Phone Access Research Articles

Patterns of usage and preferences of users for tuberculosis-related text messages and voice calls in Uganda.

Little information exists about mobile phone usage or preferences for tuberculosis (TB) related health communications in Uganda. We surveyed household contacts of TB patients in urban Kampala, Uganda, and clinic patients in rural central Uganda. Questions addressed mobile phone access, usage, and preferences for TB-related communications. We collected qualitative data about messaging preferences. We enrolled 145 contacts and 203 clinic attendees. Most contacts (58%) and clinic attendees (75%) owned a mobile phone, while 42% of contacts and 10% of clinic attendees shared one; 94% of contacts and clinic attendees knew how to receive a short messaging service (SMS) message, but only 59% of contacts aged 45 years (vs. 96% of contacts aged <45 years, P = 0.0001) did so. All contacts and 99% of clinic attendees were willing and capable of receiving personal-health communications by SMS. Among contacts, 55% preferred detailed messages disclosing test results, while 45% preferred simple messages requesting a clinic visit to disclose results. Most urban household TB contacts and rural clinic attendees reported having access to a mobile phone and willingness to receive TB-related personal-health communications by voice call or SMS. However, frequent phone sharing and variable messaging abilities and preferences suggest a need to tailor the design and monitoring of mHealth interventions to target recipients.

Characteristics of mobile phone access and usage in rural and urban Guatemala: assessing feasibility of text message reminders to increase childhood immunizations.

Despite efforts to promote vaccination in low- and middle-income countries (LMICs), over 20 million infants remain under-immunized and at risk for unnecessary morbidity and mortality. Mobile health technologies, such as Short Message Service (SMS) texts, have tremendous and untapped potential for disease management. Patient reminder systems are an important mechanism for improving childhood vaccination coverage and can be easily adapted to SMS platforms. However, current research lacks an understanding of the barriers and facilitators to mHealth program design, implementation, and scale in LMICs. We analyzed survey data collected March-November 2016 at the enrollment visit from a randomized controlled trial conducted at public health clinics in urban and rural Guatemala. Participants included eligible infants 6 weeks to 6 months of age receiving the first dose of the primary immunization series. At least one parent needed to own a mobile phone and be capable of deciphering SMS. Chi-square or Fisher's exact and Student's t-test were used to assess significance levels in demographic differences to describe factors that contribute to the feasibility of using an SMS-based vaccination reminder system. Of 1,088 families approached for enrollment, 871 were eligible and 720 (82.7%) participated with equal numbers of urban and rural children enrolled; 54 parents did not own a mobile phone with SMS capability and three parents could not use SMS. There was no significant difference between urban and rural maternal mobile phone ownership (94.4% vs. 93.3%, P=0.53), but more urban fathers owned mobile phones (72.8% vs. 47.1%, P<0.0001) and, overall, more mothers compared to fathers owned mobile phones (93.9% vs. 61.1%, P<0.0001). Most families (90.4%) chose to have reminders sent to the mother. Urban participants reported more mobile phones present in the home (P<0.0001), but rural participants reported more telephone landlines (34.7% vs. 15.6%, P<0.0001). Most participants reported a daily average of ≤5 telephone calls made (87.4%), ≤10 texts sent (91.0%), and ≤10 texts received (89.9%), with urban families reporting greater telephone usage (P=0.006, P<0.001, and P<0.001 respectively). Parents preferred to make calls over sending texts (74.7% vs. 25.3%, P<0.0001), with more urban families preferring text messaging (31.9% vs. 18.6%, P<0.0001). Our study results provide important insight into mobile phone access, usage, and preferences for voice and text communication across rural and urban populations of an LMIC that can be used to inform future mHealth interventions. Our findings suggest that offering a combination of more traditional communication methods with newer, modern technologies may be more effective at reminding families about vaccination visits, particularly for our rural population, and that targeting mothers for mobile phone interventions may provide the greatest benefits. Overall, our study suggests that using SMS reminders in LMICs can be a feasible tool for public health interventions.

