Here are my suggestions for some of the top articles in medicine for April-May 2013: Antibiotics for COPD exacerbations: Further Evidence of Benefit http://buff.ly/WOANHG Diet does not work: substituting dietary linoleic acid in place of saturated fats increased the rates of death - BMJ http://buff.ly/WOAZH5 The Physician in US Cigarette Advertisements, 1930–1953 (illustrated review) http://1.usa.gov/VcuA7W via @Skepticscalpel Nearsighted kids may get worse in winter http://trib.in/VcvmC1 -- Myopia progression seem to decrease in periods with longer days and to increase in periods with shorter days. Children should be encouraged to spend more time outside during daytime to prevent myopia (study) http://buff.ly/X1cFSm The average physician spends nearly 11% of his or her career with an unresolved medical liability claim http://buff.ly/WZQZWJ When Diet Meets Delicious - The Mediterranean Approach http://buff.ly/XCsvTJ -- Mediterranean diet prohibits nothing that was recognized as food by your great-grandmother. Designing Tomorrows Vaccines - NEJM free full text http://buff.ly/XCybNK FDA Approves New Class of Type 2 Diabetes Drug: Invokana (canaglifozin) tablet http://buff.ly/16cNuNR Incidence of coccidioidomycosis ("valley fever") increased 8-fold in the endemic area of U.S. between 1998-2011 http://buff.ly/YpvSyp Erectile Dysfunction Severity as a Risk Marker for Cardiovascular Disease Hospitalisation and All-Cause Mortality http://bit.ly/16djmSx More than 80% of prescriptions in the USA are now for generic (not brand name) drugs http://bit.ly/16djvWd Smoke alarm - mental illness and tobacco - of 10 UK million smokers, up to 3 mln have a mental health disorder http://bit.ly/16djIZx 1 in 3 Americans has dementia at time of death http://buff.ly/11aMpXB Studies conducted in high-income countries suggest that 2%–14% of scientists may have fabricated or falsified data http://buff.ly/YHHOYG Discontinuation of Statins: most patients who are rechallenged can tolerate statins long-term http://buff.ly/16uEbe5 "Big Data" for Global Infectious Disease Surveillance - Free dynamic risk maps http://buff.ly/11j8Hq9 The articles were selected from my Twitter and RSS streams. Please feel free to send suggestions for articles to clinicalcases AT gmail.com and you will receive acknowledgement in the next edition of this publication.

Prof. Angela D. Friederici, of the Max Planck Institute for Human Cognitive and Brain Sciences in Leipzig talks about Language Acquisition. She asserts that babies learn language right from birth, even cry with the intonations of their mother tongue. Source: How and when do we learn to talk? | Tomorrow Today - Interview - YouTube http://bit.ly/15DQJSQ

By comparison, smoking a single cigarette reduces life expectancy by about 11 minutes. An adult who spends an average of six hours a day watching TV over the course of a lifetime can expect to live 4.8 years fewer than a person who does not watch TV. References: Get Up. Get Out. Dont Sit. - NYTimes, 2012 http://nyti.ms/10oXBQd Comments from Twitter and Google Plus: Humera Naqvi, MD @nayab78: hmmm that means we ppl should be dying early taking the amount of tv watched but life expectancy has increased. K Dillon, RDMS,CPC-A @comalliwrites: Confounders & confirmation bias not accounted for... @ShadolooDoll: Misleading. It isnt TV itself, but the lack of activity. A person who is dedicated to exercise can still watch TV, right? Timothy Cook: Great, since I stopped watching TV. I can start smoking again! ;-) Davíð Þórisson: Phew - no mention of watching Youtube! :-) Jimena Yosara Aguilar Jimenez: Ill never watch tv again Dimiter Stanev: Does that mean that disabled people suffer from this too? Image source: Wikipedia, Creative Commons Attribution ShareAlike 2.5 License.

