'A lightbulb moment': carers' experiences of behavioural symptoms in motor neurone disease before and after MiNDToolkit.

BACKGROUND: To explore carers' experiences of behavioural symptoms in Motor Neurone Disease (MND), before and after using the MiNDToolkit, a novel internet-based psychoeducational intervention to support management of behavioural symptoms (BehSymp) in MND. The study also investigated carers' views and acceptability of MiNDToolkit. METHODS: A qualitative process evaluation of carers engagement with, and acceptability of, the MiNDToolkit conducted using semi-structured interviews with carers (n = 11). All interviews were audio-recorded, professionally transcribed verbatim and analysed thematically. RESULTS: Five themes were identified: (1) In the dark: carers' experiences and reactions to BehSymp; (2) Others can see: the role of HCPs in identifying symptoms - and perceived opportunities for carers to receive support; (3) Shedding light: carers implementation and perceived impact of the MiNDToolkit content; (4) Acceptability and carers' engagement with MiNDToolkit; (5) Future implementation. Carers' experience of BehSymp was particularly distressing when symptoms were apparently out of context. MiNDToolkit appeared to support learning that BehSymp were part of MND. Content resonated with carers, who reported learning about the full picture of MND, which led to acceptance and use of newly learned strategies. Engagement with the platform was good, with varied input from HCPs. Greater and nuanced involvement from HCPs seem important to support management of BehSymp. Recommendations for a full-scale trial emerged, including adding a paper booklet to accompany the intervention and creation of new modules on emotional lability, changes in relationships, and transitioning to a care home. CONCLUSIONS: MiNDToolkit was acceptable to carers overall. Recommended improvements should be actioned in a full-scale trial.

Caregivers' Internet-Delivered Insomnia Intervention Engagement and Benefit: SHUTi-CARE Trial Primary Quantitative Analysis.

BACKGROUND: Delivering insomnia treatment by the Internet holds promise for increasing care access to family caregivers, but their ability to adhere to and benefit from such fully-automated programs has not been rigorously tested. PURPOSE: This fully-powered, single-group trial tested whether characteristics of the caregiving context influence high-intensity caregivers' engagement with and benefit from an empirically validated Internet intervention for insomnia. METHODS: At baseline, caregivers providing unpaid time- and responsibility-intensive care who reported insomnia (N = 100; age M = 52.82 [SD = 13.10], 75% non-Hispanic white, 66% ≥college degree) completed questionnaires about caregiving context and sleep, then 10 prospectively-collected online daily sleep diaries. Caregivers then received access to SHUTi (Sleep Healthy Using the Internet), which has no caregiver-specific content, for 9 weeks, followed by post-assessment (questionnaires, diaries). Engagement was tracked by the SHUTi delivery system. RESULTS: Sixty caregivers completed SHUTi, 22 initiated but did not complete SHUTi, and 18 did not initiate SHUTi. Caregivers were more likely to use SHUTi (than not use SHUTi) when their care recipient (CR) had worse functioning, and were more likely to complete SHUTi when supporting more CR activities of daily living (ADL; ps < .03). Higher caregiver guilt, more CR problem behaviors, and being bedpartners with the CR related to more improved sleep outcomes, whereas supporting more CR instrumental ADL related to less improvement (ps < .05). CONCLUSIONS: Factors associated with greater caregiving burden, including greater CR impairment and caregiving guilt, were generally associated with better engagement and outcomes. Caregivers with substantial burdens can adhere to and benefit from a fully automated insomnia program without caregiver-specific tailoring.

This study examined how family caregivers, who often have trouble sleeping due to their responsibilities, used an online insomnia treatment program. The goal was to determine if certain aspects of caregiving would influence how caregivers engage with or benefit from the program. Researchers surveyed 100 caregivers with insomnia about their caregiving situation and sleep, and caregivers also kept online sleep diaries for 10 days. Afterward, caregivers used an online insomnia program with no caregiver-specific content called Sleep Healthy Using the Internet (SHUTi) for 9 weeks. Caregivers' usage was monitored, and they repeated measures of sleep outcomes and 10 online sleep diaries. Sixty caregivers completed SHUTi, 22 partially completed the program, and 18 did not initiate the program. Caregivers who cared for individuals with more severe functional limitations were more likely to use and complete SHUTi. Additionally, caregivers experiencing more guilt and those who managed more challenging behaviors from the person they cared for tended to report greater improvements in their sleep. This study suggests that caregivers, even those with significant care responsibilities, can use and benefit from an online insomnia treatment program like SHUTi, even when it has not been specifically tailored for caregivers.

