Developing a Multiprofessional Mobile App to Enhance Health Habits in Older Adults: User-Centered Approach

BACKGROUND

Although comprehensive lifestyle habits are crucial for healthy aging, their adherence tends to decline as individuals grow older. Sustaining a healthy life over time poses a motivational challenge. Some digital tools, such as smartphone apps aimed at promoting healthy habits, have been used to counteract this decline. However, a more profound investigation is necessary into the diverse experiences of users, particularly when it concerns older adults or those who are unfamiliar with information and communications technologies.

OBJECTIVE

We aimed to develop a mobile app focused on promoting the health of older adults based on the principles of software engineering and a user-centered design. The project respected all ethical guidelines and involved the participation of older adults at various stages of the development of the app.

METHODS

This study used a mixed methods approach, combining both quantitative and qualitative methodologies for data collection. The study was conducted in Ribeirão Prêto, São Paulo, Brazil, and involved 20 older adults of both genders who were aged ≥60 years and enrolled in the Physical Education Program for the Elderly at the University of São Paulo. The research unfolded in multiple phases, encompassing the development and refinement of the app with active engagement from the participants.

RESULTS

A total of 20 participants used a mobile health app with an average age of 64.8 (SD 2.7) years. Most participants had a high school education, middle-class status, and varying health literacy (mean score 73.55, SD 26.70). Overall, 90% (18/20) of the participants owned smartphones. However, 20% (4/20) of the participants faced installation challenges and 30% (6/20) struggled with web-based searches. The focus groups assessed app usability and satisfaction. Adjustments increased satisfaction scores significantly (Suitability Assessment of Materials: 34.89% to 70.65%; System Usability Scale: 71.23 to 87.14). Participant feedback emphasized font size, navigation, visual feedback, and personalization, and suggestions included health device integration, social interaction, and in-app communication support.

CONCLUSIONS

This study contributes to the development of health care technologies tailored to the older adult population, considering their specific needs. It is anticipated that the resulting app will serve as a valuable tool for promoting healthy habits and enhancing the quality of life for older adults.

An analysis of E-governance in Pakistan from the lens of the Chinese governance model

In this era of digitalization, the role of information and communication technology (ICT) has significantly increased. The integration of ICT into the government system has improved efficiency and working processes. Some countries such as China have successfully integrated ICT into their governance system. However, many other countries especially the developing world are yet to effectively utilize the role of ICT in their governance structure and these countries are struggling to produce a better governance system. It is, therefore, imperative for the developing world to learn from successful nations and devise their governance systems so that ICT can be fully utilized and produce good governance. However, such comparative analyses are not done as such to bring strengths and weaknesses in the integration of ICT into the governance system especially in developing countries' governance systems. This study contributes by conducting a comparative study on the China-Pakistan e-government progress. China has widely implemented e-government, which has helped the country to ensure good governance. Pakistan, on the other hand, is also moving towards digitalization and making efforts to implement e-government. This research examines the United Nations' E-Government Development Index (EGDI) reports and rankings. The findings of our research show that China has significantly improved its ranking, whereas Pakistan's ranking has indicated a gradual decline except for the year 2008. This happened because of a lack of investment in infrastructure, scarcity of financial resources, weak institutional capabilities, and limited access to advanced technologies. Moreover, there is a big gap between public policy and public implementation in Pakistani scenarios. However, it has been dug out in this study that employing the Chinese model and seeking cooperation with China can improve e-governance ranking and overall governance in Pakistan. The study advances the understanding of e-governance and its challenges in Pakistan and the findings of the study will assist researchers, policymakers, and officials in the implementation and development of e-projects in Pakistan.

Tele neuropsychological exploratory assessment of indicators of mild cognitive impairment and autonomy level in Mexican population over 60 years old

Due to the cognitive decline associated with aging, it is necessary to determine the variables involved in this process to implement preventive actions to avoid or help slow the progression of cognitive decline to dementia in older adults. This is a priority in the current pandemic situation, due to the consequences of periods of confinement due to COVID-19. To address these challenges, this study was conducted through Information and Communication Technologies (ICTs), by adapting an in-person assessment protocol into an online Tele neuropsychological consultation. The correlation between autonomy and cognitive performance variables is analyzed in 47 Mexican subjects over 60 years of age. The results of the statistical analyses suggest a moderate correlation between the level of autonomy and cognitive performance (with MOCA and Clock Drawing Test), significant correlation values are outlined in some of the variables reviewed, and interesting data were found in the correlation of cognitive reserve with cognitive decline and the educational level from the participants. Finally, future analysis is proposed of the sensitivity of screening tests (CDT) to find indicators of Mild Cognitive Impairment (MCI) in this population that is not detected in classical tests (MOCA). Developing ICT-based screening protocols for the elderly may be a key tool in these coronavirus times or under any given circumstances.

Relevance of a citizen participation technology platform to strengthen sub-Saharan health systems

Introduction

A citizen participation intervention using a toll-free number combined with an interactive voice server to collect citizens’ opinions on their health systems was conducted in Burkina Faso, Benin, and the Democratic Republic of Congo between 2020 and 2021.

Purpose of research

This paper aims to assess the effectiveness, sustainability, and transferability of this m-participation intervention to the health systems strengthening.

Results

The analysis shows the relevance of the telephone to include citizens in the governance of sub-Saharan health systems.

Conclusion

Information and communication technologies are an important support in the quest for better health democracy in sub-Saharan Africa.

Challenges and Strategies for Enhancing eHealth Capacity Building Programs in African Nations

eHealth applications play a crucial role in achieving Universal Health Coverage. (1) Background: To ensure successful integration and use, particularly in developing and low/middle-income countries (LMIC), it is vital to have skilled healthcare personnel. The purpose of this study was to describe challenges that hinder capacity-building initiatives among healthcare personnel in developing and LMIC and suggest interventions to mitigate them. (2) Methods: Adopted a descriptive research design and gathered empirical data through an online survey from 37 organizations. (3) Results: The study found that in developing and LMIC, policymakers and eHealth specialists face numerous obstacles integrating and using eHealth including limited training opportunities. These obstacles include insufficient funds, inadequate infrastructure, poor leadership, and governance, which are specific to each context. The study suggests implementing continuous in-service training, computer-based systems, and academic modules to address these challenges. Additionally, the importance of having solid and appropriate eHealth policies and committed leaders were emphasized. (4) Conclusions: These findings are consistent with previous research and highlight the need for practical interventions to enhance eHealth capacity-building in LMICs. However, it should be noted that the data was collected only from BETTEReHEALTH partners. Therefore, the results only represent their respective organizations and cannot be generalized to the larger population.

Can Income Inequality be Affected by the Interaction Between ICTs and Human Capital?: The Evidence from Developing Countries

Income inequality in developing countries remains a major concern. It has been established that higher inequality makes a greater proportion of the population vulnerable to poverty. This paper aimed to analyse the effect of the interaction between ICTs and human capital on income inequality in developing countries. Covering 89 developing countries for the period 2000 to 2015 and based on panel fixed effects instrumental variables technique, this study finds that the interaction between ICTs and human capital reduces overall income inequality on the one hand, and on the other, leads to an increase in the income shares of the poorest, and in particular relative to the richest in developing countries. Furthermore, the interaction between ICTs and human capital reinforces the impact of ICTs on income inequality in developing countries. These results suggest that prioritizing the acquisition of human capital by the poorest, as well as promoting access to and use of ICTs for the benefit of the poorest would significantly contribute to reduce overall income inequality and increase income shares of the poorest in developing countries.

