Minding the gap: The moderating role of education between subjective health and social life perception and Internet use time

Introduction: Internet addiction results in intense and frequent use. There is a gap in the literature in relation to the unawareness of problematic Internet use (PIU) in predicting Internet use time (IUT). Objective: To identify sociodemographic/psychological variables contributing and moderating IUT. Participants: 1,270 participants of the European Social Survey (EES), Round 8. Instruments: EES variables assessing Internet use (IU), health perception, well-being, social life, and sociodemographic variables, underlying the construct. Results: Age, education, sources of household income, social activities compared to others of the same age and subjective general health explain IU per day; and age, years of education, domicile and socially meeting with other people with whom to discuss intimate matters explain IU per week. Education was found to be a significant moderator in the relationship between subjective general health and IU per week; and in the relationship between socially meeting with other people and IU per day. Discussion: Maladaptive IU, when the perception of health is worse, and adaptive IU, when the perception of social life is better, are both suggested, depending on education. Conclusions: These findings point to the need to study IUT involving educational level, keeping in mind that what may be PIU at one educational level may not be the case at another.

Introdução: O vício da Internet traduz-se numa utilização intensa e frequente. Existe uma lacuna na literatura sobre o desconhecimento dos preditores do uso problemático da Internet (PIU) do tempo de utilização da Internet (IUT). Objetivo: Identificar as variáveis sociodemográficas/psicológicas que contribuem e moderam o IUT. Participantes: 1270 participantes da European Social Survey (EES), Round 8. Instrumentos: Variáveis ESS que avaliam a utilização da Internet (IU), perceção de saúde, bem-estar, vida social e variáveis sociodemográficas, sub jacentes ao construto. Resultados: Idade, escolaridade, fontes de renda familiar, atividades sociais em comparação com outras da mesma idade e saúde geral subjetiva explicam IU por dia e idade, anos de escolaridade, domicílio, convívio social com outras pessoas e quem para discutir assuntos íntimos explicam IU por semana. A escolaridade mostrou-se um moderador significativo na relação entre saúde geral subjetiva e IU por semana; e na relação entre encontro social com outras pessoas e IU por dia. Discussão: IU desadaptativa, quando a perceção de saúde é pior, e IU adaptativa, quando a perceção de vida social é melhor, dependem da escolaridade. Conclusões: Os resultados sugerem o estudo do IUT de acordo com o nível educacional, pois o que pode ser um PIU num nível educacional pode não ser noutro.

Factores tecnológicos-educativos asociados a problemas fisioergonómicos en estudiantes de medicina

Introducción: Existe evidencia sobre el efecto negativo del uso de tecnologías de información y comunicación en estudiantes, sin embargo, poco se conoce sobre problemas fisioergonómicos secundarios a su uso. Objetivo: Identificar los factores tecnológicos-educativos asociados al reporte de 4 problemas fisioergonómicos en estudiantes de medicina. Métodos: Estudio transversal en estudiantes de medicina de 11 países de Latinoamérica y el Caribe. Se utilizó un cuestionario cuyas variables fueron las características socio-educativas y tecnológicas, así como los problemas fisioergonómicos (dolor de cuello, dolor de espalda, ojo seco/rojo y dolor de cabeza). Resultados: De 11 587 estudiantes, 14,5 % reportó presentar 4 problemas fisioergonómicos. La mayoría reportó dolor de cuello (50 %), dolor de espalda (50,5 %) y dolor de cabeza (53,7 %). Tuvieron mayor frecuencia de presentar estos problemas fisioergonómicos las mujeres (RP= 1,06), quienes estudiaron una carrera previa (RP= 1,19), pertenecer a todos los años de estudios (RP= 1,12-1,20), quienes tenían mayor uso de Internet en horas (RP= 1,01) y aquellos que accedían a Twitter en horas de clases (RP= 1,30). La frecuencia de presentar estos problemas disminuyó en quienes tenían menor edad en años (RP= 0,99), procedían de una universidad privada (RP= 0,81), y quienes pertenecían a cualquier grupo extracurricular (RP= 0,67-0,93). Conclusiones: Los factores tecnológicos-educativos asociados al reporte de 4 problemas fisioergonómicos en estudiantes de medicina son ser mujer, tener carrera previa, pertenecer a todos los años de estudios, horas de uso de internet y el acceso a Twitter durante clases.

Introduction: There is evidence on the negative effect of the use of information and communication technologies on students, however, little is known about physio-ergonomic problems secondary to their use. Objective: To identify the technological-educational factors associated with the report of 4 physio-ergonomic problems in medical students. Methods: Cross-sectional study in medical students from 11 countries in Latin America and the Caribbean. A questionnaire was used whose variables were socio-educational and technological characteristics, as well as physio-ergonomic problems (neck pain, back pain, dry/red eye and headache). Results: Of 11 587 students, 14.5% reported presenting 4 physio-ergonomic problems. Most reported neck pain (50%), back pain (50.5%), and headache (53.7%). Women (PR= 1.06), who studied a previous degree (PR= 1.19), who belonged to all years of studies (PR= 1.12-1.20), who had greater use of the Internet, had a higher frequency (in hours) of presenting these physio-ergonomic problems (PR= 1.01) and those who accessed Twitter during school hours (PR= 1.30). They decreased the frequency of presenting these problems, being younger in years (PR= 0.99), coming from a private university (PR= 0.81), and who belonged to any extracurricular group (PR= 0.67-0.93). Conclusions: The technological-educational factors associated with the report of 4 physio-ergonomic problems in medical students were being a woman, having a previous degree, belonging to all the years of study, hours of Internet use and access to Twitter during classes.

