National surveys of U.S. adults have observed significant increases in health-related internet use (HRIU), but there are documented disparities. The study aims to identify social and demographic patterns of health-related internet use among U.S. adults. Using data from the Health Information National Trends Survey (HINTS) 4 cycle 3 and HINTS 5 cycle 1, we examined HRIU across healthcare, health information seeking, and participation on social media. Primary predictors were gender, race/ethnicity, age, education, income, and nativity with adjustments for smoking and survey year. We used multivariable logistic regression with survey weights to identify independent predictors of HRIU. Of the 4817 respondents, 43% had used the internet to find a doctor; 80% had looked online for health information. Only 20% had used social media for a health issue; 7% participated in an online health support group. In multivariable models, older and low SES participants were significantly less likely to use the internet to look for a provider, use the internet to look for health information for themselves or someone else, and less likely to use social media for health issues. Use of the internet for health-related purposes is vast but varies significantly by demographics and intended use.
Background: Psychological complications are frequent in type 1 diabetes (T1D) but they might be difficult to distinguish one from the other in clinical practice. Our objective was to study the distinguishing characteristics, overlaps and their use in the literature between three concepts of T1D: depression, diabetes distress (DD) and diabetes burnout (DB). Methods: A scoping review (PRISMA guidelines) performed in three databases (PubMed/MEDLINE, PsycInfo, Web of Science) with the keywords: T1D, depression, diabetes and burnout, from January 1990 to June 2021. We selected original studies with participants with T1D, which reported depression, DD, or DB. We extracted information about the concepts, their sub-concepts and screening tools. Findings: Of the 4763 studies identified, 201 studies were included in the study. Seventy-three percent, 57% and 45% of sub-concepts do not overlap in depression, DD, and DB, respectively. We observed overlap between depression (27%)/DD (27%) and between DD (20%)/DB (50%). Interpretation: A number of sub-concepts distinguish depression and DD. Overlaps between concepts suggest that a more precise definition is still lacking. DB is still a relatively new concept and more research is needed to better understand how it can present itself differently, in order to personalize care in comparison to those having DD.
Background Approximately 1.2 million children are estimated to be infected with tuberculosis (TB) worldwide. The World Health Organization (WHO) routinely updates guidelines for the treatment to lateen tuberculosis infection (LTBI) in children with the last update provided in 2020. The objective of our study was to assess the impact of these updates on national LTBI guidelines devised by 30 high burden countries. Method We collected National LTBI guidelines from health ministries of high burden countries. Eleven countries had guidelines that were in English and published in the last 6 years out of the 30 high burden countries. The guidelines from the respective countries were compared for concordance with the most recent WHO guidelines on LTBI management in the pediatric population. Results We identified four subsections of the WHO guidelines: at-risk groups for LTBI testing, algorithms to rule out active TB disease, testing for LTBI, and TB preventive treatment options. Guidelines from Nigeria and Pakistan had the highest concordance in identifying at-risk groups for LTBI at 83.3% each, whereas Namibia had the lowest concordance for this subcategory at 16.67% . Nigeria had 100% concordance in defining an algorithm to rule out active TB disease. Pakistan and Uganda had 80% concordance for algorithms to rule out disease. Philippines, Nigeria and Pakistan had 100% concordance with testing for LTBI, with Ethiopia, Kenya and Myanmar having the lowest concordance with 0%. Namibia and Myanmar had the highest concordance in regards to TB preventive treatment options, with 64% and 50% concordance respectively; all other included guidelines had low concordance for TB preventive treatment options. Conclusion Our study examined general concordance of national LTBI guidelines with the WHO guidelines and in the domains of identification, testing, algorithms, treatment, and prevention. Most guidelines among the high burden countries had high concordance in identifying at-risk groups for LTBI testing and algorithms to rule out active TB disease. Further research is needed to assess factors that lead to discordance between national and WHO guidelines.
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