With widespread use of the smartphone, clinical evidence for smartphone addiction remains unclear. Against this background, we analyzed the effect of smartphone use patterns on smartphone addiction in Korean adolescents. A total of 370 middle school students participated. The severity of smartphone addiction was measured through clinical interviews and the Korean Smartphone Addiction Proneness Scale. As a result, 50 (13.5%) were in the smartphone addiction group and 320 (86.5%) were in the healthy group. To investigate the effect of smartphone use patterns on smartphone addiction, we performed self-report questionnaires that assessed the following items: smartphone functions mostly used, purpose of use, problematic use, and parental attitude regarding smartphone use. For smartphone functions mostly used, the addiction group showed significantly higher scores in “Online chat.” For the purpose of use, the addiction group showed significantly higher “habitual use,”“pleasure,”“communication,”“games,”“stress relief,”“ubiquitous trait,” and “not to be left out.” For problematic use, the addiction group showed significantly higher scores on “preoccupation,”“tolerance,”“lack of control,”“withdrawal,”“mood modification,”“conflict,”“lies,”“excessive use,” and “loss of interest.” For parental attitude regarding children's smartphone use, the addiction group showed significantly higher scores in “parental punishment.” Binary logistic regression analysis indicated that “female,”“use for learning,”“use for ubiquitous trait,”“preoccupation,” and “conflict” were significantly correlated with smartphone addiction. This study demonstrated that the risk factors for smartphone addiction were being female, preoccupation, conflict, and use for ubiquitous trait; the protective factor was use for learning. Future studies will be required to reveal the additional clinical evidence of the disease entity for smartphone addiction.
Adolescent* ; Female ; Humans ; Learning ; Logistic Models ; Parents ; Protective Factors ; Risk Factors* ; Smartphone*

BACKGROUND: The recurrence rate of rosacea was not known very well, but has been reported as 60% in 6 months after withdrawal of the drug. It is not known which treatment can reduce relapses of rosacea effectively. OBJECTIVE: The objective was to identify whether 595 nm-pulsed dye laser (PDL) treatment reduced recurrence rate among rosacea patients who were treated with oral minocycline. METHODS: One hundred and seven Korean patients with rosacea who started treatment with oral minocycline (100 mg/d) with or without PDL (2∼4 sessions) were evaluated retrospectively. The recurrence rate was estimated using the Kaplan-Meier method, and difference was evaluated using the log-rank test. Cox proportional hazards model was used to estimate hazard ratios and 95% confidence intervals (CIs) of risk factors for the recurrence of rosacea. RESULTS: The recurrence-free survival analysis revealed that the group with oral minocycline plus PDL was significantly different compared with the group with oral minocycline alone (p=0.011). Cox proportional hazards model showed that the combined use of PDL with oral minocycline appeared to be a significant protective factor for the hazard of recurrence of rosacea (hazard ratio, 0.492; 95% CI, 0.257∼0.941; p=0.032). CONCLUSION: PDL can be used added to oral minocycline to reduce relapses among rosacea patients who are undergoing oral minocycline treatment.
Humans ; Lasers, Dye* ; Methods ; Minocycline* ; Proportional Hazards Models ; Protective Factors ; Recurrence* ; Retrospective Studies ; Risk Factors ; Rosacea*

OBJECTIVE: Prospective data of risky online gamers in Turkey is missing. Therefore, we aimed to investigate the change in gaming behaviors and addiction rates of Travian players within two years to search diagnostic stability of internet gaming disorder and some psychosocial risk factors. METHODS: 110 responders completed the whole questionnaire package including 21-item Game Addiction Scale (GAS), Satisfaction with Life Scale (SLS), Rosenberg Self-Esteem Scale (RSES), and Multi-dimensional Scale of Perceived Social Support (MSPSS). A hierarchical linear modeling approach was followed to test the linear change in game addiction scores of the participants from 2013 to 2015. RESULTS: GAS scores of gamers significantly decreased within two years (p=0.026). MSPSS scores significantly and negatively associated with GAS scores (p < 0.001) and the negative association of time remained significant (p=0.035). Decrement in the MSPSS scores in two years was associated with increment in GAS scores. 9 (90%) of 10 participants with internet gaming disorder according to monothetic format and 26 (52%) of 50 participants with internet gaming disorder according to polythetic format were found to not to meet the diagnosis in the follow-up. 33 out of all participants reported that they were not playing any online games for at least last 6 months. CONCLUSION: Social support seems to be a protective factor for game addiction and diagnosis of internet gaming disorder has low temporal stability among Travian players in Turkey.
Diagnosis ; Follow-Up Studies* ; Internet ; Linear Models ; Prospective Studies ; Protective Factors ; Risk Factors* ; Turkey

