Relationships between internet addiction, smartphone addiction, sleep quality, and academic performance among high-school students

SUMMARY OBJECTIVE: In this study, we aimed to evaluate the relationships between Internet addiction, smartphone addiction, sleep quality, and academic success. METHODS: In this cross-sectional study, high-school students were surveyed to evaluate sleep quality, Internet addiction, and smartphone addiction. Students were queried about their demographics, and grade averages from the previous term were taken as an indicator of academic success. RESULTS: A total of 1,959 students were enrolled in this study, with 1,034 (52.8%) girls and 925 (47.2%) boys, and the median age of the participants was 16 (13-21) years. Multivariate analyses found that poor sleep quality in students who did not have breakfast before going to school was 1.58 times higher than those who did (p<0.001). Students who stayed in a dormitory had 1.79 times more poor sleep quality than those who stayed with their family, and a one-unit increase in the total score of the Young's Internet Addiction Test short form resulted in a 1.08-fold increase (both, p<0.001). CONCLUSION: Our study has shown that students' sleep quality was predicted to be lower if they stayed in a dormitory and skipped breakfast. In addition, Internet and smartphone addictions have a negative effect on sleep quality and academic performance.

Diagnóstico da retinopatia diabética por inteligência artificial por meio de smartphone / Diagnosis of diabetic retinopathy by artificial intelligence using smartphone

RESUMO Objetivo: Obter imagens de fundoscopia por meio de equipamento portátil e de baixo custo e, usando inteligência artificial, avaliar a presença de retinopatia diabética. Métodos: Por meio de um smartphone acoplado a um dispositivo com lente de 20D, foram obtidas imagens de fundo de olhos de pacientes diabéticos; usando a inteligência artificial, a presença de retinopatia diabética foi classificada por algoritmo binário. Resultados: Foram avaliadas 97 imagens da fundoscopia ocular (45 normais e 52 com retinopatia diabética). Com auxílio da inteligência artificial, houve acurácia diagnóstica em torno de 70 a 100% na classificação da presença de retinopatia diabética. Conclusão: A abordagem usando dispositivo portátil de baixo custo apresentou eficácia satisfatória na triagem de pacientes diabéticos com ou sem retinopatia diabética, sendo útil para locais sem condições de infraestrutura.

ABSTRACT Introduction: To obtain fundoscopy images through portable and low-cost equipment using artificial intelligence to assess the presence of DR. Methods: Fundus images of diabetic patients' eyes were obtained by using a smartphone coupled to a device with a 20D lens. By using artificial intelligence (AI), the presence of DR was classified by a binary algorithm. Results: 97 ocular fundoscopy images were evaluated (45 normal and 52 with DR). Through AI diagnostic accuracy around was 70% to 100% in the classification of the presence of DR. Conclusion: The approach using a low-cost portable device showed satisfactory efficacy in the screening of diabetic patients with or without diabetic retinopathy, being useful for places without infrastructure conditions.

Relationship between depression, anxiety, stress and smartphone addiction in COVID-19 nursing students / Relación entre depresión, ansiedad, estrés y dependencia del smartphone en estudiantes de enfermería durante la COVID-19 / Relação entre depressão, ansiedade, estresse e dependência de smartphone em estudantes de enfermagem na COVID-19

Objective: to verify the relationship between symptoms of depression, anxiety, stress and smartphone addiction in COVID-19 nursing students. Method: this was a descriptive-analytical study of 206 nursing students. A sociodemographic characterization and smartphone use instrument adapted from the literature and the following scales Depression, Anxiety and Stress Scale and Smartphone Addiction Inventory were used for data collection. Sociodemographic data and smartphone use were analyzed using descriptive statistics and the relationship between symptoms of depression, anxiety, stress and smartphone addiction was analyzed using multiple logistic regression. Results: the prevalence of smartphone addiction among nursing students was 129 (62.6%) and there was a relationship between symptoms of moderate depression (p=0.049), severe/very severe depression (p=0.005) and mild anxiety (p=0.028) and severe/very severe anxiety (p=0.019) and smartphone addiction. Conclusion: the data show that the construction and implementation of smartphone use policies in the academic and hospital context to prevent smartphone addiction and control associated risk factors is necessary.

