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Prolonged mobile phone use has been demonstrated to be associated with mental health problems and suicidal behavior in adolescents. This study examined the mediating role of depressive symptoms in the association between duration of mobile phone use (DMPU) and suicidal behavior in adolescents.A total of 6,923 participants from the Shandong Adolescent BehaviorHealth Cohort (SABHC) were included in the analysis. Participants completed a self-administered questionnaire to assess DMPU on weekdays and weekends, mental disorders, insomnia symptoms, depressive symptoms, suicidal behavior (thought, plan, or attempt), and family demographics in November-December 2015. One year later, a follow-up survey was conducted to ask participants to report their depressive symptoms and suicidal behavior. Path analyses with logistic regressions were performed to examine the mediating role of depressive symptoms in the DMPU-suicidal behavior link.Of the sample, mean age was 14.58 (SD = 1.45) and 3,455 (49.9 %) were female at baseline. 12.12 % of participants reported having ever suicidal behavior during the past 12 months at baseline, and 10.63 % reported having ever suicidal behavior during 1-year follow-up. Path analyses showed that the depressive symptoms played a partial mediating role in the association of DMPU on weekdays and weekends with subsequent suicidal behavior. After controlling for covariates, depressive symptoms accounted for 33.6 % and 58.6 % of the total effect of DMPU on weekdays and weekends on suicidal behavior, respectively.All variables were measured based on self-report.The link between DMPU and suicidal behavior was partially mediated by depressive symptoms. Prolonged mobile phone use and depressive symptoms should be assessed and intervened to prevent suicidal behavior in adolescents.

Cellphone distraction is a major contributing factor for traffic crashes, a leading cause of death worldwide. The novel naturalistic driving study (NDS) study with continuously collected in situ driving videos provides an opportunity to accurately estimate the safety impact of cellphone distraction.We apply a case-cohort study design to the Second Strategic Highway Research Program NDS, the largest NDS up-to-date with more than 3400 participants. The data include with 842 level 1-3 crashes and 19,338 randomly selected control driving segments. We propose a partial Population Attributable Risk (PAR) estimator that provides consistent and stable estimation over time and across different driving behaviors.The US population-adjusted PAR show that 8% of crashes (PAR = 0.08, 95 %CI: [0.06, 0.19]) can be reduced if cellphone distraction were switched to sober, alert, and attentive driving behavior. Young adults (age 20-29 years) and middle-aged drivers (age 30-64 years) each contribute 39% of the population level PAR. Within each age group, the PARs vary substantially from 18% for young adult drivers to 5% for middle-aged drivers. The contribution of cellphone visual-manual tasks to crashes is more than 4 times larger than cellphone talking and accounts for 87.5% of cellphone-related crashes (PAR = 0.07).Cellphone distraction contributes to a considerable part of crashes. Young drivers are more susceptible to the influence of cellphone distraction and visual-manual distraction accounts for the majority of cellphone-related crashes.

Alexithymia can lead to problematic mobile phone use (PMPU). However, the underlying mechanisms remain unclear.Drawing on the Interaction of Person-Affect-Cognition-Execution model, the present study tests the mediating effects (parallel and serial) of social interaction anxiety (SIA) and core self-evaluations (CSE) on the relationship between alexithymia and PMPU. We obtained 1267 valid responses from adolescent students (mean age, 20.36, standard deviation, 0.97) from southeast China who completed the Mobile Phone Addiction Index, Toronto Alexithymia-20 Scale, Social Interaction Anxiousness Scale, and Core Self-Evaluation Inventory.After controlling for demographic variables (i.e., gender) as covariates, the results revealed that: (1) alexithymia had a positive predictive effect on PMPU in adolescent students; (2) SIA and CSE mediated the association between alexithymia and PMPU; and (3) a series of indirect pathways (i.e., from alexithymia to PMPU via SIA and CSE) were detected. Thus, alexithymia can directly affect (parallel mediation) PMPU by increasing SIA and lowering CSE simultaneously. However, alexithymia can also indirectly affect (serial mediation) PMPU by increasing the level of SIA by decreasing CSE.Data were collected by participant self-report. This method may lead to recall bias. Further, we adopted a cross-sectional rather than an experimental design, thus precluding causal conclusions. Lastly, it would be useful to validate our findings with other age groups outside southeast China.The current study findings are conducive to understanding the relationship between alexithymia and PMPU and inspire the prevention and intervention of PMPU.

Mobile phones play an irreplaceable role in modern people’s lives. However, the radiofrequency electromagnetic radiation produced by mobile phones has also caused increasing concern. A cross-sectional study was conducted to investigate the effect of radiofrequency electromagnetic radiation produced by mobile phones on semen parameters in 1634 men who underwent semen examination at the Department of Reproductive Endocrinology, Women’s Hospital, School of Medicine, Zhejiang University, China. Analysis of variance and multivariate linear regression were used to explore differences among different groups. A P

Although questions fuel children's learning, adult

Summary Background Excessive use of digital smart devices, including smartphones and tablet computers, could be a risk factor for myopia. We aimed to review the literature on the association between digital smart device use and myopia. Methods In this systematic review and meta-analysis we searched MEDLINE and Embase, and manually searched reference lists for primary research articles investigating smart device (ie, smartphones and tablets) exposure and myopia in children and young adults (aged 3 months to 33 years) from database inception to June 2 (MEDLINE) and June 3 (Embase), 2020. We included studies that investigated myopia-related outcomes of prevalent or incident myopia, myopia progression rate, axial length, or spherical equivalent. Studies were excluded if they were reviews or case reports, did not investigate myopia-related outcomes, or did not investigate risk factors for myopia. Bias was assessed with the Joanna Briggs Institute Critical Appraisal Checklists for analytical cross-sectional and cohort studies. We categorised studies as follows: category one studies investigated smart device use independently; category two studies investigated smart device use in combination with computer use; and category three studies investigated smart device use with other near-vision tasks that were not screen-based. We extracted unadjusted and adjusted odds ratios (ORs), β coefficients, prevalence ratios, Spearman's correlation coefficients, and p values for associations between screen time and incident or prevalent myopia. We did a meta-analysis of the association between screen time and prevalent or incident myopia for category one articles alone and for category one and two articles combined. Random-effects models were used when study heterogeneity was high (I2>50%) and fixed-effects models were used when heterogeneity was low (I2≤50%). Findings 3325 articles were identified, of which 33 were included in the systematic review and 11 were included in the meta-analysis. Four (40%) of ten category one articles, eight (80%) of ten category two articles, and all 13 category three articles used objective measures to identify myopia (refraction), whereas the remaining studies used questionnaires to identify myopia. Screen exposure was measured by use of questionnaires in all studies, with one also measuring device-recorded network data consumption. Associations between screen exposure and prevalent or incident myopia, an increased myopic spherical equivalent, and longer axial length were reported in five (50%) category one and six (60%) category two articles. Smart device screen time alone (OR 1·26 [95% CI 1·00–1·60]; I2=77%) or in combination with computer use (1·77 [1·28–2·45]; I2=87%) was significantly associated with myopia. The most common sources of risk of bias were that all 33 studies did not include reliable measures of screen time, seven (21%) did not objectively measure myopia, and nine (27%) did not identify or adjust for confounders in the analysis. The high heterogeneity between studies included in the meta-analysis resulted from variability in sample size (range 155–19 934 participants), the mean age of participants (3–16 years), the standard error of the estimated odds of prevalent or incident myopia (0·02–2·21), and the use of continuous (six [55%] of 11) versus categorical (five [46%]) screen time variables Interpretation Smart device exposure might be associated with an increased risk of myopia. Research with objective measures of screen time and myopia-related outcomes that investigates smart device exposure as an independent risk factor is required. Funding None.

Community-wide lockdowns in response to COVID-19 influenced many families, but the developmental cascade for children with autism spectrum disorder (ASD) may be especially detrimental. Our objective was to evaluate behavioral patterns of risk and resilience for children with ASD across parent-report assessments before (from November 2019 to February 2020), during (March 2020 to May 2020), and after (June 2020 to November 2020) an extended COVID-19 lockdown. In 2020, our study Mobile-based care for children with ASD using remote experience sampling method (mCARE) was inactive data collection before COVID-19 emerged as a health crisis in Bangladesh. Here we deployed “Cohort Studies”, where we had in total 300 children with ASD (150 test group and 150 control group) to collect behavioral data. Our data collection continued through an extended COVID-19 lockdown and captured parent reports of 30 different behavioral parameters (e.g., self-injurious behaviors, aggression, sleep problems, daily living skills, and communication) across 150 children with ASD (test group). Based on the children’s condition, 4–6 behavioral parameters were assessed through the study. A total of 56,290 behavioral data points was collected (an average of 152.19 per week) from parent cell phones using the mCARE platform. Children and their families were exposed to an extended COVID-19 lockdown. The main outcomes used for this study were generated from parent reports child behaviors within the mCARE platform. Behaviors included of child social skills, communication use, problematic behaviors, sensory sensitivities, daily living, and play. COVID-19 lockdowns for children with autism and their families are not universally negative but supports in the areas of “Problematic Behavior” could serve to mitigate future risk.

