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The aim of this study is to evaluate the differences between residents and visitors in their attitudes and behaviours towards sustainable tourism. The study examines the validity of the 21-item ver...

People around the world spend hours of their daily lives using smartphones; therefore, it is important to conduct cross-cultural research on the effects of smartphone use on health and well-being a...

Los usuarios de Internet frecuentemente experimentan problemas relacionados con su uso de Internet y, aunque la cultura tiene una influencia importante en la forma en que las personas se comunican, en lo que valoran y, por lo tanto, en cómo utilizan Internet, las publicaciones sobre investigación intercultural del uso problemático de Internet son escasas. La herramienta más común para medir dicho uso, el Internet Addiction Test (IAT), se ha utilizado en varios países, por lo que en este estudio comparamos los resultados interculturales de las investigaciones más recientes sobre el análisis factorial del IAT. Encontramos que, en países con dos o más estudios, los resultados a menudo se replican, lo que sugiere que el contexto cultural influye en los comportamientos en Internet. Luego realizamos nuestros propios estudios de análisis factorial del IAT en tres países (España, EE. UU y Colombia) con 1,273 participantes. Al comparar nuestros resultados con los de estudios previos en esos países, encontramos que nuestros resultados también fueron similares a los de estudios anteriores. El hallazgo más notable fue que todos los análisis factoriales de IAT que realizamos y los anteriores en las mismas regiones contenían un factor relacionado con los problemas de gestión del tiempo y otro factor relacionado con problemas emocionales/psicologicos, lo que sugiere que el control de impulsos y las necesidades emocionales no satisfechas son componentes importantes en el desarrollo del uso problemático de Internet en todo el mundo. La investigación futura sobre el uso problemático de Internet debería centrarse en estos aspectos. Internet users worldwide often experience problems related to their Internet use, and although culture has an important influence over how people communicate, what they value, and therefore how they use the Internet, little cross-cultural research on the subject of problematic Internet use has been carried out. The Internet Addiction Test (IAT), the most common measurement tool for this purpose, has been used in various countries. In this study we compared and analyzed the cross-cultural results found in the most recent research on the IAT factor analysis. We found that in countries with two or more studies, results are often replicated, suggesting that cultural context influences Internet behaviors. We conducted our own IAT factor analysis studies in three countries - Spain, USA, and Colombia - with a total of 1,273 participants. We compared our results with those from previous studies in the same countries and found similar results. The most notable finding was that all the IAT factor analyses, both ours and the previous ones in the same regions, contained a factor related to loss of control/time management problems and another factor related to emotional/psychological problems, thereby suggesting that impulse control problems and unfulfilled emotional needs are the most important components in the development of problematic Internet use in various countries around the world. Future research on problematic Internet use should focus on these aspects.

Introduction The amount of people who survive a stroke is increasing annually. Persons with stroke suffer neurological deficits and a physical deconditioning that compromise walking ability, basic activities of daily living and health-related quality of life (HRQoL). The aim of the study was to determine the effects of a 12-week multimodal low–moderate intensity exercise rehabilitation program on walking speed, walking endurance and adherence to physical activity. Material and methods An observational repeated-measures design was used. The intervention consisted of 24 sessions of 1 hour per session two alternative days a week. A total of 31 participants were recruited and were evaluated at baseline, post-intervention and at six months follow up. Results Twenty-five participants completed the rehabilitation program. Significant improvements were found at the end of the intervention and those were maintained at six months on walking speed (10MWT *p ≤ 0.004), walking endurance (6MWT **p ≤ 0.000) and adherence (walking min/day **p ≤ 0.000). Participants reported an overall satisfaction with the rehabilitation program of 94%: fitness, walking capacity, balance, accomplished expectations, satisfaction with the rehabilitation program, satisfaction with self-efficacy, learned strategies to improve QoL, adequate timing and would recommend the low–moderate intensity exercise rehabilitation program. Conclusions Promoting low–moderate intensity physical activity may be an interesting rehabilitation strategy for stroke survivors.