Objetivo: verificar la relación entre síntomas de depresión, ansiedad, estrés y dependencia del smartphone en estudiantes de enfermería durante la COVID-19. Método: estudio descriptivo-analítico realizado con 206 estudiantes de enfermería. Para la recogida de datos se utilizaron un instrumento de caracterización sociodemográfica y uso del smartphone adaptado de la literatura y las siguientes escalas: Depression, Anxiety and Stress Scale y Smartphone Addiction Inventory. Los datos sociodemográficos y el uso del smartphone se analizaron mediante estadísticas descriptivas y la relación entre síntomas de depresión, ansiedad, estrés y dependencia del smartphone se analizó mediante la regresión logística múltiple. Resultados: la prevalencia de dependencia del smartphone en estudiantes de enfermería fue de 129 (62,6%) y hubo relación entre síntomas de depresión moderada (p=0,049), grave/muy grave (p=0,005) y ansiedad leve (p=0,028) y grave/muy grave (p=0,019) y dependencia del smartphone. Conclusión: los datos revelan que la construcción e implementación de políticas de uso del smartphone en el contexto académico y hospitalario para la prevención de la dependencia del smartphone y el control de los factores de riesgo asociados son necesarias.

Objetivo: verificar a relação entre sintomas de depressão, ansiedade, estresse e dependência de smartphone em estudantes de enfermagem na COVID-19. Método: estudo descritivo-analítico realizado com 206 estudantes de enfermagem. Para coleta de dados foram utilizados um instrumento de caracterização sociodemográfica e uso do smartphone adaptado da literatura e as seguintes escalas: Depression, Anxiety and Stress Scale e Smartphone Addiction Inventory. Os dados sociodemográficos e o uso do smartphone foram analisados por meio de estatísticas descritivas e a relação entre sintomas de depressão, ansiedade, estresse e dependência de smartphone foi analisada a partir de regressão logística múltipla. Resultados: a prevalência de dependência de smartphone em estudantes de enfermagem foi de 129 (62,6%) e houve relação entre sintomas de depressão moderada (p=0,049), grave/muito grave (p=0,005) e ansiedade leve (p=0,028) e grave/muito grave (p=0,019) e dependência de smartphone. Conclusão: os dados revelam que a construção e a implementação de políticas de uso do smartphone no contexto acadêmico e hospitalar para prevenção da dependência de smartphone e controle dos fatores de risco associados são necessárias.

Smartphone addiction and postural alterations in the cervical region in adolescents / Dependência do smartphone e alteração postural da região cervical de adolescentes

ABSTRACT Objective: To evaluate smartphone addiction and postural alterations in the cervical region in adolescents. Methods: A cross-sectional study with 281 adolescents (15 to 19 years old), attending the 1st to the 3rd grades of High School, carried out between September and October 2019 in the city of Fortaleza, Ceará, Brazil. Data collection took place in two stages. In the first, they answered four self-administered questionnaires: sociodemographic questionnaire, health conditions and smartphone use, Nordic Musculoskeletal Symptom Questionnaire (NMQ), Self-Report Questionnaire (SRQ-20) and the Smartphone Addiction Inventory (SPAI-BR). In the second stage, they were submitted to photogrammetry using the Postural Assessment Software (SAPO) and anthropometric assessment (weight and height). The software SPSS Statistics version 23.0 was used for data analysis. Results: Of the total number of adolescents, 63.3% (n=178) showed smartphone addiction, using it for 5.8 hours (±3.5) during the week and 8.7 (±4.0) hours on the weekend. When analyzing postural alignment in the anterior view, a significant reduction in the lateral head tilt was observed when typing on the smartphone (p=0.002) compared to the anatomical position (baseline). In the lateral view, an increase in head anteriorization was observed during smartphone use (p<0.05). There was an association between smartphone addiction and head anteriorization (p<0.05). Conclusions: The use of the smartphone in the typing position causes postural alterations in the cervical region, especially in adolescents with smartphone addiction. Therefore, health promotion measures that alert adolescents to the adverse effects caused by prolonged smartphone use are necessary.

RESUMO Objetivo: Avaliar a dependência do smartphone e a alteração postural da região cervical em adolescentes. Métodos: Estudo transversal, com 281 adolescentes (15 a 19 anos), que frequentavam da 1ᵃ à 3ᵃ série do ensino médio, realizado entre setembro e outubro de 2019 na cidade de Fortaleza, Ceará, Brasil. A coleta dos dados ocorreu em duas etapas. Na primeira, eles responderam a quatro questionários autoaplicáveis: questionário sociodemográfico, condições de saúde e uso do smartphon e, Questionário Nórdico de Sintomas Musculoesqueléticos (NMQ), Self-Report Questi onnaire (SRQ-20) e o Smartphone A ddiction Inventory (SPAI-BR). Na segunda etapa, foram submetidos a fotogrametria pelo Software de Avaliação Postural (SAPO) e avaliação antropométrica (peso e altura). Para a análise dos dados, foi utilizado o SPSS Statistics versão 23.0. Resultados: Do total, 63,3% (n=178) dos adolescentes apresentaram dependência do smartphone, com o uso de 5,8 horas (±3,5) durante a semana e 8,7 (±4,0) no fim de semana. Ao analisar o alinhamento postural na visão anterior, observou-se redução significativa da inclinação lateral de cabeça ao digitar no smartphon e (p=0,002) comparado à posição anatômica (baseline). Na visão lateral foi constatado aumento da anteriorização de cabeça durante o uso do smartphon e (p<0,05). Houve associação da dependência do smartphone com a anteriorização de cabeça (p<0,05). Conclusões: O uso do smartphone na posição de digitação causa alteração postural na região cervical, destacadamente naqueles que apresentam dependência do dispositivo. Dessa forma, são necessárias medidas de promoção de saúde que alertem os adolescentes sobre os efeitos adversos causados pelo uso prolongado do smartphone.

