The first part of this dissertation evaluates the effectiveness of food assistance by gathering evidence from developing countries and the United States. The first essay applies a multi-market model to three developing countries and simulate recent spikes in staple prices and food aid impacts. Results indicate that higher food prices would result in reduction in household real income and deterioration of household welfare. Food aid in the form of cash transfers targeted at low-income groups could improve household real income of the target group after world price shocks and, partially or completely, offset the negative impacts of higher food prices. The impact of cash transfer on untargeted groups is ambiguous. It is likely to be positive for households that are net producers of the commodities that have increased production and prices under cash transfer and the production surplus is sufficiently large. The second essay focuses on the Food Stamp Program (FSP), a cornerstone of food assistance safety net efforts in the U.S. to reduce household food insecurity, particularly among children. The essay examines the dynamic relationship between FSP participation and child food security using monthly measures. Empirical estimates using the Panel Study of Income Dynamics demonstrate that child food security declines in the months immediately prior to FSP entrance, but then partially recovers following program entrance. These dynamic FSP effects are masked when annual measures are employed. The third paper of this dissertation studies the potential impacts of patient's widespread use of online health information. In particular, the essay employs a principal agent model and focuses on the quality of online health information. The model shows that when the quality of health information improves, since medical consultations become more efficient and less costly, a higher effort will be induced or contracted from the physician. Diagnosis becomes more accurate, because physicians will try exert more effort in diagnosing patients and patients will suffer less loss from their illnesses. / Ph. D.

UA Open Access Publishing Fund / Background: Internet and mobile health (mHealth) apps hold promise for expanding the reach of evidence-based health interventions. Research in this area is rapidly expanding. However, these studies may experience problems with recruitment and retention. Web-based and mHealth studies are in need of a wide-reaching and low-cost method of recruitment that will also effectively retain participants for the duration of the study. Online recruitment may be a low-cost and wide-reaching tool in comparison to traditional recruitment methods, although empirical evidence is limited. Objective: This study aims to review the literature on online recruitment for, and retention in, mHealth studies. Methods: We conducted a review of the literature of studies examining online recruitment methods as a viable means of obtaining mHealth research participants. The data sources used were PubMed, CINAHL, EbscoHost, PyscINFO, and MEDLINE. Studies reporting at least one method of online recruitment were included. A narrative approach enabled the authors to discuss the variability in recruitment results, as well as in recruitment duration and study design. Results: From 550 initial publications, 12 studies were included in this review. The studies reported multiple uses and outcomes for online recruitment methods. Web-based recruitment was the only type of recruitment used in 67% (8/12) of the studies. Online recruitment was used for studies with a variety of health domains: smoking cessation (58%; 7/12) and mental health (17%; 2/12) being the most common. Recruitment duration lasted under a year in 67% (8/12) of the studies, with an average of 5 months spent on recruiting. In those studies that spent over a year (33%; 4/12), an average of 17 months was spent on recruiting. A little less than half (42%; 5/12) of the studies found Facebook ads or newsfeed posts to be an effective method of recruitment, a quarter (25%; 3/12) of the studies found Google ads to be the most effective way to reach participants, and one study showed better outcomes with traditional (eg in-person) methods of recruitment. Only one study recorded retention rates in their results, and half (50%; 6/12) of the studies recorded survey completion rates. Conclusions: Although online methods of recruitment may be promising in experimental research, more empirical evidence is needed to make specific recommendations. Several barriers to using online recruitment were identified, including participant retention. These unique challenges of virtual interventions can affect the generalizability and validity of findings from Web-based and mHealth studies. There is a need for additional research to evaluate the effectiveness of online recruitment methods and participant retention in experimental mHealth studies.

