eHealth and People with Schizophrenia Spectrum Disorders

eHealth is the transfer of health services and health care by information and communications technology. People with schizophrenia-spectrum disorders (SSD) use the Internet for general and health-related reasons. Yet, it is unclear what kind of schizophrenia-related health information this population finds online. eHealth literacy is the ability of Internet users to find, understand, and apply the health information they acquire, to make appropriate health decisions. People with SSD exhibit cognitive deficits and consequently, their eHealth literacy can be affected. The goal of the study was to describe schizophrenia-related health information, to investigate eHealth use among adults with SSD in Finland and Greece, and to compare the country groups. The methodology consisted of three principle procedures. First, a mixed methods study was conducted with descriptive, cross-sectional design, in order to describe and compare schizophrenia-related health information and videos found online when searched in Finnish and Greek language. Content analysis was performed. Data were analyzed with quantitative and descriptive statistics. Second, a survey study with a descriptive, cross-sectional design was conducted to describe and compare eHealth use among Finnish and Greek people with schizophrenia-spectrum disorders (SSD). Data were collected by a structured questionnaire and analyzed with quantitative, descriptive statistics, partially, group comparisons were made with logistic regression techniques. Third, a systematic literature review and meta-analysis were performed to assess the potential effectiveness of social media interventions for people with SSD. Our findings, first, showed that assessed online schizophrenia-related health information tended to be of low quality, with no significant differences between the two countries. Furthermore, schizophrenia-related videos tended to present mental illness in a negative, not medically-oriented way, again, without significant differences between the countries. Second, Internet use (FI: 87% vs. GR: 33%) and eHealth literacy (FI: mean 27.05 vs. GR: mean 23.15) of Finnish people with SSD was significantly higher (P<.0001) than their Greek counterparts. The interest component of attitudes toward computer/Internet was significantly higher (P=.006) among the Greek group (FI: mean 2.60 vs. GR: mean 3.16). Third, the systematic review and meta-analysis did not show superiority of social media mental health interventions than treatment as usual. In conclusion, it is recommended that in the future, better quality mental health information and videos need to be made available in several languages and to be easily accessible through the most popular search engines and social media sites. eHealth literacy instruction and training is necessary so that people with SSD can find, understand, and apply the health information they retrieve online.Sähköiset terveyspalvelut skitsofreniaspektrin sairauksien hoidossa eHealth –käsite tarkoittaa terveyspalveluja, jotka välitetään informaatio- ja kommunikaatioteknologian avulla. Skitsofreniaspektrin häiriöitä sairastavat henkilöt käyttävät Internetiä yleisiin ja terveyteen liittyviin tarkoituksiin. On kuitenkin epäselvää, minkälaista skitsofreniaan liittyvää terveystietoa he löytävät Internetistä. Sähköinen terveyslukutaito kuvaa Internetin käyttäjien kykyä löytää ja ymmärtää löytämäänsä terveystietoa sekä käyttää sitä tarkoituksenmukaisesti terveyteen liittyvissä päätöksissä. Koska henkilöillä, joilla on skitsofreniaspektrin häiriö, ilmenee usein kognitiivisia vajavaisuuksia, heidän terveyslukutaitonsa saattaa olla alentunut. Tämän tutkimuksen tarkoituksena oli kuvata skitsofreniaan liittyvää terveystietoa sähköisissä palveluissa, selvittää näiden terveyspalvelujen käyttöä aikuisten, skitsofreniaspektrin häiriöitä sairastavien henkilöiden keskuudessa sekä Suomessa että Kreikassa ja verrata maiden ryhmiä toisiinsa. Aluksi toteutettiin tutkimus eri tutkimusmenetelmiä yhdistämällä (mixed methods) deskriptiivisellä, poikkileikkaavalla tutkimusotteella. Tarkoituksena oli kuvata ja verrata Internetistä suomeksi ja kreikaksi löytyvää terveystietoa ja videoita skitsofreniaa koskien. Aineisto analysoitiin sisällönanalyysin sekä kuvailevin tilastomenetelmin. Seuraavaksi suoritettiin kysely samalla tutkimusasetelmalla, jossa kuvattiin ja verrattiin sähköisten terveyspalvelujen käyttöä suomalaisten ja kreikkalaisten skitsofreniaspektrin häiriöitä sairastavien henkilöiden keskuudessa. Aineisto kerättiin strukturoidulla kyselylomakkeella ja analysoitiin kuvailevin tilastomenetelmin. Ryhmien väliset vertailut tehtiin logistisen regressioanalyysin avulla. Kolmanneksi tehtiin systemaattinen kirjallisuuskatsaus ja meta-analyysi, jossa arvioitiin sosiaalisen median vaikuttavuutta skitsofreniaspektrin häiriöitä sairastavien henkilöiden hoidossa. Tulokset osoittivat, että skitsofreniaan liittyvää terveystieto oli yleisesti ottaen huonolaatuista molemmissa maissa; tutkittavien maiden välillä ei ollut tilastollisesti merkitseviä eroja. Skitsofreniaan liittyvät videot kuvasivat mielisairauksia negatiivisessa, ei-lääketieteellisessä valossa; tulokset eivät eronneet tilastollisesti maiden välillä. Suomalaisten skitsofreniaspektrin häiriöitä sairastavien henkilöiden Internetin käyttö (Suomi 87% vs. Kreikka 33%) ja sähköisen terveystiedon lukutaito (ka 27.05 vs. ka 23.15) oli korkeampi suomalaisilla kuin kreikkalaisilla potilailla; maiden väliset erot olivat tilastollisesti merkitsevät (P<.0001). Tietokoneisiin/Internetiin kohdistuvat asenteet olivat merkittävästi positiivisimmat kreikkalaisen keskuudessa (ka 2.60 vs. ka 3.16, P=.006). Systemaattinen kirjallisuuskatsaus ja meta-analyysi eivät osoittaneet sosiaalisen median olevan tehokkaampi kuin perinteiset hoitomenetelmät. Tulevaisuudessa korkealaatuista mielenterveysinformaatiota ja videoita olisi oltava helposti löydettävissä eri kielillä suosituimpien hakukoneiden ja sosiaalisen median avulla. Potilaat tarvitsevat koulutusta sähköisten palvelujen medialukutaitoon.Siirretty Doriast