Childhood exposure to intimate partner violence (IPV) and other adversities has been shown to have adverse effects on health and well-being not only in childhood but also throughout the lifespan. This paper focuses on the prevalence of childhood adversities including exposure to IPV. The intersection of adverse childhood experiences and IPV victimization/perpetration in adulthood is also explored. The neurobiology of trauma is discussed and by understanding the impact of trauma on health, it is hoped that enhancement of resilience is possible. Based on the identification of protective factors at the individual, familial, and community level, examples of interventions that encourage safe, stable, and nurturing relationships between parents and children are described.
Child ; Hope ; Humans ; Intimate Partner Violence* ; Neurobiology ; Parents ; Prevalence ; Protective Factors

BACKGROUND: Dental injury as a result of oroendotracheal intubation during general anesthesia is very common. We report our experiences of using mouthguard to prevent dental injury during intubation based on our protocol. METHODS: This retrospective study enrolled patients referred for preanesthetic evaluation, those patients with a history of any of the dental treatments to their anterior teeth listed on our fabrication protocol from January 1, 2009 to June 30, 2010. RESULTS: No cases of dental trauma during oroendotracheal intubation were reported among the 202 patients who used a protective device. 66% of the patients had risk factors for hard tissue damage aged 10-40 years. At the ages of 40-70 years, the incidence of risk group for periodontal damage was higher. CONCLUSIONS: Preanesthetic consultation was effective for preventing dental injury, so preanesthetic questionnaire and proper dental consultation would be helpful.
Anesthesia, General ; Humans ; Incidence ; Intubation* ; Protective Devices ; Retrospective Studies ; Risk Factors ; Splints* ; Tooth

BACKGROUND AND PURPOSE: Patients with active cancer are at an increased risk for stroke. Hypercoagulability plays an important role in cancer-related stroke. We aimed to test whether 1) hypercoagulability is a predictor of survival, and 2) correction of the hypercoagulable state leads to better survival in patients with stroke and active cancer. METHODS: We recruited consecutive patients with acute ischemic stroke and active systemic cancer between January 2006 and July 2015. Hypercoagulability was assessed using plasma D-dimer levels before and after 7 days of anticoagulation treatment. The study outcomes included overall and 1-year survival. Plasma D-dimer levels before and after treatment were tested in univariate and multivariate Cox regression models. We controlled for systemic metastasis, stroke mechanism, age, stroke severity, primary cancer type, histology, and atrial fibrillation using the forward stepwise method. RESULTS: A total of 268 patients were included in the analysis. Patients with high (3rd–4th quartiles) pre-treatment plasma D-dimer levels showed decreased overall and 1-year survival (adjusted HR, 2.19 [95% CI, 1.46–3.31] and 2.70 [1.68–4.35], respectively). After anticoagulation treatment, post-treatment D-dimer level was significantly reduced and independently associated with poor 1-year survival (adjusted HR, 1.03 [95% CI, 1.01–1.05] per 1 μg/mL increase, P=0.015). The successful correction of hypercoagulability was a protective factor for 1-year survival (adjusted HR 0.26 [CI 0.10–0.68], P=0.006). CONCLUSIONS: Hypercoagulability is associated with poor survival after stroke in patients with active cancer. Effective correction of hypercoagulability may play a protective role for survival in these patients.
Atrial Fibrillation ; Humans ; Methods ; Mortality* ; Neoplasm Metastasis ; Plasma ; Prognosis ; Protective Factors ; Stroke* ; Thrombophilia*

OBJECTIVES: The aim of this study was to model the avoidable burden of the risk factors of road traffic crashes in Iran and to prioritize interventions to reduce that burden. METHODS: The prevalence and the effect size of the risk factors were obtained from data documented by the traffic police of Iran in 2013. The effect size was estimated using an ordinal regression model. The potential impact fraction index was applied to calculate the avoidable burden in order to prioritize interventions. This index was calculated for theoretical, plausible, and feasible minimum risk level scenarios. The joint effects of the risk factors were then estimated for all the scenarios. RESULTS: The highest avoidable burdens in the theoretical, plausible, and feasible minimum risk level scenarios for the non-use of child restraints on urban roads were 52.25, 28.63, and 46.67, respectively. In contrast, the value of this index for speeding was 76.24, 37.00, and 62.23, respectively, for rural roads. CONCLUSIONS: On the basis of the different scenarios considered in this research, we suggest focusing on future interventions to decrease the prevalence of speeding, the non-use of child restraints, the use of cell phones while driving, and helmet disuse, and the laws related to these items should be considered seriously.
Accidents, Traffic ; Cell Phones ; Child ; Head Protective Devices ; Humans ; Iran* ; Joints ; Jurisprudence ; Police ; Prevalence ; Risk Factors*

