Internet Health Research Articles

Internet use, cardiometabolic multimorbidity, and death in older adults: a multi-cohort study spanning developing and developed countries

BackgroundInternet use is a double-edged sword for older adults’ health. Whether internet use can prevent cardiometabolic diseases and death in older adults remains controversial.MethodsFour cohorts across China, Mexico, the United States, and Europe were utilized. Internet use was defined using similar questions. Cardiometabolic diseases included diabetes, heart diseases, and stroke, with 2 or more denoting cardiometabolic multimorbidity. Depressive symptoms were assessed using the Center for Epidemiological Studies Depression Scale and Europe-depression scale. The competing risk analysis based on subdistribution hazard regression, random-effects meta-analysis, and mediation analysis were utilized.ResultsA total of 104,422 older adults aged 50 or older were included. Internet users (vs. digital exclusion) were at lower risks of diabetes, stroke, and death, with pooled sHRs (95% CIs) of 0.83 (0.74–0.93), 0.81 (0.71–0.92), and 0.67 (0.52–0.86), respectively, which remained significant in sensitivity analyses. The inverse associations of internet use with new-onset cardiometabolic diseases and death were progressively significant in Mexico, China, the United States, and Europe. For instance, older internet users in Europe were at 14-30% lower cardiometabolic risks and 40% lower risk of death. These associations were partially mediated by reduced depressive symptoms and were more pronounced in those with high socioeconomic status and women. Furthermore, patients with prior cardiometabolic conditions were at about 30% lower risk of death if they used the internet, which was also mediated by reduced depressive symptoms. However, certain cardiometabolic hazards of internet use in those aged < 65 years, with low socioeconomic status, men, and single ones were also observed.ConclusionEnhancing internet usage in older adults can reduce depressive symptoms and thus reduce the risks of cardiometabolic diseases and death. The balance of internet use, socioeconomic status, and health literacy should be considered when popularizing the internet in older adults.

Pregnancy-Related Information-Seeking Behavior and Information Literacy Profiles of Women at Reproductive Age

ABSTRACT The purpose of this article is to capture pregnancy-related information seeking behavior of women and its correlation with socio-economic status and with Internet health information literacy profiles. A user survey based on Wilson’s’ macro-model of information seeking behavior was designed and carried out. The survey included 289 women at reproductive age who provided valid feedback on information needs, motives for seeking pregnancy-related information online, information resources employed and Internet information literacy. Responses were collected via an anonymous questionnaire and processed using SPSS (Statistical Package for Social Sciences) version 25.0. The results demonstrate that women have increased information needs during pregnancy, that they are primarily concerned about the health of their embryos and that they tend to turn mainly to their doctors, their family and to the Web for obtaining pregnancy-related information. Internet is most used by younger women and online information is generally deemed useful. The analysis of survey responses indicated that pregnancy-related information literacy profiles are influenced by women’s educational status and age. Official online information sources should be made available in Greece, where women could find useful and trusted information about pregnancy issues.

Internet Health Resources on Nocturnal Enuresis: A Readability, Quality, and Accuracy Analysis.