Patient-Centered Care Transitions After Injury Hospitalization: A Comparative Effectiveness Trial

Objective: The investigation aimed to compare two approaches to the delivery of care for hospitalized injury survivors, a patient-centered care transition intervention versus enhanced usual care. Method: This pragmatic comparative effectiveness trial randomized 171 acutely injured trauma survivors with three or more early postinjury concerns and high levels of emotional distress to intervention (I; n = 85) and enhanced usual care control (C; n = 86) conditions. The care transition intervention components included care management that elicited and targeted improvement in patients’ postinjury concerns, 24/7 study team cell phone accessibility, and stepped-up care. Posttraumatic concerns, symptomatic distress, functional status, and statewide emergency department (ED) service utilization were assessed at baseline and over the course of the 12 months after injury. Regression analyses assessed intervention and control group outcome differences over time. Results: Over 80% patient follow-up was attained at each time point. Intervention patients demonstrated clinically and statistically significant reductions in the percentage of any severe postinjury concerns expressed when compared to controls longitudinally (Wald chi-square = 11.29, p = 0.01) and at the six-month study time point (C = 74%, I = 53%; Fisher’s exact test, p = 0.02). Comparisons of ED utilization data yielded clinically significant cross-sectional differences (one or more three- to six-month ED visits; C = 30.2%, I = 16.5%, [relative risk (95% confidence interval] C versus I = 2.00 (1.09, 3.70), p = 0.03) that did not achieve longitudinal statistical significance (F (3, 507) = 2.24, p = 0.08). The intervention did not significantly impact symptomatic or functional outcomes. Conclusions: Orchestrated investigative and policy efforts should continue to evaluate patient-centered care transition interventions to inform American College of Surgeons’ clinical guidelines for U.S. trauma care systems.

Reliability of Self-Reported Mobile Phone Ownership in Rural North-Central Nigeria: Cross-Sectional Study.

BackgroundmHealth practitioners seek to leverage the ubiquity of the mobile phone to increase the impact and robustness of their interventions, particularly in resource-limited settings. However, data on the reliability of self-reported mobile phone access is minimal.ObjectiveWe sought to ascertain the reliability of self-reported ownership of and access to mobile phones among a population of rural dwellers in north-central Nigeria.MethodsWe contacted participants in a community-based HIV testing program by phone to determine actual as opposed to self-reported mobile phone access. A phone script was designed to conduct these calls and descriptive analyses conducted on the findings.ResultsWe dialed 349 numbers: 110 (31.5%) were answered by participants who self-reported ownership of the mobile phone; 123 (35.2%) of the phone numbers did not ring at all; 28 (8.0%) rang but were not answered; and 88 (25.2%) were answered by someone other than the participant. We reached a higher proportion of male participants (68/133, 51.1%) than female participants (42/216, 19.4%; P<.001).ConclusionsSelf-reported access to mobile phones in rural and low-income areas in north-central Nigeria is higher than actual access. This has implications for mHealth programming, particularly for women’s health. mHealth program implementers and researchers need to be cognizant of the low reliability of self-reported mobile phone access. These observations should therefore affect sample-size calculations and, where possible, alternative means of reaching research participants and program beneficiaries should be established.

Factors influencing access of pregnant women and their infants to their local healthcare system: a prospective, multi-centre, observational study

