International trade and finance exploration using network model of computer trade platform.

International trade becomes increasingly frequent with the deepening of economic globalization. In order to ensure the stable and rapid development of international trade and finance, it is particularly crucial to predict the sales trend of foreign trade goods in advance through the network model of computer trade platform. To optimize the accuracy of sales forecasts for foreign trade goods, under the background of "Internet plus foreign trade", the controllable relevance big data mining of foreign trade goods sales, personalized prediction mechanism, intelligent prediction algorithm, improved distributed quantitative and centralized qualitative calculation are taken as the premise to design dynamic prediction model on export sales based on controllable relevance big data of cross border e-commerce (DPMES). Moreover, after the related experiments and comparative discussions, the forecast error ratios from the first quarter to the fourth quarter are 2.3%, 2.1%, 2.4% and 2.4% respectively, which are also within the acceptable range. The experimental results show that the design combines the advantages of openness and extensibility of Internet plus with dynamic prediction of big data, and achieves the wisdom, quantitative and qualitative prediction of the volume of goods sold under the background of "Internet plus foreign trade", which is controlled by the relevant data of foreign trade. The overall performance of this design is stronger than the previous models, has better dynamic evolution and high practical significance, and is of great significance in the development of international trade and finance.

Patterns and Predictors of Television Viewing and Computer Use Among Women Living in Socioeconomically Disadvantaged Neighborhoods: A Prospective Cohort Study.

BACKGROUND: Socioeconomically disadvantaged women are at an increased risk of sedentary behaviors including television (TV) viewing and computer use, so identifying determinants of these behaviors is important. METHODS: Women (n = 4349) self-reported weekly TV and computer time (in minutes per week), sociodemographic, and health data at 3 time points (2007-2013). Mixed-effect negative binomial regression was used to determine the baseline determinants of TV viewing and computer use over time, adjusting for confounders. RESULTS: Over 5 years, median TV viewing decreased while median computer time increased. Cross-sectionally TV viewing was highest among participants classified as obese, with poorer health, current smokers, with lower education, not working, with no income, without partners and with no children and computer time was greater among younger women, living in urban areas, working full time, with higher education, without partners and with no children. Average computer time per year increased among those not working (7%), with lower education (5%), and with children (5%) but decreased among those with higher education (1%). However, no factors were associated with a change in TV viewing over time. CONCLUSION: Among socioeconomically disadvantaged women, interventions aimed at preventing increases in computer time should consider women with lower education, not working, and with children in their design.

Are the problem spaces of economic actors increasingly virtual? What geo-located web activity might tell us about economic dynamism.

The principal questions this research will address are: 1) whether a higher propensity to visit websites of interest to actual or nascent entrepreneurs is associated with higher rates of new firms births in an area; 2) whether a higher propensity to visit websites of interest to those working on design problems is associated with the quality of business in terms of orientations toward design or innovation; and 3) whether a higher propensity to visit websites of interest to those pursuing arts as an avocation is associated with an increased ability to find nonobvious solutions that might be manifest in business quality. The unique data that allow examining these questions were compiled from billions of web hits by geo-located devices. These data are combined with both detailed establishment level data with reliable information on the innovation and design orientation of firms, and a longitudinal census of all establishments with a formal credit relationship in the U.S. The findings confirm that businesses located in areas with a high propensity to visit design and arts avocation websites are more likely to pursue more far ranging innovation and are more likely to integrate design into their innovation processes. Firm birth rates are higher in areas with a high propensity to visit websites of interest to entrepreneurs, and the existence of high growth firms is strongly associated with demonstrated interest in design and arts avocation websites. The possible uses of these nontraditional measures as indicators of economic dynamism are discussed.

Intergenerational Effects on the Impacts of Technology Use in Later Life: Insights from an International, Multi-Site Study.