An analysis of online health information on schizophrenia or related conditions: a cross-sectional survey

Background: Around 20% of those who seek health information online, search specifically for mental health. However, little is known about the nature of the online health information offered by two European countries, Finland and Greece, which are characterized by markedly differing levels of Internet access and online health information seeking. This study aims to assess, describe and compare websites, written in two European, non-English languages (Finnish and Greek) that appear first after performing an online search concerning schizophrenia or related conditions. Methods: The first 20 results from four search terms (searched in Finnish and Greek) in the Web search engine ‘Google’ were screened. A total of 160 websites were retrieved (80 Finnish, 80 Greek) and evaluated using a preformulated coding system which consisted of websites’ indicators, such as: types, characteristics, accountability, interactivity, aesthetics and content. Differences between websites were evaluated with Chi-Square or Fisher’s Exact tests for categorical data and independent t-tests for parametric data. Results: Twenty-four Finnish and thirty-four Greek websites (36% in total) were included. Almost two-thirds (62%, n=36) were owned by an organization, compared to 17% (n=10) by an individual. In both countries, aesthetics had the highest score (possible range 0–4, mean = 2.6, SD = .62), while interactivity the lowest (range 0–5, mean = 1.79, SD = .87). There were no statistically significant differences among the accountability, interactivity and aesthetics scores of the Finnish and Greek websites. Conclusions: All assessed indicators suggest there is a need to improve Finnish and Greek online information about schizophrenia or related conditions. The poor website interactivity is of particular concern given the challenges faced by the target group. The findings can be used to guide the development and dissemination of online mental health information aimed at Finnish and Greek online health-seekers

Connectivity to computers and the Internet among patients with schizophrenia spectrum disorders : a cross-sectional study