Nocturnal enuresis is a common yet quality-of-life-limiting pediatric condition. There is an increasing trend for parents to obtain information on the disease's nature and treatment options via the internet. However, the quality of health-related information on the internet varies greatly and is largely uncontrolled and unregulated. With this study, a readability, quality, and accuracy evaluation of the health information regarding nocturnal enuresis is carried out. A questionnaire was administered to parents and patients with nocturnal enuresis to determine their use of the internet to research their condition. The most common search terms were determined, and the first 30 websites returned by the most popular search engines were used to assess the quality of information about nocturnal enuresis. Each site was categorized by type and assessed for readability using the Gunning fog score, Simple Measure of Gobbledygook (SMOG) index, and Dale-Chall score; for quality using the DISCERN score; and for accuracy by comparison to the International Children's Continence Society guidelines by three experienced pediatric urologists and nephrologists. A total of 30 websites were assessed and classified into five categories: professional (n = 13), nonprofit (n = 8), commercial (n = 4), government (n = 3), and other (n = 2). The information was considered difficult for the public to comprehend, with mean Gunning fog, SMOG index, and Dale-Chall scores of 12.1 ± 4.3, 14.1 ± 4.3, and 8.1 ± 1.3, respectively. The mean summed DISCERN score was 41 ± 11.6 out of 75. Only seven (23%) websites were considered of good quality (DISCERN score > 50). The mean accuracy score of the websites was 3.2 ± 0.6 out of 5. Commercial websites were of the poorest quality and accuracy. Websites generally scored well in providing their aims and identifying treatment benefits and options, while they lacked references and information regarding treatment risks and mechanisms. Online information about nocturnal enuresis exists for parents; however, most websites are of suboptimal quality, readability, and accuracy. Pediatric surgeons should be aware of parents' health-information-seeking behavior and be proactive in guiding parents to identify high-quality resources.

Identifying the Information Needs and Format Preferences for Web-Based Content Among Adults With or Parents of Children With Attention-Deficit/Hyperactivity Disorder: Three-Stage Qualitative Analysis.

Attention-deficit/hyperactivity disorder (ADHD) is a highly prevalent childhood and adult behavioral disorder. Internet searches for ADHD information are rising, particularly for diagnosis and treatment. Despite effective ADHD treatments, research suggests that there are delays in seeking help for ADHD. Identifying ways to shorten delays is important for minimizing morbidity associated with ADHD. One way to shorten these delays is to improve internet health information resources. Research shows that parents of children with ADHD feel that much of the information available is technical and not tailored for their child's needs and verbal instructions given by health care providers were too pharmacologically focused with limited information about how to manage and support ADHD symptoms in daily living. A majority of parents search the internet for general and pharmacological information for ADHD and prefer web-based resources for learning about ADHD, but web-based resources may be inaccurate and of low quality. Ensuring accurate information through the internet is an important step in assisting parents and adults in making informed decisions about the diagnosis and treatment of ADHD. Although a great deal of information regarding ADHD is available on the internet, some information is not based on scientific evidence or is difficult for stakeholders to understand. Determining gaps in access to accurate ADHD information and stakeholder interest in the type of information desired is important in improving patient engagement with the health care system, but minimal research addresses these needs. This study aims to determine the information needs and formatting needs of web-based content for adults with ADHD and parents of children with ADHD in order to improve user experience and engagement. This was a 3-phase study consisting of in-depth phone interviews about experiences with ADHD and barriers searching for ADHD-related information, focus groups where participants were instructed to consider the pathways by which they made decisions using web-based resources, and observing participants interacting with a newly developed website tailored for adults with potential ADHD and caregivers of children who had or might have ADHD. Phase 1 individual interviews and phase 2 focus groups identified the needs of the ADHD stakeholders related to website content and format. Interview and focus group findings were used to develop a website. Phase 3 used think-aloud interviews to evaluate website usability to inform the tailoring of the website based on user feedback. Interviews and focus group findings revealed preferences for ADHD website information and content, website layout, and information sources. Themes included a preference for destigmatizing information about ADHD, information specific to patient demographics, and evidence-based information tailored to lay audiences. ADHD stakeholders are specifically seeking positive information about ADHD presented in a user-friendly format.

COVID-19 symptoms, internet information seeking, and stigma influence post-lockdown health anxiety.

