Reference Information Model and Interoperable Architecture for Digital Health Twins: A Position Paper.

Digital Health Twins (DHTs) hold immense potential to revolutionize healthcare by providing personalized virtual models of individual patients and their health conditions. This position paper discusses about the needs to overcoming the challenges in standardization and information models for data integration, collection, and visualization for realizing the full potential with digital twin technology. By addressing these challenges, digital health twins can enable better decision-making, enhance patient care, and contribute to the advancement of personalized healthcare solutions.

Digital Technology Use and Adolescent Mental Health Before and During the COVID-19 Pandemic: The Roles of Internet Addiction and Digital Competence.

This study examined whether Internet addiction (IA) and digital competence (DC) mediated the association between digital technology use and mental health problems in adolescents before and during the COVID-19 pandemic, when digital device use increased dramatically. Repeated cross-sectional data from a 3-year cross-cohort study adopting stratified random sampling were analyzed. In 2019, 569 adolescents (female = 312) from 14 secondary schools completed a DC assessment and an online survey on their digital technology use, IA, and mental health. In 2021, 775 adolescents (female = 397) from 11 of those 14 schools completed both instruments. Results showed that adolescents in 2021 spent more time using digital devices, were more digitally competent, and reported more mental health problems than adolescents in 2019. The prevalence of IA was 8 percent in 2019 and 12.4 percent in 2021. In both years, more frequent digital technology use predicted a higher risk of IA, which was associated with more mental health problems (indirect ß = 0.08, p < 0.001 for 2019 and ß = 0.05, p < 0.001 for 2021). In addition, in 2021, DC was positively associated with digital technology use and negatively with IA, which indirectly related to fewer mental health problems (indirect ß = -0.01, p = 0.03). In conclusion, DC is a protective factor alleviating the positive associations of digital technology use and IA with mental health problems in adolescents when the ecological context requires high levels of digital device use.

Digital competence as a protective factor against gaming addiction in children and adolescents: A cross-sectional study in Hong Kong.

Background: Digital competence can help children and adolescents engage with technology for acquiring new knowledge and for broadening social contact and support, while reducing the risk of inappropriate media use. This study investigated the effects of digital competence on the risk of gaming addiction among children and adolescents. We explored whether students with good digital competence were protected from the adverse effects of media use and the risk of gaming addiction. Methods: 1956 students (690 primary and 1266 secondary) completed a digital competence assessment and a self-report questionnaire on their mental health status, use of digital devices, and experiences of cyberbullying. Multiple regression analyses with further mediation and moderation analyses were performed to investigate the association of digital competence with gaming addiction and mental health in children and adolescents. Findings: Regression analyses showed that children and adolescents with better digital competence were less likely to develop gaming addiction (ß = -0.144, p < 0.0001) and experienced less cyberbullying behaviour as perpetrators (ß = -0.169, p < 0.0001) and as victims (ß = -0.121, p < 0.0001). Digital competence was found to mediate the relationship between digital device usage time and gaming addiction. Interpretation: Digital competence is associated with less gaming addiction and could potentially lead to better mental wellbeing by reducing the risks of gaming addiction and cyberbullying. Education that promotes digital competence is essential to maximize the benefits of media use, while reducing the potential adverse effects from the inappropriate use of digital devices. Funding: This study was supported by a grant from the Research Grants Council of the HKSAR Government (#T44-707/16N) under the Theme-based Research Scheme.

Digital Technology Use and Cyberbullying Among Primary School Children: Digital Literacy and Parental Mediation as Moderators.

Cyberbullying has become a critical issue in many parts of the world. Children affected by bullying in cyberspace may also experience various other problems in their daily lives, such as emotional and behavioral issues. Despite the well-documented positive correlation between digital technology use and cyberbullying experiences in adolescents, a paucity of research has explored the association between digital technology use and cyberbullying, and the extent to which digital literacy (DL) and parental mediation moderate these relationships among primary school-aged children. This study addressed these research gaps. A total of 736 children (third grade, female = 52 percent) in Hong Kong, selected through stratified random sampling, reported on their digital technology use, parental mediation of technology use (i.e., active mediation and restriction), and cyberbullying experiences. A performance-based assessment measured children's DL. Results showed a positive association between children's digital technology use (both for leisure activities and for schoolwork) and cyberbullying experiences (both as perpetrator and victim). These positive associations were more pronounced among children with low levels of DL (only victims) as well as among children with highly restrictive parents (both perpetrators and victims). Implications for digital citizenship education and parental intervention are discussed.

