Sports and exercise-related smartphone use is antagonistic to hedonic use in regular exercisers: A cross-sectional study examining the roles of exercise frequency and duration.

Background: Hedonic smartphone use has been associated with dependence and addiction studied under the umbrella term Problematic Smartphone Use (PSU). Research usually explores total screen time as an index of PSU. A few studies suggest that exercise is inversely related to smartphone use time. However, it is unknown which primary characteristics of exercise behavior are related to more moderate smarthone use. Furthermore, the purpose of smartphone use, such as hedonic use associated with PSU versus utilitarian use, was not tested in the sports and exercise contexts. Hedonic use generally means playing with the smartphone for joy, distraction, and satisfaction. Utilitarian use implies practical and valuable use. There is a conjecture that sports involvement may foster utilitarian use through increased involvement in sports-related information-seeking, goal-setting, and self-monitoring. Methods: Therefore, we examined whether weekly exercise frequency, workout duration, and perceived exercise intensity relate to total daily smarthone and hedonic use and whether this relationship is mediated by sports-related utilitarian device use. We tested regularly exercising adults (n = 360, 132 males, M age = 39.0 ± 9.8, M weekly exercise = 5.8 ± 1.9) who volunteered for this study and provided demographic information about their exercise habits and smartphone use. Results: The results revealed that all exercise parameters mediated the total daily smartphone use, with perceived exercise intensity being a negative predictor. Further, exercise frequency and duration (but not intensity) positively predicted sports-related smartphone use, which inversely predicted hedonic use. Conclusion: These results suggest that exercise parameters directly relate to daily smartphone use, which completely mediates hedonic use. These findings may partially account for the frequently reported inverse relationship between regular exercise and PSU by suggesting that the connection is mediated via sports-related smartphone use.

Continence App® Impact on Puerperal Women's Knowledge, Attitude and Practice: Randomized Clinical Trial.

INTRODUCTION AND HYPOTHESIS: Enhancing women's knowledge, attitude, and practice (KAP) concerning urinary incontinence (UI) through diverse educational strategies has been a focal point for professionals in recent years. This study was aimed at assessing the impact of the educational application Continence App® on the KAP of postpartum women experiencing UI. We hypothesized that access to the app would lead to improved KAP among these women. METHODS: Postpartum women who had undergone vaginal birth, aged 18 years or above, literate, admitted in a maternity ward, delivered a full-term or large-for-gestational-age infant, and possessed a smartphone or compatible device for app usage were included. Changes in KAP were evaluated using a survey specifically designed for this purpose. The Mann-Whitney U test was employed to compare KAP scores between control and intervention groups, as well as between baseline and post-intervention assessments. RESULTS: Among the 542 women screened for eligibility, 349 were enrolled in the study, with 138 completing post-intervention assessments. The mean (standard deviation [SD]) age of participants was 25.9 (5.8) years. Post-intervention scores for knowledge and practice demonstrated a decline among non-app users, whereas a significant increase was observed among those in the intervention group. Attitudinal changes remained insignificant. CONCLUSIONS: The findings highlight the effectiveness of an app-based educational intervention in enhancing the knowledge and practice related to UI among postpartum women.

Harnessing the power of nature exposure to mitigate adolescents' Internet addiction: A chain mediation model.

Previous studies have focused more on the facilitating effect of nature exposure on positive behavioural consequences. However, less attention has been paid to whether nature exposure can inhibit internalized problem behaviours, such as Internet addiction. Within the framework of the stimuli-organism-response theory, the present study examined the relationship between nature exposure and Internet addiction and investigated the mediating roles of anthropomorphism of nature and awe. In China, we recruited 1469 adolescents (mean age = 13.90 years old, SD = 0.59, 53.2% girls). Mediation analyses indicated that awe partially mediated the relationship between nature exposure and adolescents' Internet addiction. The anthropomorphism of nature and awe served as sequential mediating roles in the relationship between nature exposure and adolescents' Internet addiction. This study provides a nature-based perspective on the prevention and intervention of adolescents' Internet addiction.

Effectiveness of internet-delivered psychological treatments for children and adolescents with anxiety and/or depressive disorders: Systematic review and network meta-analysis.

