interactive Journal of Medical Research

A general medical journal, focussing on innovation in health and medical research

Baclofen treatment of bulimia nervosa and binge eating disorder: an Internet survey

Background: Bulimia nervosa (BN) and binge eating disorder (BED) are conditions difficult to treat and for which there are very few approved treatments. Objective: Some preclinical and clinical studies have shown baclofen to be effective in BED, but these effects must be confirmed, and baclofen effectiveness investigated in other forms of eating disorders, such as BN. Methods: The present study is an Internet survey targeting the use of baclofen for the treatment of BN and BED. Survey questions were released on the “Baclofène” Internet site in December 2014. These questions relate to baclofen effectiveness in both disorders, doses used, step-by-step treatment increase, adverse effects, and, more generally, attempt to evaluate the impact of baclofen treatment on quality of life. Results: Eighty-one individuals responded (35 with BN, 46 with BED); 49% of BN and 30% of BED subjects reported total recovery on baclofen, while 29% of BN and 48% of BED reported some improvement. BN subjects were significantly younger and required significantly higher doses of baclofen than those with BED. Individual effective doses were highly variable (40-430mg/d), the average maximal dose used was 170mg/d. There were no correlations between the maximal baclofen dose and the intensity of adverse effects, quality of life, and recovery. Conclusions: The results of this survey confirm the effectiveness of baclofen in the treatment of BED and suggest its potential interest in BN. Controlled studies using high-dose baclofen are needed.


Interact J Med Res articles are indexed in PubMed ( and the full text is immediately deposited in PubMed Central ( The Interact J Med Res adheres to the same quality standards as JMIR and all articles published here are also cross-listed in the Table of Contents of JMIR, the worlds' leading medical journal in health sciences / health services research and health informatics (

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Journal Description

i-JMR is a new general medical journal, harnessing the power of the Internet and mobile platforms (iPad) for knowledge dissemination and translation.

i-JMR is a general medical journal with a focus on innovation in health, health care, and medicine - through new medical techniques and innovative ideas and/or research, including - but not limited to - technology, clinical informatics, or groundbreaking research.

Published by JMIR Publications, publisher of JMIR, the leading eHealth/mHealth journal (Impact Factor 2011: 4.4), i-JMR has a broader scope and features a rapid and thorough peer-review process, professional copyediting, professional production of PDF, XHTML, and XML proofs (ready for deposit in PubMed Central), and an ipad App (in prep.).


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    An Innovative Approach to Informing Research: Gathering Perspectives on Diabetes Care Challenges From an Online Patient Community


    Background: Funding agencies and researchers increasingly recognize the importance of patient stakeholder engagement in research. Despite calls for greater patient engagement, few studies have engaged a broad-based online community of patient stakeholders in the early stages of the research development process. Objective: The objective of our study was to inform a research priority-setting agenda by using a Web-based survey to gather perceptions of important and difficult aspects of diabetes care from patient members of a social networking site-based community. Methods: Invitations to participate in a Web-based survey were sent by email to members of the PatientsLikeMe online diabetes community. The survey asked both quantitative and qualitative questions addressing individuals’ level of difficulty with diabetes care, provider communication, medication management, diet and exercise, and relationships with others. Qualitative responses were analyzed using content analysis. Results: Of 6219 PatientsLikeMe members with diabetes who were sent survey invitations, 1044 (16.79%) opened the invitation and 320 (5.15% of 6219; 30.65% of 1044) completed the survey within 23 days. Of the 320 respondents, 33 (10.3%) reported having Type 1 diabetes; 107 (33.4%), Type 2 diabetes and taking insulin; and 180 (56.3%), Type 2 diabetes and taking oral agents or controlling their diabetes with lifestyle modifications. Compared to 2005-2010 National Health and Nutrition Examination Survey data for individuals with diabetes, our respondents were younger (mean age 55.8 years, SD 9.9 vs 59.4 years, SE 0.5); less likely to be male (111/320, 34.6% vs 48.4%); and less likely to be a racial or ethnic minority (40/312, 12.8% vs 37.5%). Of 29 potential challenges in diabetes care, 19 were categorized as difficult by 20% or more of respondents. Both quantitative and qualitative results indicated that top patient challenges were lifestyle concerns (diet, physical activity, weight, and stress) and interpersonal concerns (trying not to be a burden to others, getting support from family/friends). In our quantitative analysis, similar concerns were expressed across patient subgroups. Conclusions: Lifestyle and interpersonal factors were particularly challenging for our online sample of adults with Type 1 or Type 2 diabetes. Our study demonstrates the innovative use of social networking sites and online communities to gather rapid, meaningful, and relevant patient perspectives that can be used to inform the development of research agendas.

