Headache in the international cohort study of mobile phone use and health (COSMOS) in the Netherlands and the United Kingdom

Headache is a common condition with a substantial burden of disease worldwide. Concerns have been raised over the potential impact of long-term mobile phone use on headache due to radiofrequency electromagnetic fields (RF-EMFs). We explored prospectively the association between mobile phone use at baseline (2009-2012) and headache at follow-up (2015-2018) by analysing pooled data consisting of the Dutch and UK cohorts of the Cohort Study of Mobile Phone Use and Health (COSMOS) (N = 78,437). Frequency of headache, migraine, and information on mobile phone use, including use of hands-free devices and frequency of texting, were self-reported. We collected objective operator data to obtain regression calibrated estimates of voice call duration. In the model mutually adjusted for call-time and text messaging, participants in the high category of call-time showed an adjusted odds ratio (OR) of 1.04 (95 % CI: 0.94-1.15), with no clear trend of reporting headache with increasing call-time. However, we found an increased risk of weekly headache (OR = 1.40, 95 % CI: 1.25-1.56) in the high category of text messaging, with a clear increase in reporting headache with increasing texting. Due to the negligible exposure to RF-EMFs from texting, our results suggest that mechanisms other than RF-EMFs are responsible for the increased risk of headache that we found among mobile phone users.

Targeting young driver emotions can reduce their cellphone distractions

OBJECTIVE

This study sought to evaluate the relationship between young drivers' intention to engage in cellphone distractions while driving and their emotions towards the associated risks. First, we assessed whether the emotions of guilt, shame, and fear are associated with young drivers' intention to engage in cellphone distractions, through an extended Theory of Planned Behavior (TPB) model. Second, we evaluated whether road signs that may evoke these negative emotions reduce cellphone use intentions among young drivers.

METHODS

An online survey was conducted with young drivers (18 to 25 years old) from Ontario, Canada. 403 responses were collected, of which, 99 responses were used to evaluate the first objective and all 403 responses were used to evaluate the second objective.

RESULTS

Anticipating feelings of guilt, shame, and fear negatively predicted the intention to engage in cellphone distractions, above and beyond the standard TPB constructs (i.e., attitudes, subjective norms, and perceived behavioral control). When prompted with potentially emotion-evoking road signs (children crossing, my mom/dad works here), an increase in anticipated feelings of these emotions corresponded with lower intention to engage in cellphone distractions.

CONCLUSION

Countermeasures that target young driver emotions toward distracted driving risks may be effective in reducing their distraction engagement. Future studies in more controlled environments can investigate causal relationships between emotions and distracted driving among young drivers.

Mobile phone use while cycling among e-bikers in China: Reasoned or social reactive?

INTRODUCTION

China has the largest number of e-bikers in the world, and e-bike crashes cause thousands of fatalities and tens of thousands of serious injuries annually. Mobile phone use while e-biking is a violation of Chinese law and associated with increased crash risk. The current study investigated mobile phone use behavior while cycling among Chinese e-bikers and the psychological factors surrounding why individuals might choose to engage in this risk-taking behavior.

METHOD

In particular, this study investigates whether the decision to use a mobile phone while cycling is explained through reasoned decision making or is a social reactive decision, or both, as defined by the prototype willingness model (PWM). Questionnaire data were collected from 784 Chinese adults with e-bike experience.

RESULTS

Results showed that 40.2 % of the participants reported mobile phone use while cycling e-bikes in the past month. Both behavioral intention and behavioral willingness were predictors of mobile phone while using e-bikes, and they were approximately equal in their magnitude of predictive power (β_BI = 0.25; β_BW = 0.26). E-bikers' attitudes, perceived behavioral control, and perception of prototype similarity and favorability were strong predictors of intention, willingness, and self-reported behavior to use mobile phones while e-biking.

CONCLUSIONS

Both social reactive decision-making and reasoned decision-making contribute to decisions to use a mobile phone while riding an e-bike.

PRACTICAL APPLICATIONS

Results have implications for guiding development of interventions to prevent and reduce mobile phone use when e-bike cycling.

Nomophobia, attitude and mobile phone use while riding an E-bike: Testing a dual-process model of self-control

Using a mobile phone while participating in traffic is a growing safety concern all over the world. However, mobile phone use (MPU) while riding an e-bike has not yet been given enough attention by researchers and practitioners. To fill this gap, this study conducted a preliminary online interview and a questionnaire-based survey in China to study what kinds of MPU behaviors e-bikers commonly engaged in and the prevalence of these behaviors. A conceptual dual-process framework consisting of e-bikers' demographics, e-bike usage pattern, nomophobia, attitude and self-control was also proposed to analyze the psychological mechanism underlying this phenomenon. The preliminary online interview revealed 7 typical types of MPU behaviors performed by e-bikers on the road. Results of the questionnaire survey showed that though the overall frequencies of MPU behaviors were low, nearly 60% of the respondents reported a history of mobile phone use during riding in the last three months. E-bikers' MPU frequencies were significantly impacted by e-bikers' gender, attitude, self-control and information-related nomophobia. Besides, self-control also significantly moderated the predictive effects of information-related nomophobia and attitude on MPU frequencies while ring an e-bike. Fears of being unable to access information on the mobile phone only contributed to MPU at low levels of self-control. In contrast, the protective effect of unfavorable attitude against engagement in the behavior became stronger at high self-control levels. The results not only offer deeper insights into the current situation of MPU among e-bikers in China, but also could facilitate the development of intervention and safety promotion strategies targeting this specific road user group.

[The problematic use of the mobile phone: cross-sectional analysis of the individual profile and associated factors.]