Background: Anxiety and depression symptomatology has increased in the child and adolescent population. Internet-delivered psychological treatments (IDPT) can help to reduce this symptomatology, attending to the largest possible population. Aim: To conduct a systematic review and network meta-analysis of IDPT to reduce anxiety and depression symptoms in children and adolescents. Methods: The search for studies was conducted in SCOPUS, PsycINFO, PSICODOC, PsycARTICLES and Medline, between 2000 and 2022, in December 2022. Studies were selected if they were conducted with a sample of children and/or adolescents with previous symptoms of anxiety and depression, had applied IDPT, and included at least two comparative groups with pretest-posttest measures. Network meta-analyses were separately performed for anxiety and depression outcomes. Publication bias was analyzed using Egger's test and funnel plots, and mixed-effects meta-regression models were applied to account for heterogeneity. Results: 37 studies were included in the meta-analysis, providing a total of 74 comparative groups. IDPT exhibited low-to-moderate, statistically significant average effect sizes when compared to both inactive and active controls. No statistical significance was found when IDPT was compared with other types of interventions. Discussion: IDPT is recommended to reduce anxiety and depression symptomatology in children and adolescents, but more studies are needed which compare treatments with other types of interventions, such as face-to-face therapy.

Industry 4.0 Technologies in Maternal Health Care: Bibliometric Analysis and Research Agenda.

BACKGROUND: Industry 4.0 (I4.0) technologies have improved operations in health care facilities by optimizing processes, leading to efficient systems and tools to assist health care personnel and patients. OBJECTIVE: This study investigates the current implementation and impact of I4.0 technologies within maternal health care, explicitly focusing on transforming care processes, treatment methods, and automated pregnancy monitoring. Additionally, it conducts a thematic landscape mapping, offering a nuanced understanding of this emerging field. Building on this analysis, a future research agenda is proposed, highlighting critical areas for future investigations. METHODS: A bibliometric analysis of publications retrieved from the Scopus database was conducted to examine how the research into I4.0 technologies in maternal health care evolved from 1985 to 2022. A search strategy was used to screen the eligible publications using the abstract and full-text reading. The most productive and influential journals; authors', institutions', and countries' influence on maternal health care; and current trends and thematic evolution were computed using the Bibliometrix R package (R Core Team). RESULTS: A total of 1003 unique papers in English were retrieved using the search string, and 136 papers were retained after the inclusion and exclusion criteria were implemented, covering 37 years from 1985 to 2022. The annual growth rate of publications was 9.53%, with 88.9% (n=121) of the publications observed in 2016-2022. In the thematic analysis, 4 clusters were identified-artificial neural networks, data mining, machine learning, and the Internet of Things. Artificial intelligence, deep learning, risk prediction, digital health, telemedicine, wearable devices, mobile health care, and cloud computing remained the dominant research themes in 2016-2022. CONCLUSIONS: This bibliometric analysis reviews the state of the art in the evolution and structure of I4.0 technologies in maternal health care and how they may be used to optimize the operational processes. A conceptual framework with 4 performance factors-risk prediction, hospital care, health record management, and self-care-is suggested for process improvement. a research agenda is also proposed for governance, adoption, infrastructure, privacy, and security.

Comparing Federal Communications Commission and Microsoft Estimates of Broadband Access for Mental Health Video Telemedicine Among Veterans: Retrospective Cohort Study.

BACKGROUND: The COVID-19 pandemic highlighted the importance of telemedicine in health care. However, video telemedicine requires adequate broadband internet speeds. As video-based telemedicine grows, variations in broadband access must be accurately measured and characterized. OBJECTIVE: This study aims to compare the Federal Communications Commission (FCC) and Microsoft US broadband use data sources to measure county-level broadband access among veterans receiving mental health care from the Veterans Health Administration (VHA). METHODS: Retrospective observational cohort study using administrative data to identify mental health visits from January 1, 2019, to December 31, 2020, among 1161 VHA mental health clinics. The exposure is county-level broadband percentages calculated as the percentage of the county population with access to adequate broadband speeds (ie, download >25 megabits per second) as measured by the FCC and Microsoft. All veterans receiving VHA mental health services during the study period were included and categorized based on their use of video mental health visits. Broadband access was compared between and within data sources, stratified by video versus no video telemedicine use. RESULTS: Over the 2-year study period, 1,474,024 veterans with VHA mental health visits were identified. Average broadband percentages varied by source (FCC mean 91.3%, SD 12.5% vs Microsoft mean 48.2%, SD 18.1%; P<.001). Within each data source, broadband percentages generally increased from 2019 to 2020. Adjusted regression analyses estimated the change after pandemic onset versus before the pandemic in quarterly county-based mental health visit counts at prespecified broadband percentages. Using FCC model estimates, given all other covariates are constant and assuming an FCC percentage set at 70%, the incidence rate ratio (IRR) of county-level quarterly mental video visits during the COVID-19 pandemic was 6.81 times (95% CI 6.49-7.13) the rate before the pandemic. In comparison, the model using Microsoft data exhibited a stronger association (IRR 7.28; 95% CI 6.78-7.81). This relationship held across all broadband access levels assessed. CONCLUSIONS: This study found FCC broadband data estimated higher and less variable county-level broadband percentages compared to those estimated using Microsoft data. Regardless of the data source, veterans without mental health video visits lived in counties with lower broadband access, highlighting the need for accurate broadband speeds to prioritize infrastructure and intervention development based on the greatest community-level impacts. Future work should link broadband access to differences in clinical outcomes.

