scholarly journals The Security State of the German Health Web: An Exploratory Study

2021 ◽  
Author(s):  
Frederic Henn ◽  
Richard Zowalla ◽  
Andreas Mayer
Keyword(s):  
Web Sites ◽  
Exploratory Study ◽  
Healthcare Providers ◽  
Web Pages ◽  
Security Vulnerabilities ◽  
Face To Face ◽  
German Health ◽  
Health Related ◽  
Future Work ◽  
Country Code

The internet has become an important resource for health information and for interactions with healthcare providers. However, information of all types can go through many servers and networks before reaching its intended destination and any of these has the potential to intercept or even manipulate the exchanged information if data’s transfer is not adequately protected. As trust is a fundamental concept in healthcare relationships, it is crucial to offer a secure medical website to maintain the same level of trust as provided in a face-to-face meeting. This study provides a first analysis of the SSL/TLS security of and the security headers used within the health-related web limited to web pages in German, the German health web (GHW). Methods: testssl.sh and TLS-Scanner were used to analyze the URLs of the 1,000 top-ranked health-related web sites (according to PageRank) for each of the country- code top level domains: “.de”, “.at” and “.ch”. Results: Our study revealed that most websites in the GHW are potentially vulnerable to common SSL/TLS security vulnerabilities, offer deprecated SSL/TLS protocol versions and mostly do not implement HTTP security headers at all. Conclusions: These findings question the concept of trust within the GHW. Website owners should reconsider the use of outdated SSL/TLS protocol versions for compatibility reasons. Additionally, HTTP security headers should be implemented more consequently to provide additional security aspects. In future work, the authors intend to repeat this study and to incorporate a website’s category, i.e. governmental or public health, to get a more detailed view of the GHW’s security.

scholarly journals Crawling the German Health Web: Exploratory Study and Graph Analysis

10.2196/17853 ◽  
2020 ◽  
Vol 22 (7) ◽  
pp. e17853
Author(s):  
Richard Zowalla ◽  
Thomas Wetter ◽  
Daniel Pfeifer
Keyword(s):  
Health Information ◽  
Large Fraction ◽  
Support Vector ◽  
Web Pages ◽  
Data Set ◽  
Total N ◽  
Harvest Rate ◽  
Health Domain ◽  
German Health ◽  
Health Related

Background The internet has become an increasingly important resource for health information. However, with a growing amount of web pages, it is nearly impossible for humans to manually keep track of evolving and continuously changing content in the health domain. To better understand the nature of all web-based health information as given in a specific language, it is important to identify (1) information hubs for the health domain, (2) content providers of high prestige, and (3) important topics and trends in the health-related web. In this context, an automatic web crawling approach can provide the necessary data for a computational and statistical analysis to answer (1) to (3). Objective This study demonstrates the suitability of a focused crawler for the acquisition of the German Health Web (GHW) which includes all health-related web content of the three mostly German speaking countries Germany, Austria and Switzerland. Based on the gathered data, we provide a preliminary analysis of the GHW’s graph structure covering its size, most important content providers and a ratio of public to private stakeholders. In addition, we provide our experiences in building and operating such a highly scalable crawler. Methods A support vector machine classifier was trained on a large data set acquired from various German content providers to distinguish between health-related and non–health-related web pages. The classifier was evaluated using accuracy, recall and precision on an 80/20 training/test split (TD1) and against a crowd-validated data set (TD2). To implement the crawler, we extended the open-source framework StormCrawler. The actual crawl was conducted for 227 days. The crawler was evaluated by using harvest rate and its recall was estimated using a seed-target approach. Results In total, n=22,405 seed URLs with country-code top level domains .de: 85.36% (19,126/22,405), .at: 6.83% (1530/22,405), .ch: 7.81% (1749/22,405), were collected from Curlie and a previous crawl. The text classifier achieved an accuracy on TD1 of 0.937 (TD2=0.966), a precision on TD1 of 0.934 (TD2=0.954) and a recall on TD1 of 0.944 (TD2=0.989). The crawl yields 13.5 million presumably relevant and 119.5 million nonrelevant web pages. The average harvest rate was 19.76%; recall was 0.821 (4105/5000 targets found). The resulting host-aggregated graph contains 215,372 nodes and 403,175 edges (network diameter=25; average path length=6.466; average degree=1.872; average in-degree=1.892; average out-degree=1.845; modularity=0.723). Among the 25 top-ranked pages for each country (according to PageRank), 40% (30/75) were web sites published by public institutions. 25% (19/75) were published by nonprofit organizations and 35% (26/75) by private organizations or individuals. Conclusions The results indicate, that the presented crawler is a suitable method for acquiring a large fraction of the GHW. As desired, the computed statistical data allows for determining major information hubs and important content providers on the GHW. In the future, the acquired data may be used to assess important topics and trends but also to build health-specific search engines.

