BACKGROUND: Internet addiction is an emerging mental health issue in this digital age. Nowadays, children start using the internet in early childhood, thus making them vulnerable to addictive use. Previous studies have reported that the risk of internet addiction tends to be higher in lower-income regions with lower quality of life, such as Indonesia. Indonesia has high risks and prevalence of internet addiction, including in children. Digital interventions have been developed as an option to combat internet addiction in children. However, little is known about what parents and therapists in Indonesia perceive about these types of interventions.
OBJECTIVE: This study aims to investigate the experiences, perceptions, and considerations of parents and therapists regarding digital interventions for combating internet addiction in young Indonesian children.
METHODS: This study used a qualitative exploratory approach through semistructured interviews. We involved 22 parents of children aged 7 to 11 years and 6 experienced internet addiction therapists for children. The interview data were transcribed and analyzed using thematic analysis.
RESULTS: Participants in this study recognized 3 existing digital interventions to combat internet addiction: Google Family Link, YouTube Kids, and Apple parental control. They perceived that digital interventions could be beneficial in continuously promoting healthy digital behavior in children and supporting parents in supervision. However, the existing interventions were not highly used due to limitations such as the apps\' functionality and usability, parental capability, parent-child relationships, cultural incompatibility, and data privacy.
CONCLUSIONS: The findings suggest that digital interventions should focus not only on restricting and monitoring screen time but also on suggesting substitutive activities for children, developing children\'s competencies to combat addictive behavior, improving digital literacy in children and parents, and supporting parental decision-making to promote healthy digital behavior in their children. Suggestions for future digital interventions are provided, such as making the existing features more usable and relatable, investigating gamification features to enhance parental motivation and capability in managing their children\'s internet use, providing tailored or personalized content to suit users\' characteristics, and considering the provision of training and information about the use of interventions and privacy agreements.

UNASSIGNED: During the pandemic, health issues associated with using digital devices and exploring social media, such as Computer Vision Syndrome (CVS), have increased considerably.
UNASSIGNED: This study looked into CVS and its significance in Jordan and the CVS outcomes of undergraduate nursing students who used digital devices to surf social media during COVID-19.
UNASSIGNED: To assess CVS, a quantitative cross-sectional research design was used. Data were collected in 2022 through an online diagnostic and formative survey utilizing the CVS-Questionnaire (CVS-Q) with 310 undergraduate nursing students from a government and a private university in Jordan. Descriptive statistics and the univariate general linear model were used to analyze the collected data.
UNASSIGNED: To report the prevalence of CVS among the studied sample, the median score was 1.80. The median prevalence score was 24.50 (range = 13-31), and 26.75% of participants reported having intense social media searches. For a student in this study to be diagnosed with CVS, they must receive a score of at least 5, and the current sample score was around 2, indicating they didn\'t have a CVS; however, it was moderate when it occurred. About 26.75% of participants reported having problematic social media searches. Back and neck pain and headaches were the typical signs of CVS. The average daily hours spent using digital devices for social media searches increased during the pandemic utilizing mobile phones, especially among male nursing students. Being a junior student with no social media account and unable to balance study and social media were among the predictors of CVS. Most students used protective tools on their digital devices, such as protective films and phone screens, to prevent or accommodate CVS.
UNASSIGNED: There were no prior collected data about CVS in Jordan, and based on the international trend, the COVID-19 pandemic didn\'t directly contribute to the prevalence of CVS. However, when the CVS occurred, it was moderate, which mandates proactive and prophylactic redesigning of our educational system.

UNASSIGNED: We aimed to assess the validity and reproducibility of a wearable hydration device in a cohort of maintenance dialysis patients.
UNASSIGNED: We conducted a prospective, single-arm observational study on 20 haemodialysis patients between January and June 2021 in a single centre. A prototype wearable infrared spectroscopy device, termed the Sixty device, was worn on the forearm during dialysis sessions and nocturnally. Bioimpedance measurements were performed 4 times using the body composition monitor (BCM) over 3 weeks. Measurements from the Sixty device were compared with the BCM overhydration index (litres) pre- and post-dialysis and with standard haemodialysis parameters.
UNASSIGNED: 12 out of 20 patients had useable data. Mean age was 52 ± 12.4 years. The overall accuracy for predicting pre-dialysis categories of fluid status using Sixty device was 0.55 [K = 0.00; 95% CI: -0.39-0.42]. The accuracy for the prediction of post-dialysis categories of volume status was low [accuracy = 0.34, K = 0.08; 95% CI: -0.13-0.3]. Sixty outputs at the start and end of dialysis were weakly correlated with pre- and post-dialysis weights (r = 0.27 and r = 0.27, respectively), as well as weight loss during dialysis (r = 0.31), but not ultrafiltration volume (r = 0.12). There was no difference between the change in Sixty readings overnight and the change in Sixty readings during dialysis (mean difference 0.09 ± 1.5 kg), [t(39) = 0.38, p = 0.71].
UNASSIGNED: A prototype wearable infrared spectroscopy device was unable to accurately assess changes in fluid status during or between dialysis sessions. In the future, hardware development and advances in photonics may enable the tracking of interdialytic fluid status.