  • (cc) Pehora et al. How parents attending a Canadian tertiary hospital are using the Internet for their child's health information.

    Are Parents Getting it Right? A Survey of Parents’ Internet Use for Children’s Health Care Information


    Background: The use of the Internet to search for medical and health-related information is increasing and associated with concerns around quality and safety. Objective: We investigated the current use and perceptions on reliable websites for children’s health information by parents. Methods: Following institutional ethics approval, we conducted a survey of parents/guardians of children presenting for day surgery. A 20-item survey instrument developed and tested by the investigators was administered. Results: Ninety-eight percent of respondents reported that they used the Internet to search for information about their child’s health. Many respondents reported beginning their search at public search engines (80%); less than 20% reported starting their search at university/hospital-based websites. Common conditions such as colds/flu, skin conditions and fever were the most frequently searched, and unique conditions directly affecting the child were second. Despite low usage levels of university/hospital-based websites for health information, the majority of respondents (74%) regarded these as providing safe, accurate, and reliable information. In contrast, only 24% of respondents regarded public search engines as providing safe and reliable information. Fifty percent of respondents reported that they cross-checked information found on the internet with a family physician. Conclusions: An unprecedented majority of parents and guardians are using the Internet for their child’s health information. Of concern is that parents and guardians are currently not using reliable and safe sources of information. Health care providers should begin to focus on improving access to safe, accurate, and reliable information through various modalities including education, designing for multiplatform, and better search engine optimization.

  • Side-by-side view of desktop layout (A) versus mobile layout (B) depicting appendicitis (ie, inflammation of the appendix). The control panel folds if the screen resolution is too small (B) to provide an unhindered view on the slide. Pathological annotations are shown.

    A Virtual Microscope for Academic Medical Education: The Pate Project


    Background: Whole-slide imaging (WSI) has become more prominent and continues to gain in importance in student teaching. Applications with different scope have been developed. Many of these applications have either technical or design shortcomings. Objective: To design a survey to determine student expectations of WSI applications for teaching histological and pathological diagnosis. To develop a new WSI application based on the findings of the survey. Methods: A total of 216 students were questioned about their experiences and expectations of WSI applications, as well as favorable and undesired features. The survey included 14 multiple choice and two essay questions. Based on the survey, we developed a new WSI application called Pate utilizing open source technologies. Results: The survey sample included 216 students—62.0% (134) women and 36.1% (78) men. Out of 216 students, 4 (1.9%) did not disclose their gender. The best-known preexisting WSI applications included Mainzer Histo Maps (199/216, 92.1%), Histoweb Tübingen (16/216, 7.4%), and Histonet Ulm (8/216, 3.7%). Desired features for the students were latitude in the slides (190/216, 88.0%), histological (191/216, 88.4%) and pathological (186/216, 86.1%) annotations, points of interest (181/216, 83.8%), background information (146/216, 67.6%), and auxiliary informational texts (113/216, 52.3%). By contrast, a discussion forum was far less important (9/216, 4.2%) for the students. Conclusions: The survey revealed that the students appreciate a rich feature set, including WSI functionality, points of interest, auxiliary informational texts, and annotations. The development of Pate was significantly influenced by the findings of the survey. Although Pate currently has some issues with the Zoomify file format, it could be shown that Web technologies are capable of providing a high-performance WSI experience, as well as a rich feature set.

  • Illustrative pictures of the SintromacWeb software. In patient’s personal area (panel A), current medication schedule is available; INR results are introduced and sent to health care center. In physician’s area (panel B), the hematologist analyzes the data and introduces new medication schedule for patient.

