Websites Of Centers Research Articles

Use of the internet related to infertility by infertile women and men in Turkey.

Objective:To determine differences in use of the Internet related to infertility between infertile women and men, whether they benefit or are negatively affected from information on the Internet, and share this information with health professional.Methods:This cross-sectional study was carried out with 285 infertile women and 158 men between December 2015 and February 2016. Data were collected by a survey Form which included questions related to sociodemographic characteristics, related to infertility (duration of treatment, type of treatment) and questions about use of the Internet. Chi-square analysis was used to evaluate the differences in Internet use and independent variables for patients.Results:Seventy-four percent of women and 68.4% of men used the Internet related to infertility. Women and men most often looked for information related to assisted reproductive technology and the causes of infertility. Men searched for information related to fertility drugs used in treatment significantly less than women. They often visited the websites of fertility centers and doctors. A high percentage of them have benefited from information on the Internet. Almost half of the women and men shared the information obtained from the Internet with health professional.Conclusion:Most frequently, infertile patients use the Internet to obtain information related to infertility and they benefited from information on the Internet. For health professional it is important to direct Internet users to safe and true information resources.

What are Infertility Treatment Center Websites Telling Couples about Male Factor Infertility?

IntroductionWe evaluated patient directed information provided on the websites of infertility treatment centers. MethodsWe identified 428 infertility treatment centers based on the 2011 CDC (Centers for Disease Control and Prevention) Fertility Clinic Success Rates Report. The website of each center was evaluated for the presence and/or description of terms related to the etiology, workup and treatment of male factor infertility using a standardized data abstraction form. Differences in the variables were examined with respect to United States Census Bureau geographic regions, academic center status and affiliation with urologists. The Flesch-Kincaid readability score was assessed. ResultsOnly 78% of websites acknowledged a male factor etiology for infertility, 85% mentioned any evaluation of the male partner, 63% mentioned any treatment options for male factor infertility and 23% discussed referral to a urologist. When stratified by geographic region, academic status and urologist affiliation, differences in the variables of interest were most likely when stratified by urologist affiliation. The median website reading level was twelfth grade. ConclusionsPatient directed information pertaining to the etiology, workup and treatment of male factor infertility on the websites of infertility treatment centers is variable at best. Etiology is completely lacking on more than 20% of websites. It is likely that couples relying on Internet based information regarding infertility evaluation and treatment are not well informed about the importance or the benefit of a male factor evaluation.

Quality of Prostate Cancer Treatment Information on Cancer Center Websites.

IntroductionCancer center websites are trusted sources of internet information about treatment options for prostate cancer. The quality of information on these websites is unknown. The objective of this study was to evaluate the quality of information on cancer center websites addressing prostate cancer treatment options, outcomes, and toxicity.Materials and methodsWe evaluated the websites of all National Cancer Institute-designated cancer centers to determine if sufficient information was provided to address eleven decision-specific knowledge questions from the validated Early Prostate Cancer Treatment Decision Quality Instrument. We recorded the number of questions addressed, the number of clicks to reach the prostate cancer-specific webpage, evaluation time, and Spanish and mobile accessibility. Correlation between evaluation time and questions addressed were calculated using the Pearson coefficient.ResultsSixty-three websites were reviewed. Eighty percent had a prostate cancer-specific webpage reached in a median of three clicks. The average evaluation time was 6.5 minutes. Information was available in Spanish on 24% of sites and 59% were mobile friendly. Websites provided sufficient information to address, on average, 19% of questions. No website addressed all questions. Evaluation time correlated with the number of questions addressed (R2 = 0.42, p < 0.001).ConclusionsCancer center websites provide insufficient information for men with localized prostate cancer due to a lack of information about and direct comparison of specific treatment outcomes and toxicities. Information is also less accessible in Spanish and on mobile devices. These data can be used to improve the quality and accessibility of prostate cancer treatment information on cancer center websites.

Objective assessment of the oncofertility educational information, available to women, on the websites of NCI-designated cancer centers in the US: do socioeconomic demographic profiles by state make a difference?