The effect of transport services and ICTs on carbon dioxide emissions in South Africa

The rising trend in carbon dioxide emissions has implications on economic livelihoods through global warming and climate change. Attaining lower carbon dioxide emissions is therefore crucial for the realization of the sustainable development goals. South Africa happens to be one of the leading countries in ICT and transport infrastructure in the sub-Saharan African region. Oppossing arguments on how ICT and tranport services affect carbon dioxide emissions exist. However, their effects on the rising trend in carbon emissions in the country has not received much empirical attention. The study analyses the role ICTs and the transportation sector play in the carbon dioxide emissions of South Africa. Regression analysis of data for the 1989-2018 period shows mobile adoption, internet usage, and telephone usage increases carbon dioxide emissions while transportation services in the country helps reduce carbon dioxide emissions. Income positively affects carbon dioxide emissions while urbanization has negative effects. Implications from the findings include the urgent need to have electricity that power ICT devices and equipment be generated from renewable and sustainable sources rather than from heavy polluting sources.

Social Overview of Smartphone Use by Teenagers

Information and Communication Technologies have led to a new way of life and, in particular, of socialization. The objective of this study is to analyse the image social media disseminate of news taken from digital newspapers, based on the opportunities and drawbacks attributed to smartphone use by teenagers. An essentially qualitative methodology was used, on a sample of 1704 news items published in digital newspapers. The results and conclusions show that smartphone use by teenagers improves development of their digital competence, presents new academic opportunities (through gamification or mobile learning) and provides them with digital tools for school and leisure. The widespread drawbacks reflect the effects of the device on the deterioration of health (dependence, stress, psychosocial problems) and emotions, thereby succinctly affecting academic performance. A noticeable increase of positive news about smartphones was published in the major newspapers in December, while that on its negative effects, in September.

Obstacles of eHealth Capacity Building and Innovation Promotion Initiative in African Countries

eHealth applications and tools have the potential to improve coordination, knowledge, and information sharing between health professionals as well as continuity of care. One of the main obstacles hindering its full integration and use, particularly in the healthcare sector in developing and low and middle-income countries is the lack of qualified staff and healthcare personnel. To explore obstacles that hinder capacity and innovation promotion initiatives, a survey was conducted among BETTEReHEALTH partners. A questionnaire was used to collect quantitative data from 37 organizations. Although there are different buckets of capacity-building and innovation promotion activities going on, the findings showed very few targeting policymakers and eHealth specialists. The findings found that obstacles to capacity building and innovation promotion include lack of finance, poor infrastructure, poor leadership, and governance, and these obstacles are context or region specific. Findings from our study concur with those from previous research on the need to identify practical solutions and simple interventions to address eHealth obstacles to capacity building in developing countries. As measures to mitigate these obstacles, our study proposed the need for adequate policies, strong political commitment, the development of academic modules to be integrated into existing educational programs, and the creation of more in-country and on-site capacity-building activities. While this study contributes to the discourse on eHealth capacity-building and innovation promotion initiatives among healthcare and public health professionals, the study has a limitation as data was collected only from BETTEReHEALTH partners.

How Does Migration Working Experience Change Farmers' Social Capital in Rural China?

While a growing number of farmers migrate to urban sectors to engage in off-farm employment, little is known whether and how the migration working experience (MWE) changes farmers, especially their social capital. Using a survey data set with 2863 farm households in 14 provinces in China, we developed a mediation model to examine the impact of MWE on social capital, as well as the roles of household income, farmers' risk attitude, and information and communications technologies (ICTs). We show that MWE has a significantly positive impact on social capital and weak ties in social capital, which is mediated by household income, risk attitude, and ICT adoption. In particular, MWE can increase income, enhance risk preference, and promote ICT adoption, thus, leading to higher social capital. Moreover, ICTs play a moderating role in the impact of MWE on income and risk preference, that is, ICTs can decrease the impact of MWE on income, and completely substitute the impact of MWE on risk attitude. Our study provides an explanation for the reason why farmers are willing to migrate despite unfavorable working conditions they may endure in urban areas.

The persuasive role of the past: Policy feedback and citizens' acceptance of information communication technologies during the COVID-19 pandemic in China

How can the enforcement of policies in the past influence a society's future adoption of information communication technologies (ICTs)? In this paper, we tackle this question by exploring how past e-governance policies influence citizens' willingness to use the health QR code, which is a COVID-19 tracing app widely used in China's pandemic control. Past policies regarding smart-city development in China involve two aspects: the construction of electronic infrastructure and the applications of specific technologies. Empirical analysis based on a nationwide dataset in China suggests that past policies exhibit persuasive effects and influence citizens' acceptance of the health QR code. Specifically, e-governance applications in cities significantly enhance citizens' acceptance through the demonstration of their usefulness. However, the construction of e-governance infrastructure per se does not have the same impact on citizens' acceptance. By connecting citizens' acceptance of new technology with past e-governance policies, the study illustrates a nuanced policy feedback mechanism through which past policies can substantially reshape public opinion by policy outcomes.

The Use of Information Communication Technologies in a South African Deaf Older Adult Population Living in a Residential Care Home to Communicate with Emigrant Family Members

South Africa has experienced considerable international outward migration in the last half century, which has had a severe psychological impact on members of families affected by this phenomenon. Older parents who remain behind may experience feelings of loss and isolation. Information Communication Technologies (ICTs) are useful in maintaining relationships between family members separated by migration and increasingly allow migrant families to experience a virtual co-presence despite geographical separation. However, the process may be challenging, especially for older people with hearing difficulties. This article reports on a qualitative study exploring the perceptions of a group of older adults who have difficulty hearing and who live in a residential care home about using ICTs to communicate with family abroad. Interview data were analysed using thematic analysis. Most of the participants used either a fixed line telephone or a mobile phone. They reported challenges in communicating with family members abroad arising from their deafness, as well as difficulties using technological devices together with their hearing aids. These challenges resulted in feelings of helplessness and frustration. Although the data collection took place prior to the COVID-19 pandemic, these findings may be of particular relevance to situations such as those during the pandemic when many older adults became more reliant on technology to communicate with family members because of restrictions on direct contact. Accordingly, suggestions are made to address challenges in communication between older adults and loved ones who are geographically separated.

On not 'being there': Making sense of the potent urge for physical proximity in transnational families at the outbreak of the COVID-19 pandemic

This paper investigates transnational families' experiences of the COVID-19 pandemic outbreak and the accompanying sudden and unexpected travel restrictions. Our data consist of written stories collected in April-June 2020 from migrants with ageing kin living in another country. For many respondents, the situation provoked an acutely felt urge for physical proximity with their families. By analysing their experiences of 'not being there', we seek to understand what exactly made the urge to 'be there' so forceful. Bringing into dialogue literature on transnational families with Jennifer Mason's recent theoretical work on affinities, we move the focus from families' transnational caregiving practices to the potent connections between family members. We argue that this approach can open important avenues for future research on families-transnational or otherwise-because it sheds light on the multisensory and often ineffable charges between family members that serve to connect them.