Wireless optimization for sensor networks using IoT-based clustering and routing algorithms.

Wireless sensor networks (WSN) are among the most prominent current technologies. Its popularity has skyrocketed because of its capacity to operate in difficult situations. The WSN market encompasses various industries, including building automation, security networks, healthcare systems, logistics, and military operations. Therefore, increasing the energy efficiency of these networks is of utmost importance. Hierarchical topology, which typically uses a clustering methodology, is one of the most well-known methods for WSN energy optimization. To achieve energy efficiency in WSN, hierarchical topology low-energy adaptive clustering hierarchy (LEACH) was first introduced, and this served as the foundation. However, conventional LEACH has several limitations, which have led to extensive research into improving LEACH's efficacy in its current form. The use of particular algorithms and strategies to enhance the functionality of the conventional LEACH protocol forms the basis of ongoing efforts. Utilizing this enhanced LEACH, performance in terms of throughput and network life may be enhanced by concentrating on elements such as cluster head formation and transmission energy consumption. The enhanced LEACH algorithm demonstrates significant improvements in both throughput and network lifetime compared with conventional LEACH. Through rigorous experimentation, it was found that the enhanced algorithm increases the throughput by 25% on average, which is attributed to its dynamic clustering and optimized routing strategies. Furthermore, the network lifetime is extended by approximately 30%, primarily because of enhanced energy efficiency through adaptive clustering and transmission power control.

Detection of malicious nodes based on consortium blockchain.

With the development of technology, more and more devices are connected to the Internet. According to statistics, Internet of Things (IoT) devices have reached tens of billions of units, which forms a massive Internet of Things system. Social Internet of Things (SIoT) is an essential extension of the IoT system. Because of the heterogeneity present in the SIoT system and the limited resources available, it is facing increasing security issues, which hinders the interaction of SIoT information. Consortium chain combined with the trust problem in SIoT systems has gradually become an important goal to improve the security of SIoT data interaction. Detection of malicious nodes is one of the key points to solve the trust problem. In this article, we focus on the consortium chain network. According to the information characteristics of nodes on the consortium chain, it can be analyzed that the SIoT malicious node detection combined with the consortium chain network should have the privacy protection, subjectivity, uncertainty, lightweight, dynamic timeliness and so on. In response to the features above and the concerns of existing malicious node detection methods, we propose an algorithm based on inter-block delay. We employ unsupervised clustering algorithms, including K-means and DBSCAN, to analyze and compare the data set intercepted from the consortium chain. The results indicate that DBSCAN exhibits the best clustering performance. Finally, we transmit the acquired data onto the chain. We conclude that the proposed algorithm is highly effective in detecting malicious nodes on the combination of SIoT and consortium chain networks.

Enhancing user experience in the digital service environment: A comprehensive study on the design and evaluation of internet-based healthcare products.

RATIONALE: In the era of burgeoning digital technology, healthcare is a challenging transformative change towards virtual and digital platforms. Internet-based healthcare services are emerging as a popular trend within the medical area. User experience (UX) is paramount for the healthcare service, as it significantly influences experience satisfaction and fosters user viscosity. Gaining a profound understanding of users' demands and crafting services that align with their expectations is essential. METHODS: Consequently, exploring an effective design approach for the digital healthcare service that prioritizes UX along with utilizing a comprehensive evaluation methodology to handle UX data, is of profound importance. This study introduces a design methodology for Internet-based healthcare products grounded in the UX and mental (UX-M) model. Aiming to refine the Internet-based healthcare product design by integrating insights from the experience data, it employs the Delphi-ANP and the fuzzy comprehensive evaluation to determine evaluation indexes and conduct experiential assessments. RESULTS: The UX evaluation results of existing schemes are compared with the proposed design scheme of the intelligent guidance and internet hospital. The findings indicate that the UX evaluation of Internet-based medical services with the proposed method outperforms the existing schemes. CONCLUSIONS: On the one hand, UX research of Internet-based healthcare products can significantly enhance service satisfaction for patients utilizing online medical treatments. On the other hand, the analysis of experience-based evaluation empowers designers to refine and improve UX design of Internet-based medical services. Such research endeavors are critical for enhancing the overall quality of service offerings and elevating user satisfaction in the digital healthcare landscape.