Transtorno de uso de internet entre graduandos de Medicina no primeiro ano da pandemia de Covid-19 / Internet addiction disorder among medicine students in the first year of the covid-19 pandemic

Resumo: Introdução: Apesar das facilidades proporcionadas pela internet, seu uso inadequado e excessivo pode gerar Transtorno de Uso de Internet, principalmente entre os universitários que a utilizam para entretenimento, comunicação e atividades acadêmicas, como ocorreu durante a pandemia de Covid-19, quando o ensino ficou on-line. Esse transtorno culmina em prejuízos, como a redução no desempenho estudantil e a exacerbação ou o aparecimento de doenças psiquiátricas. Objetivo: Este estudo teve como objetivo avaliar a presença do transtorno de uso de internet entre estudantes de Medicina em universidades do estado de Alagoas, Brasil. Método: Trata-se de um estudo quantitativo, transversal e analítico realizado com estudantes de Medicina de duas instituições de ensino superior do estado de Alagoas durante o primeiro ano de pandemia de Covid-19. A coleta foi feita por um instrumento on-line com uma avaliação sociodemográfica, o Teste de Dependência de Internet e as variáveis sexo, idade, período, cidade de origem e coeficiente acadêmico de rendimento. Os dados foram analisados nos programas SPSS 24 e JASP 0.14. Resultado: Participaram da pesquisa 325 estudantes, dos quais 97,2% afirmaram ter aumentado o consumo da internet durante o período da pandemia. A média de pontuação no teste foi de 32,5, no qual 80,6% apresentaram algum grau de transtorno de uso de internet, sendo 66,8% leve e 13,8% moderado. Constatou-se maior prevalência da dependência no sexo masculino, com achado entre eles de criar novas amizades pela internet, de ocultar revelar o que faz on-line e gastar mais tempo que o planejado navegando. Houve maior gravidade de compulsão nos estudantes de classes sociais mais baixas, em períodos iniciais do curso, provenientes de instituição pública, oriundos de cidades com até 50 mil habitantes e nos imigrantes. Houve uma relação negativa significativa entre menor coeficiente do último período cursado e maior nota no teste (Pearson -0,121, valor de p: 0,045). Conclusão: Os dados apontaram que os estudantes de Medicina estão propensos a desenvolver transtorno de uso de internet e que houve maior gravidade entre o sexo masculino, em classes sociais mais baixas, nos períodos iniciais do curso, nos procedentes de instituição pública, de cidades com até 50 mil habitantes e nos imigrantes. A presença do transtorno foi inversamente proporcional à performance acadêmica.

Abstract: Introduction: Although the internet provides various facilities, its inadequate and excessive use can cause Internet Addiction Disorder, especially among university students, who browse the web for entertainment, communication and academic activities, and even more so during the COVID-19 pandemic, when education switched to online. This disorder results in several detrimental consequences such as diminished student performance and aggravation or triggering of other psychiatric conditions. Objective: To evaluate the presence of Internet Addiction Disorder in medical students at the state of Alagoas, Brazil. Methods: Quantitative, cross-sectional and analytic study conducted among medical students from two universities in the state of Alagoas during the first year of the COVID-19 pandemic. The data was gathered through an online form with a social-demographic questionnaire, the Internet Addiction Test, and variables (sex, age, semester of study, city of birth, grade point average). The data was analysed in the SPSS 24 and JASP 0.14 programs. Results: The survey was applied to 325 students, 97.2% of whom affirmed to have increased their internet usage during the pandemic. The average score in the Internet Addiction Test was 32.5, with 80.6% displaying some degree of disorder, 66.8% a mild dependence, and 13.8% moderate dependence. A higher prevalence of the disorder was found among males, who were also shown to be more used to making new friendships through the internet, to hide what they are doing online, and to spend more time logged in than planned. The compulsion was more severe in lower social classes, initial semester and those who came from public university, cities with a population of less than 50.000, and immigrants. There was a negative correlation between lower final semester grades and higher grades in the Internet Addiction Test (Pearson -0,121, p-value: 0,045). Conclusions: The data of this study point to a major possibility of medical students developing Internet Addiction Disorder, with more severe dependence among those who are males, from lower social classes, in earlier periods of study, students from public universities, from cities with a population of less than 50.000 inhabitants and immigrants. The presence of Internet Addiction Disorder was inversely proportional to academic performance.

"Vá para casa, seu idoso!" Ageísmo na pandemia da covid-19: netnografia na plataforma Youtube™ / "Go home, old man!" Ageism in the covid-19 pandemic: netnography on the Youtube™ platform

Resumo Objetivo Analisar as repercussões do ageísmo direcionado a pessoas idosas durante a covid-19, por meio dos conteúdos disponíveis na plataforma Youtube™. Método Estudo netnográfico, exploratório e qualitativo, cujos dados foram coletados em vídeos na plataforma Youtube™; foi realizada análise temática de conteúdo de Bardin e os elementos foram discutidos à luz da Teoria do Estigma. Resultados Três categorias explicam as repercussões do fenômeno investigado: expressões do ageísmo pré-existentes à pandemia, com expressões de exclusão, desconsideração e desrespeito; expressões de ageísmo durante a pandemia a partir do rótulo de grupo de risco que fortalece os estereótipos de doentes e incapazes; e sentimentos e atitudes da pessoa idosa frente às repercussões do ageísmo, que levaram a repercussões nas interações sociais, no estilo de vida e na saúde das pessoas idosas. Conclusões As repercussões podem ocasionar sequelas de ordem física, cognitiva, social e psíquica, e o combate aos seus impactos parte da esfera educativa para um pacto social que permita uma convivência respeitosa e empática entre as gerações.

Abstract Objective To analyze the repercussions of ageism directed at older people during covid-19, through the content available on the Youtube™ platform. Method Netnographic, exploratory and qualitative study, whose data were collected in videos on the Youtube™ platform; a thematic analysis of Bardin's content was performed and the elements were discussed in the light of the Theory of Stigma. Results Three categories explain the repercussions of the investigated phenomenon: expressions of ageism pre-existing to the pandemic, with expressions of exclusion, disregard and disrespect; expressions of ageism during the pandemic from the risk group label that strengthens stereotypes of sick and incapable people; and feelings and attitudes of the older people towards the repercussions of ageism, which led to repercussions on social interactions, lifestyle and health of older people. Conclusions The repercussions can cause physical, cognitive, social and psychic sequelae, and the fight against its impacts starts from the educational sphere towards a social pact that allows a respectful and empathetic coexistence between generations.

