Competencias digitales en los ingresantes a la carrera de Licenciatura en Enfermería

Objetivo: Determinar las habilidades y conocimientos sobre las tecnologías de la información y la comunicación (TIC) de los ingresantes a la carrera de Licenciatura en Enfermería de una institución superior pública de Bahía Blanca, Provincia de Buenos Aires, Argentina. Metodología: Estudio observacional, descriptivo, transversal y cuantitativo. Se implementó un instrumento conformado por 59 preguntas con opciones de respuesta cerrada orientado a valorar las competencias digitales en los ingresantes a la carrera. Resultados: Participaron 386 ingresantes, mayormente de género femenino (85.49 %), del primer ciclo (74.35 %) y con 20 años o menos de edad (47.15 %). El 98.19 % tenía acceso a internet, el 79.27 % tiene computadora y más del 80 % tiene un amplio uso de redes sociales (WhatsApp, Instagram) y correo electrónico. Los ingresantes se autoevaluaron competentes en el programa MS Word, mientras que en MS Excel se declararon menos competentes. Hay desconocimiento y bajo desarrollo de habilidades para generar contenido, y un amplio despliegue de habilidades para buscar y descargar información de la web. La edad, el género, el tiempo diario de uso de internet y el ciclo de ingreso mostraron relación con el dominio de las herramientas digitales aplicadas a la educación. Conclusiones: Se identificó un desarrollo intermedio de competencias digitales aplicadas a la educación, lo que podría ameritar el diseño de programas que nivelen estas habilidades durante el proceso de ingreso o durante la formación.

Objetivo: determinar habilidades e conhecimentos sobre as tecnologias da informação e comunicação (TIC) dos calouros no curso de bacharelado em enfermagem em uma instituição pública de ensino superior na cidade de Bahía Blanca, província de Buenos Aires, Argentina. Metodologia: estudo observacional, descritivo, transversal e quantitativo. Foi utilizado um instrumento composto por 59 perguntas com opções de resposta fechada para avaliar as competências digitais dos calouros do curso. Resultados: Participaram 386 estudantes, em sua maioria do gênero feminino (85,49 %), do primeiro ciclo estudantil (74,35 %) e com idade igual ou inferior a 20 anos (47,15 %). 98,19 % tinham acesso à internet, 79,27 % tinham computador e mais de 80 % usavam amplamente as redes sociais (WhatsApp, Instagram) e o e-mail. Os calouros se auto-avaliaram competentes no programa MS Word, enquanto no MS Excel se declararam menos competentes. Há desconhecimento e baixo desenvolvimento de habilidades para gerar conteúdo e uma ampla demonstração de habilidades para pesquisar e baixar informações da web. A idade, o gênero, o tempo diário de uso da Internet e o ciclo de ingresso estudantil mostraram relação com o domínio das ferramentas digitais aplicadas à educação. Conclusões: Foi identificado um desenvolvimento intermediário de competências digitais aplicadas à educação, o que poderia demandar a concepção de programas que nivelem essas competências durante o processo de admissão ou durante a formação.

Objective: To determine the skills and knowledge about information and communication technologies (ICT) of entrants to the Bachelor's Degree in Nursing at a public higher institution in Bahía Blanca, Province of Buenos Aires, Argentina. Methodology: Observational, descriptive, transversal and quantitative study. An instrument was implemented consisting of 59 questions with closed response options aimed at assessing digital competencies in those entering the career. Results: 386 entrants participated, mostly female (85.49 %), from the first cycle (74.35 %) and 20 years old or younger (47.15%). 98.19 % had access to the internet, 79.27 % have a computer and more than 80 % have extensive use of social networks (WhatsApp, Instagram) and email. The entrants evaluated themselves as competent in the MS Word program, while in MS Excel they declared themselves less competent. There is a lack of knowledge and low development of skills to generate content and a wide range of skills to search and download information from the web. Age, gender, daily time of Internet use and entry cycle showed a relationship with the mastery of digital tools applied to education. Conclusions: An intermediate development of digital competencies applied to education was identified, and a high one for the use of social networks. The variables age, gender, daily time of Internet use and entry cycle were related to the knowledge and skills for using ICT applied to education.

Reconfiguration of uncertainty: Introducing AI for prediction of mortality at the emergency department.