OBJECTIVE

The problematic use of mobile phones is a phenomenon that can be associated with a specific individual profile and it has been seen that there are associated factors, although most of them have been studied in a limited way and in small samples. The aim of this study was to describe the association between the problematic use of the mobile phone and social traits, health, and health-related behaviors among high school students.

METHODS

This is a cross-sectional study performed in a representative sample of students aged 13-18 years in the Lifestyle Risk Factors in Secondary School Students (FRESC) survey conducted in 2016 in Barcelona (n=3,778). Problematic mobile phone use was obtained from the Mobile Related Experiences Questionnaire (CERM). Multivariate logistic regression models were built to assess the relationship between this variable and social, health and behavioural variables.

RESULTS

A total of 52% of girls and 44% of boys reported frequent or occasional problems with their mobile phone usage. The factors associated with the dependent variable were poor relationships with the family, mobile phone usage before sleeping or during dinner, inadequate hours of sleep, sedentariness, substance consumption and poor mental health.

CONCLUSIONS

The problematic use of the mobile is frequent among students and there are several associated social, health and behavioral factors. There are substantial differences by sex and age, with the strongest associations in younger girls.

Analysis of mobile phone use engagement during naturalistic driving through explainable imbalanced machine learning

While driver distraction remains an issue in modernized societies, technological advancements in data collection, storage and analysis provide the means for deeper insights of this complex phenomenon. In this research, factors influencing when driver distraction through mobile phone use occurs during naturalistic driving are investigated. Naturalistic data from a 6-stage, 230-driver experiment are exploited, in which drivers installed a non-intrusive driving recording application in their devices and conducted their trips normally across a 21-month timespan, coupled with corresponding questionnaire data. The various experiment stages involved providing progressively more behavioral feedback to drivers while continuing to record them. Subsequently, supervised Machine Learning XGBoost algorithms were employed to model the contributions of naturalistic driving and questionnaire features to the decision to engage mobile phone use. Mobile phone use percentages were heavily skewed towards zero, therefore imbalanced ML with a minority-oversampling approach in a binary format was employed. To increase the explainability offered by the algorithm, SHAP values were calculated for the informative features. Results indicate that the decision of drivers to use a mobile while driving is governed by a number of complex, non-linear relationships. Total trip distance is the most significant predictor variable by a wide margin, with mean SHAP values of 0.79 towards affecting the model decisions for the probability of mobile phone use of each driver. However, other variables influence the final predictions as well, such as the number of tickets in the last three years (m.SHAP = 0.30), declared mobile phone use (m.SHAP = 0.26), the amount and variety of provided feedback (m.SHAP = 0.17) (i.e. experiment phase number) and family member numbers (m.SHAP = 0.09) decrease the probability of using a mobile phone while driving. Conversely, increases in driver experience (m.SHAP = 0.22), driver age (m.SHAP = 0.11), engine capacity (m.SHAP = 0.11) and total kilometers driven annually (m.SHAP = 0.08) increase the probability of using a mobile phone in naturalistic driving conditions. SHAP dependency plots reveal non-linear effects present in almost all variables. Fuel consumption had a particularly strong non-linear effect, as higher values of this variable lead to both higher and lower probability of drivers using a mobile phone, deviating from the safer average. Legislation, campaigns and enforcement measures can be restructured to take advantage of gains margins in terms of understanding and predicting driver distraction behavior, as explored in the present study.

Investigating the impact of environmental and temporal features on mobile phone distracted driving behavior using phone use data

Mobile phone distracted driving (MPDD) is one of the most significant and common factors in distraction-affected crashes. In previous studies, MPDD has been described as a self-selected behavior that affects driving performance, rather than a multidimensionally impacted behavior. In this study, the researchers hypothesized that external environmental features significantly impacted MPDD and tested this hypothesis by structural equation modeling (SEM). Three external latent variables (road, operation, and control factors) were measured at different times during weekdays in urban areas of Texas by integrating a large number of mobile phone sensor data and roadway inventory data. A structural model was developed to test the relationship between the latent variables and the rate of drivers involved in MPDD (MPDDR) on the roadway during different time periods. Finally, the data summary and model results revealed significant temporal effects. Standardized estimates from the SEM results revealed the positive impact of roads factors in the morning peak that broader shoulders, wider medians, and smaller curve radians were correlated with higher MPDDR in the morning peak hours; the negative impact of operation factors that higher average annual daily truck traffic (truck AADT) were associated with lower MPDDR significantly. And the impact of control factors on MPDDR is positive. In other words, the road segments with a large number of traffic signals in urban areas had a higher MPDDR than those without traffic signals. These findings could assist transportation and legislation agencies in the development of appropriate countermeasures or enforcement tactics and implement them effectively to reduce the occurrence of MPDD. In addition, this study provides a novel perspective close to the actual consideration of drivers about using mobile phones while driving, in the context of MPDD research, rather than comparing driver groups and vehicle performance.

Longitudinal associations of the duration of mobile phone use with suicidal behavior in adolescents: The mediating role of depressive symptoms

BACKGROUND

Prolonged mobile phone use has been demonstrated to be associated with mental health problems and suicidal behavior in adolescents. This study examined the mediating role of depressive symptoms in the association between duration of mobile phone use (DMPU) and suicidal behavior in adolescents.

METHODS

A total of 6,923 participants from the Shandong Adolescent Behavior & Health Cohort (SABHC) were included in the analysis. Participants completed a self-administered questionnaire to assess DMPU on weekdays and weekends, mental disorders, insomnia symptoms, depressive symptoms, suicidal behavior (thought, plan, or attempt), and family demographics in November-December 2015. One year later, a follow-up survey was conducted to ask participants to report their depressive symptoms and suicidal behavior. Path analyses with logistic regressions were performed to examine the mediating role of depressive symptoms in the DMPU-suicidal behavior link.