Objective To assess depression in a sample of individuals with spinal cord injury (SCI) living in the community, and to determine the prevalence of probable major depressive disorder (PMDD) among those with traumatic spinal cord injury (T-SCI) and those with nontraumatic spinal cord injury (NT-SCI). Design Cross-sectional. Setting Data were collected on individuals with SCI now living in the community, who completed a comprehensive follow-up assessment at the hospital. Participants Individuals with T-SCI or NT-SCI (N=831) completed the Patient Health Questionnaire-9 (PHQ-9) and were included. Interventions Not applicable. Main Outcome Measure The PHQ-9 was used to detect the presence of PMDD and to measure the severity of the depression. Results The most frequent etiology of SCI was T-SCI (66.9%). Overall, 16.2% of participants met the criteria for PMDD; however, a higher prevalence was noted for individuals with NT-SCI (21.1%) than for individuals with T-SCI (13.8%). Risk factors between T-SCI and NT-SCI did not differ greatly. Female sex, chronic pain, and lower levels of/difficulties in participation were associated with the presence of PMDD. Conclusions PMDD appears to occur at a higher rate in individuals with NT-SCI, with greater symptom severity. The finding that problems with participation are directly associated with depression raises the need for specific treatment goals, with the aim of empowering individuals with SCI to reintegrate into the community. Potential stress factors (eg, environmental barriers, limited participation options) should be addressed accordingly.

Casual videogames (CVGs), played on smartphones, are becoming increasingly popular, especially among females and adults. Whereas the addictive potential of online (computer) videogames is well-established, there is yet insufficient evidence for Internet gaming disorder (IGD) in mobile gamers and for the mediating role of some mechanisms involved. The aim of this study is to investigate the impact of the frustration of psychological needs on mobile videogamers&rsquo, addictive behavior as well as the role of cognitions (game-use expectancies) and behaviors (time spent playing) through a hypothesized serial mediation model, while controlling for important correlates, such as game genre, age, gender and payment during play. A total of 471 mobile game users (211 males) with an average age of 21.73 replied to an online survey containing sociodemographic and game variables, the Need Satisfaction and Frustration Scale (NSFS), the Internet Gaming Disorder Scale-Short Form (IGDS9-SF) and a slightly modified version of the Internet Use Expectancies Scale (IUES). The results corroborate the negative effects of need frustration on IGD among mobile gamers and clarify the role of time spent playing and game-use expectancies in the development of IGD, highlighting the important role of cognitions in this relationship. We conclude that both the time spent playing and game-use expectancies should be important targets for clinical interventions, even though they are not included in the diagnostic criteria.

It has been more than a decade since a concern about the addictive use of the Internet and mobile phones was first expressed, and its possible inclusion into the lists of mental disorders has recently become a popular topic of scientific discussion. Thus, it seems to be a fitting moment to investigate the prevalence of this issue over time. The aim of the present study was to analyze the prevalence of the perception of problematic Internet and smartphone use in young people over the period 2006–2017. To this end, a questionnaire on Internet use habits and two questionnaires on the negative consequences of Internet and smartphone use were administered to a sample of 792 university students. The scores were then compared with the results of former studies that had used these questionnaires. The perception of problematic Internet and mobile phone use has increased over the last decade, social networks are considered responsible for this increase, and females are perceived to be more affected than males. The current study shows how strong smartphone and Internet addiction and social media overlap. Participants from 2017 report higher negative consequences of both Internet and mobile phone use than those from 2006, but long-term observations show a decrease in problematic use after a sharp increase in 2013. We conclude that the diagnosis of technological addictions is influenced by both time and social and culture changes.

It has been more than a decade since a concern about the addictive use of the Internet and mobile phones was first expressed, and its possible inclusion into the lists of mental disorders has recently become a popular topic of scientific discussion. Thus, it seems to be a fitting moment to investigate the prevalence of this issue over time. The aim of the present study was to analyze the prevalence of the perception of problematic Internet and smartphone use in young people over the period 2006–2017. To this end, a questionnaire on Internet use habits and two questionnaires on the negative consequences of Internet and smartphone use were administered to a sample of 792 university students. The scores were then compared with the results of former studies that had used these questionnaires. The perception of problematic Internet and mobile phone use has increased over the last decade, social networks are considered responsible for this increase, and females are perceived to be more affected than males. The current study shows how strong smartphone and Internet addiction and social media overlap. Participants from 2017 report higher negative consequences of both Internet and mobile phone use than those from 2006, but long-term observations show a decrease in problematic use after a sharp increase in 2013. We conclude that the diagnosis of technological addictions is influenced by both time and social and culture changes.

Passion represents one of the factors involved in online video gaming. However, it remains unclear how passion affects the way gamers are involved in massively multiplayer online role-playing games (MMORPGs). The objective of the present study was to analyze the relationships between passions and motivations for online game playing. A total of 410 MMORPG players completed an online questionnaire including motives for gaming and the Passion Scale. Results indicated that passionate gamers were interested in relating with others through the game and exhibited a high degree of interest in discovery of the game, gaining leadership and prestige but little interest in escape from reality. However, some differences were observed with respect to the role of the two types of passion in the different types of motivation. Specifically, harmonious passion (HP) predicted higher levels of exploration, socialization, and achievement, in that order, while obsessive passion (OP) predicted higher levels of dissociation, achievement, and socialization. The present findings suggest that HP and OP predict different ways of engaging in MMORPGs and confirm that passion is a useful construct to help understand different motivational patterns demonstrated by MMORPG players.