    Effective and Safe Management of Oral Anticoagulation Therapy in Patients Who Use the Internet-Accessed Telecontrol Tool SintromacWeb


    Background: Despite the existing evidence that highlights the benefits of oral anticoagulation therapy (OAT) self-testing and self-management by patients in comparison with conventional control, significant progress is still needed in the implementation of computer-based, Internet-assisted systems for OAT within health care centers. The telecontrol tool “SintromacWeb” is a previously validated system for OAT management at home, which is currently operative and accessed by patients through a hospital Web portal. Objective: The intent of the study was to assess the effectiveness and safety of OAT management in patients using the SintromacWeb telecontrol system in reference to control in patients using the conventional system (management at the hematology department), in terms of time in therapeutic range (TTR) of International Normalized Ratio (INR). Methods: In this observational prospective study, patients were identified by their physician and divided in two groups according to the OAT management system that they were already using (conventional control or telecontrol with SintromacWeb). For 6 months, patients were required to visit the hematology department every time their physician considered it necessary according to usual clinical practice. Sociodemographic and clinical variables for the study were collected at first visit (baseline) and at those visits closest to 2, 4, and 6 months after first visit. Results: A total of 173 patients were evaluated, 87 with conventional control and 86 with telecontrol. Follow-up time was a median of 6.3 (range 5.2-8.1) months. The average time of OAT treatment prior to enrollment was 9.2 (SD 6.4) years. Patients in the telecontrol group tested their INR a median of 21 (range 4-22) days versus a median of 35 (range 14-45) days in patients in the conventional control group (P<.001). TTR in the telecontrol group was 107 (SD 37) days versus 94 (SD 37) days in the conventional control group (an increase of 12.6%; P=.02). In all visits, the percentage of TTR was higher in the telecontrol group (at the third visit: 59% vs 48%; P=.01). Higher TTR (positive coefficient) was associated with patients under OAT telecontrol (P=.03). Under-anticoagulation (INR<1.5) and over-anticoagulation (INR>5) were observed in 34 (19.7%, 34/173) and 38 (22.0%, 38/173) patients, respectively (no differences between treatment groups). Seven thrombotic and/or bleeding events were serious, 12 were non-serious, and most of them (5 and 10, respectively) occurred in the conventional control group. Conclusions: In clinical practice, OAT management with the Internet-based tool SintromacWeb is effective and safe for those patients who are eligible for OAT telecontrol.

  • Table of Contents thumbnail.
It is from the bimonthly publication of National Health Insurance Administration, Ministry of Health and Welfare.


    Web-Based and Telephone Surveys to Assess Public Perception Toward the National Health Insurance in Taiwan: A Comparison of Cost and Results


    Background: Numerous studies have examined the impact of global budget payment systems of health insurance on patient access to medical care. In order to monitor the population’s accessibility to health services, a series of survey are often used to understand public perceptions of the health care provider. Taiwan implemented the single-payer National Health Insurance in 1995 and has been conducting a series of surveys to monitor public perception of the NHI after adopting a global budget payment system in 2002. Although telephone surveys are commonly used in obtaining public opinions on various public health issues, limitations such as higher cost and influence of interviewers do raise some concerns. Web-based surveys, one of the alternative methods, may be free from these problems. Objective: Our aim was to examine the difference of sociodemographic characteristics, satisfaction of NHI and NHI-contracted health care providers, attitude toward NHI-related issues, behavior in seeking medical advice and self-reported health status between those who completed Web-based surveys and those reached by telephone. Methods: This study compared the demographic factors of participants who took either a Web-based survey (1313 participants) or random digit dialing telephone survey (2411 participants) that contained identical questions. Results: Compared to telephone survey respondents, Web-based respondents tended to be younger (P<.001), unmarried (P<.001), non-smokers (P<.001), with a higher education (P<.001), and a higher monthly household income (P<.001) and worse self-reported health status (P=.008); however, they were less likely to report suffering from a chronic disease (P<.001). Despite these differences in background characteristics, no significant differences were observed in their answers related to the seeking of medical care or NHI-related issues. Telephone survey respondents reported greater satisfaction with NHI services. Web-based surveys were also shown to provide a lower average cost per sample (US$0.71) compared to telephone surveys (US$3.98). Conclusions: Web-based surveys provide a low-cost alternative method for the polling of public attitudes toward NHI-related issues. Despite general similarities between the two polling methods with regard to responses, respondents to telephone surveys reported a stronger agreement with regard to satisfaction with NHI services and a more positive self-reported health status.