From the WSJ: Our average attention span halved in a decade, from 12 to five minutes. To combat this, a "museum intervention" is now mandatory at Yales School of Medicine for all first-year medical students. Called Enhancing Observational Skills, the program asks students to look at and then describe paintings—not Pollocks and Picassos but Victorian pieces, with whole people in them. The aim? To improve diagnostic knack. The Waterseller of Seville, 1618-1622, Oil on canvas. This is not considered an example of the "Victorian pieces" mentioned in the WSJ article. Image source: Wikipedia, public domain. Each student is assigned a painting which they examine for 15 minutes, recording all they see. Then the group discusses its observations. "We are trying to slow down the students. They have an urge to come up with a diagnosis immediately and get the right answer." The study did not provide a huge improvement in the diagnostic acumen though. After the completion of the study project, the medical students were 10% more effective at diagnosis. Nonetheless, the program has now expanded to more than 20 U.S. medical schools. The evidence behind this intervention is not very convincing. References: Reviving the Art of Observation | Marvels - WSJ, 2012 http://goo.gl/iOhAV Comments from Google Plus and Twitter: Dr John Weiner @AllergyNet: Soon to become 140 characters? MT @DrVes: "Attention span halved in a decade, from 12 to 5 minutes” goo.gl/fb/818DN andrew murphy, md @PAallergy: @DrVes took to long for me to read that story : ) Mike Moore: Interesting. Whats the reference for "Attention span halved in a decade, from 12 to 5 minutes" Ves Dimov, M.D.: The reference is the text: "Our average attention span halved in a decade, from 12 to five minutes, according to a study commissioned by Lloyds TSB Insurance. (And that was in 2008.)" I havent checked the source beyond the referenced WSJ article in this case. Mike Moore: Sorry, that was a bit of a rhetorical question. This is the best I could find, it doesnt appear to be an actual published study... http://www.insurance.lloydstsb.com/personal/general/mediacentre/homehazards_pr.asp Mike Moore: Even better, here is an analysis of when the "data" was initially released in 2008. http://neuroskeptic.blogspot.com/2008/11/spooky-case-of-disappearing-crap.html [The link to David Moxon, the "researcher" who was commissioned by Lloyds to do the study is now dead, replaced with a generic landing page. I guess he doesnt do "Psychological Research" anymore.] CMDoran @TheFebrileMuse: Yes, phones may be a part of this? very distracting..

Watch and learn how high-density lipoprotein (HDL) cholesterol can protect the body from heart disease in this whiteboard session lead by Cleveland Clinic Cardiologist Michael Rocco, MD. Here are more videos from the same series: What is LDL? - YouTube http://bit.ly/18cuEay What is a lipid profile? - YouTube http://bit.ly/18cuFLE What is cholesterol? - YouTube http://bit.ly/18cuHmX What are the types of cholesterol? - YouTube http://bit.ly/18cuKPA Time to treat your cholesterol numbers - YouTube http://bit.ly/18cuLmD Know your cholesterol numbers - YouTube http://bit.ly/18cuMa7

According to the "World Happiness Report", the happiest people in the world live in Denmark, Finland and Norway. The report is published by the United Nations (the first edition was in 2012). According to one of the people interviewed, its all an expectations game: "We dont expect much from life in Denmark, and we are happily surprised when something goods happens." (quote from memory). I doubt that it is that simple. Here is the Deutsche Welle video: The top 10 happiest nations on the planet are: 1. Denmark 2. Finland 3. Norway 4. Netherlands 5. Canada 6. Switzerland 7. Sweden 8. New Zealand 9. Australia 10. Ireland Happier countries tend to be richer countries. Over time as living standards have risen, happiness has increased in some countries, but not in others (like for example, the United States). On average, the world has become a little happier in the last 30 years (by 0.14 times the standard deviation of happiness around the world). Stable family life and enduring marriages are important for the happiness of parents and children. In advanced countries, women are happier than men, while the position in poorer countries is mixed. Happiness is lowest in middle age. References: First World Happiness Report Launched at the United Nations - The Earth Institute - Columbia University http://bit.ly/ZdgyAr