O uso excessivo da Internet na saúde mental de estudantes universitários de enfermagem / Excessive use of the Internet on the mental health of nursing university students

O uso da internet cresce em 4% até 2023 e tornou-se uma ferramenta fundamental em nossa vida cotidiana, no entanto, seu uso excessivo pode contribuir para problemas de saúde mental, como ansiedade, depressão e esgotamento, especialmente em estudantes universitários de saúde. Este estudo teve como objetivo determinar o risco de ansiedade e esgotamento devido ao uso excessivo da internet em estudantes universitários do curso de enfermagem. A pesquisa teve uma abordagem quantitativa não experimental, com um design explicativo. O estudo contou com a participação de 337 estudantes de enfermagem da Universidad Privada San Carlos SAC de Puno, com uma idade média de 30,35 ± 9,274 anos; 15,70% (n=53) eram homens e 84,30% (n=284) eram mulheres. Os estudantes que usaram a Internet excessivamente por mais de quatro horas por dia tiveram um risco 3,160 vezes maior de desenvolver ansiedade (IC 95%: 1,519-6,577); 1,704 vezes maior de desenvolver esgotamento emocional (IC 95%: 0,925-3,215); 1,786 vezes maior de desenvolver distúrbios de despersonalização (IC 95%: 0,931-3,413) e 2,101 vezes maior de desenvolver a falta de realização pessoal em comparação com os estudantes que usam a internet por menos de três horas diárias. Os níveis de ansiedade estão positivamente associados ao esgotamento emocional (rho=0,765; p<0.001); despersonalização (rho=0,744; p<0.001); falta de realização pessoal (rho=0,631; p<0.001), o que indica que o uso excessivo da internet por estudantes universitários teve efeitos negativos prejudiciais para a saúde mental.

Internet use has grown by 4% by 2023 and has become a fundamental tool in our everyday lives, however, its excessive use can contribute to mental health problems such as anxiety, depression and burnout, especially in university health students. This study aimed to determine the risk of anxiety and burnout due to excessive internet use in university nursing students. The research had a non-experimental quantitative approach, with an explanatory design. The study had the participation of 337 nursing students from the Universidad Privada San Carlos SAC de Puno, with an average age of 30.35 ± 9.274 years; 15.70% (n=53) were men and 84.30% (n=284) were women. Students who used the internet excessively for more than four hours a day had a 3.160 times greater risk of developing anxiety (95% CI: 1.519-6.577); 1.704 times more likely to develop emotional exhaustion (95% CI: 0.925-3.215); 1.786 times more likely to develop depersonalization disorders (95% CI: 0.931-3.413) and 2.101 times more likely to develop a lack of personal fulfillment compared to students who use the internet for less than three hours a day. Anxiety levels are positively associated with emotional exhaustion (rho=0.765; p<0.001); depersonalization (rho=0.744; p<0.001); lack of personal fulfillment (rho=0.631; p<0.001), which indicates that excessive internet use by university students had harmful negative effects on mental health.

Ferramentas tecnológicas utilizadas para a melhoria da saúde física e mental da população: uma revisão sistemática / Technological tools used to improve the physical and mental health of the population: a systematic review / Herramientas tecnológicas utilizadas para mejorar la sa- lud física y mental de la población: una revisión sistemática

Os recursos tecnológicos podem ser eficazes na atenuação e tratamento de diversas doenças. O objetivo deste estudo é demonstrar ferramentas tecnológicas utilizadas para a melhoria da saúde física e mental da população, a fim de orientar futuras intervenções com esta população. A busca foi realizada nas bases de dados eletrônicas LILACS, MEDLINE, PEDro, SciELO e Science Direct. Como critério de inclusão, adotou-se a estratégia PICO(s). A busca resultou em 76 artigos, e após todas as etapas de seleção, cinco atenderam os requisitos para esta revisão. Todos os trabalhos selecionados propõem intervenção por meio de ferramentas tecnológicas disponíveis, sendo que em três estudos foi necessário o uso de celular para acessar aplicativos, como: COPe, BePrepared e SMART Eating. Foram investigadas diversas adaptações relacionadas ao sistema tecnológico utilizado em hospitais ou centros de saúde, cujo objetivo era analisar o bem-estar mental, a capacidade física, a usabilidade de aplicativos, o consumo de álcool e a qualidade alimentar. Sendo assim, o levantamento de informações indica que o uso da tecnologia é benéfico aos usuários dos sistemas de saúde.

Technological resources can be effective in mitigating and treating various diseases. The objective of this study is to demonstrate technological tools used to improve the physical and mental health of the population, in order to guide future interventions with this population. The search was carried out in LILACS, MEDLINE, PEDro, SciELO and Science Direct electronic databases. As an inclusion criterion, the PICO (s) strategy was adopted. The search resulted in 76 articles, and after all the selection steps, five met the requirements for this review. All works selected intervention proposal through avai- lable technological tools, and in three studies it was necessary to use a cell phone to access apps, such as: COPe, BePrepared and SMART Eating. Several adaptations related to the technological system used in hospitals or health centers were investigated, whose objec- tive was to analyze mental well-being, physical capacity, apps usability, alcohol con- sumption and food quality. Therefore, the survey of information indicates that the use of technology is beneficial to users of health systems.

Los recursos tecnológicos pueden ser eficaces para mitigar y tratar diversas enfermedades. El objetivo de este estudio es demostrar las herramientas tecnológicas uti- lizadas para mejorar la salud física y mental de la población, con el fin de orientar futuras inter-venciones con esta población. La búsqueda se realizó en las bases de datos electró- nicas LILACS, MEDLINE, PE-Dro, SciELO y Science Direct. Como criterio de inclu- sión, se adoptó la estrategia PI-CO (s). La búsqueda resultó en 76 artículos, y después de todos los pasos de selección, cinco cumplieron los requisitos para esta revisión. Todos los trabajos seleccionaron la propuesta de intervención a través de herramientas tecnológicas disponibles, y en tres estudios fue necesario el uso de un teléfono móvil para acceder a apps, como: COPe, BePrepared y SMART Eating. Se investigaron varias adaptaciones relacionadas con el sistema tecnológico utilizado en hospitales o centros de salud, cuyo objetivo era analizar el bienestar mental, la capacidad física, la usabilidad de las apps, el consumo de alcohol y la calidad de los alimentos. Por lo tanto, el estudio de la informa- ción indica que el uso de la tecnología es beneficioso para los usuarios de los sistemas de salud.