Altered Heart Rate Variability During Mobile Game Playing and Watching Self-Mobile Gaming in Individuals with Problematic Mobile Game Use: Implications for Cardiac Health.

Introduction: The surge in mobile gaming, fueled by smartphone and internet accessibility, lacks a comprehensive understanding of physiological changes during gameplay. Methods: This study, involving 93 participants (average age 21.75 years), categorized them into Problematic Mobile Gaming (PMG) and non-problematic Mobile Gaming (nPMG) groups based on Problematic Mobile Gaming Questionnaire (PMGQ) scores. The PMGQ is a 12-item scale developed in Taiwan to assess symptoms of problematic mobile gaming. The research delved into heart rate variability (HRV) alterations during real-time mobile gaming and self-gaming video viewing. Results: Results showed that the PMG group significantly presents a lower root mean square of successive differences (RMSSD), and High Frequency (lnHF) than does the nPMG group (F=4.73, p=0.03; F=10.65, p=0.002, respectively) at the baseline. In addition, the PMG group significantly displayed elevated HF and low-frequency to high-frequency (LF/HF) in the mobile-gaming (F=7.59, p=0.007; F=9.31, p=0.003) condition as well as in the watching self-gaming videos (F=9.75, p=0.002; F=9.02, p=0.003) than did the nPMG. Conclusion: The study suggests targeted interventions to mitigate autonomic arousal, offering a potential avenue to address adverse effects associated with problematic mobile gaming behavior. The PMG group displayed increased craving scores after real-time mobile gaming and watching self-gaming video excerpts, unlike the nPMG group. Elevated LF/HF ratios in frequent gaming cases heightened autonomic arousal, presenting challenges in relaxation after mobile gaming. These findings contribute to a nuanced understanding of the complex interplay between mobile gaming activities, physiological responses, and potential intervention strategies.

The Association Between Intolerance of Uncertainty and Mobile Phone Addiction Among Overseas Chinese Students During COVID-19: The Mediating Roles of Perceived Stress and Rumination.

Purpose: This study investigated the mechanism underlying the association between intolerance of uncertainty and mobile phone addiction among Chinese overseas students during the COVID-19 pandemic by examining the mediating roles of perceived stress and rumination. Patients and Methods: An online questionnaire survey was distributed via social media platforms popular in mainland China. The items collected demographic information and assessed intolerance of uncertainty, perceived stress, rumination, and mobile phone addiction. A total of 249 respondents completed the questionnaire. Results: The findings suggest a considerably high risk of mobile phone addiction in the study period among overseas Chinese students, as three-fourths of the participants may have been susceptible to mobile phone addiction according to the suggested cut-off point of the Chinese version of the Smartphone Addiction Scale-Short Form. Intolerance of uncertainty showed a significant positive direct effect on mobile phone addiction. The mediation analyses suggest that intolerance of uncertainty affected mobile phone addiction mainly through three pathways: the mediating effect of perceived stress, the mediating effect of rumination, and the chain mediating effect of perceived stress and rumination. Conclusion: This study enhances understanding of mobile phone addiction among Chinese overseas students and suggests the mediating roles of rumination and perceived stress in the relationship between intolerance of uncertainty and mobile phone addiction. The study also provides suggestions for interventions among Chinese students overseas.

An Empirical Investigation of the Relationships Among Self-Esteem, Depression and Self-Serving Bias in People with Internet Gaming Disorder.