Accuracy of an artificial intelligence-based mobile application for detecting cataracts: Results from a field study

Purpose: To assess the accuracy of e?Paarvai, an artificial intelligence?based smartphone application (app) that detects and grades cataracts using images taken with a smartphone by comparing with slit lamp?based diagnoses by trained ophthalmologists. Methods: In this prospective diagnostic study conducted between January and April 2022 at a large tertiary?care eye hospital in South India, two screeners were trained to use the app. Patients aged >40 years and with a best?corrected visual acuity <20/40 were recruited for the study. The app is intended to determine whether the eye has immature cataract, mature cataract, posterior chamber intra?ocular lens, or no cataract. The diagnosis of the app was compared with that of trained ophthalmologists based on slit?lamp examinations, the gold standard, and a receiver operating characteristic (ROC) curve was estimated. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were computed. Results: The two screeners used the app to screen 2,619 eyes of 1,407 patients. In detecting cataracts, the app showed high sensitivity (96%) but low specificity (25%), an overall accuracy of 88%, a PPV of 92.3%, and an NPV of 57.8%. In terms of cataract grading, the accuracy of the app was high in detecting immature cataracts (1,875 eyes, 94.2%), but its accuracy was poor in detecting mature cataracts (73 eyes, 22%), posterior chamber intra?ocular lenses (55 eyes, 29.3%), and clear lenses (2 eyes, 2%). We found that the area under the curve in predicting ophthalmologists’ cataract diagnosis could potentially be improved beyond the app’s diagnosis based on using images only by incorporating information about patient sex and age (P < 0.0001) and best?corrected visual acuity (P < 0.0001). Conclusions: Although there is room for improvement, e?Paarvai app is a promising approach for diagnosing cataracts in difficult?to?reach populations. Integrating this with existing outreach programs can enhance the case detection rate.

A pilot non-randomized trial of smartphone-based anaglyph system for treatment of adult amblyopia through VR (Virtual Reality)

Purpose: To evaluate the effectiveness of amblyopia treatment through a smartphone?based anaglyph system by virtual reality (VR) in adult patients. Methods: A total of 10 subjects diagnosed with anisometropic amblyopia were enrolled during the study period. Best Corrected Visual Acuity (BCVA), stereoacuity, and contrast acuity were evaluated during three visits (at presentation, 3 months and 6 months) of smartphone?based anaglyph video run in the VR mode. All the amblyogenic factors including stereopsis, color vision, and contrast acuity were compared using Friedman two?way analysis of variance. Statistical significance was considered if P < 0.05. Results: Mean BCVA in amblyopic eye improved significantly from a logMAR value of 0.73 ± 0.64 before Virtual reality vision therapy (VRVT) to a post?training VRVT value of 0.48 ± 0.44 (P < 0.01). Mean stereoacuity changed from a value of 560.00 ± 301.58 before VRVT to a value of 263.00 ± 143.58 seconds of arc after training (VRVT) (P < 0.01). Mean accommodation changes from a value of 15.00 ± 7.40 before training or VRVT to value of 12.60 ± 6.10 cm after training (P < 0.01). Mean contrast acuity changes from a value of 1.21 ± 0.72 at presentation to a value of 1.52 ± 0.49 log unit after VRVT. Conclusion: A smartphone?based anaglyph system using VR vision therapy appears to be an effective treatment option for amblyopia in adults.

The role of mobile teledermoscopy in skin cancer triage and management during the COVID-19 pandemic

The unprecedented onset of the COVID-19 crisis poses a significant challenge to all fields of medicine, including dermatology. Since the start of the coronavirus outbreak, a stark decline in new skin cancer diagnoses has been reported by countries worldwide. One of the greatest challenges during the pandemic has been the reduced access to face-to-face dermatologic evaluation and non-urgent procedures, such as biopsies or surgical excisions. Teledermatology is a well-integrated alternative when face-to-face dermatological assistance is not available.Teledermoscopy, an extension of teledermatology, comprises consulting dermoscopic images to improve the remote assessment of pigmented and non-pigmented lesions when direct visualisation of lesions is difficult. One of teledermoscopy’s greatest strengths may be its utility as a triage and monitoring tool, which is critical in the early detection of skin cancer, as it can reduce the number of unnecessary referrals, wait times, and the cost of providing and receiving dermatological care. Mobile teledermoscopy may act as a communication tool between medical practitioners and patients. By using their smartphone (mobile phone) patients can monitor a suspicious skin lesion identified by their medical practitioner, or alternatively self-detect concerning lesions and forward valuable dermoscopic images for remote medical evaluation. Several mobile applications that allow users to photograph suspicious lesions with their smartphones and have them evaluated using artificial intelligence technology have recently emerged. With the growing popularity of mobile apps and consumer-involved healthcare, this will likely be a key component of skin cancer screening in the years to come. However, most of these applications apply artificial intelligence technology to assess clinical images rather than dermoscopic images, which may lead to lower diagnostic accuracy. Incorporating the direct-to-consumer mobile dermoscopy model in combin

