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The leading peer-reviewed journal for digital medicine, and health & healthcare in the Internet age
The Journal of Medical Internet Research (JMIR), now in its 20th year, is the pioneer open access eHealth journal and is the flagship journal of JMIR Publications. It is the leading digital health journal globally in terms of quality/visibility (Impact Factor 2017: 4.671, ranked #1 out of 22 journals) and in terms of size (number of papers published). The journal focuses on emerging technologies, medical devices, apps, engineering, and informatics applications for patient education, prevention, population health and clinical care. As leading high-impact journal in its' disciplines (health informatics and health services research), it is selective, but it is now complemented by almost 30 specialty JMIR sister journals, which have a broader scope. Peer-review reports are portable across JMIR journals and papers can be transferred, so authors save time by not having to resubmit a paper to different journals.
As open access journal, we are read by clinicians, allied health professionals, informal caregivers, and patients alike, and have (as all JMIR journals) a focus on readable and applied science reporting the design and evaluation of health innovations and emerging technologies. We publish original research, viewpoints, and reviews (both literature reviews and medical device/technology/app reviews).
We are also a leader in participatory and open science approaches, and offer the option to publish new submissions immediately as preprints, which receive DOIs for immediate citation (eg, in grant proposals), and for open peer-review purposes. We also invite patients to participate (eg, as peer-reviewers) and have patient representatives on editorial boards.
Be a widely cited leader in the digitial health revolution and submit your paper today!
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Background: The onset of mental health problems peaks between adolescence and young adulthood, however young people face barriers to treatment and are often reluctant to seek professional help. Many a...
Background: The onset of mental health problems peaks between adolescence and young adulthood, however young people face barriers to treatment and are often reluctant to seek professional help. Many are instead seeking support and information regarding their mental health online, especially via social networking sites (SNSs), so there is a promising opportunity to use SNSs to deliver or integrate with youth-focused online mental health interventions. Previous reviews have evaluated the effectiveness of SNSs for specific disorders in young people, however none to date have covered the breadth of SNS-based youth mental health interventions available across all mental health issues. Objective: The aim of this review was to systematically identify available evidence regarding the use of SNS-based interventions to support the mental health of young people, in order to evaluate their effectiveness, suitability and safety, and identify gaps and opportunities for future research. Methods: The PubMed and PsycInfo databases were searched using Medical Subject Headings (MeSH) terms and exploded keywords and phrases. Retrieved abstracts (n=974) were double screened, yielding 235 articles for screening at the full-text level. Of these, nine articles met the review inclusion criteria. Given the small number of studies, their exploratory nature and the variety of outcome measures used, a quantitative meta-analysis was not possible. Results: The nine articles (quantitative studies, qualitative studies and descriptions of the iterative design process) covered five separate interventions. Two interventions used purpose-built platforms based on the Moderated Online Social Therapy (MOST) model, two used Facebook, and one evaluated a purpose-built mobile app. The two MOST interventions targeted specific mental health issues (depression and psychosis), while the others focused on improving mental health literacy, social support and general wellbeing. Only three quantitative studies were identified, and all used a pre-post design (without a control group) to establish ‘proof of concept’. Of the outcome variables assessed, there were significant improvements in mental health knowledge and number of depressive symptoms, but no improvement in anxiety or psychosis symptoms. Acceptability of and engagement with the SNS platforms was generally high, as were perceptions of usefulness and safety, with no adverse incidents reported. Moderation by clinical experts was identified as a key component of the more successful interventions. When offered a choice, users showed a preference for mobile apps over web-based interfaces. Conclusions: The evidence reviewed suggests young people find SNS-based interventions highly usable, engaging and supportive. However, future studies need to address the current lack of high-quality evidence for their efficacy in reducing mental health symptoms. Given that young people are already turning to SNSs to engage in knowledge-seeking and peer-to-peer support, SNS-based youth mental health interventions provide an opportunity to address some of the barriers young people face in accessing qualified mental health support and information.
Background: Attention deficit hyperactivity disorder is a neurobehavioral disease that makes children who suffer from it display behaviors of inattention, hyperactivity or impulsivity, thus affecting...
