Is it worth it? The costs and benefits of bringing a laptop to a university class.

Students often bring laptops to university classes, however, they do not limit their laptop use to class-related activity. Off-task laptop use occurs frequently in university classrooms and this use negatively impacts learning. The present study addresses whether potential benefits of class-related laptop use might mitigate the costs of off-task laptop activity. We used tracking software to monitor both class-related and off-task laptop use by undergraduate students enrolled in an introductory psychology course, and we observed how types of laptop use related to course performance. We found a positive correlation between class-related use and exam scores that was driven by viewing lecture slides during class. We also found a negative correlation between off-task laptop use and exam scores, but class-related activities did not predict an increase in off-task use. Thus, for students who constrain their laptop use to class-related activity, the benefits outweigh the costs. While a laptop may be beneficial for some, it is unclear which students are able to constrain themselves to class-related activities and whether the benefits of class-related laptop use obtained by slide viewing could be achieved by other means. Thus, students and educators should carefully consider the costs and benefits of laptop use in the classroom.

ERICA: use of screens and consumption of meals and snacks by Brazilian adolescents.

OBJECTIVE To describe the length of exposure to screens and the prevalence of consumption of meals and snacks by Brazilian adolescents in front of screens. METHODS We evaluated 74,589 12 to 17-year old adolescents from 1,247 schools in 124 Brazilian municipalities. A self-administered questionnaire was used. Its segment regarding nutrition contained questions about using TV, computers, and video game systems, having meals while watching TV, and consuming snacks in front of screens. Consumption of meals and snacks in front of screens was analyzed according to the following variables: geographical region, gender, age range, type of school (public or private), and school shift. The prevalences and their respective 95% confidence intervals were estimated under a complex sampling design. RESULTS A great deal of the adolescents (51.8% IC95% 50.7-53.0) [corrected] reported spending two or more hours a day in front of screens. That habit was more frequent among male adolescents, private school students, morning shift students, and students from Brazil's South region. More than half of the adolescents (56.6%, 95%CI 55.4-57.8) reported almost always or always having meals in front of TV, and 39.6% (95%CI 38.8-40.5) of them said they consumed snacks in front of screens exactly as often. Both situations were the most prevalent ones among the girls, who attended public schools and were from Brazil's Midwest region. CONCLUSIONS Length of exposure to screens and consumption of meals and snacks almost always or always in front of screens are high among Brazilian adolescents. It is necessary to develop strategies aiming to reduce the length of screen use, considering the media reality that children and adolescents have been experiencing from earlier and earlier ages. That context must therefore be analyzed in an indissociable way.

The Development and User Satisfaction Evaluation of Internet-Based N-Screen Healthcare Walking Content to Increase Continuous Usage Motivation.

OBJECTIVE: The purpose of the current study is (1) to apply Internet-based N-Screen (this is used like the term "emultiscreen"; as the technology that provides services of shared content or application via N devices, it includes all screens such as personal computers [PCs], TV, and mobile devices) services to healthcare services by developing games for improving one's health and (2) to present ways to activate the use of health promotion contents in the future by investigating user satisfaction and whether there is any intention to accept the contents and/or use the services continuously. MATERIALS AND METHODS: In order to evaluate the customized health maintenance content provided by the healthcare walking system developed in the current study, 98 adult men and women residing in Seoul, Korea, were instructed to use 10 minutes' worth of the walking content. Perceived quality, level of trust in the results, effectiveness of the exercise, and overall satisfaction were measured in regard to the N-Screen-based walking content, including those for the cell phone, PC, and Internet protocol TV (IPTV). RESULTS: Walking contents using N-Screen services were perceived with high levels of trust in the results of the exercise, the effectiveness of the exercise, and overall satisfaction. In terms of the usability of N-Screen services, the younger the participants, the more usable they found the mobile or PC programs. The older the participants, the more usable they found the IPTV screens, although they still struggled with using the content given; operating IPTVs proved to be difficult for them. Furthermore, participants who were engaged in exercise on a regular basis were less satisfied with the program, in general. CONCLUSIONS: The present study has developed a walking system using N-Screen programs to make the most common and effective forms of exercise-walking and running-accessible indoors. This may increase motivation to exercise by offering services that boost one's interest in exercising, such as personal monitoring and real-time feedback regarding one's workout progress.

Older People with Access to Hand-Held Devices: Who Are They?