Profiles of Adolescents' Perceptions of Democratic Classroom Climate and Students' Influence: The Effect of School and Community Contexts.

Students' learning experiences and outcomes are shaped by school and classroom contexts. Many studies have shown how an open, democratic classroom climate relates to learning in the citizenship domain and helps nurture active and engaged citizens. However, little research has been undertaken to look at how such a favorable classroom climate may work together with broader school factors. The current study examines data from 14,292 Nordic eighth graders (51% female) who had participated in the International Civic and Citizenship Education Study in 2009, as well as contextual data from 5,657 teachers and 618 principals. Latent class analysis identifies profiles of students' perceptions of school context, which are further examined with respect to the contextual correlates at the school level using two-level fixed effects multinomial regression analyses. Five distinct student profiles are identified and labeled "alienated", "indifferent", "activist", "debater", and "communitarian". Compared to indifferent students, debaters and activists appear more frequently at schools with relatively few social problems; being in the communitarian group is associated with aspects of the wider community. Furthermore, being in one of these three groups (and not in the indifferent group) is more likely when teachers act as role models by engaging in school governance. The results are discussed within the framework of ecological assets and developmental niches for emergent participatory citizenship. The implications are that adults at school could enhance multiple contexts that shape adolescents' developmental niches to nurture active and informed citizens for democracies.

How Internal Political Efficacy Translates Political Knowledge Into Political Participation: Evidence From Germany.

This study presents evidence for the mediation effect of political knowledge through political self-efficacy (i.e. internal political efficacy) in the prediction of political participation. It employs an action theoretic approach-by and large grounded on the Theory of Planned Behaviour-and uses data from the German Longitudinal Election Study to examine whether political knowledge has distinct direct effects on voting, conventional, and/or unconventional political participation. It argues that political knowledge raises internal political efficacy and thereby indirectly increases the chance that a citizen will participate in politics. The results of mediated multiple regression analyses yield evidence that political knowledge indeed translates into internal political efficacy, thus it affects political participation of various kinds indirectly. However, internal political efficacy and intentions to participate politically yield simultaneous direct effects only on conventional political participation. Sequentially mediated effects appear for voting and conventional political participation, with political knowledge being mediated by internal political efficacy and subsequently also by behavioural intentions. The mediation patterns for unconventional political participation are less clear though. The discussion accounts for restrictions of this study and points to questions for answer by future research.

Future Telehealth and Telecare Reference Design based on IoT Technologies: From Remote Monitoring to Smart Collaborative Services with Decision Support.

The demographic changes are producing aging societies across the world, resulting in greater demands on the health and care systems due to age-related disabilities and chronic diseases. Efficient telehealth and telecare services are needed to control the corresponding expenditures, by supporting increased collaboration between different professional and involving informal health care providers, and by empowering the patients to manage their health and well-being. Emerging trial systems for remote patient monitoring present preliminary solutions not exempt of certain limitations. We propose a future eHealth reference system architecture and core components, aiming at secure, smarter and more collaborative telehealth and telecare services. The implicit cooperation between the so-far separated domains of consumer well-being services and public telehealth and telecare services will be beneficial for all parties.

Telemedicine and Cooperative Remote Healthcare Services: COPD Field Trial.

The introduction of sustainable telemedicine solutions throughout Europe requires the development of secure, flexible and expandable systems and the evaluation of their operation in real-world settings such as field trials. This paper describes a system for a remote monitoring and care support field trial with Chronic Obstructive Pulmonary Disease (COPD) patients. By following a user-centred-development and Privacy by Design approach, the needs of all involved user groups could be addressed, while fulfilling, at the same time, national requirements with emphasis in security and privacy protection. The solution covers specific applications and services for COPD patients and their remote care takers, but allows the generalization of its applicability to other patient groups.

When dual identity becomes a liability: identity and political radicalism among migrants.

This article examines the role of dual identity in political radicalism among migrants. Dual identity is defined as identification with both one's ethnocultural minority in-group and one's society of residence. We employed a longitudinal research design using members of the two largest migrant groups in Germany (Turkish migrants and Russian migrants) as participants. We reasoned that when dual identity is burdened with incompatibility between component identifications, it may foster controversial or even destructive forms of political mobilization, such as radicalism. Multiple regression analysis controlling for other influences confirmed the hypothesized moderated relationship between dual identification and sympathy for radical action. When accompanied by high, as opposed to low, perceived identity incompatibility, dual identification predicted increases in sympathy for radical action among both Turkish migrants and Russian migrants. The implications for public life in ethnically and culturally heterogeneous societies are discussed.