Purpose: Information and communication technologies have been developed for a variety of health care applications and user groups in the field of health care. This study examined the connectivity to computers and the Internet among patients with schizophrenia spectrum disorders (SSDs). Patients and methods: A cross-sectional survey design was used to study 311 adults with SSDs from the inpatient units of two psychiatric hospitals in Finland. The data collection lasted for 20 months and was done through patients' medical records and a self-reported, structured questionnaire. Data analysis included descriptive statistics. Results: In total, 297 patients were included in this study (response rate =96%). More than half of them (n=156; 55%) had a computer and less than half of them (n=127; 44%) had the Internet at home. Of those who generally had access to computers and the Internet, more than one-fourth (n=85; 29%) used computers daily, and > 30% (n=96; 33%) never accessed the Internet. In total, approximately one-fourth of them (n=134; 25%) learned to use computers, and less than one-third of them (n=143; 31%) were known to use the Internet by themselves. Older people (aged 45-65 years) and those with less years of education (primary school) tended not to use the computers and the Internet at all (P <0.001), and younger people and those with higher education were associated with more active use. Conclusion: Patients had quite good access to use computers and the Internet, and they mainly used the Internet to seek information. Social, occupational, and psychological functioning (which were evaluated with Global Assessment of Functioning) were not associated with access to and frequency of computer and the Internet use. The results support the use of computers and the Internet as part of clinical work in mental health care.Peer reviewe

Secondary School Pupils' Mental Wellbeing Is Associated with Belonging to a Perceived Minority and Experiencing Discrimination

Adolescents' mental health is a global issue and there is a growing interest in tackling mental health in schools. The study aimed to assess secondary school pupils' mental wellbeing and the factors related to their mental wellbeing (sociodemographic characteristics, perception of belonging to a minority, and discrimination). Data were collected from 12-17-year-old pupils of a Finnish secondary school via an online questionnaire. Data were analyzed with descriptive statistics and ANOVA for group comparisons. Participants' (N = 114) mental wellbeing scores were above average (47.5, max. 70). Worse family relations were independently associated with worse mental wellbeing. Additionally, significantly lower scores on mental wellbeing were found among pupils who thought they belonged to a minority due to appearance, sexual orientation, and/or chronic disease. Participants who had experienced discrimination had significantly lower mental wellbeing scores in comparison to those who never had such an experience. In conclusion, mental health promotion interventions which promote good family relations should be targeting different youth groups in order to address their specific needs. Thus, screening programs which identify pupils who are at risk or belong to minority groups are needed, in order to direct them to proper services when needed and/or implement mental health promotion interventions accordingly

Mental Health Needs of Adolescents Assessed During the Years of Global Financial Crisis: a Systematic Review

Introduction: Mental health issues during adolescence are common and worsen when financial crisis occur across the world. Identification of mental health needs as they are expressed by adolescents themselves is important for efficient mental health promotion interventions. Aim: This systematic review examined studies on the mental health needs among adolescents from their own perspective. Methods: Four databases were searched between 2008-2018, starting with 2008 when the global financial crisis began. Results: The seven studies that fulfilled the inclusion criteria used different data collection methods. Emotional and behavioral problems and hyperactivity were found, while adolescents’ own perceptions also showed positive indicators for mental health. Most studies focus on specific adolescent populations, while the general adolescent population needs more attention as a target group for mental health interventions. Conclusion: Interventions should address the needs as they are identified by adolescents in order to promote their mental health. Researchers should develop an instrument which assesses exclusively the adolescents’ mental health needs.</p

Connectivity to computers and the Internet among patients with schizophrenia spectrum disorders: a cross-sectional study

PurposeInformation and communication technologies have been developed for a variety of health care applications and user groups in the field of health care. This study examined the connectivity to computers and the Internet among patients with schizophrenia spectrum disorders (SSDs).Patients and methodsA cross-sectional survey design was used to study 311 adults with SSDs from the inpatient units of two psychiatric hospitals in Finland. The data collection lasted for 20 months and was done through patients’ medical records and a self-reported, structured questionnaire. Data analysis included descriptive statistics.ResultsIn total, 297 patients were included in this study (response rate =96%). More than half of them (n=156; 55%) had a computer and less than half of them (n=127; 44%) had the Internet at home. Of those who generally had access to computers and the Internet, more than one-fourth (n=85; 29%) used computers daily, and >30% (n=96; 33%) never accessed the Internet. In total, approximately one-fourth of them (n=134; 25%) learned to use computers, and less than one-third of them (n=143; 31%) were known to use the Internet by themselves. Older people (aged 45–65 years) and those with less years of education (primary school) tended not to use the computers and the Internet at all (PConclusionPatients had quite good access to use computers and the Internet, and they mainly used the Internet to seek information. Social, occupational, and psychological functioning (which were evaluated with Global Assessment of Functioning) were not associated with access to and frequency of computer and the Internet use. The results support the use of computers and the Internet as part of clinical work in mental health care.</p