Here are my suggestions for some of the top articles related to healthcare social media (#HCSM) in the past 2 weeks: Cardiologist: Physicians Beware on the Twittersphere http://buff.ly/YWDE3x -- William Dillon, MD: "I was left at a conversational disadvantage because of the loss of context that is inherent to 140-character interactions on Twitter. This is a complex issue, and surely not suitable for Twitter. Engaging on this medium on this topic was a mistake. I learned from it." "Smartphone will evolve to become a soulmate device that knows your body better than you know it yourself" http://buff.ly/Rz6PaK 70% of Americans sleep with their cell phone within arm’s reach. 61% check their phones every hour. http://buff.ly/WX3UoT 10 reputation management tips for doctors http://buff.ly/S04bea The Rise of Patient Communities on Twitter http://buff.ly/X2oXqa Chronic Disease and Social Networks http://buff.ly/REhcKp Increased Use of Twitter at a Medical Conference: A Report and a Review of the Educational Opportunities http://buff.ly/ZdwhVi Online portal leads patients back to doctors offices - amednews http://buff.ly/VPXTt8 Tweets, Google searches help solve migraine mysteries - Harvard Health blog http://buff.ly/VNLNB4 - Migraine Tweets – What can online behavior tell us about disease? http://buff.ly/R625Z5 -- We did a similar study for allergies. Using Social Media to Improve Continuing Medical Education: A Survey of Course Participants http://buff.ly/Uh0u37 Internet-based self-management improved asthma control after 3 months - however, all benefits were lost after 12 mo http://buff.ly/Uh25G0 Online urologist ratings usually positive: study http://buff.ly/UZBf2U -- Online Reviews Of 500 Urologists http://buff.ly/UmXcv7 The interaction between the medical profession and the media is becoming increasingly complex http://buff.ly/UZChfb What were the top Nature papers according to social media in 2012? Nobody is quite sure, apparently http://buff.ly/UhJPMP 94% of high school students accessed social media on their phones during class http://buff.ly/V6Yqbx How to Supercharge Google RSS Reader with Styles and Extensions http://buff.ly/HT8L8a Share, Discuss and Learn, Socially - Disrupting Medical Education by Redefining “Social Media” http://buff.ly/UpUkvD Lessons from 12 Years of Blogging http://buff.ly/Wrzry8 Most STD educational apps have failed to attract user attention and positive reviews http://buff.ly/11aAryf The articles were selected from my Twitter and RSS streams. Please feel free to send suggestions for articles to clinicalcases at gmail.com and you will receive an acknowledgement in the next edition of this publication.

How Twitter is Changing the Job Hunt. Some recruiters say Twitter has transformed their prospecting and hiring, helping them identify candidates they wouldnt have found otherwise, but others say the messaging platform has some way to go before it can replace LinkedIn, Facebook or other job-hunting tools. Lauren Weber from the WSJ reports:

A study by the producer of Kleenex, Kimberly-Clark, found that the 6 "Dirtiest Places" in Your Office are: - break room sink-faucet handles - microwave door handles - keyboards - refrigerator door handles - water fountain buttons - vending machine buttons And dont forget that the "Five Second Rule" doesnt work, says Dr. Susan Rhem, an infectious disease specialist from the Cleveland Clinic: A common superstition, the five-second rule states that food dropped on the ground will not be contaminated with bacteria if it is picked up within five seconds of being dropped (Wikipedia). References: Office Germs: The 6 Dirtiest Work Places. WebMD, 2012. Image source: Wikipedia, CDC.

The “Best of Medical Blogs - weekly review and blog carnival” is a weekly summary of the best posts from medical blogs. Please email your suggestions for inclusion to clinicalcases@gmail.com. Best of Medical Blogs (BMB) is published every Tuesday, just like the old Grand Rounds. LOGIC IS NOT GOOD ENOUGH. WE NEED EVIDENCE. WHY SHOULD PERFORMANCE MEASURES RECEIVE A PASS ON EVALUATION? We once thought it was logical to give antiarrythmic drugs to patients after they had a myocardial infarction. We once thought that beta blockers were contraindicated in systolic dysfunction. We consistently follow logic and conventional wisdom, yet find out that we were wrong. Why should performance measures receive a pass on evaluation? From dbs Medical Rants: http://buff.ly/16uF3j7 HAS TWITTER CHANGED? REMEMBER WHEN TWITTER WAS A GREAT PLACE TO HAVE CONVERSATIONS? When people now want to have a little bit deeper discussion, they send me an e-mail, or even a text to my phone - and the conversation takes place off the "public" airwaves. But why? In my opinion, here are reasons why "rich engagement" has gone private: Political Correctness prevents deep analysis; This hyper-partisian world leaves little room for the "middle of the road" opinion; Being taken "out of context" is no longer the exception, it is the rule. From Family Medicine Rocks: http://bit.ly/Z0ynE5 DR. WES: MAINTAINING BOARD CERTIFICATION EVERY TWO YEARS http://bit.ly/17gFAU9 WE NEED MORE “OLD FASHIONED” DOCTORS. Spending time with patients should not be considered “old fashioned”. Using technology sparingly should not be considered “old fashioned”. Technology is a tool not an answer. http://www.medrants.com/archives/7249 WORK LIFE BALANCE - from Life in the Fast Lane medical education blog http://bit.ly/XoPZ12 Times have changed… we might break free from the self-flagellating oppression of yesteryear to forge a fitter and more fulfilling future

From Deutsche Welle: When musicians play, what is happening inside their brains? Scientists at Berlins Max Planck Institute for Human Development have discovered that while performing together, their neurological activity goes into a kind of synchronization mode - almost as though they were connected by a wireless network.

