Utilidad de la app Abeona Health® para la participación del paciente en la identificación de toxicidad inducida por quimioterapia según la clasificación CTCAE / Utility of the Abeona Health® app for patient participation in the identification of chemotherapy- induced toxicity according to the CTCAE classification

Fundamentos: Desde 2003, el Instituto Nacional del Cáncer (NCI) de los Estados Unidos de América ha sido uno de los líderes mundiales en la clasificación de los Efectos Adversos (EA). Actualmente, los teléfonos inteligentes permiten, entre otras muchas cosas, la monitorización de estos EA de la quimioterapia desde el domicilio para mejorar la seguridad y la calidad de vida de los pacientes. El objetivo de este estudio fue realizar un análisis comparativo descriptivo del contenido de los EA de la aplicación Abeona Health® y la última versión de los CTCAE (Common Terminology Criteria for Adverse Events). Métodos: Se utilizó la app Abeona Health® y la guía CTCAE v5. Posteriormente, se analizaron los EA más recurrentes en el tratamiento quimioterápico, según la NCI y la Sociedad Española de Oncología Médica (SEOM) y, finalmente, si los pacientes podían identificarlos. Resultados: El CTCAE v5 recoge 837 EA, donde 225 son signos y síntomas. El NCI clasifica cincuenta y cinco signos y síntomas como los más recurrentes, y la SEOM dieciséis, de los cuales quince coinciden con el NCI. La aplicaciónAbeona Health® dispone de siete EA, y todos se incluyen en el CTCAE v5. De estos siete, seis aparecen en las listas de EA más recurrentes del NCI y cuatro en la de la SEOM, todos ellos identificables por el paciente. Conclusiones: Laapp de Abeona Health® se considera adecuada para la participación del paciente en su autocuidado, si biense podrían ampliar algunos campos.(AU)

Bbackground: Since 2003, the National Cancer Institute (NCI) of the United States of America has been one of the world leaders in classifying adverse effects (AEs). Currently, smartphones allow, among many other things, the monitoring of these AEs of chemotherapy from home to improve the safety and quality of life of patients. The aim was to perform a descriptive comparative analysis of the AEs content of the Abeona Health® app and the latest version of the CTCAE (Common Terminology Criteria for Adverse Events). Methods: The Abeona Health® app and the CTCAE v5 guide were used. Subsequently, the most recurrent AEs in the existing chemotherapy treatment were analysed according to the NCI and the Spanish Society of Medical Oncology (SEOM) and finally, whether patients could identify them. Results: The CTCAE v5 (collects 837 AEs), where two hundred and twenty-five are signs and symptoms. The NCI classifies fifty-five signs and symptoms as the most recurrent, and the SEOM sixteen, of which fifteen coincide with the NCI. The Abeona Health® application has seven AEs, all included in the CTCAE v5. Of these seven, six appear in the NCI lists of most recurrent AEs and four in the SEOM list, all identifiable by the patient. Conclusions: TheAbeona Health® app is considered adequate for the patient participation in their self-care, although somefields could be expanded.(AU)

Dependência do smartphone: relação entre procrastinação, saúde geral e valores humanos / Dependencia del smartphone: relación entre procrastinación, salud general y valores humanos / Smartphone addiction: relationship between procrastination, general health and human values

Esta pesquisa objetivou conhecer o papel preditivo dos valores humanos, da procrastinação e da saúde geral com relação à dependência do smartphone. Contou-se com a participação de 390 pessoas da população geral, com idades variando de 18 a 69 anos (M=27,DP=8,91), sen-do a maioria do sexo feminino (71%). Estes responderam à Escala de Dependência do Smartpho-ne (versão reduzida), Escala de Procrastinação de Tuckman, Questionário de Saúde Geral (QSG-12), Questionário dos Valores Básicos (QVB)e perguntas demográficas. Os resultados indicaram que a dependência do smartphone está positivamente relacionada à procrastinação, resultando em prejuízos à saúde geral, tais como níveis maiores de ansiedade e depressão. Conclui-se que os valores, a procrastinação e os níveis de ansiedade atuam como importantes preditores para o comportamento dependente do smartphone. (AU)