Investigating the links between ICTs, passenger transportation, and environmental sustainability

This paper investigates linkages between ICTs, passenger transportation, and environmental sustainability with regard to a panel dataset of 46 countries over the years 1998-2016. Telephone and internet penetration are employed to measure ICTs, while environmental damages are proxied in terms of three different indicators related to carbon emissions coming from different sources. The empirical methodology employs the 2-step system Generalized Method of Moments (GMM) with the consideration of two empirical specifications: without and with conditioning variables (per capita GDP growth, urbanization, and energy consumption). The findings show that the association between ICTs and passenger transportation activity can positively affect environmental sustainability with regard to carbon emission reductions. Second, the adoption of the telephone in the road transport sector is more efficient than the internet in reducing carbon emissions. Third, internet connectivity is better employed in the air and rail passenger sectors. Public policies and their effective implementations are discussed.

Older Adults' Engagement in Residential Care: Pitfalls, Potentials, and the Role of ICTs

Over the previous years, the residential care sector has gone through a transition from a rather paternalistic approach towards a more democratic way of caregiving. Nevertheless, many care organizations still find it challenging to engage their residents in the process of care. In this study, we investigated the challenges regarding the engagement of older adults in residential care. As recent studies indicated the increasing opportunities of ICTs, we paid particular attention to this in the process of engagement. We followed a participatory action research approach among caregivers and older adults at a somatic care department in a care residence in the Netherlands. Methods used included 15 participants in two homogeneous group sessions, reflections on action in practice, and one mixed focus group. Our findings show that both caregivers and older adults acknowledge the importance of engagement in daily care. However, their different perspectives on how this should take place, made the actual engagement of older adults a challenge. We determined three dilemmas complicating this engagement in care, and labeled these (1) autonomy versus dependence; (2) personal experiences versus privacy; and (3) happiness versus honesty. We found different ways of how caregivers and older adults deal with these dilemma’s in practice and defined these in terms of pitfalls and potentials. ICTs were shown to reinforce both the pitfalls and potentials. Paying attention to these challenges in residential care, including how caregivers and older adults deal with these challenges, will encourage a mutual understanding and actual engagement in decisions on daily care. Further research is recommended on the role of organizations’ management, older adults’ relatives, or older adults with cognitive impairments.

Government responsiveness and public acceptance of big-data technology in urban governance: Evidence from China during the COVID-19 pandemic

The COVID-19 global pandemic has posed unprecedented challenges to nations and cities worldwide. Governments have adopted Information and Communication Technologies (ICTs) to rapidly control the spread of a novel coronavirus. As an innovative but controversial ICT-based tool, health QR code plays a vital role by assisting rapid contact tracing. Yet, whether and how citizens accept this policy tool remains an unknown theoretical and empirical question. In this paper, we study the sources that determine citizens' acceptance of health QR code in city governance. Based on a nation-wide online survey covering 28 major provincial-capital cities in China, we find that individual experiences and political identities affect citizens' acceptance of QR code. Even though public opinion regarding this issue is diverse, the government's responses to citizens' requests play a critical role in enhancing their acceptance of using QR code both in the current and future stages. Specifically, as the citizens perceive a higher level of city government responsiveness, they are less worried about privacy leaks and more likely to perceive the effectiveness of health QR code in improving public health, thus resulting in a higher acceptance. The results offer broad policy implications for smart cities and urban governance.

Telework and Mental Health during COVID-19

COVID-19 has come to change societal organization. Due to lockdowns, work typologies have been rethought and telework has gained strength. However, the impact of the constant use of information and communication technologies on the mental health of workers needs to be considered. We aimed to investigate the impact of different work conditions on mental health, to which end we disseminated an online questionnaire during lockdowns to assess imagined surveillance, mobile maintenance expectation, communication overload, feelings of entrapment, depression, anxiety, stress, and flourishing in four groups (employed in telework, employed on-site, employed in layoff, and unemployed). We computed mean comparisons and serial mediations. We show that depression and anxiety were more prevalent in women; parents flourished more than people without children; and people with a higher level of education feel more entrapment. Crucially, we show that telework was associated with imagined surveillance and communication overload, which mediated the association with mobile maintenance expectations and entrapment (which was exacerbated by parenthood), impacting mental health and the quality of life. However, this was also partially observed in the remaining work conditions. Finally, flourishing worked as a protector against mental health issues in all work conditions. We discuss this given the massification of digital migration.

Benefits, Satisfaction and Limitations Derived from the Performance of Intergenerational Virtual Activities: Data from a General Population Spanish Survey

The growing social gap between people of different generations has led to a greater interest in the study of intergenerational interactions. Digital technologies have become necessary for people of all ages to perform daily activities, increasingly including older people. The use of information and communication technologies (ICTs) and virtual tools can provide older people with excellent opportunities to connect with other generations, improving their quality of life and well-being. The aim of this study was to examine the benefits, satisfaction, and limitations of intergenerational interactions generated by the use of virtual tools. The participants are subjects of any age and different social groups residing in Spain and have completed an online survey. The analysis of sociodemographic data of the respondents showed that there is a significant correlation between the use of social networks and all the variables analyzed, except for their level of autonomy. Most participants who participated in intergenerational virtual activities reported the benefits of their social participation, relationships, mood, mental health, and academic education. Moreover, most participants were quite or very satisfied with the person with whom they used the virtual tools, especially if the person was a friend, their partner, sibling, another relative, or colleague. Except for grandparents, people who participated in intergenerational virtual activities and who had no limitations or disabilities were more frequently reported by the participants. In conclusion, intergenerational interactions through the use of virtual tools can contribute to improving the social inclusion and relationships of all people involved.

Does regional integration matter for sustainable economic growth? Fostering the role of FDI, trade openness, IT exports, and capital formation in BRI countries

IT exports, capital formation, FDI, and trade openness are the key elements to bring sustainable economic growth to any country, since these act as a lifeline to bring sustainability to countries. This study aims to estimate the impact of IT exports, gross capital formation, FDI, and trade openness on sustainable economic growth with regional integration of BRI countries using the annual panel data from 2013 to 2018. Moderating variable is regional integration, while the trade freedom index, investment freedom index, real interest rate, and inflation are control variables. The two-step system GMM technique is applied to the sample as the number of moment conditions is greater than the number of parameters. The results suggest that FDI and gross capital formation have a substantial positive impact on economic growth, whereas IT exports and trade openness have a negative, insignificant impact. The overall results suggest that China's outward FDI has boosted the economic growth in countries while trade openness has a negligible since most developing countries need to invest in industrialization and encourage exports based growth.

Using Information and Communication Technologies to Engage Citizens in Health System Governance in Burkina Faso: Protocol for Action Research

BACKGROUND

Health systems are complex systems involving a vast range of actors. In West Africa, they are often not accessible or responsive. Burkina Faso has widely expressed, in its public health policy, the need to improve both access to quality care and health system responsiveness. There is also a strong wish to give more voice to citizens. To support Burkinabè institutions in achieving these goals, we have developed an action research (AR) protocol.