Rodeo Bulls Kick Higher and Buck Harder. A great bucking bronco can be worth hundreds of thousands of dollars, and an entire industry has sprung up thats dedicated to breeding these superior bulls. The result? A lot of cowboys with broken bones. WSJs Michael M. Phillips reports:

Here are my suggestions for some of the top articles related to healthcare social media (#HCSM) in the past 2 weeks: The articles were selected from my Twitter and RSS streams. Please feel free to send suggestions for articles to clinicalcases at gmail.com and you will receive an acknowledgement in the next edition of this publication. How to use social media to supplement a novel curriculum in medical education. Twitter and Facebook are excellent applications of "push technology" as a means to deliver educational conten http://buff.ly/131Q8tW Wiki as a Participatory Tool for Patients in Clinical Guideline Development http://buff.ly/SSA2cV There are no definitive numbers on how many doctors prescribe apps but 10% of users have health apps on their phones http://buff.ly/QhKy0h 9% of medical school and residency program directors/coordinators search Facebook and Twitter to evaluate candidates http://buff.ly/UABZK4 Banned on Wall St.: Facebook, Twitter and Gmail. The number of global organizations blocking social media is declining 10 percent annually. By 2014, fewer than 30 percent of all large organizations are expected to be blocking employee access to social media. http://buff.ly/Ybn1Ay 59 Top Physician Blogs Worth Reading http://buff.ly/V37c91 Sign of the times: WSJ discontinues its health Blog http://buff.ly/YlouV8 How college students find and use information [Infographic] http://buff.ly/V2bXzx Medical school applicants might want to rethink that last tweet http://buff.ly/YoTjZ5 “Human-powered discovery engine for interestingness” is what the NYTimes calls Maria Popova. The Web has a presentism bias, with Facebook updates, tweets and blog entries always appearing with the latest first http://buff.ly/VcDQFb Productivity tips: TalkTyper and more http://buff.ly/VjmdUc Social Media May Help Fight Childhood Obesity http://buff.ly/VjcIEx

Dr. Mike has put together a few resources on concussions at http://www.myfavouritemedicine.com/2012/03/07/concussions/ Dr. Mike Evans is founder of the Health Design Lab at the Li Ka Shing Knowledge Institute, an Associate Professor of Family Medicine and Public Health at the University of Toronto, and a staff physician at St. Michaels Hospital. http://twitter.com/docmikeevans http://www.facebook.com/docmikeevans Conceived, written, and presented by Dr. Mike Evans, Illustrated by Liisa Sorsa, Produced, directed, and filmed by Nick De Pencier, Picture and sound edit by David Schmidt, Gaffer, Martin Wojtunik, Whiteboard construction by James Vanderkleyn, Production assistant, Chris Niesing, ©2011 Michael Evans and Mercury Films Inc.

"Steve Backshall risks being strangled by a Boa Constrictor snake as he demonstrates their lethal killing technique - on himself! Incredible clip from Deadly 60 series 2." Source: Strangled by a Boa Constrictor - Deadly 60 - BBC - YouTube http://bit.ly/XCfXhK