BACKGROUND: Telemedicine requires either the use of digital tools or a minimum technological knowledge of the patients. Digital health literacy may influence the use of telemedicine in most patients, particularly those with frailty. We aimed to explore the association between frailty, the use of digital tools, and patients\' digital health literacy.
METHODS: We prospectively enrolled patients referred to arrhythmia outpatient clinics of our cardiology department from March to September 2022. Patients were divided according to frailty status as defined by the Edmonton Frail Scale (EFS) into robust, pre-frail, and frail. The degree of digital health literacy was assessed through the Digital Health Literacy Instrument (DHLI), which explores seven digital skill categories measured by 21 self-report questions.
RESULTS: A total of 300 patients were enrolled (36.3% females, median age 75 (66-84)) and stratified according to frailty status as robust (EFS ≤ 5; 70.7%), pre-frail (EFS 6-7; 15.7%), and frail (EFS ≥ 8; 13.7%). Frail and pre-frail patients used digital tools less frequently and accessed the Internet less frequently compared to robust patients. In the logistic regression analysis, frail patients were significantly associated with the non-use of the Internet (adjusted odds ratio 2.58, 95% CI 1.92-5.61) compared to robust and pre-frail patients. Digital health literacy decreased as the level of frailty increased in all the digital domains examined.
CONCLUSIONS: Frail patients are characterized by lower use of digital tools compared to robust patients, even though these patients would benefit the most from telemedicine. Digital skills were strongly influenced by frailty.

To determine the association between poor visual acuity, the use of digital devices and physical activity (PA) during the COVID-19 pandemic.
A total of 327,646 Chinese children and adolescents were included in the analysis using a cluster random sampling method; this is a case-control study, of those 144,708 children and adolescents with poor visual acuity were included in the case group, while 182,938 who did not have poor visual acuity were included in the control group. A logistic regression model was used to assess the contribution of PA and the use of digital devices to poor visual acuity.
A total of 144,708 children and adolescents experienced poor visual acuity during the COVID-19 pandemic; 54.8% were male, and 55.2% live in rural areas. Compared to controls, children and adolescents with poor visual acuity exhibited more time for the use of digital devices (4.51 ± 2.44 vs. 3.79 ± 2.34 for cases and controls, respectively; P < 0.001) and PA (3.07 ± 0.92 vs. 2.85 ± 1.00 for cases and controls, respectively; P < 0.001). During the COVID-19 pandemic, risk factors related to poor visual acuity among children and adolescents included the use of digital devices (OR 1.135; 95% CI 1.132-1.139), and PA (OR 1.269; 95%CI 1.259-1.278). The results of interaction analysis show that for children and adolescents aged 12 to 17, the positive association between the use of digital devices and poor visual acuity decreased. The interaction effect between PA and digital devices is 0.987.
Children and adolescents were at risk of poor visual acuity during the COVID-19 pandemic. Extended use of the digital devices increased the risk of poor visual acuity, especially for children aged 6-11 years. But the risk of poor visual acuity among children and adolescents decreases as the time spent on PA increases.

As digital technology and online activities have become more widely accessible over the past few years, information and communication technology have grown in importance in all students\' lives. Most of them routinely use digital devices for a range of activities, primarily for online learning, activities, assignments, conversing, and Internet browsing. This study elucidated the relationship between neck and low back pain intensity and the use of digital devices among Saudi nursing students. A cross-sectional descriptive exploratory research design was applied using a convenience sample of 120 nursing students enrolled in an undergraduate nursing program at a Saudi government university located in Riyadh, the capital city of Saudi Arabia. A valid and reliable self-administered survey was employed. Data about sociodemographic characteristics, the Neck Disability Index and the Roland-Morris Disability Questionnaire were collected. The participants reported 9.1 ± 4.6 study hours on average per week. A total of 82.5% of them do not receive enough exercise, and 87.5% indicated daily use of digital devices. Around half (54.2%) of participants reported having neck pain of a mild intensity. About 60% of the participants regularly shift positions to rest their backs, 39.2% are only able to stand for limited periods due to back issues, and 39.2% expressed concern for others about what might happen to their health. Although there was an association between neck pain intensity and the age or gender of all research participants, there was a significant association between neck pain severity and marital status (χ2 = 15.226, p = 0.019). Our findings suggest that nursing students should maintain neutral neck and back postures on a regular basis to reduce pain, which could be attributed to extensive reading on digital devices.