As the use of technology becomes further integrated into the daily lives of all persons, including older adults, it is important to investigate how the perceptions and use of technology intersect with intergenerational relationships. Based on the international multi-centered study Technology In Later Life (TILL), this paper emphasizes the perceptions of older adults and the interconnection between technology and intergenerational relationships are integral to social connectedness with others. Participants from rural and urban sites in Canada and the UK (n = 37) completed an online survey and attended a focus group. Descriptive and thematic analyses suggest that older adults are not technologically adverse and leverage intergenerational relationships with family and friends to adjust to new technologies and to remain connected to adult children and grandchildren, especially when there is high geographic separation between them. Participants referenced younger family members as having introduced them to, and having taught them how to use, technologies such as digital devices, computers, and social networking sites. The intergenerational support in the adoption of new technologies has important implications for helping older persons to remain independent and to age in place, in both age-friendly cities and in rural communities. The findings contribute to the growing literature in the fields of gerontology and gerontechnology on intergenerational influences and the impacts of technology use in later life and suggest the flexibility and willingness of older persons to adopt to new technologies as well as the value of intergenerational relationships for overcoming barriers to technology adoption.

Social inequalities in traditional and emerging screen devices among Portuguese children: a cross-sectional study.

BACKGROUND: Children are often exposed to too much screen time but few studies have explored the use of old and new digital media among young children. This study assesses screen time, including traditional and mobile devices, in pre-school and elementary school-aged children, according to their gender, age, and socioeconomic position (SEP). METHODS: A total of 8430 children (3 to 10 years; 50.8% boys) from the north, center and south-central Portugal were included in the present study. Data was collected by a parental questionnaire during 2016/2017. Children's screen time (by media device, weekdays and at the weekend; calculated by mean minutes per day) were reported by parents. Analysis were carried to compare screen time by children's age, gender and family SEP (classified using father's educational degree). RESULTS: Daily screen time was high both in children aged 3 to 5 and 6 to 10 years - 154 min/day (95% CI: 149.51-158.91) and 200.79 min/day (95% CI: 197.08-204.50), respectively - and the majority of children, independently of their gender, exceed the recommended 2 h/day of screen viewing. Children are still primarily engaging in screen time through television but the use of mobile devices, particularly tablets, were already high among 3 year-old children and increased with age. SEP was a negative predictor of screen time in the linear regression analysis, including after adjustment. CONCLUSIONS: Considering the negative health impacts of excessive screen time, recognizing subgroups at risk of excessive screen time and identifying how each device is used according to age is fundamental to enable appropriate future interventions. The screen time in children aged 3-10 years is longer than the recommended, particularly among boys and in those children from lower SEP. Parents and policymakers should have in mind that children spend most of their screen time watching television but mobile devices are becoming extremely popular starting at a young age.

Nonrelocatable Occupations at Increased Risk During Pandemics: United States, 2018.

Objectives. To characterize which occupations in the United States could likely work from home during a pandemic such as COVID-19.Methods. I merged 2018 US Bureau of Labor Statistics (BLS) national employment and wage data with measures ranking the importance of computer use at work and the importance of working with or performing for the public from the BLS O*NET survey.Results. Approximately 25% (35.6 million) of US workers are employed in occupations (such as technology, administrative, financial, and engineering) that could be done from home; the remaining 75% work in occupations (including health care, manufacturing, retail, and food services) that are challenging to do from home.Conclusions. Most US workers are employed in occupations that cannot be done at home, putting 108.4 million workers at increased risk for adverse health outcomes related to working during a pandemic. These workers tend to be lower paid. The stress experienced by lower-income groups, coupled with job insecurity, could result in a large burden of mental health disorders in the United States in addition to increased cases of COVID-19 from workplace transmission.

Technology and social media use by adult patients with intellectual and/or developmental disabilities.

BACKGROUND: Technology and social media offer individuals with intellectual and/or developmental disabilities (I/DD) unique and innovative ways to facilitate active participation in their own healthcare process. What remains unclear is the extent to which devices are currently used by this growing patient population. OBJECTIVE: To explore the prevalence of technology and social media use, as well as the possible barriers, among adult patients with I/DD. METHODS: A cross-sectional study utilizing an anonymous, accessible survey was used to obtain data from all adult patients (18 + years of age) with I/DD presenting for primary care services at a healthcare facility in New York between September and December of 2016. RESULTS: A total of 370 individuals completed the survey (529 approached, 69.9% response rate). Less than half (44.6%) of respondents used devices such as a tablet, smartphone or desktop; most (86.8%) did not use social media. Only 21.6% of respondents indicated that they use some type of assistive technology. While some respondents (46.0%) were identified by their caregivers as having a disability that would prevent them from learning/using technology, other respondents reported having no challenges (18.0%), needing training and/or ongoing support (7.4%), or being uncertain as to whether they would experience any challenges (15.5%). CONCLUSIONS: Many adult patients with I/DD do not use technology and social media that could promote self-determination and participation in their healthcare. Continued efforts must be made to promote technology use among adults with I/DD and to ensure that appropriate training is available for both the individual and his/her caregivers to achieve adoption and utilization.