BackgroundThe successful implementation of maternal vaccination relies on results of clinical trials, considering the prenatal and postnatal attendance at selected healthcare institutions. This study evaluated factors influencing maternal/infant access to healthcare facilities to identify potential barriers to participation in future clinical trials on maternal vaccination.MethodsIn this prospective, multi-centre, observational study, pregnant women (N = 3243) were enrolled at ten sites across Panama, the Dominican Republic, South Africa, and Mozambique between 2012 and 2014. They completed questionnaires at enrolment, delivery, and infant follow-up (90 days post-partum) visits, including questions on transportation, phone accessibility, alternative childcare, gestational age at enrolment, delivery location, and health status of their infant. Logistic regression was used to identify factors significantly associated with return to study site for delivery or infant follow-up visits.ResultsAmong 3229 enrolled women with delivery information, 63.6% (range across sites: 25.3–91.5%) returned to study site for delivery. Older women and those at later gestational age at enrolment were more likely to deliver at the study site. While heterogeneities were observed at site level, shorter travel time at delivery and increased transportation costs at enrolment were associated with increased likelihood of women returning to study site for delivery. Among 3145 women with live-born infants, 3077 (95.3%) provided 90-day follow-up information; of these, 68.9% (range across sites: 25.6–98.9%) returned to study site for follow-up visits. Women with other children and with lower transportation costs at delivery were more likely to return to study site for follow-up visits. Among 666 infants reported sick, 94.3% were taken to a healthcare facility, with only 41.9% (range across sites: 4.9–77.3%) to the study site.ConclusionAlthough high retention was observed from enrolment through 90 days after delivery, post-partum surveillance should be broadened beyond the study sites and additional follow-up visits should be planned within the neonatal period. The factors influencing maternal/infant access to healthcare facilities and the issues identified in this study should be taken into consideration in planning future clinical studies on maternal immunisation in low- and middle-income countries.Trial registrationThe study was registered at ClinicalTrial.gov (NCT01734434) on November 22, 2012.

Developing Drop Box Systems for non-eLearning-based Tertiary Programmes – A Hong Kong Case Study with Broad Relevance

This paper describes a development project aimed at providing Drop Box systems for non-eLearning-based self-financing Tertiary programmes with due consideration on the speed, efficiency, usability and user acceptance for the stakeholders including students, teaching faculties, programme administrative staff. During the development process, different stakeholders were involved covering students, program administrative staff and teaching faculties. The result was very favorable due to the speed of access, the clarity of design based on newest Microsoft Rapid Application Prototyping platform plus latest Microsoft Database Management system, and the User Interface design technique targeted primarily for smart phone and other smart device access.

FCC Rules Improve Phone Accessibility for People With Hearing Loss

FCC Rules Improve Phone Accessibility for People With Hearing Loss

Mobile Health Technology (mDiab) for the Prevention of Type 2 Diabetes: Protocol for a Randomized Controlled Trial.

BackgroundThe prevalence of type 2 diabetes is increasing in epidemic proportions in low- and middle-income countries. There is an urgent need for novel methods to tackle the increasing incidence of diabetes. The ubiquity of mobile phone use and access to Internet makes mobile health (mHealth) technology a viable tool to prevent and manage diabetes.ObjectiveThe objective of this randomized controlled trial is to implement and evaluate the feasibility, cost-effectiveness, and sustainability of a reality television–based lifestyle intervention program. This intervention program is delivered via a mobile phone app (mDiab) to approximately 1500 Android smartphone users who are adults at a high risk for type 2 diabetes from three cities in India, namely, Chennai, Bengaluru, and New Delhi.MethodsThe mDiab intervention would be delivered via a mobile phone app along with weekly coach calls for 12 weeks. Each participant will go through a maintenance phase of 6 to 8 months post intervention. Overall, there would be 3 testing time points in the study: baseline, post intervention, and the end of follow-up. The app will enable individuals to track their weight, physical activity, and diet alongside weekly video lessons on type 2 diabetes prevention.ResultsThe study outcomes are weight loss (primary measure of effectiveness); improvement in cardiometabolic risk factors (ie, waist circumference, blood pressure, glucose, insulin, and lipids); and improvement in physical activity, quality of life, and dietary habits. Sustainability will be assessed through focus group discussions.ConclusionsIf successful, mDiab can be used as a model for translational and implementation research in the use of mHealth technology for diabetes prevention and may be further expanded for the prevention of other noncommunicable diseases such as hypertension and cardiovascular diseases.Trial RegistrationClinical Trials Registry of India CTRI/2015/07/006011 http://ctri.nic.in/Clinicaltrials/pdf_generate.php? trialid=11841 (Archived by WebCite at http://www.webcitation.org/6urCS5kMB)