Current guidelines recommend that reproductive age women, newly diagnosed with cancer, should be counseled on fertility preservation (FP). Hospital websites increasingly serve as portals for reliable web-based resources to supplement the knowledge of patients and families regarding their diagnoses & treatments. This study aims to assess the quality of hospital web-based resources which are available to women undergoing cancer treatment at major cancer centers.

Information about Sexual Health on Crisis Pregnancy Center Web Sites: Accurate for Adolescents?

Study ObjectiveThe objective of this study was to evaluate the quality and accuracy of sexual health information on crisis pregnancy center Web sites listed in state resource directories for pregnant women, and whether these Web sites specifically target adolescents. DesignA survey of sexual health information presented on the Web sites of crisis pregnancy centers. SettingInternet. ParticipantsCrisis pregnancy center Web sites. InterventionsEvaluation of the sexual health information presented on crisis pregnancy center Web sites. Main Outcome MeasuresThemes included statements that condoms are not effective, promotion of abstinence-only education, availability of comprehensive sexual education, appeal to a young audience, provision of comprehensive sexual health information, and information about sexually transmitted infections (STIs). Results and ConclusionCrisis pregnancy center Web sites provide inaccurate and misleading information about condoms, STIs, and methods to prevent STI transmission. This information might be particularly harmful to adolescents, who might be unable to discern the quality of sexual health information on crisis pregnancy center Web sites. Listing crisis pregnancy centers in state resource directories might lend legitimacy to the information on these Web sites. States should be discouraged from listing Web sites as an accurate source of information in their resource directories.

Cost-effectiveness analysis of strategies introducing integrated ¹⁸F-FDG PET/CT into the mediastinal lymph node staging of non-small-cell lung cancer.

The aim of the study was to establish the most cost-effective strategy for using integrated 18F-fluorodeoxyglucose PET and computed tomography (CT) for mediastinal lymph node staging (N-staging) of preoperative non-small-cell lung cancer (NSCLC). Four N-staging decision models for operative NSCLC, model A (CT only), model B (PET/CT for negative CT), model C (CT and PET/CT for all), and model D (PET/CT only), were constructed according to the Chinese edition of NCCN Clinical Practice Guidelines in Oncology Non-Small-Cell Lung Cancer and China NSCLC N-staging practices. Data including the parameters for decision models, life expectancy, and expenditures were retrieved from the literature, from websites of PET Reservation Centers, and on consultation with experts. On the basis of model A, incremental cost-effectiveness ratios were calculated for the other three models. Robustness of the result was evaluated by univariate sensitivity analysis. Life expectancy (years) was 2.60 for model A, 2.57 for model B, 2.67 for model C, and 2.66 for model D. The probabilities for improper therapy due to wrong staging were 36.78, 13.00, 8.91, and 12.95%, respectively. Surgical mortality rates were 1.87, 1.01, 1.13, and 1.24%, respectively. Model C, for which the incremental cost-effectiveness ratio (37 960 CNY/year) was lower than that of model D (65 175 CNY/year) and 2012 GDP per capita in China (38 459 CNY), was cost-effective and optimal, and this result was robust. Model C was the most cost-effective strategy for NSCLC N-staging in the China mainland. Introduction of model C into Chinese N-staging protocols for NSCLC would be helpful for treatment selection, for reducing surgical mortality rates, and for extending life expectancy.

Human resources for cancer control in uttar pradesh, India: a case study for low and middle income countries.

