Can Online Consumers Contribute to Drug Knowledge? A Mixed-Methods Comparison of Consumer-Generated and Professionally Controlled Psychotropic Medication Information on the Internet

Background Ongoing initiatives to filter online health searches exclude consumer-generated content from search returns, though its inferiority compared with professionally controlled content is not demonstrated. The antidepressant escitalopram and the antipsychotic quetiapine have ranked over the last 5 years as top-selling agents in their respective drug classes. Both drugs have various off-label mental health and non?mental health uses, ranging from the relief of insomnia and migraines to the treatment of severe developmental disorders. Objective Our objective was to describe the most frequently reported effects of escitalopram and quetiapine in online consumer reviews, to compare them with effects described in professionally controlled commercial health websites, and to gauge the usability of online consumer medication reviews. Methods A stratified simple random sample of 960 consumer reviews was selected from all 6998 consumer reviews of the two drugs in 2 consumer-generated (www.askapatient.com and www.crazymeds.us) and 2 professionally controlled (www.webmd.com and www.revolutionhealth.com) health websites. Professional medication descriptions included all standard information on the medications from the latter 2 websites. All textual data were inductively coded for medication effects, and intercoder agreement was assessed. Chi-square was used to test for associations between consumer-reported effects and website origination. Results Consumers taking either escitalopram (n = 480) or quetiapine (n = 480) most frequently reported symptom improvement (30.4% or 146/480, 24.8% or 119/480) or symptom worsening (15.8% or 76/480, 10.2% or 49/480), changes in sleep (36% or 173/480, 60.6% or 291/480) and changes in weight and appetite (22.5% or 108/480, 30.8% or 148/480). More consumers posting reviews on consumer-generated rather than professionally controlled websites reported symptom worsening on quetiapine (17.3% or 38/220 versus 5% or 11/220, P \u3c .001), while more consumers posting on professionally controlled websites reported symptom improvement (32.7% or 72/220 versus 21.4% or 47/220, P = .008). Professional descriptions more frequently listed physical adverse effects and warnings about suicidal ideation while consumer reviews emphasized effects disrupting daily routines and provided richer descriptions of effects in context. The most recent 20 consumer reviews on each drug from each website (n = 80) were comparable to the full sample of reviews in the frequency of commonly reported effects. Conclusion Consumer reviews and professional medication descriptions generally reported similar effects of two psychotropic medications but differed in their descriptions and in frequency of reporting. Professional medication descriptions offer the advantage of a concise yet comprehensive listing of drug effects, while consumer reviews offer greater context and situational examples of how effects may manifest in various combinations and to varying degrees. The dispersion of consumer reviews across websites limits their integration, but a brief browsing strategy on the two target medications nonetheless retrieved representative consumer content. Current strategies for filtering online health searches to return only trusted or approved websites may inappropriately address the challenge to identify quality health sources on the Internet because such strategies unduly limit access to an entire complementary source for health information

Respect in the Classroom: A Developmental Approach

This article examines respect through Piaget\u27s theory, recent empirical research, and exemplary practice in order to highlight a developmental approach to understanding and fostering respect in the classroom

Connection between conjunctive capacity and structural properties of graphs

No description supplie

The Role of Pedagogical Mentoring in Virtual Exchange

[EN] Virtual exchange, or telecollaboration, is a well-known pedagogical approach in foreign language education that involves engaging classes in online intercultural collaboration projects with international partners as an integrated part of their educational programmes. This article focuses on the role of the teacher as pedagogical mentor in virtual exchange and examines the impact of the strategies and techniques that teachers use in their classes to support students’ learning during their online intercultural projects. The article begins with a proposed categorization of pedagogical mentoring reported in the literature to date. It then reports on the outcomes of a virtual exchange project carried out by three classes of initial English teacher education in Israel, Spain, and Sweden that involved two types of pedagogical mentoring. Qualitative content analysis enabled the identification of the impact of mentoring that took place before the exchange and also revealed insights into what students learned when their own online interactions were integrated into class work. The article concludes by discussing the limitations and challenges of different types of pedagogical mentoring in virtual exchange and by outlining a list of recommendations for carrying out pedagogical mentoring in such projects.SIThe research reported in this article was supported by the project Evaluating and Upscaling Telecollaborative Teacher Education (EVALUATE) (582934-EPP-1-2016-2-ES-EPPKA3-PI-POLICY). This project is funded by Erasmus+Key Action 3 (EACEA No 34/2015): European policy experimentations in the fields of education, training, and youth led by high-level public authoritie

Identification of a WNT5A-Responsive Degradation Domain in the Kinesin Superfamily Protein KIF26B.