Objective: To explore the effect of problematic mobile phone use on college students’ physical activity and their relationships. Methods: A cross-sectional study was conducted among 3980 college students from three universities in Jiangsu province by random cluster sampling. The International Physical Activity Questionnaire Short (IPAQ-SF) measured college students’ physical activity. The Mobile Phone Addiction Tendency Scale for College Students (MPATS) measured problematic mobile phone use tendencies. College students’ physical activity was measured by the International Physical Activity Questionnaire Short (IPAQ-SF), and the Mobile Phone Addiction Tendency Scale measured their mobile phone addiction tendency for College Students (MPATS). Results: (1) The proportions of the low-, medium-, and high-intensity physical activity were 83.5%, 10.7%, and 5.8%, respectively, with gender differences; The score of problematic mobile phone use tendency was 38.725 ± 15.139. (2) There were significant differences in problematic mobile phone use tendency among college students with different physical activity intensity (F = 11.839, p < 0.001, η2 = 0.007). (3) The level of physical activity was significantly correlated with the tendency of problematic mobile phone use (r = −0.173, p < 0.001). (4) Physical activity of college students could significantly predict the tendency of problematic mobile phone use (F (3,3605) = 11.296, p < 0.001). Conclusions: The physical activity of college students was mainly moderate to low intensity, while the tendency of problematic mobile phone use was high. College students’ physical activity level was one of the important constraints of problematic mobile phone use tendency.

Objective A large body of research has established that cellphone use while driving (CUWD) is common and dangerous. However, little research has been conducted about how people react psychologically to various distraction-reduction strategies and, ultimately, support or do not support them. Understanding support for reduction is important for predicting use of technological solutions and compliance with laws and for improving communication and education about the risks of CUWD. Methods We measured support for a variety of legislative, technological, and organizational strategies to reduce CUWD in an online sample of American drivers (N = 648). We also developed evidence-based communication techniques, describing strategies in terms of benefits vs. costs or using freedom-invoking vs. freedom-reducing language to assess what would influence support. Results Support for CUWD reduction was generally high. It was predicted by driver characteristics and beliefs. For example, drivers who supported reducing CUWD more also had lower CUWD reactance, greater anti-CUWD beliefs, higher personal risk perceptions of CUWD, and greater self-reported distracted driving. Age and perceived ability to drive distracted did not predict overall support. However, two strategies that allow for handsfree phone use were supported more by people who engaged in more CUWD, perceived they had greater ability to CUWD, perceived more benefits to CUWD, had more positive affect to cellphones, and were younger. Communication techniques also influenced support. Specifically, the same strategy was supported more when described using benefits and permissive language instead of costs and restrictive language. Conclusions Most respondents supported strategies to reduce CUWD, and beliefs about risks and benefits predicted this snupport. Reactance to CUWD messaging emerged as a key predictor of lower support (and of greater self-reported distracted driving), indicating that it could be an important variable to consider when designing strategies to reduce CUWD. When targeting people resistant to quitting CUWD entirely, communicators could recommend a switch to handsfree use. Communicators who emphasize benefits and use permissive language also may increase support for CUWD reduction.

Objective Unintentional injuries are the leading killer of children in the United States. Caregiver supervision decreases child injury risk; however, little research has examined the effects of distractions (e.g., cell phone use) on caregiver supervision and subsequent ability to protect children from injury. In particular, despite the prevalence of cell phone use, no research has examined the degree to which caregiver cell phone use may impair caregivers’ ability to supervise their children effectively. The present study used a within-subjects design to examine whether caregiver cell phone use impacted caregiver vigilance and child engagement with potential hazards. Methods A total of 51 caregiver–child dyads were observed in a pseudo hazards room across three conditions (cell phone distraction, pen-and-paper distraction, no distraction) to examine the effects of cell phone use on caregiver vigilance and child behavior (i.e., engagement with hazards) related to injury risk. Results Caregiver vigilance was higher in the no distraction condition compared to the two distraction conditions (cell phone and pen-and-paper). Moreover, child engagement with hazards was lower in the no distraction condition than in the two distraction conditions. Although both distraction conditions impaired caregiver vigilance, caregivers were more impaired in the pen-and-paper condition compared to the cell phone condition. Discussion Regardless the form, distracting tasks (both cell phone use and pen-and-paper task) impacted both caregiver and child behavior associated with injury risk. It is important that professionals working with parents educate them about the risks of supervising children while distracted and encourage mindful supervision to ensure safety.

Objectives To investigate whether a possible association of mobile phone use with hearing impairment was conducted a systematic review and meta-analysis. Content This is a systematic review and meta-analysis. A comprehensive literature search was carried out based on the Meta-analysis of Observational Studies in Epidemiology (MOOSE) methodology using PubMed, Scopus, Web of Science, OVID, and Cochrane. The Robins-I tool was used for quality assessment and risk of bias. Two investigators independently reviewed all articles. Pooled effect size was calculated and meta-analysis was performed to compute an overall effect size. Summary Overall, five relevant studies (two cross-sectional and three cohort studies) with 92,978 participants were included in the analysis. The studies were stratified by design, there was no significant association between mobile phone use and hearing impairment in cross-sectional studies (OR=0.94, 95% CI=0.57–1.31) and cohort studies (OR=1.09, 95% CI=0.93–1.25). In addition, the effect estimates did not differ significantly between cross-sectional and cohort studies (Q=0.50, p=0.48). Overall, the pooled odds ratio (OR) of hearing impairment was 1.07 (95% CI: 0.94–1.20), which indicates no significant association between mobile phone use and hearing impairment. Outlook Our findings indicate no association between mobile phone use and hearing impairment. However, these findings must be interpreted with caution.

Supplemental Digital Content is available in the text., Background: As of January 2020, 18 of 50 US states comprehensively banned almost all handheld cellphone use while driving, 3 states and the District of Columbia banned calling and texting, 27 states banned texting on a handheld cellphone, and 2 states had no general cellphone ban for all drivers. However, it remains unknown whether these bans were associated with fewer traffic deaths and whether comprehensive handheld bans are more effective than isolated calling or texting bans. We evaluated whether cellphone bans were associated with fewer driver, non-driver, and total fatalities nationally. Methods: We conducted a longitudinal panel analysis of traffic fatality rates by state, year, and quarter. Population-based rate ratios and 95% CIs were estimated comparing state–quarters with and without cellphone bans. Results: From 1999 through 2016, 616,289 persons including 344,003 drivers died in passenger vehicle crashes in the United States. Relative to no ban, comprehensive handheld bans were associated with lower driver fatality rates (adjusted rate ratio aRR = 0.93, 95% CI = 0.90, 0.97) but not for non-driver fatalities (aRR = 1.01, 95% CI = 0.95, 1.07) or total fatalities (aRR = 0.98, 95% CI = 0.94, 1.01). We found no differences in driver fatalities for calling-only bans (aRR = 1.00, 95% CI = 0.97, 1.03), texting-only bans (aRR = 1.02, 95% CI = 0.99, 1.05), texting plus phone-manipulating bans (aRR = 0.99, 95% CI = 0.93, 1.04), or calling and texting bans (aRR = 0.98, 95% CI = 0.88, 1.09). Conclusions: Comprehensive handheld bans were associated with fewer driver fatalities.

Although previous studies have discussed the association between mobile phone use addiction (MPUA) and depressive symptoms in adolescents, studies on Chinese adolescents are limited, with no studies being reported on adolescents from ethnic minority areas within Yunnan. This study aimed to explore the mediating mechanism of insomnia in the association between MPUA and depressive symptoms among Yunnan college students.A sample survey was conducted among 10,121 college students from four colleges in Yunnan province, China, from November to December 2021 via cluster sampling. Insomnia was assessed using the Insomnia Severity Index Scale, MPUA was assessed using the Self-Rating Questionnaire for Adolescent Problematic Mobile Phone Use, and depressive symptoms were assessed using the Patient Health Questionnaire-9 items. A generalized linear model was used to analyze the association between MPUA, insomnia, and depressive symptoms. The structural equation model was used to analyze the mediating effect of insomnia.The positive rates of depressive symptoms, MPUA, and insomnia were 39.2 %, 30.8 %, and 22.3 %, respectively. After adjusting for the demographic and confounding variables, MPUA (β = 0.14, 95 % CI: 0.13-0.15, P 0.01) and insomnia (β = 0.44, 95 % CI: 0.43-0.46, P 0.01) were associated with depressive symptoms (P 0.05). The mediating effect of insomnia accounted for 34.7 % of the total effect in the mediating model of MPUA associated with depressive symptoms.Our findings suggest that insomnia partially mediates the association between MPUA and depressive symptoms among Yunnan college students.