INTRODUCTION: Multiple comorbid conditions among older patients require frequent physician office and emergency room visits, at times leading to hospitalization. In recent years, mobile health (m-health) systems utilizing hand-held devices (e.g., smartphones) have been developed, which could be used for health-related interventions. This study investigates sociodemographic and clinical characteristics of individuals who have or have not accessed Internet via hand-held devices. MATERIALS AND METHODS: Adults older than 65 years of age who participated in the Health Tracking survey of the Pew Internet and American Life Project in 2012 were included in the analysis. Data were analyzed for prevalence of Internet access via hand-held devices and differences in sociodemographic and clinical characteristics. Different online health information seeking behavior is also reported. RESULTS: In the weighted sample size of 3,116 responses, 472 (15.1%) had access to Internet via hand-held devices. Those with such an access were younger and had higher income and education and better overall quality of life and quality of life at the time of answering the survey. They were more likely to be female and married or living as married. Those with diabetes or significant change in physical condition in the prior year were less likely to have such an access. In the multivariate analysis, older or diabetic individuals had lower probability of such access. Higher likelihood of access was associated with higher income and education, being married, female gender, better quality of life, higher number of comorbid illnesses, and emergency room visit or hospital admission in the last 12 months. CONCLUSIONS: Investigators should pay attention to sociodemographic and clinical disparities of older adults to develop feasible m-health interventions.

Individual, social and physical environmental correlates of sedentary behaviours in adults: a systematic review protocol.

BACKGROUND: Adults spend the majority of their time being sedentary, and evidence suggests that those who spend more of their day engaged in sedentary activities (TV viewing, sitting, screen-based activities) are at increased risk for morbidity and mortality, regardless of whether they exercise regularly. In order to develop effective interventions to reduce sedentary time, it is necessary to identify and understand the strongest modifiable factors of these behaviours. Therefore, the objective of this systematic review is to examine the available evidence in order to identify individual, social, environmental and policy correlates and determinants of sedentary behaviours (TV time, sitting time, screen time) and total sedentary time among adults. METHODS/DESIGN: Six electronic databases will be searched to identify all studies that report on individual, social and/or environmental correlates and determinants of sedentary behaviours and total sedentary time in adults. Grey literature sources including theses, published conference abstracts and websites from relevant organizations will also be included. Articles that report on modifiable individual (e.g. health behaviours and status, self-efficacy, socio-economic status), social (e.g. crime, safety, social support, climate and capital), environmental (e.g. weather, workplace, home, neighbourhood, recreation environment, transportation environment) and policy correlates and determinants (based on study design) of sedentary behaviours in an adult population (mean age ≥18 years) will be included. Study quality and risk of bias will be assessed within and across all included studies. Harvest plots will be used to synthesize results across all correlates, and meta-analyses will be conducted where possible among studies with sufficient homogeneity. DISCUSSION: This review will provide a comprehensive examination of evidence in the field and will serve to highlight gaps for future research on the determinants of sedentary behaviours and inform intervention design. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42014009814.

Ophthalmic patients' utilization of technology and social media: an assessment to improve quality of care.

BACKGROUND: E-health tools have the potential to improve the quality of care for ophthalmic patients, many of whom have chronic conditions. However, little research has assessed ophthalmic patients' use or acceptance of technological devices and social media platforms for health-related purposes. The present study evaluated utilization of technological devices and social media platforms by eye clinic patients, as well as their willingness to receive health reminders through these technologies. SUBJECTS AND METHODS: A 31-item paper questionnaire was administered to eye clinic patients (n=843) at an urban, tertiary-care center. Questions focused on technology ownership, comfort levels, frequency of use, and preferences for receiving health reminders. Demographic data were also recorded. RESULTS: Eye clinic patients most commonly owned cellular phones (90%), landline phones (81%), and computers (80%). Overall, eye clinic patients preferred to receive health reminders through phone calls and e-mail and used these technologies frequently and with a high level of comfort. Less than 3% of patients preferred using social networking to receive health reminders. In addition, age was significantly associated with technology ownership, comfort level, and frequency of use (p<0.05). The majority of patients 18-45 years of age preferred to receive appointment reminders via text message (57%) and e-mail (53%). This age group also used these technologies more frequently and with a higher comfort level (p<0.001). CONCLUSIONS: These data support the proposal that e-mail and text-messaging e-health tools are likely to be immediately adopted by eye clinic patients and therefore have the greatest potential to improve health outcomes and increase quality of care. Eye clinic patients are interested in these technologies for appointment reminders, general eye and vision health information, asking urgent medical questions, and requesting prescription refills. Future controlled trials could further explore the efficacy of e-health tools for these purposes.

Assessment of low-income adults' access to technology: implications for nutrition education.