A study on smart phone use and its perceived health effects among the adolescents attending Medical College and Hospital, Kolkata

Background: Smartphone usage is gradually escalating among Indian adolescents, which is having adverse consequences on their health and well-being. Awareness regarding adverse health impacts of smartphone usage among adolescents is thus necessary. Aims and Objectives: This study assessed the smartphone usage pattern and perception regarding its health effects among adolescents attending adolescent friendly health clinic (AFHC) at Medical College and Hospital, Kolkata. Materials and Methods: This cross-sectional study was conducted among 187 adolescents from January to March 2023 at AFHC of Medical College and Hospital, Kolkata selected by systematic random sampling technique. Pre-designed self-administered questionnaire was utilized for data collection. Data were analyzed using SPSS software. Factors associated with the duration of smartphone usage were analyzed using the Chi-square test. Results: Smartphone was used by all the study participants (n = 187). A significant proportion has utilized smartphones for >3-year duration, whereas 114 (60.9%) used them for 1–2 h per day and 56 (29.9%) used them for ?3 h per day. The major adverse health impacts of smartphone usage perceived by the participants were eye symptoms (64.2%), headache (50.8%), and neck pain (46.5%). Gender (?2=12.98, df = 2, P = 0.0012), type of residence (?2 = 7.98, df = 2, P = 0.018), and socioeconomic status (?2 = 34.96, df = 2, P < 0.001) were factors significantly associated with the duration of smartphone usage per day. Conclusion: Smartphone should be optimized to protect the physical and mental well-being of adolescents. Motivation and counselling regarding the adverse effects of smartphone usage is should be given the utmost priority. Generating awareness among parents at the community level through field health workers is also the need of the hour.

Prevalence of smart phone addiction among medical students

Background: The use of smart phone is very common specially in young individuals. Excessive use leads to smart phone addiction, which may have harmful effect on the health of individuals. Aims and Objectives: The aim of our study is to assess the smart phone usage in 1st-year medical students. Materials and Methods: In this cross-sectional study, we have included 187 students from 1st-year MBBS. Out of which 125 (66.84%) are boys and 62 (33.16%) are girls in age group of 18–22 years. All the data were collected in Google form. We have used smart phone addiction scale long version. The Google form was filled by students who are willing to participate in this study. Result: We have found that out of total 187 students, 96 (51.34%) students having high smart phone use, out of which 68 (54.40%) are boys and 28 (45.16%) are girls while 91 (48.66%) students having low smart phone use, out of which 57 (45.60%) are boys and 34 (54.84%) are girls. Conclusion: The high smart phone usages present in the student can be prevented by specific intervention programs at college level.

Smartphone addiction and its impact on quality of sleep and academic performance among nursing students. institutional based cross-sectional study in Western Rajasthan (India) / Adicción a los teléfonos inteligentes y su impacto en la calidad del sueño y el rendimiento académico entre los estudiantes de enfermería. estudio transversal de base institucional en el oeste de Rajastán (India) / Dependência de smartphones e seu impacto na qualidade do sono e desempenho acadêmico entre estudantes de enfermagem. Estudo transversal de base institucional no oeste do Rajastão (Índia)

Objective.To explore the smartphone addiction and its impact on quality of sleep and academic performance among the nursing students. Methods. A descriptive cross-sectional study was conducted among the nursing students (n=160) in tertiary care teaching hospital in western Rajasthan (India) by using standardized Smartphone Addiction Scale Short Version (SAS-SV), the quality of sleep was assessed by standardized Pittsburg's Sleep Quality Index scale (PSQI) and academic performance was assessed by self ­made Academic Performance Scale. Results.In this study 38.1 % students were having moderate smartphone addiction. The smartphone addiction is directly associated with hours daily spend on smartphone (p<0.001), time check smartphone after wake up in the morning (p<0.001), and frequency of smartphone pickups in a day (p=0.003) of students. The quality of sleep is inversely associated with duration of smartphone use (p=0.004), hours daily spend on smartphone (p=0.002), time check smartphone after wake up in morning (p=0.010), of students The academic performance is significantly associated with hours daily spend on smartphone (p=0.003), time check smartphone after wake up in morning (p=0.001), and frequency of smartphone pickups in a day (p=0.015) of students. Conclusion. A high proportion of nursing students have moderate smartphone addiction. This addiction was associated with an increased risk of poor sleep quality and poor academic performance. Educational activities on the healthy use of smartphones are needed in the studied group.