Perspectives on Online Resources for People Experiencing Pain: A Qualitative Study.

BACKGROUND: Innovations in technology offer potential solutions to address pain care inequities. To maximize impacts, greater understanding is needed regarding preferences and priorities of people experiencing or treating pain. OBJECTIVES: This study conducted focus groups to investigate the perspectives of people with pain and healthcare workers regarding online resources for pain management. Researchers asked about barriers to current pain management and what resources would be most desired in an online format to meet needs. METHODS: Participants were a randomly selected sub-sample of adults from a northwestern region of the United States who participated in an online, survey-based study. Eligible participants identified as either a person who had received treatment for pain or a healthcare worker who cared for people with pain. Of the 199 survey respondents, 30 participated in one of three focus group sessions. Focus groups were conducted using videoconferencing technology, then recorded, transcribed, and analyzed using thematic analysis. RESULTS: Focus group participants included 22 adults who identified as a person treated for pain of any type and 8 healthcare workers. Themes relating to eHealth use reflected desires for (1) freely accessible and vetted pain management information in one place, (2) reliable information tailored to need and pain type, and (3) easy-to-use resources. Findings revealed that some effective pain management resources do exist, yet obstacles including inflexible and inequitable healthcare practices and lack of knowledge about options may limit access to these resources. CONCLUSION: Including preferences of user groups can assist in creating resources that are likely to be useful for those with pain and their caregivers. Innovations are needed to address persisting gaps in care.

Effectiveness of digital interventions to reduce school-age adolescent sexual risks: A systematic review.

INTRODUCTION: The increase in risky sexual behaviors among adolescent students has sparked alarm and has become an area of research interest. As adolescents prioritize confidentiality and accessibility, digital interventions are becoming increasingly relevant in sex education. We therefore posed the following research question: Are digital application interventions effective to prevent risky sexual behaviors in school adolescents? DESIGN: A systematic peer review was conducted between January and December 2023 in five databases (PubMed, Web of Science, Scopus, EMBASE, and PsycINFO) without restricting for language or year of publication. METHOD: We included randomized control trials or quasi-experimental studies that measured the effectiveness of interventions targeting young people aged 10-19 years or their parents and developed in a school setting. Interventions aimed at young people with intellectual disabilities, learning difficulties, or any disease requiring a specific intervention were excluded. RESULTS: The search ultimately yielded 27 studies covering a total of 18 digital interventions that demonstrated positive effects, not maintained over time, on knowledge, attitudes, and behaviors, although the latter to a lesser extent. DISCUSSION: We have found very interesting digital interventions with effects, among others, on knowledge, attitudes, and contraceptive use in adolescents. In general, digital interventions have positive effects on knowledge and attitudes, but it is more difficult to modify behaviors with strictly digital interventions or combined with complementary face-to-face sessions or group class activities. CONCLUSION: We thus believe that digital interventions are adequate to reduce adolescent sexual risk behaviors, and our systematic review facilitates the implementation of these interventions by sharing existing digital interventions that have had positive effects, as well as the main characteristics a digital intervention should possess to reduce sexually risky behaviors in adolescents. CLINICAL RELEVANCE: Digital interventions with adolescents improve sexual behaviors and can be a valuable resource in education on this topic due to their accessibility and confidentiality, two key points for young people.