The increased use of digital devices has implications for health and, particularly, the eyes, due to Computer Vision Syndrome (CVS). Millions of individuals of all ages are at risk of CVS, and its prevalence ranges from 25% to 93%. This trial will evaluate the effectiveness of the Super Enhanced Single Vision Lens 01 (SESL01) versus standard single vision lens in reducing symptoms of CVS assessed by the Computer Vision Syndrome Questionnaire (CVS-Q®) scores.
A double-blind, two-arm parallel randomized controlled trial will be conducted at the University of Central Lancashire, Preston (UK), recruiting students and staff with CVS-Q score ≥ 6. A 1:1 randomization and a sample size of 300 participants will be sufficient to detect a 2-point difference in the CVS-Q score between the intervention and control groups with an alpha of 5%, two-sided, allowing for a dropout of 10%. The control group will use standard single vision lenses, and the intervention group SESL01. The primary outcome to week 14 will be the difference in the CVS-Q score between SESL01 and standard single vision lenses. Secondary outcomes include the percentage of participants with CVS-Q score < 6 (no symptoms) and CVS-Q score ≥ 6 (symptoms) in the SESL01 and the standard single vision group at weeks 6, 10 and 14; the percentage of participants in each group with a total CVS-Q score < 6, 6-12, 13-19, and ≥ 20 at weeks 6, 10 and 14. The primary analysis will be the intention to treat.
Findings may inform decisions about adopting the SESL01 lenses to reduce CVS.
clinicaltrial.gov identifier: NCT05545878. Registered: Sept. 19, 2022.

BACKGROUND: Childhood obesity remains one of the most significant challenges in public health globally.
OBJECTIVE: The aim of this study was to assess the association between home food availability, parenting practices, health beliefs, screen time, and childhood overweight/obesity.
METHODS: This was a cross-sectional analysis of 12 041 parent-child dyads from six European countries. Details on the home food environment, parenting practices, health beliefs, and digital devices were collected by questionnaires.
RESULTS: Permissive parenting or rewarding children with screen time at a frequency of rarely/never and parents disagreeing with the statement \"I believe that people have little power to prevent disease\" were negatively associated with childhood overweight/obesity; whereas being \"physically active with my child\" rarely/never was positively associated. Regarding the home environment, the availability of fruit rarely/never was positively associated with childhood overweight/obesity, whereas the absence of digital devices in the child\'s room was negatively associated.
CONCLUSIONS: Findings from the present study suggested that future school- and community-based initiatives in Europe that aim to prevent childhood obesity should also target the home environment, parenting beliefs, and practices. Programs designed to educate, facilitate, and support parents to adopt a healthy and active lifestyle with their children would empower parents to be agents of good role models and are probably the most efficient ways forward to tackle the childhood obesity epidemic. Future longitudinal intervention studies are needed to confirm the long-term efficacy of positive parenting in reducing childhood overweight/obesity.

BACKGROUND: In recent years, the use of digital mobile measurement devices (DMMDs) for self-documentation in cardiovascular care in Western industrialized health care systems has increased. For patients with chronic heart failure (cHF), digital self-documentation plays an increasingly important role in self-management. Data from DMMDs can also be integrated into telemonitoring programs or data-intensive medical research to collect and evaluate patient-reported outcome measures through data sharing. However, the implementation of data-intensive devices and data sharing poses several challenges for doctors and patients as well as for the ethical governance of data-driven medical research.
OBJECTIVE: This study aims to explore the potential and challenges of digital device data in cardiology research from patients\' perspectives. Leading research questions of the study concerned the attitudes of patients with cHF toward health-related data collected in the use of digital devices for self-documentation as well as sharing these data and consenting to data sharing for research purposes.
METHODS: A cross-sectional survey of patients of a research in cardiology was conducted at a German university medical center (N=159) in 2020 (March to July). Eligible participants were German-speaking adult patients with cHF at that center. A pen-and-pencil questionnaire was sent by mail.
RESULTS: Most participants (77/105, 73.3%) approved digital documentation, as they expected the device data to help them observe their body and its functions more objectively. Digital device data were believed to provide cognitive support, both for patients\' self-assessment and doctors\' evaluation of their patients\' current health condition. Interestingly, positive attitudes toward DMMD data providing cognitive support were, in particular, voiced by older patients aged >65 years. However, approximately half of the participants (56/105, 53.3%) also reported difficulty in dealing with self-documented data that lay outside the optimal medical target range. Furthermore, our findings revealed preferences for the self-management of DMMD data disclosed for data-intensive medical research among German patients with cHF, which are best implemented with a dynamic consent model.
CONCLUSIONS: Our findings provide potentially valuable insights for introducing DMMD in cardiovascular research in the German context. They have several practical implications, such as a high divergence in attitudes among patients with cHF toward different data-receiving organizations as well as a large variance in preferences for the modes of receiving information included in the consenting procedure for data sharing for research. We suggest addressing patients\' multiple views on consenting and data sharing in institutional normative governance frameworks for data-intensive medical research.

BACKGROUND: Coronavirus (COVID-19) pandemic has caused social and economic damages. People have adapted to a new reality of physical distance.
OBJECTIVE: The study aimed to assess the use of digital devices and social media, focusing on psychosocial and demographic factors of people´s sexual behavior during the pandemic.
METHODS: A total of 1,357 Brazilian adults participated in a cross-sectional online survey. They were recruited through social media to obtain information regarding sexual behavior and the use of digital devices and social media.
RESULTS: Digital devices and social media were used by 38.8% of the participants. Among the group that used technological devices, most claimed to have changed their sexual behavior, with 76.9% consuming more sexual content through movies or series.
CONCLUSIONS: In a smaller group, technological resources appeared as an alternative for safer sex, reducing the risks of COVID-19 transmission.