Testing 3 Digital Health Platforms to Improve Mental Health Outcomes in Adults With Type 1 Diabetes: A Pilot Trial

OBJECTIVE

Our aim in this study was to examine the potential impact of a 3-pronged digital health pilot intervention (TRIFECTA) on diabetes distress and depressive symptoms among adults with type 1 diabetes (T1D) in British Columbia.

METHODS

We recruited 60 adults with T1D (mean age 38.9±15.1 years, 75% female, 77% Caucasian) who participated in the 6-month pilot intervention involving 3 digital health platforms: monthly, provider-led, group-based sessions over Zoom (virtual huddles); a WhatsApp peer texting group; and a web-based "Ask-the-expert" portal. Assessments were conducted at baseline and 6 months and measured diabetes distress (T1D Diabetes Distress Scale), depressive symptoms (9-item Personal Health Questionnaire), and TRIFECTA engagement metrics.

RESULTS

Participation in TRIFECTA was associated with significant reductions in Overall Distress (p=0.011) and 4 distress subscales: Powerlessness (p=0.006), Management Distress (p=0.001), Hypoglycemia Distress (p=0.029), and Eating Distress (p<0.001). A higher number of virtual huddles attended predicted lower Overall Distress (p=0.019) and Family/Friends Distress (p=0.023). A higher number of "Ask-the-expert" posts viewed predicted lower Overall Distress (p=0.046), whereas a higher number of WhatsApp messages posted predicted lower Management Distress (p=0.006). Furthermore, engagement in all 3 metrics was a predictor for lower Negative Social Perceptions Distress (p<0.05). No associations were seen in other distress subscales or for depressive symptoms.

CONCLUSIONS

Participation in TRIFECTA was linked to reduced diabetes distress levels, but not depressive symptoms, in a platform-dependent manner. This study provides promising pilot data for a subsequent large-scale and fully powered randomized controlled trial.

Health professions learners' evaluation of e-learning scenario-based case study design: Reinvigorating flipped classroom modalities

OBJECTIVES

Interactive scenario-based learning (SBL) cases were developed using the SoftChalk platform to deliver content about patients' barriers to accessing healthcare and patient management strategies connecting oral to systemic health. The interactive cases were designed to engage the digital-savvy learners, meet them where they are by leveling up, and seek their feedback to determine flipped (FC) or modified flipped classroom (MFC) content delivery approaches.

METHODS

Health professions students completed interactive SBL cases (Phase-I) using either FC as assigning content outside of class time preparation or MFC as allocating time at the beginning of the class deliveries, and a 12-item post-completion survey. The senior dental student cohort (Phase-II) completed an anonymous Qualtrics survey that assessed their confidence leading to clinical competence two years after the interactive SBL case deliveries. The final survey (Phase-III) of first-year dental students evaluated the improved interactive scenario-based cases post modifications. [Corrections added on 03 October 2023: After first online publication the first sentence of methods section has been updated.] RESULTS: No significant differences existed between the FC and MFC content delivery scores; however, learners preferred the structured time allotted in the MFC approach as a learning style for participants (N=989). The overall means percent score was 93.2% (n = 398) for FC and 96.5% (n = 591) for MFC. Thematic analysis of written responses indicated that learners felt the vignettes were relevant, thought-provoking, incorporated decision-making, and provided feedback. Four themes about strengths emerged as engaging, interactive, relevant, and critical. Design and technological challenges emerged as interactive SBL improvements. A follow-up report (74/103, 2021) revealed that 48% of senior dental students surveyed recollected the SBL cases when they delivered preventive, patient-centered dental services as juniors and seniors. They also recalled that the interactive cases prepared them for clinical success. The Final comments (2022) did not commend any significant improvements.

CONCLUSION

Interactive scenario-based approaches nurture active learning and critical thinking. The educator can engage learners by incorporating teaching modalities as SBL cases to enhance their knowledge and create educational environments by meeting learners where they are. Learners can be valuable partners as educators define their instructional strategies to be equitable and student-centered. [Correction added on 04 October 2023: after first online publication, abstract section has been revised.].

Patient-reported symptoms and diagnostic journey in Multiple Myeloma

Introduction

Late presentation of multiple myeloma (MM) heightens the risk of complication risks, including end-organ damage. This study aimed to: 1) detail the diagnostic journey of MM patients, encompassing symptoms, initial diagnoses, and healthcare professionals met; 2) establish the median duration from symptom onset to MM diagnosis; and 3) examine factors linked to timely MM diagnosis within 12 weeks.