RESULTS

Of the sample, mean age was 14.58 (SD = 1.45) and 3,455 (49.9 %) were female at baseline. 12.12 % of participants reported having ever suicidal behavior during the past 12 months at baseline, and 10.63 % reported having ever suicidal behavior during 1-year follow-up. Path analyses showed that the depressive symptoms played a partial mediating role in the association of DMPU on weekdays and weekends with subsequent suicidal behavior. After controlling for covariates, depressive symptoms accounted for 33.6 % and 58.6 % of the total effect of DMPU on weekdays and weekends on suicidal behavior, respectively.

LIMITATION

All variables were measured based on self-report.

CONCLUSIONS

The link between DMPU and suicidal behavior was partially mediated by depressive symptoms. Prolonged mobile phone use and depressive symptoms should be assessed and intervened to prevent suicidal behavior in adolescents.

The effect of risk perception and other psychological factors on mobile phone use while crossing the street among pedestrians

Pedestrians may be the most vulnerable group among road users, and mobile phone use while crossing the street is ubiquitous worldwide in this information era. However, previous studies have found that such distracting behaviors may increase the risk of injury and death. The present study primarily aimed to explore the effect of reinforcement sensitivity theory components (i.e., Behavioral Inhibition System (BIS), Behavioral Approach System (BAS)), risk perception, attitudes towards red light running, and fear of missing out (FoMO) on mobile phone use while crossing the street among pedestrians. Risk perception was measured in three ways (i.e., assessing the probability of a negative outcome (RP-Pro), judging the severity of the consequence (RP-Se), and evaluating the general riskiness of the behavior (RP-Ri)). An online questionnaire survey was conducted, and only valid responses (N = 425) were used for subsequent data analyses. The results indicated significant differences in the responses across the risk perception questions with different focuses. Participants who reported engaging in more distracted street-crossing (i.e., high-risk takers) perceived a significantly lower risk, and this difference did not depend on the focus of risk perception. Three path analysis models with differential risk perception constructs (RP-Pro, RP-Se, and RP-Ri) were developed to examine the relationship between risk perception and distracted street-crossing. The results suggest that the relationship between these two variables does not depend on the focus of the risk perception questions. Moreover, FoMO was a predictor of mobile phone use while crossing the street, while attitudes had both direct and indirect effects on behavior. BIS and BAS had the lowest total effect on mobile phone use among pedestrians. In particular, a direct association between BAS and distracted street-crossing was found only in the model in which risk perception was measured by judging the severity of crashes caused by mobile phone use distraction. This study may be meaningful for understanding the associations between psychological factors and mobile phone use among pedestrians. The implications of the findings for the development of safety interventions are discussed in this study.

Designing an SMS reminder intervention to improve vaccination uptake in Northern Nigeria: a qualitative study

BACKGROUND

Penta3 coverage in Nigeria was low at 33 % in 2017. The most reported reason for non-vaccination was lack of knowledge about the immunization place, time, and need. To address knowledge gaps and improve vaccination uptake, we designed an Immunization Reminder and Information SMS System (IRISS) to educate and remind parents/caregivers about immunization using SMS. A formative study was conducted to understand the contextual and behavioural factors that would inform the IRISS intervention design and implementation.

METHODS

We conducted the study in four Local Government Areas (LGAs) of Kebbi State Nigeria in October 2018, amongst a diverse selection of participants. Data on social norms about vaccinations, barriers to immunization uptake, mobile phone use, SMS message testing, and willingness to accept SMS reminders were collected from focus group discussions (N = 11), in-depth interviews (N = 12), and key informant interviews (N = 13). In addition, we assessed 33 messages covering schedule reminders, normative, motivational, educational, and informative contents for clarity, comprehensibility, relevance, cultural appropriateness, and ability to motivate action among community members from Argungu and Fakai LGAs. All interviews were analyzed using a thematic analysis approach.

RESULTS

We interviewed 135 people, and 90 % were community members. While we found positive perceptions about immunizations among those interviewed, pockets of misconceptions existed among community members. Lack of awareness on the importance of vaccination was a consistent reason for under-vaccination across the LGAs. In addition, most community members do not own phones, could not read SMS messages, and were unaware of how to check/open text messages received. Despite concerns about low literacy levels and phone ownership, community members still saw a role in SMS reminders when phone owners receive messages. For instance, community leaders can disseminate said messages to community members through existing channels such as town announcers and religious gatherings. Therefore, the SMS becomes a source of information, with phone owners acting as a conduit to community dissemination mechanisms. We generally found the tested messages to be relevant, motivating, and culturally acceptable.

CONCLUSIONS

SMS reminders have the potential to bridge the information gap in community awareness for vaccination, which can translate to improved immunization uptake. In rural communities with low literacy levels and phone ownership, immunization information can be disseminated when existing community leadership structures are engaged.

Efficacy of Mobile phone use on adherence to Nevirapine prophylaxis and retention in care among the HIV-exposed infants in prevention of mother to child transmission of HIV: a randomized controlled trial

BACKGROUND

HIV is a major contributor to infant mortality. A significant gap remains between the uptake of infant and maternal antiretroviral regimens and only a minority of HIV-exposed infants receives prophylaxis and safe infant feeding. Losses to follow-up of HIV-exposed infants are associated with shortcomings of facility-based PMTCT models with weak community support of linkages. Use of mobile phones offers an opportunity for improving care and promoting retention assessed by timely attendance of scheduled appointments for the mother-baby pairs and achievement of an HIV-free generation. The objective of this study was to compare self-reported adherence to infant Nevirapine (NVP) prophylaxis and retention in care assessed by timely attendance of scheduled appointments over 10 weeks in HIV exposed infants randomized to 2-weekly mobile phone calls (intervention) versus no phone calls (control).