OBJECTIVE: The main objective of this study was to investigate access and use of technologies such as the Internet among Indiana's low-income population. The secondary objective was to determine whether access and use of computers significantly differed by age, race, and/or education level. METHODS: Data were collected from low-income adult Supplemental Nutrition Assistance Program Education participants for a 2-year period using a cross-sectional questionnaire about access and use of technology. RESULTS: Approximately 50% of the total respondents (n = 1,620) indicated that they had a working computer in their home, and of those, the majority (78%) had a high-speed Internet connection. Chi-square analysis revealed that younger adults who were white and had more education were more likely to have a computer (P < .001) and Internet. CONCLUSIONS AND IMPLICATIONS: The results of this study provide evidence that using Internet-based nutrition education in a low-income population is a viable and possibly cost-effective option.

Computer access and Internet use by urban and suburban emergency department customers.

BACKGROUND: Patients are increasingly using the Internet (43% in 2000 vs. 70% in 2006) to obtain health information, but is there a difference in the ability of urban and suburban emergency department (ED) customers to access the Internet? STUDY OBJECTIVE: To assess computer and Internet resources available to and used by people waiting to be seen in an urban ED and a suburban ED. METHODS: Individuals waiting in the ED were asked survey questions covering demographics, type of insurance, access to a primary care provider, reason for their ED visit, computer access, and ability to access the Internet for health-related matters. RESULTS: There were 304 individuals who participated, 185 in the urban ED and 119 in the suburban ED. Urban subjects were more likely than suburban to be women, black, have low household income, and were less likely to have insurance. The groups were similar in regard to average age, education, and having a primary care physician. Suburban respondents were more likely to own a computer, but the majority in both groups had access to computers and the Internet. Their frequency of accessing the Internet was similar, as were their reasons for using it. Individuals from the urban ED were less willing to schedule appointments via the Internet but more willing to contact their health care provider via e-mail. The groups were equally willing to use the Internet to fill prescriptions and view laboratory results. CONCLUSION: Urban and suburban ED customers had similar access to the Internet. Both groups were willing to use the Internet to access personal health information.

Unobtrusive in-home assessment by means of everyday computer mouse usage.

An important component of future proactive healthcare is the detection of changes in the individual's physical or cognitive performance, especially for aging and for those with neurodegenerative diseases. For a variety of reasons, the current techniques for neuropsychological assessment are not suitable for continuous monitoring and assessment. This paper proposes a technique for continuous monitoring of behaviors that could potentially be used to complement the traditional assessment techniques. In particular we monitor the movements of a computer pointing device (mouse) to assess cognitive and sensory-motor functionality of human users unobtrusively. The focus of this paper is on an approach that can be used to identify moves so that they can later be used as the basis for constructing sensory-motor measures. Due to the nature of the data the distinction between moves and pauses between moves is not immediately apparent. The segmentation of the data into moves is done by constructing an estimated distribution of the mouse cursor velocity for the entire computer session and locating a particular minimum which indicates a likely point of division between active moves and inter-move intervals. We analyzed computer usage data for 113 elderly participants over a period of two years, and the technique applied to that data was able to divide data from a session of computer usage into a series of mouse moves in 98% of observed computer sessions with a physically sensible value for the cutoff dividing moves from stops.

Point-of-care technology supports bedside documentation.

As the conversion to an electronic health record intensifies, the question of which data-entry device works best in what environment and situation is paramount. Specifically, what is the best mix of equipment to purchase and install on clinical units based on staff preferences and budget constraints? The authors discuss their evaluation of stationary personal computers, workshops on wheels, and handheld tablets related to timeliness of data entry and their use of focus groups to ascertain the pros/cons of data-entry devices and staff preferences. An assessment of the implications for costs related to the timeliness of data entry is also presented.

Residential accessibility to information technology retailers and self reported computer use among patients attending community clinics.

The actual mechanisms that maintain the individual disparities in home computer use and internet access that are collectively termed "the digital divide" remain unclear. We hypothesized that geographic accessibility to IT retailers would independently influence community clinic patients self reported use of computers at home thus limiting their ability to access health related information via the internet. To test this we obtained information on the locations of IT retailers in Los Angeles County, California and generated accessibility scores for the patient's home residence. Geographic measures of accessibility to IT retailers independently predicted clinic patient's self reported use of computers at home, and this effect was driven by low income individuals. Our results indicate that the causes of the digital divide are influenced by less commonly considered factors such as local IT retailer availability.

Mobile computing initiatives within pharmacy education.