With the lifting of Zero-COVID policies in China, rapid transmission of the virus has led to new challenges for patients' health anxiety. This study aimed to evaluate the relationship between COVID-19 symptoms and health anxiety, as well as the mediation paths between them in individuals infected with COVID-19. A cross-sectional study was conducted in December 2022, following the relaxation of anti-COVID measures in China. A validated online questionnaire was used to collect data from COVID-19 patients on the number and severity of symptoms, health anxiety, internet health information-seeking behavior (IHISB), and perceived stigma. Structural equation modeling was used to examine the mediation model in which COVID-19 symptoms would affect health anxiety via IHISB and perceived stigma. Overall, 1,132 participants (women, 67.6%) were included, with a mean (SD) age of 28.12 (10.07) years. Participants had an average of seven COVID-19 symptoms, with cough (91.3%), nasal congestion (89.1%) and fatigue (87.8%) being the most common. The number and severity of COVID-19 symptoms, IHISB, perceived stigma, and health anxiety were positively correlated with each other after adjusting for covariates (r ranging from 0.10 to 0.81, all p < 0.05). IHISB (effect = 0.14, p < 0.001) and perceived stigma (effect = 0.04, p < 0.001) fully mediated the relationship between COVID-19 symptoms and health anxiety. Interventions for health anxiety reduction during and after pandemics should target improving the quality of online health information, enhancing individuals' online healthy literacy, and reducing stigma.

Internet addiction and health profile among medical, dental and nursing graduates of India

Internet addiction and health profile among medical, dental and nursing graduates of India

Association Between Problematic Internet Use and Health Risks in Adolescents With and Without Chronic Health Conditions

Background. Sedentary and unhealthy lifestyle behaviors are modifiable health risks that often develop during adolescence. A comprehensive analysis of unhealthy behaviors in adolescents with and without chronic health conditions (CHC) could inform the development of more effective prevention approaches.&#x0D; The aim. This study aimed to measure associations between Problematic Internet Use (PIU), lifestyle habits and subjective health complaints among adolescents with and without CHC. In addition, health behaviors and prevalence of subjective health complaints between adolescents with and without CHC were compared.&#x0D; Methods. A total of 171 adolescents (87 without CHC and 84 with CHC) completed an online survey. The PIU was assessed by the Problematic and Risky Internet Use Screening Scale. The subjective health complaints assessed were somatic and psychological symptoms. Healthy lifestyle behaviors assessed were daily physical activities, time spent by screens, eating habits, and duration of sleep.&#x0D; Results. The results showed that 21.83% of adolescents with CHC and 36.78% without CHC scored at risk for problematic internet use. Adolescents without CHC reported significantly more frequent psychological health complaints than their peers with CHC. This study found that multiple health complaints and unhealthy eating habits were significantly associated with PIU in adolescents with CHC, while nervousness and eating fast food in adolescents without CHC. Girls without CHC reported significantly higher PRIUSS scores and prevalence of subjective health complaints than boys (p &lt;.05).&#x0D; Conclusions. Adolescents without CHC reported significantly higher levels of moderate and vigorous intensity physical activities weekly than their peers with CHC. PIU behaviors are mainly associated with psychological health complaints and unhealthy eating behaviors in adolescents with and without CHC. These findings highlight the need to identify the specific problematic internet use activities that are associated with different health risks in adolescents.&#x0D; Keywords: problematic internet use, chronic health conditions, lifestyle behaviors, health, adolescents.