Methods

A total of 300 adults self-reporting MM were analysed from the Rare and Undiagnosed Diseases cohort Study (RUDY). The RUDY study is a web-based platform, where participants provide dynamic consent and self-report their MM diagnosis and information about their diagnostic journey. This includes the estimated date of initial potential first symptoms, descriptions of these symptoms, the healthcare professionals they consulted, and other diagnoses received before the MM diagnosis. Descriptive statistics, combinatorial analyses and logistic regression analyses were used to describe and examine the diagnostic journey of individuals with MM.

Results

Overall, 52% of the participants reported other diagnoses before MM diagnosis, with musculoskeletal disorders (47.8%), such as osteoporosis, costochondritis, or muscle strains, being the most common. The most prevalent initial reported symptom was back pain/vertebral fractures (47%), followed by chest/shoulder pain, including rib pain and fractures (20%), and fatigue/tiredness (19.7%). 40% of participants were diagnosed by direct referral from primary care to haematology without seeing other healthcare professionals whilst 60% consulted additional specialists before diagnosis. The median time from symptom onset to MM diagnosis was 4 months (IQR 2-10 months, range 0-172). Seeing an Allied Healthcare Professional such as a physiotherapist, chiropractor or an osteopath (OR = 0.25, 95% CI [0.12, 0.47], p <0.001), experiencing infection symptoms (OR = 0.32, 95% CI [0.13, 0.76], p = 0.013), and having chest or shoulder pain (OR = 0.45, 95% CI [0.23, 0.86], p = 0.020) were associated with a lower likelihood of being diagnosed with MM within 12 weeks. Older age (OR = 1.04, 95% CI [1.02, 1.07], p = 0.001) was associated with a higher likelihood of diagnosis within 12 weeks.

Discussion

Developing resources for allied health professionals may improve early recognition of MM.

The Impact of Shared Information Presentation Time on Users' Privacy-Regulation Behavior in the Context of Vertical Privacy: A Moderated Mediation Model

Combining data-sharing models and algorithm technologies has led to new data flow structures and usage patterns. In this context, the presentation time of shared low-sensitivity information across platforms has become a crucial factor that affects user perception and privacy-regulation behavior. However, previous studies have not conducted an in-depth exploration of this issue. Based on privacy process theory, this study discusses the impact and potential mechanism of the presentation time (immediate or delayed) of shared low-sensitivity information across platforms on privacy-regulation behavior. Through a pre-study and two online survey experimental studies, which included 379 participants in total, we verified that the immediate information presentation time has a significantly higher impact on online vigilance and privacy-regulation behavior than the delayed condition, βdirect = 0.5960, 95% CI 0.2402 to 0.9518; βindirect = 0.1765, 95% CI 0.0326 to 0.3397, and users' perceived control as the moderating role influences online vigilance and privacy-regulation behaviors (preventive or corrective), βpreventive = -0.0562, 95% CI -0.1435 to -0.0063; βcorrective = -0.0581, 95% CI -0.1402 to -0.0065. Based on these results, we suggest that the presentation time of using shared low-sensitivity information across platforms should be concerned by companies' recommendation algorithms to reduce users' negative perceptions and privacy behaviors and improve user experience.

Importance-performance analysis in fitness apps. A study from the viewpoint of gender and age

Background

We are currently undergoing a profound process of digital transformation that has favoured the development and use of apps in multiple facets of people's daily lives. In the fitness industry, this situation has facilitated the control of exercise and the maintenance of healthier lifestyles. However, it is not known how the perceived quality and importance of fitness apps vary for users based on gender and age, which is the objective of this study conducted among users of fitness centres.

Methods

By means of a convenience sample, 321 users from different centres of the boutique fitness chain Sano Centre (238 females and 83 males) took part in the study. They answered the 16 items of the MARS scale, distributed in four dimensions, in terms of importance and perceived quality. The existence of significant differences was analysed using non-parametrical statistics such as the U-Mann-Whitney (gender) and the H-Kruskal-Wallis (age). In addition, a cluster analysis, combining hierarchical and non-hierarchical methods, was analysed considering as a dependent variable the level of recommendation of fitness apps.

Results

Considering gender, in importance-performance analysis (IPA), credibility was the most important attribute for females and quality of information for males. In the case of age, credibility was the most important attribute in all the ranges. The cluster analysis established two groups (high and low recommendations of the fitness app). In importance, the first group scored better on all factors except entertainment and interest. In valuation, the scores were lower than on importance, especially in the low recommendation group.