OBJECTIVE

This paper presents the protocol that will address citizens' participation in health policies and their empowerment through the expression of opinions, for accountability, as well as the strengthening of the health system using information and communication technologies (ICTs).

METHODS

Our approach will consist of (1) enabling people to express their opinions on the health system by means of a toll-free (TF) service coupled with an interactive voice server (IVS); (2) building an information base with anonymous and reliable data; and (3) conducting information awareness-raising activities, including knowledge transfer (KT) and advocacy, social integration activities, development of OpenData platforms, and the capitalization and media coverage of governance issues. For this purpose, the AR project will be implemented in Burkina Faso. The design uses a concurrent mixed-methods approach. This AR project will evaluate the acceptability, process, effectiveness, and economic costs of the device's implementation. We will also analyze the potential for the data collected by the device to be used to improve practices.

RESULTS

Data collection is in progress; the TF number was officially launched on July 1, 2020, and data collection is planned to continue throughout 2021. By using mixed methods, our AR will be approached from a variety of perspectives. Mixed methods will support us in combining the partial insights into sophisticated realities from qualitative inquiries with the data analyses produced by quantitative research.

CONCLUSIONS

This AR is expected to add knowledge on how to increase the empowerment of the population, especially the most vulnerable, to participate in democratic processes and enjoy and exercise their human rights. This protocol recommends implementing a low-cost, contextually adapted technology, associated with an evidence-based approach and carried out on a significant scale. The originality of this approach lies in the fact that it introduces a real AR dimension with local communities and nongovernmental organizations (NGOs), combined with an integrated strategy of KT and application throughout the project for all stakeholders.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/28780.

Addressing the severity and intensity of poverty in Sub-Saharan Africa: how relevant is the ICT and financial development pathway?

The study examines the effectiveness of ICT diffusion and financial development in reducing the severity and intensity of poverty in Sub-Saharan Africa (SSA). Using data from the World Development Indicators and the Global Consumption and Income Project (1980-2019), we provide evidence, robust to several specifications from the dynamic system GMM and the panel corrected standard errors estimation techniques, to show that, compared to financial access, ICT usage, and ICT access, ICT skills is remarkable in reducing both the severity and intensity of poverty. The results further revealed that, though ICT skills reduce poverty, the effect is more pronounced in the presence of enhanced financial development. Policy recommendations are provided in line with the region's green growth agenda and technological progress.

Moving towards environmental sustainability: information and communication technology (ICT), freight transport, and CO2 emissions

This study explores the links between ICTs, transport, and CO₂ emissions. Despite the harmful consequences of transport activity on the environmental quality, there is less scientific attention accorded to this major issue. In this regard, we explore the possibility of reducing environmental damages through the association of new technologies with freight transport activities (i.e. inland, rail, and air). The empirical technique based on 43 countries between 2002 and 2014 employs the 2-step system Generalized Method of Moments (GMM). Overall, the results are very ambitious confirming the ability of ICT in dampening pollution once it's well adapted in the transportation sector. First, the telephone and mobile phones are the most efficient technologies in terms of environmental sustainability when used in the rail and the inland transport sector, while the internet is best utilized in the air transport sector. Second, the telephone plays the role of an accelerator when interacting with intermodality to better improve the environment. Public policies and their implications are considered in the study.

Growth Factors in Developed Countries: A 1960-2019 Growth Accounting Decomposition

Using a new and original database, our paper contributes to the growth accounting literature with three original aspects: First, it covers a long period from the early 60's to 2019, just before the COVID-19 crisis; second, it analyzes a large set of economies (30 plus the Euro Area) at the country level; finally, it singles out the growth contribution of information and communications technologies (ICTs) capital as well as robots. Our findings show that the main drivers of labor productivity growth over the whole 1960-2019 period appear to have been education, total factor productivity (TFP), non-ICT and non-robot capital deepening. The relative contribution of ICT capital is found to be declining from the mid-2000s, although our country-level economy dataset does not make it possible to estimate the TFP contribution of ICTs. The contribution of robots to productivity growth through capital deepening and TFP appears to be significant in Germany and Japan in the sub-period 1975-1995, in France and Italy in 1995-2005, and in several Eastern European countries in 2005-2019. Our findings also confirm the slowdown in TFP in most countries from at least 1995 onwards. This slowdown is mainly accounted for by a decrease in the contributions of non-ICT non-robot capital deepening and TFP.

Does Polychronicity Undermine Procrastination Behavior Through ICTs? Insights From Multi-Level Modeling

Information and communication technologies (ICTs) are widely used in developing nations as a dynamic solution for socio-economic development. Pakistan has seen a rapid increase in the use of ICTs during the previous decade. The purpose of this study is to examine how polychronicity affects procrastination behavior when it is influenced by ICTs. According to this study, individuals are described as a dynamic and destructive kind of self-regulation failure in ICTs. Procrastination is a behavior that prevents emerging economies from growing from developing countries. We researched the group-level polychronicity influence of the individual behavior and the mechanism of procrastination from a team-level perspective of worker behavior. This study data collected 231 workers from 76 groups working in ICTs in Pakistan. The results revealed that the group polychronicity and the behavior of group members were positively linked by taking the work overload as a mediator. Moreover, group cohesiveness moderates the role between polychronicity and work overload diminishing the mediation procession between-group polychronicity and individual procrastination. The practical importance of this study is to understand the causes of procrastination, and how to decrease this obstacle to a fairer workplace. It also helps to decide the professional route that is most suited to personality characteristics.

Achieving pro-poor growth and environmental sustainability agenda through information technologies: as right as rain

The pro-poor growth and environmental sustainability are the twin agendas widely discussed in environmental science literature. The technology-embodied growth helps to attain both agendas through knowledge sharing and technology transfer, which trickle down to the poor income group and improve their living standards. Hence, the role of information and communication technologies (ICTs) is deemed crucial in boosting economic growth and is under deep consideration to establish its role in reducing poverty and environmental pollution. The current study examines the long-run relationship between ICTs, poverty reduction, and ecological degradation in Pakistan using time series data from 1975-2018. The short- and long-run parameter estimates were obtained through the Autoregressive Distributed Lag (ARDL) model for robust inferences. The results substantiate the inverted U-shaped Environmental Kuznets Curve relationship between income and emissions with a turning point at US$1000 in the short-run and US$800 in the long-run. The results confirmed the decisive intervention of ICTs factors in the poverty reduction, i.e., computer communications and mobile-telephone-broadband subscriptions support to reduce poverty incidence with the mediation of inbound FDI in a country. As far as income inequality is concerned, it shows that computer services support minimizing income inequality via a channel of high-technology exports in a country. The technology embodied emissions verified in the long-run, where mobile-telephone-broadband subscriptions increase carbon emissions. Finally, mobile-telephone-broadband subscriptions and inbound FDI both are significant contributors to amplify the country's economic growth. The results conclude that poverty reduction and environmental sustainability agenda are achieved by developing green ICT infrastructure in a country.

