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To validate digitally displayed photographic portion-size estimation aids (PSEA) against a weighed meal record and compare findings with an atlas of printed photographic PSEA and actual prepared-food PSEA in a low-income country.
Participants served themselves water and five prepared foods, which were weighed separately before the meal and again after the meal to measure any leftovers. Participants returned the following day and completed a meal recall. They estimated the quantities of foods consumed three times using the different PSEA in a randomized order.
Two urban and two rural communities in southern Malawi.
Women (n 300) aged 18–45 years, equally divided by urban/rural residence and years of education (≤4 years and ≥5 years).
Responses for digital and printed PSEA were highly correlated (>91 % agreement for all foods, Cohen’s κw = 0·78–0·93). Overall, at the individual level, digital and actual-food PSEA had a similar level of agreement with the weighed meal record. At the group level, the proportion of participants who estimated within 20 % of the weighed grams of food consumed ranged by type of food from 30 to 45 % for digital PSEA and 40–56 % for actual-food PSEA. Digital PSEA consistently underestimated grams and nutrients across foods, whereas actual-food PSEA provided a mix of under- and overestimates that balanced each other to produce accurate mean energy and nutrient intake estimates. Results did not differ by urban and rural location or participant education level.
Digital PSEA require further testing in low-income settings to improve accuracy of estimations.
To examine whether social media and online behaviours are associated with unhealthy food and beverage consumption in children.
A cross-sectional online survey was used to assess Internet and social media use, including engagement with food and beverage brand content, and frequency of consumption of unhealthy foods and beverages. Linear regression models were used to examine associations between online behaviours, including engagement with food and beverage brand content, and consumption of unhealthy foods and beverages, adjusting for age, sex and socio-economic status.
New South Wales, Australia, in 2014.
Children aged 10–16 years (n 417).
Watching food brand video content on YouTube, purchasing food online and seeing favourite food brands advertised online were significantly associated with higher frequency of consumption of unhealthy foods and drinks after adjustment for age, sex and socio-economic status.
Children who have higher online engagement with food brands and content, particularly through online video, are more likely to consume unhealthy foods and drinks. Our findings highlight the need to include social media in regulations and policies designed to limit children’s exposure to unhealthy food marketing. Social media companies have a greater role to play in protecting children from advertising.
The potential of digital health tools such as smartphones and sensors to increase access to and enhance delivery of healthcare is well known. However, a lack of regulation and delineation between those technologies seeking to offer direct clinical diagnostics and treatments and those involving clinical care enhancements or direct-to-consumer resources has led to patient and clinician confusion about the appropriate use and role of digital health. Here, we propose that creating boundaries and better defining the scope of digital health technology will advance the field through matching the right use cases with the right tools. We further propose that ethical clinicians, as stewards of standard of care, are well suited to uphold these boundaries and to safeguard best practices in digital health.
Declaration of interest
H.H. is an employee of Verily Life Sciences and owns equity in this company. The views expressed here are those of the authors and are not official views of Verily Life Sciences.
Depression is a major contributor to the burden of disease in the adolescent population. Internet-based interventions can increase access to treatment.
To evaluate the efficacy of internet-based cognitive–behavioural therapy (iCBT), including therapist chat communication, in treatment of adolescent depression.
Seventy adolescents, 15–19 years of age and presenting with depressive symptoms, were randomised to iCBT or attention control. The primary outcome was the Beck Depression Inventory II (BDI-II).
Significant reductions in depressive symptoms were found, favouring iCBT over the control condition (F(1,67) = 6.18, P < 0.05). The between-group effect size was Cohen's d = 0.71 (95% CI 0.22–1.19). A significantly higher proportion of iCBT participants (42.4%) than controls (13.5%) showed a 50% decrease in BDI-II score post-treatment (P < 0.01). The improvement for the iCBT group was maintained at 6 months.
The intervention appears to effectively reduce symptoms of depression in adolescents and may be helpful in overcoming barriers to care among young people.
Declaration of interest
N.T. and G.A. designed the programme. N.T. authored the treatment material. The web platform used for treatment is owned by Linköping University and run on a non-for-profit basis. None of the authors receives any income from the programme.
Screening women for depression and psychosocial risk during the perinatal period is recognised best practice. Screening by current pen and paper methods can be time consuming, and prone to scorer error. The lack of readily available translated versions of screening tools also excludes many women from different cultures.
To evaluate a perinatal mental health digital screening platform, iCOPE. The trial was conducted in a community maternal and child health setting in Melbourne, Australia.
A descriptive, cohort design was used. All women attending the urban clinic were invited to complete their routine perinatal screening on the digital platform, designed to automate score calculations and produce instant clinical and client reports whilst collecting data in real time. Screening included the Edinburgh Postnatal Depression Scale (EPDS) and psychosocial risk questions in line with current national clinical guidelines. Functionality of iCOPE was assessed according to duration of screening, completion rates, accuracy of reporting and level of engagement by women.
During the trial, 144 screens were performed. The mean screening time was 6.7 min (SD=3.78). Most (65.7% n=94) women took between 3 and 6 min. Mean EPDS score was 7.2 with 16% (n=23) scoring 13 or more. The accuracy of reports was 100% and screening completion rate was 99.3%. Many women (81.3%) requested a copy of their personal report.