Objetivo. Explorar la adicción a los teléfonos inteligentes y su impacto en la calidad del sueño y el rendimiento académico entre los estudiantes de enfermería. Métodos. Se realizó un estudio descriptivo transversal entre los estudiantes de enfermería (n=160) en el hospital universitario de atención terciaria en el oeste de Rajastán (India). Se empleó la escala estandarizada Smartphone Addiction Scale Short Version (SAS-SV), la calidad del sueño se evaluó mediante el Pittsburg's Sleep Quality Index (PSQI) y el rendimiento académico se evaluó mediante la Escala de Rendimiento Académico de elaboración propia.Resultados. En este estudio, el 38.1% de los estudiantes presentaban adicción moderada a los teléfonos inteligentes. Esta adicción se asoció con las horas diarias dedicadas a los teléfonos inteligentes (p<0.001), el tiempo de revisión de los teléfonos después de despertarse por la mañana (p<0.001), y la frecuencia de uso durante el día (p=0.003). La calidad del sueño se asoció inversamente con los años de uso del teléfono inteligente (p=0.004), las horas diarias de uso (p=0.002) y el tiempo de revisión del teléfono después de despertarse por la mañana (p=0.01). El rendimiento académico también se asoció en forma inversa con las horas diarias de uso del teléfono (p=0.003), el tiempo de revisión del teléfono después de despertarse por la mañana (p=0.001), y la frecuencia de uso del teléfono en un día (p=0.015). Conclusión. Una alta proporción de estudiantes de enfermería tienen adicción moderada a los teléfonos inteligentes. Esta adicción se asoció a un mayor riesgo de mala calidad del sueño y de bajo rendimiento académico. Es necesario llevar a cabo actividades educativas sobre el uso saludable de los teléfonos inteligentes en el grupo estudiado.

Objetivo. Explorar o vício em smartphones e seu impacto na qualidade do sono e no desempenho acadêmico entre estudantes de enfermagem. Métodos. Um estudo transversal descritivo foi realizado entre estudantes de enfermagem (n = 160) em um hospital universitário terciário no Oeste Rajasthan (Índia). Foi utilizada a escala padronizada de dependência de smartphones, Scale Short Version (SAS-SV), a qualidade do sono foi avaliada usando o Pittsburg's Sleep Quality Index (PSQI) e desempenho acadêmico foi avaliado por meio da Escala de Desempenho Acadêmico de nossa própria elaboração. Resultados. Neste estudo, 38.1% dos alunos apresentaram dependência moderada de smartphones. Esse vício foi associado a horas diárias gastas em smartphones (p<0.001), tempo verificando telefones após acordar pela manhã (p<0.001) e frequência de uso durante o dia (p=0.003). A qualidade do sono foi inversamente associada à duração do uso do smartphone (p=0.004), horas diárias de uso (p=0.002) e tempo gasto checando o telefone após acordar pela manhã (p=0.01). O desempenho acadêmico também foi inversamente associado com horas diárias de uso do telefone (p=0.003), tempo gasto verificando o telefone após acordar pela manhã (p=0.001) e frequência de uso do telefone num dia (p=0.015). Conclusão.Uma alta proporção de estudantes de enfermagem tem um vício moderado em smartphones. Esse vício foi associado a um risco aumentado de má qualidade do sono e baixo desempenho acadêmico. É necessária a realização de atividades educativas sobre o uso saudável de smartphones no grupo estudado.

Universal slit-lamp–mounted mobile adapter with 20 D lens for fundus photography: “Litter to glitter”

Fundus photography is an arduous task as it involves using 90 D in one hand and a smartphone attached on an eyepiece of a slit-lamp biomicroscope in the other hand. Similarly, with a 20 D lens, the filming distance is adjusted by moving the lens or mobile forward or backward, which makes it difficult to adjust and focus the image in busy ophthalmology outpatient departments (OPDs). Moreover, fundus camera costs thousands of dollars. Authors describe a novel technique of performing fundus photography with a 20 D lens and a universal slit-lamp–mounted mobile adapter made from trash. By the use of this simple, yet frugal innovation, primary care physicians or ophthalmologists without a fundus camera can easily snap a fundus photo and subject it to digital analysis by retina specialists across the world. This will help in simultaneous ocular examination and fundus photos taken via mounted 20 D on a slit lamp itself and also reduce the need for unnecessary retina referrals to tertiary eye care centers.