Introduction: People are generally characterized by a self-serving bias which describes the tendency to ascribe positive outcomes or success to internal or personal causes (self-enhancement motivation) and ascribe negative outcomes or failure to external or situational causes (self-protection motivation). It has been found that the individuals with internet gaming disorder (IGD) who have low self-esteem and high depression exhibit an attenuated self-serving bias. However, the relationships among self-esteem, depression and self-serving bias are not clearly identified. Methods: A sample of 138 IGD participants completed self-esteem and depression scales and a causal attribution task (Study 1) to examine the relationships among self-esteem, depression and self-serving bias (both self-enhancement and self-protection). In follow-up Study 2, 28 IGD participants were recruited to undertake self-affirmation intervention which can affirm one's sense of global self-view and bolster self-esteem to explore whether self-affirmation would trigger a reduction of depression and a raise of self-serving bias. Results: The results of path analysis in Study 1 showed that the self-serving bias was predicted by self-esteem and depression, and the depression played a mediating role between self-esteem and self-serving bias. The results of Study 2 showed that the IGD participants reported higher self-esteem, lower depression and engaged in more self-protection motivation after affirming-self manipulation as compared with affirming-other manipulation. Conclusion: These findings suggest that self-esteem predicts self-serving bias through depression and self-affirmation could trigger an increase of self-esteem, further decrease depression and improve self-serving bias for the individuals with IGD. The present article clearly identified the relationships among these factors and provided a new approach to promote positive self-concept in individuals with IGD. Future research is warranted to explore the lasting benefits of self-affirmation on domains of education, relationships and gaming withdrawal for the individuals with IGD among different populations.

Alignment of port policy to the context of the Physical Internet.

The Physical Internet (PI) is a paradigm-changing and technology-driven vision, which is expected to significantly impact the development of the freight transport and logistics (FTL) system of today. However, the development of the FTL system towards the PI creates much uncertainty for its current stakeholders. Ports are one of those stakeholders that are expected to be profoundly affected by these developments. However, research that focuses on port policy, under the uncertain developments towards the PI, is still lacking. By providing port authorities with insights and recommendations on robust policy areas, we address this void in literature. We conduct a scenario analysis in combination with multi-criteria decision analysis (MCDA) to determine the importance of port performance indicators and policy areas in different scenarios. The most significant, uncertain, and orthogonal factors for the development of the PI are technological development and institutional development. We find that for a proper alignment with the PI vision, in three out of four scenarios, ports should prioritize the implementation of digital solutions and standards, as opposed to an infrastructure focused policy.

Evaluation of Telemedicine Consultations Using Health Outcomes and User Attitudes and Experiences: Scoping Review.

BACKGROUND: Despite a recent rise in adoption, telemedicine consultations retention remains challenging, and aspects around the associated experiences and outcomes remain unclear. The need to further investigate these aspects was a motivating factor for conducting this scoping review. OBJECTIVE: With a focus on synchronous telemedicine consultations between patients with nonmalignant chronic illnesses and health care professionals (HCPs), this scoping review aimed to gain insights into (1) the available evidence on telemedicine consultations to improve health outcomes for patients, (2) the associated behaviors and attitudes of patients and HCPs, and (3) how supplemental technology can assist in remote consultations. METHODS: PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guided the scoping review process. Inclusion criteria were (1) involving adults with nonmalignant, noncommunicable chronic conditions as the study population; (2) focusing on health outcomes and experiences of and attitudes toward synchronous telemedicine consultations between patients and HCPs; and (3) conducting empirical research. A search strategy was applied to PubMed (including MEDLINE), CINAHL Complete, APA PsycNet, Web of Science, IEEE, and ACM Digital. Screening of articles and data extraction from included articles were performed in parallel and independently by 2 researchers, who corroborated their findings and resolved any conflicts. RESULTS: Overall, 4167 unique articles were identified from the databases searched. Following multilayer filtration, 19 (0.46%) studies fulfilled the inclusion criteria for data extraction. They investigated 6 nonmalignant chronic conditions, namely chronic obstructive pulmonary disease, diabetes, chronic kidney disease, ulcerative colitis, hypertension, and congestive heart failure, and the telemedicine consultation modality varied in each case. Most observed positive health outcomes for patients with chronic conditions using telemedicine consultations. Patients generally favored the modality's convenience, but concerns were highlighted around cost, practical logistics, and thoroughness of clinical examinations. The majority of HCPs were also in favor of the technology, but a minority experienced reduced job satisfaction. Supplemental technological assistance was identified in relation to technical considerations, improved remote workflow, and training in remote care use. CONCLUSIONS: For patients with noncommunicable chronic conditions, telemedicine consultations are generally associated with positive health outcomes that are either directly or indirectly related to their ailment, but sustained improvements remain unclear. These modalities also indicate the potential to empower such patients to better manage their condition. HCPs and patients tend to be satisfied with remote care experience, and most are receptive to the modality as an option. Assistance from supplemental technologies mostly resides in addressing technical issues, and additional modules could be integrated to address challenges relevant to patients and HCPs. However, positive outcomes and attitudes toward the modality might not apply to all cases, indicating that telemedicine consultations are more appropriate as options rather than replacements of in-person visits.