For addressing the growing burden of cancer in low and middle income countries, an important first step is to estimate the human resources required for cancer control in a country, province, or city. However, few guidelines are available to decision makers in that regard. Here, we propose a methodology for estimating the human and other resources needed in the state of Uttar Pradesh (UP), India as a case study. Information about the population of UP and its cities was obtained from http://citypopulation.de/. The number of new cancer cases annually for the commonest cancers was estimated from GLOBOCAN 20081. For estimating the human resources needed, the following assumptions were made: newly diagnosed cancer patients need pathology for diagnosis and for treatment surgery, chemotherapy, and/or radiotherapy. The percentage of patients requiring each of those modalities, their average lengths of stay as in-patients, and number of in-patient oncology beds were estimated. The resources already available in UP were determined by a telephone survey and by searching the websites of radiation therapy centers and medical colleges. Twenty-four radiation oncologists at 24 cancer centers in 10 cities responded to the survey. As detailed in this manuscript, an enormous shortage of human resources for cancer control exists in UP. Human resources are the key to diagnosing cancers early and treating them appropriately. Addressing the shortage will not be easy but we hope that the methodology described here can guide decision makers and form a framework for discussion among the various stakeholders. This methodology is readily adaptable to local practices and data.

What are infertility treatment center websites telling couples about male factor infertility?

Abstract Introduction We evaluated patient directed information provided on the websites of infertility treatment centers. Methods We identified 428 infertility treatment centers based on the 2011 CDC (Centers for Disease Control and Prevention) Fertility Clinic Success Rates Report. The website of each center was evaluated for the presence and/or description of terms related to the etiology, workup and treatment of male factor infertility using a standardized data abstraction form. Differences in the variables were examined with respect to United States Census Bureau geographic regions, academic center status and affiliation with urologists. The Flesch-Kincaid readability score was assessed. Results Only 78% of websites acknowledged a male factor etiology for infertility, 85% mentioned any evaluation of the male partner, 63% mentioned any treatment options for male factor infertility and 23% discussed referral to a urologist. When stratified by geographic region, academic status and urologist affiliation, differences in the variables of interest were most likely when stratified by urologist affiliation. The median website reading level was twelfth grade. Conclusions Patient directed information pertaining to the etiology, workup and treatment of male factor infertility on the websites of infertility treatment centers is variable at best. Etiology is completely lacking on more than 20% of websites. It is likely that couples relying on Internet based information regarding infertility evaluation and treatment are not well informed about the importance or the benefit of a male factor evaluation.

Crisis pregnancy center websites: Information, misinformation and disinformation

ObjectiveMost states with 24-h waiting periods prior to abortion provide state resource directories to women seeking abortion. Our objective was to evaluate the information on abortion provided on the websites of crisis pregnancy centers listed in these resource directories. Study designWe performed a survey of the websites of crisis pregnancy centers referenced in state resource directories for pregnant women. We searched for these state-provided resource directories online. We contacted state Departments of Health and Human Services for a print copy when a directory could not be found online. The crisis pregnancy center websites were evaluated for the information provided on abortion. Standardized data collection tools were used. Descriptive statistics were generated. ResultsResource directories of 12 states were procured. A total of 254 websites referring to 348 crisis pregnancy centers were identified. Overall, a total of 203/254 [80%, 95% confidence interval (CI) 75%–84%] of websites provided at least one false or misleading piece of information. The most common misleading or false information included on the websites were a declared link between abortion and mental health risks (122/254 sites; 48%, 95% CI 42%–54%), preterm birth (54/254; 21%, 95% CI 17%–27%), breast cancer (51/254; 20%, 95% CI 16%–25%) and future infertility (32/254; 13%, 95% CI 9%–17%). ConclusionMost crisis pregnancy centers listed in state resource directories for pregnant women provide misleading or false information regarding the risks of abortion. States should not list agencies that provide inaccurate information as resources in their directories.

Evaluation of the information provided in web sites of organ transplantation centers in Turkey from the perspective of medical ethics: A qualitative study