There is a considerable body of literature that outlines the dangers of mobile phone use by drivers. However, there is very little research that explores the role and effectiveness of attempts to tackle this specific road user problem. Generally, normative motives are more likely to generate compliance with traffic law, and are more likely to be developed through approaches which focus on engagement and education. There would seem to be little potential for them to be developed through the use of penalty points and fines, which rely on more instrumental logic. Nonetheless, the decision was made in the UK in recent years to cease offering ‘courses’ (inputs to detected phone-using drivers offered as an alternative to prosecution) for mobile phone offences. This decision was made despite a lack of evidence one way or another about their effectiveness in tackling both handheld mobile phone use and handsfree mobile phone distraction – a form of distraction not explicitly covered in law. This research project aimed to explore driver education as an alternative to prosecution for mobile phone use while driving offences, focusing on perceptions and experiences of one particular educational intervention. This paper draws on 46 semi-structured interviews with those involved in delivering a specific intervention aimed at reducing handheld mobile phone use by drivers that was previously offered as an alternative to prosecution in the UK; the police officers identifying offenders for referral to such courses, those delivering the intervention, drivers attending the course as an alternative to prosecution and members of the public attending the course as general education. Four key themes, with underpinning subthemes, emerged; 1) Police officer discretion and entry into the criminal justice system 2) Police-public interactions, 3) Course experiences, and 4) Post-course considerations. \ud \ud Firstly, police officer discretion is an important determinant of criminal justice system outcome, based on subjective rather than legal decisions about whether or not to report drivers for an offence. \ud \ud Secondly, police officers negotiate encounters with road users using the avoidance of prosecution as a way of diffusing difficult conversations, sometimes by offering a course as a preferable alternative to prosecution, sometimes by encouraging handsfree phone use. \ud \ud Thirdly, course attendance provides an opportunity to develop both normative alignment through increased understanding of police work, and to appreciate a range of instrumental consequences associated with mobile phone use. Both self-reportedly impacted upon mobile phone use while driving. Finally, post-course considerations emphasised a focus on who should be offered courses as an alternative to prosecution, focusing upon desires for both punitive and rehabilitative responses to mobile phone using drivers.

Several studies have been conducted globally to assess the impact of usage of mobile phones on quality and duration of sleep as also on day time sleepiness. The objective of the present study was to assess the effect of mobile phone usage on the quality and composition of sleep in a sample from Indian population.The study was conducted at two tertiary care hospitals in north India from July 2014 to September 2019. A total of 566 participants were recruited in this study from both the centres. Sleep quality was assessed with the help of the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Subsequently, actigraphy was done in 96 participants and polysomnography in 95 participants.Of the 566 participants, 128 (22.61%) had PSQI ≥5, reflecting poor sleep quality. A higher use of mobile phone was significantly associated with a poor sleep quality as a component of PSQI questionnaire (P=0.01) and higher overall PSQI score (P=0.01). The latency from sleep onset to N2 and N3 sleep stages was significantly shorter in participants having a higher mobile phone usage as compared to those with a lower usage [Median (range): 13.5 min (1.5-109) vs. 6.5 min (0-89); P=0.02] and [Median (range): 49 min (8.5-220.5) vs. 28.75 min (0-141); P=0.03], respectively.This study focused on the maladaptive changes brought on by mobile phone usage on sleep. More studies with larger sample sizes need to be done that may serve to confirm the hypothesis generating findings of our study.

As novice teen drivers are uniquely susceptible to the harmful effects of secondary activities on cellphones, 38 states and Washington D.C. have banned all types of cellphone usage for drivers younger than 18 years or in the learner/intermediate phase of driving. Despite the prevalence of such cellphone prohibitions, several surveillance studies have highlighted the persistent engagement of teenagers in cellphone-distracted driving, which increases the related crash risk. Most of the prior studies broadly consider cellphone usage as a general distraction instead of investigating different distraction-related tasks associated with cellphone use. This study analyzed the cellphone crashes of novice teenagers (aged 15–17 years) to discover the grouping of contributing factors by crash severity levels and cellphone usage types. The current study collected five years (2015–2019) of related crash data from the Louisiana Department of Transportation and Development. A manual effort was carried out to recognize the type of cellphone tasks before collision by reading the narratives of police-investigated crash reports. Association rule mining was applied to explore the associations between numerous crash attributes in multiple circumstances without relying on any predetermined hypotheses. The cumulative effect of cellphone distraction and no seatbelt usage is frequently visible in confirmed injury crash scenarios. Cellphone crashes of novice teenagers at intersections are strongly associated with talking/listening rather than texting/browsing/dialing and reaching for/answering/locating. The associations among environmental factors and modes of cellphone usage significantly influence the manner of collisions. Single-vehicle crashes are associated with cellphone manipulation while driving on weekends in cloudy weather, whereas sideswipe collisions are frequent in evening hours during reaching for/answering/locating the cellphones. In relation to texting/browsing/dialing, novice teenagers operating vans/SUVs are strongly associated with traffic control violations. The findings are expected to be beneficial for policymakers and other safety officials to develop strategic planning and implementable countermeasures when dealing with cellphone-distracted novice teenagers. The association of factors identified from the analysis exhibits real-world crash scenarios critical to strengthening driver education programs to mitigate teen driver crashes. Moreover, cellphone crashes and related casualties can be reduced by eliminating or improving one of the attributes involved in the crash patterns.

Background HIV is a major contributor to infant mortality. A significant gap remains between the uptake of infant and maternal antiretroviral regimens and only a minority of HIV-exposed infants receives prophylaxis and safe infant feeding. Losses to follow-up of HIV-exposed infants are associated with shortcomings of facility-based PMTCT models with weak community support of linkages. Use of mobile phones offers an opportunity for improving care and promoting retention assessed by timely attendance of scheduled appointments for the mother-baby pairs and achievement of an HIV-free generation. The objective of this study was to compare self-reported adherence to infant Nevirapine (NVP) prophylaxis and retention in care assessed by timely attendance of scheduled appointments over 10 weeks in HIV exposed infants randomized to 2-weekly mobile phone calls (intervention) versus no phone calls (control). Methods In this open label randomized controlled study, one hundred and fifty HIV infected women drawn from 3 health facilities in Western Kenya and their infants were randomly assigned to receive either phone-based reminders on PMTCT messages or standard health care messages (no calls) within 24 h of delivery. Women in the intervention arm continued to receive fortnightly phone calls. At 6- and 10-weeks following randomization we collected data on infant adherence to Nevirapine, mode of infant feeding, early HIV testing and retention in care in both study arms. All analyses were intention to treat. Results At 6 weeks follow-up, 90.7% (n = 68) of participants receiving phone calls reported adherence to infant NVP prophylaxis, compared with 72% (n = 54) of participants in the control group (p = 0.005). Participants in the intervention arm were also significantly more likely to remain in care than participants in the control group [78.7% (n = 59) vs. 58.7% (n = 44), p = 0.009 at 6 weeks and 69.3% (n = 52) vs. 37.3% (n = 28), p Conclusions These results suggest that phone calls are potentially an important tool to improve adherence to infant NVP prophylaxis and retention in care for HIV-exposed infants. Trial registration PACTR202007654729602. Registered 6 June 2018 - Retrospectively registered, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=3449

Adolescence is a time of increased risk for developing symptoms of anxiety and depression, especially for girls. The stress and social isolation experienced during confinement add new threats to already vulnerable adolescents' daily lives. This study is aimed at determining which sociodemographic characteristics (age, family composition, achievement), confinement habits (schedule, new hobby, sleep duration, cellphone and computer use, sports, schoolwork), and sources of support (parents and teachers) are associated with more or less internalized symptoms in Canadian adolescents. Differences between boys and girls are also investigated. Between April 8 and 30 (2020) and through an online survey, 895 Canadian adolescents (74% girls) aged between 12 and 17 years (M = 14.7) were recruited. Path analysis was performed to identify significant associations between sociodemographic characteristics, confinement habits, support variables, and internalized symptoms. Independent samples t-tests and invariance tests were conducted to compare boys and girls. Results suggest that certain confinement habits (time spent using cellphones, doing sports and schoolwork, finding a new hobby) and support variables (parents working outside the home) were significantly and negatively associated with internalized symptoms. Regarding the sex differences, girls used their cellphones more and invariance test results showed that all associations between predictors and symptoms were statistically similar for boys and girls. This study's results help understand better adolescents' experience in confinement. It sheds light on the habits likely to characterize those who are less at risk of experiencing distress, making it possible to better support adolescents during this challenging period.