Background: Attention deficit hyperactivity disorder is a neurobehavioral disease that makes children who suffer from it display behaviors of inattention, hyperactivity or impulsivity, thus affecting their ability to learn and establish proper family and social relationships. Various tools are currently used by child and adolescent psychiatric clinics to diagnose, evaluate, and collect information and data that then allows professional physicians to assess if patients need further treatment, following a thorough and careful clinical diagnosis process. Objective: The scientific advancements in the domain of brainwaves, e.g. electroencephalography, have been perfecting, both portable and wearable equipment have gradually been developed with the hope of determining relevant indicators of brainwave parameters in ADHD children. Methods: The sample size consists of a total of 63 subjects, 40 males and 9 females in the experimental group; while 5 males and 9 females in the control group. The brainwave sensor and wristwatch sensor were used in the experimental process, which was divided into three stages: pre_test, in_test, and post_test, with a testing interval of 20 minutes each. We use t-test and correlation analysis to investigate indicators of the disorder children. Results: The results show the disorder is significant negative correlation with brainwaves (p<0.05), the higher the concentration of brainwave activity, the less likely that the disorder is present; while, it is significant positive correlation with the activity amounts (p<0.01), the higher the amount of activity, the greater the probability that the patient will have the disorder. Two groups achieved significant differences in the independent t-test (p<0.05), indicating that the amount of activity detected by the wristwatch sensor is capable of identifying the disorder. Finally, the amount of mean activity only in in_test stage is significant differences from pre_test and post_test stages. Conclusions: The results show that when the subjects are stimulated under restricted conditions, the disorder subjects will present with different amount of activity over the unrestricted condition due to patients’ inability to exercise control over their own concentration. Further studies are required in the future to determine whether the wristwatch sensor can be used to detect the amount of activity and help physicians diagnose the disorder in order to develop more objective, rapid auxiliary diagnostic tools.
Background: Whiplash is a world-wide health and economic burden. Contributing to this burden is poor guideline adherence and lack of identifying and addressing modifiable risk factors. Online tools th...
Background: Whiplash is a world-wide health and economic burden. Contributing to this burden is poor guideline adherence and lack of identifying and addressing modifiable risk factors. Online tools that facilitate clinical pathways of care are a novel solution to improve management. Objective: To develop, implement and evaluate an online tool to support whiplash management following a robust framework. Methods: We followed the first three processes of a research translation framework including idea generation, feasibility and efficacy. Development of the website involved stakeholder consultations to discuss content, design, features and functionality. Implementation strategies included classroom education, educational meetings, educational outreach, reminders and direct phone contact. Surveys and focus group discussions were conducted amongst primary and specialist health care professionals (HCPs) and people with whiplash to assess feasibility. Outcomes evaluated were; website metrics, acceptability and self-rated improvements in knowledge amongst HCPs and website logs of treatment decisions (e.g. shared-care, specialist care, referred care) made by specialist HCPs. Results: The development process delivered an interactive, user-friendly and acceptable website, My Whiplash Navigator, tailored to the needs of people with whiplash and HCPs. The content and features of the website were identified following consultative meetings between researchers and industry partners and further informed by results of surveys and focus group discussions amongst people with whiplash and HCPs. 320 registrations were recorded from June 2016-March 2018, including 260 HCPs (175 student, 65 primary, 20 specialist HCPs) and 60 people with whiplash. Most effective implementation strategies were classroom teaching for students (81% uptake) and educational meetings for primary HCPs (43% uptake). Popular pages visited were those containing information about advice and exercises and risk assessment. All HCPs agreed that their knowledge regarding risk management (81.4%) and providing appropriate exercises (87.6%) improved. Specialists’ most common decision was ‘shared care’, improving their management decisions from a previous cohort. Areas to improve were navigation and access to outcome measures. Conclusions: A robust development process resulted in an innovative, interactive, user-friendly website, the “My Whiplash Navigator”. Implementation with HCPs was best achieved through classroom education and educational meetings. Evaluation of the website showed improved knowledge and practice to be more consistent with a risk-based clinical care pathway for whiplash. The positive results provide sufficient evidence to scale implementation nationally and involving other target markets.
Background: There have been mixed results of the studies checking whether prayers do actually extend the life duration of the people prayed for. Most studies on the topic included a small number of pr...
Background: There have been mixed results of the studies checking whether prayers do actually extend the life duration of the people prayed for. Most studies on the topic included a small number of prayers and most of them focused on people already struggling with a medical condition. Intercessory prayer’s influence on health is of scholarly interest, yet it is unclear if its effect may be dependent on the number of prayers for a named individual received per annum. Objective: We sought to examine if there is a noticeable increased longevity effect of intercessory prayer for a named individual’s well-being, if he receives a very high number of prayers per annum for an extended period. Methods: We retrieved and conducted a statistical analysis of the data about the length of life for 857 Roman Catholic bishops, 500 Catholic priests, and 3038 male academics from the US, France, Italy, Poland, Brazil, and Mexico. We obtained information for these individuals who died between 1988 and 2018 from Wikidata, and conducted an observational cohort study. Bishops were chosen for the study, as they receive millions of individual prayers for well being, according to conservative estimates. Results: There was a main effect for occupation F(2, 4391) = 4.07, p = .017, ηp 2 = .002, with pairwise comparisons indicating significant differences between the mean life duration of bishops (M=30489) and of priests (M=29894), but none between the academic teachers (M=30147) and either of the other groups. A comparison analysis between bishops from the largest and the smallest dioceses showed no significant difference t(67.31)=1.61, p = .11. Our main outcome measure is covariance of the mean length of life in each of the categories: bishops, priests, academic teachers, controlled for nationality. Conclusions: The first analysis proved that bishops live longer than priests, but due to a marginal effect size this result should be treated with caution. No difference was found between the mean length of life of bishops from the largest and the smallest dioceses. We found no difference between bishops and male academics. These results show that the impact of intercessory prayers on longevity is not observable.