The “Best of Medical Blogs - weekly review and blog carnival” is a weekly summary of the best posts from medical blogs. Please email your suggestions for inclusion to clinicalcases@gmail.com. Best of Medical Blogs (BMB) is published every Tuesday, just like the old Grand Rounds. CHOOSE WISELY WHEN CHOOSING WISELY http://buff.ly/Wrjs4S From NBC: "You don’t need an MRI for lower back pain. You don’t need antibiotics for a sinus infection. And you don’t need to be screened for osteoporosis, either, if you’re under 65. A list of 90 medical ‘don’ts.’" Based on the headlines, one might think that these tests or treatments should never be done. However, this is not what the experts were saying. These are commonly overused tests and treatments, not useless. CAN COMPUTERS REPLACE PHYSICIANS? http://buff.ly/WriSUx -- Why we need physicians rather than computers http://buff.ly/WriNAn Computers might be great if we humans were identical. They might be great if our patients were accurate historians without unknown agendas. But none of those, and many other restrictions exist. We have to weigh each piece of evidence, especially the history. We use complex illness scripts and our experience. Excellent doctoring requires knowledge (computers can provide) plus wisdom. How can we program wisdom? “HOW SAFE IS Z-PAK?” With the medicalization of everything, patients and doctors need to better understand that taking medicine or having surgery means accepting trade-offs. http://buff.ly/16cMN76 Dr. Wes: The Generality of the FDAs Recommendations on Zithromax http://bit.ly/ZFKBDo WHEN 1A EVIDENCE IS NOT 1A EVIDENCE - A quest to find the truth, via Twitter http://buff.ly/XCrV8s Answering the critics of atrial fibrillation (AFib) ablation http://buff.ly/ZF6iDp Dr. Wes: The Importance of Recess in our Era of Sequestration http://bit.ly/ZFKGqp "In the 11th year of this blog, we just reached the 3 million visit bar" - medrants http://buff.ly/16cMysL

Americans overdosing on salt - Author Michael Moss talks about our addiction to salt, and how the food industry develops our taste for it. From Amazon: "From a Pulitzer Prize–winning investigative reporter at The New York Times comes the explosive story of the rise of the processed food industry and its link to the emerging obesity epidemic. Michael Moss reveals how companies use salt, sugar, and fat to addict us and, more important, how we can fight back. Every year, the average American eats 33 pounds of cheese (triple what we ate in 1970) and 70 pounds of sugar (about twenty-two teaspoons a day). We ingest 8,500 milligrams of salt a day, double the recommended amount, and almost none of that comes from the shakers on our table. It comes from processed food. It’s no wonder, then, that one in three adults, and one in five kids, is clinically obese. It’s no wonder that twenty-six million Americans have diabetes, the processed food industry in the U.S. accounts for $1 trillion a year in sales, and the total economic cost of this health crisis is approaching $300 billion a year. In Salt Sugar Fat, Pulitzer Prize–winning investigative reporter Michael Moss shows how we got here. Featuring examples from some of the most recognizable (and profitable) companies and brands of the last half century—including Kraft, Coca-Cola, Lunchables, Kellogg, Nestlé, Oreos, Cargill, Capri Sun, and many more—Moss’s explosive, empowering narrative is grounded in meticulous, often eye-opening research. Moss takes us inside the labs where food scientists use cutting-edge technology to calculate the “bliss point” of sugary beverages or enhance the “mouthfeel” of fat by manipulating its chemical structure. He unearths marketing campaigns designed—in a technique adapted from tobacco companies—to redirect concerns about the health risks of their products: Dial back on one ingredient, pump up the other two, and tout the new line as “fat-free” or “low-salt.” He talks to concerned executives who confess that they could never produce truly healthy alternatives to their products even if serious regulation became a reality. Simply put: The industry itself would cease to exist without salt, sugar, and fat. Just as millions of “heavy users”—as the companies refer to their most ardent customers—are addicted to this seductive trio, so too are the companies that peddle them. You will never look at a nutrition label the same way again."

After it was announced that Google Reader will be shut down in July, some of my Twitter buddies asked me what I plan to use in the future as a RSS reader. I have already switched to RSS OWL. PROS: - faster and more powerful than Google Reader - portable program that does not require installation (choose the version labeled "rssowl-2.1.6.windows.zip"). You can take it on a USB drive if you wish. - keyboard shortcuts - you can either customize the existing shortcuts or create new ones - social media sharing integration (Buffer, Twitter, Facebook, etc.) - Easy export and import of your RSS subscriptions as an OPML file - open source (just like WordPress, Firefox, WebKit, etc.) - free CONS: - it is a downloadable program, not a website For an ONLINE RSS READER, I would recommend Feedly in "Google Reader view". However, I prefer RSS Owl because it is faster and more customizable. You can make Feedly look like Reader by going to preferences and changing "Default View" to "Condensed". WHY USE RSS READER? RSS is the most efficient way to collect information from multiple websites in one location. If you need to do that, thats the way to do it. From Rex Hammock: "I used to attempt to get my friends to use a newsreader. For whatever reason, most never quite got it. It’s one of the few things I use that I consider a competitive advantage and a tool I couldn’t operate professionally without. I decided to stop wasting time trying to give that secret away." Please share your opinion via Twitter or in the comments section below. References: Google Reader was a Google Pigpen product | Rex Hammocks RexBlog.com http://bit.ly/XMB5A0 Which is the Best Alternative to Google Reader http://bit.ly/ZFKLKT Comments from Twitter: What is the current best RSS reader? http://bit.ly/WzPXST - I prefer the portable RSS Owl over online Feedly (quicker/custom kb shortcuts)

Disclaimer: I was an Assistant Professor of Medicine at the Cleveland Clinic from 2005 to 2008.