Gaming Disorder: The role of a gamers flow profile.

Digital games are widely popular and integral to contemporary entertainment. Nevertheless, a proportion of users present with disordered/excessive gaming behaviours, provisionally classified as Internet Gaming Disorder (IGD). Previous literature suggests examining the contribution of an individual's profile of immersive engagement with their gaming activity, known as online flow, for disordered gaming behaviours. Therefore, the main goals of this study were (1) to categorise gamers into distinct profiles based on their online flow experiences and (2) to investigate the differences in disordered gaming among these different flow profiles. A sample of 565 gamers (12-68 years, Mage = 29.3 years) was assessed twice over six months with the Online Flow Questionnaire (OFQ), the Internet Gaming Disorder Scale-Short-Form (IGDS9-SF), and the Gaming Disorder Test (GDT). Latent profile analysis (LPA) identified five distinct profiles encompassing 'High-Flow with High Loss of Control' (HF-HLOC; 14.0 %), 'Low Flow with Low Enjoyment' (LF-LE; 11.9 %), 'Average Flow with Low Enjoyment' (AF-LE; 17.5 %), 'Low Flow with High Enjoyment' (LF-HE; 20.2 %), and 'High Loss of Sense of Time with Low Loss of Control' groups (HLOT-LLOC; 36.5 %). As hypothesised, individuals across varying profiles evidenced differences in their concurrent and longitudinal disordered gaming behaviours. Overall, findings suggest that 'loss of sense of time' may be the most pivotal factor in differentiating flow states and profiles during gaming, advocating its consideration in disordered gaming assessment and treatment.

Internet addiction among adolescents during the COVID-19 pandemic: Associations with sociodemographic and psychological distress.

Background: The COVID-19 pandemic has had tremendous implications for billions of adolescents worldwide due to school closures, forcing students to embrace internet usage for daily tasks. Uncontrolled use of the internet among adolescents makes them vulnerable to internet addiction (IA). This study aims to determine the prevalence of IA among adolescents and assess its association with sociodemographic factors, smartphone use, and psychological distress during the pandemic. Method: A cross-sectional self-administered online survey was conducted among students aged 13-17 from May 15th, 2021, until May 30th, 2021, using the Malay version of the Internet Addiction Test (MVIAT), the Depression, Anxiety, and Stress Scale (DASS-21), and the Coronavirus Impacts Questionnaires, as well as a sociodemographic information form. The data was analyzed with IBM SPSS Statistics version 23. Results: A total of 420 adolescents participated in the survey. The majority of them (70.7%) were female, with a mean age of 15.47 years (±1.49 years old). About 45.5% of the respondents were classified as internet addicted users. The Chi-square test analysis showed that age (p = 0.002), smartphone usage (p = 0.010), rate of midnight use (p < 0.001), frequency (p < 0.001), duration (p < 0.001) of device usage, and presence of depression, anxiety, and stress (p < 0.001) were all significantly associated with IA. Multiple logistic regression showed age (aOR = 1.16, 95% CI [1.00-1.35], p = 0.048), smartphone usage (aOR =3.52, 95% CI [1.43-8.67], p = 0.006), mild or moderate depression (aOR = 2.43, 95% CI [1.36-4.34], p = 0.003), severe or extremely severe stress (aOR = 6.41, 95% CI [2.18-18.82], p = 0.001) were significantly related to IA. Conclusions: Late adolescence, the use of smartphones, and the presence of psychological distress like depression, and stress were potentially associated with IA. Wise use of smartphones and early identification of any psychological distress among adolescents are warranted, especially during the pandemic.

Cognitive, Metacognitive, Motivational, and Emotional Predictors of the Intensity of Internet Gaming Disorder among Adolescents.