Noncanonical WNT pathways function independently of the β-catenin transcriptional co-activator to regulate diverse morphogenetic and pathogenic processes. Recent studies showed that noncanonical WNTs, such as WNT5A, can signal the degradation of several downstream effectors, thereby modulating these effectors' cellular activities. The protein domain(s) that mediates the WNT5A-dependent degradation response, however, has not been identified. By coupling protein mutagenesis experiments with a flow cytometry-based degradation reporter assay, we have defined a protein domain in the kinesin superfamily protein KIF26B that is essential for WNT5A-dependent degradation. We found that a human disease-causing KIF26B mutation located at a conserved amino acid within this domain compromises the ability of WNT5A to induce KIF26B degradation. Using pharmacological perturbation, we further uncovered a role of glycogen synthase kinase 3 (GSK3) in WNT5A regulation of KIF26B degradation. Lastly, based on the identification of the WNT5A-responsive domain, we developed a new reporter system that allows for efficient profiling of WNT5A-KIF26B signaling activity in both somatic and stem cells. In conclusion, our study identifies a new protein domain that mediates WNT5A-dependent degradation of KIF26B and provides a new tool for functional characterization of noncanonical WNT5A signaling in cells

Quantitative Information Flow as Safety and Liveness Hyperproperties

We employ Clarkson and Schneider's "hyperproperties" to classify various verification problems of quantitative information flow. The results of this paper unify and extend the previous results on the hardness of checking and inferring quantitative information flow. In particular, we identify a subclass of liveness hyperproperties, which we call "k-observable hyperproperties", that can be checked relative to a reachability oracle via self composition.Comment: In Proceedings QAPL 2012, arXiv:1207.055

Kolmogorov-Sinai entropy from recurrence times

Observing how long a dynamical system takes to return to some state is one of the most simple ways to model and quantify its dynamics from data series. This work proposes two formulas to estimate the KS entropy and a lower bound of it, a sort of Shannon's entropy per unit of time, from the recurrence times of chaotic systems. One formula provides the KS entropy and is more theoretically oriented since one has to measure also the low probable very long returns. The other provides a lower bound for the KS entropy and is more experimentally oriented since one has to measure only the high probable short returns. These formulas are a consequence of the fact that the series of returns do contain the same information of the trajectory that generated it. That suggests that recurrence times might be valuable when making models of complex systems

Random perfect lattices and the sphere packing problem

Motivated by the search for best lattice sphere packings in Euclidean spaces of large dimensions we study randomly generated perfect lattices in moderately large dimensions (up to d=19 included). Perfect lattices are relevant in the solution of the problem of lattice sphere packing, because the best lattice packing is a perfect lattice and because they can be generated easily by an algorithm. Their number however grows super-exponentially with the dimension so to get an idea of their properties we propose to study a randomized version of the algorithm and to define a random ensemble with an effective temperature in a way reminiscent of a Monte-Carlo simulation. We therefore study the distribution of packing fractions and kissing numbers of these ensembles and show how as the temperature is decreased the best know packers are easily recovered. We find that, even at infinite temperature, the typical perfect lattices are considerably denser than known families (like A_d and D_d) and we propose two hypotheses between which we cannot distinguish in this paper: one in which they improve Minkowsky's bound phi\sim 2^{-(0.84+-0.06) d}, and a competitor, in which their packing fraction decreases super-exponentially, namely phi\sim d^{-a d} but with a very small coefficient a=0.06+-0.04. We also find properties of the random walk which are suggestive of a glassy system already for moderately small dimensions. We also analyze local structure of network of perfect lattices conjecturing that this is a scale-free network in all dimensions with constant scaling exponent 2.6+-0.1.Comment: 19 pages, 22 figure

Robustness of raw quantum tomography

We scrutinize the effects of non-ideal data acquisition on the homodyne tomograms of photon quantum states. The presence of a weight function, schematizing the effects of the finite thickness of the probing beam or equivalently noise, only affects the state reconstruction procedure by a normalization constant. The results are extended to a discrete mesh and show that quantum tomography is robust under incomplete and approximate knowledge of tomograms.Comment: 7 pages, 1 figure, published versio