Holly J. Humphrey, MD83, and James N. Woodruff, MD, describe the Match Day experience at the University of Chicago Pritzker School of Medicine as the medical students discover where they will be placed for their residencies. Look at the pure joy in their faces: The most popular specialties chosen this year by Pritzker students were Internal Medicine (21), Pediatrics (11), Family Medicine (6), Obstetrics-Gynecology (6), and General Surgery (5). For more information, see the Match Results at http://bit.ly/Yz681a Disclaimer: I am an Assistant Professor of Medicine and Pediatrics at UChicago.

WHAT IS ACUTE OTITIS EXTERNA? Acute otitis externa is a common condition involving inflammation of the ear canal. It is caused by bacteria such as Pseudomonas aeruginosa and Staphylococcus aureus. Acute otitis externa often occurs following swimming or minor trauma from inappropriate cleaning. WHAT ARE THE SYMPTOMS OF ACUTE OTITIS EXTERNA? The rapid onset of ear canal inflammation leads to otalgia (earache), itching, canal edema, erythema, and otorrhea. Tenderness with movement of the tragus or pinna is a classic finding. WHAT IS THE TREATMENT FOR ACUTE OTITIS EXTERNA? For uncomplicated cases, use topical antimicrobials or antibiotics such as acetic acid, aminoglycosides, polymyxin B, and quinolones. Some of these agents come in preparations with topical corticosteroids which may help resolve symptoms more quickly. There is no evidence that any one antimicrobial or antibiotic preparation is clinically superior to another. Here two suggested approaches: - Neomycin/polymyxin B/hydrocortisone preparations are a reasonable first-line therapy when the tympanic membrane is intact. - Oral antibiotics are used when the infection has spread beyond the ear canal or in patients at risk of a rapidly progressing infection. REFERENCES: Acute otitis externa: an update. Schaefer P, Baugh RF. Am Fam Physician. 2012 Dec 1;86(11):1055-61. Image source: Wikipedia, a GNU Free Documentation License.

With the help of a science lab, the filmmaker Casey Neistat found that calorie listings on food labels can be highly inaccurate - mostly underestimating the amount of calories in food products such as muffins, sandwiches, burrito, etc. He selected 5 items he might consume in an average day: a muffin, a tofu sandwich, a Subway sandwich, a Starbucks Frappuccino and a Chipotle burrito. Then, two food scientists tested the caloric content of each using a device called a calorimeter. It’s a precise but slow process — taking more than an hour per sample. The results were surprising. Four out of the five items had more calories than their labels reported, adding up to 550 calories. If he unknowingly consumed those extra calories every day, in a week he would put on an extra pound of body weight. References: ‘Calorie Detective’ - NYTimes.com http://nyti.ms/Yit3KO

Watch this About.com video to learn how to properly dispose of your medications, and protect the environment at the same time. For more information, check the selected references below: FDA Consumer Updates > How to Dispose of Unused Medicines http://1.usa.gov/16yTnIf Safe Disposal of Medicines > Disposal of Unused Medicines: What You Should Know http://1.usa.gov/16yTqnh

In Germany, as the number of seniors is increasing, the number of younger people is decreasing, and there are not enough caregivers. Scientists are examining a possible role for robots in the care for the elderly.

From This survey included urban youth (aged 14-24 years) to asses the Use of Technology with Health Care Providers. Eight focus groups including 82 primarily low-income urban African-American adolescents and young adults were completed. Low-income urban adolescents and young adults (mean age, 18.5 years) reported high access to and use of technology. However, they still preferred face-to-face meetings with a healthcare provider because they felt that the information provided would be better tailored to their individual needs and more credible. Many worried about the confidentiality of conversations conducted using technology. In conclusion, although low-income urban youth are high users of technology, they still prefer face-to-face meetings with a healthcare provider. References: Use of Technology with Health Care Providers: Perspectives from Urban Youth. Sarah Lindstrom Johnson et al. The Journal of Pediatrics, Volume 160, Issue 6 , Pages 997-1002, June 2012.