Associations Between Insurance Provider and Assistive Technology Use for Computer and Electronic Devices 1 Year After Tetraplegia: Findings From the Spinal Cord Injury Model Systems National Database.

OBJECTIVE: To investigate the association between insurance provider and reported assistive technology (AT) use to access computers and electronic devices 1 year after sustaining tetraplegia. DESIGN: Multicenter cross-sectional study. SETTING: Participants enrolled in the Spinal Cord Injury Model Systems (SCIMS) National Database. INTERVENTIONS: Not applicable. PARTICIPANTS: Men and women with tetraplegia (N=498) enrolled in the SCIMS National Database were included in the analysis. MAIN OUTCOME MEASURES: The primary study outcome was the use of AT when operating a computer or other mobile electronic device. The primary predictor was the subject's principal health insurance provider, which was grouped into the 3 categories: government (Medicare, Medicaid, and other government), private (private insurance, private funds, and other), and workers' compensation. RESULTS: Overall, 34.7% of participants reported using AT to access computers and electronic devices. Results of logistic regression analysis revealed sex, injury level, injury completeness, self-perceived health status, and 12-month history of pressure ulcer were all significantly associated with AT use. After adjusting for these factors, participants with workers' compensation were more likely to report AT use than individuals with either government or private insurance. CONCLUSIONS: Despite significant technological advances, AT is not readily available to the people who might benefit most from its use. Findings from the present study are the first to shed light on AT funding sources and reveal that individuals with workers' compensation are more likely use AT than individuals with either government or private insurance. Additional work focused on AT use and functional outcomes is needed to assess the effect of barriers to use. Collectively, this work may inform insurers of the importance of having AT available for this unique population to potentially improve quality of life and participation.

Disconnected: a survey of users and nonusers of telehealth and their use of primary care.

OBJECTIVE: The study sought to assess awareness, perceptions, and value of telehealth in primary care from the perspective of patients. MATERIALS AND METHODS: We conducted a cross-sectional, Web-based survey of adults with access to telehealth services who visited healthcare providers for any of the 20 most-commonly seen diagnoses during telehealth visits. Three groups were studied: registered users (RUs) of telehealth had completed a LiveHealth Online (a health plan telehealth service provider) visit, registered nonusers (RNUs) registered for LiveHealth Online but had not conducted a visit, and nonregistered nonusers (NRNUs) completed neither step. RESULTS: Of 32 831 patients invited, 3219 (9.8%) responded and 766 met eligibility criteria and completed surveys: 390 (51%) RUs, 117 (15%) RNUs, and 259 (34%) NRNUs. RUs were least likely to have a primary care usual source of care (65.6% vs 78.6% for RNUs vs 80.0% for NRNUs; P < .001). Nearly half (46.8%) of RUs were unable to get an appointment with their doctor, and 34.8% indicated that their doctor's office was closed. Among the 3 groups, RUs were most likely to be employed (89.5% vs 88.9% vs 82.2%; P = .007), have post-high school education (94.4% vs 93.2% vs 86.5%; P = .003), and live in urban areas (81.0% vs 69.2% vs 76.0%; P = .021). CONCLUSIONS: Telehealth users reported that they relied on live video for enhanced access and were less connected to primary care than nonusers were. Telehealth may expand service access but risks further fragmentation of care and undermining of the primary care function absent better coordination and information sharing with usual sources of patients' care.

Longitudinal Sedentary Time Among Females Aged 17 to 23 Years.