Conclusion

Regarding usage behaviour, credibility is the factor to which users attach the highest importance and rating, regardless of gender and age. The main demand focuses on improving the gestural design and visual appeal, which will facilitate a better user experience.

Female sexual health digital resources: women and health care providers need more options

INTRODUCTION

Female sexual health and female sexual dysfunction (FSD) are usually poorly diagnosed and treated because of the numerous barriers providers and patients face. Internet platforms, such as mobile applications (apps) are potential tools that help overcome these barriers and improve patient access to education and management options for FSD.

OBJECTIVES

The aim of this review was to identify existing applications on female sexual health and evaluate their educational content and services.

METHODS

We searched the internet and Apple App Store using multiple keywords. A panel of physicians specialized in the treatment of FSD reviewed the apps for content quality, the scientific basis of provided information, interactivity, usability, and whether they would recommend it as a reference tool for patients.

RESULTS

Of the 204 apps identified, 17 met the inclusion criteria and were reviewed further. The selected apps were organized into groups based on common themes such as educational (n = 6), emotions and communication (n = 2), relaxation and meditation (n = 4), general sexual health (n = 2), and social and fun (n = 3). All apps from the educational category provided scientific information in collaboration with health experts. When assessed for usability, 1 app received good and 5 received excellent scores based on the System Usability Scale. Most apps (n = 5) provided information on pathology and treatments of orgasmic dysfunction, but only 1 app, created by a physician, provided comprehensive information on all the types of FSD.

CONCLUSION

Digital technology could be an effective way to overcome barriers to accessing information and ultimately care for female sexual health. Our review demonstrated that there is still a need for more accessible educational resources addressing female sexual health and FSD for patients and providers.

Debate: Should academics collaborate with digital companies to improve young people's mental health?

Should academics collaborate with social media and gaming companies to identify and reduce mental health impacts on children and young people? While opinions on this question sharply diverge within the academic community, in practice collaboration is already widespread. As digital platforms increasingly dominate the time and attention of many young people and are the source of both considerable concern as well as offering innovative opportunities for beneficial interventions, researchers are recognising the potential for collaboration to accelerate positive impact. However, concerns over the independence and transparency of collaborative research have received little institutional or collective response. Recognising both the promise and the pitfalls, this debate article calls for multidisciplinary deliberation within the academy to support the co-development of clear guidelines on the principles and processes by which collaboration is best undertaken, as well as the basis for ensuring that some research remains independent.

Learning behavior, digital platforms for learning and its impact on university student's motivations and knowledge development

Background

Learning digital technologies in higher education is a process of knowledge generation, and the rapid growth of technology in education has a significant impact on students' learning behaviors, motivation, and knowledge development. Pakistan's remarkable technological breakthrough has increased in the education field.

Study objectives

The study focuses on estimating students' learning behaviors, identifying the positive influence of educational apps on digital learning platforms, and analyzing their impact on students' motivation and knowledge development.

Materials and methods

According to the study's objectives, a questionnaire survey was conducted to gather the primary data. The participants were students of universities in Lahore city of Pakistan. For this study, the sample size was N = 300, carefully chosen using the purposive sampling technique. Of the respondents, there were 146 male and 154 female students, and the sample consisted of individuals aged 25-35 years. Smart-PLS-Bootstrapping, T-Values (PLS) 3.2.9 and the structural equation model (SEM) were applied to get the appropriate outcomes from the proposed study framework.

Results

SEM analysis results shows that all proposed hypotheses [Animated Movies (AM) -> Student Motivation (SM), Educational Apps (EA) -> Knowledge Development (KD), Learning Behavior (LB) -> Animated Movies, Learning Behavior -> Educational Apps, Learning Behavior -> Knowledge Development, Learning Behavior -> Virtual Classrooms (VCr), Virtual Classrooms -> Knowledge Development, Virtual Classrooms -> Student Motivation] are confirmed while Learning Behavior -> Student Motivation is not confirmed.

Conclusion

This study found that digital learning platforms significantly impact students' learning and what motivates them to learn. The study also found that using educational apps and virtual classrooms more often helps students learn more and be more motivated to learn.