This research aimed to understand the predictive role of human values, procrastination and general health in relation to smartphone dependence. Participated 390 people from the gen-eral, with ages ranging from 18 to 69 years old (M=27, SD=8.91), mostly female (71%). They answered the Smartphone Addiction Scale (SAS, reduced version), Tuckman's Procrastination Scale, General Health Questionnaire (GHQ-12), Basic Values Survey (BVS) and demographic questions. The results indicating that smartphone dependence is positively related to procras-tination, resulting in damage to general health, such as higher levels of anxiety and depres-sion. It was concluded that values, procrastination and anxiety levels were shown to be im-portant predictors for smartphone-dependent behavior. (AU)

Smartphone-Based Screening for Cardiovascular Diseases: A Trend?

Abstract Cardiovascular diseases are the leading cause of death in the world. People living in vulnerable and poor places such as slums, rural areas and remote locations have difficulty in accessing medical care and diagnostic tests. In addition, given the COVID-19 pandemic, we are witnessing an increase in the use of telemedicine and non-invasive tools for monitoring vital signs. These questions motivate us to write this point of view and to describe some of the main innovations used for non-invasive screening of heart diseases. Smartphones are widely used by the population and are perfect tools for screening cardiovascular diseases. They are equipped with camera, flashlight, microphone, processor, and internet connection, which allow optical, electrical, and acoustic analysis of cardiovascular phenomena. Thus, when using signal processing and artificial intelligence approaches, smartphones may have predictive power for cardiovascular diseases. Here we present different smartphone approaches to analyze signals obtained from various methods including photoplethysmography, phonocardiograph, and electrocardiography to estimate heart rate, blood pressure, oxygen saturation (SpO2), heart murmurs and electrical conduction. Our objective is to present innovations in non-invasive diagnostics using the smartphone and to reflect on these trending approaches. These could help to improve health access and the screening of cardiovascular diseases for millions of people, particularly those living in needy areas.

O uso de smartphones como ferramenta de aprendizado por estudantes de Odontologia / The use of smartphones as a learning tool by dental students

As tecnologias podem ser potentes facilitadoras do processo de aprendizagem dos alunos, principalmente nas gerações atuais. Os smartphonessão ferramentas rotineiramente utilizadas a qualquer momento e em qualquer lugar na busca de variadas informações. Assim, a aquisição de conhecimento por meiodeste dispositivo móvel, alinhada com as perspectivas de ensino e resultados esperados para o aprendizado, parece fazer cada vez mais sentido. Neste contexto, este estudo foi proposto com o objetivo de conhecer o perfil do uso de smartphones como ferramenta de aprendizagem ativa e móvel por estudantes de Odontologia. Trata-se de um estudo transversal, realizado por meiode um questionário eletrônico, composto por perguntas objetivas e abertas, as quais avaliaram características sociodemográficas, tipo de aparelho e conexão, usogerale para aprendizado odontológico, bem como aatitude dos alunos em relação ao uso. Do total de estudantes elegíveis ao estudo, 169 alunos responderam ao questionário (taxa de resposta de 49,1%). A maioria dos participantes eram mulheres, com faixa etária de 19 a 21 anos. Todos os estudantes afirmaram ter smartphone, com conexão à internet. Os principais usos descritos foram relacionados à comunicação, gerenciamento de tempo e educação. As vantagens relatadas foram praticidade, flexibilidade de uso, acesso a diferentes conteúdos, capacidade de pesquisar informações e de se comunicar rapidamente. Os desafios identificados incluíram distração e excesso de uso. Os resultados permitiram concluir que os estudantes utilizam os smartphonescomo ferramenta de aprendizagem ativa, principalmente, para acessar e-books, artigos científicos, escutar podcasts,assistir livese visualizar publicações de conteúdos teóricos e práticos no Instagram (AU).

