PURPOSE: The aim of this research is to examine the moderating effects of self-esteem and resilience in the relationship between smartphone addiction and depression among middle school students. METHODS: Data were collected from 324 middle school students in D City during the period of July 1st-17th, 2015. Multiple regression analysis, the Baron & Kenny's mediation verification, and Sobel test were conducted to measure the mediating effects of self-esteem and resilience on depression. RESULTS: There were significant correlations among the variables; smartphone addiction, self-esteem, resilience, and depression. Self-esteem had a complete mediating effect(β=-.40, p<.001) in the relationship between smartphone addiction and depression(Sobel test: Z=4.68, p<.001). Resilience had a partial mediating effect(β=-.15, p<.001) in the relationship between smartphone addiction and depression(Sobel test: Z=2.40, p<.001). CONCLUSION: This study suggests to apply self-esteem and resilience in developing nursing intervention programs for adolescent depression caused by smartphone addiction.
Adolescent ; Behavior, Addictive ; Depression* ; Humans ; Negotiating* ; Nursing ; Resilience, Psychological ; Self Concept ; Smartphone*

No abstract available.
Delivery of Health Care*

Objectives: Systematic evaluations of the benefits of health information technology (HIT) play an essential role in enhancing healthcare quality by improving outcomes. However, there is limited empirical evidence regarding the benefits of IT adoption in healthcare settings. This study aimed to review the benefits of artificial intelligence (AI), the internet of things (IoT), and personal health records (PHR), based on scientific evidence. Methods: The literature published in peer-reviewed journals between 2016 and 2022 was searched for systematic reviews and meta-analysis studies using the PubMed, Cochrane, and Embase databases. Manual searches were also performed using the reference lists of systematic reviews and eligible studies from major health informatics journals. The benefits of each HIT were assessed from multiple perspectives across four outcome domains. Results: Twenty-four systematic review or meta-analysis studies on AI, IoT, and PHR were identified. The benefits of each HIT were assessed and summarized from a multifaceted perspective, focusing on four outcome domains: clinical, psycho-behavioral, managerial, and socioeconomic. The benefits varied depending on the nature of each type of HIT and the diseases to which they were applied. Conclusions Overall, our review indicates that AI and PHR can positively impact clinical outcomes, while IoT holds potential for improving managerial efficiency. Despite ongoing research into the benefits of health IT in line with advances in healthcare, the existing evidence is limited in both volume and scope. The findings of our study can help identify areas for further investigation.

Objectives: With growing attention on the healthcare industry as a potential market for big data and artificial intelligence in the Fourth Industrial Revolution, countries around the world are introducing and developing various policies and projects related to health information technology (HIT). To assist prioritizing HIT topics in policy making, this study adopts the Delphi technique to garner expert opinions from various fields of health informatics. Methods: Data were collected from November 2019 to February 2020 using the Delphi technique through two rounds of surveys administered via email. The Delphi panel consisted of 16 experts with a high level of experience in health informatics. They were from the Health Information Policy Advisory Committee of the Ministry of Health and Welfare of Korea, and the board of directors of the Korean Society of Medical Informatics. The experts were asked to assess the importance, urgency, and difficulty of HIT topics in three domains: technology, application, and infrastructure. Results: Of the 40 topic items, a 100% agreement was reached for the importance of 6 items, including 2 items in technology, 1 item in application, and 3 items in infrastructure domains. Especially, Quadrant I of a 2×2 matrix showing high importance and high urgency included 7 items in the technology domain, 2 items in the application domain, and 13 items in the infrastructure domain. Conclusions Most items with high importance and urgency belonged to the infrastructure domain. The findings indicated that fostering an infrastructural environment should be polices with top priorities of HIT.

OBJECTIVES: A citation analysis of biomedical and health sciences journals was conducted based on their enlistment in journal databases to identify the factors contributing to the citation metrics. METHODS: Among the 1,219 academic journals managed by the National Center for Medical Information and Knowledge at the Korea Centers for Disease Control and Prevention, 556 journals were included for analysis as of July 2016. The characteristics of the journals include history years, publication media, language, open-access policy as well as the status enlisted in international and domestic databases, such as Science Citation Index (SCI), Scopus, Medline, PubMed Central, Embase, and Korea Citation Index (KCI). Six bibliometric measures were collected from SCI, Scopus, and KCI as of 2015, the most recent disclosure year. Analyses of group differences and influential factors were conducted using t-tests, Mann-Whitney tests, and multiple regression. RESULTS: Journal characteristics, such as history years, publication media, and open-access policy, were not significant factors influencing global or domestical citation of the journals. However, global citations were higher for SCI and Medline enlisted journals than for their counterparts. Among KCI journals, the KCI impact factors of journals published in English only were lower. CONCLUSIONS: Efforts by journals to be enlisted in international databases, especially in SCI and Medline, are critical to enhance their global circulation. However, articles published in English only hinder the use of domestic researchers. Different strategies are required for enhancing international and domestic readerships.
Access to Information ; Centers for Disease Control and Prevention (U.S.) ; Disclosure ; Journal Impact Factor ; Korea* ; Medical Subject Headings ; Publications ; Regression Analysis ; Republic of Korea

