Strävan efter digitalt välbefinnande : En studie om hur anpassning, uppmuntran och synliggörande främjar digitalt välbefinnande i Digital Self-Control Tools

Sociala medier (SM) har blivit en central del i många människors vardagliga liv där applikationer som Instagram, TikTok och Snapchat, lockar många användare genom bland annat kommunikation, underhållning, och rekommendationer. Den stora användningen av SM bidrar till att det kan finnas ett konstant behov av att vilja vara uppkopplad, vilket resulterat i ett vanebeteende många användare har svårt att styra över. Överanvändning av SM kan leda till allvarliga hälsoproblem som trötthet, frustration, ångest, stress och depression.  För att främja digitalt välbefinnande bland användare har flera Digital Self-Control Tools (DSCT) designats, med målet att stödja användare att kontrollera deras SM användning. Trots att det finns flera hundra nedladdningsbara applikationer är det en utmaning att engagera användarna till att inte överge verktygen. Studien ämnar utforska vad designers kan ta i beaktande vid utformande av verktyg för att upprätthålla ett digitalt välbefinnande. Detta besvaras genom att studien utforskar hur användare upplever restriktiva och icke-begränsande DSCTs i relation till deras användande av SM. Respektive verktyg implementerades i deltagarnas telefoner och deras upplevelser inhämtades genom semistrukturerade intervjuer och dagboksundersökning. Studien identifierade tre teman designers kan ta i beaktande när DSCTs designas. Dessa tre teman är “Anpassa DSCTs utifrån typ av användning”, “Uppmuntra användandet av DSCTs” och “Synliggör användarvanor med hjälp av DSCTs”. Social media (SM) has become a central part of many people's daily lives, where applications such as Instagram, TikTok, and Snapchat attract users through communication, entertainment, and recommendations. The extensive use of SM can contribute to a constant need among users to stay connected, resulting in habitual behavior, that users struggle to control. Overuse of SM can lead to serious health problems such as fatigue, frustration, anxiety, stress, and depression. To promote digital well-being among users, several Digital Self-Control Tools (DSCTs) have been designed with the goal of supporting users in controlling their SM usage. Despite the availability of hundreds of downloadable applications, engaging users to not abandon these tools is a challenge. This study aims to explore what designers can consider when designing tools to maintain digital wellbeing. This is addressed by investigating how users experience restrictive and non-restrictive DSCTs in relation to their use of SM. Each tool was implemented on participants' phones, and their experiences were collected through semi-structured interviews and diary studies. The study identified three themes that designers can consider when designing DSCTs. These three themes are "Customizing DSCTs determined by type of use," "Encouraging the use of DSCTs," and "Visualizing user habits using DSCTs.

A prospective study of growth and rupture risk of small-to-moderate size ascending aortic aneurysms

ObjectiveThe natural history of small-to-moderate size ascending aortic aneurysms is poorly understood. To follow these patients better, we have developed a method to objectively and reproducibly measure ascending aortic volume on the basis of gated contrast computed tomography scans.MethodsFrom 2009 to 2011, 507 patients were referred for management of ascending aortic aneurysms. A total of 232 patients (46%) with small-to-moderate size aneurysms who did not have compelling indications for operation had measurement(s) of ascending aortic and total aortic volume; 166 patients had more than 1 scan, allowing measurement of growth. A total of 66 patients admitted to the emergency department without ascending aortic pathology served as a reference group.ResultsNone of the patients experienced rupture, dissection, or death; 3 patients ultimately underwent operation. Ascending aortic volume and volume/total aortic volume differed for the surveillance and reference groups: 132.8 ± 39.4 mL versus 78.0 ± 24.5 mL; 38.3% ± 7.4% versus 29.1% ± 3.9%, respectively (both P < .001). Diameters at the sinotubular junction and mid-ascending aortic were 4.1 ± 0.6 cm and 4.4 ± 0.6 cm, respectively, for the surveillance group and 3.0 ± 0.4 cm and 3.2 ± 0.4 cm, respectively, for controls. The increase in ascending aortic volume was 0.95 ± 4.5 mL/year and 0.73% ± 3.7%/year (P = .007 and .012, respectively). Analysis of risk factors for ascending aortic growth revealed only the use of antithrombotic medication as possibly significant.ConclusionsComputed tomography volume measurements provide an objective method for ascertaining aortic size and monitoring expansion. Patients with small-to-moderate ascending aortic aneurysms who are carefully followed and managed appropriately have slow aneurysm growth and a small risk of rupture or dissection. Annual computed tomography screening may not be indicated, and elective resection—absent other surgical indications—is not necessary. The rupture/dissection risk for even larger aneurysms in carefully followed patients may be lower than currently believed

Endovascular coil embolization of segmental arteries prevents paraplegia after subsequent thoracoabdominal aneurysm repair: An experimental model

ObjectivesTo test a strategy for minimizing ischemic spinal cord injury after extensive thoracoabdominal aneurysm (TAAA) repair, we occluded a small number of segmental arteries (SAs) endovascularly 1 week before simulated aneurysm repair in an experimental model.MethodsThirty juvenile Yorkshire pigs (25.2 ± 1.7 kg) were randomized into 3 groups. All SAs, both intercostal and lumbar, were killed by a combination of surgical ligation of the lumbar SAs and occlusion of intercostal SAs with thoracic endovascular stent grafting. Seven to 10 days before this simulated TAAA replacement, SAs in the lower thoracic/upper lumbar region were occluded using embolization coils: 1.5 ± 0.5 SAs in group 1 (T13/L1), and 4.5 ± 0.5 SAs in group 2 (T11-L3). No SAs were coiled in the controls. Hind limb function was evaluated blindly from daily videotapes using a modified Tarlov score (0 = paraplegia, 9 = full recovery). After death, each segment of spinal cord was graded histologically using the 9-point Kleinman score (0 = normal, 8 = complete necrosis).ResultsHind limb function remained normal after coil embolization. After simulated TAAA repair, paraplegia occurred in 6 of 10 control pigs, but in only 2 of 10 pigs in group 1; no pigs in group 2 had a spinal cord injury. Tarlov scores were significantly better in group 2 (control vs group 1, P = .06; control vs group 2, P = .0002; group 1 vs group 2, P = .05). A dramatic reduction in histologic damage, most prominently in the coiled region, was seen when SAs were embolized before simulated TAAA repair.ConclusionsEndovascular coiling of 2 to 4 SAs prevented paraplegia in an experimental model of extensive hybrid TAAA repair, and helped protect the spinal cord from ischemic histopathologic injury. A clinical trial in a selected patient population at high risk for postoperative spinal cord injury may be appropriate