YouTubeTM as a Tool to Teach Dentists about Molar Incisor Hypomineralization (MIH): Analysis of Quality Content

ABSTRACT Objective: To evaluate the quality of information about Molar incisor Hypomineralization (MIH) on YouTubeTM. Material and Methods: Only videos in Portuguese aimed at dentists were included. The selected videos were analyzed by two calibrated evaluators, who extracted the information (classification, etiology, diagnosis, and treatment of MIH) and the quality was evaluated through a 20-point-checklist, according to the International Association of Pediatric Dentistry and European Academy of Pediatric Dentistry. Descriptive analysis and statistical tests were applied to assess the association (ANOVA and Kruskal-Wallis) or correlation (Spearman) between the final scores of the videos and their demographics. Results: Nineteen videos with 13.8±4.76 mean points were considered eligible. Most of the videos did not report the possible involvement of other groups of teeth (n=12), presence of atypical restorations (n=8) and hypersensitivity (n=7); and the different treatments for MIH were very variable. Twelve videos discussed differential diagnosis and 78.95% possible etiological factors; however, all of them presented clinical images. Data related to the video source and viewer interaction were not related to its quality (p>0.05). The number of likes (r=0.26), views (r=0.34) and video time (=0.58) show a weak and moderate correlation, respectively, with video score. Conclusion: Videos on YouTubeTM about MIH presented moderate or high quality, with heterogeneous information, and can act as a complementary aid source of information.

Toothpaste-related interests of Google users from different countries

Abstract The Internet is a growing source of knowledge and can provide information about oral health. This ecological study aimed to characterize the interests in toothpaste among Google users from different countries. Our hypothesis was that there would be an increase in Google users' interest in information about toothpaste. This retrospective longitudinal ecological study analyzed the toothpaste-related interest of Google users from 10 countries between January 2004 and December 2020. The monthly variation in relative search volume (RSV) and the main related queries were determined using Google Trends. Autoregressive integrated moving average (ARIMA) forecasting models were built to establish the predictive RSV values for toothpaste for an additional 12 months. Autocorrelation plots and the generalized additive model (GAM) were used to diagnose trends and seasonality in RSV curves. Additionally, the influence of social isolation related to the outbreak of COVID-19 was analyzed. Although not detected by autocorrelation function (ACF) and partial autocorrelation function (PACF) analyses, the heuristic analysis showed an increase in the interest in toothpaste-related information in all countries, with a stable trend observed in the 12-month forecasts, except for the increases in the United Kingdom and South Africa. Also, GAM analyses demonstrated a non-significant monthly or quarterly seasonal influence on data. In addition, social isolation during the COVID-19 pandemic did not influence the online information-seeking behavior of Google Search users linked to this topic. We confirmed the hypothesis that the interest of Google Search users in information about toothpaste increased in all of the 10 assessed countries.

Administração de medicamentos por via intramuscular: caracterização dos vídeos brasileiros veiculados no YouTube® / Intramuscular drug administration: characterization of Brazilian videos on YouTube®

RESUMO Objetivo caracterizar os vídeos que contém a demonstração do procedimento de administração de medicamentos por via intramuscular em indivíduos adultos. Métodos estudo de corte transversal descritivo, foram selecionados 44 vídeos brasileiros disponíveis no YouTube® que abordavam o procedimento de administração de medicamentos por via intramuscular. Resultados a maioria dos vídeos selecionados é de origem pessoal (86,4%), tem como autor um técnico de Enfermagem (59,1%), adota a região dorsoglútea como local de injeção (54,5%), foi produzido em ambiente de saúde utilizando um paciente para a demonstração do procedimento (52,3%). Nenhum vídeo apresentou a completude do procedimento, sendo identificada grande frequência de erros em todas as etapas do procedimento. Observou-se uma diferença estatisticamente significante entre os testes de confiabilidade e popularidade dos vídeos (p=0,042). Conclusão os vídeos que abordam o procedimento de administração de medicamentos por via intramuscular disponíveis na plataforma YouTube® foram considerados atuais, de pouca relevância, elaborados por fontes não confiáveis, de baixa acurácia e frágil finalidade. Contribuições para a prática os vídeos disponíveis na plataforma YouTube® sobre a administração de medicamentos por via intramuscular não devem ser indicados como material educativo para a formação ou atualização profissional.

ABSTRACT Objective to characterize videos that contain a demonstration of the procedure for administering drugs intramuscularly to adults. Methods a descriptive cross-sectional study, 44 Brazilian videos available on YouTube® were selected which addressed the procedure of intramuscular drug administration. Results the majority of the videos selected are of personal origin (86.4%), were made by a Nursing technician (59.1%), used the dorsal gluteal region as the injection spot (54.5%), and were produced in a healthcare environment using a patient to demonstrate the procedure (52.3%). No video showed the completeness of the procedure, and a high frequency of errors was identified at all stages of the procedure. There was a statistically significant difference between the reliability and popularity tests of the videos (p=0.042). Conclusion the videos on intramuscular drug administration available on the YouTube® platform were considered to be up-to-date, of little relevance, produced by unreliable sources, of low accuracy, and with a weak purpose. Contributions to practice the videos available on the YouTube® platform on intramuscular drug administration should not be used as educational material for professional training or updating.

Testing the efficacy of group cognitive-behavioral therapy for pathological internet use among undergraduates in Nigeria

Abstract Introduction The aim of this study was to examine the effect of group cognitive-behavioral therapy (GCBT) on pathological internet use (PIU). Method The study applied a group randomized controlled trial design to assign participants to intervention and control groups. A total of 40 college students aged 18 to 30 who were pathological internet users (PIUs) participated in this study and were randomly assigned to treatment and control groups. Participants completed a self-report scale entitled the Problematic Internet Use Scale (PIUS) at three time points. The intervention lasted 8 weeks. The data collected were statistically analyzed using repeated-measures analysis of variance (ANOVA). Results The results showed that GCBT has significant efficacy, decreasing the symptoms of PIU among the GCBT participants compared to those in the control group and that the improvements were maintained at follow-up. We also found a significant interaction effect by time for PIU. Conclusion From the study findings, we can conclude that GCBT has significant benefit for mitigating the severity of PIU in college students. Therefore, mental health professionals are encouraged to explore the benefits of GCBT in treating symptoms associated with PIU in school settings and beyond.

