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Directly observed treatment (DOT) has been the standard of care for tuberculosis since the early 1990s, but it is inconvenient for patients and service providers. Video-observed therapy (VOT) has been conditionally recommended by WHO as an alternative to DOT. We tested whether levels of treatment observation were improved with VOT. We did a multicentre, analyst-blinded, randomised controlled superiority trial in 22 clinics in England (UK). Eligible participants were patients aged at least 16 years with active pulmonary or non-pulmonary tuberculosis who were eligible for DOT according to local guidance. Exclusion criteria included patients who did not have access to charging a smartphone. We randomly assigned participants to either VOT (daily remote observation using a smartphone app) or DOT (observations done three to five times per week in the home, community, or clinic settings). Randomisation was done by the SealedEnvelope service using minimisation. DOT involved treatment observation by a health-care or lay worker, with any remaining daily doses self-administered. VOT was provided by a centralised service in London. Patients were trained to record and send videos of every dose ingested 7 days per week using a smartphone app. Trained treatment observers viewed these videos through a password-protected website. Patients were also encouraged to report adverse drug events on the videos. Smartphones and data plans were provided free of charge by study investigators. DOT or VOT observation records were completed by observers until treatment or study end. The primary outcome was completion of 80% or more scheduled treatment observations over the first 2 months following enrolment. Intention-to-treat (ITT) and restricted (including only patients completing at least 1 week of observation on allocated arm) analyses were done. Superiority was determined by a 15% difference in the proportion of patients with the primary outcome (60% vs 75%). This trial is registered with the International Standard Randomised Controlled Trials Number registry, number ISRCTN26184967. Between Sept 1, 2014, and Oct 1, 2016, we randomly assigned 226 patients; 112 to VOT and 114 to DOT. Overall, 131 (58%) patients had a history of homelessness, imprisonment, drug use, alcohol problems or mental health problems. In the ITT analysis, 78 (70%) of 112 patients on VOT achieved ≥80% scheduled observations successfully completed during the first 2 months compared with 35 (31%) of 114 on DOT (adjusted odds ratio [OR] 5·48, 95% CI 3·10–9·68; p<0·0001). In the restricted analysis, 78 (77%) of 101 patients on VOT achieved the primary outcome compared with 35 (63%) of 56 on DOT (adjusted OR 2·52; 95% CI 1·17–5·54; p=0·017). Stomach pain, nausea, and vomiting were the most common adverse events reported (in 16 [14%] of 112 on VOT and nine [8%] of 114 on DOT). VOT was a more effective approach to observation of tuberculosis treatment than DOT. VOT is likely to be preferable to DOT for many patients across a broad range of settings, providing a more acceptable, effective, and cheaper option for supervision of daily and multiple daily doses than DOT. National Institute for Health Research.

COVID-19 pandemic and its related containment measures have been associated with increased levels of stress, anxiety and depression in the general population. While the use of digital media has been greatly promoted by national governments and international authorities to maintain social contacts and healthy lifestyle behaviors, its increased access may also bear the risk of inappropriate or excessive use of internet-related resources. The present study, part of the COVID Mental hEalth Trial (COMET) study, aims at investigating the possible relationship between social isolation, the use of digital resources and the development of their problematic use. A cross sectional survey was carried out to explore the prevalence of internet addiction, excessive use of social media, problematic video gaming and binge watching, during Italian phase II (May–June 2020) and III (June–September 2020) of the pandemic in 1385 individuals (62.5% female, mean age 32.5 ± 12.9) mainly living in Central Italy (52.4%). Data were stratified according to phase II/III and three groups of Italian regions (northern, central and southern). Compared to the larger COMET study, most participants exhibited significant higher levels of severe-to-extremely-severe depressive symptoms (46.3% vs. 12.4%; p < 0.01) and extremely severe anxiety symptoms (77.8% vs. 7.5%; p < 0.01). We also observed a rise in problematic internet use and excessive gaming over time. Mediation analyses revealed that COVID-19-related general psychopathology, stress, anxiety, depression and social isolation play a significant role in the emergence of problematic internet use, social media addiction and problematic video gaming. Professional gamers and younger subjects emerged as sub-populations particularly at risk of developing digital addictions. If confirmed in larger and more homogenous samples, our findings may help in shedding light on possible preventive and treatment strategies for digital addictions.