INTRODUCTION: Time spent in sedentary behaviors is a newer risk factor for poor cardiometabolic health. This study examined longitudinal correlates of sedentary time among a cohort of females from about age 17 to age 23 years. METHODS: The cohort included females originally participating in the Trial of Activity for Adolescent Girls Maryland site who had assessments in 2009 and 2015 (n=431). Percentage daily time in sedentary behaviors was determined from accelerometers. Sociodemographics, psychosocial factors, and health behaviors were assessed by questionnaire. Lasso variable selection identified potential variables included in linear mixed effects models. As a secondary analysis, a k-means algorithm for longitudinal data identified homogeneous clusters of individual sedentary time trajectories. RESULTS: Percentage daily sedentary time did not change over time (67% to 68%). Not of black race (p=0.04), higher father's education (p<0.001), more weekday computer hours (p<0.001), more weekend TV hours (p=0.01), more physical activity barriers (p=0.003), fewer days per week driving (p=0.01), and more vehicles in the household (p=0.02) were associated with greater sedentary time. Cluster analysis resulted in two patterns: more (70%) versus less (60%) time being sedentary. The more sedentary individuals were more likely to be college graduates (p<0.001), have a higher income (p=0.03), and work fewer hours (p=0.009). They were also less likely to be married or in a common-law relationship (p=0.05) or in a parenting role (p=0.02). CONCLUSIONS: Time spent in sedentary behaviors remained stable. Factors associated with sedentary time were significant across the socioecologic framework and included several factors indicating higher SES.

An Implementation and Visualization of the Tree-Based Scan Statistic for Safety Event Monitoring in Longitudinal Electronic Health Data.

INTRODUCTION: Longitudinal electronic healthcare data hold great potential for drug safety surveillance. The tree-based scan statistic (TBSS), as implemented by the TreeScan® software, allows for hypothesis-free signal detection in longitudinal data by grouping safety events according to branching, hierarchical data coding systems, and then identifying signals of disproportionate recording (SDRs) among the singular events or event groups. OBJECTIVE: The objective of this analysis was to identify and visualize SDRs with the TBSS in historical data from patients using two antifungal drugs, itraconazole or terbinafine. By examining patients who used either itraconazole or terbinafine, we provide a conceptual replication of a previous TBSS analyses by varying methodological choices and using a data source that had not been previously used with the TBSS, i.e., the Optum Clinformatics™ claims database. With this analysis, we aimed to test a parsimonious design that could be the basis of a broadly applicable method for multiple drug and safety event pairs. METHODS: The TBSS analysis was used to examine incident events and any itraconazole or terbinafine use among US-based patients from 2002 through 2007. Event frequencies before and after the first day of drug exposure were compared over 14- and 56-day periods of observation in a Bernoulli model with a self-controlled design. Safety events were classified into a hierarchical tree structure using the Clinical Classifications Software (CCS) which mapped International Classification of Diseases, 9th Revision (ICD-9) codes to 879 diagnostic groups. Using the TBSS, the log likelihood ratio of observed versus expected events in all groups along the CCS hierarchy were compared, and groups of events that occurred at disproportionally high frequencies were identified as potential SDRs; p-values for the potential SDRs were estimated with Monte-Carlo permutation based methods. Output from TreeScan® was visualized and plotted as a network which followed the CCS tree structure. RESULTS: Terbinafine use (n = 223,968) was associated with SDRs for diseases of the circulatory system (14- and 56-day p = 0.001) and heart (14-day p = 0.026 and 56-day p = 0.001) as well as coronary atherosclerosis and other heart disease (14-day p = 0.003 and 56-day p = 0.004). For itraconazole use (n = 36,025), the TBSS identified SDRs for coronary atherosclerosis and other heart disease (p = 0.002) and complications of an implanted or grafted device (14-day p = 0.001 and 56-day p < 0.05). Use of both drugs was associated with SDRs for diseases of the digestive system at 14 days (p < 0.05) and this SDR had been observed among terbinafine users in a previous TBSS analysis with a different data source. The TreeScan® visualization facilitated the identification of the atherosclerosis and other heart disease SDRs as well as highlighting the consistency of the SDR for diseases of the digestive system across drugs and data sources. CONCLUSION: With the TBSS, we identified potential SDRs related to the circulatory system that may reflect the cardiac risk that was described in the itraconazole product label. SDRs for diseases of the digestive system among terbinafine users were also reported in a previous signal detection analysis, although other SDRs from the previous publications were not replicated. The TBSS visualizations aided in the understanding and interpretation of the TBSS output, including the comparisons to the previous publications. In this conceptual replication, differences in the results observed in our analysis and the previous analyses could be attributable to variation in modeling and design choices as well as factors that were intrinsic to the underlying data sources. The broad consistency, but far from perfect concordance, of our results with the known safety profile of these antifungals including the risks from the itraconazole product label supports the rationale for continued investigations of signal detection methods across differing data sources and populations.