TikTok as a platform for hysteroscopy information: An analytical video-based cross-sectional study to assess quality, reliability, and accuracy.

OBJECTIVE: To assess the quality, reliability, and level of misinformation in TikTok videos about hysteroscopy. METHODS: A cross-sectional analysis of TikTok videos retrieved using "hysteroscopy" as search term was performed. Patient education materials assessment tool for audio-visual content (PEMAT A/V), the modified DISCERN (mDISCERN), global quality scale (GQS), video information and quality index (VIQI) and misinformation assessment were used. RESULTS: Of three hundred videos captured, 156 were excluded and 144 were included. Most videos were partially accurate or uninformative (43.8% and 34.7%, respectively). Non-healthcare providers produced more inaccurate or uninformative videos than healthcare workers (51.1% vs 4.0%; P < 0.001). Compared to content by professionals, content by patients showed increased distrust towards gynecologists (11.7% vs 0%; P = 0.012) and increased incidence of anxiety and concern towards hysteroscopy (25.5% vs 2%; P < 0.001). PEMAT A/V scores for understandability and actionability were low at 42.9% (interquartile range [IQR]: 11.1-70) and 0% (IQR: 0-0), respectively. Understandability (P < 0.001) and actionability (P = 0.001) were higher for professionals' created content relative to patients' videos. Similarly, median mDISCERN score was low (1 [IQR 0-2]), with significantly higher score for healthcare professionals compared to patients (P < 0.001). Overall video quality was also low, with median VIQI and GQS score of 7 (IQR 4-11) and 1 (IQR 1-3), respectively, and significantly higher scores for healthcare workers' captions compared to patients' for both (P < 0.001 and P = 0.001, respectively). CONCLUSION: TikTok videos' quality on hysteroscopy seems unsatisfactory and misinformative, with low understandability and actionability scores. Videos recorded by healthcare workers show higher quality and less misinformation than those by patients. Raising the awareness regarding the low quality of medical information on social media is crucial to increase future reliability and trustworthiness.

PdMoPtCoNi High Entropy Nanoalloy with d Electron Self-Complementation-Induced Multisite Synergistic Effect for Efficient Nanozyme Catalysis.

Engineering multimetallic nanocatalysts with the entropy-mediated strategy to reduce reaction activation energy is regarded as an innovative and effective approach to facilitate efficient heterogeneous catalysis. Accordingly, conformational entropy-driven high-entropy alloys (HEAs) are emerging as a promising candidate to settle the catalytic efficiency limitations of nanozymes, attributed to their versatile active site compositions and synergistic effects. As proof of the high-entropy nanozymes (HEzymes) concept, elaborate PdMoPtCoNi HEA nanowires (NWs) with abundant active sites and tuned electronic structures, exhibiting peroxidase-mimicking activity comparable to that of natural horseradish peroxidase are reported. Density functional theory calculations demonstrate that the enhanced electron abundance of HEA NWs near the Fermi level (EF) is facilitated via the self-complementation effect among the diverse transition metal sites, thereby boosting the electron transfer efficiency at the catalytic interface through the cocktail effect. Subsequently, the HEzymes are integrated with a portable electronic device that utilizes Internet of Things-driven signal conversion and wireless transmission functions for point-of-care diagnosis to validate their applicability in digital biosensing of urinary biomarkers. The proposed HEzymes underscore significant potential in enhancing nanozymes catalysis through tunable electronic structures and synergistic effects, paving the way for reformative advancements in nano-bio analysis.

Online Child Sexual Exploitation and the Role of Computer-Mediated Communication: A Scoping Review.

The online landscape has shifted since the rise of smartphones and social media in the 2010s and altered the way children use technologies. Along with a reliance on computer-mediated communication (CMC) is the concern of online child sexual exploitation (OCSE). This scoping review provided an updated examination of the prevalence, risk factors, outcomes, and disclosures of OCSE since 2010. Systematic searches were conducted using three databases for studies published between January 2010 and January 2023. Results indicated an alarming prevalence of, and a wide range of risk factors and consequences associated with OCSE worldwide. Many young victims struggled to recognize OCSE as a serious form of abuse. The need to monitor the ever-changing Internet landscape for young users is highlighted.

Analyzing anonymous activities using Interrupt-aware Anonymous User-System Detection Method (IAU-S-DM) in IoT.