Discrimination of artificial intelligence in healthcare

Currently, artificial intelligence (AI) plays an important role in various fields as a primary worker or assistant, especially in healthcare. AI has many functions that can be performed even better than humans do due to the high speed of compiling a large amount of data from various sources (Internet and electronic health records), which increases the productivity of doctors. Less discussed, though equally important, is the discrimination of AI in healthcare. Doctors, who have a lot of responsibility, cannot rely on AI due to multiple vulnerabilities. First, AI collects huge amounts of data. However, AI does not guarantee error-free results, despite its non-autonomy and operator control, since human factors can play a role, becoming a source of inaccuracy. Therefore, a high risk of using poor quality data in further decision-making processes exists. Errors, biases (ethnic, gender, age, and social), and data gaps worsen AI outcomes, leading, for example, to discrimination against minorities and inaccurate prescriptions. In addition, AI may act unethically or even violate laws (e.g., Title VI, Section 1557 of the Affordable Care Act, which prohibits discrimination by race, color, national origin, sex, age, or disability in certain healthcare programs and activities).&#x0D; Secondly, AI may be called secretive due to the indeterminacy of the algorithms. This means that no one can explain how or why the AI reached this or that decision, as stated by Judea Pearl in The Book of Why: The New Science of Cause and Effect. Therefore, doctors cannot check the facts and make sure that the analysis is done correctly and the conclusion is accurate. Difficulties in solving real-world problems using AI that cannot be solved by formal and mathematical rules of logic as humans do (e.g., natural language and face recognition) must be recognized. AI makes the work of medical professionals easier, however, posing many unresolved problems that mislead doctors and contribute to wrong decisions.

How value drivers of internet medical business model affect value creation: a configurational approach

PurposeThis paper aims to investigate how value drivers of internet medical business model affect value creation through a configurational approach. The internet medical business model (IMBM) is such a business model that integrates online and offline medical services with the driving force of internet technologies covering prediagnosis, in-diagnosis and postdiagnosis. The outbreak of COVID-19 and the support of national policies have boosted the development of internet health care. However, there are still many challenges in practice, such as the unclear innovation path, as well as difficulties in landing and profiting. Academic research has not yet provided sufficient theoretical insights. Therefore, to better explain and guide practice, it is urgent to clarify the innovation path and mechanism of value creation for IMBM.Design/methodology/approachBased on the sample of 58 internet medical firms in China, this paper adopts fuzzy-set qualitative comparative analysis (fsQCA) to explore the configurational effects of IMBM’s value drivers on value creation.FindingsBuilding on the business model canvas and the characteristics of internet health care, five value drivers of IMBM are identified, namely, functional value proposition, emotional value proposition, user involvement, resource capabilities and connection properties. And the five value drivers form three configurations, which are, respectively, labeled as resource-driven configuration, user-operated configuration and product-combined configuration. From the perspective of the integration of traditional and emerging theories, such as resource-based view, internet economics and value cocreation, each configuration leads to value creation and improves value results with different mechanisms behind it.Originality/valueFirst, combined with the business model canvas and the characteristics of internet health care, this paper identifies five value drivers of IMBM, thus improving the relevant research on internet health care. Second, based on the configurational effects, this paper discusses the mechanism behind the configurational effects of IMBM’s value drivers on value creation, thus expanding relevant research on the value creation of business models. Third, applying fsQCA and combining the advantages of qualitative research and quantitative research, this paper adds to the configurations of IMBM’s value drivers that achieve high-value results.

Effectiveness of Internet-based health management in patients with dyslipidemia: A four-year longitudinal study

Background and aimsDyslipidemia is an important risk factor for coronary artery disease and stroke, and it has emerged as a major public health issue worldwide. Internet-based health management and intervention may offer a new approach to health management. This study was conducted to provide health guidance and education to people with dyslipidemia using an Internet health management platform and to assess the effectiveness of Internet health management and intervention in improving health-related behaviors and controlling blood lipids. MethodsStarting in 2013 (Baseline, N = 56,542), a Western longitudinal study in China was performed, and all interventional objects were provided with Internet health management. Health checkups were conducted annually, and questionnaires were administered every two years to analyze changes in health behaviors two years (2015) and four years (2017) following the intervention. In addition, factors affecting behavioral changes and lipid control were analyzed in the dyslipidemic population to understand the effectiveness and influencing factors of Internet health management on lipid control. ResultsBy guiding interventional objects through the Internet health management platform, the awareness rate of dyslipidemia increased from 19.1% in 2013 to 34.4% in 2017; and the control rate of dyslipidemia increased from 9.1% at baseline to 18.5%. Certain health-related behaviors that are beneficial to health (tobacco use, physical activity, and partial dietary) were gradually improved over the intervention time. For patients with dyslipidemia, triglyceride decreased from 2.90 mmol/L (2013) to 2.77 mmol/L (2017) as the years went by. Analysis of factors affecting lipid control showed that non-compliance with health instructions affected lipid control; in addition to these, being female (0.722, 95% CI: 0.546,0.954) was found to be a protective factor for effective lipid control. ConclusionsThe basic Internet-based health management platform in this study appears to be moderately successful and is a valuable and feasible application. Tobacco, dietary, and physical activity interventions provided significant protection against dyslipidemia in patients.