Currently about 2.71 billion humans use a smartphone worldwide. Although smartphone technology has brought many advances, a growing number of scientists discuss potential detrimental effects due to excessive smartphone use. Of importance, the likely culprit to understand over-usage is not the smartphone itself, but the excessive use of applications installed on smartphones. As the current business model of many app-developers foresees an exchange of personal data for allowance to use an app, it is not surprising that many design elements can be found in social media apps and Freemium games prolonging app usage. It is the aim of the present work to analyze several prominent smartphone apps to carve out such elements. As a result of the analysis, a total of six different mechanisms are highlighted to illustrate the prevailing business model in smartphone app development. First, these app-elements are described and second linked to classic psychological/economic theories such as the mere-exposure effect, endowment effect, and Zeigarnik effect, but also to psychological mechanisms triggering social comparison. It is concluded that many of the here presented app-elements on smartphones are able to prolong usage time, but it is very hard to understand such an effect on the level of a single element. A systematic analysis would require insights into app data usually only being available for the app-designers, but not for independent scientists. Nevertheless, the present work supports the notion that it is time to critically reflect on the prevailing business model of ‘user data in exchange for app-use allowance’. Instead of using a service in exchange for data, it ultimately might be better to ban or regulate certain design elements in apps to come up with less addictive products. Instead, users could pay a reasonable fee for an app service.

Describes how the inception of the iPhone has transformed society and skyrocketed Apple to the most valuable company in the world, detailing how the most current technological advances have become inseparable to everyday life.

Background Smartphones are becoming a daily necessity for most undergraduates in Mainland China. Because the present scenario of problematic smartphone use (PSU) is largely unexplored, in the current study we aimed to estimate the prevalence of PSU and to screen suitable predictors for PSU among Chinese undergraduates in the framework of the stress-coping theory. Methods A sample of 1062 undergraduate smartphone users was recruited by means of the stratified cluster random sampling strategy between April and May 2015. The Problematic Cellular Phone Use Questionnaire was used to identify PSU. We evaluated five candidate risk factors for PSU by using logistic regression analysis while controlling for demographic characteristics and specific features of smartphone use. Results The prevalence of PSU among Chinese undergraduates was estimated to be 21.3%. The risk factors for PSU were majoring in the humanities, high monthly income from the family (≥1500 RMB), serious emotional symptoms, high perceived stress, and perfectionism-related factors (high doubts about actions, high parental expectations). Conclusions PSU among undergraduates appears to be ubiquitous and thus constitutes a public health issue in Mainland China. Although further longitudinal studies are required to test whether PSU is a transient phenomenon or a chronic and progressive condition, our study successfully identified socio-demographic and psychological risk factors for PSU. These results, obtained from a random and thus representative sample of undergraduates, opens up new avenues in terms of prevention and regulation policies.

\"If you are a budding or established musician looking to use your iPad or iPhone as a portable musical instrument, recording studio, or composition tool, then you've come to the right place! iPad and iPhone For Musicians For Dummies explains in plain English how to hook up your preferred instrument to your iPad or iPhone to work on music projects within a plethora of recording apps. You'll also learn how to incorporate both real and MIDI instruments and audio, edit individual tracks, work with effects and chain multiple apps together, and mix and master songs. Thanks to apps such as AmpliTube, AudioBus, and Apple's own GarageBand, musicians can record entire songs in the comfort of their own homes and then mix, master, and distribute them right there on their iPads or iPhones. Packed with tons of step-by-step instructions, this friendly guide shows you how to use your device to go from recording a basic piece of music to creating and uploading complete songs with full instrumentation and multiple tracks, instruments, and effects\" -- from publisher's web site.

Previous research has shown that problematic smartphone use (PSU) is related to several affect-related psychopathology variables. Emotion dysregulation has been regarded as a central psychological factor associated with that type of psychopathology. In this paper, the association between expressive emotional suppression, a form of emotion dysregulation, with PSU was investigated. Furthermore, we tested if types of smartphone use (process and social use) mediated that association. Three hundred American college students participated in a web-based survey that included the Smartphone Addiction Scale (for problematic smartphone use), Emotion Regulation Questionnaire (assessing suppression), and Process vs. Social Smartphone Usage scale. We found that expressive suppression was correlated with both process smartphone use and PSU severity. Mediation analysis showed that process smartphone use completely mediated relations between suppression and PSU severity. The findings suggest that dysfunctional emotion regulation could lead to more process smartphone use that, in turn, may manifest in PSU severity. Contributions and limitations of the study are discussed.