Assessing Mobile Phone Access and Willingness for Text-Based mHealth Intervention to Improve Prenatal Care at Primary Care Centers in North West Ethiopia: a Cross-sectional Study (Preprint)

Assessing Mobile Phone Access and Willingness for Text-Based mHealth Intervention to Improve Prenatal Care at Primary Care Centers in North West Ethiopia: a Cross-sectional Study (Preprint)

Does Ecuadorians with asthma has preferences in the use of information and communication technologies? Pilot study

Inadequate communication between asthmatic patients and their physicians may interfere directly with asthma control. In the last years, the use of information and communication technologies (ICTs) it has increased in Latin-America. This technology seems to be a good tool to improve communication and management of the asthmatic patient. We evaluated the frequency and preference patterns of communication and information technologies in Ecuadorian patients with bronchial asthma. We conducted a pilot cross-sectional study to identify the frequency and preferences of ICT in patients with asthma. The Spanish version of the Michigan questionnaire was used. Age and educational level were categorized into 3 groups. We used logistic regression between these groups regarding the frequency of use, interest in seeking and receiving information related to their asthma for the age and educational level of the patients. A total of 222 patients participated in our study. The mean age was 45.6 years (SD 17.4), the most common sex was female with 89.25 %. Almost all patients had a cell phone (87.5 %) and internet access (62.7 %). The three ICTs most likely to be used to search for or receive information about their illness were WhatsApp, Facebook and email (p <0.05). Information and communication technologies improve the care of asthmatic patients. In our pilot study email and text messages are the most preferred ICT among patients however WhatsApp and Facebook may be appropriate for certain ages especially young asthmatic. Knowledge of preferences can help the development of ICT in a personalized way and improve the outcomes in patients with asthma.

Smart phone accessibility and mHealth use in a limited resource setting.

To determine smartphone access and use including future opportunities for mHealth and potential ethical implications among health care professionals practicing at a health care facility in Bengaluru, India. The evolution of smart phones can provide convenient, portable, and rapid access to resources for health care professionals. While mobile phone accessibility has improved in recent years in many low and middle-income countries, the use of smart phones to address health priorities remains limited in some limited resource settings. A quantitative descriptive design was used. A survey was administered in November of 2016 to nurses and physicians at a tertiary care hospital in India. All respondents had a mobile phone, and the majority owned a smart phone that was used for text messaging, email, accessing internet, and downloading apps. Participants recommended smart phone use to improve health care provider access to continuing education and to improve patient knowledge about health. Physicians had better access to mHealth resources compared with nurses. Credible, evidence-based, affordable mobile applications are needed to provide a platform for continuing health education to health professionals and patients in India and limited resource settings. Nurses need equitable access to mHealth resources to build successful mHealth initiatives.