The promise behind many advanced digital technologies in healthcare is to provide novel and accurate information, aiding medical experts to navigate and, ultimately, decrease uncertainty in their clinical work. However, sociological studies have started to show that these technologies are not producing straightforward objective knowledge, but instead often become associated with new uncertainties arising in unanticipated places and situations. This study contributes to the body of work by presenting a qualitative study of an Artificial Intelligence (AI) algorithm designed to predict the risk of mortality in patients discharged to home from the emergency department (ED). Through in-depth interviews with physicians working at the ED of a Swedish hospital, we demonstrate that while the AI algorithm can reduce targeted uncertainty, it simultaneously introduces three new forms of uncertainty into clinical practice: epistemic uncertainty, actionable uncertainty and ethical uncertainty. These new uncertainties require deliberate management and control, marking a shift from the physicians' accustomed comfort with uncertainty in mortality prediction. Our study advances the understanding of the recursive nature and temporal dynamics of uncertainty in medical work, showing how new uncertainties emerge from attempts to manage existing ones. It also reveals that physicians' attitudes towards, and management of, uncertainty vary depending on its form and underscores the intertwined role of digital technology in this process. By examining AI in emergency care, we provide valuable insights into how this epistemic technology reconfigures clinical uncertainty, offering significant theoretical and practical implications for the integration of AI in healthcare.

Missed opportunities to provide sexually transmitted and blood-borne infections testing in British Columbia: An interpretive description of users' experiences of Get Checked Online's design and implementation.

Background: Digital testing services for sexually transmitted and blood-borne infections (STBBIs), such as GetCheckedOnline, experience significant user drop-offs. For example, 32% of GetCheckedOnline users needing testing at account creation do not test, constituting missed opportunities. We explored the influence of users' expectations and experiences of GetCheckedOnline's web design and implementation on missed opportunities. Methods: This interpretive description purposively sampled 14 GetCheckedOnline users who created accounts between April 2022 and February 2023, indicated needed testing at account creation but did not test. We conducted semi-structured interviews and cognitive walkthroughs of GetCheckedOnline on Zoom, exploring participants' expectations and experiences, including problems using the service. Interviews were audio recorded, transcribed verbatim, and analyzed using reflexive thematic analyses. Results: Three themes were identified: (a) transitioning between GetCheckedOnline and laboratory services is a major testing barrier; (b) users' appraisal of their health and social contexts is a determinant of testing through GetCheckedOnline; and (c) tailoring GetCheckedOnline's design and implementation to accommodate varying user needs can promote equitable testing. Health equity issues occurred along sociodemographic gradients as the GetCheckedOnline-laboratory transition was more onerous for older users. Users' appraisal of their testing needs which varied by age and gender, and their assessment of time, and travel requirements for testing in remote communities influenced testing. Learning about GetCheckedOnline from healthcare providers improved testing compared with learning about the service through Google search which raised trust concerns regarding GetCheckedOnline's authenticity. Suggested improvements to promote health equity include personalized education, mail-in testing options, and simpler seamless web experiences. Conclusions: To promote equitable access to digital STBBI testing services such as GetCheckedOnline, we can adapt web-design and implementation to suit user needs and contexts, ensuring simplicity and options for testing that reduce user burdens.

Community nursing and the digital technology revolution: the past, present and future.

While very much in its infancy in terms of becoming an established tool, the use of digital technology in community nursing is steadily growing, despite the persistent barriers to, and challenges encountered in its uptake and implementation. The mobile nature and high workload of a community nurse's daily practice should facilitate the rapid uptake of time-saving technology. However, there are indications that technology may not be the panacea it was originally proclaimed to be. Francesca Ramadan elaborates on the past and present applications of digital technology in community nursing and delves into the principles that should shape the future potential of tools such as artificial intelligence, automation technologies and clinical decision support systems.

Feasibility of Measuring Smartphone Accelerometry Data During a Weekly Instrumented Timed Up-and-Go Test After Emergency Department Discharge: Prospective Observational Cohort Study.