  • Searching the Internet for health information. (Photo: Arthur Dubowicz).

    Medical Information on the Internet: A Tool for Measuring Consumer Perception of Quality Aspects


    Background: Most of adult Internet users have searched for health information on the Internet. The Internet has become one of the most important sources for health information and treatment advice. In most cases, the information found is not verified with a medical doctor, but judged by the “online-diagnosers” independently. Facing this situation, public health authorities raise concern over the quality of medical information laypersons can find on the Internet. Objective: The objective of the study was aimed at developing a measure to evaluate the credibility of websites that offer medical advice and information. The measure was tested in a quasi-experimental study on two sleeping-disorder websites of different quality. Methods: There were 45 survey items for rating the credibility of websites that were tested in a quasi-experimental study with a random assignment of 454 participants to either a high- or a low-quality website exposure. Using principal component analysis, the original items were reduced to 13 and sorted into the factors: trustworthiness, textual deficits of the content, interferences (external links on the Web site), and advertisements. The first two factors focus more on the provided content itself, while the other two describe the embedding of the content into the website. The 45 survey items had been designed previously using exploratory observations and literature research. Results: The final scale showed adequate power and reliability for all factors. The loadings of the principal component analysis ranged satisfactorily (.644 to .854). Significant differences at P<.001 were found between the low- and high-quality groups. Advertisements on the website were rated as disturbing in both experimental conditions, meaning that they do not differentiate between good and bad information. Conclusions: The scale reliably distinguished high- and low-quality of medical advice given on websites.

  • Copyright of Austin Health Urology

    Patients' Perspectives of Accessibility and Digital Delivery of Factual Content Provided by Official Medical and Surgical Specialty Society Websites: A...


    Background: Health care websites provide a valuable resource of health information to online consumers, especially patients. Official surgical and medical society websites should be a reliable first point of contact. Objective: The primary aim of this study was to quantitatively assess medical and surgical society websites for content and highlight the essential features required for a high-quality, user-friendly society website. Methods: Twenty specialty association websites from each of the regions, Australia, UK, Canada, Europe, and the USA were selected for a total of 100 websites. Medical and surgical specialities were consistent across each region. Each website was systematically and critically analysed for content and usability. Results: The average points scored per website was 3.2 out of 10. Of the total (N=100) websites, 12 scored at least 7 out of 10 points and 2 scored 9 out of 10. As well, 35% (35.0/100) of the websites had an information tab for patients on their respective homepages while 38% (38.0/100) had download access to patient information. A minority of the websites included different forms of multimedia such as pictures and diagrams (24.0/100, 24%) and videos (18.0/100, 18%). Conclusions: We found that most society websites did not meet an adequate standard for delivery of information. Half of the websites were not patient accessible, with the primary focus being for health professionals. As well, most required logins for information access. Specialty health care societies should create patient-friendly websites that would be beneficial to all online consumers.

  • Image courtesy of [ambro] at

    Patterns of Technology Use in Patients Attending a Cardiopulmonary Outpatient Clinic: A Self-Report Survey