Perception of Internet Use in Relation to Health Decision-Making among Nursing Students.

Internet use has increased worldwide during the COVID-19 pandemic, to the point where it has inadvertently integrated into our lives. University students use the Internet daily for different purposes: seeking information, entertaining, as a teaching and learning tool, they consider social networks as a means of connection and social interaction, and to seek information to make health decisions. Because of this, the Internet and social networks have gained popularity among this group, to the point of developing an abusive use that is not perceived as an addictive risk. A descriptive analysis was performed through the adaptation of a survey about Internet use, social networks and health perception; this survey was given to nursing students of the Gimbernat School during the academic year 2021-2022. Students completed the ad hoc questionnaire (N = 486; 83.5% female, 16.3% male; only 1 declared to be non-binary gender). Our hypothesis had to do with whether the population of nursing students at Gimbernat School had increased, after the pandemic, its use of the Internet and social networks to make decisions about health problems. The objective of the study was to analyse differences in students' habits of use of the Internet and social networks as they look for health information, their decision-making when they find the information and their perception of health as nursing students from a gender perspective. The results showed a clear positive relationship between the variables studied. Of nursing students, 60.4% spend between 20 and more than 40 h a week using the Internet, and 43.6% of these hours are spent on social networks. Of students, 31.1% make health decisions by searching for information on the Internet and consider it useful and relevant. The use of the Internet and social media in relation to health decisions is clearly affected. To try to reduce the incidence of the problem, interventions are needed regarding the prevention and/or consequences of Internet abuse and health education of student nurses as future health assets.

Minding the gap: The moderating role of education between subjective health and social life perception and Internet use time

Introduction: Internet addiction results in intense and frequent use. There is a gap in the literature in relation to the unawareness of problematic Internet use (PIU) in predicting Internet use time (IUT). Objective: To identify sociodemographic/psychological variables contributing and moderating IUT. Participants: 1,270 participants of the European Social Survey (EES), Round 8. Instruments: EES variables assessing Internet use (IU), health perception, well-being, social life, and sociodemographic variables, underlying the construct. Results: Age, education, sources of household income, social activities compared to others of the same age and subjective general health explain IU per day; and age, years of education, domicile and socially meeting with other people with whom to discuss intimate matters explain IU per week. Education was found to be a significant moderator in the relationship between subjective general health and IU per week; and in the relationship between socially meeting with other people and IU per day. Discussion: Maladaptive IU, when the perception of health is worse, and adaptive IU, when the perception of social life is better, are both suggested, depending on education. Conclusions: These findings point to the need to study IUT involving educational level, keeping in mind that what may be PIU at one educational level may not be the case at another.

Physician Perspectives on Internet-Informed Patients: Systematic Review.