Engaging the public or asking your friends? Analysing science-related crowdfunding using behavioural and survey data

Science-related crowdfunding enables public engagement with science. However, we know little about citizens engaging with science this way: Who are the people engaging with and donating to science through crowdfunding - and how do they decide how much to give? This study analyses behavioural and survey data from the Swiss crowdfunding platform wemakeit (N = 576). Results illustrate that a small, non-representative segment of the public engages with science through crowdfunding. Compared to the general public in Switzerland, these backers have an above-average education and income. Science-related crowdfunding mainly reaches citizens with an existing interest in science, personal ties to project initiators or the scientific community. The size of backers' donations correlates with perceived personal appeals in campaigns or connections to initiators rather than projects' scientific merit. While science-related crowdfunding thus opens up new avenues for public outreach by the scientific community, its potential for broader public engagement with science seems limited.

The trail less traveled: Analytical approach for creating shortened versions for virtual reality-based color trails test

The Color Trails Test ("CTT") is among the most popular neuropsychological assessment tests of executive function, targeting sustained visual attention (Trails A), and divided attention (Trails B). During the pen-and-paper (P&P) test, the participant traces 25 consecutive numbered targets marked on a page, and the completion time is recorded. In many cases, multiple assessments are performed on the same individual, either under varying experimental conditions or at several timepoints. However, repeated testing often results in learning and fatigue effects, which confound test outcomes. To mitigate these effects, we set the grounds for developing shorter versions of the CTT (<25 targets), using virtual reality (VR) based CTT (VR-CTT). Our aim was to discover the minimal set of targets that is sufficient for maintaining concurrent validity with the CTT including differentiation between age groups, and the difference between Trails A and B. To this aim, healthy participants in three age groups (total N = 165; young, middle-aged, or older adults) performed both the P&P CTT, and one type of VR-CTT (immersive head-mounted-device VR, large-scale 3D VR, or tablet). A subset of 13 targets was highly correlated with overall task completion times in all age groups and platforms (r > 0.8). We tested construct validity and found that the shortened-CTT preserved differences between Trails A and B (p < 0.001), showed concurrent validity relative to the P&P scores (r > 0.5; p < 0.05), and differentiated between age groups (p < 0.05). These findings open the possibility for shortened "CTT-versions", to be used in repeated-measures experiments or longitudinal studies, with potential implications for shortening neurocognitive assessment protocols.

Is the COVID-19 pandemic accelerating the platformisation of the urban economy?

This paper shows that, while the pandemic lockdown decelerated everyday life, it has also potentiated further acceleration of the platformisation of urban economic sectors. We show this through an empirical qualitative study of the restaurant sector in Lisbon, in which we found that: (i) the digitalisation of three management tasks during the COVID-19 lockdown - namely marketing, customer relationship management, and delivery tasks - was the trigger for the acceleration of the platformisation of the restaurant sector in Lisbon and (ii) restaurant firms had different departure points in terms of the use of digital technologies - which are linked to their location within the city - and these led to different rhythms in the platformisation of restaurants. We conclude that, as the lockdown measures led to a deceleration of social and economic activities, they also promoted further acceleration of economic change, especially under the logic of the platform economy. Additionally, we show that firms unable to engage with digital platforms have been trying to mimic online dynamics through the implementation of non-platformised digital processes, which leads us to consider that the effects of the process of platformisation extend beyond the platform itself.

Designing and scaling up integrated youth mental health care

Mental ill-health represents the main threat to the health, survival and future potential of young people around the world. There are indications that this is a rising tide of vulnerability and need for care, a trend that has been augmented by the COVID-19 pandemic. It represents a global public health crisis, which not only demands a deep and sophisticated understanding of possible targets for prevention, but also urgent reform and investment in the provision of developmentally appropriate clinical care. Despite having the greatest level of need, and potential to benefit, adolescents and emerging adults have the worst access to timely and quality mental health care. How is this global crisis to be addressed? Since the start of the century, a range of co-designed youth mental health strategies and innovations have emerged. These range from digital platforms, through to new models of primary care to new services for potentially severe mental illness, which must be locally adapted according to the availability of resources, workforce, cultural factors and health financing patterns. The fulcrum of this progress is the advent of broad-spectrum, integrated primary youth mental health care services. They represent a blueprint and beach-head for an overdue global system reform. While resources will vary across settings, the mental health needs of young people are largely universal, and underpin a set of fundamental principles and design features. These include establishing an accessible, "soft entry" youth primary care platform with digital support, where young people are valued and essential partners in the design, operation, management and evaluation of the service. Global progress achieved to date in implementing integrated youth mental health care has highlighted that these services are being accessed by young people with genuine and substantial mental health needs, that they are benefiting from them, and that both these young people and their families are highly satisfied with the services they receive. However, we are still at base camp and these primary care platforms need to be scaled up across the globe, complemented by prevention, digital platforms and, crucially, more specialized care for complex and persistent conditions, aligned to this transitional age range (from approximately 12 to 25 years). The rising tide of mental ill-health in young people globally demands that this focus be elevated to a top priority in global health.