Cross-sectional validation study.To adapt the Spinal Cord Lesion-related Coping Strategies Questionnaire into the Spanish language (SCL CSQ-S) and to examine the relationship between coping strategies, global quality of life and psychological adaptation.Data were collected through individuals with spinal cord injury (SCI) now living in the community who completed their routine follow-up assessment at the Institute Guttmann in Barcelona, Spain.Forward and backward translation into Spanish of the English version of the questionnaire. Questionnaires of global Quality of Life, Community Integration, Coping, Depression, Anxiety and Functional Independence were administered to 349 adults with paraplegia and 162 adults with tetraplegia. Statistical analysis included confirmatory factor analysis and regression analysis.The factorial structure of the questionnaire was partly verified. The original correlated, three-factor model sufficiently fit the data obtained in this study: χ(2)(48)=109.46; P0.001; Comparative Fit Index=0.96; Tucker-Lewis Index=0.96; Root Mean Square Error of Approximation=0.050 (0.038-0.062); Akaike information criterion=13.46. Items were found to be good indicators of their respective latent factors, showing adequate factorial charge ranges (between 0.41 and 0.75). The reliability coefficient (Cronbach's α) for the Acceptance subscale was 0.74, for Social reliance 0.76 and for Fighting spirit 0.69. Coping strategies as measured by SCL-CSQ-S contributed to the prediction of outcomes related to adaptation to disability.The results of the study show some evidence for the robustness of the structure of SCL CSQ-S and show that the Spanish version of the questionnaire largely replicate previous results. Coping strategies, especially Acceptance, are related to adaptation to injury.

The aim of this study was to determine the effectiveness of a 12-week multimodal exercise rehabilitation program on walking speed, walking ability and activities of daily living (ADLs) among people who had suffered a stroke. Thirty-one stroke survivors who had completed a conventional rehabilitation program voluntarily participated in the study. Twenty-six participants completed the multimodal exercise rehabilitation program (2 days/wk, 1 hr/session). Physical outcome measures were: walking speed (10-m walking test), walking ability (6-min walking test and functional ambulation classification) and ADLs (Barthel Index). The program consisted on: aerobic exercise; task oriented exercises; balance and postural tonic activities; and stretching. Participants also followed a program of progressive ambulation at home. They were evaluated at baseline, postintervention and at the end of a 6-month follow-up period. After the intervention there were significant improvements in all outcomes measures that were maintained 6 months later. Comfortable and fast walking speed increased an average of 0.16 and 0.40 m/sec, respectively. The walking distance in the 6-min walking test increased an average of 59.8 m. At the end of the intervention, participants had achieved independent ambulation both indoors and outdoors. In ADLs, 40% were independent at baseline vs. 64% at the end of the intervention. Our study demonstrates that a multimodal exercise rehabilitation program adapted to stroke survivors has benefits on walking speed, walking ability and independence in ADLs.

Fear of missing out (FoMO) is described as a pervasive, unpleasant sensation that others might be having rewarding experiences of which one is not part, as well as the desire to stay continually connected with what others are doing. It has been shown to play an important mediating role in predicting negative outcomes of heavy use of social networks. The aim of the present study was to analyze the different profiles found among users. 5,280 Spanish speaking social media users from Latin America replied via an online survey to the Spanish version of the FoMO scale, as well as to a short set of questionnaires on online social network use (frequency, intensity and type of access) and indicators of mobile phone addiction. FoMO correlated with the number of different networks used and with all indicators of social network use and mobile phone addiction. Using a Latent Profile Analysis, four classes of users were identified: low-engagement light users, high-engagement heavy users, high-engagement low-risk users, and high-engagement high-risk users; individuals from the fourth class (7.6 % of the sample) can be considered at risk of developing addiction to online social networks. Accessing social networks via the mobile phone and presenting addictive behavior seem to be important correlates of FoMO. La por de perdre’s alguna cosa (fear of missing out, FoMO) es descriu com una sensació aguda i desagradable que altres podrien estar tenint experiències gratificants dels quals un no és part, així com el desig de mantenir- se en contacte contínuament amb el que altres estan fent. S’ha demostrat que té un paper mediador important en la predicció dels resultats negatius de l’ús intensiu de les xarxes socials. L’objectiu del present estudi va ser analitzar els diferents perfils que es troben entre els usuaris. 5.280 usuaris de xarxes socials online d’Amèrica Llatina castellanoparlants van respondre a través d’una enquesta en línia a la versió espanyola de l’escala FoMO, així com a una sèrie de qüestionaris curts sobre l’ús en línia de xarxes socials (freqüència, intensitat i tipus d’accés) i a indicadors d’addicció al telèfon mòbil. Es va trobar que FoMO correlaciona amb el nombre de diferents xarxes socials que s’utilitzen, amb tots els indicadors d’ús de xarxes socials, i amb l’addicció al telèfon mòbil. Mitjançant una Anàlisi de Perfils Latents es van identificar quatre classes d’usuaris: usuaris amb us moderat i compromís baix, usuaris amb ús fort i compromís fort, usuaris amb ús fort i baix risc, i usuaris amb ús fort i alt risc; els individus de la quarta classe (7,6% de la mostra) poden ser considerats en risc de desenvolupar addicció a les xarxes socials en línia. L’accés a les xarxes socials a través del telèfon mòbil i l’existència d’una conducta addictiva sembla ser correlats importants de FoMO.