Background: Older adults discharged from the emergency department (ED) face elevated risk of falls and functional decline. Smartphones might enable remote monitoring of mobility after ED discharge, yet their application in this context remains underexplored. Objective: This study aimed to assess the feasibility of having older adults provide weekly accelerometer data from an instrumented Timed Up-and-Go (TUG) test over an 11-week period after ED discharge. Methods: This single-center, prospective, observational, cohort study recruited patients aged 60 years and older from an academic ED. Participants downloaded the GaitMate app to their iPhones that recorded accelerometer data during 11 weekly at-home TUG tests. We measured adherence to TUG test completion, quality of transmitted accelerometer data, and participants' perceptions of the app's usability and safety. Results: Of the 617 approached patients, 149 (24.1%) consented to participate, and of these 149 participants, 9 (6%) dropped out. Overall, participants completed 55.6% (912/1639) of TUG tests. Data quality was optimal in 31.1% (508/1639) of TUG tests. At 3-month follow-up, 83.2% (99/119) of respondents found the app easy to use, and 95% (114/120) felt safe performing the tasks at home. Barriers to adherence included the need for assistance, technical issues with the app, and forgetfulness. Conclusions: The study demonstrates moderate adherence yet high usability and safety for the use of smartphone TUG tests to monitor mobility among older adults after ED discharge. Incomplete TUG test data were common, reflecting challenges in the collection of high-quality longitudinal mobility data in older adults. Identified barriers highlight the need for improvements in user engagement and technology design.

Digital Mental Health Interventions for Alleviating Depression and Anxiety During Psychotherapy Waiting Lists: Systematic Review.

BACKGROUND: Depression and anxiety have become increasingly prevalent across the globe. The rising need for treatment and the lack of clinicians has resulted in prolonged waiting times for patients to receive their first session. Responding to this gap, digital mental health interventions (DMHIs) have been found effective in treating depression and anxiety and are potentially promising pretreatments for patients who are awaiting face-to-face psychotherapy. Nevertheless, whether digital interventions effectively alleviate symptoms for patients on waiting lists for face-to-face psychotherapy remains unclear. OBJECTIVE: This review aimed to synthesize the effectiveness of DMHIs for relieving depression and anxiety symptoms of patients on waiting lists for face-to-face therapy. This review also investigated the features, perceived credibility, and usability of DMHIs during waiting times. METHODS: In this systematic review, we searched PubMed, PsycINFO, Cochrane, and Web of Science for research studies investigating the effectiveness of DMHIs in reducing either depression or anxiety symptoms among individuals waiting for face-to-face psychotherapy. The search was conducted in June 2024, and we have included the studies that met the inclusion criteria and were published before June 6, 2024. RESULTS: Of the 9267 unique records identified, 8 studies met the eligibility criteria and were included in the systematic review. Five studies were randomized controlled trials (RCTs), and 3 studies were not. Among the RCTs, we found that digital interventions reduced depression and anxiety symptoms, but the majority of interventions were not more effective compared to the control groups where participants simply waited or received a self-help book. For the non-RCTs, the interventions also reduced symptoms, but without control groups, the interpretation of the findings is limited. Finally, participants in the included studies perceived the digital interventions to be credible and useful, but high dropout rates raised concerns about treatment adherence. CONCLUSIONS: Due to the lack of effective interventions among the reviewed studies, especially among the RCTs, our results suggest that waiting list DMHIs are not more effective compared to simply waiting or using a self-help book. However, more high-quality RCTs with larger sample sizes are warranted in order to draw a more robust conclusion. Additionally, as this review revealed concerns regarding the high dropout rate in digital interventions, future studies could perhaps adopt more personalized and human-centered functions in interventions to increase user engagement, with the potential to increase treatment adherence and effectiveness.

Usability, Ergonomics, and Educational Value of a Novel Telestration Tool for Surgical Coaching: Usability Study.