The internet has become a prevalent source of health information for patients. However, its accuracy and relevance are often questionable. While patients seek physicians' expertise in interpreting internet health information, physicians' perspectives on patients' information-seeking behavior are less explored. This review aims to understand physicians' perceptions of patients' internet health information-seeking behavior as well as their communication strategies and the challenges and needs they face with internet-informed patients. An initial search in PubMed, Scopus, CINAHL, Communication and Mass Media Complete, and PsycINFO was conducted to collect studies published from January 1990 to August 1, 2022. A subsequent search on December 24, 2023, targeted recent studies published after the initial search cutoff date. Two reviewers independently performed title, abstract, and full-text screening, adhering to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement guidelines. Thematic analysis was then used to identify key themes and systematically categorize evidence from both qualitative and quantitative studies under these themes. A total of 22 qualifying articles were identified after the search and screening process. Physicians were found to hold diverse views on patients' internet searches, which can be viewed as a continuous spectrum of opinions ranging from positive to negative. While some physicians leaned distinctly toward either positive or negative perspectives, a significant number expressed more balanced views. These physicians recognized both the benefits, such as increased patient health knowledge and informed decision-making, and the potential harms, including misinformation and the triggering of negative emotions, such as patient anxiety or confusion, associated with patients' internet health information seeking. Two communicative strategies were identified: the participative and defensive approaches. While the former seeks to guide internet-informed patients to use internet information with physicians' expertise, the latter aims to discourage patients from using the internet to seek health information. Physicians' perceptions were linked to their strategies: those holding positive views tended to adopt a participative approach, while those with negative views favored a defensive strategy. Some physicians claimed to shift between the 2 approaches depending on their interaction with a certain patient. We also identified several challenges and needs of physicians in dealing with internet-informed patients, including the time pressure to address internet-informed patient demands, a lack of structured training, and being uninformed about trustworthy internet sites that can be recommended to internet-informed patients. This review highlights the diverse perceptions that physicians hold toward internet-informed patients, as well as the interplay between their perceptions, communication strategies, and their interactions with individual patients. Incorporating elements into the medical teaching curriculum that introduce physicians to reliable internet health resources for patient guidance, coupled with providing updates on technological advancements, could be instrumental in equipping physicians to more effectively manage internet-informed patients. PROSPERO CRD42022356317; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=356317.

The relationship between health literacy and internet addiction among middle school students in Chongqing, China: A cross-sectional survey study.

Internet addiction has emerged as a major global concern as a potential adverse impact of internet exposure on adolescents. Internet addiction is associated with many demographic variables; however, there is a lack of consensus on its relationship with health literacy. Therefore, the aim of the present study was to assess the rates of internet addiction and health literacy level among middle school students (grades 7 to 12) in Chongqing, China, as well as to investigate the association between them. A cross-sectional, questionnaire-based study was conducted among 8971 students who were randomly selected by using stratified cluster sampling between November and December 2019. The Internet Addiction Diagnostic Questionnaire, Adolescent Health Literacy Scale and a self-designed basic information questionnaire were used to collect data. Chi-square tests were performed to compare the differences in the distribution of internet addiction across health literacy levels as well as some sociodemographic characteristics. Multivariate logistic regression analyses were conducted to identify the association between health literacy and internet addiction. The prevalence of internet addiction among middle school students in Chongqing was 6.1%. The percentage of the students who spent more than 4 hours online every day in the past week was 14.3%. In addition, 26.7%, 26.0%, 28.3% and 26.3% of the participants reported low functional, interactive, critical and total health literacy, respectively. After adjusting for the confounding effects of demographics, multivariate regression analysis showed that critical health literacy was a protective variable for internet addiction, while functional, and interactive health literacy were the risk variable (P<0.05). Furthermore, the internet addiction rates were higher among boys, students with good peer relationships, and students without parental supervision, whereas internet addiction rates were lowest among students in grade 12. The prevalence of internet addiction among middle school students in Chongqing is relatively high. Internet addiction is strongly negatively associated with critical health literacy, but it is positively associated with functional and interactive health literacy but not total health literacy. This study provides preliminary evidence for the predictive role of health literacy in internet addiction of adolescents.

Association Between Internet Use and Physical Health, Mental Health, and Subjective Health in Middle-aged and Older Adults: Nationally Representative Cross-sectional Survey in China.