METHODS

In this open label randomized controlled study, one hundred and fifty HIV infected women drawn from 3 health facilities in Western Kenya and their infants were randomly assigned to receive either phone-based reminders on PMTCT messages or standard health care messages (no calls) within 24 h of delivery. Women in the intervention arm continued to receive fortnightly phone calls. At 6- and 10-weeks following randomization we collected data on infant adherence to Nevirapine, mode of infant feeding, early HIV testing and retention in care in both study arms. All analyses were intention to treat.

RESULTS

At 6 weeks follow-up, 90.7% (n = 68) of participants receiving phone calls reported adherence to infant NVP prophylaxis, compared with 72% (n = 54) of participants in the control group (p = 0.005). Participants in the intervention arm were also significantly more likely to remain in care than participants in the control group [78.7% (n = 59) vs. 58.7% (n = 44), p = 0.009 at 6 weeks and 69.3% (n = 52) vs. 37.3% (n = 28), p < 0.001 at 10 weeks].

CONCLUSIONS

These results suggest that phone calls are potentially an important tool to improve adherence to infant NVP prophylaxis and retention in care for HIV-exposed infants.

TRIAL REGISTRATION

PACTR202007654729602. Registered 6 June 2018 - Retrospectively registered, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=3449.

A systematic review of musculoskeletal complaints, symptoms, and pathologies related to mobile phone usage

BACKGROUND

In the past decade, mobile phone usage rates have increased and there have been concerns that overuse of mobile phones may contribute to various musculoskeletal (MSK) problems.

OBJECTIVES

The aim of the present study was to systematically review available literature on the prevalence of MSK complaints, symptoms, and pathologies associated with mobile phone use.

STUDY DESIGN

Systematic review.

METHOD

In this systematic review, Medline (Pubmed), Wiley, WOS, and EMBASE electronic databases were searched for studies published in English between January 1, 2000 and March 25, 2019 using the following. KEY TERMS: 'mobile phone', 'smartphone', 'musculoskeletal pain', 'pain', 'musculoskeletal symptoms', and 'musculoskeletal pathology'.

RESULTS

The search strategy identified 196 papers, of which 18 met the inclusion criteria. Among the studies included in the systematic review, five were high quality, twelve were of acceptable quality, and one was of low quality. The review demonstrated that the prevalence of MSK complaints among mobile phone users ranged 8.2%-89.9%, and that neck and upper back complaints had the highest prevalence rates ranging from 55.8% to 89.9%. The most common MSK symptom associated with mobile phone use was pain. Myofascial pain syndrome, fibromyalgia, thoracic outlet syndrome, tendonitis, and De Quervain's syndrome were the most commonly associated MSK pathologies.

CONCLUSION

The evidence concerning MSK complaints among mobile phone is somewhat limited because the data were obtained from cross-sectional and case-control study results. Consequently, there is need for higher quality and prospective studies to better understand the relationship between mobile phone use and MSK symptoms and pathologies.

The moderating effect of physical activity in the relation between problematic mobile phone use and depression among university students

AIM

To examine the moderating effect of physical activity (PA) between problematic mobile phone use (PMPU) and depression in university students.

METHODS

The sample consisted of 4624 students (55.5% females and 44.5% males) aged 17-25 years old (M=19.91, SD=1.27). Patient Health Questionnaire (PHQ-9) and Center for Epidemiologic Studies Depression Scale (CES-D) were applied to evaluate the state of depression in all participants. The data of PMPU and PA were collected by standardized questionnaires named Self-rating Questionnaire for Adolescent Problematic Mobile Phone Use (SQAPMPU) and International physical activity Questionnaire-Short Form (IPAQ-SF). Chi-square tests and multivariate logistic regressions were applied to examine the associations of PMPU and depression, as well as the moderating effects of PA.

RESULTS

The prevalence of PMPU and depression were 27.5%, 6.1% (PHQ-9 at clinical level) and 25.1% (CES-D≥20), respectively. The relationships between PMPU and depression have been shown in our study. The rates of depression were higher among students with PMPU or low PA. Hierarchical analysis indicated that moderate or high PA was related to a greater decrease in the risk of depression for students with PMPU.

CONCLUSIONS

The findings indicate that PA moderates the association between PMPU and depression. Future researches with longitudinal design are warranted. The intervention programs of depression should consider individuals' health behaviors.

The severity of mobile phone addiction and its relationship with quality of life in Chinese university students

Objective

This study examined the severity of mobile phone addiction and its relationship with quality of life (QOL) in Chinese university students.

Methods

A total of 2,312 university students from Macao, Hong Kong and mainland China participated in this cross-sectional study. The Mobile Phone Addiction Scale (MPAS), and the World Health Organization Quality of Life-Brief version (WHOQOL-BREF) rating instruments were used to assess the severity of mobile phone addiction and QOL, respectively.

Results

Compared to students in mainland China, those in Macao and Hong Kong were more likely to have excessive mobile phone use. Multiple linear regression revealed that high academic pressure and poor academic performance were positively associated, while male gender, greater interest in academic major and long sleep duration were negatively associated with the severity of mobile phone addiction. Students addicted to mobile phone use had significantly lower scores across all QOL domains.

Conclusion

Due to the adverse impact of excessive mobile phone use on QOL, public education and effective preventive measures should be developed for Chinese university students.