Background: The use of technological devices is growing rapidly, and the use of cell phones increases in parallel. Dependence on technological devices is a particular factor in this increased exposure. Many studies have been performed on this electromagnetic field, but no definite conclusions have been drawn. Objective: The purpose of this research was to investigate exposure to electromagnetic field, cell phone use behaviors, the specific absorption rate (SAR) values, and changes in health occurring after exposure in university students. Methods: A questionnaire was administered to 1,019 volunteer students aged 18–24 years at the Niğde Ömer Halisdemir and Recep Tayip Erdoğan Universities in 2018–2019. The questions were based on a survey of the literature. Results: The students spent an average 4–8 hours per day on their cell phones, and findings such as headache (p=0.002), concentration deficit (p=0.001), tiredness on waking in the morning (p=0.001), hyperactivity (p=0.001), general feeling of fatigue (p=0.001), and lethargy (p=0.001) increased in a statistically significant manner with length of use. Conclusions: Participants exhibited high levels of cell phone use and experienced biological, behavioral, and sleep problems. They also had very little knowledge about specific SAR values, an important criterion concerning cell phones. RESUMO Introdução: O uso de dispositivos tecnológicos está crescendo rapidamente e o uso de telefone celulares aumenta em paralelo. A dependência de dispositivos tecnológicos é um fator nesse aumento de exposição. Diversos estudos sobre o campo eletromagnético foram realizados, mas nenhuma conclusão definitiva foi alcançada. Objetivo: O objetivo desta pesquisa foi investigar a exposição ao campo eletromagnético, os comportamentos de uso do telefone celular, os valores de absorção específica (specific absorption rate — SAR) dos telefones celulares utilizados e as alterações na saúde ocorridas após a exposição em adolescentes universitários. Métodos: Um questionário foi aplicado a 1.019 alunos voluntários com idades entre 18–24 anos nas universidades Niğde Ömer Halisdemir e Recep Tayip Erdoğan em 2018–2019. As perguntas foram baseadas em um levantamento bibliográfico. Resultados: Os estudantes gastaram em média 4–8 horas por dia em seus celulares, e achados como cefaleia (p=0,002), dificuldade de concentração (p=0,001), cansaço ao acordar pela manhã (p=0,001), hiperatividade (p=0,001), sensação geral de fadiga (p=0,001) e letargia (p=0,001) aumentaram de forma estatisticamente significativa com o tempo de uso. Conclusões: Os participantes exibiram altos níveis de uso de telefone celular e problemas biológicos, comportamentais e de sono. Eles também tinham pouco conhecimento sobre valores específicos de SAR, um critério importante para telefones celulares.

This study aimed to investigate the brain grey matter volume (GMV) related to problematic mobile phone use (PMPU), and whether these regions of GMV play a potential moderating role in the relationship between PMPU and depressive symptoms. We recruited 266 students who underwent magnetic resonance imaging (MRI) scanning. PMPU and depressive symptoms were assessed by a self-rating questionnaire for adolescent PMPU and patient health questionnaire-9, respectively. A multiple regression model was performed to detect GMV and white matter (WM) integrity associated with PMPU by voxel-based morphometry (VBM) and tract-based spatial statistics (TBSS) methods, and the moderating analysis was conducted by PROCESS using SPSS software. VBM analysis found an inverse correlation between the GMV of the anterior cingulate gyrus (ACC) and right fusiform gyrus (FFG) with PMPU (PFDR

Tinnitus is a perception of sound in the absence of an external source. The aim of our study was to investigate with a meta-analytical approach, whether mobile phone (MP) use increases the risk of tinnitus. Eight studies reporting the risk of tinnitus in relation to MP use were identified, and six high-quality studies (two cohort studies, one case-control study, and three cross-sectional ones) were included in the meta-analysis. The quality assessment was performed using the Newcastle-Ottawa scale. The risk of tinnitus was analyzed depending on the exposure to MPs in subgroups according to the study design and method of exposure assessment. Two cohort studies, which assessed the exposure to MPs using network operator data, indicated no significantly increased risk of tinnitus among highly exposed MP users in comparison to lightly exposed individuals (odds ratio [OR]: 1.03 [95% confidence interval [CI]: 0.93-1.15]). Likewise, the self-reported exposure data from two cohorts/case-control and four cross-sectional studies did not find an association between exposure to MPs and tinnitus (OR: 1.20 [95% CI: 0.40-3.61] and OR: 1.73 [95% CI: 0.67-4.49], respectively). Current scientific knowledge, including high-quality studies with a reliable exposure assessment based on network operator data, does not support the hypothesis that MP use is associated with tinnitus. © 2020 Bioelectromagnetics Society.

Parental mobile device use while parenting has been associated with reduced parental responsiveness and increased negative affect among children. However, it remains unclear whether it can interfere with the process of acquiring social communication skills. Thus, this study sought to experimentally examine whether maternal mobile phone use while interacting with the child has an immediate effect on the frequency of mothers' and infants' joint attention (JA) behaviors, the likelihood that these behaviors will lead to JA episodes, and the duration of established JA episodes. Participants were a community sample of 114 (

Due to their ubiquity, compulsive mobile phone use (CMPU) should include cognitive, psychological, and behavioral dimensions. This study has two main objectives-(a) explicate a multidimensional measure of CMPU and examine individual differences in the various dimensions and (b) conceptualize mobile phone self-efficacy and examine its relationship with CMPU. A survey with 446 U.S. adults was conducted in which respondents completed assessments related to CMPU, mobile phone self-efficacy, and mobile phone use frequency. Results showed the presence of a three-dimensional factor structure for CMPU. While gender, age, and mobile phone activity were associated with CMPU, mobile phone self-efficacy was not. The relevance of the findings is discussed along with implications for future research.

Some case-control studies have suggested substantial increased risks of glioma in association with mobile phone use; these risks would lead to an increase in incidence over time.Incidence rates of glioma from 1995 to 2020 by age, sex, and site in New Zealand (NZ) recorded by the national cancer registry were assessed and trends analysed. Phone use was based on surveys.In these 25 years there were 6677 incident gliomas, giving age-standardised rates (WHO world standard) of 6.04 in males, and 3.95 in females per 100,000. The use of mobile phones increased rapidly from 1990 to more than 50% of the population from about 2000, and almost all the population from 2006. The incidence of glioma from ages 10-69 has shown a small decrease over the last 25 years, during which time the use of mobile phones has become almost universal. Rates in the brain locations receiving most radiofrequency energy have also shown a small decrease. Rates at ages of 80 and over have increased.There is no indication of any increase related to the use of mobile phones. These results are similar to results in Australia and in many other countries. The increase in recorded incidence at ages over 80 is similar to that seen in other countries and consistent with improved diagnostic methods.

A previous cross-sectional study found that problematic mobile phone use (PMPU) was associated with students' eating disorder symptoms. However, since the cross-sectional study cannot infer the causality and the direction of effect, the longitudinal relationship between the two and the mechanism behind this relationship are unclear. Therefore, the present study explores the prospective association between PMPU and eating disorder symptoms and related mediation mechanisms using a 1-year longitudinal study of 1,181 college students (from December 2019 [T1] to December 2020 [T2]). Survey tools used include the Mobile Phone Addiction Tendency Scale, the 10-item Connor-Davidson resilience scale, and the 12 item Short Form of the Eating Disorder Examination Questionnaire. The longitudinal relationship between PMPU and eating disorder symptoms and the mediating effect of resilience was analyzed using a cross-lagged model. The results showed that PMPU (β = 0.086, P < 0.01) and resilience (β = −0.145, P < 0.01) at T1 predicted eating disorder symptoms at T2, but not vice versa. PMPU was bidirectionally associated with resilience, and the prediction effect of PMPU at T1 to resilience at T2 (β = −0.151, P < 0.001) was higher than the prediction effect of resilience at T1 to PMPU at T2 (β = −0.134, P < 0.001). The standardized indirect effect of PMPU at T1 on eating disorder symptoms at T2 via resilience was significant (β = 0.022, 95% CI = 0.010~0.040, P < 0.001). Therefore, PMPU and resilience were predictive for eating disorder symptoms in college students, and resilience may play a mediating role in the prospective association between PMPU and eating disorder symptoms. This study provides new ideas and higher-level evidence for the development of prevention and intervention measures for college students' eating disorder symptoms.

Background and Objectives: Phonoholism is the excessive and harmful use of a smartphone. We are now observing this phenomenon among adults more often. Using a smartphone for several hours may lead to somatic and psychological symptoms, such as headaches and depression. The aim of this study is to assess the prevalence of phonoholism and to assess the association between smartphone overuse and neuropsychiatric disorders. Materials and Methods: A total of 368 people (70.1% were woman), aged between 19 and 82 years (average age 26.1), took part in an anonymous questionnaire consisting of the following elements: Hospital Anxiety and Depression Scale (HADS), Mobile Phone Problem Use Scale (MPPUS-9), and original questions regarding headaches and sleep quality, along with a subjective assessment of the use of smartphones and an objective evaluation based on data from the applications “Stay Free” and “Screen Time”. Results: A total of 61 respondents (16.6%) obtained a score on the MPPUS-9 scale, which revealed their problematic use of mobile devices. Patients with phonoholism had significantly more headaches (85% vs. 58.7%, p = 0.027). Subjects with phonoholism had significantly shorter mean sleep duration (7.14 h vs. 7.42 h, p = 0.0475) and were less likely to feel sleepy during the day (43.33% vs. 59.73%, p = 0.0271). The group with phonoholism had significantly higher scores on the HADS-A anxiety scale (8.29 vs. 10.9, p = 0.015), but a statistical significance was not confirmed for depressive symptoms. Conclusions: The excessive use of the telephone negatively affects both somatic and mental health and can pose a significant clinical problem.