scholarly journals Crawling the German Health Web: Exploratory Study and Graph Analysis (Preprint)

2020 ◽  
Author(s):  
Richard Zowalla ◽  
Thomas Wetter ◽  
Daniel Pfeifer
Keyword(s):  
Health Information ◽  
Large Fraction ◽  
Support Vector ◽  
Web Pages ◽  
Data Set ◽  
Total N ◽  
Harvest Rate ◽  
Health Domain ◽  
German Health ◽  
Health Related

BACKGROUND The internet has become an increasingly important resource for health information. However, with a growing amount of web pages, it is nearly impossible for humans to manually keep track of evolving and continuously changing content in the health domain. To better understand the nature of all web-based health information as given in a specific language, it is important to identify (1) information hubs for the health domain, (2) content providers of high prestige, and (3) important topics and trends in the health-related web. In this context, an automatic web crawling approach can provide the necessary data for a computational and statistical analysis to answer (1) to (3). OBJECTIVE This study demonstrates the suitability of a focused crawler for the acquisition of the German Health Web (GHW) which includes all health-related web content of the three mostly German speaking countries Germany, Austria and Switzerland. Based on the gathered data, we provide a preliminary analysis of the GHW’s graph structure covering its size, most important content providers and a ratio of public to private stakeholders. In addition, we provide our experiences in building and operating such a highly scalable crawler. METHODS A support vector machine classifier was trained on a large data set acquired from various German content providers to distinguish between health-related and non–health-related web pages. The classifier was evaluated using accuracy, recall and precision on an 80/20 training/test split (TD1) and against a crowd-validated data set (TD2). To implement the crawler, we extended the open-source framework StormCrawler. The actual crawl was conducted for 227 days. The crawler was evaluated by using harvest rate and its recall was estimated using a seed-target approach. RESULTS In total, n=22,405 seed URLs with country-code top level domains .de: 85.36% (19,126/22,405), .at: 6.83% (1530/22,405), .ch: 7.81% (1749/22,405), were collected from Curlie and a previous crawl. The text classifier achieved an accuracy on TD1 of 0.937 (TD2=0.966), a precision on TD1 of 0.934 (TD2=0.954) and a recall on TD1 of 0.944 (TD2=0.989). The crawl yields 13.5 million presumably relevant and 119.5 million nonrelevant web pages. The average harvest rate was 19.76%; recall was 0.821 (4105/5000 targets found). The resulting host-aggregated graph contains 215,372 nodes and 403,175 edges (network diameter=25; average path length=6.466; average degree=1.872; average in-degree=1.892; average out-degree=1.845; modularity=0.723). Among the 25 top-ranked pages for each country (according to PageRank), 40% (30/75) were web sites published by public institutions. 25% (19/75) were published by nonprofit organizations and 35% (26/75) by private organizations or individuals. CONCLUSIONS The results indicate, that the presented crawler is a suitable method for acquiring a large fraction of the GHW. As desired, the computed statistical data allows for determining major information hubs and important content providers on the GHW. In the future, the acquired data may be used to assess important topics and trends but also to build health-specific search engines.

Empathic Communication Skills Across Applied Undergraduate Psychology Courses: A Replication Study

2021 ◽  
pp. 009862832199543
Author(s):  
Catherine M. Reich ◽  
Lara J. LaCaille ◽  
Katherine E. Axford ◽  
Natalina R. Slaughter
Keyword(s):  
Communication Skills ◽  
Communication Competence ◽  
Learning Gains ◽  
Face To Face ◽  
Helping Skills ◽  
Empathic Communication ◽  
Health Related ◽  
Psychology Courses ◽  
Undergraduate Psychology ◽  
Over Time

Background: Although undergraduate psychology curriculum should cultivate performance-based skills to prepare students for helping professions, little work to date has addressed this standard. Objective: This research replicates the methods used in a previous study by examining pre-post changes in empathic communication skills and perceived communication competence across two applied psychology courses: Basic Helping Skills and Internship. This study extended this work by also exploring learning gains from different formats (i.e., face-to-face vs. online), internship types (mental health-related vs. not mental health-related), and the longevity of learning gains. Method: Psychology students ( N = 171) completed a measure of communication competence and provided written empathic responses on a vignette-based performance measure at the start and end of the semester. Results: Students perceived their communication skills as improving over time; however, only students in the Basic Helping Skills course showed improved empathic communication skills, especially when the instruction was in a face-to-face format. Students with previous skill training maintained their learning gains over time. Conclusion: Student empathic communication improves most with face-to-face instruction in Basic Helping Skills rather than an internship experience. Teaching Implications: For the development of empathic communication skills, prerequisite requirements for Internship and instructive scaffolding for the application of skills may be recommended.