Smartphone for retinal imaging – Case series in resource-limited rural settings

Purpose: There is a clinical need for a cost?effective, reliable, easy?to?use, and portable retinal photography. The use of smartphone fundus photography for documentation of retinal changes in resource?limited settings, where retinal imaging was not previously possible, is studied here. The introduction of smartphone?based retinal imaging has resulted in the increase in available technologies for fundus photography. On account of the cost, fundus cameras are not readily available in ophthalmic practice in developing countries. Because smartphones are readily available, easy to use, and also portable, they present a low?cost alternative method in resource?limited settings. The aim is to explore the use of smartphones (iphones) for retinal imaging in resource?limited settings. Methods: A smartphone (iphone) was used to acquire retinal images with the use of +20 D lens in patients with dilated pupils by activating the video mode of the camera. Results: Clear retinal images were obtained in different clinical conditions in adults and children, including branch retinal vein occlusion with fibro?vascular proliferation, choroidal neo?vascular membranes, presumed ocular toxoplasmosis, diabetic retinopathy, retinoblastoma, ocular albinism, and hypertensive retinopathy. Conclusion: New inexpensive, portable, easy?to?operate cameras have revolutionized retinal imaging and screening programs and play an innovative role in research, education, and information sharing

Fundoscopy in the smartphone age: current ophthalmoscopy methods in neurology / A fundoscopia na era dos smartphones: métodos atuais de oftalmoscopia na neurologia

Abstract The observation of the human retina in vivo began in 1851 after the invention of the first ophthalmoscope by the German physicist Hermann von Helmholtz. In the following decades, direct and indirect ophthalmoscopy, with the use of ophthalmoscopes and condensing lenses, respectively, became part of the clinical examination, especially in ophthalmology and neurology. Today, over 170 years later, many ophthalmoscopes and condensing lenses exist on the market. Nevertheless, ophthalmoscopy is still not widely adopted as part of the physical exam of general practitioners, and the teaching of ophthalmoscopy in medical school remains challenging. Studies have shown that students prefer using newer ophthalmoscope models or condensing lenses during training, but most do not feel confident in performing ophthalmoscopy afterwards, regardless of the models used. Also, few students acquire ophthalmoscopes for their future practice, and clinical trials have not clearly demonstrated superiority of newer ophthalmoscope models over the conventional ones in diagnostic accuracy. The technological improvement of smartphone cameras in recent years has made it feasible to photograph the fundus of the eye using ophthalmoscopes or condensing lenses, reducing the need for retinographs and similar equipment. Smartphone assisted indirect fundoscopy is becoming increasingly popular. This approach allows adequate identification of the structures of the fundus, is cost-efficient, easy to implement, and permits easy recording and sharing of the images obtained, which is useful for case discussions and medical teaching. However, controlled clinical trials validating this method in the evaluation of optic nerve pathologies are needed.

Resumo A observação da retina humana in vivo começou em 1851, após a invenção do primeiro oftalmoscópio pelo físico alemão Hermann von Helmholtz. Nas décadas seguintes, a oftalmoscopia direta e indireta, com o uso de oftalmoscópios e lentes condensadoras, respectivamente, tornou-se parte do exame clínico, especialmente em oftalmologia e neurologia. Hoje, mais de 170 anos depois, diversos oftalmoscópios e lentes condensadoras estão disponíveis no mercado. No entanto, a oftalmoscopia ainda não é amplamente realizada no exame físico de médicos generalistas e o ensino da oftalmoscopia na faculdade de medicina ainda é desafiador. Estudos mostram que estudantes preferem usar modelos novos de oftalmoscópio ou lentes condensadoras durante seu treinamento, porém a maioria dos estudantes não se sente suficientemente confiante em realizar oftalmoscopia mais tarde, mesmo quando utilizam os modelos mais novos. Além disso, poucos alunos adquirem oftalmoscópios para sua prática futura, e ensaios clínicos não demonstraram uma clara superioridade dos novos modelos de oftalmoscópio em relação ao modelo convencional em acurácia diagnóstica. O aperfeiçoamento tecnológico das câmeras de smartphones nos últimos anos tornou possível fotografar o fundo do olho utilizando oftalmoscópios ou lentes condensadoras, reduzindo a necessidade de retinógrafos e equipamentos similares. A fundoscopia indireta realizada com smartphones vem se tornando cada vez mais popular. Esta abordagem permite a adequada identificação das estruturas do fundo do olho, é custo-efetiva, fácil de implementar e permite o fácil registro e compartilhamento das imagens obtidas, o que é útil para discussão de casos clínicos e para o ensino médico. Entretanto, ensaios clínicos controlados para a validação deste método na avaliação de patologias do nervo óptico são necessários.

