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Tuesday, October 10, 2017

Public Health Issue: Epidemics, blame the Smartphone

I resisted buying a smartphone until about two years ago.  All my sons have had them for 10 years or more.  No they did not have them when they were three or four.  My eldest son bought an iPhone when he was 18.  ( I couldn't afford one, with 3 in college.

My first was a prepaid LG which was a month to month...These phones are all cheaply made, with poor screens, inadequate memory and other issues I do not fathom. I found one for $125 with a monthly fee of $45.00 The idea of having a contract appealed less to me than paying  $125 dollars or more for a 'bundled cable/internet/phone service.  

By now my brother had an iPhone, Macbook and iMac.  My son had traded up twice with his iPhone and also a Macbook. Two of my sons are computer scientists . I cautioned them about the technical of DUI (of smartphones).I doubt they listen to me.  It is equivalent to having 2 or 3 alcoholic drinks or having an open bottle in the car.

Suggestions for safer us of your smartphone



The smartphone has insidiously crept into our lives, much like antibiotic resistant bacteria. It can be found in our toilet areas, and other private spaces. No longer do hormonally gifted girls and boys flirt with a wink, they can do it electronically or even more boldly with suggestive photos. How does one use "protection" in such a situation?

Like any opiod it soothes and eases pain and eventually is an addiction. The temptation was too great   I caved, at first trying an iPhone....it was not so great !. I opted for the latest greatest most expensive Galaxy S8+.   Then I perseverated over cases and protectors.!  Another story and not worth explaining here to my entrapped audience.

Along with my own opinions I found several articles written about the subject. Andrew Doan, M.D., PhD in neuroscience and fellow ophthalmologist has done research into video game and internet addiction, discussing the role of endorphin release in users of videogames and the like.

Associated literature (from PubMed)


Tendon rupture associated with excessive smartphone gaming.



Abstract

IMPORTANCE:

Excessive use of smartphones has been associated with injuries.

OBSERVATIONS:

A 29-year-old, right hand-dominant man presented with chronic left thumb pain and loss of active motion from playing a Match-3 puzzle video game on his smartphone all day for 6 to 8 weeks. On physical examination, the left extensor pollicis longus tendon was not palpable, and no tendon motion was noted with wrist tenodesis. The thumb metacarpophalangeal range of motion was 10° to 80°, and thumb interphalangeal range of motion was 30° to 70°. The clinical diagnosis was rupture of the left extensor pollicis longus tendon. The patient subsequently underwent an extensor indicis proprius (1 of 2 tendons that extend the index finger) to extensor pollicis longus tendon transfer. During surgery, rupture of the extensor pollicis longus tendon was seen between the metacarpophalangeal and wrist joints.

CONCLUSIONS AND RELEVANCE:

The potential for video games to reduce pain perception raises clinical and social considerations about excessive use, abuse, and addiction. Future research should consider whether pain reduction is a reason some individuals play video games excessively, manifest addiction, or sustain injuries associated with video gaming.

Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports.

Abstract

Traditional factors that once explained men's sexual difficulties appear insufficient to account for the sharp rise in erectile dysfunction, delayed ejaculation, decreased sexual satisfaction, and diminished libido during partnered sex in men under 40. This review (1) considers data from multiple domains, e.g., clinical, biological (addiction/urology), psychological (sexual conditioning), sociological; and (2) presents a series of clinical reports, all with the aim of proposing a possible direction for future research of this phenomenon. Alterations to the brain's motivational system are explored as a possible etiology underlying pornography-related sexual dysfunctions. This review also considers evidence that Internet pornography's unique properties (limitless novelty, potential for easy escalation to more extreme material, video format, etc.) may be potent enough to condition sexual arousal to aspects of Internet pornography use that do not readily transition to real-life partners, such that sex with desired partners may not register as meeting expectations and arousal declines. Clinical reports suggest that terminating Internet pornography use is sometimes sufficient to reverse negative effects, underscoring the need for extensive investigation using methodologies that have subjects remove the variable of Internet pornography use. In the interim, a simple diagnostic protocol for assessing patients with porn-induced sexual dysfunction is put forth.

Excessive Video Game Use, Sleep Deprivation, and Poor Work Performance Among U.S. Marines Treated in a Military Mental Health Clinic: A Case Series.

Abstract

Excessive use of video games may be associated with sleep deprivation, resulting in poor job performance and atypical mood disorders. Three active duty service members in the U.S. Marine Corps were offered mental health evaluation for sleep disturbance and symptoms of blunted affect, low mood, poor concentration, inability to focus, irritability, and drowsiness. All three patients reported insomnia as their primary complaint. When asked about online video games and sleep hygiene practices, all three patients reported playing video games from 30 hours to more than 60 hours per week in addition to maintaining a 40-hour or more workweek. Our patients endorsed sacrificing sleep to maintain their video gaming schedules without insight into the subsequent sleep deprivation. During the initial interviews, they exhibited blunted affects and depressed moods, but appeared to be activated with enthusiasm and joy when discussing their video gaming with the clinical provider. Our article illustrates the importance of asking about online video gaming in patients presenting with sleep disturbances, poor work performance, and depressive symptoms. Because excessive video gaming is becoming more prevalent worldwide, military mental health providers should ask about video gaming when patients report problems with sleep.
The evidence is strong that persistent use of many types of electronic devices may be addictive and contributory to multiple disorders, even extending to traumatic injury.

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