Sleep pattern, socioenvironmental factors, and use of electronic devices among Nigerian school-attending adolescents.

OBJECTIVES: To determine the sleep pattern among Nigerian school-attending adolescents and its association with socioenvironmental factors and the use of electronic devices. DESIGN: Descriptive cross-sectional survey. SETTING: Public and private secondary schools in Ile-Ife, Osun State, Nigeria. PARTICIPANTS: Multistage sampling technique was used to select 346 school-attending adolescents aged 10-19 years. MEASUREMENTS: A modified version of the Adolescent Sleep Habits Survey Questionnaire was administered to respondents in the school setting using the facilitated self-administration method. RESULTS: Participants' mean age was 13.5±2.29 years, and the male-female ratio was 1:1.1. The mean total sleep duration on weekends of 9 hours (h) 08 minutes (min) ± 113 min was significantly higher than that of weekdays (7 h 15 min ± 86 min) (P < .001). About half of the respondents (48.7 %) had access to a computer. Majority of the respondents (80.9%) use one or more electronic device at bedtime, although cell phone was used by more than half (52.3%) of the respondents at bedtime. The proportion of adolescents with short sleep duration was 44.4% for weekdays and 5.5% for weekends. Lower social class and non-use of computers in the night time were independent predictors of adequate sleep duration on weekdays, whereas female sex, age (early adolescence), and polygamous family setting were independent predictors of sufficient sleep on weekends. CONCLUSION: A high proportion of school-attending adolescents have insufficient sleep on weekdays and significantly sleep less during weekdays compared to weekends. There is a need to target adolescents, parents, and school authorities with education on sleep issues.

More than Moore's Mores: Computers, Genomics, and the Embrace of Innovation.

The genomics community has frequently compared advances in sequencing to advances in microelectronics. Lately there have been many claims, including by the National Human Genome Research Institute (NHGRI), that genomics is outpacing developments in computing as measured by Moore's law - the notion that computers double in processing capability per dollar spent every 18-24 months. Celebrations of the "$1000 genome" and other speed-related sequencing milestones might be dismissed as a distraction from genomics' slowness in delivering clinical breakthroughs, but the fact that such celebrations have been persistently encouraged by the NHGRI reveals a great deal about the priorities and expectations of the American general public, the intended audience of the genomics-computing comparison. By delving into the history of speculative thinking about sequencing and computing, this article demonstrates just how much more receptive to high-risk/high-payoff ventures the NIH and the general public have become. The article also provides access to some of the roots and consequences of the association of "innovation talk" with genomics, and the means to look past that association to the less glamorous (but arguably much more important) contributions of the NHGRI to building the field of genomics.

Reciprocal Associations between Electronic Media Use and Behavioral Difficulties in Preschoolers.

The use of electronic media has increased substantially and is already observable in young children. The present study explored associations of preschoolers’ use of electronic media with age, gender, and socio-economic status, investigated time trends, and examined reciprocal longitudinal relations between children’s use of electronic media and their behavioral difficulties. The study participants included 527 German two- to six-year-old children whose parents had provided information on their use of electronic media and their behavioral difficulties at two time points, with approximately 12 months between baseline and follow-up. The analyses revealed that older vs. younger children, as well as children from families with a lower vs. higher socio-economic status, were more often reported to use electronic media. Furthermore, the usage of mobile phones increased significantly between 2011 and 2016. Most interestingly, baseline usage of computer/Internet predicted more emotional and conduct problems at follow-up, and baseline usage of mobile phones was associated with more conduct problems and hyperactivity or inattention at follow-up. Peer relationship problems at baseline, on the other hand, increased the likelihood of using computer/Internet and mobile phones at follow-up. The findings indicate that preschoolers’ use of electronic media, especially newer media such as computer/Internet and mobile phones, and their behavioral difficulties are mutually related over time.

Patterns of Physical Activity and Screen Time Among Brazilian Children.