Códigos QR en Educación Médica - Parte 3. Una Innovación en el Proceso de Enseñanza - Aprendizaje / QR Codes in Medical Education - Part 3. An Innovation in the Teaching-Learning Process

En esta tercera y última parte de la serie Códigos QR en Educación Médica analizaremos una nueva forma de Código QR con complementos de función y los distintos contextos educativos en los que se pueden emplear como una herramienta tecnológica innovadora durante el proceso de enseñanza ­ aprendizaje. Nuestro objetivo es lograr que los educadores se familiaricen con esta tecnología y puedan incorporarla al material educativo utilizado tanto en el aula tradicional como en los cursos virtuales.

In this third and last section of the series QR Codes in Medical Education we will analyze a new form of QR Code with complements of function and the different educational contexts in which they can be used as an innovative technological tool during the teaching-learning process. The final purpose is to ensure that all educators feel familiar with this technology and can incorporate it into the educational material used both in the traditional classroom and in virtual courses.

Prevalence of Smartphone Addiction and its Relation with Depression among School-going Adolescents

Background: Smartphone addiction among adolescents is an increasingly recognized problem worldwide. It affects the psychological well-being of an individual. Aim and objective: The current study aimed to assess smartphone addiction’s prevalence and its relation to depression among adolescents. Methods: This cross-sectional study was conducted among 400 school-going adolescents. Smartphone Addiction Scale - Short version (SAS-SV) and Patient Health Questionnaire (PHQ-9) were used to assess the prevalence of smartphone addiction and depression. Data were analyzed using Epi info software for windows (CDC, Atlanta). Statistical significance was set at p < 0.05. Results: The mean age of study participants was 14.4 years (SD=1.5 years). The prevalence of smartphone addiction was 23%, while depression was present among 45% of the study participants. Comparatively higher duration of smartphone use was significantly associated with smartphone addiction. Depression was significantly higher among smartphone addicts (77.2%) as compared to their counterparts (35.4%). Conclusion and Recommendation: The smartphone usage of adolescents, if not monitored, could lead to its addiction and thus increase the risk of depression among them. To prevent smartphone addiction, limiting children’s screen time is recommended. In this regard, parents can play a pivotal role by becoming responsible digital role models for their children.

A cross-sectional study to find out association between smartphone addiction and dry eye disease among medical students in Jamnagar

Background: In the recent times, use of smart phone and multimedia devices is extensive. With prolonged use of smart phones, multimedia devices and social media ophthalmic and psychiatric complications are rising in young population. Aim and Objectives: The aim of the study was to find out prevalence of smartphone addiction and dry eye disease and association between smartphone addiction and dry eye disease in medical students. Material and Methods: This study was conducted in M.P. Shah Government Medical College and included 201 medical students. This was analytical survey-based study. Data collection was done through Google form and the survey included demographic questions, pre-structured smartphone addiction scale-short version, and ocular surface disease index questionnaire. Results: The prevalence of dry eye disease in medical students was 52.73% and the prevalence of smartphone addiction was 20%. In our study, dry eye disease was present in 45% of subjects with smartphone addiction. Conclusion: The prolonged usage of smartphone leads to increased screen exposure time which may be causative factor for ophthalmic problems and dry eye disease. More awareness in adolescent and young population about potential hazards of prolonged screen exposure and smartphone is necessary nowadays.

Smartphone co-aided cobalt blue anterior segment with intraocular lens photography

In this report, we have utilized a smartphone-based innovative tool named anterior segment photography with an intraocular lens (ASPI) with a cobalt blue filter on the smartphone flash for photographing fluorescein-stained corneas. An intraocular lens along with a cobalt blue filter was attached to the smartphone camera to achieve this purpose. The filter could block out all wavelengths of light except the blue wavelength (450–490 nm) emerging from the smartphone camera. A pilot study was conducted on 27 eyes of 25 patients where images of various corneal pathologies were obtained using ASPI blue light imaging. The images were clear and highly magnified and could be used for documentation, teleconsultation for expert opinion, education, and monitoring of disease progression. ASPI-aided blue light imaging could be easily fabricated and is a frugal inexpensive device, which is used by different ophthalmic personnel to obtain fluorescein-stained corneal images.

