas and 3 m in forests, respectively. Finally, subtracting SRTM and NASA DEMs from TanDEM-X and Copernicus DEMs, respectively, successfully identified large areas of deforestation caused by hurricane Kyril in 2007 and a subsequent bark beetle disturbance in the Bohemian Forest. However, local errors in TanDEM-X, associated mainly with forest-covered west-facing slopes, resulted in erroneous identification of deforestation. Therefore, caution is needed when combining SRTM and TanDEM-X data in multitemporal studies in a mountain environment. Still, we can conclude that SRTM and TanDEM-X data represent suitable near global sources for the identification of deforestation in the period between the time points of their acquisition.

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Health Information Accessed on the Internet: The Development in 5 European Countries

International Journal of Telemedicine and Applications ◽

10.1155/2012/297416 ◽

2012 ◽

Vol 2012 ◽

pp. 1-3 ◽

Cited By ~ 19

Author(s):

Per Egil Kummervold ◽

Rolf Wynn

Keyword(s):

Health Information ◽

Major Part ◽

Information Access ◽

European Countries ◽

Northern Europe ◽

The Internet ◽

Continuous Growth ◽

Media Source ◽

Use Of The Internet ◽

Near Future

The aim of this study was to summarize and analyse findings from four prior studies on the use of the Internet as a source of health information in five European countries (Norway, Denmark, Germany, Greece, and Portugal). A cross-study comparison of data was performed. All the studies included fit with a trend of a sharp and continuous growth in the use of the Internet for health information access in the major part of the last decade. Importantly, the Internet has become an important mass media source of health information in northern Europe. While the use of the Internet for health information is somewhat less common in the south European countries, its use is also clearly increasing there. We discuss the advantages of cross-study comparisons of data and methodological challenges. As the use of the Internet for health information is likely to peak in some countries in the near future, new population surveys on health information access should focus more on the details of information that is accessed and which sites that are most used and trusted.

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Meta-analysis of effect sizes reported at multiple time points: A multivariate approach

Clinical Trials ◽

10.1177/1740774512453218 ◽

2012 ◽

Vol 9 (5) ◽

pp. 610-620 ◽

Cited By ~ 28

Author(s):

Thomas A Trikalinos ◽

Ingram Olkin

Keyword(s):

Random Effects ◽

Treatment Effects ◽

Multivariate Analyses ◽

Meta Analysis ◽

Effect Sizes ◽

Multiple Time ◽

Time Points ◽

Fixed And Random Effects ◽

Multiple Time Points ◽

Meta Analyses

Background Many comparative studies report results at multiple time points. Such data are correlated because they pertain to the same patients, but are typically meta-analyzed as separate quantitative syntheses at each time point, ignoring the correlations between time points. Purpose To develop a meta-analytic approach that estimates treatment effects at successive time points and takes account of the stochastic dependencies of those effects. Methods We present both fixed and random effects methods for multivariate meta-analysis of effect sizes reported at multiple time points. We provide formulas for calculating the covariance (and correlations) of the effect sizes at successive time points for four common metrics (log odds ratio, log risk ratio, risk difference, and arcsine difference) based on data reported in the primary studies. We work through an example of a meta-analysis of 17 randomized trials of radiotherapy and chemotherapy versus radiotherapy alone for the postoperative treatment of patients with malignant gliomas, where in each trial survival is assessed at 6, 12, 18, and 24 months post randomization. We also provide software code for the main analyses described in the article. Results We discuss the estimation of fixed and random effects models and explore five options for the structure of the covariance matrix of the random effects. In the example, we compare separate (univariate) meta-analyses at each of the four time points with joint analyses across all four time points using the proposed methods. Although results of univariate and multivariate analyses are generally similar in the example, there are small differences in the magnitude of the effect sizes and the corresponding standard errors. We also discuss conditional multivariate analyses where one compares treatment effects at later time points given observed data at earlier time points. Limitations Simulation and empirical studies are needed to clarify the gains of multivariate analyses compared with separate meta-analyses under a variety of conditions. Conclusions Data reported at multiple time points are multivariate in nature and are efficiently analyzed using multivariate methods. The latter are an attractive alternative or complement to performing separate meta-analyses.

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Use of the internet for health information: A study of Australians and New Zealanders

Informatics for Health and Social Care ◽

10.1080/17538150903102448 ◽

2009 ◽

Vol 34 (3) ◽

pp. 149-158 ◽

Cited By ~ 30

Author(s):

Robin Gauld ◽

Sheila Williams

Keyword(s):

Health Information ◽

The Internet ◽

Use Of The Internet ◽

New Zealanders

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Protocol paper for the ‘Harnessing resources from the internet to maximise outcomes from GP consultations (HaRI)’ study: a mixed qualitative methods study

BMJ Open ◽

10.1136/bmjopen-2018-024188 ◽

2018 ◽

Vol 8 (8) ◽

pp. e024188

Author(s):

Maureen Seguin ◽

Laura Hall ◽

Helen Atherton ◽

Rebecca Barnes ◽

Geraldine Leydon ◽

...