Technologies can be powerful and helpful tools for students' learning process, especially for the current generations. Smartphones are routinely used to search for a wide rangeof information, at anytime and anywhere. Thus, knowledge acquisition through this mobile device, for teaching and learning outcomes, seems to increasingly make more and more sense. Therefore, the aim of thisstudy was to understand the profile of the use of smartphones as an active learning tool by dental students. The data of this cross-sectional study was collected by an electronic questionnaire, with open and closed questions regarding the socio-demographic characteristics, type of device and connection, general use for dentallearning, as well as the students' attitudes towards the use of smartphone for learning. Out of the total number of students eligible for the study, 169 students responded to the questionnaire (response rate of 49.1%). Most participants were women, aged between 19 and 21 years. All students declaredtohave a smartphone, with internet connection. The main uses described were related to communication, time management,and education. The advantages pointed out by the participants were convenience, flexibility of use, access to different contents in different ways, ability to search for information,and rapid communication. The main challenges included distraction and overuse. The results of this study demonstrate that students use smartphones as an active learning tool, mainly to access e-books, scientific articles, to listen to podcasts, watch lives,and view publications of theoretical and practical content on Instagram (AU).

Development, Validation, and Results of a Survey of Personal Electronic Device Use Among 299 Anesthesia Providers From a Single Institution.

BACKGROUND: The pattern of perioperative use of personal electronic devices (PEDs) among anesthesia providers in the United States is unknown. METHODS: We developed a 31-question anonymous survey of perioperative PED use that was sent to 813 anesthesiologists, anesthesiology residents, and certified registered nurse anesthetists at 3 sites within one health system. The electronic survey assessed patterns of PED use inside the operating room (OR), outside the OR, and observed in others. Questions were designed to explore the various purposes for PED use, the potential impact of specific hospital policies or awareness of medicolegal risk on PED use, and whether PED was a source of perioperative distraction. RESULTS: The overall survey response rate was 36.8% (n = 299). With regard to often/frequent PED activity inside the OR, 24% reported texting, 5% reported talking on the phone, and 11% reported browsing on the Internet. With regard to often/frequent PED activity outside the OR, 88% reported texting, 26% reported talking on the phone, and 63% reported browsing the Internet. With regard to often/frequent PED activity observed in others, 52% reported others texting, 14% reported others talking on the phone, and 34% reported others browsing the Internet. Two percent of respondents self-reported a distraction compared to 15% who had observed a distraction in others. Eighty percent of respondents recognized PED as a potential distraction for patient safety. CONCLUSIONS: Our data reinforce that PED use is prevalent among anesthesia providers.

Time spent on the smartphone does not relate to manual dexterity in young adults.

BACKGROUND: The Grooved Pegboard Test (GPT) is widely adopted to evaluate manual dexterity, it presents normative data but the test is influenced by different factors. The influence of time spent on smartphones has not been considered before, for this reason, the objective of this study was to evaluate if smartphone use influences the time to complete the GPT. A total of 38 (21 women; 17 men) young adults 20.7 (1.5) years participated in the study. The time spent on the smartphones during the last seven days was recorded through the device itself and the GPT performance was measured. A correlation analysis between the time spent on the smartphone and GPT was performed while the t-test was adopted to evaluate gender differences. RESULTS: No statistically significant differences were detected between men and women in the time to complete the GPT (p = 0.20) and in the time spent on the smartphone (p = 0.87). The GPT and the time spent using the smartphone were not correlated (r = 0.044, p = 0.78). CONCLUSION: The time spent on the smartphone by young adults does not influence the time to complete the GPT, indicating that smartphone use does not influence measures of manual dexterity.

Using Smartphone-Based Accelerometer Data to Objectively Assess Outcomes in Spine Surgery.

BACKGROUND: In order to deliver optimal patient care, spine surgeons must integrate technological changes to arrive at novel measures of functional outcomes. Historically, subjective patient-reported outcome (PRO) surveys have been used to determine the relative benefit of surgical treatments. Using smartphone-based accelerometers, surgeons now have the ability to arrive at objective outcome metrics. OBJECTIVE: To use Apple Health (Apple Inc, Cupertino, California) data to approximate physical activity levels before and after spinal fusion as an objective outcome measurement. METHODS: Personal activity data were acquired retrospectively from the cellphones of consenting patients. These data were used to measure changes in activity level (daily steps, flights climbed, and distance traveled) before and after patients underwent spine surgery at a single institution by a single surgeon. After data collection, we investigated the demographic information and daily physical activity pre- and postoperatively of participating patients. RESULTS: Twenty-three patients were included in the study. On average, patients first exceeded their daily 1-yr average distance walked, flights climbed, and steps taken at 10.3 ± 14, 7.6 ± 21.1, and 8 ± 9.9 wk, respectively. Mean flights climbed, distance traveled, and steps taken decreased significantly from 6 mo prior to surgery to 2 wk postoperatively. Distance traveled and steps taken significantly increased from 6 mo prior to surgery to 7 to 12 mo postoperatively. CONCLUSION: We demonstrated a valuable supplement to traditional PROs by using smartphone-based activity data. This methodology yields a rich data set that has the potential to augment our understanding of patient recovery.