Analysis of Digital Competence for Spanish Teachers at Pre-University Educational Key Stages during COVID-19

Over time, the role of information and communication technologies (ICT) has become increasingly important in most areas of our lives, including education. So much so, that during the COVID-19 pandemic, the use of these tools has been essential to continue the teaching process. One of the great challenges facing teachers today is their need to adapt to this new educational scenario by acquiring the necessary digital skills. The aim of this study is to determine the level of competence of teaching in pre-university education key stages. To this end, a questionnaire was distributed among education centres and teachers in the Autonomous Community of Extremadura, obtaining 109 valid responses. The analysis methodology was the formation of clusters using the K-means model. The results confirmed that the teachers perceived a medium-high level of knowledge and use of ICT. Moreover, that this digital competence is conditioned by factors such as age, experience, gender, and level of education. In conclusion, public administrations are encouraged to facilitate teachers' knowledge and application of ICT according to the profiles identified.

[Assessment of competency to stand a trial and the use of remote information and communication techniques in the argentine Justice]

The COVID-19 has changed the way of working of forensic doctors, and the use of Information and Communication Technologies (ICTs) has gained relevance. But its implementation, for psychiatric-forensic evaluations, should comply with standards endorsed by the scientific community. Psycho-legal instruments are necessary in order to determine the procedural capacity of an accused person to stand trial. In the Justice of the Autonomous City of Buenos Aires (CABA), virtual proceedings are carried out, as the National Government decreed the obligatory social lockdown. In the case of the criminal jurisdiction, web platforms and electronic notifications are used for the processing of legal cases. However, in the practice of forensic medicine, there are difficulties in the use of ICTs to determine a person's capacity for criminal prosecution.

The Effect of Information and Communication Technology and Social Networking Site Use on Older People's Well-Being in Relation to Loneliness: Review of Experimental Studies

BACKGROUND

In the last decades, the relationship between social networking sites (SNSs) and older people's loneliness is gaining specific relevance. Studies in this field are often based on qualitative methods to study in-depth self-perceived issues, including loneliness and well-being, or quantitative surveys to report the links between information and communication technologies (ICTs) and older people's well-being or loneliness. However, these nonexperimental methods are unable to deeply analyze the causal relationship. Moreover, the research on older people's SNS use is still scant, especially regarding its impact on health and well-being. In recent years, the existing review studies have separately focused their attention on loneliness and social isolation of older people or on the use of ICTs and SNSs in elderly populations without addressing the relationship between the former and the latter. This thorough qualitative review provides an analysis of research performed using an experimental or quasi-experimental design that investigates the causal effect of ICT and SNS use on elderly people's well-being related to loneliness.

OBJECTIVE

The aims of this review are to contrast and compare research designs (sampling and recruitment, evaluation tools, interventions) and the findings of these studies and highlight their limitations.

METHODS

Using an approach that integrates the methodological framework for scoping studies and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews, we identified 11 articles that met our inclusion criteria. A thematic and content analysis was performed based on the ex post categorization of the data on the selected studies, and the data were summarized in tables.

RESULTS

The analysis of the selected articles showed that: (1) ICT use is positively but weakly related to the different measures of older people's well-being and loneliness, (2) overall, the studies under review lack a sound experimental design, (3) the main limitations of these studies lie in the lack of rigor in the sampling method and in the recruitment strategy.

CONCLUSIONS

The analysis of the reviewed studies confirms the existence of a beneficial effect of ICT use on the well-being of older people in terms of reduced loneliness. However, the causal relationship is often found to be weak. This review highlights the need to study these issues further with adequate methodological rigor.

Predictors of Adherence in Three Low-Intensity Intervention Programs Applied by ICTs for Depression in Primary Care

Depression is one of the most common disorders in psychiatric and primary care settings, and is associated with disability, loss in quality of life, and economic costs. Internet-based psychological interventions have been shown to be effective in depression treatment but present problems with a low degree of adherence. The main aim of this study is to analyze the adherence predictors in three low-intensity interventions programs applied by Information and Communication Technologies (ICTs) for depression. A multi-center, randomized, controlled clinical trial was conducted with 164 participants with depression, who were allocated to: Healthy Lifestyle Program, Positive Affect Promotion Program or Mindfulness Program. Sociodemographic characteristics, Patient Health Questionnaire-9, Visual Analog Scale, Short Form Health Survey, Positive and Negative Affect Schedule, Five Facets Mindfulness Questionnaire, Pemberton Happiness Index and Treatment Expectancy Questionnaire were used to study adherence. Results showed that positive affect resulted in a predictor variable for Healthy Lifestyle Program and Positive Affect Promotion Program. Perceived health was also a negative adherence predictor for the Positive Affect Promotion Program. Our findings demonstrate that there are differences in clinical variables between treatment completers and non-completers and we provide adherence predictors in two intervention groups. Although new additional predictors have been examined, further research is essential in order to improve tailored interventions and increase adherence treatment.

Developing an App to Screen for Dual Disorders: A Tool for Improving Treatment Services in Mexico

Background: Previous studies in Mexico undertaken at residential facilities for treating substance use disorders (SUDs) reported that the prevalence of Dual Disorders (DDs) is over 65%. DDs pose a major challenge for the Mexican health system, particularly for community-based residential care facilities for SUDs, due to the shortage of certified professionals to diagnose and treat these patients. Moreover, the lack of standardized algorithms for screening for and evaluating DDs to refer patients to specialized services (whether private or public) hinders timely care, delaying the start of integrated treatment. The use of new technologies provides a strategic opportunity for the timely detection of DDs through the development of standardized digital applications for the timely detection of DDs. Objective: To develop an app to screen for DDs, which will contribute to referral to specialized services in keeping with the level of severity of psychiatric and addictive symptomatology, and be suitable for use by community-based residential care facilities for SUDs. Method: The research project was implemented in two stages. Stage 1 involved obtaining the psychometric properties of the Dual Diagnosis Screening Interview (DDSI). Stage 2 consisted of two steps to test the Beta version of the app and the quality of version 1.0. Results: The DDS obtained sensitivity and specificity scores above 85%. The app and its algorithm to screen for and refer DDs proved to be efficient and easy to apply with satisfactory community acceptance. Conclusion: The app promises to be a useful screening tool at residential addiction treatment centers.

The effects of air transportation, energy, ICT and FDI on economic growth in the industry 4.0 era: Evidence from the United States

This study analyses the causal and long-run linkage between air transport and economic growth. It was conducted to validate the tourism-led growth hypothesis for the United States (US) during the period 1981-2017 and includes Information and Communication Technologies (ICTs) alongside coal rents in the tourism-led growth hypothesis. This study presents a new direction for future studies by considering the relevance of the fourth industrial revolution (Industry 4.0), particularly in the US. To achieve the stated claim, this study considers as additional explanatory variables how ICTs moderate the impact of Foreign Direct Investment (FDI) on GDP. The empirical result confirms a connection between the Industry 4.0 era and the role of ICTs, which promotes substantial changes in the way of life and productivity. This has led to a vast technological advancement, which is in line with but at a faster pace than the technological advancement of previous revolutions. From empirical results, the study provides relevant policy recommendations related to the role of natural resources, new technologies and tourism on US GDP, while it also provides evidence of the positive effect of ICTs over FDI under the Industry 4.0 era.