Keyword(s):

Health Information ◽

Current Evidence ◽

The Internet ◽

Online Health Information ◽

Online Information ◽

Wide Range ◽

Patient Questionnaires ◽

Ethical Approval ◽

Use Of The Internet ◽

Questionnaire Studies

IntroductionMany patients now turn to the internet as a resource for healthcare information and advice. However, patients’ use of the internet to manage their health has been positioned as a potential source of strain on the doctor–patient relationship in primary care. The current evidence about what happens when internet-derived health information is introduced during consultations has relied on qualitative data derived from interview or questionnaire studies. The ‘Harnessing resources from the internet to maximise outcomes from GP consultations (HaRI)’ study combines questionnaire, interview and video-recorded consultation data to address this issue more fully.Methods and analysisThree data collection methods are employed: preconsultation patient questionnaires, video-recorded consultations between general practitioners (GP) and patients, and semistructured interviews with GPs and patients. We seek to recruit 10 GPs practising in Southeast England. We aim to collect up to 30 patient questionnaires and video-recorded consultations per GP, yielding up to 300. Up to 30 patients (approximately three per participating GP) will be selected for interviews sampled for a wide range of sociodemographic characteristics, and a variety of ways the use of, or information from, the internet was present or absent during their consultation. We will interview all 10 participating GPs about their views of online health information, reflecting on their own usage of online information during consultations and their patients’ references to online health information. Descriptive, conversation and thematic analysis will be used respectively for the patient questionnaires, video-recorded consultations and interviews.Ethics and disseminationEthical approval has been granted by the London–Camden & Kings Cross Research Ethics Committee. Alongside journal publications, dissemination activities include the creation of a toolkit to be shared with patients and doctors, to guide discussions of material from the internet in consultations.

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Sex Differences in the Use of the Internet as a Source of Health Information Among Adolescents

Telemedicine Journal and e-Health ◽

10.1089/tmj.2009.0062 ◽

2010 ◽

Vol 16 (2) ◽

pp. 145-153 ◽

Cited By ~ 6

Author(s):

Jaime Jiménez-Pernett ◽

Antonio Olry de Labry-Lima ◽

Jose Francisco García-Gutiérrez ◽

Maria del Carmen Salcedo-Sánchez ◽

Clara Bermúdez-Tamayo

Keyword(s):

Sex Differences ◽

Health Information ◽

The Internet ◽

Use Of The Internet

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Directed Use of the Internet for Health Information by Patients With Chronic Kidney Disease: Prospective Cohort Study

Journal of Medical Internet Research ◽

10.2196/jmir.2848 ◽

2013 ◽

Vol 15 (11) ◽

pp. e251 ◽

Cited By ~ 22

Author(s):

Clarissa Jonas Diamantidis ◽

Wanda Fink ◽

Shiming Yang ◽

Marni R Zuckerman ◽

Jennifer Ginsberg ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Cohort Study ◽

Kidney Disease ◽

Health Information ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

The Internet ◽

Use Of The Internet

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THE ROLE OF MEMORY PERSPECTIVE IN SOCIAL PHOBIA: IMMEDIATE AND DELAYED MEMORIES FOR ROLE-PLAYED SITUATIONS

Behavioural and Cognitive Psychotherapy ◽

10.1017/s1352465802004034 ◽

2002 ◽

Vol 30 (4) ◽

pp. 415-425 ◽

Cited By ~ 34

Author(s):

Meredith E. Coles ◽

Cynthia L. Turk ◽

Richard G. Heimberg

Keyword(s):

Social Phobia ◽

Multiple Time ◽

Behavioral Models ◽

Social Situations ◽

Time Points ◽

Cognitive Behavioral Models ◽

Multiple Time Points ◽

Memory Perspective ◽

Field Perspective

Cognitive-behavioral models (Clark & Wells, 1995; Rapee & Heimberg, 1997) and recent research suggest that individuals with social phobia (SP) experience both images (Hackmann, Surawy, & Clark, 1998) and memories (Coles, Turk, Heimberg, & Fresco, 2001; Wells, Clark, & Ahmad, 1998) of anxiety-producing social situations from an observer perspective. The current study examines memory perspective for two role-played situations (speech and social interaction) at multiple time points (immediate and 3 weeks post) in 22 individuals with generalized SP and 30 non-anxious controls (NACs). At both time points, SPs recalled the role-plays from a more observer/less field perspective than did NACs. Further, over time, the memory perspective of SPs became even more observer/less field while the memory perspective of NAC remained relatively stable.

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