Association Between Text Neck and Neck Pain in Adults.

STUDY DESIGN: Observational cross-sectional study. OBJECTIVE: The aim of this study was to investigate the association between text neck and neck pain (NP) in adults. SUMMARY OF BACKGROUND DATA: It has been hypothesized that the inappropriate neck posture adopted when texting and reading on a smartphone, called text neck, is related to the increased prevalence of NP. METHODS: The sample was composed of 582 volunteers aged between 18 and 65 years. Sociodemographics, anthropometrics, lifestyle, psychosocial, NP, and smartphone use-related questions were assessed by a self-reported questionnaire. Text neck was assessed by measuring the cervical flexion angle of the participants standing and sitting while typing a text on their smartphones, using the Cervical Range of Motion (CROM) device. RESULTS: Multiple logistic regression analysis and linear regression analysis showed the cervical flexion angle of the standing participant using a smartphone did not associate with the prevalence of NP (odds ratio [OR] = 1.00; 95% confidence interval [CI]: 0.98-1.02; P = 0.66), NP frequency (OR = 1.01; 95% CI: 1.00-1.03; P = 0.056), or maximum NP intensity (beta coefficient = -5.195 × 10-5; 95% CI: -0.02 to 0.02; P = 0.99). Also, the cervical flexion angle of the sitting participant using the smartphone did not associate with NP (OR = 0.99; 95% CI: 0.98-1.01; P = 0.93), NP frequency (OR = 1.01; 95% CI: 0.99-1.02; P = 0.13), or maximum NP intensity (beta coefficient = 0.002; 95% CI: -0.002 to 0.02; P = 0.71). CONCLUSION: Text neck was not associated with prevalence of NP, NP frequency, or maximum NP intensity in adults.Level of Evidence: 4.

Changes in Low Back Muscle Activity and Spine Kinematics in Response to Smartphone Use During Walking.

STUDY DESIGN: Within-subject design of an experimental study. OBJECTIVE: The aim of this study was to determine the effects of smartphone use on the activity level of the lumbar erector spinae muscles and spine kinematics during walking. SUMMARY OF BACKGROUND DATA: Using a smartphone while walking makes the user hold the phone steady and look downward to interact with the phone. Walking with this non-natural posture of the head and the arms may alter the spine kinematics and increase the muscular load on the low back extensor muscles. METHODS: Twenty healthy young individuals participated in the laboratory experiment. Each participant walked on a treadmill in five different conditions: normal walking without using a phone, conducting one-handed browsing while walking, two-handed texting while walking, walking with one arm bound, and walking with both arms bound. Spine kinematics variables and the myoelectric activity levels of the lumbar erector spinae muscles were quantified and compared between the five walking conditions. RESULTS: Participants walked with significantly (P < 0.05) more thoracic kyphosis and lumbar lordosis when using a phone compared to when walking without using the phone. The median level of muscle activity was also 16.5% (browsing) to 31.8% (texting) greater for the two smartphone use conditions than for the normal walking condition, and the differences were significant (P < .05). Between the normal walking and the two bound arm walking conditions, no significant difference in the muscle activity was found. CONCLUSION: Study results show that the concurrent use of a smartphone while walking could pose a larger muscular load to the lumbar erector spinae muscles than that of normal walking. Habitual use of a smartphone while walking could be a risk factor for low back musculoskeletal problems.Level of Evidence: N/A.

Telehealth in the time of Corona: 'doctor in the house'.

The COVID-19 pandemic has led to many physicians working from home whenever possible. Although the concept of 'remote' patient care has been around for decades, present circumstances have provided a grand impetus in that direction with a view to protecting both patient and caregiver. In this article, we discuss some of the various challenges to moving forward with telemedicine, drawing in part on our own experiences in dealing with the COVID-19 pandemic. Clinical, technical, financial and cultural barriers to telemedicine are identified, along with a discussion concerning anticipated benefits. We conclude that the COVID-19 pandemic will likely forever change how healthcare is conducted as telemedicine figures increasingly prominently in the clinical landscape.