OBJECTIVES: To identify mobile computing initiatives within pharmacy education, including how devices are obtained, supported, and utilized within the curriculum. METHODS: An 18-item questionnaire was developed and delivered to academic affairs deans (or closest equivalent) of 98 colleges and schools of pharmacy. RESULTS: Fifty-four colleges and schools completed the questionnaire for a 55% completion rate. Thirteen of those schools have implemented mobile computing requirements for students. Twenty schools reported they were likely to formally consider implementing a mobile computing initiative within 5 years. CONCLUSIONS: Numerous models of mobile computing initiatives exist in terms of device obtainment, technical support, infrastructure, and utilization within the curriculum. Responders identified flexibility in teaching and learning as the most positive aspect of the initiatives and computer-aided distraction as the most negative, Numerous factors should be taken into consideration when deciding if and how a mobile computing requirement should be implemented.

Faculty concerns about requiring laptops in the classroom.

Although the use of laptops in the classroom is not a new idea, very few colleges of nursing require students to purchase and use them in the classroom. The authors report on a survey of faculty experiences and concerns related to the required use of laptops in the classroom.

Mobile technology and healthcare: the adoption issues and systemic problems.

Although the benefits that are associated with mobile technology have been recognised as offering great potential in the healthcare sector, its widespread adoption has been lagging. We propose that fundamental systemic issues are likely to be the main barriers to adoption. We explain that the fragmented nature of the conservative healthcare system, the contradictory incentives and improper outcome measures conspire to make the innovative adoption of mobile technology problematic. Researchers can only gain a limited understanding of a technology's potential success by using technology adoption frameworks and need to supplement this with a 'systems' perspective that takes a more strategic view.

Trends in media use.

American youth are awash in media. They have television sets in their bedrooms, personal computers in their family rooms, and digital music players and cell phones in their backpacks. They spend more time with media than any single activity other than sleeping, with the average American eight- to eighteen-year-old reporting more than six hours of daily media use. The growing phenomenon of "media multitasking"--using several media concurrently--multiplies that figure to eight and a half hours of media exposure daily. Donald Roberts and Ulla Foehr examine how both media use and media exposure vary with demographic factors such as age, race and ethnicity, and household socioeconomic status, and with psychosocial variables such as academic performance and personal adjustment. They note that media exposure begins early, increases until children begin school, drops off briefly, then climbs again to peak at almost eight hours daily among eleven- and twelve-year-olds. Television and video exposure is particularly high among African American youth. Media exposure is negatively related to indicators of socioeconomic status, but that relationship may be diminishing. Media exposure is positively related to risk-taking behaviors and is negatively related to personal adjustment and school performance. Roberts and Foehr also review evidence pointing to the existence of a digital divide--variations in access to personal computers and allied technologies by socioeconomic status and by race and ethnicity. The authors also examine how the recent emergence of digital media such as personal computers, video game consoles, and portable music players, as well as the media multitasking phenomenon they facilitate, has increased young people's exposure to media messages while leaving media use time largely unchanged. Newer media, they point out, are not displacing older media but are being used in concert with them. The authors note which young people are more or less likely to use several media concurrently and which media are more or less likely to be paired with various other media. They argue that one implication of such media multitasking is the need to reconceptualize "media exposure."

Barriers and facilitators to home computer and internet use among urban novice computer users of low socioeconomic position.

BACKGROUND: Despite the increasing penetration of the Internet and amount of online health information, there are significant barriers that limit its widespread adoption as a source of health information. One is the "digital divide," with people of higher socioeconomic position (SEP) demonstrating greater access and usage compared to those from lower SEP groups. However, as the access gap narrows over time and more people use the Internet, a shift in research needs to occur to explore how one might improve Internet use as well as website design for a range of audiences. This is particularly important in the case of novice users who may not have the technical skills, experience, or social connections that could help them search for health information using the Internet. The focus of our research is to investigate the challenges in the implementation of a project to improve health information seeking among low SEP groups. The goal of the project is not to promote health information seeking as much as to understand the barriers and facilitators to computer and Internet use, beyond access, among members of lower SEP groups in an urban setting. OBJECTIVE: The purpose was to qualitatively describe participants' self-identified barriers and facilitators to computer and Internet use during a 1-year pilot study as well as the challenges encountered by the research team in the delivery of the intervention. METHODS: Between August and November 2005, 12 low-SEP urban individuals with no or limited computer and Internet experience were recruited through a snowball sampling. Each participant received a free computer system, broadband Internet access, monthly computer training courses, and technical support for 1 year as the intervention condition. Upon completion of the study, participants were offered the opportunity to complete an in-depth semistructured interview. Interviews were approximately 1 hour in length and were conducted by the project director. The interviews were held in the participants' homes and were tape recorded for accuracy. Nine of the 12 study participants completed the semistructured interviews. Members of the research team conducted a qualitative analysis based on the transcripts from the nine interviews using the crystallization/immersion method. RESULTS: Nine of the 12 participants completed the in-depth interview (75% overall response rate), with three men and six women agreeing to be interviewed. Major barriers to Internet use that were mentioned included time constraints and family conflict over computer usage. The monthly training classes and technical assistance components of the intervention surfaced as the most important facilitators to computer and Internet use. The concept of received social support from other study members, such as assistance with computer-related questions, also emerged as an important facilitator to overall computer usage. CONCLUSIONS: This pilot study offers important insights into the self-identified barriers and facilitators in computer and Internet use among urban low-SEP novice users as well as the challenges faced by the research team in implementing the intervention.