Uso de internet y su relación con depresión, insomnio y autoestima en estudiantes de bachillerato, Quito (Ecuador) / Internet use and its relationship with depression, insomnia and self-esteem in high school students, Quito (Ecuador)

El internet ha revolucionado la vida de las personas, ha trasformado las relaciones familiares, personales, laborales y sociales; el uso indiscriminado podría tener efectos negativos principalmente en los adolescentes. Objetivo: Estimar la asociación entre la adicción a internet con los trastornos de depresión, insomnio y autoestima en estudiantes de secundaria de la unidad educativa municipal "Quitumbe" y Colegio fiscomisional "María Augusta Urrutia" de fe y Alegría, del distrito metropolitano de Quito, en el año lectivo 2017-2018. Material y método: Se realizó un estudio no experimental de corte transversal a 336 estudiantes; se realizó el cálculo de la muestra con una prevalencia de adición a internet reportada en otros estudios del 26 %, con intervalo confianza del 95 % y probabilidad de error del 5 %, de forma aleatoria simple; los participantes fueron seleccionados al azar dentro de cada clase usando una tabla de números aleatorios para asegurar la representatividad de la muestra. Resultados: Las prevalencias del riesgo de adicción a internet, depresión, insomnio y baja autoestima fueron del 46%, 62 %, 42% y 76% respectivamente. Se estimó que el riesgo de adicción a internet constituyó un factor de riesgo para la presencia de depresión e insomnio (OR = 3.82, IC 95 %: 2.36 ­ 6.18; p < ,000) y (OR = 2.59, IC 95 %: 1.66 ­ 4.04; p < ,000) Conclusiones: El presente estudio encontró que el riesgo de adicción a internet se asoció con síntomas depresivos y con insomnio en cualquiera de sus grados en los adolescentes estudiados(AU)

The internet has revolutionized people's lives, has transformed relationships family, personal, work and social; indiscriminate use could have negative effects mainly in adolescents. Objective: To estimate the association between Internet addiction with depression, insomnia and self-esteem disorders in high school students from the unit "Quitumbe" municipal educational institution and "María Augusta Urrutia" fiscomisional College of Fe y Alegría, of the Metropolitan District of Quito, in the 2017-2018 school year. Material and method: A non-experimental cross-sectional study of 336 students; the sample calculation was performed with a prevalence of Internet addiction reported in other studies of 26%, with interval 95% confidence and 5% probability of error, simple random; participants were randomly selected within each class using a table of random numbers to ensure the representativeness of the sample. Results: Prevalences of addiction risk internet, depression, insomnia and low self-esteem were 46%, 62%, 42% and 76% respectively. It was estimated that the risk of Internet addiction constituted a risk factor for the presence of depression and insomnia (OR = 3.82, 95% CI: 2.36 ­ 6.18; p < .000) and (OR = 2.59, CI 95%: 1.66 ­ 4.04; p < ,000) Conclusions: The present study found that the risk of addiction Internet access was associated with depressive symptoms and with insomnia in any of its degrees in the studied adolescents(AU)

Funcionamento familiar e dependência da internet em adolescentes / Family functioning and internet addiction in adolescents / Funcionamiento familiar y adicción a internet en adolescentes

Resumo O presente estudo teve como objetivo principal explorar de que forma variáveis do funcionamento familiar se relacionam com a dependência da internet. A amostra final foi constituída por 568 participantes, com idades compreendidas entre os 14 e 18 anos, que frequentam o Ensino Secundário, num distrito da região Norte de Portugal. Foi usado um Questionário Sociodemográfico, o Internet Addiction Test (IAT) e o Systemic Clinical Outcome Routine Evaluation (SCORE-15). Verificou-se que 73.1% dos participantes apresentaram dependência leve a moderada, mas não foram encontradas diferenças na dependência da internet entre o sexo masculino e o feminino. Por outro lado, verificaram-se diferenças a nível de funcionamento familiar, sendo que o sexo masculino apresentou, ligeiramente, mais dificuldades na comunicação na família e dificuldades familiares. Observaram-se diferenças entre os grupos em estudo (utilizadores normais, utilizadores com dependência leve e utilizadores com dependência moderada) em todas as dimensões do funcionamento familiar. Para além disso, foi possível observar associações positivas entre as dimensões do funcionamento familiar e a dependência da internet. Por fim, verificou-se que a comunicação na família foi a única variável do funcionamento familiar que apresentou um papel preditor na dependência da internet. Portanto, as dificuldades no funcionamento familiar, sobretudo na comunicação na família, parecem apresentar um papel fundamental no desenvolvimento da dependência da internet, sendo que se considera importante o desenvolvimento de ações preventivas, com vista a promoção do funcionamento familiar saudável, assim como do uso saudável da internet.

Abstract This study aimed at exploring how family functioning variables are related to internet addiction. The final sample consisted of 568 participants, aged between 14 and 18, who attend Secondary Education, in a district in the North Region of Portugal. A Sociodemographic Questionnaire, the Internet Addiction Test (IAT) and the Systemic Clinical Outcome Routine Evaluation (SCORE-15) were used. It was found that 73.1% of the participants had mild to moderate addiction, but there were no differences in internet addiction between male and female. On the other hand, differences in terms of family functioning have been verified, with male presenting slightly more difficulties in communicating in the family and more family difficulties. Differences were observed between the study groups (normal users, users with mild dependence and users with moderate dependence) in all dimensions of family functioning. In addition, it was possible to observe positive associations between the dimensions of family functioning and internet addiction. Finally, it was found that communication in the family was the only variable of family functioning that had a predictive role in internet addiction. Therefore, difficulties in family functioning, especially in communication among the members, seem to play a fundamental role in the development of internet addiction, and it is crucial to develop preventive actions, to promote healthy family functioning, as well as healthy internet use.

Resumen El presente estudio tuvo como objetivo principal explorar cómo las variables del funcionamiento familiar están relacionadas con la adicción a internet. La muestra final consistió en 568 participantes, con edades comprendidas entre 14 y 18 años, que asisten a la Educación Secundaria, en un distrito en el norte de Portugal. Se utilizó cuestionario sociodemográfico, Internet Addiction Test (IAT) y Systemic Clinical Outcome Routine Evaluation (SCORE-15). Se encontró que el 73.1% de los participantes tenían una adicción leve a moderada, pero no hubo diferencias en la adicción a internet entre sexo masculino y femenino. Por otro lado, hubo diferencias en el funcionamiento familiar, ya que el género masculino tuvo un poco más de dificultades para comunicarse en la familia y más dificultades familiares. Se observaron diferencias entre los grupos de estudio (usuarios normales, usuarios con adicción leve y usuarios con adicción moderada) en todas las dimensiones del funcionamiento familiar. Además, fue posible observar asociaciones positivas entre las dimensiones del funcionamiento familiar y la adicción a internet. Finalmente, se descubrió que la comunicación en la familia era la única variable en el funcionamiento familiar que tenía un papel predictivo en la adicción a internet. Por lo tanto, las dificultades en el funcionamiento familiar, especialmente en la comunicación en la familia, parecen desempeñar un papel fundamental en el desarrollo de la adicción a internet, y se considera importante desarrollar acciones preventivas, con miras a promover un funcionamiento familiar saludable, así como el uso de internet saludable.