The intrusion detection process is important in various applications to identify unauthorized Internet of Things (IoT) network access. IoT devices are accessed by intermediators while transmitting the information, which causes security issues. Several intrusion detection systems are developed to identify intruders and unauthorized access in different software applications. Existing systems consume high computation time, making it difficult to identify intruders accurately. This research issue is mitigated by applying the Interrupt-aware Anonymous User-System Detection Method (IAU-S-DM). The method uses concealed service sessions to identify the anonymous interrupts. During this process, the system is trained with the help of different parameters such as origin, session access demands, and legitimate and illegitimate users of various sessions. These parameters help to recognize the intruder's activities with minimum computation time. In addition, the collected data is processed using the deep recurrent learning approach that identifies service failures and breaches, improving the overall intruder detection rate. The created system uses the TON-IoT dataset information that helps to identify the intruder activities while accessing the different data resources. This method's consistency is verified using the metrics of service failures of 10.65%, detection precision of 14.63%, detection time of 15.54%, and classification ratio of 20.51%.

User's Search for Information: A Multi-Language Cross-Sectional Assessment of Websites about Healthcare-Associated Infections.

Introduction: Healthcare-associated infections have a significant impact on public health, and many patients and their next-of-kin are seeking information on the internet. The study aimed to assess the quality of online written content about healthcare-associated infections available in English, Romanian, and Hungarian languages. Materials and methods: The study sample included 75 websites, 25 for each language subgroup. The assessment involved examining the general characteristics, adherence to established credibility criteria, and the completeness and accuracy of informational content. The evaluation was conducted using a topic-specific, evidence-based benchmark. Two evaluators independently graded completeness and accuracy; scores were recorded on a scale from 0 to 10. A comparative analysis of websites was performed, considering pertinent characteristics, and potential factors influencing information quality were subjected to testing. The statistical significance was set at 0.05. Results: For the overall study sample, the average credibility, completeness, and accuracy scores were 5.1 (SD 1.7), 2.4 (SD 1.5), and 5.9 (SD 1.0), respectively. Pairwise comparison tests revealed that English websites rated significantly higher than Romanian and Hungarian websites on all three quality measures (P<0.05). Website specialization, ownership, and main goal were not associated with credibility or content ratings. However, conventional medicine websites consistently scored higher than alternative medicine and other websites across all three information quality measures (P<0.05). Credibility scores were positively but weakly correlated with completeness (rho=0.273; P=0.0176) and accuracy scores (rho=0.365; P=0.0016). Conclusions: The overall quality ratings of information about healthcare-associated infections on English, Romanian, and Hungarian websites ranged from intermediate to low. The description of information regarding the symptoms and prevention of healthcare-associated infections was notably unsatisfactory. The study identified website characteristics possibly associated with higher-quality online sources about healthcare-associated infections, but additional research is needed to establish robust evidence.

Problematic Internet Use and Technology Interactions Among Transgender Adolescents.

Purpose: To compare risk of problematic internet use (PIU) and importance of digital media interactions for transgender and cisgender adolescents. Methods: A nationally representative group of adolescents took an online survey that included a measure of PIU (Problematic and Risky Internet Use Screening Scale-3 [PRIUSS-3]) and technology interactions (Adolescent Digital Technology Interactions and Importance scale). We compared mean scores for these scales and their subscales and rates of positive screens for PIU for transgender and cisgender adolescents. Results: Of 4575 adolescents participating, 53 (1.2%) were transgender, nonbinary, and gender-diverse (TNG) adolescents. TNG adolescents had higher PRIUSS-3 scores and higher mean scores for importance of technology to explore identity/go outside their offline environment. Conclusions: TNG adolescents report higher PIU risk, which may relate to differences in technology importance for this group.

Relationship between adolescent internet addiction and adolescent non-suicidal self-injury: a moderated mediation model.