Inclusão Digital de idosos: as (TICs) e o uso do celular / Digital inclusion of seniors: the (ICTs) and the use of the smartphone

O envelhecimento humano é um fenômeno que vem crescendo em escala global e se constitui como um acontecimento que chama a atenção de alguns anos para cá. Outro fator de muita relevância na contemporaneidade são as Tecnologias da Informação e Comunicação (TICs) que nos possibilitam questionar quais são os significados atribuídos pelos idosos a essas tecnologias, levando em consideração o uso do smartphone. O presente estudo tem como objetivo conhecer de que forma os idosos utilizam e como se relacionam com este aparelho. Trata-se de um estudo quantitativo, em que a coleta de dados foi realizada por meio da aplicação de questionários a 100 pessoas com mais de sessenta anos, participantes de grupos de convivência em uma cidade do interior do Rio Grande do Sul. Os dados foram analisados pelo programa Statistical Package for the Social Sciences (SPSS) versão 25, possibilitando a análise por meio de uma estatística descritiva. A pesquisa possibilitou a compreensão de como os idosos se relacionam com esta tecnologia, as dificuldades de inserção em um mundo conectado e as limitações que estes apresentam ao manusear seu smartphone. Também foram listados os aplicativos mais utilizados pela categoria pesquisada, contemplando durante a discussão os benefícios de utilizarem as TICs e os sentimentos que acometem esses idosos.(AU)

Human aging is a phenomenon that has been growing on a global scale and constitutes an event that has drawn attention in recent years. Another very relevant factor in contemporaneity are the Information and Communication Technologies (ICTs) that allow us to question what are the meanings attributed by the elderly to these technologies, considering the use of smartphones. The present study aims to understand how the elderly use and relate to this device. This is a quantitative study, in which data collection was carried out by applying questionnaires to 100 people over sixty years old, participants of socialization groups in a city in the countryside of Rio Grande do Sul. The data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 25, enabling analysis by using descriptive statistics. The research made it possible to understand how the elderly relate to this technology, the difficulties of insertion in a connected world, and the limitations they present when handling their smartphone. The applications most used by this researched category were also listed, contemplating during the discussion the benefits of using ICTs and the feelings that affect these elderly people.(AU)

Smartphone addiction and life satisfaction: mediating effect of negative emotions / Adicción a teléfonos inteligentes y satisfacción con la vida: efecto mediador de las emociones negativas

Background: Smartphone users have increased worldwide, due to their multifunctionality and accessibility. Objective: To determine the mediating effect of negative emotions between life satisfaction and smartphone addiction in college students. Method: A structural equation explanatory model was proposed in which each negative emotion (depression, anxiety, and stress) has a mediating role between life satisfaction and cell phone addiction. To this end, 1109 university students from Metropolitan Lima were selected and administered the DASS 21, SABAS, SWLS. Result: A partial effect of each mediating model was found, in addition to Satisfaction with life achieved a direct effect on cell phone addiction; at the same time the mediating variables achieved a significant direct effect on addictive behavior. Conclusion: Negative emotions have a mediating role in explaining smartphone addiction.

Introducción: Los usuarios de teléfonos inteligentes se han incrementado a nivel mundial, debido a su multifuncionalidad y accesibilidad. Objetivo: Determinar el efecto mediador de las emociones negativas entre la satisfacción con la vida y la adicción a los teléfonos inteligentes en universitarios. Método: Se planteó un modelo explicativo de ecuaciones estructurales en el cual cada emoción negativa (depresión, ansiedad y estrés) tienen un rol mediador entre la satisfacción con la vida y la adicción a los celulares. Con tal fin, se seleccionaron 1109 universitarios de Lima Metropolitana a los cuales se les aplicaron el DASS 21, SABAS, SWLS. Resultados: Se encontró un efecto parcial de cada modelo mediador, además la Satisfacción con la vida logró un efecto directo sobre la adicción a los teléfonos celulares; al mismo tiempo las variables mediadoras consiguieron un efecto directo significativo sobre la conducta adictiva. Conclusión: las emociones negativas tienen un rol mediador en la explicación de la adicción a los teléfonos inteligentes.

Smartphone-assisted online brief cognitive behavioral therapy to treat maternal depression: findings of a randomized controlled trial

Objective: To test the efficacy of smartphone-assisted online brief cognitive behavioral therapy (b-CBT) to treat maternal depression compared to online brief CBT plus an active control app. Methods: A randomized controlled trial was conducted. Assessments were performed at baseline (T0), midpoint (T1, week 4-5), post-treatment (T2, week 8), and follow-up (T3, 2-month postnatal follow-up) by blinded interviewers. The primary outcome was depression measured by the Edinburgh Postnatal Depression Scale (EPDS) at T2. We also assessed anxiety, stress, sleep quality, well-being, physical activity, treatment response, and offspring child behavior problems. Results: Eighty-one participants were randomized to the intervention (n=37) or active control (n=44) groups. Seventy-one participants completed the post-treatment assessment or reported primary outcome data. No differences were found between the intervention and active control groups regarding maternal depression or other mental health outcomes. Overall, we found large within-group effect sizes, with 80% of the total sample responding to treatment. Conclusions: Our data showed no difference between the groups, suggesting that adding apps to psychotherapy treatment may not enhance treatment effects on prenatal depression. A within-groups analysis showed that most participants with depression responded to treatment; however, future studies are needed to confirm whether this effect is related to factors other than the intervention.