The relationship between mobile phone use and suicide-related behaviors among adolescents: The mediating role of depression and interpersonal problems

BACKGROUND

This study examined (a) the relationship that interpersonal problems and depression share with the intensity of mobile phone use and (b) their effects on suicide-related behaviors (SRBs) and self-harming behaviors among adolescents.

METHODS

In this cross-sectional study, adolescents were recruited from 11 middle and high schools in Shenzhen, China. They completed self-reported measures that assessed mobile phone use, their history of SRBs (i.e., suicidal ideation, suicidal planning, and attempted suicide) and self-harming behaviors, depression, and interpersonal problems.

RESULTS

Interpersonal problems and depression mediated the relationship between high-intensity mobile phone use and the risk for SRBs and self-harming behaviors among Chinese adolescents.

CONCLUSIONS

The findings delineate the pathways through which interpersonal problems and depression increase the risk for SRBs and self-harming behaviors among adolescents who report high-intensity mobile phone use. Future studies should develop interventions that alleviate interpersonal problems and depressive symptoms to reduce the risk for SRBs and self-harming behaviors among adolescents who report high-intensity mobile phone use.

[Mobile phone use in early pregnant and infant sleep-wake behaviour in 6 months: a cohort study]

Objective: To describe the epidemiological characteristics of mobile phone use in early pregnancy, and to explore the relationship between pregnancy mobile use and infant sleep-wake behavior. Methods: During February 2015 to August 2016, 2 212 subjects who had their first antenatal examination at Maanshan Maternity and Child Health Hospital were recruited in this cohort study and followed until postpartum for 6 months. Information of phone use was collected through questionnaire in the third trimester. There were 1 779 pregnant reported hours of mobile phone use in the questionnaire. A total of 1 951 parent reported the night-wake times. Data on night-wake behavior in infants was collected during the 6 months study. Questionnaires were completed by parents when taking the physical examination. More than 3 times per night was defined as the night-wake frequency. Unconditional multivariate logistic regression was applied to analyze the association of pregnancy time of mobile phone use and the infant night-wake frequencies. Results: In this cohort study, the average age of 2 212 pregnant women was (26.95±3.82) years, with 1 983 of them were followed up to the time of delivery. The incidence of night-wake frequency was 28.3% (553/1 951) among these 6-month-old infants. After adjusted for feeding factors in the first trimester, frequencies of using the phone as "3 to 4 hour per day" and "5 hour and above per day" were both positively associated with the frequencies of night-wake behavior in infants. The adjusted OR (95%CI) were 1.49 (1.07-2.07) and 1.79 (1.31-2.46), respectively. Conclusions: The mobile phone use during pregnancy was associated with night-wake of infants. Mobile phone should be rationally used during pregnancy.

Factor structure and measurement invariance of the problematic mobile phone use questionnaire-short version across gender in Chinese adolescents and young adults

BACKGROUND

Problematic mobile phone use (PMPU) has become a public health issue in China, particularly in adolescents and young adults. The Problematic Mobile Phone Use Questionnaire-Short Version (PMPUQ-SV) is a validated instrument that measures multiple aspects of PMPU. The current study aimed to test the psychometric characteristics of a Chinese adaption of the PMPUQ-SV and examine its measurement invariance across gender.

METHODS

A total of 2086 participants were recruited form nine schools (six undergraduate colleges and three vocational colleges) through an online platform. Measures included socio-demographic variables, patterns of mobile phone use, the Chinese version of the PMPUQ-SV (C-PMPUQ-SV), the Chinese version of the Smartphone Addiction Proneness Scale (C-SAPS), and the Depression Anxiety Stress Scales (DASS-21).

RESULTS

Exploratory and confirmatory factor analyses conducted in two independent subsamples confirmed that the postulated dimensions fit the data well. Four items, judged as either outdated or not adapted to the Chinese context, performed poorly and were removed, resulting in a shorter 11-item scale. Convergent validity was established through correlations between emotional symptoms and the C-PMPUQ-SV and addictive smartphone use. Additional measurement invariance analyses showed that the scale performed largely similarly in male and female participants.

CONCLUSIONS

The present study demonstrated that the C-PMPUQ-SV is an adequate instrument to study various types of PMPU in Chinese adolescents and young adults. The updated 11-item scale shortens the evaluation time and is adapted to assess contemporary smartphone use.

Prolonged mobile phone use is associated with depressive symptoms in Chinese adolescents

BACKGROUND

Prolonged screen time has negative impacts on health and well-being. This study examined the association between the duration of mobile phone use (DMPU) and depressive symptoms in a large sample of Chinese adolescents.

METHODS

11,831 adolescent students participated in the baseline Shandong Adolescent Behavior and Health Cohort (SABHC) survey in Shandong, China in 2015. A self-administered questionnaire was used to measure DMPU on weekdays and the weekend, sleep, mental health, and family environment. The Center for Epidemiologic Studies Depression Scale (CES-D) and Youth Self-Report (YSR) depression scales were used to assess depressive symptoms.

RESULTS

The mean age of participants was 15.0 (SD = 1.5) and 51% were male. The prevalence of depressive symptoms increased with prolonged DMPU. After adjusting for adolescent and family covariates, DMPU ≥ 2 h/day on weekdays (OR = 1.78, 95%CI = 1.48-2.15) and ≥ 5 h/day on the weekend (OR = 1.67, 95%CI = 1.41-1.98) was associated with increased risk of depressive symptoms as assessed by CES-D. The DMPU-depression association was found to be partially mediated by short sleep duration or insomnia. Similar associations were observed for depression as assessed by YSR.

