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      Smartphone addiction in children: patterns of use and musculoskeletal discomfort during the COVID-19 pandemic in Iran

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          Abstract

          Background

          Smartphone use has increased significantly, especially during the period of global pandemic caused by the novel SARS-CoV2 coronavirus (COVID-19). Concurrently, smartphone addiction is a growing social problem in children and adolescents with the consequence of adverse health outcomes. This study assessed the prevalence of smartphone addiction, patterns of use, and the experienced body-region discomfort among Iranian school students during the COVID-19 pandemic.

          Methods

          A cross-sectional study with students from grades 1–9 recruited n = 585 participants (mean age = 14.49 (2.26 years); female = 65.8%). Data were collected from parents and students through the online 'Smartphone addiction scale-short version’ (SAS-SV), self-reported demographic questionnaires, and extracts of the Nordic musculoskeletal questionnaire for the evaluation of musculoskeletal disorders.

          Results

          The prevalence rate of smartphone addiction (53.3%) was relatively high in the overall sample. Participants spent 6.85 (4.62) hours per day on their smartphones, which had increased 53.86% relative to the pre-pandemic period. The primary smartphone uses were for social networking (77.9%), web-surfing (53.3%), and camera activities (50.9%). There was a positive correlation between smartphone addiction as assessed with the SAS-SV and daily use time ( r = 0.34, p < 0.001), and the percentage of change relative to the pre-pandemic period ( r = 0.26, p < 0.001). Discomfort related to smartphone use was mostly reported as present in the eyes (39.7%) and neck (39.1%). A positive correlation was found ( p < 0.001) between smartphone addiction and discomfort in the eyes, neck, wrists, shoulders, and upper-back.

          Conclusion

          The more frequent usage of smartphones by students during the Covid-19 pandemic were associated predominantly with discomfort to the eyes and neck. Parents should consider the complications of musculoskeletal and postural changes during the child’s future years and pay particular attention to the individual’s patterns of smartphone use with an emphasis on posture and usage that reduces discomfort to the eyes and the musculoskeletal system, particularly the neck.

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          Most cited references46

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          The Smartphone Addiction Scale: Development and Validation of a Short Version for Adolescents

          Objective This study was designed to investigate the revised and short version of the smartphone addiction scale and the proof of its validity in adolescents. In addition, it suggested cutting off the values by gender in order to determine smartphone addiction and elaborate the characteristics of smartphone usage in adolescents. Method A set of questionnaires were provided to a total of 540 selected participants from April to May of 2013. The participants consisted of 343 boys and 197 girls, and their average age was 14.5 years old. The content validity was performed on a selection of shortened items, while an internal-consistency test was conducted for the verification of its reliability. The concurrent validity was confirmed using SAS, SAPS and KS-scale. Receiver operating characteristics analysis was conducted to suggest cut-off. Results The 10 final questions were selected using content validity. The internal consistency and concurrent validity of SAS were verified with a Cronbach's alpha of 0.911. The SAS-SV was significantly correlated with the SAS, SAPS and KS-scale. The SAS-SV scores of gender (p<.001) and self-evaluation of smartphone addiction (p<.001) showed significant difference. The ROC analysis results showed an area under a curve (AUC) value of 0.963(0.888–1.000), a cut-off value of 31, sensitivity value of 0.867 and specificity value of 0.893 in boys while an AUC value of 0.947(0.887–1.000), a cut-off value of 33, sensitivity value of 0.875, and a specificity value of 0.886 in girls. Conclusions The SAS-SV showed good reliability and validity for the assessment of smartphone addiction. The smartphone addiction scale short version, which was developed and validated in this study, could be used efficiently for the evaluation of smartphone addiction in community and research areas.
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            Smartphone use and smartphone addiction among young people in Switzerland