Enhancement of endogenous midbrain neurogenesis by microneurotrophin BNN-20 after neural progenitor grafting in a mouse model of nigral degeneration

We have previously shown the neuroprotective and pro-neurogenic activity of microneurotrophin BNN-20 in the substantia nigra of the “weaver” mouse, a model of progressive nigrostriatal degeneration. Here, we extended our investigation in two clinically-relevant ways. First, we assessed the effects of BNN-20 on human induced pluripotent stem cell-derived neural progenitor cells and neurons derived from healthy and parkinsonian donors. Second, we assessed if BNN-20 can boost the outcome of mouse neural progenitor cell intranigral transplantations in weaver mice, at late stages of degeneration. We found that BNN-20 has limited direct effects on cultured human induced pluripotent stem cell-derived neural progenitor cells, marginally enhancing their differentiation towards neurons and partially reversing the pathological phenotype of dopaminergic neurons generated from parkinsonian donors. In agreement, we found no effects of BNN-20 on the mouse neural progenitor cells grafted in the substantia nigra of weaver mice. However, the graft strongly induced an endogenous neurogenic response throughout the midbrain, which was significantly enhanced by the administration of microneurotrophin BNN-20. Our results provide straightforward evidence of the existence of an endogenous midbrain neurogenic system that can be specifically strengthened by BNN-20. Interestingly, the lack of major similar activity on cultured human induced pluripotent stem cell-derived neural progenitors and their progeny reveals the in vivo specificity of the aforementioned pro-neurogenic effect

Multidimensional signals and analytic flexibility: Estimating degrees of freedom in human speech analyses

Recent empirical studies have highlighted the large degree of analytic flexibility in data analysis which can lead to substantially different conclusions based on the same data set. Thus, researchers have expressed their concerns that these researcher degrees of freedom might facilitate bias and can lead to claims that do not stand the test of time. Even greater flexibility is to be expected in fields in which the primary data lend themselves to a variety of possible operationalizations. The multidimensional, temporally extended nature of speech constitutes an ideal testing ground for assessing the variability in analytic approaches, which derives not only from aspects of statistical modeling, but also from decisions regarding the quantification of the measured behavior. In the present study, we gave the same speech production data set to 46 teams of researchers and asked them to answer the same research question, resulting insubstantial variability in reported effect sizes and their interpretation. Using Bayesian meta-analytic tools, we further find little to no evidence that the observed variability can be explained by analysts’ prior beliefs, expertise or the perceived quality of their analyses. In light of this idiosyncratic variability, we recommend that researchers more transparently share details of their analysis, strengthen the link between theoretical construct and quantitative system and calibrate their (un)certainty in their conclusions

Antibodies against endogenous retroviruses promote lung cancer immunotherapy

B cells are frequently found in the margins of solid tumours as organized follicles in ectopic lymphoid organs called tertiary lymphoid structures (TLS). Although TLS have been found to correlate with improved patient survival and response to immune checkpoint blockade (ICB), the underlying mechanisms of this association remain elusive. Here we investigate lung-resident B cell responses in patients from the TRACERx 421 (Tracking Non-Small-Cell Lung Cancer Evolution Through Therapy) and other lung cancer cohorts, and in a recently established immunogenic mouse model for lung adenocarcinoma. We find that both human and mouse lung adenocarcinomas elicit local germinal centre responses and tumour-binding antibodies, and further identify endogenous retrovirus (ERV) envelope glycoproteins as a dominant anti-tumour antibody target. ERV-targeting B cell responses are amplified by ICB in both humans and mice, and by targeted inhibition of KRAS(G12C) in the mouse model. ERV-reactive antibodies exert anti-tumour activity that extends survival in the mouse model, and ERV expression predicts the outcome of ICB in human lung adenocarcinoma. Finally, we find that effective immunotherapy in the mouse model requires CXCL13-dependent TLS formation. Conversely, therapeutic CXCL13 treatment potentiates anti-tumour immunity and synergizes with ICB. Our findings provide a possible mechanistic basis for the association of TLS with immunotherapy response