Internet gaming disorder (IGD) is multifaceted and can have significant negative consequences. The present study examined the contribution of cognitive, metacognitive, motivational, and emotional factors as predictors for IGD severity. In a cross-sectional study, 703 Iranian adolescents (36.8% females, mean age = 16.98 years [SD = 1.23]) completed an online survey. Hierarchical regression analysis showed that the cognitive, metacognitive, motivational, and emotional factors predicted 7.8%, 17.4%, 1.4%, and 1.9% of the variance in IGD symptoms, respectively. The findings indicated that the cognitive factors including some maladaptive cognitions, such as cognitive salience, regret, and perfectionism, and metacognitive factors including some maladaptive metacognitions (negative metacognitions regarding the uncontrollability of online gaming and negative metacognitions regarding the dangers of online gaming) were significant predictors of IGD severity, highlighting their importance in understanding and predicting problematic gaming behaviors. Although contributing to the variance in IGD, motivational factors (escape, coping, and skill development) and emotional factors including emotion regulation (especially reappraisal) played relatively smaller roles compared to cognitive and metacognitive factors. Of the examined predictive factors, metacognitions were the most important predictor of IGD severity. Exploratory moderator analyses showed significant interactions between three predictors of IGD (reappraisal, negative metacognitions, and cognitive salience) with loneliness, stress, anxiety, and depressive symptoms. Reappraisal was the most frequent predictor and had a significant interaction with these variables. Other predictors independently impacted IGD irrespective of the level of loneliness, stress, anxiety, or depressive symptoms. Based on these findings, special attention to metacognitive, cognitive, emotional, and motivational factors is suggested in the treatment of IGD.

Similarities and differences in the psychological factors associated with generalised problematic internet use, problematic social media use, and problematic online gaming.

Problematic online behaviours are a concern among university students. Although previous research has identified that psychological distress, cognitive distortions, conscientiousness and neuroticism traits, motor impulsivity, and emotion regulation strategies have a significant direct effect on generalised problematic Internet use (GPIU), problematic social media use (PSMU), and problematic online gaming (POG), it is still necessary to determine the extent to which these psychological factors, taken together, are associated with each of the problematic online behaviours. In a sample of 690 Spanish university students, the present study examined the relationship of these psychological factors with GPIU, PSMU, and POG. Correlation and regression analyses were performed. Results reported that (1) high psychological distress, low conscientiousness trait and high motor impulsivity were common associated factors of GPIU and PSMU, but not of POG; (2) high levels of cognitive distortions and cognitive reappraisal were common associated factors of GPIU, PSMU and POG; and (3) expressive suppression and neuroticism trait had no effect on any of the three problematic online behaviours. The findings will help to develop effective prevention and intervention strategies for each problematic online behaviour in the university context.

Accuracy, readability, and quality of websites about metastatic renal cell carcinoma treatment.

OBJECTIVES: Patients with metastatic renal cell carcinoma (mRCC) face complex treatment decisions and frequently turn to the Internet for treatment information. The content of patient educational websites about mRCC treatment has not been evaluated. This study evaluated the accuracy, readability, and quality of websites about the treatment of mRCC. METHODS: A total of 2,700 Internet queries were performed. Across 3 Internet search engines, 25 links of 36 permutations of mRCC keywords and their synonyms were screened for eligibility. Eligible websites were English-language websites containing information about mRCC treatments. Sponsored, social media, provider-facing, and news websites were excluded. Accuracy of eligible websites was evaluated in 2 domains: (1) Completeness by calculating the percentage of mRCC facts included in websites using an investigator-created checklist based on the NCI's RCC Treatment (PDQ®)-patient version, and (2) Correctness by identifying incorrect statements that were inconsistent with guidelines. Websites containing ≥60% of checklist items had a "passing" completeness score. Incorrect statements were tallied and qualitatively categorized. Readability was evaluated using the Fry and SMOG formulae, which calculate reading grade levels. Quality was evaluated using validated instruments that appraise health information quality: QUEST (scored 0-28), which focuses on online information, and DISCERN (scored 16-80), which focuses on treatment choices. RESULTS: Thirty-nine websites were analyzed. Mean completeness score was 30% (range 0%-69%); only 2 (5%) websites had a passing score. Twelve (31%) websites had ≥1 incorrect statement, such as listing homeopathy or hormone therapy as mRCC treatment options, or including outdated statements. Mean readability levels were 11th and 12th grades for the Fry and SMOG methods, respectively. No website had a reading level lower than 9th grade. Mean QUEST score was 19 (range 9-28); authorship, complementarity, and currency items had the lowest scores. Mean DISCERN score was 56 (range 42-76), with 7 (18%) websites rated "excellent", 22 (56%) rated "good", and 10 (26%) rated fair. CONCLUSIONS: Many websites about mRCC treatment have incomplete, inaccurate, and unreadable information. Quality is highly variable. Efforts to improve accuracy, readability, and quality are needed to ensure that patients with mRCC can make well-informed treatment decisions and avoid harm from misinformation.

