The Effect of Smartphone Use and Nomophobia on Sleep Quality and Daytime Sleepiness in Turkey

Abstract Background Smartphones used unconsciously and in an uncontrolled manner make young people experience sleep problems. This study aimed to investigate the effects of university students’ smartphone addiction and nomophobia levels on sleep quality and excessive daytime sleepiness. Methods This study, which had a cross-sectional design, was conducted with 390 people who were first-year and senior students at Inonu University between November and December 2019. The Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Nomophobia Scale, and Smartphone Addiction Scale were used in the present study used. For statistical analysis, the chi-squared test, the Student’s t-test, one-way ANOVA, Spearman’s rank correlation coefficient and binomial logistic regression analysis were used. The research has ethics committee approval.The error level was chosen as p = 0.05. Results The smartphone use time of the students was finded to be 5.4±2.6 years, daily online time was 4.3±2.6 hours, and daily sleep time was 7.4±1.5 hours. The students received 78.3±25.8 points from the Nomophobia Scale, 90.3±29.7 from the Smartphone Addiction Scale, 7.2±2.8 from the Pittsburgh Sleep Quality Index, and 5.9±4.1 points from the Epworth Sleepiness Scale. A total of 54.4% of students had moderate, and 22.8% had severe nomophobic symptoms; 83.6% of the group had poor sleep quality, and 14.6% had excessive daytime sleepiness. A positive, moderate and significant relation was detected between the mean Nomophobia score and the mean Smartphone Addiction Scale score. It was also determined that those with less than 30 minutes of smartphone use before sleeping had low nomophobia, smartphone addiction and daytime sleepiness scores, and better sleep quality. Conclusions Nomophobic symptoms and smartphone addiction were observed to be high in university students. Most students had poor sleep quality. The awareness of students on healthy sleep, and conscious and controlled smartphone use should be increased. Key messages • Smartphone addiction increases the level of nomophobia moderately in university students. • Those who use a smartphone less than 30 minutes before going to sleep have better sleep quality and lower daytime sleepiness.


Background:
Since heart transplantation (HTx) has become the gold standard therapy in end-staged heart failure, many factors, including metabolic syndrome (MS), represent a burden in HTx patients. Considering key role of immunosuppressive therapy and its side effects on the appearance of MS, we focused on modifiable factors including adherence to Mediterranean Diet (MD) and improvement of dietary habits. Methods: 21 heart-transplanted patients were enrolled and randomized in a control group (CG; N 10) and an intervention group (IG; N 11). During two meetings (baseline, 6-month follow-up) were administered a validated Food Frequency Questionnaire (FFQ), to assess adherence to MD, and collected clinical and anthropometric parameters, IG were additionally requested to fill a food diary. IG received personalized advices, CG received standard recommendations. Comparison between IG and CG were analyzed, differences into the IG were also assessed.

Conclusions:
Dietary intervention based on MD perhaps can improve MS risks in heart-transplanted patients. Further investigations may be needed to assess the fundamental role of a structured nutritional follow-up in these patients.

Key messages:
Personalized nutritional advices based on the MD, compared to general recommendation, can significantly improve health and quality of life in heart-transplanted patients.
A structured nutritional follow-up for heart-transplanted patients may be desirable to prevent risks of Metabolic Syndrome as a public health instrument in selected categories as these patients.  -4,9) in the hospice group compared to the control. Family caregiver burden was 4,6 points better in the hospice group (95% CI: -0,26 -9.3). Mean treatment costs, including direct medical costs and out-of-pocket expenditures over 14 days were $31 lower for the hospice group (95% CI: $29 -$32). There was a significant correlation between the total cost of treatment and patients' quality of life (rxy = 0,58; p < 0,01). The cost-effectiveness plane graphically represents 10,000 replications, 85% of them showed that hospice care has better outcomes and lower costs than the control group. A positive, moderate and significant relation was detected between the mean Nomophobia score and the mean Smartphone Addiction Scale score. It was also determined that those with less than 30 minutes of smartphone use before sleeping had low nomophobia, smartphone addiction and daytime sleepiness scores, and better sleep quality.

Conclusions:
Nomophobic symptoms and smartphone addiction were observed to be high in university students. Most students had poor sleep quality. The awareness of students on healthy sleep, and conscious and controlled smartphone use should be increased.

Key messages:
Smartphone addiction increases the level of nomophobia moderately in university students. Those who use a smartphone less than 30 minutes before going to sleep have better sleep quality and lower daytime sleepiness.

Issue/problem:
The United Kingdom (UK) hosts c.136,000 refugees and last year received the most asylum applications in two decades. Despite this, expertise in migrant health is not widespread in general practice, with few comprehensive toolkits available to support crucial initial health assessments of new arrivals.

Description of the problem:
A large influx of Afghan refugees entered the UK in autumn 2021. In London, primary care practitioners quickly identified a lack of readily accessible, comprehensive guidance to support them in conducting health assessments for arrivals with a complex range of needs. This was compounded by many in primary care having little or no experience of migrant health.

Results:
To address this gap in advice on conducting initial health assessments, a bespoke toolkit was created. The toolkit consolidated advice from a range of partners and resources: the UK Afghan migrant health guide, clinicians with humanitarian experience, front-line practitioners, Doctors of the World, and those leading on the health and public health response. The toolkit ensured greater consistency in the nature and content of assessments, considered not only primary needs but also broader wellbeing, and was responsive to both anticipated and known health priorities.

Lessons:
The initial health assessment toolkit for Afghan migrants was well received by frontline staff and has implications for international practice in other areas providing similar health support. The toolkit and associated supporting information has formed a template that can be rapidly adapted to suit emerging needs, as has been done for new arrivals from Ukraine. This work has fed into best practice by the UK National Asylum Steering Group and is to be a case study for a WHO project on country-specific health assessments.

Key messages:
The toolkit is a proof of concept for partnership working towards holistic initial health assessments of new migrants in primary care, bringing together best evidence and pragmatic practice. This work has implications for other countries experiencing similar trends in migration and providing health support to an increasing number of new refugees.

Background:
The last two decades saw an extensive effort to design and implement integrated and multidimensional healthcare evaluation systems in high-income countries. However, in low/ middle-income countries, few experiences of such systems implementation have been reported in the scientific literature. We developed and piloted an innovative tool to assess the performance of health services provision for communicable diseases in three African countries.

Methods:
A total of 42 indicators, 14 per each communicable disease care pathway (Tuberculosis, Gastroenteritis, and HIV/AIDS), were developed. A sub-set of 23 indicators was included in the evaluation process. The indicators assessed four care phases: prevention, diagnosis, treatment, and outcome. All indicators were calculated for the period 2017-2019, while performance evaluation was performed for 2019. The analysis involved four health districts and their relative hospitals in Ethiopia, Tanzania, and Uganda. Results: Substantial variability was observed over time and across the four different districts. In the TB pathway, the majority of indicators scored below the standards and below-average performance was mainly reported for prevention and diagnosis