Issue addressed Caregivers have a crucial role to play in keeping children safe at public swimming pool facilities, with the most common factor contributing to childhood drowning being a lapse in adult supervision. Methods A mixed methods approach was used to collect observations (n = 301) and interviews (n = 10) with caregivers of children aged 0-10 years at two public swimming pool facilities located in the Perth metropolitan area, Western Australia (WA). Results Of the 449 children observed, children aged 6-10 years were significantly less likely to be provided with ideal supervision (26%) compared to younger children aged 0-5 years (62%). Of the caregivers who were using their mobile phone while supervising children (n = 100, 22% of children observed), none provided ideal supervision. Overall supervision levels among caregivers differed with gender, with only 44% (n = 74) of female caregivers providing ideal supervision, compared to 72% (n = 96) of male caregivers. The 10 interviews revealed several themes, including the following: caregivers' perceptions of their supervision responsibilities; barriers to supervision; and awareness and perceptions of a communications campaign designed by the Royal Life Saving WA Branch, known as Watch Around Water (WAW). Conclusion Caregiver supervision at public swimming pools remains an important issue, particularly the use of mobile phones and its deleterious impact on supervision. The WAW program plays an integral role in educating caregivers of supervision responsibilities. Furthermore, this study adds to the limited evaluation of the WAW program, and thus will help guide future improvements to ensure caregiver supervision is consistent. SO WHAT?: Further research is needed to create strategies to reduce mobile phone use among caregivers, in order to provide safer swimming environments.

How circadian rhythms of activity manifest themselves in social life of humans remains one of the most intriguing questions in chronobiology and a major issue for personalized medicine. Over the past years, substantial advances have been made in understanding the personal nature and the robustness—i.e. the persistence—of the circadian rhythms of social activity by the analysis of phone use. At this stage however, the consistency of such advances as their statistical validity remains unclear. The present paper has been specifically designed to address this issue. To this end, we propose a novel statistical procedure for the measurement of the circadian rhythms of social activity which is particularly well-suited for the existing framework of persistence analysis. Furthermore, we illustrate how this procedure works concretely by assessing the persistence of the circadian rhythms of telephone call activity from a 12-month call detail records (CDRs) dataset of adults over than 65 years. The results show the ability of our approach for assessing persistence with a statistical significance. In the field of CDRs analysis, this novel statistical approach can be used for completing the existing methods used to analyze the persistence of the circadian rhythms of a social nature. More importantly, it provides an opportunity to open up the analysis of CDRs for various domains of application in personalized medicine requiring access to statistical significance such as health care monitoring.

Purpose: Traffic accidents are one of the major health problems in the world, being the first cause of burden of illness and the second leading cause of death in Iran. The Sistan-Baluchestan province is one of the most accidental provinces of Iran with the highest rate of accidents-caused deaths. This study was conducted to determine the risk factors associated with traffic accidents in Zahedan through 2013 to 2016. Methods: This analytical cross-sectional study was carried out on 223 drivers from Zahedan who were traumatized by traffic accident and sent to Zahedan hospitals. The data were obtained through interviews taken by the trained interviewers via refereeing to the medical records and collected in the researcher-made checklist. Census was obtained from the study subjects. For data analysis, independent t-test, one-way ANOVA, Chi-square and logistic regression were used with the Stata software version 11.0. Results: In this study, 223 male subjects with the mean age of (32.54 ± 12.95) years, 39.8% single and 60.2% married, entered for investigation. Most accidents (38.8%) occurred between 12:00 to 17:59. While driving, 47.1% of the study subjects were using cell phones, 89.1% had manual use of mobile phones, 21.9% had a habit of sending short message service (SMS) and 23.4% had sent SMS within 10 min before the accident. The one way analysis of variance showed that the mean age of individuals with marital status, driving experience, education and accident with motorcycle were significantly different (p

Background The World Health Organization (WHO) declared a global pandemic of Covid-19 on 11 March 2020. The lockdown caused a lifestyle changes: an increase in the use of mobile media devices (MMDs), sleep and psychiatric disorders, incorrect habits regarding food and physical activities. We investigate prevalence of admission for seizures at our emergency department (ED), during Italian lockdown, comparing with that of the same period of the previous year (2019), and the relationship with some lifestyle changes. Methods In this observational study, patients (4–14 years) with seizures that accessed at our ED, during Italian lockdown, were eligible. Non-epileptic events and febrile seizures were excluded. We describe two groups: patients with new-onset seizures and not. Moreover, a questionnaire concerning use of MMDs and sleep habits was administered. Results Fifty-seven patients were included; median age 8.03 years. Considering only paediatric medical emergencies, the prevalence of accesses for seizures was 2.6% (CI 95% 0.020–0.034), while the incidence was 0.94% (CI 95% 0.006–0.0149). There was a statistically significant difference with prevalence of previous years, χ2 102.21 (p = 0.0001). We also reported a difference in daily screen time (DST) (p = 0.001) and total sleep time (TST) (p = 0.045), in all population, between period pre- and during lockdown. A negative correlation between DST and seizures latency (Spearman’s ρ -0.426, p = 0.038) was found. In the two groups, the results were partially overlapping. Conclusions During lockdown period, we assisted to an increase of accesses for seizures. It is conceivable that a sleep time change and/or higher MMD use could act as triggers for seizures.

Background The aim of this study was to compare health workers knowledge and skills competencies between those trained using the onsite simulation-based, low-dose, high frequency training plus mobile mentoring (LDHF/m-mentoring) and the ones trained through traditional offsite, group-based training (TRAD) approach in Kogi and Ebonyi states, Nigeria, over a 12-month period. Methods A prospective cluster randomized controlled trial was conducted by enrolling 299 health workers who provided healthcare to mothers and their babies on the day of birth in 60 health facilities in Kogi and Ebonyi states. These were randomized to either LDHF/m-mentoring (intervention, n = 30 facilities) or traditional group-based training (control, n = 30 facilities) control arm. They received Basic Emergency Obstetrics and Newborn Care (BEmONC) training with simulated practice using anatomic models and role-plays. The control arm was trained offsite while the intervention arm was trained onsite where they worked. Mentorship was done through telephone calls and reminder text messages. The multiple choice questions (MCQs) and objective structured clinical examinations (OSCEs) mean scores were compared; p-value Results The mean knowledge scores between the two arms at months 3 and 12 post-training were equally high; no statistically significant differences. Both arms showed improvements in composite scores for assessed BEmONC clinical skills from around 30% at baseline to 75% and above at end line (p p Conclusion The LDHF/m-mentoring intervention is more effective than TRAD approach in improving health workers’ skills acquisition and retention. Health care managers should have the option to select the LDHF/m-mentoring learning approach, depending on their country’s priorities or context, as it ensures health workers remain in their place of work during training events thus less disruption to service delivery. Trial registration The trial was retrospectively registered on August 24, 2017 at ClinicalTrials.Gov: NCT03269240.

BackgroundA vast literature has demonstrated that using mobile phones while driving increases the risk of road traffic crashes. In response, policy-makers have introduced bans and harsher penalties on using mobile phones while driving. Even though emerging evidence suggests that such measures may reduce mobile phone use and crashes, the literature has not been systematically reviewed and synthesised.ObjectiveTo evaluate the impact of penalising mobile phone use while driving on road traffic fatalities, serious injuries and the prevalence of mobile phone use while driving.MethodsWe employed a comprehensive search strategy using electronic databases, websites, handsearching and other sources to locate studies evaluating legislation on mobile phone use while driving. Randomised controlled trials, interrupted time series’, controlled before–after studies with control(s) not exposed to harsher sanctions and panel data designs were included if they measured the outcomes of fatalities, serious injuries or the prevalence of mobile phone use while driving. Eligible studies were critically appraised. Due to substantial heterogeneity, the results were synthesised narratively. The synthesis structured studies according to the type of legislation and outcome measure.ResultsOf the 7420 studies retrieved, 32 were included. The evidence on the effects of penalising mobile phone use while driving was weak, and somewhat inconsistent, but pointed to a potential decrease in the prevalence of mobile phone use and fatalities for all-driver primary enforcement hand-held bans and texting bans.ConclusionsPreventing fatalities from risky driving practices may be helped by implementing harsher laws that penalise mobile phone use while driving.