PURPOSE: This study aimed to explore the protective factors of demoralization in cancer patients via investigation of cancer patients' demographic and disease characteristics. METHODS: This was a cross-sectional descriptive study. We used a structured questionnaire, which contained items on demographic and disease characteristics, as well as the Demoralization Scale Mandarin Version (DS-MV), with a cutoff of 30 or more indicating high demoralization. Data were analyzed with age-matched and gender-matched conditional logistic regression analysis. For the study, 428 questionnaires were delivered and 411 were recovered. After being age-matched and gender-matched, 182 participants of high demoralization (DS-MV > 30) and low demoralization (DS-MV ≤ 30) were obtained respectively, for a total of 364 participants. RESULTS: Cancer patients' demoralization was significantly related to family support (p = .019), education (p = .049), and monthly income (p = .001). Family support [odds ratio = 0.38; p = .028; 95% confidence interval (0.16, 0.91)] and monthly income [odds ratio = 0.49; p = .009; 95% confidence interval (0.29, 0.84)] were protective factors of demoralization in cancer patients. CONCLUSION: Early and appropriate demoralization assessment of cancer patients' demographic and disease characteristics is very important in clinical settings. Healthcare providers might regularly monitor demoralization in cancer patients, and develop related nursing care guidelines or treatment for demoralization in cancer patients. The study results can be a reference for healthcare providers who work with cancer patients.
Education ; Health Personnel ; Humans ; Logistic Models ; Nursing Care ; Odds Ratio ; Protective Factors* ; Taiwan*

PURPOSE: The purpose of this study was to investigate the relationship between cell phone dependency and aggression in elementary school students with the mediating effect of leisure activities in South Korea. METHODS: Data were cross-sectional in study design with 1,555 fourth grade elementary school students participating in the 4th-year Korean Children and Youth Panel Survey. Data analysis was performed using the SPSS/WIN 23.0 and AMOS 21.0 program. RESULTS: Cell phone dependency has a significant effect on aggression, but it did not act as a control variable in the relationship between the protective factor, weekly book reading time and the amount of daytime play with aggression. Weekly entertainment time and weekly TV and video viewing time had a significant statistical effect on aggression, thus this study confirmed that cell phone dependency acts as a control variable in relation to aggression. CONCLUSION: As the entertainment time for elementary school students, the time spent watching TV and videos play a negative role, it is necessary to prepare a leisure activity management practice and strategies with an emphasis on entertainment time as well as, TV and video viewing as elementary school students' leisure activities for a healthy school life.
Adolescent ; Aggression ; Cell Phones ; Child ; Dependency (Psychology) ; Humans ; Korea ; Leisure Activities ; Negotiating ; Protective Factors ; Statistics as Topic

Early detection is a crucial milestone in the prevention and treatment of schizophrenia spectrum psychosis, which might alter the course of schizophrenia. Currently, there are two complementary approaches to characterizing the clinical-high risk state of psychosis : the ultra-high risk (UHR) and basic symptoms criteria. Individuals at UHR have two phase-specific problems : heightened risk for the potential pathology of schizophrenia spectrum psychosis and the symptoms, distress and psychosocial functional impairment, which make them seek help. The clinical characteristics of UHR are similar to those of overt psychotic disorders in terms of psychopathological symptoms dimensions, psychosocial disability, neurocognitive and socio-cognitive impairments, history of trauma and abuse experience, lack of protective factors and dysfunctional metacognitive beliefs, and the comorbidity of psychiatric illness. Regarding the risk, the pretest risk probability of a psychotic disorder in each high-risk clinic is considered an important factor for predicting the power of an early detection strategy. For the distress and psychosocial disability, the strategies of the therapeutic intervention will be a focus of clinical attention. On the follow-up, one of third of the UHR individuals have sufficient positive symptom to fulfil the at-risk criteria. Most of the UHR individuals have suffered from comorbid psychiatric illness at the times of both baseline and follow-up, and there is no improvement of psychosocial functioning. Currently, it is essential to optimize the early detection and intervention strategy according to the referring and recruitment characteristics of each high-risk clinic in Korean practice situations.
Comorbidity ; Diagnosis* ; Follow-Up Studies ; Pathology ; Protective Factors ; Psychotic Disorders* ; Schizophrenia