Gatekeepers of our lives [Internet censorship

WHAT'S WRONG WITH women's nipples? Or rather, why do some social-media platforms allow men post topless pictures of themselves, but ban women from doing the same thing? The answer this question neatly encapsulates the key issue of online censorship today. We may think of the online world as a global commons, a public space for free expression, but it is increasingly a series of private spaces within which we are given limited permission act. Our access each other and the resources available within these spaces is increasingly being controlled not just by law, but by gatekeepers whose motivations may include political advantage, social control, or simple profit. For example, the Free The Nipple movement was launched in 2012 highlight the differing ways in which society expects the bodies of women and men be portrayed, as part of a campaign focused on equality, empowerment and the freedom of all human beings. When women started posting topless images of themselves using the #freethenipple hashtag on Instagram, their posts were banned for breaching the service's Community Guidelines. In a 2015 interview with Business Insider, Kevin Systrom, CEO of Instagram, explained that one reason for this was meet the content guidelines of Apple's App Store. One gatekeeper (Instagram) bowed another (Apple) control how a campaign for equality was expressed online. In a sense, this should be no surprise. When Steve Jobs launched the iPhone App Store in 2008, he said that apps would not be allowed distribute pornography, hog bandwidth, breach user privacy, act maliciously, or otherwise violate rules set by the company. The motivation, Jobs said, was to get a ton of apps out there. This is fair enough in the context of furthering a business' interests. However, as the web, Facebook, YouTube, Instagram, Twitter, WhatsApp, Sina Weibo, Snapchat and more gather billions of users and become prime conduits for our communications, the way they are governed and controlled becomes increasingly important the functioning of society. How big an issue is online censorship? According estimates by Freedom House, a US watchdog backed by sponsors ranging from the US State Department and the Dutch Ministry of Foreign Affairs BAE Systems and Google: . 3.2 billion people have access the internet . 67 per cent live in countries where criticism of the government, military, or ruling family has been subject censorship . 60 per cent live in countries where ICT users were arrested or imprisoned for posting content on political, social and religious issues . 49 per cent live in countries where individuals have been attacked or killed for their online activities since June 2015 . 47 per cent live in countries where insulting religion online can result in censorship or jail time . 33 per cent live in countries where online discussion of LGBT+ issues can be repressed or punished . 38 per cent live in countries where social media or messaging apps were blocked over the past year . 27 per cent live in countries THIS IIIS MRCI'IIME FIGHTS IMTERλeET SHUTDOWMS #Keej On The pressure group Access Now monitors and campaigns against internet shutdowns Eπgiπaartnthetas 8 Tichnology November 2017 www.EandTmagazine ceπwhere users have been arrested for writing, sharing or even liking Facebook posts . 38 per cent live under governments that disconnected internet or mobile phone access, often for political reasons. In other words, the global commons is increasingly strictly policed, and offending its gatekeepers can lead harsh punishments.

Blood on Boylston: Digital Memory and the Dramatisation of Recent History in &lt;em&gt;Patriots Day&lt;/em&gt;

Blood on Boylston: Digital Memory and the Dramatisation of Recent History in &lt;em&gt;Patriots Day&lt;/em&gt;

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OBJECTIVES/SPECIFIC AIMS: This study sought to determine the accessibility, utilization, and preference for mobile phone use among a marginalized population of teens enrolled in an adolescent substance abuse treatment program and their parents. Specific study aims were to: (1) characterize mobile phone use, (2) assess the accessibility and reliability of mobile phone usage, (3) determine specific barriers to mobile phone use, and (4) examine parent and teen perceptions of the utility of integrating communication technology in substance use treatment. METHODS/STUDY POPULATION: In total, 103 (78.6% female; 75.7% Hispanic) parents of teens participating in an outpatient substance abuse treatment program with an average age of 42.60 (SD=9.28) participated in our study. Upon enrollment in a substance abuse treatment program between October 2014 and July 2016, parents completed a technology use survey as part of program development and a chart review of clinic outbound calls to parent mobile phones was completed to evaluate reliability of parent mobile phone access throughout treatment. Survey collection among teens is ongoing. Study population information for teens will be presented at the conference. RESULTS/ANTICIPATED RESULTS: The vast majority of parents owned a cell phone and used it as their primary phone (97.1%); 83% of parents owned smart phones in particular, with the majority being Android phones (68.7%). Parents were more likely to have pay-as-you-go (41.4%) and yearly (32.3%) contracts, and only 15% of the sample endorsed changing their phone number more than once in the past year (64%=never; 21%=once). Parents reported using several of the phone features: text (97%), email (76%), pictures (93%), and accessing the internet (92%); 92% reported they did not have a texting limit; and the most popular use of the mobile phone was to send and receive text messages (58.6%), followed by accessing the internet (19.2%). During the course of a 10-week treatment program, the clinic made 2776 confirmation phone calls to parents who completed surveys. Report of accessibility matched the clinic’s ability to reach parents. Of the 2776 calls, 97.2% were made to the original number provided, which was in service. Only 2.7% were determined to be disconnected, with the median number of days for disconnected service being 2 days with no voice and no texting capabilities (range=14) and 2 days with no voice, but with texting capabilities (range=28). In terms of parent perceptions of the utility of integrating communication technology in substance use treatment, 91% of parents reported they would be receptive to receiving text messages with parenting tips as aftercare support. Preferred content areas included: strategies for monitoring teen substance use (56%), strategies for using consequences (62%), suggestions for encouraging positive activities (62%), and ways to improve parent-child communication (63%). Accessibility, utilization, and preference for mobile phone use in a treatment program among teen respondents will be presented at the conference. DISCUSSION/SIGNIFICANCE OF IMPACT: This study characterized both subjective and objective mobile phone accessibility and usability among teens participating in an adolescent substance abuse treatment program and their parents. This study also provides information on teen and parent perceptions of using mobile phones during the aftercare period and ratings of acceptable messages following treatment. This data will help researchers design mobile-based interventions both during and after treatment, which is the future direction of our research group.