Background: Both Internet addiction (IA) and non-suicidal self-injury (NSSI) are major public health concerns among adolescents, association between internet addiction and non-suicidal self-injury have been observed among adolescents. However, it is unclear how, and under what conditions, internet addiction relates to non-suicidal self-injury. According to our hypothesis, there is a positive relationship between IA and NSSI among Chinese adolescents, but this relationship is affected by the mediating role of loneliness and the moderating role of cognitive reappraisal. Method: A cross-sectional survey was conducted on 1046 Chinese adolescents from 3 middle schools. Measurements: Adolescent Self-Harm Scale; Young's Internet Addiction Test (IAT); University of California at Los Angels (UCLA) Loneliness Scale; Emotional Regulation Questionnaire (ERQ), They were asked to complete self-report questionnaires. Results: In our sample, the detection rate of NSSI was 12.3%. IA was positively associated with NSSI, and loneliness partially mediated the association between them. In addition, cognitive reappraisal moderated the first half path of the mediation model. Specifically, the higher the level of cognitive reappraisal, the weaker the positive effect of IA on NSSI through loneliness. Conclusion: Interventions targeted to reduce loneliness and increase cognitive reappraisal strategies may reduce the risk of NSSI in adolescents with Internet addiction.

Longitudinal Coadaptation of Older Adults With Wearables and Voice-Activated Virtual Assistants: Scoping Review.

BACKGROUND: The integration of smart technologies, including wearables and voice-activated devices, is increasingly recognized for enhancing the independence and well-being of older adults. However, the long-term dynamics of their use and the coadaptation process with older adults remain poorly understood. This scoping review explores how interactions between older adults and smart technologies evolve over time to improve both user experience and technology utility. OBJECTIVE: This review synthesizes existing research on the coadaptation between older adults and smart technologies, focusing on longitudinal changes in use patterns, the effectiveness of technological adaptations, and the implications for future technology development and deployment to improve user experiences. METHODS: Following the Joanna Briggs Institute Reviewer's Manual and PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines, this scoping review examined peer-reviewed papers from databases including Ovid MEDLINE, Ovid Embase, PEDro, Ovid PsycINFO, and EBSCO CINAHL from the year 2000 to August 28, 2023, and included forward and backward searches. The search was updated on March 1, 2024. Empirical studies were included if they involved (1) individuals aged 55 years or older living independently and (2) focused on interactions and adaptations between older adults and wearables and voice-activated virtual assistants in interventions for a minimum period of 8 weeks. Data extraction was informed by the selection and optimization with compensation framework and the sex- and gender-based analysis plus theoretical framework and used a directed content analysis approach. RESULTS: The search yielded 16,143 papers. Following title and abstract screening and a full-text review, 5 papers met the inclusion criteria. Study populations were mostly female participants and aged 73-83 years from the United States and engaged with voice-activated virtual assistants accessed through smart speakers and wearables. Users frequently used simple commands related to music and weather, integrating devices into daily routines. However, communication barriers often led to frustration due to devices' inability to recognize cues or provide personalized responses. The findings suggest that while older adults can integrate smart technologies into their lives, a lack of customization and user-friendly interfaces hinder long-term adoption and satisfaction. The studies highlight the need for technology to be further developed so they can better meet this demographic's evolving needs and call for research addressing small sample sizes and limited diversity. CONCLUSIONS: Our findings highlight a critical need for continued research into the dynamic and reciprocal relationship between smart technologies and older adults over time. Future studies should focus on more diverse populations and extend monitoring periods to provide deeper insights into the coadaptation process. Insights gained from this review are vital for informing the development of more intuitive, user-centric smart technology solutions to better support the aging population in maintaining independence and enhancing their quality of life. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/51129.

Digital Media Usage Behavior and Its Impact on the Physician-Patient Relationship: Cross-Sectional Study Among Individuals Affected by Psoriasis in Germany.