The aim of this study was to develop a Digit Triplet Test (DTT) using NZ English. The DTT is a hearing screening tool that uses spoken numbers presented in background noise to estimate speech recognition thresholds (SRTn). The NZ DTT will be made available via telephone or the internet, and will provide each person who completes the screening test with information about whether they should seek a professional hearing assessment. Normal-hearing participants (22 listeners) with hearing thresholds ≤20 dB HL were tested to establish the intelligibility of the individual digits at various signal-to-noise ratios (-20; -17.5; -15.0; -12.5; -10.0; -7.5; and -5.0 dB). The mid-points of the resulting psychometric functions were then used to adjust the level of each digit to achieve the same intelligibility. A SRT of -10.40 ± 1.75 dB SNR for the broadband presentation was established for the separate ear triplet test with the average slope of 17.3%/dB ± 3.9 %/dB for the ten test lists generated. The binaural ear DTT results were compared to best ear threshold PTA and found to have a highly significant correlation (r = 0.816, p<0.001) and a significant correlation to the QuickSIN sentence-in-noise test (r = 0.668, p<0.001). The binaural triplet test was found to have a sensitivity of 100% and specificity of 85%. The separate ear DTT results were compared to the best ear threshold pure tone audiometry and found to have a highly significant correlation (r = 0.809, p<0.001). The separate ear triplet test was found to have a sensitivity of 88% and specificity of 81% (1 – specificity = 0.187). The internet version of the DTT hearing screening test will provide New Zealanders with an easily accessible and objective test that will raise awareness about hearing and hopefully reduce the length of time people take before seeking advice about their hearing.

Licentiatavhandling (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 2 uppsatser.

The purpose of the study was to examine the relationships between types of health information tasks and the Internet information search processes of Chinese graduate students at the University of North Texas. the participants' Internet information search processes were examined by looking at the source used to start the search, language selection, use of online translation tools, and time spent. in a computer classroom, 45 Chinese graduate students searched the Internet and completed three health information search tasks: factual task, interpretative task, and exploratory task. Data of the Chinese graduate students’ health information search processes were gathered from Web browser history files, answer sheets, and questionnaires. Parametric and non-parametric statistical analyses were conducted to test the relationships between the types of tasks and variables identified in the search process. Results showed that task types only had a statistically significant impact on the time spent. for the three tasks, the majority of Chinese graduate students used search engines as major sources for the search starting point, utilized English as the primary language, and did not use online translation tools. the participants also reported difficulties in locating relevant answers and recommended ways to be assisted in the future when searching the Internet for health information. the study provided an understanding of Chinese graduate students' health information seeking behavior with an aim to enrich health information user studies. the results of this study contribute to the areas of academic library services, multilingual health information system design, and task-based health information searching.

Internet technologies are increasingly advocated as a means for transforming health care and improving people’s health. In the field of e-health questions on the health implications of internet use are typically approached through attempts at measuring the effect of internet use on health outcomes. In this, information is usually conceptualised as a form of knowledge/power and online information practices are enrolled in discourses on patient empowerment. Taking the different meanings ascribed to information in these approaches as my point of departure, in this thesis I rethink the implications of internet use on health through an empirical exploration of alternative conceptualisations of the relationship between information and health in the context of contemporary HIV treatment and care. I do this through two analytical moves. First, drawing on the concept of performativity, a concern with what effect internet use has on health is turned into one of how internet use enacts health. Second, rather than treating information as knowledge/power, through an analysis of how a specific group of women ‘living with HIV’ in the UK use the internet, I reconfigure the connections between internet use and health through a conceptualisation of information as care. Drawing on a range of empirical materials – including forty-seven in-depth interviews with patients and internet content providers, non-participant observations, document and website analysis – three areas of health-related internet use are analysed in detail: the seeking out of health-related and specifically biomedical information; the seeking out and sharing of experiential knowledge and narratives about living with HIV; meeting prospective partners and dating. However, rather than studying these areas of internet use in order to interrogate what they can tell us about the internet, I analyse them as part of the ethical regime of ‘living with HIV’, in which the virus, previously thought of as ‘terminal’, becomes, through info and bio technologies, normalised as ‘chronic’. From this perspective, enacting health not only entails working on and with one’s body, but also always invokes its distribution across bodies, to other areas and relations, including internet technologies and the networks of relations established via these technologies.