Ziele und Gestaltung digitaler Plattformen für Produktionsnetzwerke

Die interorganisatorische Zusammenarbeit in Produktionsnetzwerken kann Herausforderungen durch eine hohe Marktdynamik, immer anspruchsvollere Kundenbedürfnisse und steigenden Kostendruck entgegenwirken. Neben der klassischen vertikalen Verschiebung von Kapazitäten in Richtung geeigneter Zulieferer, lassen sich Fertigungskapazitäten auch durch eine horizontale Zusammenarbeit zwischen produzierenden Unternehmen handeln. Im Sinne der Sharing Economy bieten digitale Plattformen eine geeignete Infrastruktur zur Verknüpfung und Koordination der Marktakteure eines Produktionsnetzwerks. So können Fertigungsunternehmen flexibel Produktionsausfällen entgegenwirken und freie Maschinenkapazitäten auslasten. Eine wesentliche Voraussetzung für den Erfolg solcher digitalen Plattformen für Produktionsnetzwerke ist die Definition von Zielen, welche bisher in der Literatur nur unzureichend und nicht bezogen auf diese spezifische Plattformart untersucht wurden. In dieser Arbeit wird ein umfängliches konzeptionelles Zielmodell für diese spezifische Plattformart erstellt. Zu spezifischen Zielen digitaler Plattformen für Produktionsnetzwerke zählen neben wirtschaftlichen oder technischen Zielen beispielsweise auch produktionsbezogene Marktleistungsziele wie die Gewährleistung von Produktionsflexibilität. Aufbauend darauf wird gezeigt, wie das Design der beschriebenen Plattformen einen Einfluss auf die Erreichung bestimmter Ziele hat und wie spezielle Mechanismen zur Zielerreichung beitragen.

A large-scale study of stress, emotions, and blood pressure in daily life using a digital platform

Exaggerated blood pressure (BP) reactivity is associated with the development of hypertension and cardiovascular disease. Stress, and, to a lesser extent, emotions are suggested to be linked to BP reactivity, but this theorizing lacks robust evidence beyond small laboratory or field studies with narrow participant demographics. Using an app-based research study and analyzing more than 330,000 daily responses from over 20,000 people, we show that momentary stress, conceptualized as the perception of demands relative to resources, is associated with greater BP and heart rate reactivity. High-arousal negative emotions are associated with increased physiologic reactivity whereas low-arousal positive emotions are associated with decreased reactivity. These data point to daily stress experiences as likely candidates for improving physical health.

Stress is often associated with pathophysiologic responses, like blood pressure (BP) reactivity, which when experienced repeatedly may be one pathway through which stress leads to poor physical health. Previous laboratory and field studies linking stress to physiological measures are limited by small samples, narrow demographics, and artificial stress manipulations, whereas large-scale studies often do not capture measures like BP reactivity in daily life. We examined perceived stress, emotions, heart rate, and BP during daily life using a 3-wk app-based study. We confirmed the validity of a smartphone-based optic sensor to measure BP and then analyzed data from more than 330,000 daily responses from over 20,000 people. Stress was conceptualized as the ratio of situational demands relative to individual resources to cope. We found that greater demands were associated with higher BP reactivity, but critically, the ratio of demands relative to resources improved prediction of BP changes. When demands were higher and resources were lower, there was higher BP reactivity. Additionally, older adults showed greater concordance between self-reported stress and physiologic responses than younger adults. We also observed that physiologic reactivity was associated with current emotional state, and both valence and arousal mattered. For example, BP increased with high-arousal negative emotions (e.g., anger) and decreased with low-arousal positive emotions (e.g., contentment). Taken together, this work underscores the potential for expanding stress science and public health data using handheld phones to reliably and validly measure physiologic responses linked to stress, emotion, and physical health.