BACKGROUND: Psoriasis is a chronic skin disorder with a high burden of disease. People affected with psoriasis increasingly use the internet for health-related reasons, especially those with younger age, higher education, and higher disease severity. Despite advantages such as enhancing the individuals' knowledge with the use of digital media for health-related issues, disadvantages were also present such as quality control, and variability in the individuals' health information literacy. While patients with psoriasis within medical settings generally trust physicians over digital media, they commonly withhold their web-based research findings from health care providers. OBJECTIVE: The study aims to (1) identify further factors associated with regular psoriasis-related internet use, (2) rank specific digital media platforms used, and (3) examine digital media within the physician-patient relationship among individuals with and without dermatological treatment. METHODS: A cross-sectional, questionnaire-based study was conducted among individuals with self-reported psoriasis in Germany between September 2021 and February 2022. Participants were recruited via digital media platforms and in person at a University Hospital Department of Dermatology in southern Germany. The questionnaire asked about demographic and medical information, individual psoriasis-related digital media use, and the impact of digital media on the physician-patient relationship. Data were analyzed descriptively, and logistic regression models were performed to assess the factors associated with regular psoriasis-related internet use. RESULTS: Among 321 individuals with a median age of 53 (IQR 41-61) years (nonnormally distributed; females: 195/321), female sex, shorter disease duration, moderate mental burden of disease, and good self-assessed psoriasis-related knowledge were associated with regular psoriasis-related internet use. Of the 188 participants with a mean age of 51.2 (SD 13.9) years (normally distributed) who used digital media 106 (56.4%) usually searched for information on psoriasis-based websites and 98 (52.1%) on search engines, primarily for obtaining information about the disease and therapy options, while social media were less frequently used (49/188, 26.1%). Nearly two-thirds of internet users (125/188) claimed that their physicians did not recommend digital media platforms. About 44% (82/188) of the individuals reported to seek for additional information due to the insufficient information provided by their physician. CONCLUSIONS: This study revealed the importance of digital media in the context of psoriasis, especially among women, individuals with shorter disease duration, and moderate mental disease severity. The lack of physicians' digital media recommendations despite their patients' desire to receive such and being more involved in health-related decisions seems to be a shortcoming within the physician-patient relationships. Physicians should guide their patients on digital media by recommending platforms with evidence-based information, thereby potentially creating an adequate framework for shared decision-making. Future research should focus on strategies to prevent the spread of false information on digital media and address the needs of patients and physicians to enhance health-related digital media offerings.

Internet use and physical activity among family caregivers of older adults: Evidence from the China Health and Retirement Longitudinal Study.

This study examined the influence of Internet use on light-intensity physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) among family caregivers of older adults, utilizing data from the 2018 China Health and Retirement Longitudinal Study (N = 3,194). The Tobit model and Propensity Score Matching were first used to test the focal associations. Subsequently, mediation analyses and heterogeneity analysis were conducted to explore the pathways and urban-rural disparities. The results indicated that Internet use was negatively associated with MVPA and was not correlated with LPA. The Internet use - MVPA relationship was mediated by participation in economic activities, while participation in social activities acted as a suppressor. Further, the focal association was only found in rural family caregivers. The findings suggest that effective health promotion interventions are needed to mitigate the negative influence of Internet use on the MVPA of family caregivers of older adults, especially for those in the rural.

[Public school teachers' perceptions of internet gaming problems among students：current status and challenges].

Objectives　This study aimed to identify and understand the challenges faced by public school teachers regarding issues related to Internet gaming.Methods　An electronic questionnaire was administered to 400 public school teachers in the Saitama Prefecture from September to November 2021. A total of 352 valid responses were obtained. The survey content included teachers' knowledge of gaming disorders, whether their students experienced gaming-related problems, difficulties perceived by teachers, how they discovered the problems, how they dealt with them, the challenges they faced in dealing with the problems, and desired support. Data were analyzed based on the teachers' roles, responsibilities, type of school, and knowledge of gaming difficulties. Fisher's exact probability tests were used to determine significance, and adjusted standardized residuals were used to assess the differences between groups.Results　Nearly 63.1% of the teachers already had knowledge of gaming disorders, and 49.4% acknowledged the existence of students with gaming problems. The most common reasons for discovering problems were disrupted daily rhythm (51.7%) and increased tardiness and early dismissal (34.7%). The main actions taken to address gaming problems were "consultation and information sharing with families" (48.6%) and "individual guidance by teachers" (34.1%). Approximately half of the teachers indicated that they regularly experienced difficulties in activities related to prevention, early detection, student support, and interaction with parents. Specific challenges included limited guidance and involvement with families (61.4%) and the inability to intervene and provide effective support (62.5%). Teachers' support included programs for addiction recovery (56.8%), awareness programs for parents (56.0%), and staff training to increase the understanding of gaming disorders (50.5%). The responses varied according to teacher role and school type, indicating that implementation rates and difficulties were higher in middle schools.Conclusion　We found that teachers tended to view internet gaming problems as family problems and provide complementary support for home education. Teachers also found it difficult to deal with students with gaming problems. Depending on the teacher's role in the school and the type of school, requests for support varied. Elementary and special-needs schools needed teaching materials that could be used for classroom and school-wide instruction and guidance for concerned students and their parents; junior high schools needed a consultation system with school counselors and other professionals and cooperation with healthcare; and high schools needed measures and support, including social support.