Denna rapport är en sammanställning av en litteraturstudie som undersöker trådlös nätverksuppkoppling (WLAN) ombord på fartygsbryggor. Samhället utvecklas hela tiden och användandet av enheter med tillgång till internet ökar ständigt. Arbetets syfte var att undersöka den trådlösa uppkopplingens positiva och negativa effekter samt för- respektive nackdelar. En litteratursökning genomfördes och baserades tillsammans med analysen på en mindmap. Resultatet visar flera negativa effekter genom att vara uppkopplad på fartygsbryggan. De slutsatser som arbetet kom fram till var att ökad tillgänglighet leder till ökat användande. Användandet påverkar individens fokus och hälsa negativt. Det kan även påverka sömnen negativt där både mängd och kvalitet försämras. Det positiva som WLAN kan bidra till är ett ökat välmående för individen samt att underlätta arbetet genom sammankoppling av enheter. Det är viktigt att optimera arbetsplatsen så att hälsorisker minimeras. WLAN har överlag en negativ effekt på bryggvakten. Möjligheterna som kommer med WLAN är få i förhållande till riskerna. / This report describes a literature study that examines the wireless local area network (WLAN) aboard the vessels bridge. Society is constantly evolving and the usage of electronic devices with access to the Internet is constantly increasing. The aim of the work was to investigate the wireless connection´s advantages, disadvantages, as well as its positive and negative effects. A literature review was performed and together with the analysis based on a mind map. The results suggests that more negative effects than positive comes with being connected on the vessel´s bridge. The conclusions that can be drawn are that increased availability leads to increased usage. This use affects the individual's focus and health negatively. It can also affect sleep negatively where both quantity and quality deteriorates. The positive aspects WLAN can contribute to are increased well-being of the individual as well as facilitate the work by linking devices together. It is important to optimize the workplace so that health risks are minimized. WLAN generally has a negative effect on the bridge watch. The possibilities that come with WLAN are few in relation to the risks.

Cette thèse explore les multiples rationalités à l’œuvre derrière la production et la publication en masse d’information de santé en langue française sur le web. Une clarification des notions essentielles entourant l’univers de l’e-santé facilite l’appréhension de l’état des lieux de ce domaine et du contexte de cette étude. La méthodologie mobilisée est décrite de façon détaillée : depuis la constitution d’un corpus à partir de contenus ciblés extraits de 367 sites jusqu’à l’interprétation des données collectées. Douze profils-types d’éditeurs composant le paysage du web de la santé ont émergé de l’exploitation de ce corpus, eux-mêmes classés dans quatre grandes catégories. Pour chaque type d’éditeur défini, quatre caractéristiques distinctives sont examinées : les différents acteurs concernés, les informations diffusées sur leurs sites, leurs modèles économiques, ainsi que les objectifs qu’ils déclarent. Les analyses approfondies menées sur ces critères déterminants sont confrontées aux résultats d’autres travaux de recherche issus de disciplines hétérogènes pour dégager les principaux enjeux qui sous-tendent la mise en ligne d’information de santé à destination du grand public. / This thesis explores multiple logics of action at work behind the production and widespread dissemination of health information in French on the Web. Key e-health concepts are clarified to facilitate understanding of the field and the study context. The methodology is described in detail from the constitution of a corpus of focused content from 367 websites to the interpretation of the data collected. Twelve standard publisher profiles in the e-health Web sector emerged from our analysis of the corpus, and were classified in four main categories. Four distinctive criteria were studied for each type of publisher: the stakeholders, the information available on their websites, their business models and their stated purposes. Analyses of these criteria were compared with results from other studies in a variety of fields in order to identify the key issues involved in launching e-health information for the general public.