Using Digital Platforms to Promote Blood Donation: Motivational and Preliminary Evidence from Latin America and Spain

The lack of blood donors is a global problem that prevents the demand for blood prompted by an ageing population and increased life expectancy from being met. The aim of this study was to conduct an initial exploration of the reasons for using digital platforms in blood donation. Using a Theory of Planned Behaviour (TPB) framework, microdata for 389 participants from Latin American countries and Spain, and Partial Least Square-Structural Equation Modelling (PLS-SEM), the study obtained three main prediction paths. The first two started from feelings of trust in the digital community and a positive mood state associated with a modern lifestyle, and they were linked to attitudes and behavioural control in the explanation of the intention to donate and actual blood donation. The third path started from modern lifestyles, and was linked to the subjective norm in the prediction of intention and actual donation. These paths represent one of the very first attempts to predict intentions of donation and collaborative donation by taking a PLS-SEM approach. By determining the paths underpinning collaborative blood donors' motives, the results of this study provide strong support for the usefulness of the TPB model within the context of digital platform use and blood donation.

The Global Trust Deficit Disorder: A Communications Perspective on Trust in the Time of Global Pandemics

There has been much discussion worldwide about the crisis of trust, with evidence of declining trust in social, economic, political and media institutions. The rise of populism, and the differing impacts of the COVID-19 pandemic between nations, has been drawing attention to wider implications of pervasive distrust, including distrust of the media. In this article, I develop three propositions. First, I identify trust studies as a rich interdisciplinary field, linking communication to other branches of the social sciences and humanities. Second, I argue that we lack a comprehensive account of how trust has been understood in communication, and that doing so requires integrating macro-societal approaches with the "meso" level of institutions, and the "micro" level of interpersonal communication. Third, I propose that a focus upon trust would open up new perspectives on two important topics-the future of news media and journalism, and the global rise of populism.

Sex Education in the Spotlight: What Is Working? Systematic Review

Adolescence, a period of physical, social, cognitive and emotional development, represents a target population for sexual health promotion and education when it comes to achieving the 2030 Agenda goals for sustainable and equitable societies. The aim of this study is to provide an overview of what is known about the dissemination and effectiveness of sex education programs and thereby to inform better public policy making in this area. Methodology: We carried out a systematic review based on international scientific literature, in which only peer-reviewed papers were included. To identify reviews, we carried out an electronic search of the Cochrane Database Reviews, ERIC, Web of Science, PubMed, Medline, Scopus and PsycINFO. This paper provides a narrative review of reviews of the literature from 2015 to 2020. Results: 20 reviews met the inclusion criteria (10 in school settings, 9 using digital platforms and 1 blended learning program): they focused mainly on reducing risk behaviors (e.g., VIH/STIs and unwanted pregnancies), whilst obviating themes such as desire and pleasure, which were not included in outcome evaluations. The reviews with the lowest risk of bias are those carried out in school settings and are the ones that most question the effectiveness of sex education programs. Whilst the reviews of digital platforms and blended learning show greater effectiveness in terms of promoting sexual and reproductive health in adolescents (ASRH), they nevertheless also include greater risks of bias. Conclusion: A more rigorous assessment of the effectiveness of sexual education programs is necessary, especially regarding the opportunities offered by new technologies, which may lead to more cost-effective interventions than with in-person programs. Moreover, blended learning programs offer a promising way forward, as they combine the best of face-to-face and digital interventions, and may provide an excellent tool in the new context of the COVID-19 pandemic.

Forcing the Digital Economy: How will the Structure of Digital Markets Change as a Result of the COVID-19 Pandemic

Could the forced digitalization of multiple spheres of human life caused by the coronavirus pandemic lead to radical changes in the global and Russian economies? How and to what extent have ubiquitous lockdowns affected the digital transformation? The new model of the digital economy growth, formed during the ongoing crisis, actually contributes to the accelerated development of secondary digital infrastructure (platforms and artificial intelligence technologies) through the creation of mass markets, the noticeably higher consumption in the field of ICT services, and the redistribution of a significant part of resources from other sectors. However, this digital forcing, within the framework of which traditional industries were placed in a deliberately losing situation due to artificially created circumstances, is taking place during a fundamental structural crisis of the global economy. Therefore, unlike the technological revolutions of the past, this one will have serious objective limitations associated with narrowed opportunities for the development of the primary digital infrastructure, without which extensive development of digital services and markets is impossible. In addition, further implementation of the adopted model of building a digital economy, based on the collection and processing of big data, is fundamentally impossible outside globalization processes and implies a significant imbalance between the new “world technological center” (the United States and China, who, however, are in a state of trade war) and the “world technological periphery.” For most other countries, including Russia, it means the need to “fit” into one of the two currently possible peripheral contours of the global digital transformation.