            Smartphone addiction, its association with smartphone use, and its predictors have not yet been studied in a European sample. This study investigated indicators of smartphone use, smartphone addiction, and their associations with demographic and health behaviour-related variables in young people. A convenience sample of 1,519 students from 127 Swiss vocational school classes participated in a survey assessing demographic and health-related characteristics as well as indicators of smartphone use and addiction. Smartphone addiction was assessed using a short version of the Smartphone Addiction Scale for Adolescents (SAS-SV). Logistic regression analyses were conducted to investigate demographic and health-related predictors of smartphone addiction. Smartphone addiction occurred in 256 (16.9%) of the 1,519 students. Longer duration of smartphone use on a typical day, a shorter time period until first smartphone use in the morning, and reporting that social networking was the most personally relevant smartphone function were associated with smartphone addiction. Smartphone addiction was more prevalent in younger adolescents (15–16 years) compared with young adults (19 years and older), students with both parents born outside Switzerland, persons reporting lower physical activity, and those reporting higher stress. Alcohol and tobacco consumption were unrelated to smartphone addiction. Different indicators of smartphone use are associated with smartphone addiction and subgroups of young people have a higher prevalence of smartphone addiction. The study provides the first insights into smartphone use, smartphone addiction, and predictors of smartphone addiction in young people from a European country, which should be extended in further studies.
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              Long-term psychological distress of Bosnian war survivors: an 11-year follow-up of former displaced persons, returnees, and stayers

              Background Research on the long-term mental health consequences of war and displacement among civilians who live in post-conflict countries is rare. The aim of this study was to examine the developmental trajectories and predictors of general psychological distress in three samples of Bosnian war survivors over an 11-year period. Methods In 1998/99, about three years after the war in Bosnia and Herzegovina, a representative sample of 299 adult Sarajevo citizens was examined in three subsamples: individuals who had stayed in Sarajevo throughout the siege, individuals who had been internally displaced, and refugees who had returned. Of the 138 study participants who could be located 11 years later, 100 were re-assessed (71%) using the Brief Symptom Inventory. Results Over time, psychological symptoms and general psychological distress decreased in those survivors who had stayed and increased in returnees. Former displaced persons did not show any significant changes. After controlling for other factors, cumulative trauma exposure before and during the war predicted general psychological distress at baseline. Eleven years later, higher trauma exposure during and after the war, returnee status, and more current stressors were all associated with higher levels of general psychological distress. Conclusions Levels of psychological symptoms remained high in three subsamples of Bosnian war survivors. The differential symptom trajectories may correspond to distinct war experiences and contemporary stressors. Still, the cumulative effect of war traumata on mental distress persisted more than a decade after war and displacement, although the influence of current stressors seemed to increase over time. Electronic supplementary material The online version of this article (10.1186/s12888-018-1996-0) contains supplementary material, which is available to authorized users.
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                Author and article information

                Contributors
                Hrmokhtarinia@yahoo.com
                maryam_ht_70@yahoo.com
                nasim_farmani@yahoo.com
                abiglarian@uswr.ac.ir
                cp.gabel@bigpond.com
                Journal
                BMC Pediatr
                BMC Pediatr
                BMC Pediatrics
                BioMed Central (London )
                1471-2431
                26 November 2022
                26 November 2022
                2022
                : 22
                : 681
                Affiliations
                [1 ]GRID grid.472458.8, ISNI 0000 0004 0612 774X, Department of Ergonomics, , University of Social Welfare and Rehabilitation Sciences, ; Kodakyar Ave. Daneshjo Blvd, Evin, PC: 1985713834 Tehran Iran
                [2 ]Iran Welfare Organization, PhD of Social Work, Tehran, Iran
                [3 ]GRID grid.472458.8, ISNI 0000 0004 0612 774X, Department of Biostatistics and Epidemiology, , Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, ; Tehran, Iran
                [4 ]Access Physiotherapy, Coolum Beach, Sunshine Coast, Queensland (QLD), Australia
                Article
                3748
                10.1186/s12887-022-03748-7
                9701359
                36435748
                26168ec8-00b5-4746-bd4e-863777c1ef11
                © The Author(s) 2022

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 29 May 2022
                : 11 November 2022
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100008974, University of Social Welfare and Rehabilitation Sciences;
                Award ID: 2644
                Award ID: 2644
                Award ID: 2644
                Award ID: 2644
                Award ID: 2644
                Award Recipient :
                Categories
                Research
                Custom metadata
                © The Author(s) 2022

                Pediatrics
                pandemics,problematic smartphone usage,addictions,neck pain,social networking
                Pediatrics
                pandemics, problematic smartphone usage, addictions, neck pain, social networking

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