The relationship between internet addiction, sleep quality, and psycho-social problems among secondary school students in Erbil, 2023-2024.

OBJECTIVE: This study aimed to show the association between internet addiction (IA), sleep quality, and psycho-social problems among secondary school students DESIGN: A cross-sectional, descriptive, and correlational study design was used. SAMPLE: A total of 557 students from four secondary schools in Erbil were selected using multistage cluster sampling MEASUREMENTS: The questionnaires of this research contained socio-demographic data, Internet Addiction Test (IAT), Pittsburgh Sleep Quality Index (PSQI), and Pediatric Symptom Checklist-Y (PSC-Y) questionnaire. RESULTS: Findings indicated that students displayed a mild IA, averaging a score of 42.9 ± 19.18. Furthermore, the average sleep quality (PSQI) score was 8.95 ± 2.75, indicating moderate sleep disturbance, and the average score for psycho-social problems was 27.78 ± 13.29. Importantly, there was a strong and positive association between IA and psycho-social issues, as shown by a correlation coefficient of 0.31 (p < .001). Sleep quality was correlated with IA and psychosocial issues (p < .001, correlation values: .23 and .27, respectively) CONCLUSIONS: The study highlights the urgent need for health policymakers and nursing managers in Erbil to develop targeted interventions, such as awareness campaigns and digital well-being programs in school curricula, to mitigate the interlinked issues of IA, sleep quality, and psycho-social problems among students.

Measuring the adoption of internet and communication technologies among practitioners in routine disability services: a stepped inclusive approach.

PURPOSE: Existing measurements of the use of information and communication technologies (ICTs) among practitioners in disability services often treat ICT adoption as a monolithic concept, overlooking its multifaceted nature within the disability field. This study introduces a stepped, inclusive approach to capturing this complexity, elucidating disparities in the utilization of various ICT dimensions, the present vs. anticipated use, and variations among different clinical-demographic groups. MATERIALS AND METHODS: A cross-sectional survey was conducted in Hong Kong, gathering valid data from 324 practitioners spanning diverse disciplines and disability services. RESULTS: Data analysis produced a three-factor model categorizing ICT tools into (1) information and communication tools, (2) screening and monitoring tools, and (3) treatment and rehabilitation tools. The first category was identified as the predominant ICT utilized currently, with significant projected growth in the latter two categories' usage. Variances in current ICT adoption were influenced by practitioners' roles, clientele, positions, affiliating agencies, and educational attainments. CONCLUSIONS: This research provides a deeper understanding of the key dimensions of ICT adoption within disability services. It underscores the importance of devising specific and customized strategies for the effective integration of ICTs, ensuring a more tailored approach to meeting the unique demands of the disability field.

Future studies focusing on information and communication technologies (ICTs) adoption or relevant concepts, such as e-health and telerehabilitation may consider employing similar methodological approaches accustomed to one's local context.Future attention and investment in ICT adoption in disability services should focus more on domains directly relevant to clinical and rehabilitation practice, tailoring strategies to the specific needs of the field.There exists an urgent imperative to enhance ICT training, especially for psychosocial and medical professionals, while also increasing investments in non-governmental organizations.Such support needs to be gender- and age-inclusive, ensuring it meets the diverse needs of practitioners at all organizational levels.

Effect of an Internet-based mental health promotion intervention among immigrant Chinese women: A quasi-experimental study.