OBJECTIVE: This study was planned as a qualitative one that aimed to evaluate the information on the web sites of Turkey’s organ transplantation centers from the perspective of medical ethics. METHODS: The name of organ transplantation centers listed in the relevant directive issued by the Ministry of Health and the terms “organ transplantation center(s)” were used with the Google internet search engine. The information presented in the web sites accessed was evaluated with regard to medical ethics. At the end of the evaluation process performed independently by two different medical ethicists, the results were compared and the 12 sites considered to contain ethically problematic statements according to both of the researchers were detected. Of these 12 sites, only one was a public center, while the rest were institutions in the private sector. RESULTS: A total of 12 web sites were found to include ethically problematic statements which were classified under 4 different titles consisting of “Claims used by the centers to promote themselves”, “claims used by the centers to promote their health care professionals”, “claims regarding the laparoscopic method” and “claims regarding life with one kidney”. Statements in the sites were observed to have been aimed for advertising rather than informing, whereas the ethically and legally sensitive aspects of the process and particularly of living organ donation seemed to have been neglected. Statements containing one-sided, selective or incomplete information and claims written to promote the interest of the centers and incentivize living organ donation were detected. CONCLUSION: The informational content of the web sites of organ transplantation centers must be audited and private sector institutions should be prioritized in the process. It has also been concluded that efforts to increase the knowledge and sensitivity of the administrators and health care professionals of organ transplantation centers with regard to the ethical and legal aspects of the issue, and particularly of living organ donation, can make a positive contribution to this issue.

Systemic Family Therapy in Greece: Polyphony and Diversity

The paper aims at presenting the state of the art regarding systemic/family therapy in Greece, in relation to practice, professional and accreditation issues and training. It is argued that systemic/family therapy in Greece constitutes a lively and diverse terrain with roots in the 1960s and a rapid dissemination of the approach following the mid 1980s. The field’s development in Greece is out-sketched by means of ‘data’ collected from a variety of sources, like web sites of associations and training centers, published articles and informal and semi-structured interviews conducted with seminal figures. First, a concise historical overview of the birth of systemic/family therapy is presented in relation to the wider socio-political context and the attempt for the reform of the psychiatric system in Greece during the 1980s. Second, a brief sketch of the existing associations as well as of the contexts where systemic/family therapy is practiced is outlined in relation to issues regarding accreditation and statutory regulations. Third, a non-exhaustive list of currently existing training programs is reviewed in respect of axis, like their content and structure, accreditation issues, entry requirements, etc. The paper concludes with inferences regarding the existing state of the art including future potential directions, whilst hinting to research ventures, which could enrich our understanding of both the history and the potential of the field in the Greek context.

O uso da internet como fonte de informação sobre cirurgia plástica na Bahia, Brasil

BACKGROUND: The Internet has become one of the most important sources of health information. However, few studies have assessed the characteristics of Internet usage by patients or how the information obtained affects decisions to undergo surgery. This study describes the characteristics of Internet usage by patients who intended to undergo plastic surgery at the Unified Health System (SUS) and private networks and how it affected their confidence. METHODS: A cross-sectional observational study was performed using data collected by 200 surveys filled out by patients before the operation. One hundred surveys were sent to patients attending the outpatient clinic of Plastic Surgery of Professor Edgard Santos University Hospital (SUS), and the remaining 100 to patients treated in private health clinics in Salvador, BA. RESULTS: The frequency of Internet use to seek health information on plastic surgery differed significantly between the SUS (n = 24; 24%) and private health services (n = 64; 64%). Most of the patients (n = 48; 54.5%) visited 1 to 3 sites. The websites of plastic surgery centers were the most sought (n = 74; 84.1%), followed by the Brazilian Society of Plastic Surgery website. Half of the patients reported the existence of contradictory information. Moreover, 71 (80.7%) of the respondents reported feeling that undergoing surgery was safe. CONCLUSIONS: The Internet was widely used to seek information on plastic surgery. Although visited sites contained contradictory information, most patients felt safe before undergoing their desired surgery.