Mediaciones parentales y uso de internet por niños, niñas y adolescentes colombianos / Parental mediations and internet use by colombian children and adolescents

Resumen Este artículo presenta los resultados de un estudio correlacional sobre los controles y las mediaciones parentales frente al uso de internet por niños, niñas y adolescentes colombianos. Se trata de la encuesta EU Kids Online que fue aplicada en el año 2010 en 25 países europeos y, posteriormente, en Brasil en 2013 y en Chile en 2016. En el presente estudio, le encuesta fue adaptada y validada para la población colombiana mediante un panel de expertos y entrevistas cognitivas a usuarios. Se conformó una muestra estratificada y no probabilística de 303 estudiantes de ambos sexos de colegios públicos y privados, con edades entre 9 y 17 años y uno de sus padres o cuidadores, habitantes de 11 ciudades del país, quienes respondieron a los tres instrumentos de KidsOnline, una encuesta autoaplicada, otra dirigida a los estudiantes, y una tercera dirigida a los padres o cuidadores. Los resultados muestran relaciones entre el control parental y un menor tiempo de conexión a internet por parte de los hijos: el control del padre está relacionado con menor presencia de conductas adictivas a internet y al celular y, por el contrario, una relación autoritaria con la madre está relacionada con mayor presencia de conductas de riesgo en los hijos y específicamente, en el uso de internet. Además, las habilidades digitales de los padres son las que mejor están asociadas con una mediación activa, que los involucra más en las actividades digitales de sus hijos.

Abstract Nowadays, parents must develop strategies to accompany their children in the use of digital technologies. The reason for this is that the internet is a social space. Online life offers possibilities for individual and social development, but it also promotes the emergence of new risks such as sexting, cyberbullying, and cyber dependence. There are two ways parents can guide their children: parental mediation and parental control. Parental mediation is the set of actions that parents take to manage the use and consumption of the media by their sons and daughters. There are three types of parental mediation: restrictive mediation, permissive mediation, and active mediation. In this context, this research aims to correlate mediation and parental control strategies with their use of the internet for children and adolescents. The EU Kids Online survey was used to achieve this goal. This questionnaire was adapted for the Colombian population through expert review and cognitive validation to children and adolescents in Medellin, Cali, and Cartagena (Colombia). The adaptation followed the procedures and standards of Kids Online Brasil and Kids Online Chile. The stratified and non-probabilistic sample consisted of 303 children and adolescents aged 9 to 17 years from ten cities in Colombia. The results indicate that the more parental control, the shorter the child connection time. Whether it's behavioral or psychological control. While the greater the psychological control of the mother, the greater the presence of addictive behaviors of children and adolescents to the internet and cell phone. Besides, the more psychological control of the mother, the more risky behaviors the children assume. Conversely, if the mother performs greater behavioral control, the presence of risky behaviors in the child is less. Also, restrictive control of internet use has a higher relationship with a lower presence of general risk behaviors and lower risks assumed by children on the internet. This was also related to high rates of restrictive mediation by parents. As conclusions, it is possible to say that any type of control that parents exercise over their children's use of the internet (restrictive, co-visioned or technical) is related to shorter connection time and less cell phone addiction. Besides, a conflicting relationship with the mother increases the addictive behaviors of the internet and the smartphone. Especially when the kind of control the mother exerts is psychological. Whereas, if the mother exerts greater behavioral control, the presence of risky behaviors in the child is less. This research could serve as the basis for the design and implementation of psychoeducational training programs for parents and caregivers aimed at developing effective parental mediation skills and strategies to guide children and adolescents in their use of digital technologies. Also, the findings of this study could lay the scientific basis for the presentation of social projects that impact public policies on the responsible and healthy use of the internet. Moreover, when Colombia has a Ministry of Information and Communication Technologies and media outreach strategies on ICT care. Finally, researches done in psychology about this topic are limited in Latin America. For this reason, the findings of this work are a significant step forward on the explanation of ITC use in the region from a disciplinary point of view. This article seeks to encourage researchers to continue to advance their knowledge of the relationships between parental mediation and the use of the internet by children and adolescents.

Associação entre uso de Internet, autoconsciência ruminativa e diferenças de gênero em universitários / Asociación entre el uso de Internet, la autoconciencia rumiativa y las diferencias de género en estudiantes universitarios / Association Between Internet Use, Ruminative Self-Consciousness, and Gender Differences in University Students

Resumo O uso descontrolado de Internet já é considerado um problema de saúde pública em alguns países. De uma perspectiva psicológica, evidências sugerem uma relação entre o uso descontrolado de Internet e a autoconsciência ruminativa (quando a autoatenção é direcionada para uma avaliação negativa de si mesmo) que, por sua vez, pode estar associada a transtornos mentais. Neste sentido, a presente pesquisa teve o objetivo de verificar as relações entre as variáveis nível de uso de Internet, estilo de autoconsciência (ruminativa e reflexiva) e gênero em adultos jovens universitários. Participaram do estudo quantitativo 450 universitários, entre 18 e 25 anos de idade (50 % do gênero feminino), que responderam ao Teste de Dependência de Internet e ao Questionário de Ruminação e Reflexão. Os dados foram submetidos à análise estatística descritiva e inferencial (Teste t para Amostras Independentes, Análise de Variância e Regressões Lineares Múltiplas). Os resultados apontam que o estilo de autoconsciência ruminativo está significativamente associado ao gênero feminino. A regressão linear múltipla, para cada gênero, considerando o uso descontrolado de Internet como variável dependente apontou que, tanto para participantes do gênero masculino quanto do feminino, a autoconsciência ruminativa explicou direta e significativamente o uso descontrolado de Internet. Discutem-se implicações da associação do estilo ruminativo à má adaptação psicológica e sua possível interferência no nível de uso de Internet, enquanto obstáculo à percepção dos gatilhos desencadeadores de uma dependência e a busca de resolução de conflitos e de problemas relacionados ao uso descontrolado da Internet.