Innovative Digital Technologies for Purchasing and Consumption in Urban and Regional Agro-Food Systems: A Systematic Review

The use of digital technologies in the agro-food sector is growing worldwide, and applications in the urban and regional food systems represent a relevant segment of such growth. The present paper aims at reviewing the literature on which and how digital technologies support urban and regional agro-food purchasing and consumption, as well as their characteristics. Data collection was performed on Scopus and Web of Science. Articles were selected using a research string and according to specific inclusion and exclusion criteria. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow approach was adopted to explain data screening and selection. The 57 resulting studies were included in the final qualitative analysis, which explored the characteristics of the research studies and of the digital technologies analysed. Most of the studies analysed concerned the implications of digital technologies on local food consumption, especially focusing on consumption, primary production and hotel-restaurant-café-catering sector (HORECA), and to a limited extent on the retail sector. Consumers and farmers are the main targets of Information and Communications Technology (ICT) tools, whose principal aims are providing information on agro-food products and enhancing networking along the food supply chain. Analysing digital technologies allows a better understanding of their most popular features in order to support their spread among citizens. Digital technologies, and particularly Apps, can be a valuable instrument to strengthen agro-food chain actor relations and to promote urban and regional food systems.

Young Adults' Perspectives on the Use of Symptom Checkers for Self-Triage and Self-Diagnosis: Qualitative Study

BACKGROUND

Young adults often browse the internet for self-triage and diagnosis. More sophisticated digital platforms such as symptom checkers have recently become pervasive; however, little is known about their use.

OBJECTIVE

The aim of this study was to understand young adults' (18-34 years old) perspectives on the use of the Google search engine versus a symptom checker, as well as to identify the barriers and enablers for using a symptom checker for self-triage and self-diagnosis.

METHODS

A qualitative descriptive case study research design was used. Semistructured interviews were conducted with 24 young adults enrolled in a university in Ontario, Canada. All participants were given a clinical vignette and were asked to use a symptom checker (WebMD Symptom Checker or Babylon Health) while thinking out loud, and were asked questions regarding their experience. Interviews were audio-recorded, transcribed, and imported into the NVivo software program. Inductive thematic analysis was conducted independently by two researchers.

RESULTS

Using the Google search engine was perceived to be faster and more customizable (ie, ability to enter symptoms freely in the search engine) than a symptom checker; however, a symptom checker was perceived to be useful for a more personalized assessment. After having used a symptom checker, most of the participants believed that the platform needed improvement in the areas of accuracy, security and privacy, and medical jargon used. Given these limitations, most participants believed that symptom checkers could be more useful for self-triage than for self-diagnosis. Interestingly, more than half of the participants were not aware of symptom checkers prior to this study and most believed that this lack of awareness about the existence of symptom checkers hindered their use.

CONCLUSIONS

Awareness related to the existence of symptom checkers and their integration into the health care system are required to maximize benefits related to these platforms. Addressing the barriers identified in this study is likely to increase the acceptance and use of symptom checkers by young adults.

Ageism in the era of digital platforms

Ageism is the most invisible form of discrimination. While there is some awareness of gender, racial, and socioeconomic discrimination on digital platforms, ageism has received less attention. This article analyzes some tools that are frequently embedded on digital platforms from an old-age perspective, in order to increase awareness of the different ways in which ageism works. We will firstly look at how innovation teams, following homophilic patterns, disregard older people. Secondly, we will show how ageism tends to be amplified by the methods often used on digital platforms. And thirdly, we will show how corporate values contradict the usability issues that mainly affect people with a low level of (digital) skills, which is more common among older people. Counterbalancing the abusive power control of the corporations behind digital platforms and compensating for the underrepresentation of groups in less favorable situations could help to tackle such discrimination.

