We evaluated the association between sleep duration, dental caries, and periodontitis by using representative nationwide data. We examined 8,356 subjects aged ≥19 years who participated in the sixth Korea National Health and Nutrition Examination Survey (2013~2014). Sleep duration were grouped into ≤5, 6, 7, 8, and ≥9 hours. Presence of dental caries was defined as caries in ≥1 permanent tooth on dental examination. Periodontal status was assessed by using the community periodontal index (CPI), and a CPI code of ≥3 was defined as periodontitis. A chi-square test and multiple logistic regression analysis were used to determine statistical significance. Model 1 was adjusted for age and sex, model 2 for household income, educational level, and marital status plus model 1, and model 3 for smoking status, alcohol consumption, blood pressure level, fasting blood glucose level, total cholesterol level, and body mass index plus model 2. The prevalence of dental caries according to sleep duration showed a U-shaped curve of 33.4%, 29.4%, 28.4%, 29.4%, and 31.8% with ≤5, 6, 7, 8, and ≥9 hours of sleep, respectively. In the fully adjusted model 3, the risk of developing dental caries was significantly higher with ≤5 than with 7 hours of sleep (odds ratio, 1.23; 95% confidence interval, 1.06~1.43). The prevalence of periodontitis according to sleep duration showed a U-shaped curve of 34.4%, 28.6%, 28.1%, 31.3%, and 32.5%, respectively. The risk of periodontitis was significantly higher with ≥9 than with 7 hours of sleep in models 1 and 2, whereas the significant association disappeared in model 3. In a nationally representative sample, sleep duration was significantly associated with dental caries formation and weakly associated with periodontitis. Adequate sleep is required to prevent oral diseases such as dental caries and periodontitis.
Adult* ; Alcohol Drinking ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Cholesterol ; Dental Caries* ; Family Characteristics ; Fasting ; Health Surveys ; Humans ; Korea* ; Logistic Models ; Marital Status ; Nutrition Surveys* ; Periodontal Index ; Periodontitis* ; Prevalence ; Smoke ; Smoking ; Tooth

Purpose: This study aimed to provide basic data for the future development of school-based sexuality education and school nurse placement policies by examining the sexuality education experience in middle schools according to levels of school nurse placement and identifying factors influencing on adolescent sexual risk behaviors. Methods: This study examined data from the 2018 14th Korean Youth Risk Behavior Survey. The raw data from 30,229 middle school students enrolled in 400 schools were analyzed using descriptive statistics, Chi-square test, independent t test, and complex sample logistic regression analysis. Results: It is found that, in Korea, school nurse placement rates varied by region from 37.9% to 114.8%, resulting in different levels of sexuality and alcohol prevention education (p < .001). Sexuality and alcohol prevention education lowered the likelihood of sexual risk behaviors by 0.54 and 0.87 times, respectively. The experience of drinking alcohol increased a student's likelihood of committing sexual risk behaviors by 4.40 and 3.57 times, respectively, whereas the experience of using a drug increased the risk by 9.42 and 5.00 times, respectively. Personal factors (e.g., gender and academic achievement) and socioenvironmental factors (e.g., school type and perceived economic status) were also found to influence on the sexual risk behaviors of adolescents, although, not to the same degree as sexuality education or health risk behaviors. Conclusion To protect students' sex-related health equity, more elaborate support policies are needed to ensure adequate placement of school nurses able to provide professional sexuality and related health education.

Purpose: This study aimed to provide basic data for the future development of school-based sexuality education and school nurse placement policies by examining the sexuality education experience in middle schools according to levels of school nurse placement and identifying factors influencing on adolescent sexual risk behaviors. Methods: This study examined data from the 2018 14th Korean Youth Risk Behavior Survey. The raw data from 30,229 middle school students enrolled in 400 schools were analyzed using descriptive statistics, Chi-square test, independent t test, and complex sample logistic regression analysis. Results: It is found that, in Korea, school nurse placement rates varied by region from 37.9% to 114.8%, resulting in different levels of sexuality and alcohol prevention education (p < .001). Sexuality and alcohol prevention education lowered the likelihood of sexual risk behaviors by 0.54 and 0.87 times, respectively. The experience of drinking alcohol increased a student's likelihood of committing sexual risk behaviors by 4.40 and 3.57 times, respectively, whereas the experience of using a drug increased the risk by 9.42 and 5.00 times, respectively. Personal factors (e.g., gender and academic achievement) and socioenvironmental factors (e.g., school type and perceived economic status) were also found to influence on the sexual risk behaviors of adolescents, although, not to the same degree as sexuality education or health risk behaviors. Conclusion To protect students' sex-related health equity, more elaborate support policies are needed to ensure adequate placement of school nurses able to provide professional sexuality and related health education.