Background: The emerging field of Information and Communications Technology (ICT) has brought about new interaction styles. Its excessive use may lead to addictive behaviours. The objective is to determine the prevalence of the problematic use of ICT such as Internet, mobile phones and video games, among adolescents enrolled in mandatory Secondary Education (ESO in Spanish) and to examine associated factors. Methods: Cross sectional, multi-centric descriptive study. Population: 5538 students enrolled in years one to four of ESO at 28 schools in the Vallès Occidental region (Barcelona, Spain). Data collection: self-administered socio-demographic and ICT access questionnaire, and validated questionnaires on experiences related to the use of the Internet, mobile phones and video games (CERI, CERM, CERV). Results: Questionnaires were collected from 5,538 adolescents between the ages of 12 and 20 (77.3 % of the total response), 48.6 % were females. Problematic use of the Internet was observed in 13.6 % of the surveyed individuals; problematic use of mobile phones in 2.4 % and problematic use in video games in 6.2 %. Problematic Internet use was associated with female students, tobacco consumption, a background of binge drinking, the use of cannabis or other drugs, poor academic performance, poor family relationships and an intensive use of the computer. Factors associated with the problematic use of mobile phones were the consumption of other drugs and an intensive use of these devices. Frequent problems with video game use have been associated with male students, the consumption of other drugs, poor academic performance, poor family relationships and an intensive use of these games. Conclusions: This study offers information on the prevalence of addictive behaviours of the Internet, mobile phones and video game use. The problematic use of these ICT devices has been related to the consumption of drugs, poor academic performance and poor family relationships. This intensive use may constitute a risk marker for ICT addiction

Addiction to the Information and Communication Technologies (ICT) has become an important research topic. The aims of the present study were to determine the problematic uses of Internet and cell phones in Spanish teenagers and young students and analyze the predictive capacity of these problematic uses to explain scores on the CERI (Cuestionario de Experiencias Relacionadas con Internet) and CERM (Cuestionario de Ex- periencias Relacionadas con el Movil). Three questionnaires were applied to 1,879 students: a general questionnaire for Internet and cell phone use, one scale for problematic use of Internet (CERI) and one for cell phone (CERM). Cluster analysis yielded a solution involving three groups for both CERI and for CERM: no problems, occasional problems and frequent problems. There were no differences between males and females in Inter- net but there were more females showing frequent problematic use of cell phone. A comparison with nine previous Spanish studies suggests that: a) the amount of time spent connected is not a good indicator of problems deriving from its use; b) the factor that could explain problematic use is al- tered identity communication (AIC), which occurs when users hide or alter their true identity; and c) population survey data alone do not allow to con- firm the existence of a persistent addictive disorder related to ICT.

Each year, accidents involving mountain sports have many repercussions, including alarming public opinion and society. This study outlines the results of a qualitative study on the responses of 135 survivors of accidents that took place while mountaineering, climbing, downhill skiing and ski mountaineering, hiking, cross-country biking, and mountain racing. A content analysis was performed on the textual data obtained from the responses to an online survey. The identified causes were: environmental events, equipment, medical events, behavioral events, and time pressure, but they appear combined in different ways for the analyzed disciplines. Results show that for downhill skiing, direct causes of accidents were mainly behavioral: excessive speed, skiing errors, and fatigue. For ski mountaineering, direct causes were errors in decision-making and skiing. In mountaineering, precursors were unfavorable conditions, fatigue, lack of preparation, and skill errors. In climbing, difficulty is an omnipresent feature, but the precursors are mainly errors. Our results highlight the multi-causal nature of accidents that take place when practicing mountain sports. Finally, we examine the need to promote a mountain sports culture that highlights safety and injury prevention.