To Improve Substance Use Disorder Prevention, Treatment and Recovery: Engage the Family

: Approximately 21 million people in the United States have a substance use disorder (SUD); the number of family members impacted by a loved one's SUD is exponentially greater. Affected family members of individuals with SUDs are at high risk for developing chronic medical and psychiatric health conditions, are high utilizers of the health care system, and have high health care expenditures. Family members play a central role in the lives of many individuals with SUDs; information given to family members can have a significant impact on persons with addiction and therefore the SUD treatment that an individual might receive. Evidence-based interventions targeting affected family members have been shown to: improve health outcomes for all family members, result in better addiction treatment outcomes, and prevent adolescent substance use. Despite mounting evidence, the health care system has been hesitant to engage families in a meaningful way. Health care providers should consider how implicit and explicit assumptions about the role of family members in SUD development, treatment, and recovery may contribute to this underlying reluctance. Antiquated policies and procedures that alienate family members should be modified (e.g., limiting phone access). Family members have a right to receive professional treatment and to be educated about the difference between mutual/peer support and evidence-based treatment options. Despite the potential for family members to move the needle on the country's current addiction crisis they remain an underutilized resource. A paradigm shift will be required to get the current SUD care continuum to adopt a family-centric model.

Text messaging to decrease tuberculosis treatment attrition in TB-HIV coinfection in Uganda.

BackgroundLow tuberculosis (TB) treatment completion rates in sub-Saharan Africa are an important driver of multidrug resistance. Mobile technology-based interventions have been shown to improve adherence to antiretroviral therapy in sub-Saharan Africa. We aimed to test the effect of a short-message service (SMS) intervention on loss to follow-up (LFU).Materials and methodsIn this quasi-experimental study, all adult, literate, HIV-infected patients with mobile phone access diagnosed with TB between November 2010 and October 2011 in an urban clinic in Uganda were eligible to receive adherence and appointment reminders and educational quizzes during the first 8 weeks of TB treatment. Their risk of LFU in the first 8 weeks of treatment was compared with that of patients starting treatment between March 2009 and August 2010 using logistic regression.ResultsOne of 183 (0.5%) enrolled patients was lost to FU during the intervention compared to six of 302 (2.0%) in the preintervention control group (RR 0.27, 95% CI 0.03–2.07; P=0.22). The SMS intervention was rated as very helpful by 96%. Barriers identified included interrupted phone access (26%, median 14 days) and difficulties responding by SMS. The response rate to educational quizzes was below 10%. There were no unintentional disclosures of TB or HIV status due to the intervention.ConclusionAn SMS reminder service did not show a clear effect on short-term risk of LFU in this study, which was underpowered due to a lower baseline risk in the control group than expected. The SMS-reminder service was rated highly, and there were no breaches of confidentiality. Important technological barriers have implications for larger-scale implementation, not only for TB but also other disease modalities.

Traditional Resources, Internet Resources, and Youth Online Political Participation: The Resource Theory Revisited in the Chinese Context

This study tests whether resource theory can be used to examine the effects of traditional resources and Internet-specific resources on youth online political participation using a representative sample of Chinese college students studying in Shanghai in 2012. The authors find that traditional resources in the form of civic skills and family income are negatively associated with online participation while a distinct set of Internet-specific resources are significantly and positively associated with different modes of youth online political participation depending on their unique cost structures. Mobile phone Internet access and advanced Internet skills are crucial for youth online expressive political participation, advanced Internet skills, mobile phone and home Internet access, and perceived Internet freedom are required for youth online collective action participation. We contribute to the literature by demonstrating that the Chinese political system moderates the cost structures for various types of political behaviors.