Resumen El uso incontrolado de Internet ya se considera un problema de salud pública en algunos países. Desde una perspectiva psicológica, la evidencia sugiere una relación entre el uso descontrolado de Internet y la autoconciencia rumiativa (cuando la atención de uno mismo se dirige hacia una autoevaluación negativa) que, a su vez, puede estar asociada con trastornos mentales. En este sentido, la presente investigación tuvo como objetivo verificar la relación entre las variables nivel de uso de Internet, estilo de autoconciencia (rumiativa y reflexiva) y género en jóvenes universitarios. En el estudio cuantitativo participaron 450 estudiantes universitarios, entre 18 y 25 años (50 % mujeres), quienes respondieron el Test de Dependencia de Internet y el Cuestionario de Rumiación y Reflexión. Los datos se sometieron a análisis estadístico descriptivo e inferencial (prueba t para muestras independientes, análisis de varianza y regresiones lineales múltiples). Los resultados muestran que el estilo de autoconciencia rumiativa se asocia significativamente con el género femenino. La regresión lineal múltiple, para cada género, considerando el uso descontrolado de Internet como variable dependiente, señaló que, tanto para hombres como para mujeres, la autoconciencia rumiativa explicaba directa y significativamente el uso descontrolado de Internet. Se discuten las implicaciones de la asociación del estilo rumiativo con la mala adaptación psicológica y su posible interferencia en el nivel de uso de Internet, como obstáculo para la percepción de los desencadenantes que liberan una adicción y para la búsqueda de resolución de conflictos y problemas relacionados con el uso descontrolado de Internet.

Abstract Uncontrolled use of the Internet is already considered a public health problem in some countries. From a psychological perspective, evidence suggests a relationship between the uncontrolled use of the Internet and the ruminative self-consciousness (when attention is directed towards a negative self-assessment), which, in turn, may be associated with mental disorders. In this sense, the present research had the objective of verifying the relationships between the variable level of Internet use, self-consciousness styles (ruminative and reflexive), and gender in young university students. The participants in the quantitative study were 450 university students between 18 and 25 years (50 % female) who answered the Internet Dependence Test and the Rumination-Reflection Questionnaire. The data were submitted to descriptive and inferential statistical analyses (t Test for Independent Samples, analysis of variance, and multiple linear regressions). The results show that the style of ruminative self-consciousness is significantly associated with the female gender. The multiple linear regression for each gender, considering the uncontrolled use of the Internet as a dependent variable, indicated that, for both male and female participants, ruminative self-consciousness directly and significantly explained the uncontrolled use of the Internet. The implications of the association of the ruminative style to psychological maladaptation and its possible interference in the level of Internet use are discussed as obstacles to the perception of the triggers that foster addiction and the search for conflict resolution and problems related to the uncontrolled use of the Internet.

Validating the Utilization of the Patient Compliance Instruction Support System “FollowNavi” for Follow-up Inhalation Instructions / 医薬品情報学

Objective: Following the amendment of the Pharmaceutical and Medical Device Act in December 2019, continuous follow-up of patients during treatment has been mandated for pharmacists. The follow-up methods may involve contacting patients via telephone and social networking services (SNS). The SNS is advantageous over telephone, because patients can respond to the pharmacists at their convenience. Therefore, we developed a patient compliance instruction support system “FollowNavi” using LINE. We prepared a content of inhalation drugs used to treat bronchial asthma for assessment using FollowNavi and conducted questionnaire surveys among patients and pharmacists to validate its utility.Methods: FollowNavi was used from May1 to July 31, 2020, to follow up patients diagnosed with bronchial asthma for whom long-term control medicine (inhalation drugs) was prescribed for the first time or prescriptions were changed from other inhalation drugs. Subsequently, when the patients revisited the pharmacy, we conducted a questionnaire survey regarding the usability of FollowNavi. We also conducted a questionnaire survey among the pharmacists.Results: Seven and five responses were received from patients who were followed up via FollowNavi and pharmacists who used FollowNavi, respectively. Furthermore, 28.6% of the patients responded “I could solve the problem through LINE” and 71.4% responded “I did not have anything in particular that I could not understand.” As for pharmacists, 60.0% responded that they could obtain sufficient information from the patients through FollowNavi.Conclusion: The results suggest that follow-up after providing inhalation instructions using the inhalation drug content of FollowNavi may be useful for both patients and pharmacists.

How, when, and where information about breast cancer in Brazil is found using Google

Introduction: This article sought to clarify the sources that women seek to find information about breast cancer. Methods: With a data collection from Google Trends, it was possible to list which keywords are most used when the population performs these searches and to know the volume of searches for the words "breast cancer" (câncer de mama), "breast self-exam" (autoexame de mama), and "mammography" (mamografia) from 2009 to 2019. Results: In the search for "breast cancer" (câncer de mama), it was seen that the searches for "breast cancer" (câncer de mama), "breast cancer symptoms" (câncer de mama sintomas), "symptoms of breast cancer" (sintomas de câncer de mama), "what is cancer of breast" (o que é câncer de mama), and "types of breast cancer" (tipos de câncer de mama) are the five most prevalent. Data were also displayed that reflect the importance of the awareness campaign for this type of cancer, the Pink October, since the months of October of the years in question were the ones that had the highest search volume for the keywords "cancer of breast" (câncer de mama), "breast self-examination" (autoexame de mama), and "mammography" (mamografia). In addition, it was noticed that many sites with a greater chance of getting hits due to their being in the first places in the survey did not have the name of the sources from which they had obtained their data and/or the names of the authors, and it was not possible to know the quality of the information published there. Conclusion: It is possible to notice the positive effect that the Pink October campaign has, which can contribute to a greater awareness of the importance of breast selfexamination and mammography. In addition, it is necessary to be careful when looking for information in the online environment, since not all sites inform the source and/or the name of the author of the article.