Detection rates in pediatric diagnostic imaging: A picture archive and communication system compared with a web-based imaging system.

OBJECTIVE: This prospective study assesses whether there are differences in accuracy of interpretation of diagnostic images among users of a picture archive and communication system (PACS) diagnostic workstation, compared with a less costly Web-based imaging system on a personal computer (PC) with a high-resolution monitor. METHODS: One hundred consecutive pediatric chest or abdomen and skeletal X-rays were selected from hospital inpatient and outpatient studies over a 5-month interval. They were classified as normal (n = 32), obviously abnormal (n = 33), or having subtle abnormal findings (n = 35) by 2 senior radiologists who reached a consensus for each individual case. Subsequently, 5 raters with varying degrees of experience independently viewed and interpreted the cases as normal or abnormal. Raters viewed each image 1 month apart on a PACS and on the Web-based PC imaging system. McNemar tests were used to compare accuracy of interpretation across both imaging systems. Confidence intervals (CIs) were calculated for differences in the proportion assessed incorrectly on the PACS, compared with the Web-based PC imaging system. RESULTS: There was no relation between accuracy of detection and the system used to evaluate X-ray images (P = 0.92). The total percentage of incorrect interpretations on the Web-based PC imaging system was 23.2%, compared with 23.6% on the PACS (P = 0.92). For all raters combined, the overall difference in proportion assessed incorrectly on the PACS, compared with the PC system, was not significant at 0.4% (95%CI, -3.5% to 4.3%). CONCLUSION: The high-resolution Web-based imaging system via PC is an adequate alternative to a PACS clinical workstation. Accordingly, the provision of a more extensive network of workstations throughout the hospital setting could have potentially significant cost savings.

E-health: determinants, opportunities, challenges and the way forward for countries in the WHO African Region.

BACKGROUND: The implementation of the 58th World Health Assembly resolution on e-health will pose a major challenge for the Member States of the World Health Organization (WHO) African Region due to lack of information and communications technology (ICT) and mass Internet connectivity, compounded by a paucity of ICT-related knowledge and skills. The key objectives of this article are to: (i) explore the key determinants of personal computers (PCs), telephone mainline and cellular and Internet penetration/connectivity in the African Region; and (ii) to propose actions needed to create an enabling environment for e-health services growth and utilization in the Region. METHODS: The effects of school enrolment, per capita income and governance variables on the number of PCs, telephone mainlines, cellular phone subscribers and Internet users were estimated using a double-log regression model and cross-sectional data on various Member States in the African Region. The analysis was based on 45 of the 46 countries that comprise the Region. The data were obtained from the United Nations Development Programme (UNDP), the World Bank and the International Telecommunications Union (ITU) sources. RESULTS: There were a number of main findings: (i) the adult literacy and total number of Internet users had a statistically significant (at 5% level in a t-distribution test) positive effect on the number of PCs in a country; (ii) the combined school enrolment rate and per capita income had a statistically significant direct effect on the number of telephone mainlines and cellular telephone subscribers; (iii) the regulatory quality had statistically significant negative effect on the number of telephone mainlines; (iv) similarly, the combined school enrolment ratio and the number of telephone mainlines had a statistically significant positive relationship with Internet usage; and (v) there were major inequalities in ICT connectivity between upper-middle, lower-middle and low income countries in the Region. By focusing on the adoption of specific technologies we attempted to interpret correlates in terms of relationships instead of absolute "causals". CONCLUSION: In order to improve access to health care, especially for the majority of Africans living in remote rural areas, there is need to boost the availability and utilization of e-health services. Thus, universal access to e-health ought to be a vision for all countries in the African Region. Each country ought to develop a road map in a strategic e-health plan that will, over time, enable its citizens to realize that vision.