Validation of Self-Reported Smartphone Usage Against Objectively-Measured Smartphone Usage in Hong Kong Chinese Adolescents and Young Adults

Objective@#This study evaluated the validity of self-reported smartphone usage data against objectively-measured smartphone usage data by directly tracking the activities in the participants’ smartphone among Chinese adolescents and young adults in Hong Kong. @*Methods@#A total of 187 participants were recruited (mean age 19.4, 71.7% female) between 2017 and 2018. A smartphone usage tracking app was installed on all participants’ smartphone for 7 consecutive days. After the 7-day monitoring period, they completed a selfadministered questionnaire on smartphone usage habits. @*Results@#Although the correlation between self-reported and objectively-measured total smartphone usage time was insignificant (ρ=-0.10, p=0.18), in three out of the four usage domains were positively and significantly correlated, namely social network (ρ=0.21, p=0.005), instant messaging (ρ=0.27, p<0.001), and games (ρ=0.64, p<0.001). Participants’ self-report of the total time spent on smartphones exceeded the objective data by around 760 min per week (self-reported 1,930.3 min/wk vs. objectively-measured 1,170.7 min/wk, p<0.001). Most of the over-reporting was contributed by the web browsing domain (self-reported 447.8 min/wk vs. objectively-measured 33.3 min/wk, p<0.001). @*Conclusion@#Our results showed large discrepancies between self-reported smartphone and objectively-measured smartphone usage except for self-reported usage on game apps.

A Comparative Study on Health Expenditure among Individuals with Diabetes and Hypertension in Rural Tamil Nadu

Introduction: Recent data reveal the diabetic prevalence in adult population to be around 8.8% and prevalence of hypertension 25–29%. Out-of-pocket (OOP) expenditure on the treatment of chronic diseases continues to be the major impediment and a burden on the people. 78% of Indian population spend out of their pockets financing for health in India. Aim and Objectives: The aim of the study is to compare OOP expenditure of diabetes and hypertension. Materials and Methods: A descriptive cross-sectional study was carried out in the rural field practice area of tertiary medical college in Trichy district of India. Mean cumulative expenditures on diabetes hypertension in medications and investigations were compared. Results: Mean cumulative OOP expenditure was Indian rupee (INR) 1435/month (approximately INR 17,200 annually) for diabetes and INR 313 (approximately INR 3756 annually) for hypertension. Comparative cumulative OOP expenditure per month between the two groups was found to be highly significant (0.009). Conclusion and Recommendations: Out of Pocket Expenditure on diabetes treatment in the present setting was 4 times the treatment of hypertension. Policymakers should consider subsidizing the cost of diabetes expenditure.

Porphyromonas gingivalis, patógeno de relevancia en la enfermedad periodontal / Porphyromonas gingivalis, pathogen of interest in periodontal disease

Porphyromonas gingivalis (P.Gingivalis) es un microorganismo comprometido en el inicio y progresión de la enfermedad periodontal crónica y agresiva, y es considerado su principal agente etiológico. Esta bacteria cuenta con una serie de factores de virulencia que le permiten, iniciar el proceso infeccioso, perpetuar la infección y también transformar la placa dental benigna en una comunidad microbiana patógena. Estudiar sus factores de virulencia y su capacidad de modular la respuesta inmunológica del huésped es muy importante para comprender el papel de este patógeno en el desarrollo y establecimiento de la enfermedad. Esta revisión proporciona una visiónactual sobre los factores de virulencia y su impacto sobre la respuesta inmunológica en relación con la patogénesis de la enfermedad periodontal.

Influences on Healthcare-seeking during Final Illnesses of Infants in Under-resourced South African Settings.

To examine how health caregivers in under-resourced South African settings select from among the healthcare alternatives available to them during the final illness of their infants, qualitative interviews were conducted with 39 caregivers of deceased infants in a rural community and an urban township. Nineteen local health providers and community leaders were also interviewed to ascertain opinions about local healthcare and other factors impacting healthcare-seeking choices. The framework analysis method guided qualitative analysis of data. Limited autonomy of caregivers in decision-making, lack of awareness of infant danger-signs, and identification of an externalizing cause of illness were important influences on healthcare- seeking during illnesses of infants in these settings. Health system factors relating to the performance of health workers and the accessibility and availability of services also influenced healthcare-seeking decisions. Although South African public-health services are free, the findings showed that poor families faced other financial constraints that impacted their access to healthcare. Often there was not one factor but a combination of factors occurring either concurrently or sequentially that determined whether, when, and from where outside healthcare was sought during final illnesses of infants. In addition to reducing health system barriers to healthcare, initiatives to improve timely and appropriate healthcare-seeking for sick infants must take into consideration ways to mitigate contextual problems, such as limited autonomy of caregivers in decision-making, and reconcile local explanatory models of childhood illnesses that may not encourage healthcare-seeking at allopathic services.

Mortalidad tardía en el IAM con ST recíproco / Slow mortality at IAM with reciprocal ST

Antecedentes: La depresión recíproca del ST en el IAM puede ser signo de una mayor masa miocárdica bajo agresión isquémica, asociada a una peor evolución inmediata y tardía (1 a 4), o un fenómeno eléctrico inocente (5 a 8). Material y métodos: Se analizan las implicancias inmediatas y tardías de la depresión recíproca del ST en el IAM en los pacientes del MDPIT. Resultados: En los pacientes con IAM anterolateral (n 484), la depresión inferior del ST en 103 se asocia a mayor incidencia de picos de CPK > 1.000 U/I. (p.005), de EF < 0.40 (p .097) y de digitalización prealeatorización (p .084). Estos pacientes presentan menor sobrevida por muertes de cualquier causa (p. 0061) y de causas cardíacas (p. 0381) y modificaciones ulteriores de la localización (p .044) y categorización (p .000.006) ECG del IAM, no atribuibles a isquemia residual ni al tratamiento con Diltiazem/Placebo. En los pacientes con IAM inferior (n 599), el infradesnivel anterior del segmento ST en 92 se relaciona con una mayor incidencia de picos de CPK > 1.000 U/I. (p .0009), congestión radiológica (p .035) y uso de diuréticos pre-Rnd (p .053). estos pacientes no presentan reducción en la sobrevida ni cambios electrocardiográficos ulteriores. Conclusiones: La depresión del segmento ST a distancia en un IAM es un indicador de una mayor agresión isquémica. En el IAM anterolateral se relaciona con una reducción de la sobrevida post-IAM y a cambios ECG ulteriores. No atribuible a isquemia residual, serían causados por el remodelamiento post-IAM.