BACKGROUND: Telementoring studies found technical challenges in achieving accurate and stable annotations during live surgery using commercially available telestration software intraoperatively. To address the gap, a wireless handheld telestration device was developed to facilitate dynamic user interaction with live video streams. OBJECTIVE: This study aims to find the perceived usability, ergonomics, and educational value of a first-generation handheld wireless telestration platform. METHODS: A prototype was developed with four core hand-held functions: (1) free-hand annotation, (2) cursor navigation, (3) overlay and manipulation (rotation) of ghost (avatar) instrumentation, and (4) hand-held video feed navigation on a remote monitor. This device uses a proprietary augmented reality platform. Surgeons and trainees were invited to test the core functions of the platform by performing standardized tasks. Usability and ergonomics were evaluated with a validated system usability scale and a 5-point Likert scale survey, which also evaluated the perceived educational value of the device. RESULTS: In total, 10 people (9 surgeons and 1 senior resident; 5 male and 5 female) participated. Participants strongly agreed or agreed (SA/A) that it was easy to perform annotations (SA/A 9, 90% and neutral 0, 0%), video feed navigation (SA/A 8, 80% and neutral 1, 10%), and manipulation of ghost (avatar) instruments on the monitor (SA/A 6, 60% and neutral 3, 30%). Regarding ergonomics, 40% (4) of participants agreed or strongly agreed (neutral 4, 40%) that the device was physically comfortable to use and hold. These results are consistent with open-ended comments on the device's size and weight. The average system usability scale was 70 (SD 12.5; median 75, IQR 63-84) indicating an above average usability score. Participants responded favorably to the device's perceived educational value, particularly for postoperative coaching (agree 6, 60%, strongly agree 4, 40%). CONCLUSIONS: This study presents the preliminary usability results of a novel first-generation telestration tool customized for use in surgical coaching. Favorable usability and perceived educational value were reported. Future iterations of the device should focus on incorporating user feedback and additional studies should be conducted to evaluate its effectiveness for improving surgical education. Ultimately, such tools can be incorporated into pedagogical models of surgical coaching to optimize feedback and training.

Generative AI in Pediatric Gastroenterology.

PURPOSE OF REVIEW: The integration of digital technology into medical practice is often thrust upon clinicians, with standards and routines developed long after initiation. Clinicians should endeavor towards a basic understanding even of emerging technologies so that they can direct its use. The intent of this review is to describe the current state of rapidly evolving generative artificial intelligence (GAI), and to explore both how pediatric gastroenterology practice may benefit as well as challenges that will be faced. RECENT FINDINGS: Although little research demonstrating the acceptance, practice, and outcomes associated with GAI in pediatric gastroenterology is published, there are relevant data adjacent to the specialty and overwhelming potential as professed in the media. Best practice guidelines are widely developed in academic publishing and resources to initiate and improve practical user skills are prevalent. Initial published evidence supports broad acceptance of the technology as part of medical practice by clinicians and patients, describes methods with which higher quality GAI can be developed, and identifies the potential for bias and disparities resulting from its use. GAI is broadly available as a digital tool for incorporation into medical practice and holds promise for improved quality and efficiency of care, but investigation into how GAI can best be used remains at an early stage despite rapid evolution of the technology.

The utilization of renewable energy and the economic potential of offshore wind power supported by digital finance.

Colombia is well-positioned for the development of sustainable energy due to its abundance of natural resources, which include water, wind, and sun. Regulating the safe and sustainable use of offshore wind energy, which is considered non-conventional, is lacking in the nation, nonetheless. The development of offshore wind technology in Colombia shows potential to meet energy needs during dry hydrological conditions and El Niño/Southern Oscillation events when the hydroelectric system power supply is low. This study examines global initiatives that have encouraged nations to develop plans for cutting their CO2 emissions, stressing both their successes and shortcomings in putting offshore wind technology into practice. An examination of Colombia's renewable energy administrative framework finds a lack of data required to carry out offshore wind projects. Furthermore, a review of previous research on marine energy emphasizes how important it is to expand our knowledge of offshore wind generation. Although the majority of local renewable energy projects concentrate on terrestrial sources, an analysis of wind speed and wind power density in Colombia at different altitudes shows promising magnitudes and good trends.Digital finance plays a crucial role in this context by providing innovative funding mechanisms, enhancing financial accessibility, and reducing investment risks through improved financial technologies. These advancements support the mobilization of capital necessary for the development and expansion of offshore wind energy projects.As a result, the technical, economic, administrative, and legal data pertinent to renewable energy in Colombia is compiled in this study. It proposes to provide information to stakeholders involved in decision-making processes and promotes the possible installation of offshore wind farms in regions close to Colombia's Caribbean coast. Because of its plentiful resources, Colombia offers a great chance to implement offshore wind energy technology, which will lessen dependency on fossil fuels and provide a backup energy source in case of supply shortages. The integration of digital finance is key to unlocking the economic potential of these projects, ensuring sustainable and scalable energy solutions for the future.