STUDY LIMITATION

This is a cross-sectional survey. Mobile phone use and depressive symptoms were measured by self-report.

CONCLUSIONS

Prolonged mobile phone use of ≥ 2 h on weekdays and ≥ 5 h on the weekend is associated with an increased risk of depressive symptoms. The association appears to be partially mediated by sleep disturbances.

Relationship between internet addiction and depression among Japanese university students

BACKGROUND

Internet addiction (IA) has various adverse effects. We sought to elucidate the relationship between IA and depression among university students and to identify factors associated with IA.

METHODS

Anonymous, self-administered questionnaires were distributed to 5,261 students and comprised basic characteristics, lifestyle habits, anxieties, the Internet Addiction Test (IAT), and the Center for Epidemiological Self-Depression Scale.

RESULTS

Responses were obtained from 4,490 students (response rate: 85.3%). After excluding those with missing responses, 3,251 participants were analyzed (valid response rate: 61.8%). Logistic regression analysis with severity of IA as the independent variable and depression as the dependent variable revealed that the odds ratio (OR) for depression increased with severity of IA (mild addiction: OR=2.87, 95% confidence interval [CI]=2.45-3.36; severe addiction: OR=7.31, 95% CI=4.61-11.61). In a logistic regression analysis with mobile phone use as the independent variable and IA as the dependent variable, the highest OR was for message board use (OR=3.74, 95% CI=2.53-5.53) and the lowest OR was for use of LINE instant messenger (OR=0.59, 95% CI=0.49-0.70). Logistic regression analysis with academic department as the independent variable and internet addiction as the dependent variable revealed high ORs for the humanities department (OR=1.59, 95% CI=1.18-2.16) and fine arts department (OR=1.55, 95% CI=1.07-2.23).

LIMITATIONS

The main limitations were the cross-sectional design, low valid response rate, single-university setting, and possible social desirability bias.

CONCLUSIONS

Our results suggest a relationship between IA and depression in university students. IA tendency differed according to mobile phone use and academic department, suggesting these factors are associated with IA.

Mobile phone involvement, beliefs, and texting while driving in Ukraine

There is extensive evidence that using a mobile phone whilst driving is one of the biggest contributors to driver distraction, which in turn increases the risk of motor vehicle collisions. Whilst most of the developed countries have been trying to deter this behaviour through legislation, enforcement and educational campaigns, in Ukraine, where the road fatality rate is the highest in Europe, this issue has only recently become publicised. The present study examined psychological factors that are associated with hand-held mobile phone use while driving among a sample of Ukrainian drivers, in particular writing or reading a text message while driving. This included drivers' behavioural, normative, and control beliefs relating to mobile phone use while driving, as well as the degree to which using a mobile phone is integral to one's everyday life (measured using the Mobile Phone Involvement Questionnaire; MPIQ). Almost one quarter to one third of the sample reported using their phone on a daily basis to write (22.2%) or read (38.2%) text messages while driving. A binary logistic regression showed that gender, higher MPIQ scores, perceived approval from family members, lower perceived likelihood of receiving traffic fines and less demanding traffic conditions were all significantly associated with mobile phone use while driving. These results suggest that dependence upon a mobile phone in everyday life may be an important factor to consider when developing interventions to reduce hand-held mobile phone use while driving.

Recall of mobile phone usage and laterality in young people: The multinational Mobi-Expo study

OBJECTIVE

To study recall of mobile phone usage, including laterality and hands-free use, in young people.

METHODS

Actual mobile phone use was recorded among volunteers aged between 10 and 24 years from 12 countries by the software application XMobiSense and was compared with self-reported mobile phone use at 6 and 18 months after using the application. The application recorded number and duration of voice calls, number of text messages, amount of data transfer, laterality (% of call time the phone was near the right or left side of the head, or neither), and hands-free usage. After data cleaning, 466 participants were available for the main analyses (recorded vs. self-reported phone use after 6 months).

RESULTS

Participants were on average 18.6 years old (IQR 15.2-21.8 years). The Spearman correlation coefficients between recorded and self-reported (after 6 months) number and duration of voice calls were 0.68 and 0.65, respectively. Number of calls was on average underestimated by the participants (adjusted geometric mean ratio (GMR) self-report/recorded = 0.52, 95% CI = 0.47-0.58), while duration of calls was overestimated (GMR=1.32, 95%, CI = 1.15-1.52). The ratios significantly differed by country, age, maternal educational level, and level of reported phone use, but not by time of the interview (6 vs. 18 months). Individuals who reported low mobile phone use underestimated their use, while individuals who reported the highest level of phone use were more likely to overestimate their use. Individuals who reported using the phone mainly on the right side of the head used it more on the right (71.1%) than the left (28.9%) side. Self-reported left side users, however, used the phone only slightly more on the left (53.3%) than the right (46.7%) side. Recorded percentage hands-free use (headset, speaker mode, Bluetooth) increased with increasing self-reported frequency of hands-free device usage. Frequent (≥50% of call time) reported headset or speaker mode use corresponded with 17.1% and 17.2% of total call time, respectively, that was recorded as hands-free use.

DISCUSSION

These results indicate that young people can recall phone use moderately well, with recall depending on the amount of phone use and participants' characteristics. The obtained information can be used to calibrate self-reported mobile use to improve estimation of radiofrequency exposure from mobile phones.