OBJECTIVE: To investigate the patterns of physical activity (PA) and screen time among children and adolescents attended by the Brazilian National Health System. METHODS: This cross-sectional study was conducted in the city of Bauru, São Paulo, Brazil. The sample was composed of 270 children and adolescents attending 5 basic health care units. PA and screen time were assessed through a questionnaire. Economic status, sex, and body composition variables were used as covariates. RESULTS: Boys were more likely to be active when compared with girls (odds ratio = 2.56; 95% confidence interval, 1.43-4.58). Children and adolescents who accumulated less screen time were more likely to be in the most active group (odds ratio = 0.41; 95% confidence interval, 0.24-0.72). When comparing data year on year, we found that the level of PA has not changed significantly among children aged 7-10 years; however, at the age of 10, we noticed a significant reduction in PA scores, which kept decreasing until the age of 12. Regarding screen time, the situation was the opposite, with the amount of time spent in this behavior increasing over the years. CONCLUSION: Our results showed an association between low PA levels and high amount of screen time among children and adolescents, showing that is necessary to encourage an active lifestyle, decreasing time spent on television, computers, cell phones, and video games.

Item-saving assessment of self-care performance in children with developmental disabilities: A prospective caregiver-report computerized adaptive test.

OBJECTIVE: The purpose of this study was to construct a computerized adaptive test (CAT) for measuring self-care performance (the CAT-SC) in children with developmental disabilities (DD) aged from 6 months to 12 years in a content-inclusive, precise, and efficient fashion. METHODS: The study was divided into 3 phases: (1) item bank development, (2) item testing, and (3) a simulation study to determine the stopping rules for the administration of the CAT-SC. A total of 215 caregivers of children with DD were interviewed with the 73-item CAT-SC item bank. An item response theory model was adopted for examining the construct validity to estimate item parameters after investigation of the unidimensionality, equality of slope parameters, item fitness, and differential item functioning (DIF). In the last phase, the reliability and concurrent validity of the CAT-SC were evaluated. RESULTS: The final CAT-SC item bank contained 56 items. The stopping rules suggested were (a) reliability coefficient greater than 0.9 or (b) 14 items administered. The results of simulation also showed that 85% of the estimated self-care performance scores would reach a reliability higher than 0.9 with a mean test length of 8.5 items, and the mean reliability for the rest was 0.86. Administering the CAT-SC could reduce the number of items administered by 75% to 84%. In addition, self-care performances estimated by the CAT-SC and the full item bank were very similar to each other (Pearson r = 0.98). CONCLUSION: The newly developed CAT-SC can efficiently measure self-care performance in children with DD whose performances are comparable to those of TD children aged from 6 months to 12 years as precisely as the whole item bank. The item bank of the CAT-SC has good reliability and a unidimensional self-care construct, and the CAT can estimate self-care performance with less than 25% of the items in the item bank. Therefore, the CAT-SC could be useful for measuring self-care performance in children with DD in clinical and research settings.

Socioeconomic inequality in screen time frequency in children and adolescents: the weight disorders survey of the CASPIAN IV study.

BACKGROUND: This study aimed to assess the socioeconomic inequality and determinants of screen time (ST) frequency in Iranian children and adolescents. METHODS: This nationwide study was conducted as part of a national school-based surveillance program among 36,486 students consisting of 50.79% boys and 74.23% urban inhabitants, aged 6-18 years, living in urban and rural areas of 30 provinces of Iran. Socioeconomic inequality in ST, including the time spent for ST, watching TV and leisure-time working with computer, was assessed across quintiles of SES using concentration index (C) and slope index of inequality (SII). RESULTS: Overall, 36,486 students completed the study (response rate 91.25%). Their mean (SD) age was 12.14 (3.36) years. The national estimation of frequency of ST was 31.66% (95% CI 31.16-32.17) with ascending change from 20.80% (95% CI 19.81-21.82) to 36.66% (95% CI 35.47-37.87) from the first to the last quintal of SES. Estimated C value at national level was positive (0.08), which indicate inequality was in favor of low SES groups. Considering the SII values, at national level [- 0.16 (- 0.39, 0.06)], the absolute difference in ST frequency between the bottom and top of the socioeconomic groups had descending trends. In multivariate logistic regression model, family history of obesity, generalized obesity and age were the main significant determinants of prolonged ST, watching TV, and computer working (P < 0.001). CONCLUSIONS: Socioeconomic inequality in ST frequency was in favor of low SES groups. These findings are useful for health policies, better programming and future complementary analyses.