Comprehensive analysis of alar base inclination and lip line cant following orthognathic correction of maxillomandibular asymmetry: A retrospective study.

This paper examines the relationship between roll rotation of the jaws and changes in alar base or lip line asymmetry in the coronal plane following orthognathic correction. The study involved patients with preoperative frontal alar base and lip line asymmetries greater than 0.5° (because it corresponds to the minimum asymmetry perception threshold) and underwent bimaxillary orthognathic surgery without (Group I) or with (Group II) genioplasty. The alar base angle (ABA), lip line cant angle (LLCA), maxillary cant angle (MxCA), and mandibular cant angle (MnCA) were measured using preoperative and 12 months postoperative cone beam computed tomography (CBCT) images. Thirty-four patients were included in the study. Significant correlations were found between changes in MxCA and ABA besides between changes in MnCA and LCA in Groups I (P = 0.016, P˂0.001, respectively) and II (P = 0.002, P˂0.001, respectively). The mean of the change in ABA/the change in MxCA and the change in LLCA/the change in MnCA ratios for Group I were 0.59 ± 1.57 and 0.73 ± 0.94, respectively, while those for Group II were 0.46 ± 3.70 and 0.39 ± 2.00, respectively. Angular measurements from jugular and mental foramina points, aligned with the bony midline, offer a convenient tool for predicting alar base and lip symmetry during bimaxillary orthognathic surgery planning.

Effect of cut-out rescanning protocol on the accuracy of digital impressions in convergent implants positioned at varying depths: An in vitro study.

BACKGROUND: This study aimed to assess the effect of the "cut-out rescan" strategy on the accuracy of intraoral digital scans from 25° convergent implants positioned at two distinct depths. MATERIAL AND METHODS: Two customized models were fabricated, each designated to receive two posterior converged implant fixtures: one at a depth of 1 mm and the other at a depth of 4 mm. Initially, the models were scanned as reference casts using a lab scanner. The test group was involved in scanning the 1-mm and 4-mm implant models using an intraoral scanner in the following order: (1) scanning the 1-mm (T1; n = 10) and (2) 4-mm (T4; n = 10) implant groups with scan bodies connected to both fixtures in each model; (3) cut-out rescan (COR) in the 1-mm (COR1; n = 10) and (4) 4-mm (COR4; n = 10) models, leading to 40 digital files in standard tessellation language format. The mean absolute deviation (MAD), in terms of trueness and precision, between the experimental and control scans was assessed through the alignment of their respective datasets using three-dimensional analysis software. Two-way analysis of variance (ANOVA) and Levene's tests were used to analyze the data. RESULTS: The COR4 group exhibited the highest MAD, indicative of both trueness and precision (Mean ±SD: 55.659 ±34.802). In contrast, the T1 group demonstrated the lowest MAD (Mean ±SD: 43.225 ±19.237). However, the ANOVA analysis showed no significant influence of depth (P = 0.506) or type of scan (P = 0.442) on the MAD. Precision also did not differ significantly across groups (P = 0.071). CONCLUSIONS: The cut-out rescan approach demonstrated an accuracy comparable to that of the one-time scan method. CLINICAL SIGNIFICANCE: Digital intraoral scanning provides clinicians with a range of tools to navigate challenging conditions in which conventional methods may prove difficult, such as cases involving angled adjacent implants. In these scenarios, the cut-out rescan tool serves as a valuable resource, aiding clinicians in overcoming the challenges associated with impression-making owing to the convergence of placed implants.

Development of a Digital Platform to Support Child Mental Health Care.

Childhood mental health problems are a leading cause of disability and frequently go untreated. Barriers to children receiving the most effective care available include shortfalls in three areas: identification, referral to specialists, and delivery of evidence-based treatment (EBT). The current paper details an effort to develop a digital health intervention, the Mental Health Advisor (MHA), to increase the number of children with mental health problems who receive optimal care through identification, specialty referral, and fidelity to EBT. We present this pilot as a case example to help guide other efforts to improve mental health care through technology.

Digital technology access, labor market behavior, and income inequality in rural China.