The Use of Smartphones as a Digital Security Blanket: The Influence of Phone Use and Availability on Psychological and Physiological Responses to Social Exclusion.

Mobile phones are increasingly becoming a part of the social environment, and when individuals feels excluded during a socially stressful situation, they often retreat to the comfort of their phone to ameliorate the negativity. This study tests whether smartphone presence does, in fact, alter psychological and physiological responses to social stress. Participants (N = 148, 84% female, mean age = 20.4) were subjected to a peer, social-exclusion stressor. Before exclusion, participants were randomized to one of the following three conditions: (1) phone-present with use encouraged, (2) phone-present with use restricted, or (3) no phone access. Saliva samples and self-report data were collected throughout the study to assess salivary alpha amylase (sAA), cortisol, and feelings of exclusion. Participants in both phone-present conditions reported lower feelings of exclusion compared with individuals who had no access to their phone (F(2,143) = 5.49, p = .005). Multilevel modeling of sAA responses revealed that the individuals in the restricted-phone condition had a significantly different quadratic trajectory after the stressor compared with the phone use (υ = -0.12, z = -2.15, p = .032), and no-phone conditions (υ = -0.14, z = -2.64, p = .008). Specifically, those in the restricted-phone condition showed a decrease in sAA after exclusion, those in the no-phone condition showed a gradual increase, and phone users exhibited little change. Cortisol responses to the stressor did not vary by condition. Taken together, these results suggest that the mere presence of a phone (and not necessarily phone use) can buffer against the negative experience and effects of social exclusion.

Mobile telephony and democracy in Ghana: Interrogating the changing ecology of citizen engagement and political communication

This paper explores how far mobile telephony, in concert with other media platforms, has borne out the optimism of the mobile phonedemocracy nexus in the context of Ghana's politics and democratic practice. It examines the relationship between mobile phone access, citizen engagement, and appropriation of the technology by the governing elite for political communication and electoral campaigns. It concludes that Ghana has witnessed a rich convergence of mobile telephony and broadcast media which, in tandem with an open political environment, has significantly transformed the ecology of political communication. This development has helped to deepen democratic engagement among citizens, and between citizens and the political class, by fostering civic vigilance and accountability and facilitating multivocal expression of views from a more diverse constituency of political participants. However, while mobile phones and related platforms have allowed contra- and counter-hegemonic voices in Ghanaian politics to find expression across the electromagnetic spectrum, this access should not be construed to necessarily mean that political discourse has shifted in significant ways as to alter the fundamental structures of political power. Overall, the fundamental structures of political power and the levers of control remain unassailed by ordinary citizens, despite some of the progress made possible by mobile telephony.

Mobile Money Landscape in the 12 SADC Countries using FinScope Survey Data

There is no doubt that mobile money is bringing the under-served and the excluded population into the main stream financial services corridors. Based on the FinScope surveys, mobile money is becoming one of the enablers of financial inclusion. In an increasing number of developing countries, a number of poor people are using basic mobile phones to transfer money, paying for goods and accessing some basic financial services. According to the World Bank, mobile financial services are amongst the most promising mobile applications in the developing world. Although FinScope results show that mobile money usage is relatively low (23%) in the SADC region, the trend of usage is coming up fast. FinScope results show that close to 7 in 10 mobile money users are using it as a remittances/money transfer vehicle while 54% for buying airtime. It is encouraging that about 7 million adults (24% of mobile money) store value or save money in their mobile money accounts. Some barriers to mobile money relate to: affordability, perceived cost of mobile money, lack of understanding of mobile money/lack of awareness and no access to cell phones. Besides these barriers, mobile money is becoming a game changer for the landscape of financial inclusion in the SADC region.