Meanings and experiences associated with computer use of older immigrant adults of lower socioeconomic status: Les sens et les expériences associés à l'utilisation des ordinateurs chez les immigrants âgés ayant un faible statut socioéconomique.

BACKGROUND: Immigrant older adults are a substantial demographic composing 12% to 30% of older adults in the United States and Canada, yet no research has addressed the meanings associated with computer use for low-socioeconomic-status and immigrant older adults. PURPOSE: The study explored the meanings, occupational engagement, and experiences associated with computer use. METHOD: A mixed-methods approach, qualitative participatory action research (photovoice) and survey (Computer Proficiency Questionnaire), was used. Data collection consisted of narratives, focus groups, and Likert scale responses for nine participants. FINDINGS: The participants expressed the meanings they associated with computer use as freedom, personal growth, and engagement. Computers promote occupational engagement in social participation, education, and leisure. IMPLICATIONS: The findings of personal growth may inform occupational therapy interventions using computers to enable adjustment to changes related to aging and wellness. Social participation and education were motivators for computer use, which may inform computer engagement strategies for this population.

Modernizing quality of life assessment: development of a multidimensional computerized adaptive questionnaire for patients with schizophrenia.

OBJECTIVE: Quality of life (QoL) is still assessed using paper-based and fixed-length questionnaires, which is one reason why QoL measurements have not been routinely implemented in clinical practice. Providing new QoL measures that combine computer technology with modern measurement theory may enhance their clinical use. The aim of this study was to develop a QoL multidimensional computerized adaptive test (MCAT), the SQoL-MCAT, from the fixed-length SQoL questionnaire for patients with schizophrenia. METHODS: In this multicentre cross-sectional study, we collected sociodemographic information, clinical characteristics (i.e., duration of illness, the PANSS, and the Calgary Depression Scale), and quality of life (i.e., SQoL). The development of the SQoL-CAT was divided into three stages: (1) multidimensional item response theory (MIRT) analysis, (2) multidimensional computerized adaptive test (MCAT) simulations with analyses of accuracy and precision, and (3) external validity. RESULTS: Five hundred and seventeen patients participated in this study. The MIRT analysis found that all items displayed good fit with the multidimensional graded response model, with satisfactory reliability for each dimension. The SQoL-MCAT was 39% shorter than the fixed-length SQoL questionnaire and had satisfactory accuracy (levels of correlation >0.9) and precision (standard error of measurement <0.55 and root mean square error <0.3). External validity was confirmed via correlations between the SQoL-MCAT dimension scores and symptomatology scores. CONCLUSION: The SQoL-MCAT is the first computerized adaptive QoL questionnaire for patients with schizophrenia. Tailored for patient characteristics and significantly shorter than the paper-based version, the SQoL-MCAT may improve the feasibility of assessing QoL in clinical practice.

Socioeconomic position and sedentary behavior in Brazilian adolescents: A life-course approach.

Socioeconomic position (SEP) is a potential correlate of sedentary behavior in adolescents. The aim of this study was to examine the associations between SEP and self-reported and objective measures of sedentary behavior in adolescents, using a life-course approach. Data from the 1993 Pelotas (Brazil) Birth Cohort Study were analyzed (N=5249). Cross-sectional and longitudinal associations between multiple SEP indicators (maternal education, family income, SEP composite, cumulative family income) at birth, 11, 15 and 18years, and five sedentary behavior outcomes (≥4h/day screen time; ≥4h/day TV; ≥2h/day computer; ≥2h/day video game; ≥12.7h/day objectively measured sedentary time) at 11, 15 and 18years, were examined. In cross-sectional analyses, higher SEP was positively associated with more screen time at ages 11 and 15years. There was a consistent and positive association between higher SEP with time spent using a computer, and with sedentary time assessed through accelerometry. SEP at birth had a positive and direct effect on screen, computer and total sedentary time at 18years. Participants in the highest cumulative income group had higher odds of high sedentary behavior in screen (OR: 2.40; 95% CI: 1.50-3.54), computer (OR: 7.35; 95% CI: 4.19-12.89) and total sedentary time (OR: 5.40; 95% CI: 3.53-10.35), respectively, compared with their counterparts with lower cumulative income. Our findings showed that SEP is an early determinant of sedentary behavior in adolescents.