Effects of internet and social media use among medical students of a tertiary care teaching hospital

Background: The launch of many free low cost data packages has put India on the global map for large scale consumption of mobile data leading to exponential usage of social media. Internet has both positive and negative advantages on its users. Excessive use of social media is affecting the lifestyle of youth moreover, statistics show that addiction to social media resulted in increased health problems and change in behavior. Objectives: The objectives of the study were to study the pattern of internet and social media use and its physical and psycho-social effects on the medical students. Materials and Methods: A cross-sectional descriptive study was conducted among medical students at a tertiary care teaching hospital in a rural area using self-administered pretested questionnaire using Google forms. The descriptive statistical analysis of data was performed in the form of mean, standard deviation, percentages, and proportions. Results: The number of male and female participants was 184 (44.4%) and 230 (55.6%), respectively. Almost 37% of students spend more than 4 h on internet daily and 56% students responded that they visit social media more than 6 times/day. Headache, sleep disturbances, and burning sensation of eyes and neck pain were the prominent disabling symptoms. One hundred and twenty-seven (30.7%) students sleep for <6 h and 64.8% students stay up late to access internet and 43.9% students check social media immediately after waking up. Conclusion: Time spent on internet, social media to perform online access can be very productive but compulsive internet and social media use can have negative impact on physical and psycho-social health.

Del acceso a la Internet a las competencias infocomunicacionales, un comparativo de resultados estadísticos para el periodo 2015 a 2017 entre Brasil, Colombia y España / From access to the Internet to the info-communication literacies, a comparison of statistical results for the period 2015 to 2017 between Brazil, Colombia and Spain

Resumen Este trabajo es el resultado de la comparación de indicadores asociados a la Internet entre Brasil, Colombia y España, con el objeto de realizar una discusión analítica, en lo concerniente al acceso, los usos o aplicaciones, y las razones de no acceso. Así se profundiza la discusión en las barreras que tienen las personas en Internet como herramienta de acceso a la información y la comunicación, llevando la discusión hacia las competencias infocomunicacionales, factor base para la inclusión y participación social hoy en día. Para esto se tomaron datos de fuentes nacionales e internacionales, como DANE, CETIC, INE, ITU y, EUROSTAT, usando informes entre 2015 y 2017 que registran o estudian el comportamiento de las personas en Internet, identificando variables comunes en el tiempo para los procesos comparativos realizados. Los datos muestran que el acceso mejora en cada país, con diferencias en la calidad del tipo de servicio recibido en la conexión de Internet. Sin embargo, el aprovechamiento está más orientado a la generación de mensajes dentro de contextos sociales, sin pasar al siguiente nivel que implica utilizar las potencialidades de Internet en la generación de bienestar económico o social. Se puede concluir que no todos los usuarios logran transformar la información y usar los medios de comunicación en beneficio grupal o individual, es decir, el desarrollo de la competencia infocomunicacional no es del todo evidente plenamente. Además, falta información que permita demostrar de forma concreta estos avances en las competencias a nivel país. Los usos y motivos varían, así como las formas de acceso en cada país, junto al seguimiento que hace cada Gobierno, todo influenciado por las políticas públicas nacionales que allí se desarrollan y los factores económicos que afectan un Estado.

Abstract. This work is the result of the comparison of indicators associated with the Internet between Brazil, Colombia and Spain, in order to carry out an analytical discussion regarding access, uses or applications and the reasons for non-access. In this way, the discussion deepens in the barriers that people have in the use of the Internet as a tool for access to information and communication, leading to discussion for the infocommunication competitions, a basic factor for inclusion and social participation today. For this, data from national and international sources, such as DANE, CETIC, INE, ITU and EUROSTAT, were taken between 2015 and 2017 that record or study the behavior of people on the Internet, identifying common variables over time for the comparative processes carried out. The data shows that access improves in each country with differences in the quality of the type of service received in the Internet connection. However, the use is more oriented in the generation of messages within social contexts, without going to the next level that involves using the potential of the Internet in the generation of economic or social welfare. It can be concluded that not all users manage to transform the information into a group or individual benefit, so the development of infocomunicational competences is not fully evident. In addition, there is a lack of information to demonstrate in a concrete way these advances in the competences at the country level. The uses and motives vary, as well as the forms of access in each country, together with the monitoring carried out by each Government, all influenced by the national public policies developed there and the economic factors that affect a State.

Social media, purpose, and use of it: A community-based cross-sectional study in a rural area of a developing nation (India)

Background: Over the past two decades, the world has witnessed drastic progress in the field of communication. Social media are the collective of online communications channels dedicated to community-based input, interaction, content-sharing, and collaboration. Objectives: The objectives of the study were to determine the prevalence of social media use, pattern, and purpose of use and usefulness for conveying health education. Materials and Methods: The current study was undertaken; in a rural community of Punjab province of India from September 2018 to February 2019. Participants were interviewed using a pre-designed, pre-tested structured interview schedule. Results: The total number of participants in the study was 4000. Six hundred eighteen (15.5%) had a smartphone and among them, nearly 90% were using internet. The proportion of male participants (22.9%) using smartphone was significantly higher than female. Seven hundred and forty-two (18.5%) had heard of any form of social media, in which WhatsApp (13.1%) was the most common. The prevalence of the use of social media among the participants was 13.5% (n = 542). Friendship and entertainment were the major purposes for using of social media. Nearly 80% of the social media users think that it should be used more for health education, but only 11.8% of the users thought that the government was using this platform very successfully. Young, male, educated, employed, and business class was using significantly more social media for communication. Conclusions: Media is changing as well as health care and medicine, so time has come to consider one of the cost-effective and popular media to solve complex and diverse problems of health and disease.

Factors affecting internet use among university students in Sarawak, Malaysia: an empirical study

Background: The internet has become an indispensable tool for communication, academic research, information and entertainment. However, heavy users of the internet lead to less confidence in social skills and the tendency to be isolated. The study aimed to assess the pattern of internet use and factors affecting problematic internet use among university students.Methods: This cross-sectional study conducted among the students of a university in Sarawak, Malaysia. A multistage cluster sampling technique was adapted to select the participants. Data were collected from 463 students by self-administered questionnaire. Hierarchical binary logistic regression analysis was done to determine the potential factors for problematic internet use.Results: The mean age of the students was 22 years, with a standard deviation of 1.6 years. Two-fifths (61.8%) of the students had no problematic internet use. However, 35.4% had moderate and 2.8% had severe problematic internet use. Hierarchical binary logistic regression analysis found that age of the students, year of study, duration of daily internet use and use of social networking like Skype appeared to be potential predictors of problematic internet use (p<0.05).Conclusions: This study was conducted in only one university, thus did not depict the overall scenarios of the country. The implications of the findings are still worth noting in the process of designing internet addiction studies among university students. Overall, this study has unearthed some useful insights which can serve as a guide to more elaborate studies.