Understanding the psychological precursors of young drivers' willingness to speed and text while driving

This study applied the Prototype Willingness Model (PWM) to investigate the factors that may predict young drivers' (non-intentional) willingness to text while driving, text while stopped, and engage in high and low levels of speeding. In addition, the study sought to assess whether general optimism bias would predict young drivers' willingness to text and speed over and above the PWM. Licenced drivers (N = 183) aged 17-25 years (M = 19.84, SD = 2.30) in Queensland, Australia completed an online survey. Hierarchical multiple regressions revealed that the PWM was effective in explaining the variance in willingness to perform all four illegal driving behaviours. Particularly, young drivers who possessed favourable attitudes and a positive prototype perception towards these behaviours were more willing to engage in texting and speeding. In contrast to the study's predictions, optimistically biased beliefs decreased young drivers' willingness to text while stopped and engage in high and low levels of speeding. The findings of the study may help inform policy and educational campaigns to better target risky driving behaviours by considering the influence of attitudes, prototypes and the non-intentional pathway that may lead to engagement in texting while driving and stopped and engagement in high and low levels of speeding.

Mind Your Step: the Effects of Mobile Phone Use on Gaze Behavior in Stair Climbing

Stair walking is a hazardous activity and a common cause of fatal and non-fatal falls. Previous studies have assessed the role of eye movements in stair walking by asking people to repeatedly go up and down stairs in quiet and controlled conditions, while the role of peripheral vision was examined by giving participants specific fixation instructions or working memory tasks. We here extend this research to stair walking in a natural environment with other people present on the stairs and a now common secondary task: using one’s mobile phone. Results show that using the mobile phone strongly draws one’s attention away from the stairs, but that the distribution of gaze locations away from the phone is little influenced by using one’s phone. Phone use also increased the time needed to walk the stairs, but handrail use remained low. These results indicate that limited foveal vision suffices for adequate stair walking in normal environments, but that mobile phone use has a strong influence on attention, which may pose problems when unexpected obstacles are encountered.

The Effect of Electromagnetic Radiation due to Mobile Phone Use on Thyroid Function in Medical Students Studying in a Medical College in South India

BACKGROUND

Enormous increase in mobile phone use throughout the world raises widespread concerns about its possible detrimental effect on human health. Radiofrequency waves are emitted by cell phones. They are non-ionising and the effect on the thyroid gland is part of their non thermal effects. The thyroid gland may be particularly vulnerable to this effect because of its normal anatomical position.

MATERIALS AND METHODS

The study was done to explore the association between radiation exposure and thyroid dysfunction among mobile phone users. It had an exploratory design and unit survey method to collect information from all medical students in a medical college in South India. Inclusion criteria included active use of mobile phone prior to and during the study period. Criteria for exclusion was presence of pre-existsting thyroid disease,thyroid nodule,thyroid goitre/nodule and altered thyroid function.

RESULTS

The sample size was 83 undergraduate students. 71% of respondents had no family history of thyroid illness. Among the remainder,20.5% had a first degree relative with thyroid dysfunction,8.4% had a second degree relative affected. Clinical examination revealed that 79.5% of the respondents were normal,13.6% had thyroid swelling,3.6% had symptoms of thyroid dysfunction and 3.6% had both thyroid swelling and symptoms of thyroid dysfunction. 53% of the respondents spent 0.5 hrs on an average talking on the phone daily,28.9% spent 1.5 hrs daily and 10.8% of respondents spent over 3.5 hours. We found there was a significant correlation between total radiation exposure and an increase in TSH among both groups -in those with and without family history of thyroid illness.

CONCLUSION

In our study there was a significant correlation between total radiation exposure and increasing TSH values among both all respondents.

Comments on "Association of excessive mobile phone use during pregnancy with birth weight: an adjunct study in Kumamoto of Japan Environment and Children's Study"

We have read with interest the article by Lu et al. entitled “Association of excessive mobile phone use during pregnancy with birth weight: an adjunct study in Kumamoto of Japan Environment and Children’s Study” published recently in the Environmental Health and Preventive Medicine. Although this paper addresses a very challenging issue, it has some shortcomings. Mortazavi et al. have previously studied the effects of ionizing and non-ionizing radiation on birth weight of newborns and found no statistical significant differences between the mean weight of newborns whose mothers had been exposed to electromagnetic fields (EMF) generated by mobile phones and those of non-exposed mothers. The study performed by Lu et al. cannot answer this very key question that whether ordinary use of mobile phone during pregnancy can lead to low birth weight. The origin of the controversy between the findings of these two studies and the shortcomings of the article by Lu et al. are discussed.

Use of mobile and cordless phones and change in cognitive function: a prospective cohort analysis of Australian primary school children

BACKGROUND

Some previous studies have suggested an association between children's use of mobile phones (MPs)/cordless phones (CPs) and development of cognitive function. We evaluated possible longitudinal associations between the use of MPs and CPs in a cohort of primary school children and effects on their cognitive function.

METHODS

Data on children's socio-demographics, use of MPs and CPs, and cognitive function were collected at baseline (2010-2012) and follow-up (2012-2013). Cognitive outcomes were evaluated with the CogHealth™ test battery and Stroop Color-Word test. The change in the number of MP/CP voice calls weekly from baseline to follow-up was dichotomized: "an increase in calls" or a "decrease/no change in calls". Multiple linear regression analyses, adjusting for confounders and clustering by school, were performed to evaluate the associations between the change in cognitive outcomes and change in MP and CP exposures.

RESULTS

Of 412 children, a larger proportion of them used a CP (76% at baseline and follow-up), compared to a MP (31% at baseline and 43% at follow-up). Of 26 comparisons of changes in cognitive outcomes, four demonstrated significant associations. The increase in MP usage was associated with larger reduction in response time for response inhibition, smaller reduction in the number of total errors for spatial problem solving and larger increase in response time for a Stroop interference task. Except for the smaller reduction in detection task accuracy, the increase in CP usage had no effect on the changes in cognitive outcomes.