Triple P for Parents of Children with Phenylketonuria: A Nonrandomized Trial

2020 ◽  
Author(s):  
Amy E Mitchell ◽  
Alina Morawska ◽  
Grace Kirby ◽  
James McGill ◽  
David Coman ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parenting Stress ◽  
Child Behavior ◽  
Triple P ◽  
Health Related Quality ◽  
Face To Face ◽  
Related Quality ◽  
Health Related ◽  
Nonrandomized Trial

Abstract Objective Families of children with phenylketonuria (PKU) report child emotional and behavioral problems, parenting stress, and parenting difficulties, which are associated with worse health-related quality of life. This study aimed to examine acceptability and feasibility of a brief, group-based parenting program (Healthy Living Triple P) for families of children with PKU. Methods An uncontrolled nonrandomized trial design was used. Families of children aged 2–12 years (N = 17) completed questionnaire measures assessing child behavior and impact of PKU on quality of life (primary outcomes), and parenting behavior, self-efficacy and stress, and children’s behavioral and emotional adjustment (secondary outcomes). Routinely collected blood phenylalanine (Phe) levels were obtained from the treating team. Parents selected two child behaviors as targets for change. The intervention comprised two, 2-hr group sessions delivered face-to-face or online. Assessment was repeated at 4-week postintervention (T2) and 4-month follow-up (T3). Results Attrition was low and parent satisfaction with the intervention (face-to-face and online) was high. All families achieved success with one or both child behavior goals, and 75% of families achieved 100% success with both behavior goals by T3; however, there was no change in health-related quality of life. There were moderate improvements in parent-reported ineffective parenting (total score, d = 0.87, 95% CI −1.01 to 2.75) and laxness (d = 0.59, 95% CI −1.27 to 2.46), but no effects on parenting stress or children’s adjustment. Phe levels improved by 6month post-intervention for children with elevated preintervention levels. Conclusions Results support intervention acceptability and feasibility. A randomized controlled trial is warranted to establish intervention efficacy.

Health of the offspring of immigrants: the BaBi birth cohort study

2019 ◽  
Vol 27 (4) ◽  
pp. 298-300
Author(s):  
Céline Miani ◽  
Oliver Razum ◽  
Jacob Spallek
Keyword(s):  
Early Childhood ◽  
Cohort Study ◽  
Cultural Diversity ◽  
Health System ◽  
Epidemiological Data ◽  
Migration Background ◽  
Heterogeneous Population ◽  
Birth Cohort Study ◽  
German Health ◽  
Health Related

Abstract Children with a migration background are more at risk of health-related problems than those without a migration background. The German health system still does not adequately meet the challenges of on increasingly heterogeneous population, not least due to a lack of adequate epidemiological data and models. The BaBi study contributes to gaining new insights in the development of health inequalities due to cultural diversity in Germany, with a focus on pregnancy and early childhood.

scholarly journals The Association of Body Mass Index with Health-Related Quality of Life: An Exploratory Study in a Multiethnic Asian Population

2008 ◽  
Vol 11 ◽  
pp. S105-S114 ◽  
Author(s):  
Hwee-Lin Wee ◽  
Yin-Bun Cheung ◽  
Wai-Chiong Loke ◽  
Chee-Beng Tan ◽  
Mun-Hong Chow ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Body Mass Index ◽  
Body Mass ◽  
Exploratory Study ◽  
Asian Population ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Protective preparation: a process central to family caregivers of persons with mild cognitive impairment

2017 ◽  
Vol 30 (3) ◽  
pp. 375-384 ◽  
Author(s):  
Ching-Lin Wang ◽  
Li-Min Kuo ◽  
Yi-Chen Chiu ◽  
Hsiu-Li Huang ◽  
Huei-Ling Huang ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Family Caregivers ◽  
Caregiver Burden ◽  
Family Caregiving ◽  
Healthcare Providers ◽  
Theory Approach ◽  
Face To Face ◽  
The Family ◽  
The Impact