Efecto de una Intervención Educativa vía WhatsApp en la Higiene Oral de Pacientes con Ortodoncia / Effect of an Educational Intervention via WhatsApp on the Oral Hygiene of Orthodontic Patients

RESUMEN: La higiene oral en pacientes con ortodoncia fija se encuentra comprometida y las nuevas tecnologías de información podrían convertirse en una herramienta valiosa de educación en salud oral. El objetivo fue determinar el efecto de una intervención educativa vía whatsapp en la higiene oral de pacientes con aparatología de ortodoncia fija. La muestra del estudio estuvo conformada por 46 pacientes (18.65 ± 3.21 años de edad) que iniciaron tratamiento de ortodoncia fija. Se realizó el índice de placa de O´Leary y se aplicó un cuestionario para medir el nivel de conocimiento en higiene oral. Los participantes se dividieron en un grupo experimental y control, mediante asignación aleatoria. Al grupo experimental se le envió una intervención educativa elaborada mediante la herramienta Play Ground Versión 2.0, vía la aplicación para mensajería instantánea WhatsApp Messenger Versión 2.19.153 y al grupo control se brindó las instrucciones de rutina sobre higiene oral. Después de 6 semanas, se evaluó el índice y cuestionario. Para el análisis de datos se utilizó el Coeficiente de Correlación de Concordancia, la prueba de Shapiro Wilk y la prueba T de Student para muestras relacionadas e independientes. Los pacientes del grupo experimental tuvieron diferencias estadísticamente significativas en el control de placa (p = 0.001) y nivel de conocimiento después de la intervención educativa (p = 0.016), a comparación del grupo control. La intervención educativa vía WhatsApp tuvo un efecto positivo en la higiene oral, con respecto al control de placa y al nivel de conocimientos de pacientes con ortodoncia fija.

ABSTRACT: Oral hygiene in patients with fixed orthodontics is compromised and new information technologies could become a valuable tool for oral health education. The objective of the study was to determine the effect of an educational intervention via WhatsApp on the oral hygiene of patients with fixed orthodontic appliances. The study sample consisted of 46 patients (18.65 ± 3.21 years old) who started fixed orthodontic treatment. The O'Leary plaque index was performed and a questionnaire was applied to measure the level of knowledge in oral hygiene. Participants were divided into an experimental and control group, by randomization. The experimental group was sent an educational intervention prepared using the Play Ground Version 2.0 tool, via the WhatsApp Messenger versión 2.19.153 instant messaging application, and the control group was given routine instructions on oral hygiene. After 6 weeks, the index and questionnaire were evaluated. For data analysis, the concordance correlation coefficient, the Shapiro Wilk test and the Student's T test for related and independent samples were used. The patients in the experimental group had statistically significant differences in plaque control (p = 0.001) and level of knowledge after the educational intervention (p = 0.016), compared to the control group. The educational intervention via WhatsApp had a positive effect on oral hygiene, with respect to plaque control and the level of knowledge of patients with fixed orthodontics.

Gerotechnology for Older Adults With Cardiovascular Diseases: JACC State-of-the-Art Review.

The growing population of older adults (age ≥65 years) is expected to lead to higher rates of cardiovascular disease. The expansion of digital health (encompassing telehealth, telemedicine, mobile health, and remote patient monitoring), Internet access, and cellular technologies provides an opportunity to enhance patient care and improve health outcomes-opportunities that are particularly relevant during the current coronavirus disease-2019 pandemic. Insufficient dexterity, visual impairment, and cognitive dysfunction, found commonly in older adults should be taken into consideration in the development and utilization of existing technologies. If not implemented strategically and appropriately, these can lead to inequities propagating digital divides among older adults, across disease severities and socioeconomic distributions. A systematic approach, therefore, is needed to study and implement digital health strategies in older adults. This review will focus on current knowledge of the benefits, barriers, and use of digital health in older adults for cardiovascular disease management.