Internet use is an important means of accessing health-related information. Identifying the associations between internet use and health outcomes could provide insight into strategies for improving public health among middle-aged and older adults (45 years and up). This study aimed to examine the relationship between internet use and health outcomes in middle-aged and older adults. Data were obtained from the 2018 China Health and Retirement Longitudinal Study. Physical, mental, and subjective health were assessed using the Activities of Daily Living (ADL) Scale, the 10-item Center for Epidemiologic Studies Depression Scale, and the 3-level Self-Rated Health Scale, respectively. The chi-square test and rank sum test were used to explore whether internet use was associated with health status. A multivariate logistic regression model was used to determine this association further after controlling for the confounding factors. Overall, 13% (1752/13,474) of the participants used the internet. Regression analyses revealed that the prevalence of depression (odds ratio [OR] 0.59, 95% CI 0.52-0.68; P<.001), negative self-rated health (OR 0.68, 95% CI 0.61-0.76; P<.001), and difficulty with ADL (OR 0.48, 95% CI 0.39-0.60; P<.001) in the participating middle-aged and older adult was lower in those using the internet than nonusers. After controlling for confounding factors, internet use was found to be negatively associated with difficulty with ADL (urban: OR 0.44, 95% CI 0.32-0.61; P<.001 vs rural: OR 0.55, 95% CI 0.41-0.75; P<.001), depression (urban: OR 0.69, 95% CI 0.57-0.84; P<.001 vs rural: OR 0.52, 95% CI: 0.43-0.63; P<.001), and self-rated health status (urban: OR 0.70, 95% CI 0.61-0.81; P<.001 vs rural: OR 0.67, 95% CI 0.57-0.78; P<.001) among middle-aged and older adults in both urban and rural areas. Internet use had a positive effect on the physical and mental health of middle-aged and older adults who participated in this study. However, the internet usage rate remains low among older Chinese people. Therefore, the internet penetration rate should be a priority.

Does internet use and adoption matter for better health outcomes in sub-Saharan African countries? New evidence from panel quantile regression

This study examines the relationship between internet use and health outcomes (i.e. infant mortality, under-five mortality, life expectancy) using generalized quantile regression approach. We used annual unbalanced panel data for 48 sub-Saharan Africa countries from 2000 to 2020. The findings show that internet use has a positive and statistically significant impact on improving health outcomes in sub-Saharan Africa to almost all quantiles (10th to 90th). This implies that internet use among individuals increases longevity (i.e. life expectancy) and lowers both infant and under-five mortality from 2000 to 2020. The findings still holds the same after checking robustness analysis. Moreover, the findings reveal the heterogeneous effect of income, health spending, carbon dioxide emissions and trade on health outcomes across different quantiles. These imply that at a certain quantile there are a diminishing returns or increases of health outcomes. Overall, the findings support the idea that increasing internet use and penetration will likely contribute to improving longevity (i.e. life expectancy) and lowering infant and under-five mortality in sub-Saharan Africa. The mechanism of internet use and adoption in influencing health outcomes is also discussed. We suggest sub-Saharan Africa countries to give priority to internet use and adoption strategies, policies or laws that ensure the availability of digital tools (such as smartphones and computers) for online searching and use of health-related information.

Harnessing Machine Learning in Tackling Domestic Violence—An Integrative Review

We extracted 3588 articles from four databases. Twenty-two articles met the inclusion criteria. Twelve articles used the supervised ML method, seven articles used the unsupervised ML method, and three articles applied both. Most studies were published in Australia (n = 6) and the United States (n = 4). Data sources included social media, professional notes, national databases, surveys, and newspapers. Random forest (n = 9), support vector machine (n = 8), and naïve Bayes (n = 7) were the top three algorithms, while the most used automatic algorithm for unsupervised ML in DV research was latent Dirichlet allocation (LDA) for topic modeling (n = 2). Eight types of outcomes were identified, while three purposes of ML and challenges were delineated and are discussed. Leveraging the ML method to tackle DV holds unprecedented potential, especially in classification, prediction, and exploration tasks, and particularly when using social media data. However, adoption challenges, data source issues, and lengthy data preparation times are the main bottlenecks in this context. To overcome those challenges, early ML algorithms have been developed and evaluated on DV clinical data.