Bibliometric Study of Technology and Occupational Health in Healthcare Sector: A Worldwide Trend to the Future

Since the eighties, technological tools have modified how people interact in their environment. At the same time, occupational safety and health measures have been widely applied. The European Agency for Safety and Health at Work considers that information and communication technologies are the main methods to achieve the goals proposed to improve working life and the dissemination of good practices. The principal objective was to determine the trends of publications focused on these technologies and occupational safety in the healthcare sector during the last 30 years. A bibliometric study was carried out. The 1021 documents showed an increased trend per country, especially for the United States (p < 0.001) and year (p < 0.001). The citations per year showed significant differences between citations of articles published before 2007 (p < 0.001). The year was also linked to the increase or decrease of articles (72.2%) and reviews (14.9%) (p < 0.001). The analysis of journal co-citations also showed that the main journals (such as Infection Control and Hospital Epidemiology) were linked to other important journals and had a major part in the clusters formed. All these findings were discussed in the manuscript and conclusions were drawn.

Does an N-shaped association exist between pollution and ICT in Turkey? ARDL and quantile regression approaches

It is a debated issue that the influence of information and communications technologies (ICTs) on the environment is positive or negative in the literature. For instance, usage and disposal of ICTs may lead to environmental degradation and it may also increase carbon emission arising from electricity generation. However, ICT applications may contribute to environmental quality creating great opportunities for smarter cities, transport systems, electrical grids, and industrial processes. These two effects reveal the possible relationship of an inverted U-shaped association also known as the environmental Kuznets curve (EKC) hypothesis relationship between ICT and CO₂. The objective of this study is to determine the structure of the relationship between environmental degradation and ICTs in Turkey for 1980-2017. The findings of the autoregressive distributed lag (ARDL) analysis indicate the validity of inverted N-shaped EKC hypothesis. However, the results of the quantile regression test are inconsistent with those of ARDL. When the coefficients from 30th to 95th quantiles are examined, it is observed that there is an inverted N-shaped relationship between ICT and CO₂, but these coefficients are not statistically significant. In addition, in the 95th quantile, coefficients of the square of ICT and ICT are statistically significant, contrary to the cube of ICT which is not. This reveals that the relationship between the variables is U-shaped.

The impact of information and communication technologies, CO2 emissions, and energy consumption on inclusive development in developing countries

This study investigates the impact of information and communication technologies, carbon dioxide emissions, and energy consumption on inclusive development of 81 developing countries for the period 2010-2014. Two-step system generalized method of moments has been employed to estimate these dynamic relationships among the variables in conditional and unconditional models. Our findings support the theory that ICTs can be used as policy instrument to dampen the negative effect of environmental degradation on inclusive development. The results suggest that ICTs in association with CO₂ emissions per capita positively affect inclusive development in an unconditional regression. When ICT complements CO₂ intensity, it positively affects inclusive development in mobile- and internet-oriented regressions. However, we also found net negative effects of association between ICTs and CO₂ emissions from liquid and fuel and CO₂ emissions from heat and electricity which reflects a decrease in inclusive human development. We suggest that policy makers should consider the nature and dimensions of CO₂ emissions while using ICTs as policy instrument to mitigate emissions and should invite and plan such investments in ICTs which help in attaining environmental sustainability and inclusive development.

Towards a People's Social Epidemiology: Envisioning a More Inclusive and Equitable Future for Social Epi Research and Practice in the 21st Century

Social epidemiology has made critical contributions to understanding population health. However, translation of social epidemiology science into action remains a challenge, raising concerns about the impacts of the field beyond academia. With so much focus on issues related to social position, discrimination, racism, power, and privilege, there has been surprisingly little deliberation about the extent and value of social inclusion and equity within the field itself. Indeed, the challenge of translation/action might be more readily met through re-envisioning the role of the people within the research/practice enterprise-reimagining what "social" could, or even should, mean for the future of the field. A potential path forward rests at the nexus of social epidemiology, community-based participatory research (CBPR), and information and communication technology (ICT). Here, we draw from social epidemiology, CBPR, and ICT literatures to introduce A People's Social Epi-a multi-tiered framework for guiding social epidemiology in becoming more inclusive, equitable, and actionable for 21st century practice. In presenting this framework, we suggest the value of taking participatory, collaborative approaches anchored in CBPR and ICT principles and technological affordances-especially within the context of place-based and environmental research. We believe that such approaches present opportunities to create a social epidemiology that is of, with, and by the people-not simply about them. In this spirit, we suggest 10 ICT tools to "socialize" social epidemiology and outline 10 ways to move towards A People's Social Epi in practice.

New ICT-based index for beach quality management

Beach management is based on administering technical, environmental, social and political issues to solve coastal problems. To assist coastal management, quality systems have evolved from Beach Certifications Schemes to indicator systems that take into account the three beach functions -natural, protection and recreation-. This study analyses: i) The usefulness of current indices for management decision making; ii) whether the beach user can both access information and participate in beach management; iii) whether the beach indices are dynamic, providing up-to-date information on the status quo of beach or is it merely a snapshot in time; iv) whether beach indices deliver the same result when used by different beach technicians. The results show that the current systems are subjective and based on static criteria, since most of them are obtained through expert opinion, visual inspection and/or interpretation of user surveys. Furthermore, most of the indices focus on the study of the recreational function leaving aside the other beach functions (especially protection). Therefore, the values obtained through these indices are more addressed to the beach user than to the beach manager, so (in general) they do not serve the beach manager in decision-making. Finally, to address the problems described above, a conceptual model based on ICT (Information and Communication Technologies) is proposed for the management and monitoring of beach quality. The computerization and automation of beach management, can be rendered more efficient and effective due to technological advances that can offer an integrated solution for the management of beaches.

Does social globalisation through access to information communication technologies drive obesity among youth? An empirical analysis, 1990-2013

Scholars debate the effects of globalisation on obesity. Using the latest data on access to ICTs and the Global Burden of Disease data on excess weight gain and obesity, we find that both social globalisation and access to ICTs lower the overweight and obese share among the global youth cohort aged 15-19. Previous studies report mixed results, which are hard to evaluate because of the use of different data, sample sizes, and estimating strategies. Using fixed-effects analyses on a global sample of over 160 countries spanning 24 years, we show that 'social globalization' reduces the obesity share of youth when fixed effects are estimated. Greater access to ICTs also independently lowers youth obesity rates. We speculate that greater access to information and knowledge about current trends, the benefits of physical activity and diet, and trends in healthy consumption spreading through ICTs might be a boon despite risks associated with greater consumption from increasing wealth and political freedoms. These results are robust to several estimating methods, including instrumental variables analysis. Our results suggest that increased access to ICTs does not increase obesity and that policy might even usefully target youth via ICTs for encouraging better health.

Older Adults and Digital Society: Scientific Coverage

While there is a progressive ageing of the population, we are witnessing a rapid development of new information and communication technologies (ICTs). Although for most of society this technology is within reach, there are population segments for whom access is limited, especially adults who are considered of old age. Due to the relevance that the relationship between ICTs and older adults acquires in today’s society, it is necessary to carry out an analysis of the scientific literature in order to understand the knowledge structure of this field. In this research, a comparative bibliometric analysis of 172 documents published in the Web of Science (WoS) and Scopus databases was carried out until 2018 and is complemented by a co-citation analysis. The results show that this subject is incipient and is in its exponential growth stage, with two thirds of the production concentrated in the 2012–2018 period. Four out of five authors are transient with a single authorship and the collaboration level is high. The most productive country is Germany followed by the United States and Australia.