CONCLUSION

Our study shows that a larger proportion of children used CPs compared to MPs. We found limited evidence that change in the use of MPs or CPs in primary school children was associated with change in cognitive function.

Mobile phone use among motorcyclists and electric bike riders: A case study of Hanoi, Vietnam

Motorcyclist injuries and fatalities are a major concern of many developing countries. In Vietnam, motorcycles are involved in more than 70% of all road traffic crashes. This paper aims to explore the prevalence and factors associated with mobile phone use among motorcyclists and electric bike riders, using a case study of Hanoi, Vietnam. A cross-sectional observation survey was undertaken at 12 sites, in which each site was surveyed during a two-hour peak period from 16:30 to 18:30 for two weekdays and one weekend day. A total of 26,360 riders were observed, consisting of 24,759 motorcyclists and 1601 electric bike riders. The overall prevalence of mobile phone use while riding was 8.4% (95% CI: 8.06-8.74%) with calling having higher prevalence than screen operation: 4.64% (95% CI: 4.39-4.90%) vs. 3.76% (95% CI: 3.52-3.99%) respectively. Moreover, the prevalence of mobile phone use was higher among motorcyclists than electric bike riders: 8.66% (95%CI: 8.30-9.01%) vs. 4.43% (95% CI: 3.40-5.47%) respectively. Logistic regression analyses revealed that mobile phone use while riding was associated with vehicle type, age, gender, riding alone, weather, day of week, proximity to city centre, number of lanes, separate car lanes, red traffic light duration, and police presence. Combining greater enforcement of existing legislations with extensive education and publicity programs is recommended to reduce potential deaths and injuries related to the use of mobile phones while riding.

Memory performance, wireless communication and exposure to radiofrequency electromagnetic fields: A prospective cohort study in adolescents

BACKGROUND

The aim of this study is to investigate whether memory performance in adolescents is affected by radiofrequency electromagnetic fields (RF-EMF) from wireless device use or by the wireless device use itself due to non-radiation related factors in that context.

METHODS

We conducted a prospective cohort study with 439 adolescents. Verbal and figural memory tasks at baseline and after one year were completed using a standardized, computerized cognitive test battery. Use of wireless devices was inquired by questionnaire and operator recorded mobile phone use data was obtained for a subgroup of 234 adolescents. RF-EMF dose measures considering various factors affecting RF-EMF exposure were computed for the brain and the whole body. Data were analysed using a longitudinal approach, to investigate whether cumulative exposure over one year was related to changes in memory performance. All analyses were adjusted for relevant confounders.

RESULTS

The kappa coefficients between cumulative mobile phone call duration and RF-EMF brain and whole body dose were 0.62 and 0.67, respectively for the whole sample and 0.48 and 0.28, respectively for the sample with operator data. In linear exposure-response models an interquartile increase in cumulative operator recorded mobile phone call duration was associated with a decrease in figural memory performance score by -0.15 (95% CI: -0.33, 0.03) units. For cumulative RF-EMF brain and whole body dose corresponding decreases in figural memory scores were -0.26 (95% CI: -0.42, -0.10) and -0.40 (95% CI: -0.79, -0.01), respectively. No exposure-response associations were observed for sending text messages and duration of gaming, which produces tiny RF-EMF emissions.

CONCLUSIONS

A change in memory performance over one year was negatively associated with cumulative duration of wireless phone use and more strongly with RF-EMF dose. This may indicate that RF-EMF exposure affects memory performance.

Problematic mobile phone use of Swiss adolescents: is it linked with mental health or behaviour?

OBJECTIVES

To investigate the associations between problematic mobile phone use and mental health and behavioural problems in 412 Swiss adolescents owning a mobile phone while controlling for amount of mobile phone use.

METHODS

Problematic mobile phone use was determined by the MPPUS-10 (Mobile Phone Problem Use Scale) and related to health and behavioural problems by means of multivariable regression modelling.

RESULTS

MPPUS-10 was 4.7 (95 % CI 1.8, 7.6) units higher in girls than in boys, increased significantly with age and was significantly decreased with increasing educational level of the parents. Furthermore, problematic mobile phone use was associated with impaired psychological well-being, impaired parent and school relationships and more behavioural problems but was not related to peer support and social acceptance.

CONCLUSIONS

Our study indicates that problematic mobile phone use is associated with external factors such as worse home and school environment and internal factors such as impaired mental health and behavioural problems of the adolescents and thus problematic mobile phone use should be addressed, in particular when dealing with adolescents showing behavioural or emotional problems.

Epidemiological characteristics of mobile phone ownership and use in korean children and adolescents

OBJECTIVES

As public concern on possible harmful effects of mobile phone in children has been raised, information of epidemiological characteristics of mobile phone use in children and adolescents will be essential for public health policy.

METHODS

Using three databases (n=21,693) collected from 2008 to 2011, we examined characteristics of mobile phone ownership and use, and socioeconomic positions (SEP) in Korean children and adolescents.

RESULTS

The ownership rate and the amount of mobile phone use were higher in females than males, in higher school grades than lower grades, and at 2011 than 2008. The average age of first mobile phone ownership was shown to decrease from 12.5 years in currently high school students to 8.4 years in currently elementary school students at 2011. More than 90% of children in the 5th grade owned a mobile phone. More children owned a mobile phone in lower SEP communities than in higher SEP. Children with parents educated less than those with parents educated more were more likely to own and use mobile phone.

CONCLUSIONS

Considering the epidemiological characteristics of mobile phone use, precautionary measures to prevent unnecessary exposure to mobile phones are needed in children and adolescents.