BackgroundPedestrians are commonly involved in vehicle collisions that result in injuries and fatalities. Pedestrian distraction has become an emerging safety issue as more pedestrians use their mobile phones while walking and crossing the street.ObjectivesThe purpose of this research synthesis and meta-analysis is to determine the extent to which cell phone conversation, text messaging or browsing, and listening to music affect a number of common pedestrian behavioural measures.MethodsA keyword search was developed with a subject librarian that used MeSH terms from selected databases including PsycINFO, SPORTDiscus, Medline and TRID. Supplemental searches were also conducted with Google Scholar and Mendeley.Effect size codingThirty-three studies met inclusion criteria and were subjected to data extraction. Statistical information (ie, M, SD, SE, 95% CI, OR, F, t) was extracted to generate standardised mean difference effect sizes (ie, Cohen’s d) and r effect sizes.ResultsFourteen experimental studies were ultimately included in an N-weighted meta-analysis (k=81 effect sizes), and eight observational studies were included in a qualitative overview. Both mobile phone conversation and text messaging increased rates of hits and close calls. Texting decreased rates of looking left and right prior to and/or during street crossing. As might be expected, text messaging was generally found to have the most detrimental effect on multiple behavioural measures.LimitationsA variety of study quality issues limit the interpretation and generalisation of the results, which are described, as are future study measurement and methods improvements.

SUMMARY OBJECTIVE Evaluate the quality of sleep and its association with the use of computers and cell-phones among medicine and dentistry students. METHODS Cross-sectional and comparative study, which evaluated 425 students through a socioeconomic questionnaire, the Pittsburgh Sleep Quality Index(PSQI), and a questionnaire on their use of computers and cell phones. RESULTS Poor sleep quality was observed in 61.4% of medical students and in 60.1% of dentistry students. Medical students with poor sleep quality had a higher mean time of computer use at night when compared to those with good sleep quality (p=0.04), as well as for computer (p

[EN] Objective: To investigate the association of estimated all-day and evening whole-brain radiofrequency electromagnetic field (RF-EMF) doses with sleep disturbances and objective sleep measures in preadolescents. Methods: We included preadolescents aged 9-12 years from two population-based birth cohorts, the Dutch Generation R Study (n = 974) and the Spanish INfancia y Medio Ambiente Project (n = 868). All-day and evening overall whole-brain RF-EMF doses (mJ/kg/day) were estimated for several RF-EMF sources including mobile and Digital Enhanced Cordless Telecommunications (DECT) phone calls (named phone calls), other mobile phone uses, tablet use, laptop use (named screen activities), and far-field sources. We also estimated all-day and evening whole-brain RF-EMF doses in these three groups separately (i.e. phone calls, screen activities, and far-field). The Sleep Disturbance Scale for Children was completed by mothers to assess sleep disturbances. Wrist accelerometers together with sleep diaries were used to measure sleep characteristics objectively for 7 consecutive days. Results: All-day whole-brain RF-EMF doses were not associated with self-reported sleep disturbances and objective sleep measures. Regarding evening doses, preadolescents with high evening whole-brain RF-EMF dose from phone calls had a shorter total sleep time compared to preadolescents with zero evening whole-brain RF-EMF dose from phone calls [-11.9 min (95%CI -21.2; -2.5)]. Conclusions: Our findings suggest the evening as a potentially relevant window of RF-EMF exposure for sleep. However, we cannot exclude that observed associations are due to the activities or reasons motivating the phone calls rather than the RF-EMF exposure itself or due to chance finding. This work was supported by the European Union Seventh Framework Program (FP7/2007-2013 No. 603794 GERoNiMO project) . Arno Thielens is a postdoctoral fellow of the Research Foundation Flanders (FWO) under grant agreement no. 12U1417N. INMA-Sabadell: This study was funded by grants from Instituto de Salud Carlos III (Red INMA G03/176; CB06/02/0041; PI041436; PI081151 incl. FEDER funds; PI12/01890 incl. FEDER funds; CP13/00054 incl. FEDER funds, MS13/00054, CPII18/00018; PI17/01340 incl. FEDER funds) , CIBERESP, Generalitat de Catalunya-CIRIT 1999SGR 00241, Generalitat de Catalunya-AGAUR (2009 SGR 501, 2014 SGR 822) , Fundacio La Marato de TV3 (090430) , Spanish Ministry of Economy and Competitiveness (SAF2012-32991 incl. FEDER funds) , French Agency for Food, Environmental and Occupational Health & Safety (EST-2016 RF-21, EST/2013/2/22) , EU Commission (261357, 308333, 603794 and 634453) .We also acknowledge support from the Spanish Ministry of Science and Innovation and State Research Agency through the "Centro de Excelencia Severo Ochoa 2019-2023" Program (CEX2018-000806-S) , and support from the Generalitat de Catalunya through the CERCA Program". INMA-Gipuzkoa: This study was funded by grants from Instituto de Salud Carlos III (FIS-PI13/02187) , CIBERESP, Department of Health of the Basque Government (2015111065) , and the Provincial Government of Gipuzkoa (DFG15/221) and annual agreements with the municipal-ities of the study area (Zumarraga, Urretxu, Legazpi, Azkoitia y Azpeitia y Beasain) . The Generation R Study: The general design of the Generation R Study is supported by the Erasmus Medical Center-Rotterdam, the Erasmus University Rotterdam, the Netherlands Organization for Health Research and Development, the Netherlands Organization for Scientific Research, and the Dutch Ministry of Health, Welfare and Sport, and the Stichting Trombosedienst and Artsenlaboratorium Rijnmond. This study was funded by a grantfromthe Netherlands organization for Health Research and Development (85500036) . Henning Tiemeier was sup-ported by a grant of the Netherlands Organization for Scientific Research (NWO/ZonMW grant 016.VICI.170.200) and of Erasmus Medical Center Efficiency Grant (MRC-2013-169) .

BackgroundWhile multiple studies have documented the impacts of mobile phone use on TB health outcomes for varied settings, it is not immediately clear what the spatial patterns of TB treatment completion rates among African countries are. This paper used Exploratory Spatial Data Analysis (ESDA) techniques to explore the clustering spatial patterns of TB treatment completion rates in 53 African countries and also their relationships with mobile phone use. Using an ESDA approach to identify countries with low TB treatment completion rates and reduced mobile phone use is the first step toward addressing issues related to poor TB outcomes.MethodsTB notifications and treatment data from 2000 through 2015 that were obtained from the World Bank database were used to illustrate a descriptive epidemiology of TB treatment completion rates among African health systems. Spatial clustering patterns of TB treatment completion rates were assessed using differential local Moran's I techniques, and local spatial analytics was performed using local Moran's I tests. Relationships between TB treatment completion rates and mobile phone use were evaluated using ESDA approach.ResultSpatial autocorrelation patterns generated were consistent with Low-Low and High-Low cluster patterns, and they were significant at different p-values. Algeria and Senegal had significant clusters across the study periods, while Democratic Republic of Congo, Niger, South Africa, and Cameroon had significant clusters in at least two time-periods. ESDA identified statistically significant associations between TB treatment completion rates and mobile phone use. Countries with higher rates of mobile phone use showed higher TB treatment completion rates overall, indicating enhanced program uptake (p < 0.05).ConclusionStudy findings provide systematic evidence to inform policy regarding investments in the use of mHealth to optimize TB health outcomes. African governments should identify turnaround strategies to strengthen mHealth technologies and improve outcomes.

Distracted driving is among the leading causes of roadway crashes worldwide. However, due to limitations of police-reported crash data, it is often challenging to understand the nature and magnitude of this problem. Distraction has also been shown to affect driver speed selection, which is important as both mean speed and speed variance have substantive impacts on crash risk. This study utilizes naturalistic driving data to investigate the relationship between the engagement in various secondary (non-driving) tasks and driver speed selection under different driving contexts. Separate analyses were conducted for low-speed and high-speed driving environments. Two-way random effects linear regression models were estimated for both speed regimes, while controlling for driver, roadway, and traffic characteristics. The differences were assessed based upon ten types of secondary tasks. In general, engagement in all tasks was found to decrease speeds in high-speed environments while the effects were mixed in low-speed settings. The changes in speeds were much pronounced for secondary tasks that include a combination of visual, manual, and cognitive distractions, such as cell phone use. Among all secondary tasks, an average episode of a driver talking on a handheld cellphone was associated with a 6-mph speed reduction in high-speed environments, but a 3.5-mph increase in low-speed settings. In addition to examining impacts on speed selection, the risk of involvement in crash and near-crash events was also evaluated in consideration of the type and duration of distraction. Interestingly, distractions tended to show similar relationships, in both direction and magnitude, with the risk of involvement in both crash and near-crash events. From a policy standpoint, this study provides further motivation for legislation and other programs aimed at curbing distracted driving.