Relevance of a Toll-Free Call Service Using an Interactive Voice Server to Strengthen Health System Governance and Responsiveness in Burkina Faso

BACKGROUND

In Africa, health systems are poorly accessible, inequitable, and unresponsive. People rarely have either the confidence or the opportunity to express their opinions. In Burkina Faso, there is a political will to improve governance and responsiveness to create a more relevant and equitable health system. Given their development in Africa, information and communication technologies (ICTs) offer opportunities in this area.

METHODS

This article presents the results of an evaluation of a toll-free call service coupled with an interactive voice server (TF-IVS) tested in Ouagadougou, Burkina Faso, to assess its relevance for improving health systems governance. The approach consisted of a 2-phased action research project to test 2 technologies: recorded messages and touch keypad. Using a concurrent mixed approach, we assessed the technological, social, and instrumental relevance of the service.

RESULTS

The call service is available everywhere, 24 hours per day, seven days per week. The equipment and its physical location were not adequately protected against technological hazards. Of the 278 days of operation, 49 were non-functional. In 8 months, there were 13 877 calls, which demonstrated the popularity of ICTs and the ease of access to telephone networks and mobile technologies. The TF-IVS was free, anonymous, and multilingual, which fostered the expression of public opinion. However, cultural context (religion, ethnic culture) and fear of reprisals may have had a negative influence. In the end, questions remained regarding people's capacity to use this innovative service. In the first trial, 49% of callers recorded their message and in the second, 48%. Touch key technology appeared more relevant for automated and real-time data collection and analysis, but there was no comprehensive strategy for translating the information collected into a response from healthcare actors or the government.

CONCLUSION

This study showed the relevance and feasibility of implementing a TF-IVS to strengthen health system responsiveness in one of the world's poorest countries. Public opinion expressed through data collected in real-time is helpful for improving system responsiveness to meet care needs and enhance equity. However, the strategy for developing this tool must take into account the implementation context and the activities needed to influence the mechanisms of social responsibility (eg, information provision, citizen action, and state response).

Does information and communication technologies improve environmental quality in the era of globalization? An empirical analysis

This study intends to examine the impact of ICTs (i.e., internet usage and mobile cellular subscriptions), globalization, electricity consumption, financial development, and economic growth on environmental quality by using 1994-2014 panel data of BRICS economies. This study employed a second-generation panel unit root test accounting for the presence of cross-sectional dependence and indicated that carbon dioxide emissions, electricity consumption, financial development, internet usage, mobile usage, globalization, and economic growth have integration of order one. The results from Westerlund panel co-integration test confirms that the variables are co-integrated and revealed that ICT-finance-globalization-electricity-GDP-CO₂ nexus has long-run equilibrium relationship. The results from dynamic seemingly unrelated regression (DSUR) indicate that internet usage and mobile cellular subscriptions (ICTs) have significant, adverse impact on carbon dioxide emissions. To put it simply, ICT positively contributes towards environmental quality. Similarly, economic growth also has an adverse effect on carbon dioxide emissions. On the other hand, electricity consumption, globalization, and financial development have a significant positive effect on carbon emissions. In addition, Granger causality test results show the presence of a bidirectional causal relationship between internet usage and environmental quality, financial development and electricity consumption, ICT and financial development, mobile cellular subscription and globalization, economic growth and environmental quality, and internet usage and economic growth. A unidirectional causal link is detected running from mobile cellular subscriptions towards environmental quality, ICT towards electricity consumption, financial development towards environmental quality, globalization towards environmental quality, and globalization towards economic growth. Moreover, time series analysis has also been done in this study to analyze the findings for each of BRICS countries which are directed towards important policy implications. For instance, ICT policy can play an integral part in improving environmental quality policy.

The new informatics of pandemic response: humanitarian technology, efficiency, and the subtle retreat of national agency

Digital communication technologies play an increasingly prominent role in humanitarian operations and in response to international pandemics specifically. A burgeoning body of scholarship on the topic displays high expectations for such tools to increase the efficiency of pandemic response. This article reviews empirical uses of communications technology in humanitarian and pandemic response, and the 2014 Ebola response in particular, in order to propose a three-part conceptual model for the new informatics of pandemic response. This model distinguishes between the use of digital communication tools for diagnostic, risk communication, and coordination activities and highlights how the influx of novel actors and tendencies towards digital and operational convergence risks focusing humanitarian action and decision-making outside national authorities' spheres of influence in pandemic response. This risk exacerbates a fundamental tension between the humanitarian promise of new technologies and the fundamental norm that international humanitarian response should complement and give primacy to the role of national authorities when possible. The article closes with recommendations for ensuring the inclusion of roles and agency for national authorities in technology-supported communication processes for pandemic response.

Health activism and the logic of connective action. A case study of rare disease patient organisations

This exploratory work investigates the role of digital media in expanding health discourse practices in a way to transform traditional structures of agency in public health. By focusing on a sample of rare disease patient organisations as representative of contemporary health activism, this study investigates the role of digital communication in the development of (1) bottom-up sharing and co-production of health knowledge, (2) health public engagement dynamics and (3) health information pathways. Findings show that digital media affordances for patient organisations go beyond the provision of social support for patient communities; they ease one-way, two-way and crowdsourced processes of health knowledge sharing, exchange and co-production, provide personalised routes to health public engagement and bolster the emergence of varied pathways to health information where experiential knowledge and medical authority are equally valued. These forms of organisationally enabled connective action can help the surfacing of personal narratives that strengthen patient communities, the bottom-up production of health knowledge relevant to a wider public and the development of an informational and eventually cultural context that eases patients' political action.

Exploring the Use of Information and Communication Technology by People With Mood Disorder: A Systematic Review and Metasynthesis

BACKGROUND

There is a growing body of evidence relating to how information and communication technology (ICT) can be used to support people with physical health conditions. Less is known regarding mental health, and in particular, mood disorder.

OBJECTIVE

To conduct a metasynthesis of all qualitative studies exploring the use of ICTs by people with mood disorder.

METHODS

Searches were run in eight electronic databases using a systematic search strategy. Qualitative and mixed-method studies published in English between 2007 and 2014 were included. Thematic synthesis was used to interpret and synthesis the results of the included studies.

RESULTS

Thirty-four studies were included in the synthesis. The methodological design of the studies was qualitative or mixed-methods. A global assessment of study quality identified 22 studies as strong and 12 weak with most having a typology of findings either at topical or thematic survey levels of data transformation. A typology of ICT use by people with mood disorder was created as a result of synthesis.

CONCLUSIONS

The systematic review and metasynthesis clearly identified a gap in the research literature as no studies were identified, which specifically researched how people with mood disorder use mobile ICT. Further qualitative research is recommended to understand the meaning this type of technology holds for people. Such research might provide valuable information on how people use mobile technology in their lives in general and also, more specifically, how they are being used to help with their mood disorders.