This study uses China Family Panel Studies (CFPS) data from 2010 to 2018 to empirically investigate the interplay between digital technology access, labor market behavior, and income inequality in rural China. The following salient conclusions are derived. Digital technology access has a substantial negative influence on individual income inequality in rural China, with a more pronounced inhibitory effect on inequality among low-income groups, males, middle and higher professional classes, and younger cohorts. Mechanism analysis suggests that digital technology access significantly impacts a range of rural labor practices, including increasing the frequency of digital technology use among rural inhabitants, decreasing credit costs, enhancing entrepreneurial activities, and boosting rural labor mobility. Based on these findings, this study proposes accelerating digital infrastructure development in rural regions, improving digital and financial literacy among rural residents, and refining inclusive digital financial services to facilitate more stable and sustainable progress to promote common prosperity.

Evaluating EHR-Integrated Digital Technologies for Medication-Related Outcomes and Health Equity in Hospitalised Adults: A Scoping Review.

The purpose of this scoping review is to identify and evaluate studies that examine the effectiveness and implementation strategies of Electronic Health Record (EHR)-integrated digital technologies aimed at improving medication-related outcomes and promoting health equity among hospitalised adults. Using the Consolidated Framework for Implementation Research (CFIR), the implementation methods and outcomes of the studies were evaluated, as was the assessment of methodological quality and risk of bias. Searches through Medline, Embase, Web of Science, and CINAHL Plus yielded 23 relevant studies from 1,232 abstracts, spanning 11 countries and from 2008 to 2022, with varied research designs. Integrated digital tools such as alert systems, clinical decision support systems, predictive analytics, risk assessment, and real-time screening and surveillance within EHRs demonstrated potential in reducing medication errors, adverse events, and inappropriate medication use, particularly in older patients. Challenges include alert fatigue, clinician acceptance, workflow integration, cost, data integrity, interoperability, and the potential for algorithmic bias, with a call for long-term and ongoing monitoring of patient safety and health equity outcomes. This review, guided by the CFIR framework, highlights the importance of designing health technology based on evidence and user-centred practices. Quality assessments identified eligibility and representativeness issues that affected the reliability and generalisability of the findings. This review also highlights a critical research gap on whether EHR-integrated digital tools can address or worsen health inequities among hospitalised patients. Recognising the growing role of Artificial Intelligence (AI) and Machine Learning (ML), this review calls for further research on its influence on medication management and health equity through integration of EHR and digital technology.

DigiDOP: A framework for applying digital technology to the Differential Outcomes Procedure (DOP) for cognitive interventions in persons with neurocognitive disorders.

We present a framework -Digi-DOP- that includes a series of evidence-based recommendations to design and apply cognitive interventions for people with Neurocognitive Disorders (NCDs) using a relatively new approach, the Differential Outcomes Procedure (DOP). To do so, we critically review the substantial experimental research conducted with relevant clinical and non-clinical populations, and the theoretical underpinnings of this procedure. We further discuss how existing digital technologies that have been used for cognitive interventions could be applied to overcome some of the limitations of DOP-based interventions and further enhance DOP benefits. Specifically, we present three digital DOP developments that are currently being designed, investigated and/or tested. Finally, we discuss constraints, ethical and legal considerations that need to be taken into account to ensure that the use of technology in DOP-based interventions proposed here does not widen disparities and inequalities. We hope that this framework will inform and guide digital health leaders and developers, researchers and healthcare professionals to design and apply DOP-based interventions for people with NCDs.

Sociodigital Determinants of eHealth Literacy and Related Impact on Health Outcomes and eHealth Use in Korean Older Adults: Community-Based Cross-Sectional Survey.