ABSTRACTBackground:To develop a theoretical model explaining the longitudinal changes in the caregiving process for family caregivers of persons with mild cognitive impairment (MCI) in Taiwan.Methods:A longitudinal, grounded theory approach using in-depth face-to-face interviews and an open-ended interview guide. We conducted 42 interviews over a two-year period; each participant was interviewed at least once every six months. All participants were interviewed in their home. The participants total of 13 family caregivers of persons with MCI.Results:One core theme emerged: “protective preparation.” This reflected the family caregiving process of preparation for a further decline in cognitive function, and protection from the impact of low self-esteem, accidents, and symptoms of comorbidities for the family member with MCI. Protective preparation contained three components: ambivalent normalization, vigilant preparation, and protective management.Conclusions:Interventions to help family caregivers manage the changes in persons with MCI can reduce caregiver burden. Our findings could provide a knowledge base for use by healthcare providers to develop and implement strategies to reduce caregiver burden for family caregivers of persons with MCI.

scholarly journals Deploying a Fotonovela to Combat Methamphetamine Abuse among South Africans with Varying Levels of Health Literacy

2021 ◽  
Vol 18 (12) ◽  
pp. 6334
Author(s):  
Burt Davis ◽  
Carel J. M. Jansen
Keyword(s):  
South Africa ◽  
Health Literacy ◽  
Healthcare Providers ◽  
Age Groups ◽  
Control Group ◽  
Western Cape ◽  
Western Cape Province ◽  
Disadvantaged Communities ◽  
South Africans ◽  
Health Related

Poor health literacy in the Western Cape Province of South Africa is one of the main factors hampering methamphetamine (MA) use prevention efforts in the area, where the abuse of this drug is a major health and social problem affecting especially previously disadvantaged communities. In the first part of a two-part study, we compared a health-related fotonovela about MA to an existing brochure group and a control group. Main findings show that the vast majority of readers preferred the fotonovela over the existing brochure. This included participants from all three age groups and for both levels of health literacy (low/high) distinguished (N = 372). Furthermore, specifically for older people with low levels of health literacy, the fotonovela outperformed the existing brochure condition for knowledge level. In the second part of the study, we found that healthcare providers (N = 75) strongly prefer a fotonovela over an existing brochure, while this cohort viewed the potential use of fotonovelas in a health care setting as very positive. Our findings add to the promising results of an earlier fotonovela study about MA use in South Africa, providing further support for considering using narratives in health communication as a serious option to effectively communicate convincing health information about this drug to target audiences in the Western Cape Province.

Abstract 247: Pilot Study Examining Heart Failure Patient Internet Use and Adherence to a Web Based Portal Designed to Support Self-Care.

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Redah Z Mahmood ◽  
Judith Grossi ◽  
Todd M Koelling
Keyword(s):  
Computer Use ◽  
Healthcare Providers ◽  
Intervention Group ◽  
Self Care ◽  
Web Based ◽  
Face To Face ◽  
Clinical Events ◽  
Home Based ◽  
Care Information ◽  
Use Of Internet

Background: Experts agree that HF patients should practice appropriate self-care behaviors to minimize the risk of adverse clinical events, including early unplanned readmissions. We sought to understand patient perceptions and adherence to a web-based system designed to support self-care of HF patients. Methods: 100 HF patients were surveyed regarding their computer use and attitudes toward using an internet based web-portal (WP) to support self-care, provide patient education, and communicate with healthcare providers (HCP’s). We then consented 42 patients to participate in a 12 week trial of using the WP to track clinical parameters (daily weights, blood pressure, sodium/fluid intake, exercise), provide links for HF self-education, and update HCP’s on their progress. Patients received a face to face teaching session on accessing and using the WP. Results: The computer use survey (N=100) demonstrated that 72% of patients reported having a computer at home, 67% used email and 71% used the internet. In the WP intervention group (N=41) only 24 (58.5%) were able to successfully access the WP and enter data during the pilot (see table 1). Conclusions: Pilot data showed a significant positive correlation (see table 1) between patients indicating use of internet to access heaIth care information (HCI) and adherence with the WP. Despite strong interest to use a home based WP for self-care and communication with providers, we found that many hurdles prevented patients from using the WP. Internet based educational tools for HF patients may be desirable, but limitations in patients’ ability to access internet based programs may ultimately render the tools ineffective.

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