La oftalmoscopia en la era del teléfono inteligente. Dispositivos actuales y comentarios sobre nuestra breve experiencia / Fundoscopy in the smartphone era. Current devices and comments on our brief experience

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Parental decision-making: infant engagement with smartphones.

Smartphones have become a ubiquitous part of life, and as a result, many children are engaging with smartphones beginning in infancy. Little is known regarding the thought processes used by parents in deciding when and how to allow their infants to engage with smartphones. Using a sample of twelve parents with infants younger than one year, this qualitative study examines parental smartphone use, their perspectives regarding use by their young children, and what sources informed their decision-making about allowing their infants to use a smartphone. Results found that the smartphone has become such a common part of everyday life that choices to use a smartphone around, and with, infants has become one that is nearly automatic. These research data showed that most parents are largely unaware of guidelines for childhood screen time provided by the American Academy of Pediatrics and the World Health Organization. Given our current knowledge that smartphone use can have a significant impact on the cognitive development of young children, this topic is an important area of future research.

Factors associated with smartphone addiction: A comparative study between Japanese and Thai high school students.

BACKGROUND: Smartphone addiction is a growing social problem with adverse health outcomes. There are few comparative studies in Asia that examine factors associated with smartphone addiction. The current study aimed to address this research gap by presenting a comparative analysis of factors associated with smartphone addiction in Japan and Thailand, two countries heterogeneous in both their level of economic development and culture. METHODS: Participant data were collected using two population-based surveys. Participants were high school students in grade 11, aged 16-17 years old, and were selected using quota sampling in Japan in 2014 and random sampling in Thailand in 2016. The outcome of interest was smartphone addiction, measured using a modified version of the Young Diagnostic Questionnaire for Internet Addiction. Multiple logistic regression analysis was performed to determine factors associated with smartphone addiction (gender; nationality; family connectedness; and average time spent on smartphone per day). RESULTS: This study included a total of 7694 students, 6585 students from Japan and 1109 students from Thailand. The prevalence of smartphone addiction was 35.9% among Thai students and 12% among Japanese students. Thai students were more likely to have smartphone addiction than Japanese students (AOR 2.76; 95% CI: 2.37-3.30). Being female was associated with increased odds of smartphone addiction in both Japanese (AOR 1.53; 95% CI: 1.32-1.78) and Thai students (AOR 1.34; 95% CI: 1.01-1.78). The parental connectedness variables "my parents noticed when I was unhappy" (AOR 0.77; 95% CI: 0.62-0.96) and "my parents noticed when I did something good" (AOR 0.78, 95% CI: 0.61-0.99) were associated with lower odds of smartphone addiction among Japanese students. CONCLUSION: Smartphone addiction was more prevalent among Thai adolescents than Japanese adolescents, and more prevalent among females than males in both countries. Interventions for reducing smartphone addiction should take into account both context and gender, and should leverage the protective effect of parental connectedness.

A pilot study using ecological momentary assessment via smartphone application to identify adolescent problematic internet use.

For some youth, pathologic Internet use can cause significant distress and dysfunction, a phenomenon known as Problematic Internet Use (PIU). PIU has been associated with poorer health outcomes in adolescents with existing psychiatric illness but understanding PIU has been challenging due to research methodologies using cross-sectional, self-report data. This study assessed the feasibility of using app-based ecological momentary assessment (EMA) to provide more ecologically-valid data to identify and characterize the relationship between mood symptoms and PIU in adolescents in active mental health treatment. 25 youth (aged 12-23) were recruited to use an EMA app for 6 weeks. 96% of participants completed the study and the majority of participants completed surveys at least once weekly. Youth with anxiety disorders endorsed significantly greater benefit from using the app to monitor PIU. While PIU severity was positively correlated with worsened anxiety and depression, analyses of the temporal relationships between PIU and mood symptoms showed that anxiety symptoms were significantly improved after episodes of PIU. Overall results suggest that app-based EMA may be both acceptable and feasible to understand PIU in this population. Follow-up studies should consider personalization of study protocols and use of digital phenotyping methodology to collect more objective measurements of behavior.

Time to listen: a mixed-method study examining community-based views of mobile technology for interventions to promote physical activity.