Effectiveness of Diet Habits and Active Life in Vocational Training for Higher Technician in Dietetics: Contrast between the Traditional Method and the Digital Resources

Vocational training of students in diet habits and active lifestyle habits has recently become an important issue, given the health problems caused as a result of a poor diet. The objective of this study is to analyze the effectiveness of different training actions (traditional method and digital resources) carried out in a program of dietary habits and active lifestyle at the vocational training stage. A quasi-experimental design of the pre-post type was developed. A sample of 177 participants was chosen. The instrument to collect the data was the validated ECHAES questionnaire. The results show that all study groups demonstrated similar averages across all dimensions, except in the digital resource post-test design, where the averages were higher than the rest. There was a significant relationship between the traditional teaching method and the post-test digital resources design in all dimensions. There was also a significant relationship between the pre-test and post-test of the traditional teaching method and the digital resource group in the dimensions. It can be concluded that both the traditional and the innovative method lead to learning in the vocational training student, although the values achieved by the group where the innovative method was adopted were much higher than in the traditional group.

COVID-19 and Health Code: How Digital Platforms Tackle the Pandemic in China

As COVID-19 is rapidly spreading around the world, some countries have launched or plan to implement contact-tracing apps to detect exposure risks. In China, the government relies on Health Code, developed by Alipay and WeChat, for identifying people potentially exposed to COVID-19. The color-based code can determine people's exposure risks and freedom of movement based on factors like travel history, duration of time spent in risky areas, and relationships to potential carriers. This essay discusses the rise of Health Code from a platform perspective, arguing that digital platforms are key players conducting health surveillance and mediating state-citizen relations in China. More importantly, tracing apps might become a normal practice in many countries, suggesting that platforms will be substantially adopted for health surveillance.

The Advertising Policies of Major Social Media Platforms Overlook the Imperative to Restrict the Exposure of Children and Adolescents to the Promotion of Unhealthy Foods and Beverages

There have been global calls to action to protect children (aged <18) from exposure to the marketing of unhealthy foods and beverages (‘unhealthy foods’). In this context, the rising popularity of social media, particularly amongst adolescents, represents an important focus area. This study aimed to examine the advertising policies of major global social media platforms related to the advertising of unhealthy foods, and to identify opportunities for social media platforms to take action. We conducted a desk-based review of the advertising policies of the 16 largest social media platforms globally. We examined their publicly available advertising policies related to food and obesity, as well as in relation to other areas impacting public health. The advertising policies for 12 of the selected social media platforms were located. None of these platforms adopted comprehensive restrictions on the advertising of unhealthy foods, with only two platforms having relevant (but very limited) policies in the area. In comparison, 11 of the 12 social media platforms had policies restricting the advertising of alcohol, tobacco, gambling, and/or weight loss. There is, therefore, an opportunity for major social media platforms to voluntarily restrict the exposure of children to the marketing of unhealthy foods, which can contribute to efforts to improve populations’ diets.

How an Environment of Stress and Social Risk Shapes Student Engagement With Social Media as Potential Digital Learning Platforms: Qualitative Study

BACKGROUND

Social media has been increasingly used as a learning tool in medical education. Specifically, when joining university, students often go through a phase of adjustment, and they need to cope with various challenges such as leaving their families and friends and trying to fit into a new environment. Research has shown that social media helps students to connect with old friends and to establish new relationships. However, managing friendships on social media might intertwine with the new learning environment that shapes students' online behaviors. Especially, when students perceive high levels of social risks when using social media, they may struggle to take advantage of the benefits that social media can provide for learning.

OBJECTIVE

This study aimed to develop a model that explores the drivers and inhibitors of student engagement with social media during their university adjustment phase.

METHODS

We used a qualitative method by interviewing 78 undergraduate students studying medical courses at UK research-focused universities. In addition, we interviewed 6 digital technology experts to provide additional insights into students' learning behaviors on social media.

RESULTS

Students' changing relationships and new academic environment in the university adjustment phase led to various factors that affected their social media engagement. The main drivers of social media engagement were maintaining existing relationships, building new relationships, and seeking academic support. Simultaneously, critical factors that inhibited the use of social media for learning emerged, namely, collapsed online identity, uncertain group norms, the desire to present an ideal self, and academic competition. These inhibitors led to student stress when managing their social media accounts, discouraged them from actively engaging on social media, and prevented the full exploitation of social media as an effective learning tool.

CONCLUSIONS

This study identified important drivers and inhibitors for students to engage with social media platforms as learning tools. Although social media supported students to manage their relationships and support their learning, the interaction of critical factors, such as collapsed online identity, uncertain group norms, the desire to present an ideal self, and academic competition, caused psychological stress and impeded student engagement. Future research should explore how these inhibitors can be removed to reduce students' stress and to increase the use of social media for learning. More specifically, such insights will allow students to take full advantage of being connected, thus facilitating a richer learning experience during their university life.