PURPOSE: This study aimed to investigate the relationships among job characteristics, knowledge sharing, organizational culture, and organizational commitment in occupational health nurses (OHN) and clinical nurses (CN) to identify factors that might influence organizational commitment. It aimed to contribute to the improvement of knowledge management in health care organizations, including industrial workplaces and hospitals. METHODS: A convenience sample of 188 nurses, specifically 100 OHN and 88 CN, was selected. Data were analyzed with descriptive statistics, t-tests, correlation coefficients, and multiple regression analysis. RESULTS: OHNs had a significantly higher education level and current work experience; higher proportion of participants with contract employment status, day work shift, less turnover experience, good lifestyle; and higher scores on organizational culture (3.3±0.61) and organizational commitment (3.1±0.60). Additionally, the correlations among organizational commitment, job characteristics, knowledge sharing, and organizational culture ware higher (r=.38~.57) among OHNs as compared to those among CNs. Further, the organizational commitment of OHNs was significantly influenced by knowledge sharing, organizational culture, working hours, and salary (R²=.32), while that of CNs was influenced by organizational culture and life event stress (R²=.11). CONCLUSION: There is a need to develop measures to enable nurses to contribute to the improvement of knowledge management in health care organizations as major human resources, by including interventions for the major factors leading to between-group differences in organizational performance.
Delivery of Health Care ; Education ; Employment ; Humans ; Knowledge Management ; Life Style ; Occupational Health* ; Organizational Culture* ; Salaries and Fringe Benefits

OBJECTIVE: This study analyzed the national claims data of veterans to generate scientific evidence of the trends and appropriateness of their drug utilization in an outpatient setting. METHODS: The claims data were provided by the Health Insurance Review & Assessment (HIRA). Through sampling and matching data, we selected two comparable groups; Veterans vs. National Health Insurance (NHI) patients and Veterans vs. Medical Aid (MAID) patients. Drug use and costs were compared between groups by using multivariate gamma regression models to account for the skewed distribution, and therapeutic duplication was analyzed by using multivariate logistic regression models. RESULTS: In equivalent conditions, veteran patients made fewer visits to medical institutions (0.88 vs. 1), had 1.86 times more drug use, and paid 1.4 times more drug costs than NHI patients (p < 0.05); similarly, veteran patients made fewer visits to medical institutions (0.96 vs. 1), had 1.11 times more drug use, and paid 0.95 times less drug costs than MAID patients (p < 0.05). The risk of therapeutic duplication was 1.7 times higher (OR=1.657) in veteran patients than in NHI patients and 1.3 times higher (OR=1.311) than in MAID patients (p < 0.0001). CONCLUSION: Similar patterns of drug use were found in veteran patients and MAID patients. There were greater concerns about the drug use behavior in veteran patients, with longer prescribing days and a higher rate of therapeutic duplication, than in MAID patients. Efforts should be made to measure if any inefficiency exists in veterans' drug use behavior.
Drug Costs ; Drug Utilization ; Humans ; Insurance, Health ; Logistic Models ; National Health Programs ; Outpatients* ; Prescriptions* ; Veterans*

Purpose: This study aimed to identify the mediating effects of communication skills and pediatric nurse-parent partnership on the relationship between emotional intelligence and job satisfaction among pediatric nurses. Methods: A survey was administered to 205 pediatric nurses working in children’s, general, and tertiary hospitals situated in Chungcheong province and Seoul. Data were collected in August and September 2022. The collected data were analyzed using SPSS Statistics version 26.0 along with the PROCESS macro program. Results: Emotional intelligence had a significant effect, and was a critical factor affecting the job satisfaction of pediatric nurses. Furthermore, communication skills and nurse-parent partnership had a serial double mediating effect. Conclusion These findings underscore the significance of conducting job satisfaction improvement programs, including strategies for augmenting emotional intelligence, bolstering communication skills, and fostering nurse-parent partnership.

Gastric cancer is a malignancy with high incidence and mortality worldwide. In gastric cancer, epithelial-mesenchymal transition (EMT) and metastasis further increase the mortality rate. Trefoil factor 1 (TFF1) has been reported as a protective factor in the gastric mucosa. In this study, TFF1 inhibited the migration and invasive capability of gastric cancer cells. Elevated TFF1 levels induced the expression of E-cadherin, the epithelial marker, and reduced the expression of N-cadherin, vimentin, Snail, Twist, Zinc finger E-box binding homeobox (ZEB) 1 and ZEB2, well-known repressors of E-cadherin expression. In addition, the expression of matrix metalloproteinase (MMP)-2, MMP-7 and MMP-9, which are major markers of cancer metastasis, was suppressed by TFF1. Upregulation of TFF1 inhibited TGF-β, a major signaling for EMT induction, and the phosphorylation of Smad2/3 activated by TGF-β in AGS cells. In conclusion, TFF1 inhibits EMT through suppression of TGF-β signaling in AGS cells, which might be used in therapeutic strategies for reducing metastatic potential and invasiveness of these cells.