Background: eHealth literacy is an essential skill for pursuing electronic health information, particularly for older people whose health needs increase with age. South Korea is now at the intersection of a rapidly digitalizing society and an increasingly aged population. eHealth literacy enables older people to maximize the effective use of emerging digital technology for their health and quality of life. Understanding the eHealth literacy of Korean older adults is critical to eliminating the gray digital divide and inequity in health information access. Objective: This study aims to investigate factors influencing eHealth literacy in older Korean adults and its impact on health outcomes and eHealth use. Methods: This was a cross-sectional survey. Community-dwelling older adults 65 years and older in 2 urban cities in South Korea were included. eHealth literacy was measured by the eHealth Literacy Scale. Ordinal logistic regression was used to analyze factors associated with eHealth literacy and multivariate ANOVA for the impact of eHealth literacy on health outcomes and eHealth use. Results: In total, 434 participants were analyzed. A total of 22.3% (97/434) of participants had high eHealth literacy skills. Increasing age, higher monthly income, and time spent on the internet were significantly associated with eHealth literacy (P<.001), and social media users were 3.97 times (adjusted odds ratio 3.97, 95% CI 1.02-15.43; P=.04) more likely to have higher skill. Higher eHealth literacy was associated with better self-perceived health and frequent use of digital technologies for accessing health and care services (P<.001). Conclusions: Disparity in socioeconomic status and engagement on the internet and social media can result in different levels of eHealth literacy skills, which can have consequential impacts on health outcomes and eHealth use. Tailored eHealth interventions, grounded on the social and digital determinants of eHealth literacy, could facilitate eHealth information access among older adults and foster a digitally inclusive healthy aging community.

Cross border e-commerce development and enterprise digital technology innovation-empirical evidence from listed companies in China.

As the main form of digital trade, cross-border e-commerce plays an important role, allowing China to expand its opening-up and promote the optimal foreign trade structure. It also provides opportunities for Chinese enterprises to develop digital technology. From the perspective of the establishment of China's cross-border e-commerce comprehensive pilot zone (CBECPZ), this article uses the multi-period DID method to examine the effects of cross-border e-commerce on enterprise digital technology innovation based on listed companies in the Shanghai and Shenzhen stock markets from 2007 to 2020. The CBECPZ dramatically promotes enterprise digital technology innovation. The mechanism test shows that the CBECPZ promotes digital technology innovation by financing constraint alleviation, digital transformation, and producer service industry agglomeration. The heterogeneity test shows that the direct effect is more significant in the enterprises of large-scale, non-state-owned, with high ICT correlation and in areas with strong government resource allocation capabilities. The research findings have important reference value for how to utilize cross-border e-commerce to promote digital technology innovation, and they also provide directional references for other developing countries to develop cross-border e-commerce.

Exploring how the design and provision of digital self-management technology can improve the uptake by older adults with chronic kidney disease, diabetes and dementia: A modified e-Delphi study.

Objectives: As development and introduction of digital self-management technologies continues to increase, the gap between those who can benefit, and those who cannot correspondingly widens. This research aimed to explore the use of digital self-management technology by older adults with three highly-prevalent long-term conditions (chronic kidney disease, diabetes and dementia), and build expert consensus across the conditions on changes needed to improve effective usage. Method: This qualitative research involved a modified e-Delphi Study. The Delphi panel was comprised of experts with personal, academic or clinical expertise related to one of the long-term conditions and/or the development and use of digital self-management technology. The e-Delphi involved a round of online semi-structured interviews followed by two rounds of a structured online survey. Results: Fourteen experts participated in the study, with eleven of the fourteen completing all three rounds. Analysis of the interviews (round 1 of the Delphi) led to 7 main themes and 29 sub-themes. These were translated into 26 statements that formed the basis of the online survey questions. In the first administration of the survey (round 2) 19 statements reached consensus. After the second administration a further 6 statements reach consensus. Conclusion: The findings reflect expert consensus on barriers to the use of digital self-management by older adults with 3 different, but inter-related conditions, and identify ways in which the design and provision of such technologies could be improved to facilitate more effective use. It is concluded that both the design and the provision of technologies should consider a combination of individual, condition-specific and age-related requirements. By building a consensus on issues and potential strategies common across the three conditions, we aim to inform future research and practice and facilitate effective self-management by older adults.

Can digital technology be affordable on industrial level? An exploration by integrating the sports and health industries.

While the significance of digital technologies like big data marketing is recognized in sport and health industries, the deployment is not in a fast pace as expected. Previous investigations argue that the financial issue can be the reason explaining such hesitation for sport and health firms to widely adopt advanced digital technologies. Through integrating firms in global sport and health industries, it is shown that the digital technology adoption can be negatively associated with firms' financial status. Therefore, the digital technologies are expensive, and the provision of sufficient financial incentives can be important to facilitate the promotion of digital technologies in sport and health industries.