Background: Owing to a lack of social support, child-rearing Chinese women in Japan experience mental health disorders, such as depression and parenting stress. Effective interventions to improve the mental health of these women are lacking. This study aimed to develop an Internet-based mental health promotion intervention for this subsection of the population and evaluate the effectiveness of the intervention. Methods: We used a quasi-experimental pre- and post-test design whereby the results of the intervention group were compared with those of a control group. Seventy-three child-rearing women were recruited from online groups of Chinese residents in Japan. In the Internet-based intervention, participants utilised an information provision application and attended online parenting workshops. The intervention group participated in the online workshops once a week for six weeks and accessed the application, whereas the control group did not. The outcome measures included the levels of mental health distress, depression, social support, and parenting stress. Data were collected from February to April 2022. Data analysis was performed using repeated-measures analysis of variance. Results: Mental health distress (F = 16.478, p < 0.001, η2 = 0.210) and depression (F = 13.078, p = 0.001, η2 = 0.174) were significantly affected in the intervention group compared with the control group. There were no significant differences in social support and parenting stress between the groups. The Internet-based mental health promotion intervention was highly appraised by the participants. Conclusions: This study developed an Internet-based mental health promotion intervention that involved an information provision application and parenting workshops. The intervention significantly reduced the mental health distress and depression of Chinese women in Japan but did not affect social support and parenting stress. The findings suggest that this intervention could be applied to foreign women with multicultural backgrounds in diverse settings to improve their psychological well-being.

The fear of smartphone notifications and calls among medical students: The phone ring phobia syndrome or telephobia.

Background: Telephobia is a kind of anxiety disorder in which the individual is afraid of either answering or making telephone calls. This study was conducted to determine the prevalence of telephobia among medical students and to determine the association of socio-demographic and other factors with this disorder. Methods: A total of 320 undergraduate medical students were enrolled at a tertiary medical college in Western India, of which 300 (93.75%) responded to the survey. A stratified sampling strategy with the proportional allocation method was used in which 40 males and 20 females were selected from each year of students, spanning 5 years. A specially designed semi-structured questionnaire was used for the study, consisting of demographic data, purpose of using the internet, gadget used, and a 10-item telephobia questionnaire modified from the Severity Measure for Agoraphobia-Adult (SMA-A) Questionnaire to measure student's avoidance of telephone calling and receiving. Results: The mean age of the study participants was 21.91 (±1.84) years, and most of the students were urban residents (184, 61.3%). The prevalence of mild, moderate, and severe telephobia was 33.0%, 7.67%, and 1.33%, respectively, giving an overall prevalence of 42%. Univariate analysis revealed that male gender (χ2 = 9.822, df = 3, p = 0.0201), higher duration of internet usage (χ2 = 41.15, df = 9, p value < 0.000), and viewing porn (χ2 = 15.94, df = 3, p = 0.0011) had significant association with higher severity of telephobia. Viewing of porn sites was reported by 65 (21.7%) medical students, exclusively among males. Conclusion: A prevalence of 9% moderate to severe telephobia among medical students is much alarming, which may aggravate further as the students move from academic to clinical settings. The phenomenon of telephobia needs further exploration, to find its determinants and predictors, especially among vulnerable populations.

Emotional eating, internet overuse, and alcohol intake among college students: a pilot study with virtual reality.

Introduction: The term emotional eating (EE) describes the tendency to eat as an automatic response to negative emotions and has been linked to anxiety and depression, common symptoms among the university population. The EE tendencies have also been associated with excessive internet use and an increase in alcohol intake among young university students. Methods: The aim of this study is to examine the relationship between the tendency towards EE and other health-compromising behaviors, such as excessive internet use or high alcohol intake. Additionally, it aims to investigate the association of these risky behaviors with the participants' performance level in a virtual reality (VR) task that assesses their executive functioning, and to assess impulsivity and levels of anxiety and depression. Results: The results associate EE with excessive internet (r = 0.332; p < 0.01). use but not with alcohol consumption. Alcohol consumption was not associated with anxiety, depression, or impulsivity, but it was related to altered executive functions in the VR task: flexibility and working memory explained 24.5% of the variance. By contrast, EE and internet overuse were not related to executive function but were associated with impulsivity, depression, and anxiety. Impulsivity and depressive symptoms accounted for 45% of the variance in EE. Depression, trait anxiety and impulsivity explained 40.6% of the variance in internet overuse. Discussion: The results reveal distinct patterns of psychological and neuropsychological alterations associated with alcohol consumption compared to emotional eating (EE) and excessive internet use. These findings underscore significant differences in the contributing factors between addictions and other substance-free addictive behaviors. For a deeper understanding of the various contributing factors to EE in college students, further research is recommended.