    Background: Self-management education for cardiopulmonary diseases is primarily provided through time-limited, face-to-face programs, with access limited to a small percentage of patients. Telecommunication tools will increasingly be an important component of future health care delivery. Objective: The purpose of this study was to describe the patterns of technology use in patients attending a cardiopulmonary clinic in an academic medical center. Methods: A prevalence survey was developed to collect data on participant demographics (age in years, sex, and socioeconomic status); access to computers, Internet, and mobile phones; and use of current online health support sites or programs. Surveys were offered by reception staff to all patients attending the outpatient clinic. Results: A total of 123 surveys were collected between March and April 2014. Technological devices were a pervasive part of everyday life with respondents engaged in regular computer (102/123, 82.9%), mobile telephone (115/117, 98.3%), and Internet (104/121, 86.0%) use. Emailing (101/121, 83.4%), researching and reading news articles (93/121, 76.9%), social media (71/121, 58.7%), and day-to-day activities (65/121, 53.7%) were the most common telecommunication activities. The majority of respondents reported that access to health support programs and assistance through the Internet (82/111, 73.9%) would be of use, with benefits reported as better understanding of health information (16/111, 22.5%), avoidance of difficult travel requirements and time-consuming face-to-face appointments (13/111, 18.3%), convenient and easily accessible help and information (12/111, 16.9%), and access to peer support and sharing (9/111, 12.7%). The majority of patients did not have concerns over participating in the online environment (87/111, 78.4%); the few concerns noted related to privacy and security (10/15), information accuracy (2/15), and computer literacy and access (2/15). Conclusions: Chronic disease burden and long-term self-management tasks provide a compelling argument for accessible and convenient avenues to obtaining ongoing treatment and peer support. Online access to health support programs and assistance was reported as useful and perceived as providing convenient, timely, and easily accessible health support and information. Distance from the health care facility and a lack of information provision through traditional health sources were both barriers and enablers to telehealth. This is particularly important in the context of a cardiopulmonary clinic that attracts patients from a large geographical area, and in patients who are most likely to have high health care utilization needs in the future. Telecommunication interfaces will be an increasingly important adjunct to traditional forms of health care delivery.

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    Preferred Features of Oral Treatments and Predictors of Non-Adherence: Two Web-Based Choice Experiments in Multiple Sclerosis Patients


    Background: Oral disease modifying therapies (DMTs) for multiple sclerosis (MS) differ in efficacy, tolerability, and safety. Objective: We sought to understand how these attributes impact patient preference and predicted DMT non-adherence among oral-naïve MS patients. Methods: Adult MS patients from the “PatientsLikeMe” Web-based health data-sharing platform completed a discrete choice exercise where they were asked to express their preference for one of three hypothetical oral DMTs, each with a certain combination of levels of tested attributes. Another Web-based exercise tested a number of possible drivers of non-adherence, mainly side effects. Data from an MS clinic were used to adjust for sample bias. Respondents’ preferences were analyzed using Hierarchical Bayesian estimation. Results: A total of 319 patients completed all questions. Most respondents were female (77.7%, 248/319) with mean age 48 years (SD 10). Liver toxicity was the attribute that emerged as the most important driver of patient preference (25.8%, relative importance out of 100%), followed by severe side effects (15.3%), delay to disability progression (10.7%), and common side effects (10.4%). The most important drivers of predicted non-adherence were frequency of daily dosing (17.4% out of 100%), hair thinning (14.8%), use during pregnancy (14.1%), severe side effects (13.8%), and diarrhea (13.0%). Conclusions: Understanding the important concerns expressed by patients may help health care providers to understand and educate their patients more completely about these concerns. This knowledge may therefore improve both choices of appropriate therapy and adherence to therapy over time.

  • Internet use by dementia caregivers.
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    Understanding Internet Use Among Dementia Caregivers: Results of Secondary Data Analysis Using the US Caregiver Survey Data

    Authors List:


    Background: Informal caregivers of persons with dementia experience higher levels of chronic stress in the caregiving trajectory. The Internet provides diverse types of caregiver resources that may help ameliorate their stress and relevant negative outcomes. However, there is limited information about the prevalence and factors of using Internet-based resources for health- and caregiving-related purposes in informal caregivers of persons with dementia. Objective: Specific aims of this study were (1) to determine the prevalence and factors of caregiver’s health-related Internet use and (2) to compare sociodemographic and caregiving-related characteristics between health-related Internet users and non–health-related Internet users among informal caregivers of persons with dementia. Methods: This quantitative investigation was a descriptive correlational design using a secondary data analysis. Primary data were collected via a survey conducted in 2009 by the National Alliance for Caregiving and the American Association of Retired Persons. Telephone interviews utilizing standardized questionnaires were used to collect self-reported information about sociodemographics and caregiving-related history (N=450). Descriptive statistics and a hierarchical binary logistic regression analysis were completed based on the stress process model. Results: Approximately 59% (265/450) of dementia caregivers were identified as health-related Internet users. Caregivers’ sociodemographics and their subjective responses of caregiving stress were the most significant factors to identify health-related Internet users followed by workload assisting in instrumental activities of daily living of persons with dementia. There were significant differences for caregiver’s age, levels of education and income, hours spent caregiving, and the relationship to persons with dementia between health-related Internet users and non–health-related Internet users (P<.05 for all). After controlling for confounding effects, younger age of persons with dementia (OR 0.278, 95% CI 0.085-0.906), higher education levels of caregivers (OR 3.348, 95% CI 2.019-5.552), shorter caregiving time spent per week (OR 0.452, 95% CI 0.243-0.840), higher levels of caregiver’s emotional stress (OR 1.249, 95% CI 1.004-1.555), and financial hardship (OR 4.61, 95% CI 1.416-14.978) were identified as newly emerging factors of health-related Internet use. Conclusions: Although the Internet provided useful resources for caregivers of persons with dementia, dementia caregivers reported lower levels of health-related Internet use compared to the general public. Our findings confirmed the impact of age, education levels, and/or income on Internet use reported in previous studies. However, the predictive value of subjective responses of caregiving stress for health-related Internet use was a new addition. These findings will assist health care providers, researchers, and policy makers in identifying who is the least likely to access Internet-based resources and how Internet-based strategies can best be designed, implemented, and distributed to meet the needs of this group of users.

  • Image courtesy of duron123 at

    Content and Quality of Information Websites About Congenital Heart Defects Following a Prenatal Diagnosis


    Background: Pregnant women and their partners use the Internet to search for information following a prenatal diagnosis of congenital heart defect. Objective: Our aim was to explore central subjects of content and to assess the accessibility, reliability, usability, and quality of written information on publicly available information websites about congenital heart defects following a prenatal diagnosis. Methods: Following searches on Bing and Google, we included websites containing patient information in English. Hits ranged from 340,000-67,500,000 and the first 50 hits from each search were screened for inclusion (N=600). Of these hits, 39.3% (236/600) were irrelevant. A total of 67 websites were included, of which 37% (25/67) were affiliated with independent information websites, 25% (17/67) with charity/private organizations, 25% (17/67) with hospitals/clinics, and 13% (8/67) had other affiliations. The majority of the websites (76%, 51/67) could not be attributed to an author. A manifest content analysis was performed to explore central subjects of content. The DISCERN instrument was used to assess the quality of information, and the LIDA tool was used to assess accessibility, usability, and reliability of the included websites. Results: The content on the majority of the websites included care and treatment of children with congenital heart defects (88%, 59/67), causes of congenital heart defects (88%, 59/67), symptoms of congenital heart defects (85%, 57/67), prevalence of congenital heart defects (81%, 54/67), potential complications of congenital heart defects (75%, 50/67), prenatal diagnostics/screening methods (72%, 48/67), and specific congenital heart defects (72%, 48/67), whereas less than 10% included information about termination of pregnancy (6%, 4/67), care during pregnancy (5%, 3/67), and information specifically directed to partners (1%, 1/67). The mean of the total DISCERN score was 27.9 (SD 9.7, range 16-53). According to the instrument, a majority of the websites were categorized as very poor regarding information about effects of no treatment (88%, 59/67), support for shared decision making (85%, 57/67), achievement of its aims (84%, 56/67), explicit aims (82%, 55/67), risks of each treatment (82%, 55/67), how treatment choices affect overall quality of life (76%, 51/67), and areas of uncertainty (76%, 51/67). The mean of the total LIDA score was 92.3 (SD 13.1, range 61-127). According to the tool, a majority of the websites were categorized as good with regard to registration (97%, 65/67) and browser test (75%, 50/67), whereas a majority were categorized as poor with regard to currency (87%, 58/67), content production (84%, 56/67), and engagability (75%, 50/67). Conclusions: Difficulties in finding relevant information sources using Web search engines and quality deficits on websites are an incentive for health professionals to take an active part in providing adequate and reliable information online about congenital heart defects.