INTRODUCTION: A mixed-method, co-design approach to studying the adoption of mobile health (mHealth) technology among African-American (AA) women has not been fully explored. Qualitative data may contextualise existing knowledge surrounding perceptions of mHealth among AA women as part of formative work for designing a physical activity application (app). METHODS: A convenience sample of 16 AA women completed an informatics survey prior to participating in focus groups exploring their use of mobile technology and health apps. Survey responses provided frequency data, while iterative transcript analysis of focus groups identified themes. RESULTS: The majority of participants (mean age=62.1 years, SD=6.6) felt comfortable using a tablet/smartphone (75.0%). Most (68.8%) reported using health-related apps, primarily focused on physical activity and nutrition. Focus groups revealed four overarching concepts, including (1) user attachment, (2) technology adoption, (3) potential facilitators and (4) potential barriers. Important features which may serve as facilitators or barriers to future adoption of a mobile app for an mHealth intervention include individual app tailoring and software concerns, respectively. DISCUSSION: Thematic analysis revealed high user attachment to smartphones and described participants' process for adopting new mHealth technology. CONCLUSION: Early engagement of target end users as a part of a broader co-design and community-based participatory research process for developing mHealth technologies may be useful for sustained adoption of these tools in future mHealth behavioural interventions.

Adolescent development and growing divides in the digital age
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Adolescents are constantly connected to their devices, and concerns have been raised that this connectivity is damaging their development more generally, and their mental health in particular. Recent narrative reviews and meta-analyses do not support a strong linkage between the quantity of adolescents' digital technology engagement and mental health problems. Instead, it appears that offline vulnerabilities tend to mirror and shape online risks in ways that may further amplify mental health inequalities among youth. New approaches for supporting youth mental health, especially for vulnerable youth and those typically excluded from traditional services, are now both possible and required.
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Los adolescentes están constantemente conectados a sus dispositivos, y se ha planteado la preocupación de que esta conectividad puede dañar su desarrollo en general, y su salud mental en particular. Las revisiones narrativas y los metanálisis recientes no establecen una relación estrecha entre el grado de participación de los adolescentes en la tecnología digital y los problemas de salud mental. En cambio, parece que las vulnerabilidades cuando no están conectados tienden a reflejar y dar forma a los riesgos cuando están en línea, de manera que se pueden amplificar aún más las desigualdades de salud mental entre los jóvenes. Actualmente es possible y necesario desarrollar nuevos enfoques para apoyar la salud mental de los jóvenes, especialmente de los más vulnerables y de aquéllos que típicamente son excluidos de los servicios tradicionales.

Le comportement des adolescents constamment connectés à leurs téléphones suscite des inquiétudes quant aux conséquences de cette connectivité sur leur développement en général et leur santé mentale en particulier. Les récentes revues de la littérature et méta-analyses n'établissent pas de lien étroit entre l'importance de l'implication des adolescents dans les technologies numériques et les problèmes de santé mentale. Il semble au contraire que les vulnérabilités hors connexion reflètent et modèlent les risques en ligne, majorant encore les inégalités de santé mentale chez les jeunes. Il est désormais possible et nécessaire d'inventer de nouvelles façons d'aider la santé mentale des jeunes, en particulier celle des plus vulnérables et de ceux qui n'ont généralement plus accès aux réseaux de soutien habituels.

COVID-19 and applications of smartphone technology in the current pandemic.

BACKGROUND: With restrictions on face to face clinical consultations in the COVID-19 pandemic and the challenges faced by health care systems in delivering patient care, alternative information technologies like telemedicine and smartphone are playing a key role. AIMS: We assess the role and applications of smartphone technology as an extension of telemedicine in provide continuity of care to our patients and surveillance during the current COVID-19 pandemic. METHODS: We have done a comprehensive review of the literature using suitable keywords on the search engines of PubMed, SCOPUS, Google Scholar and Research Gate in the first week of May 2020. RESULTS: Through the published literature on this topic, we discuss role, common applications and its support in extended role of telemedicine technology in several aspects of current COVID-19 pandemic. CONCLUSION: Smartphone technology on its own and as extension of telemedicine has significant applications in the current COVID-19 pandemic. As the smartphone technology further evolves with fifth generation cellular network expansion, it is going to play a key role in future of health medicine, patient referral, consultation, ergonomics and many other extended applications of health care.