Background Exposure to traditional media (TV, radio, and newspapers) and the use of mobile as an interpersonal communication tool allow for a variety of information provision. The purpose of this study is to investigate how women’s media and mobile access affect maternal health service (MHS) utilization. The study also aims to look into the moderated mediation effects of socioeconomic variables on the association mentioned above. Methods The study analyzed reproductive and media data of 5,011 ever-married women extracted from the latest nationally representative Bangladesh Demographic and Health Survey. Hierarchical logistic regression and moderated mediation analysis are performed to determine the association. Results Only 26.9% of women used mobile for health service use, while more than 55% had media access. Media access is significantly associated with all three types of MHS use; mobile usage also has a significant association with antenatal and delivery care. When women have both access to media and mobile, the likelihood of delivering in a health facility increased by 1.82 times (AOR: 1.82, 95%CI: 1.51, 2.20) which is slightly better than having access to only one type of media channel. Women’s education, household wealth, place of residence, religion, and current working status are among the socioeconomic factors associated with access to media and mobile. Women’s education mediates the relationship of media and MHS; however, the mediation effect of women (β: .45; LLCI: .21, ULCI: .68) on the association of media and place of delivery is seen to be moderated by household wealth. Women who belong to well-off families moderates positively (Effect: .33, 95%CI: .27, .40) the education effect of media and where to deliver. Place of residence, another moderator, significantly moderates (Effect: .09, BootLLCI: .02, BootULCI: .16) the mediation effect of women’s education on the association of media and antenatal care visits; women living in urban areas seems to have positively moderated the education effects on the mentioned association. Conclusions Provision of media access and mobile use indicate better utilization of MHS in Bangladesh, and women’s education mediates these relationships via the influence of household wealth and area of residence. Therefore, while planning interventions to increase MHS use, its relationships with the media and mobile use should be extrapolated. The collective use of these channels could be a catalyst for the success of health promotion initiatives to improve women’s health behaviors, build community capacity, and create mass awareness that supports the optimal use of MHS in Bangladesh.

Introduction:sleep plays an important role in learning and the formation of memories among adolescents, and lack of sleep affects their health, safety, and school performance, especially in the age of mobile phones. This study´s aim was to investigate sleep length and sleep quality among Moroccan adolescents and assess their relationship to mobile phone use. Methods:the population of this cross-sectional study included all the adolescent students aged 12-20 years, living in the Settat region, Morocco. We used proportionate stratified random sampling to select 800 participants from schools in the region. The researchers used a self-developed questionnaire coupled with the Pittsburgh Sleep Quality Index questionnaire to measure sleep length and evaluate sleep quality, respectively. We performed the statistical analysis using a combination of parametric and nonparametric tests to assess sleep length variables and PSQI score relationship to different independent variables. Results:participation rate was 91.2% (n = 730). The mean total sleep time was 8.01 hrs (SD = 1.46 hrs). Wake-up time was 8:17 a.m. (SD = 2.33 hrs), among late-night mobile phone users and 8:03 a.m. (SD = 2.11 hrs) among non-users. Overall, 76.7% of students from rural schools and 66.5% of students from urban schools reported poor sleep quality (p-value = 0.002). Most late-night mobile phone users (78%; p-value = 0.001) had poor sleep quality. Sleep quality decreased by age and in physically and psychologically unhealthy adolescents (p-value

Objectives: To examine whether the association previously reported between mobile phone use at night and poor sleep in adolescents also generalizes to pre-adolescent children.Design: Cross sectional.Setting: Database provided by Resilient Youth Australia Pty Ltd.Participants: Survey completed by 84,915 pre-adolescent (8-11 years), 99,680 early adolescent (12-14 years) and 67,600 late adolescent Australian children (15-18 years).Measurement: Children were asked how frequently they obtained 8 hours of sleep on most nights and if they used their mobile phone at night to send and receive messages between 10 PM and 6 AM. Binary logistic regression analyses were used to examine the association between mobile phone use at night and sleeping 8h or more on most nights with gender, socioeconomic status and year of study (2014-2018) as covariates.Results: For all age cohorts including pre-adolescent children, mobile phone use at night was associated with lower odds of obtaining 8 hours of sleep on most nights.Conclusion: The present findings confirm that the association between mobile phone use at night and poor sleep previously reported in adolescent children also generalises to pre-adolescent children. Given the increased uptake of smartphone devices in ever younger children the findings point to the need to provide parents, schools and communities with resources to promote child sleep hygiene and media use at bedtime.(c) 2022 National Sleep Foundation. Published by Elsevier Inc. All rights reserved. Refereed/Peer-reviewed

Objectives To establish the factorial structure and internal consistency of the Internet Addiction Test (IAT) in parents, the level and correlates of problematic internet use, and patterns and types of screen use. Study design Data were collected through an online questionnaire about preconception health among Canadian women and men with ≥1 child. The questionnaire included the IAT and questions about time spent on screens by device type, use of screens during meals and in the bedroom, and perceptions of overuse. Factor analysis was completed to determine the factorial structure of the IAT, with multivariable linear regression used to determine correlates of the IAT. Results The sample included 1,156 respondents (mean age: 34.3 years; 83.1% female). The IAT had two factors: “impairment in time management” and “impairment in socio-emotional functioning” of which respondents had more impairment in time management than socio-emotional functioning. Based on the original IAT, 19.4% of respondents would be classified as having a mild internet use problem with 3.0% having a moderate or severe issue. In the multivariable model, perceived stress (b = .28, SE = .05, p < .001) and depressive symptoms (b = .24, SE = .10, p = .017) were associated with higher IAT scores. Handheld mobile devices were the most common type of screen used (mean = 3 hours/day) followed by watching television (mean = 2 hours/day). Conclusion Parents spent a significant portion of their time each day using screens, particularly handheld mobile devices. The disruption caused by mobile devices may hinder opportunities for positive parent-child interactions, demonstrating the need for resources to support parents ever-growing use of technologies.

Objective: To evaluate social inequalities of Brazilians in alcohol consumption and cell phone use while driving motor vehicles. Methods: Cross-sectional study conducted with people who drive (n=23,474) in 2019. The outcomes adopted were cell phone use and alcohol consumption while driving, associated with the variables gender, age group, skin color, education and macro-region of housing and analyzed using the slope index of inequality using logistic regression. Results: The inequalities related to alcohol consumption and driving were identified in adults with brown skin color (7.8) linked to the North region (6.8). As for cell phone use while driving, they were higher for the younger age group (19.4) and individuals with higher education (27.1). Conclusion: Cell phone use and alcohol consumption while driving motor vehicles have social inequalities regarding the age group and education, and skin color and macro-region respectively. RESUMEN Objetivo: Evaluar las desigualdades sociales de brasilenõs en el consumo de alcohol y el uso de teléfono celular durante la conducción de vehículos motorizados. Métodos: Estudio transversal realizado con personas que condujeron (n=23.474) en 2019. Los resultados adoptados fueron el uso de teléfonos celulares y el consumo de alcohol durante la conducción, asociados a las variables sexo, grupo de edad, color de piel, educación y macrorregión de residencia. Las desigualdades se analizaron mediante el slope index of inequality y regresión logística. Resultados: Las desigualdades relacionadas con el consumo de alcohol y la conducción como desigualdades se identificaron en adultos de piel morena (7,8) vinculados a la región Norte (6,8). En cuanto a uso de teléfonos celulares en la conducción fueron mayores para el grupo de edad más joven (19,4), y obligatorias con la educación superior (27,1). Conclusión: El uso de teléfonos celulares y el consumo de alcohol en la dirección de vehículos motorizados tiene desigualdades sociales en cuanto a edad y educación, color de piel y región geográfica respectivamente. RESUMO Objetivo: Avaliar as desigualdades sociais de brasileiros (as) no consumo de bebida alcoólica e uso de celular durante a direção de veículos motorizados. Métodos: estudo transversal realizado com pessoas que dirigiam (n=23.474) em 2019. Os desfechos adotados foram o uso de celular e consumo de bebida alcoólica durante a direção, associado as variáveis sexo, faixa etária, cor da pele, escolaridade e macrorregião de moradia e analisadas através dos índices slope index of inequality a partir de regressão logística. Resultados: as desigualdades relacionadas ao uso de álcool e direção as desigualdades foram identificadas em adultos de cor da pele parda (7,8) vinculados a Região Norte (6,8). Quanto ao uso de celular na direção foram maiores para faixa etária mais jovem (19,4) e indivíduos com maior escolaridade (27,1). Conclusão: uso de celular e consumo de álcool na direção de veículos motorizados possui desigualdades sociais referente a faixa etária e escolaridade, e a cor de pele e macrorregião respectivamente.