Background: Quality of life (QoL) assessments, or patient-reported outcome measures (PROMs), are becoming increasingly important and can improve decision making, satisfaction, and outcomes of care. S...
Background: Quality of life (QoL) assessments, or patient-reported outcome measures (PROMs), are becoming increasingly important and can improve decision making, satisfaction, and outcomes of care. Some physicians and patients find questionnaires too burdensome, which could be reduced by using computerized adaptive testing. Furthermore, questionnaire user experience might increase by making a questionnaire more interesting, for example by providing graphical and contextualized feedback. However, little is known about how shorter assessments and feedback impact user experience. Objective: We conducted a controlled experiment to assess the impact of tailored multimodal feedback and computerized adaptive testing on user experience in QoL assessment using validated PROMs. Methods: We recruited a representative sample from the general population in the United Kingdom using the Oxford Prolific academic web panel. Participants completed either a computer adaptive testing version of the World Health Organization Quality of Life assessment (WHOQOL-CAT) or the fixed-length WHOQOL-BREF. We randomly assigned participants to conditions in which they would receive either no feedback, graphical feedback only, or graphical and adaptive text feedback. Participants rated the assessment in terms of perceived acceptability, engagement, clarity, and accuracy. Results: We included 1386 participants in our analysis. Assessment experience was improved when graphical and tailored text feedback was provided together alongside PROMs (p<0.001, Δ=0.22). Providing graphical feedback alone was not associated with improvement in overall experience (p=0.006, Δ=0.10). Graphical and text feedback made the questionnaire more interesting and users were more likely to share the results with a physician or family member (p<0.001, Δ=0.17, and p<0.001, Δ=0.17, respectively). No difference was found in perceived accuracy of the graphical feedback scores of the WHOQOL-CAT and WHOQOL-BREF (p=0.05, Δ = 0.06). Computerized adaptive testing resulted in a 25% item reduction (SE<0.45) compared to the fixed-length assessment but did not result in an increased user experience (p=0.21). Conclusions: Using tailored text feedback to contextualize numeric scores maximized the acceptability of electronic QoL assessment. Improving user experience may increase response rates and reduce attrition in research and clinical use of PROMs. In this study, CAT administration was associated with a modest decrease in assessment length but did not improve user experience. Patient perceived accuracy of feedback was equivalent when comparing CAT with fixed-length assessment. Further research is warranted to explore the relationship between assessment length, feedback, and response burden in diverse populations.
Background: Post-vaccination fever (PVF) is a mild adverse event that is naturally reversible without complications, but is highly prevalent and, in some cases, accompanied by febrile convulsions. The...
Background: Post-vaccination fever (PVF) is a mild adverse event that is naturally reversible without complications, but is highly prevalent and, in some cases, accompanied by febrile convulsions. These adverse effects may cause parents to delay or abandon vaccinating their children. Objective: The aim of this paper was to identify PVF patterns and the ability of antipyretics to affect changes in these patterns. Methods: We used the data collected by the parents of the feverish children in the mobile application named Fever Coach to identify the PVF patterns according to the vaccinations and the use of antipyretic drugs. We selected single vaccination records that contained 5 or more body temperature readings performed within 48 hours of vaccination and analyzed PVF onset, offset, duration, and maximum temperature. By observing PVF response to vaccination, we identified effects of antipyretic drugs on PVF onset, offset, and duration times; the extent of fever; and rate of decline. We also performed the logistic regression test to determine demographic variables (age, weight, and gender) to produce relatively high fevers (≥39 ° C). Results: The highest body temperature at which infants and young children received antipyretic drugs was 38 ° C (9.8% of the total data). The number of instances where this temperature threshold was reached was more than four times greater than the number reaching 37.9 ° C. Analyses showed no significant difference in onset time between antipyretic and non-antipyretic cases, but offset time and duration time were significantly shorter in non-antipyretic cases (P < .001). In non-antipyretic cases, offset times and duration times were, on average, 9.9 hours and 10.1 hours shorter, respectively than antipyretic cases. Body temperatures also decreased faster in non-antipyretic cases. Besides, we found that fevers associated with the influenza vaccine lasted relatively long, while fevers associated with the pneumococcus vaccine were relatively short-lived. Conclusions: These findings suggest that PVF has its own fever pattern that is dependent upon vaccine type and presence of antipyretic drugs, and post-vaccination temperature monitoring may ease fever phobia and reduce unnecessary use of antipyretics and medical care.