Adolescents from low-income sectors: the challenge of studying in a time of digital environments

This paper is about practices and perceptions regarding the study of adolescents from low-income sectors in the City of Buenos Aires. The methodology consisted of 26 in-depth interviews with low-income adolescents and participant observations in twenty cybercafés of the South Area of the City of Buenos Aires. Among the findings, these students highlight that ICTs allow them to handle information in a more agile and entertaining way, more consistent with their daily uses. However, doing research on school content is what students do the least, since adolescents use technology mainly for communicative, social and recreational ends. These adolescents recognise some disadvantages in using ICTs to study: the unreliable information, the difficulty to distinguish which topics related to school content are more appropriate and the disruptive and continuous use of social networks. In this sense, these adolescents tend to have more problems in benefitting from ICTs for academic purposes than other adolescents. While communication and recreational skills tend to be similar, the evaluation of different sources of information and the skill to make complex searches online are usually more strongly developed in adolescents of middle and high-income households. In conclusion, we think it is necessary to take these problems into consideration in the social sciences research of the area and besides when implementing digital literacy programs.

Health-related media use among youth audiences in Senegal

Lower- and middle-income countries (LMICs) are experiencing rapid changes in access to and use of new internet and digital media technologies. The purpose of this study was to better understand how younger audiences are navigating traditional and newer forms of media technologies, with particular emphasis on the skills and competencies needed to obtain, evaluate and apply health-related information, also defined as health and media literacy. Sixteen focus group discussions were conducted throughout Senegal in September 2012 with youth aged 15-25. Using an iterative coding process based on grounded theory, four themes emerged related to media use for health information among Senegalese youth. They include the following: (i) media utilization; (ii) barriers and conflicts regarding media utilization; (iii) uses and gratifications and (iv) health and media literacy. Findings suggest that Senegalese youth use a heterogeneous mix of media platforms (i.e. television, radio, internet) and utilization often occurs with family members or friends. Additionally, the need for entertainment, information and connectedness inform media use, mostly concerning sexual and reproductive health information. Importantly, tensions arise as youth balance innovative and interactive technologies with traditional and conservative values, particularly concerning ethical and privacy concerns. Findings support the use of multipronged intervention approaches that leverage both new media, as well as traditional media strategies, and that also address lack of health and media literacy in this population. Implementing health-related interventions across multiple media platforms provides an opportunity to create an integrated, as opposed to a disparate, user experience.

"Who's afraid?": attitudes of midwives to the use of information and communication technologies (ICTs) for delivery of pregnancy-related health information

BACKGROUND

Usage rates for information and communication technologies (ICTs) in healthcare have been increasing in recent years, but often lag behind general usage rates for populations as a whole. Research into such differential rates of ICT use across different segments of the population has identified a number of possible causal factors that limit usage.

AIM

The research investigated midwives' attitudes and experiences of ICT use to identify potential causal factors that encourage or inhibit their usage in antenatal care.

METHODS

Semi-structured interviews, focus groups and short surveys were conducted with midwives who provide antenatal education at an Australian metropolitan hospital. Thematic and statistical analyses were used to interpret the data.

FINDINGS

Although midwives recognised the potential benefits of using ICTs to deliver pregnancy-related health information many had reservations about their use in everyday work. These reservations centred on lack of training in use of ICTs, the perceived legal risks associated with social media, potential violations of patient privacy, misdiagnosis and misunderstandings between midwife and client.

CONCLUSION

Midwives face a number of barriers to effective use of ICTs in healthcare including material access, skills access, usage access and motivational access. Motivational access appears to be a key concern due to the high perception of risk associated with social media in particular. Reducing the motivational barriers through a range of interventions with midwifery staff may assist in overcoming other barriers to ICT use in antenatal care. Further research is required to determine whether these findings are generalisable to other healthcare contexts.

Role of tissue-engineered artificial tendon in healing of a large Achilles tendon defect model in rabbits

BACKGROUND

Treatment of large Achilles tendon defects is technically demanding. Tissue engineering is an option. We constructed a collagen-based artificial tendon, covered it with a polydioxanon (PDS) sheath, and studied the role of this bioimplant on experimental tendon healing in vivo.

STUDY DESIGN

A 2-cm tendon gap was created in the left Achilles tendon of rabbits (n = 120). The animals were randomly divided into 3 groups: control (no implant), treated with tridimensional-collagen, and treated with tridimensional-collagen-bidimensional-PDS implants. Each group was divided into 2 subgroups of 60 and 120 days postinjury (DPI). Another 50 pilot animals were used to study the host-implant interaction. Physical activity of the animals was scored and ultrasonographic and bioelectrical characteristics of the injured tendons were investigated weekly. After euthanasia, macro, micro, and nano morphologies and biophysical and biomechanical characteristics of the healing tendons were studied.

RESULTS

Treatment improved function of the animals, time dependently. At 60 and 120 DPI, the treated tendons showed significantly higher maximum load, yield, stiffness, stress, and modulus of elasticity compared with controls. The collagen implant induced inflammation and absorbed the migrating fibroblasts in the defect area. By its unique architecture, it aligned the fibroblasts and guided their proliferation and collagen deposition along the stress line of the tendon and resulted in improved collagen density, micro-amp, micro-ohm, water uptake, and delivery of the regenerated tissue. The PDS-sheath covering amplified these characteristics. The implants were gradually absorbed and replaced by a new tendon. Minimum amounts of peritendinous adhesion, muscle atrophy, and fibrosis were observed in the treated groups. Some remnants of the implants were preserved and accepted as a part of the new tendon.

CONCLUSIONS

The implants were cytocompatible, biocompatible, biodegradable, and effective in tendon healing and regeneration. This implant may be a valuable option in clinical practice.

Introduction of information and communication technologies in havana polyclinics: phase one evaluation

Introduction

Information and communication technologies were introduced in community-based polyclinics as a result of a Cuban health system policy to make information more readily accessible to health professionals and other health workers at the primary health care level.

Objective

Assess phase one of the Program to Introduce Information and Communication Technologies in Primary Health Care (PICT-PHC), as implemented in Havana, and in particular to determine the aspects of structure, process and outcomes with the greatest impact on this phase’s effectiveness.

Methods

From May to October 2003, an assessment was carried out in all Havana community-based polyclinics where phase one of the Program was underway. Study dimensions, criteria, and standards were established through consultation with experts and considering the level of performance expected by program directors, thus providing timely analysis to the directors concerning problem areas in need of attention. This paper concentrates on the five dimensions which were thought to have the most bearing on effectiveness of information and communication technologies (ICTs) installed in the polyclinics’ libraries: librarians’ competencies in IT skills, training received by librarians, training received by users, Program monitoring and follow-up, and exploitation of the technologies. Six data collection instruments were devised. Participants in the study included 41 librarians and 544 users. Data were processed to obtain indicators corresponding to study criteria. Each indicator was then compared with the established standard. Validity of results was established through analysis and comparison.

Results

Overall, the first phase of the PICT-PHC in Havana succeeded in making online information resources more readily available to health professionals and technicians. Some librarians had insufficient basic IT competencies, which had an impact on the quality of their work. Moreover, it was found that monitoring and follow-up activities were focused chiefly on implementation process rather than outcomes. There was consistency between the achievements and problems found for some criteria and dimensions, and their impact on related ones.

Conclusion

This study furnished evidence of the need for greater emphasis on human resources training (particularly of librarians) in the use of ICTs in the primary health care system.