Objective To determine the association between maternal mobile phone use and adverse outcomes in infants, children, and mothers. Method In March 202, we conducted a search on the MEDLINE, Embase, and Scopus databases. Data extraction and an assessment of the quality of the studies were performed by two authors. The quality of the studies was assessed using the checklist of the Newcastle-Ottawa scale. Results Studies assessing behavioral problems in infants aged 6 to 18 months reported null findings. However, an increased risk of emotional and behavioral disorders was observed in children aged between 7 and 11 years whose mothers had been exposed to cell phones. The findings regarding the association between maternal cell phone exposure and adverse outcomes in children aged 3 to 5 are controversial. A study found a significant association between the call time (p=0.002) or the history of mobile phone use (in months) and speech disorders in the children (p=0.003). However, another study found that maternal cell phone use during pregnancy was not significantly associated with child psychomotor and mental developments. Inconclusive results were observed about the adverse outcomes in fetuses, such as fetal growth restriction or t scores for birth weight in cell phone users as opposed to non-users. On the contrary, the children ofmothers who were cell phone users had a lower risk of scoring low on motor skills. Similar results were observed regarding the adverse outcomes of cell phone use in infants, such as fetal growth restriction or low birth weight, and the risk of preeclampsia was lower among subjects with medium and high cell phone exposure, as opposed to those with low exposure. Conclusion Studies on behavioral problems have reported different postnatal results, such as null findings among infants and a positive association in children. Resumo Objetivo Determinar a associação entre o uso de telefone celular pela mãe e os resultados adversos em recém-nascidos crianças e mães. Método Em março de 2020 realizou-se uma pesquisa nas bases de dados MEDLINE, Embase e Scopus. A extração de dados e avaliação da qualidade dos estudos foram realizadas por dois autores. A qualidade dos estudos foi avaliada por meio da lista de verificação da escala Newcastle-Ottawa. Resultados Estudos que avaliavam problemas comportamentais em recém-nascidos de 6 a 18 meses relataram resultados nulos. No entanto um risco aumentado de transtornos emocionais e comportamentais foi observado em crianças de 7 a 11 anos de idade cujas mães foram expostas a telefones celulares. Os resultados relacionados à associação entre a exposição materna a celulares e resultados adversos em crianças de 3 a 5 anos são controversos. Um estudo encontrou associação significativa entre o tempo de ligação (p=0.002) ou o histórico de uso de celular (emmeses) e distúrbios de fala nas crianças (p=0.003). No entanto outro estudo descobriu que o uso de telefone celular pela mãe durante a gravidez não estava significativamente associado ao desenvolvimento psicomotor e mental da criança. Resultados inconclusivos foram observados com relação aos resultados adversos de fetos como restrição de crescimento intrauterino ou valores de t para peso ao nascer em usuárias de telefone celular em oposição a não usuárias. Pelo contrário os filhos de mães usuárias de telefone celular apresentaram menor risco de pontuação baixa em habilidades motoras. Resultados semelhantes foram observados com relação a resultados adversos em recém-nascidos como restrição de crescimento intrauterino ou valores de peso ao nascere o risco de pré-eclâmpsia foimenor em indivíduos comexposição média e alta a celulares em oposição àqueles com baixa exposição. Conclusão Estudos sobre problemas comportamentais relataram resultados diferentes no pós-natal como achados nulos em recém-nascidos e associação positiva emcrianças.

ObjectiveThis study examined problematic mobile phone use (PMPU) and its relationship with life satisfaction in Chinese university students during the pandemic.MethodsAn anonymous online survey was conducted in a university in China. The Mobile Phone Addiction Index (MPAI) and the Satisfaction with Life Scale (SWLS) were used to assess the severity of problematic mobile phone use and life satisfaction, respectively. Data on demographic and health-related factors were also collected.ResultsA total of 1,491 undergraduate students (73.3% were male) completed the survey. On average, students in the survey reported spending 7.4 ± 4.3 h/day on phone use. Their MPAI score was 38.1 ± 13.3 and SWLS score was 24.9 ± 6.8, respectively. After controlling for confounding factors, the MPAI score was significantly associated with lower life satisfaction. Multiple linear regression revealed that higher monthly allowances, frequent insomnia, longer phone use duration were significantly associated with PMPU.ConclusionUniversity students in China spend nearly half of their waking hours on mobile phone use, significantly longer than before the COVID-19 pandemic. PMPU is associated with insomnia, lower life satisfaction and higher allowances. If the trend continues after the pandemic, interventions may be needed. Increase in-person interactions, limiting online social and gaming time, awareness campaign may be effective in reducing the impact of PMPU and improve life satisfaction.

Cross-sectional studies have documented a positive association between academic procrastination and problematic mobile phone use (PMPU). However, the specific predictive direction has remained controversial and the potential mechanisms underlying the association have not been rigorously evaluated. According to Davis’s cognitive-behavioral model, Brand et al.’s I-PACE model, and procrastination-related theories, academic procrastination and PMPU might have a reciprocal relationship and distraction cognitions might play a mediating role in this process. A total of 633 secondary school students completed three self-report questionnaires at three 6-month intervals over the course of 1.5 years. The cross-lagged panel model results showed that earlier academic procrastination positively predicted subsequent PMPU over time, but the reverse prediction was not stable. Furthermore, distraction cognitions played a mediating role in linking earlier academic procrastination and subsequent PMPU. These findings indicate that academic procrastination precedes PMPU with distraction cognitions as a potential mediator, which contributes to clarifying the controversial relationship and explicating the underlying mechanism. Overall, interventions for academic procrastination may be effective in reducing maladaptive cognitions associated with mobile phones and preventing adolescents from developing PMPU.

(1) The aim of this study was to estimate the scale of mobile phone addiction among young adults as well as to establish whether the low level of perceived social support is related to problematic smartphone use, and whether an addictive pattern of mobile phone use is related to the prevalence of depressiveness and excessive daytime sleepiness. (2) The study was carried out using the diagnostic poll method via the questionnaire technique. Both the author’s own questionnaire and the following standardized research tools were used: the Mobile Phone Problem Use Scale for Adolescents (MPPUSA), the Beck Depression Inventory (BDI), the Epworth Sleepiness Scale (ESS), and the Multidimensional Scale of Perceived Social Support (MSPSS). (3) Perceived social support was significantly lower in the group of respondents who problematically used their mobile phones in comparison with the ones who used them in a proper way. Severity of depressive symptoms and daytime sleepiness was significantly higher in respondents addicted to their mobiles compared to nonaddicted ones. (4) Conclusions: An important correlation between phone addiction and the prevalence of depressive symptoms and excessive daytime sleepiness exists. Problematic mobile phone use concerns individuals with low levels of perceived social support.

Radiofrequency (RF) radiation from mobile phones has been classified as possibly carcinogenic to humans (2b) by IARC. However, to date, the discussion on whether mobile phone use is a cancer risk factor has not been solved. In this context of continuing uncertainty, it is important to continue to monitor cancer incidence trends. Annual incidence rates and directly age-standardized rates of selected cancers by sex and 5-year age groups for 1996 to 2017 for England were obtained from the UK Office for National Statistics. Interpretation in light of mobile phone use as a contributing risk factor was conducted for cancers of the brain, parotid gland, thyroid, and colorectal cancer, which have all been hypothesized to be associated with RF exposure. Brain and parotid gland cancers were updated by an additional 10 years following a previous publication, and continue to provide little evidence of an association with mobile phone use. Although mobile phone use as a potential risk factor contributing to increased incidence of colorectal or thyroid cancer could not be excluded based on these ecological data, it is implausible that it is an important risk factor for either. In the absence of clarity from epidemiological studies, it remains important to continue to monitor trends. However, for the time being, and in agreement with data from other countries, there is little evidence of an association between mobile phone use and brain or parotid gland cancer, while the hypotheses of associations with thyroid or colorectal cancer are similarly weak. © 2021 Bioelectromagnetics Society.

Background Cross-sectional and longitudinal studies have found that problematic mobile phone use, bedtime procrastination, sleep quality, and depressive symptoms are strongly associated. However, studies are inconsistent regarding whether problematic mobile phone use predicts depressive symptoms or vice versa, and sleep factors have been infrequently focused on in this regard. In addition, few studies have examined the longitudinal associations and directions of effects between these factors. Therefore, this study aims to explore the longitudinal relationship among problematic mobile phone use, bedtime procrastination, sleep quality, and depressive symptoms in college students. Methods Overall, 1181 college students completed questionnaires on problematic mobile phone use, bedtime procrastination, sleep quality, and depressive symptoms at two time points 12 months apart. A cross-lagged model was used to examine the longitudinal relationship between these factors. Results Cross-lagged analyses showed significant bidirectional relationships of problematic mobile phone use with bedtime procrastination and depressive symptoms. Additionally, there were also significant bidirectional relationships of sleep quality with bedtime procrastination and depressive symptoms. Problematic mobile phone use predicted subsequent sleep quality one-way, and bedtime procrastination predicted subsequent depressive symptoms one-way. Conclusions This study further expands our understanding of the longitudinal and bidirectional relationships among problematic mobile phone use, bedtime procrastination, sleep quality and depressive symptoms and helps school mental health educators design targeted interventions to reduce problematic mobile phone use, sleep problems, and depressive symptoms among college students.