The effect of religiosity on stress, anxiety, depression, and life satisfaction during the COVID-19 pandemic in Korea

ABSTRACT Although there have been numerous studies investigating the relationship between religiosity and mental health, research related to religiosity through the Internet and mental health outcomes during the pandemic is still scarce. This study aimed to explore the relationships among online religious activities and interactions of stress, anxiety, depression, and life satisfaction during the COVID-19 pandemic in Korea. The results showed that Korean males’ religious activities and interactions were important predictors of their mental health and life satisfaction levels, however, the same was not observed for Korean females. The findings suggest implications for future research to improve mental health and facilitate happiness in Korean men and women.

Determinants Influencing the Adoption of Internet Health Care Technology Among Chinese Health Care Professionals: Extension of the Value-Based Adoption Model With Burnout Theory

The global COVID-19 pandemic has been widely regarded as a catalyst for adopting internet health care technology (IHT) in China. IHT consists of new health care technologies that are shaping health services and medical consultations. Health care professionals play a substantial role in the adoption of any IHT, but the consequences of doing so can often be challenging, particularly when employee burnout is prevalent. Few studies have explored whether employee burnout influences the adoption intention of IHT in health care professionals. This study aims to explain the determinants influencing the adoption of IHT from the perspective of health care professionals. To do so, the study extends the value-based adoption model (VAM) with consideration for employee burnout as a determining factor. A cross-sectional web-based survey using a sample of 12,031 health care professionals selected through multistage cluster sampling from 3 provinces in mainland China was conducted. The hypotheses of our research model were developed based on the VAM and employee burnout theory. Structural equation modeling was then used to test the research hypotheses. The results indicate that perceived usefulness, perceived enjoyment, and perceived complexity positively correlate with perceived value (β=.131, P=.01; β=.638, P<.001; β=.198, P<.001, respectively). Perceived value had a positive direct effect on adoption intention (β=.725, P<.001), perceived risk negatively correlated with perceived value (β=-.083, P<.001), and perceived value negatively correlated with employee burnout (β=-.308, P<.001). In addition, employee burnout was negatively related to adoption intention (β=-.170, P<.001) and mediated the relationship between perceived value and adoption intention (β=.052, P<.001). Perceived value, perceived enjoyment, and employee burnout were the most important determinants of IHT adoption intention by health care professionals. In addition, while employee burnout was negatively related to adoption intention, perceived value inhibited employee burnout. Therefore, this study finds that it is necessary to develop strategies to improve the perceived value and reduce employee burnout, which will benefit the promotion of the adoption intention of IHT in health care professionals. This study supports the use of the VAM and employee burnout in explaining health care professionals' adoption intention regarding IHT.

Academic Directors Facing Internet Addictions, Learning and Health Promotion

The result that is presented is expressed from a bibliographic review of works published during the last two years 2020-2022 and, through which it was possible to verify the relationships that are established between the work of the Academic Directors, before the latent challenge and visible that is the crossroads of Internet addictions, by university students, increased in the stage already overcome of social isolation imposed by Covid 19 but, with emphasis on the achievement of learning at this high educational level, its risks and consequent decreases in the attacks that occur as a result of procrastination. All associated with the addictive phenomenon, in a projection of health promotion that the current, humanistic, modern and developing university should not give up in any way, being precisely in this direction an unavoidable pillar of social development, which lies precisely in the high professional qualification. of the new generations committed to a prosperous and sustainable social change.&#x0D; &#x0D; Received: 8 January 2023 / Accepted: 28 February 2023 / Published: 5 March 2023