Remarkable differences between three evidence‐based guidelines on management of obstructive sleep apnea‐hypopnea syndrome

The aim of this study was to compare available guidelines for the diagnosis and treatment of patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) regarding their content, conclusions on the available evidence, and recommendations. Literature review/systematic review. We retrieved guidelines from Embase, PubMed, Web of Science, and Web sites of several health care improvement centers and with a Google Scholar search. We appraised the quality of selected guidelines according to the Appraisal of Guidelines for Research and Evaluation instrument. For similar clinical questions we compared the conclusions, the attached levels of evidence, and the references used. If differences were found, we checked search strategies, appraisal criteria, and publication date as possible sources for these differences. We selected the guidelines on diagnosis and treatment of OSAHS of the Scottish Scottish Intercollegiate Guidelines Network, the Dutch Institute for Healthcare Improvement, and the Institute for Clinical Systems Improvement in the United States for this comparison. For similar clinical questions these three guidelines showed conflicting conclusions (11%-18%), differences in attached levels of evidence (32%-62%), and remarkable discrepancies in cited studies. A plausible reason for these differences is the citation preference for articles from members of the guidelines workgroup and from their own country. Despite different publication dates, more recent guidelines fail to cite earlier published guidelines. Despite the generally accepted approach regarding the development of evidence-based guidelines, remarkable differences exist between guidelines from different countries on the same clinical subject.

Abortion misinformation provided by crisis pregnancy center websites listed on states' Department of Health Web sites as resources for pregnant women: a systematic review

To evaluate the medical accuracy of information regarding the risks of abortion provided by Web sites of crisis pregnancy centers listed on states' department of health Web sites.

Abortion misinformation from crisis pregnancy centers in North Carolina

BackgroundThis study assessed the accuracy of medical information provided by crisis pregnancy centers in North Carolina. Study DesignWe performed a secondary data analysis of a “secret shopper survey” performed by a nonprofit organization. Reports from phone calls and visits to crisis pregnancy centers were analyzed for quality and content of medical information provided. Web sites of crisis pregnancy centers in the state were also reviewed. ResultsThirty-two crisis pregnancy centers were contacted. Nineteen of these were visited. Fourteen centers (44%) offered that they “provide counseling on abortion and its risks.” Inaccurate information provided included a link between abortion and breast cancer (16%), infertility (26%) and mental health problems (26%). Of the 36 Web sites identified, 31 (86%) provided false or misleading information, including 26 sites (72%) linking abortion to “post-abortion stress.” ConclusionsMany crisis pregnancy centers give inaccurate medical information regarding the risks of abortion. Overstating risks stigmatizes abortion, seeks to intimidate women and is unethical.

Indicated Truancy Interventions: Effects on School Attendance among Chronic Truant Students

Truancy is a significant problem in the U.S. and in other countries around the world. Truancy has been linked to serious immediate and far-reaching consequences for youth, families, and schools and communities, leading researchers, practitioners, and policy makers to try to understand and to address the problem. Although numerous and significant steps have been taken at the local, state, and national levels to reduce truancy, the rates of truancy have at best remained stable or at worst been on the rise, depending on the indicator utilized to assess truancy rates. The costs and impact of chronic truancy are significant, with both short- and long-term implications for the truant youth as well as for the family, school, and community. Although several narrative reviews and one meta-analysis of attendance and truancy interventions have attempted to summarize the extant research, there are a number of limitations to these reviews. It is imperative that we systematically synthesize and examine the evidence base to provide a comprehensive picture of interventions that are being utilized to intervene with chronic truants, to identify interventions that are effective and ineffective, and to identify gaps and areas in which more research needs to be conducted to better inform practice and policy.

The Exposure of Urologists and the Treatment for Male Factor Infertility on the Web Sites of ART Centers in Taiwan

Couples with male factor disorders can have their own biologic offspring nowadays via in vitro fertilization or intracytoplasmic sperm injection technologies. Because infertile couples commonly seek treatment options through public Web sites on the Internet, an appropriate exposure of urologic opinions on male factor infertility is important. It was therefore of interest to survey the extent of urologists' exposure on the official Web sites of the assisted reproductive technology (ART) centers. We surveyed the official Web sites of all 74 qualified ART centers in Taiwan. Web sites of these centers were evaluated for their information on male factor infertility and varicoceles, especially treatment suggestions for varicocele and attitudes toward urologist referral. Among the 74 centers, only 69 had established official Web sites. Forty-eight Web sites (69.6%) provided information regarding infertility, whereas only 42 Web sites (60.9%) mentioned male factor infertility and 23 (33.3%) had descriptions of varicoceles. The quantity and quality of disclosed information varied, 11 (15.9%) sites provided treatment opinions for varicocele, and only 4 (5.8%) supported surgical intervention. Most Web sites of ART centers in Taiwan had content on male factor infertility, but the vast majority did not mention urologist referral or varicocele treatment. Urologists' opinions are relatively less exposed on the Web sites of fertility services. Further efforts should be made by urologists to provide comprehensive information to the public and to reinforce the importance of urologist referral in male factor infertility.