Gastric cancer is a malignancy with high incidence and mortality worldwide. In gastric cancer, epithelial-mesenchymal transition (EMT) and metastasis further increase the mortality rate. Trefoil factor 1 (TFF1) has been reported as a protective factor in the gastric mucosa. In this study, TFF1 inhibited the migration and invasive capability of gastric cancer cells. Elevated TFF1 levels induced the expression of E-cadherin, the epithelial marker, and reduced the expression of N-cadherin, vimentin, Snail, Twist, Zinc finger E-box binding homeobox (ZEB) 1 and ZEB2, well-known repressors of E-cadherin expression. In addition, the expression of matrix metalloproteinase (MMP)-2, MMP-7 and MMP-9, which are major markers of cancer metastasis, was suppressed by TFF1. Upregulation of TFF1 inhibited TGF-β, a major signaling for EMT induction, and the phosphorylation of Smad2/3 activated by TGF-β in AGS cells. In conclusion, TFF1 inhibits EMT through suppression of TGF-β signaling in AGS cells, which might be used in therapeutic strategies for reducing metastatic potential and invasiveness of these cells.

Hyponatremia, the most common electrolyte disorder, has been rarely reported as causing rhabdomyolysis. Osmotic demyelination syndrome (ODS), a demyelinating disease of the central pons and/or other areas of the brain, is infrequently reported as associated with rapid correction of hyponatremia. This paper reports a case of ODS after correction of severe hyponatremia complicated by rhabdomyolysis. A 47-year-old female with a history of chronic alcoholism presented herself at the hospital with altered consciousness after three days of nausea and vomiting. She was on a thiazide diuretic for essential hypertension. Her blood tests upon her hospital admission showed hyponatremia (Na+ 98 mEq/L), hypokalemia (K+ 3.0 mEq/L), and elevation of her serum creatine phosphokinase (3,370 IU/L) with an increase in her serum myoglobin level 11,267 ng/mL). She was treated with intravenous fluid therapy that included isotonic and hypertonic salines along with potassium chloride. She became more alert, and her neurological condition gradually improved after the first five days of her therapy. On the ninth day after her admission, she developed progressive quadiaresis associated with dysarthria, dysphagia, and dystonia despite the resolution of her hyponatremia. Magnetic resonance imaging of her brain on 16th day revealed symmetrical areas of signal hyperintensity in her central pons, basal ganglia, and precentral gyrus in T2-weighted images, which are consistent with ODS. Her neurological symptoms steadily improved after six weeks with only supportive treatment and rehabilitation.
Alcoholism ; Basal Ganglia ; Brain ; Consciousness ; Creatine Kinase ; Deglutition Disorders ; Demyelinating Diseases ; Dysarthria ; Dystonia ; Female ; Fluid Therapy ; Hematologic Tests ; Humans ; Hypertension ; Hypokalemia ; Hyponatremia ; Magnetic Resonance Imaging ; Myoglobin ; Nausea ; Pons ; Potassium Chloride ; Rhabdomyolysis ; Vomiting

OBJECTIVES: The purpose of this study is to evaluate the preliminary effects of school-based short term mental health awareness and school bullying prevention programs. METHODS: From April to December 2013, the Child and Adolescent Mental Health Promotion team of Seoul National Hospital conducted school-based short term social skill training (N=56, 4 sessions), mental health awareness (N=84, 4 sessions) and school bullying prevention programs (N=171, 1 session) in elementary and junior high schools located in Seoul. The changes in the subjects before and after the program were assessed. RESULTS: The a social skills training program improved the 'helping' behaviors in boys (t=-2.355, p<.05) and 'sharing' (t=-3.223, p<.01), 'cooperation' (t=-2.235, p<.05), and 'comforting' (t=-2.830, p<.01) behaviors in girls, assessed using the Prosocial Behavior Questionnaire. The mental health awareness program improved 'general health awareness' (t=2.620, p<.05), measured using the Korean General Health Questionnaire. The school bullying prevention program resulted in decreased 'self esteem' (t=3.769, p<.01), measured using the Self Esteem Scale and decreased 'anger' (t=4.198, p<.01), assessed using the Novaco Anger Scale. CONCLUSION: The results of our preliminary analysis suggest that school-based mental health awareness and school bullying prevention programs may be effective even when conducted for a short term. Future investigation is necessary in order to validate the long term effects of these programs.
Adolescent ; Anger ; Bullying* ; Child ; Education ; Female ; Humans ; Mental Health* ; Self Concept ; Seoul ; Surveys and Questionnaires