The iCOPE platform was efficient in terms of screening time, scoring accuracy, and engagement of women. The automated production of tailored client and clinical reports enabled screening outcomes to be instantly communicated to women and health professionals. The collection of data in real time facilitated the monitoring of screening rates and evaluation of outcomes by clinicians and service managers.
This chapter discusses some principal themes of the Cambridge Companion to Music in Digital Culture, emphasising the social and cultural dimensions of digital music. A historical introduction ranges from the embedding of digital technology in everyday life to the emergence of virtual realities, from digital-only genres like vaporwave to Second Life and Hatsune Miku, the virtual diva whose holographic performances are seen as emblematic of posthumanism: I sketch out an aesthetics of digital culture that emphasises continuities across its expressions, from digital multimedia and internet memes to playfulness on Reddit. Attention is also given to the real-world dimensions of digital culture, including the transition from downloads to streaming, internet-based participation, and so called Web 2.0 businesses. The digital revolution has brought about a radical restructuring of the music industry, culminating in a bizarre situation whereby music is economically underpinned by the collection of commercially valuable personal data on listeners.
This paper presents for the first time high-efficiency W-band power amplifiers (PAs), the design of which follows the digital PA (DPA) design concept. Two DPAs with different output networks have been realized: a single-band version (S-DPA) for 95 GHz and a dual-band design (D-DPA) for signal frequencies fS of 68 GHz (first band) and 76 GHz (second band), respectively. The PAs are realized as monolithic microwave-integrated circuits (MMICs) in a 0.8 μm InP DHBT transferred-substrate process. They utilize a double-emitter-finger DHBT unit cell with an emitter area of 2 × 0.8 × 6 μm3 each. In contrast to the usual W-band PAs, the proposed single-stage amplifier MMICs do not apply any special reactive matching for the transistor, which leads to very compact chip sizes of 0.27 mm2 (S-DPA) and 0.39 mm2(D-DPA). The S-DPA includes one band-pass filter (BPF) at the output with 0.6 dB insertion loss (IL) and 24 dB input return loss (RL) at the signal frequency of 95 GHz. The dual-band BPF shows 0.7 dB IL in both bands with a RL of more than 21 dB each. Applying an overdriven sinusoidal input signal to emulate digital operation the DPAs achieve a maximum output power of 14.4 dBm and power-added efficiency of 31% when using the single-band configuration. Collector efficiencies of more than 80% and the flexible multi-band operation demonstrated prove the great potential of the digital PA concept for future high-speed communications.
An effective linearization technique capable of equalizing IM3 products resulting from an arbitrary out-of-band blocking scenario in a wideband direct conversion receiver is presented. IM3 products are regenerated in the RF analog domain of a low-power mixed-signal feedforward path and are used to cancel analogous signal terms in the original receiver at digital baseband via adaptive equalization. The composite SAW-less receiver achieves an improvement in effective IIP3 from −7.1 to +5.3 dBm under worst-case UMTS Region 1 blocking when the feedforward path is active.
(1) To assess the subjective tinnitus perception of patients with audiologically proven hearing loss presenting to a tinnitus clinic, both before and after hearing aid provision; (2) to investigate subjective tinnitus perception in patients with unilateral and bilateral hearing loss; and (3) to assess the impact on tinnitus perception, if any, of a digital hearing aid programme in patients provided with hearing aids.
Prospective data collection for patients attending a tinnitus clinic over a 25-year period (1980–2004).
University teaching hospital otolaryngology department.
A total of 2153 consecutive patients attending a consultant-delivered specialist tinnitus clinic.
Main outcomes measures:
A visual analogue scale was used to assess the degree of tinnitus perception improvement, if any, comparing before versus after unilateral or bilateral aiding (in those with audiometrically proven hearing loss). A further assessment compared the effect of digital hearing aid programme introduction on symptomatic tinnitus perception in patients provided with unilateral or bilateral aids.
A total of 1440 patients were given hearing aids (826 unilateral and 614 bilateral). There was little difference in tinnitus perception, comparing overall aiding results in unilaterally or bilaterally aided patients. Overall, 554 (67 per cent) of unilaterally aided patients and 424 (69 per cent) of bilaterally aided patients reported some improvement in their tinnitus perception following aiding. There was a statistically significant improvement in tinnitus perception, comparing analogue aids with digital hearing aids, following introduction of a digital hearing aid programme in 2000, in both unilaterally (p < 0.001) and bilaterally (p < 0.001) aided patients.
Provision of hearing aids in patients with audiometrically demonstrable hearing loss can play a very important part in tinnitus control. The additional improvement in tinnitus control observed following introduction of programmable digital aids had a summative effect in the management of these patients.
The field of audiological rehabilitation in adults faces an array of opportunities. Some of these are technological, as with the advent of fully digital hearing-aids, and some involve clinical practice, such as opportunities for true multidisciplinary working, and for changes in hearing-aid prescription and provision. The development of well-validated questionnaire instruments should facilitate robust research into the effectiveness of clinical interventions in adult audiological rehabilitation, for such evidence is urgently needed if the field is to thrive.
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