  • Screenshot of YouTube 'sedentary lifestyle' page.

    Information Seeking in Social Media: A Review of YouTube for Sedentary Behavior Content


    Background: The global prevalence of sedentary lifestyles is of grave concern for public health around the world. Moreover, the health risk of sedentary behaviors is of growing interest for researchers, clinicians, and the general public as evidence demonstrates that prolonged amounts of sedentary time increases risk for lifestyle-related diseases. There is a growing trend in the literature that reports how social media can facilitate knowledge sharing and collaboration. Social sites like YouTube facilitate the sharing of media content between users. Objective: The purpose of this project was to identify sedentary behavior content on YouTube and describe features of this content that may impact the effectiveness of YouTube for knowledge translation. Methods: YouTube was searched on a single day by 3 independent reviewers for evidence-based sedentary behavior content. Subjective data (eg, video purpose, source, and activity type portrayed) and objective data (eg, number of views, comments, shares, and length of the video) were collected from video. Results: In total, 106 videos met inclusion criteria. Videos were uploaded from 13 countries around the globe (ie, Australia, Barbados, Belgium, Canada, Colombia, Kenya, New Zealand, Russia, South Africa, Spain, Ukraine, United Kingdom, United States). The median video length was 3:00 minutes: interquartile range (IQR) 1:44-5:40. On average, videos had been on YouTube for 15.0 months (IQR 6.0-27.5) and had been viewed 239.0 times (IQR 44.5-917.5). Videos had remarkably low numbers of shares (median 0) and comments (median 1). Only 37.7% (40/106) of videos portrayed content on sedentary behaviors, while the remaining 66 videos portrayed physical activity or a mix of behaviors. Academic/health organizations (39.6%, 42/106) and individuals (38.7%, 41/106) were the most prevalent source of videos, and most videos (67.0%, 71/106) aimed to educate viewers about the topic. Conclusions: This study explored sedentary behavior content available on YouTube. Findings demonstrate that there is confusion between physical activity and sedentary behaviors, that content is being uploaded to the site from around the globe, that content is primarily from health organizations and individuals with the purpose of educating fellow users, but that low views, comments, and shares suggest that sedentary behavior content is relatively underutilized on YouTube. Future research may wish to leverage social platforms, such as YouTube, to facilitate implementation and sharing of evidence-based sedentary behavior content.

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  • Baclofen treatment of bulimia nervosa and binge eating disorder: an Internet survey

    Date Submitted: Jun 19, 2015

    Open Peer Review Period: Jun 23, 2015 - Aug 18, 2015

    Background: Bulimia nervosa (BN) and binge eating disorder (BED) are conditions difficult to treat and for which there are very few approved treatments. Objective: Some preclinical and clinical studie...

    Background: Bulimia nervosa (BN) and binge eating disorder (BED) are conditions difficult to treat and for which there are very few approved treatments. Objective: Some preclinical and clinical studies have shown baclofen to be effective in BED, but these effects must be confirmed, and baclofen effectiveness investigated in other forms of eating disorders, such as BN. Methods: The present study is an Internet survey targeting the use of baclofen for the treatment of BN and BED. Survey questions were released on the “Baclofène” Internet site in December 2014. These questions relate to baclofen effectiveness in both disorders, doses used, step-by-step treatment increase, adverse effects, and, more generally, attempt to evaluate the impact of baclofen treatment on quality of life. Results: Eighty-one individuals responded (35 with BN, 46 with BED); 49% of BN and 30% of BED subjects reported total recovery on baclofen, while 29% of BN and 48% of BED reported some improvement. BN subjects were significantly younger and required significantly higher doses of baclofen than those with BED. Individual effective doses were highly variable (40-430mg/d), the average maximal dose used was 170mg/d. There were no correlations between the maximal baclofen dose and the intensity of adverse effects, quality of life, and recovery. Conclusions: The results of this survey confirm the effectiveness of baclofen in the treatment of BED and suggest its potential interest in BN. Controlled studies using high-dose baclofen are needed.