Patient Navigation: The Promise to Reduce Health Disparities

Patient Navigation: The Promise to Reduce Health Disparities

Systematic Review: Charged-Particle Radiation Therapy for Cancer

Radiation therapy with charged particles can potentially deliver maximum doses while minimizing irradiation of surrounding tissues, and it may be more effective or less harmful than other forms of radiation therapy. To review evidence about the benefits and harms of charged-particle radiation therapy for patients with cancer. MEDLINE (inception to 11 July 2009) was searched for publications in English, German, French, Italian, and Japanese. Web sites of manufacturers, treatment centers, and professional organizations were searched for relevant information. Four reviewers identified studies of any design that described clinical outcomes or adverse events in 10 or more patients with cancer treated with charged-particle radiation therapy. The 4 reviewers extracted study, patient, and treatment characteristics; clinical outcomes; and adverse events for nonoverlapping sets of articles. A fifth reviewer verified data on comparative studies. Currently, 7 centers in the United States have facilities for particle (proton)-beam irradiation, and at least 4 are under construction, each costing between $100 and $225 million. In 243 eligible articles, charged-particle radiation therapy was used alone or in combination with other interventions for common (for example, lung, prostate, or breast) or uncommon (for example, skull-base tumors or uveal melanomas) types of cancer. Of 243 articles, 185 were single-group retrospective studies. Eight randomized and 9 nonrandomized clinical trials compared treatments with or without charged particles. No comparative study reported statistically significant or important differences in overall or cancer-specific survival or in total serious adverse events. Few studies directly compared treatments with or without particle irradiation. Evidence on the comparative effectiveness and safety of charged-particle radiation therapy in cancer is needed to assess the benefits, risks, and costs of treatment alternatives.

Effective elements of school health promotion across behavioral domains: a systematic review of reviews.

BackgroundMost school health education programs focus on a single behavioral domain. Integrative programs that address multiple behaviors may be more efficient, but only if the elements of change are similar for these behaviors. The objective of this study was to examine which effective elements of school health education are similar across three particular behavioral domains.MethodsA systematic review of reviews of the effectiveness of school-based health promotion programs was conducted for the domains of substance abuse, sexual behavior, and nutrition. The literature search spanned the time period between 1995 and October 2006 and included three databases, websites of review centers and backward search. Fifty-five reviews and meta-analyses met predetermined relevance and publication criteria and were included. Data was extracted by one reviewer and checked by a second reviewer. A standardized data extraction form was used, with detailed attention to effective elements pertaining to program goals, development, content, methods, facilitator, components and intensity. Two assessors rated the quality of reviews as strong, moderate or weak. We included only strong and moderate reviews in two types of analysis: one based on interpretation of conflicting results, the other on a specific vote-counting rule.ResultsThirty six reviews were rated strong, 6 moderate, and 13 weak. A multitude of effective elements was identified in the included reviews and many elements were similar for two or more domains. In both types of analysis, five elements with evidence from strong reviews were found to be similar for all three domains: use of theory; addressing social influences, especially social norms; addressing cognitive-behavioral skills; training of facilitators; and multiple components. Two additional elements had positive results in all domains with the rule-based method of analysis, but had inconclusive results in at least one domain with the interpretion-based method of analysis: parent involvement and a larger number of sessions.ConclusionFive effective elements of school health promotion were found to be similar across the three behavioral domains examined (substance abuse, sexual behavior, nutrition). An integrative program that addresses the three domains seems feasible. The five elements are primary candidates to include in programs targeting these behaviors.