PURPOSE: The purpose of this study was to evaluate the effects of a devised posture management program based on the Theory of Planned Behavior in adolescents with mild idiopathic scoliosis. METHODS: A quasi-experimental study was conducted. It involved a nonequivalent comparison group design with pretest and posttest. Forty-four female adolescents with mild idiopathic scoliosis participated; data from 35 participants (20 for the test group, 15 for the control group) were used for the final analyses. The devised posture management program ran for 6 weeks. Posture management behavioral determinants (attitude, subjective norms, perceived behavioral control, and behavioral intention) as cognitive outcomes and muscular strength and flexibility as physical outcomes were measured three times: at baseline, week 6 and week 8. Cobb's angle as another physical outcome was measured twice: at baseline and week 8. Descriptive analysis, repeated measures analysis of variance and t test were used for data analyses. RESULTS: Attitude, perceived control, and behavioral intention were consistently enhanced by the posture management program. The intervention increased flexibility and muscular strength and decreased Cobb's angle, which reduced spinal curvature. Frequency of posture management exercise showed a gradual increase in the test group. CONCLUSION: The results indicate that the posture management program is effective in maintaining posture management behavior in adolescents with mild idiopathic scoliosis for both cognitive and physical outcomes. The posture management program should be helpful in expanding the role of school nurses in improving the health status of adolescents with mild idiopathic scoliosis.
Adolescent* ; Health Behavior ; Humans ; Intention ; Pliability ; Posture* ; Scoliosis* ; Spinal Curvatures

Stroke is a major health problem in Korea. It is the second leading cause of death, and many stroke survivors are permanently disabled. Despite the high economic and social burden of stroke, little is known about utilization of health care services for sufficiently long follow-up periods. This study assessed nationwide patterns of hospitalization for inpatients with stroke from 2000 to 2010, using national health insurance claim data. Overall, during these 10 years, the number of stroke hospitalizations grew by a compound annual growth rate of 6.4%, and health care expenditures showed continued growth at a faster rate of 13.2%. These growth trends were also consistent in different types of hospitals as well as different stroke subtypes. However, the utilization patterns of inpatient services were different across hospital types, especially in lengths of hospital stay (LOS), health care expenditures, and proportions of stroke subtypes. Concerning the proportion of patients in different types of hospitals, there were sharp increases in the use of long-term care hospitals from 5% to 20% of all stroke patients while the proportion has decreased from 49% to 39% in general hospitals. The LOS was also different across hospital types: The longest average LOS of 49 days was shown in long-term care hospitals, while the tertiary hospitals showed the shortest LOS of 15. In conclusion, despite a continuing decline in stroke mortality due to improved survival, the burden of disease due to stroke is increasing. To manage this issue, monitoring the trends of health care expenditures in detail, as well as the incidence and mortality rates, would be useful. These efforts will result in understanding the factors contributing to the increasing burden and in identifying the efficient and effective utilization of limited health care resources.
Cause of Death ; Delivery of Health Care ; Health Expenditures ; Hospitalization ; Hospitals, General ; Humans ; Incidence ; Inpatients ; Korea ; Length of Stay ; Long-Term Care ; National Health Programs ; Stroke ; Survivors ; Tertiary Care Centers

BACKGROUND: The aim of this study was to estimate the number of workers exposed to diesel engine exhaust (DEE) by industry and year in the Republic of Korea. METHOD: The estimates of workers potentially exposed to DEE in the Republic of Korea were calculated by industry on the basis of the carcinogen exposure (CAREX) surveillance system. The data on the labor force employed in DEE exposure industries were obtained from the Census on Establishments conducted by the Korea National Statistical Office from 1993 to 2013. The mean values of prevalence rates adopted by EU15 countries were used as the primary exposure prevalence rates. We also investigated the exposure prevalence rates and exposure characteristics of DEE in 359 workplaces representing 11 industries. RESULTS: The total number of workers exposed to DEE were estimated as 270,014 in 1993 and 417,034 in 2013 (2.2% of the total labor force). As of 2013, the industry categorized as “Land transport” showed the highest number of workers exposed to DEE with 174,359, followed by “Personal and household services” with 70,298, “Construction” with 45,555, “Wholesale and retail trade and restaurants and hotels” with 44,005, and “Sanitation and similar services” with 12,584. These five industries, with more than 10,000 workers exposed to DEE, accounted for 83% of the total DEE-exposed workers. Comparing primary prevalence rates used for preliminary estimation among 49 industries, “Metal ore mining” had the highest rate at 52.6%, followed by “Other mining” with 50.0%, and “Land transport” with 23.6%. CONCLUSION: The DEE prevalence rates we surveyed (1.3–19.8%) were higher than the primary prevalence rates. The most common emission sources of DEE were diesel engine vehicles such as forklifts, trucks, and vans. Our estimated numbers of workers exposed to DEE can be used to identify industries with workers requiring protection from potential exposure to DEE in the Republic of Korea.
Censuses ; Employment ; Family Characteristics ; Korea* ; Methods ; Motor Vehicles ; Prevalence ; Republic of Korea ; Restaurants ; Vehicle Emissions*

BACKGROUND: There is increasing interest in hepatocellular carcinomas (HCC) expressing "stemness"-related markers, as they have been associated with aggressive behavior and poor prognosis. In this study, we investigated the usefulness of Sal-like protein 4 (SALL4), a recently proposed candidate marker of "stemness." METHODS: Immunohistochemical stains were performed for SALL4, K19, and epithelial cellular adhesion molecule (EpCAM) on tissue microarrays constructed from 190 surgically resected HCCs, and the results were correlated with the clinicopathological features and patient survival data. RESULTS: Nuclear SALL4 expression was observed in 39/190 HCCs (20.5%), while K19 and EpCAM were expressed in 30 (15.9%) and 92 (48.7%) HCCs, respectively. The nuclear expression was generally weak, punctate or clumped. SALL4 expression was significantly associated with a poor overall survival compared to SALL4-negative HCCs (p = .014) compared to SALL4-negative HCCs. On multivariate analysis adjusted for tumor size, multiplicity, vascular invasion, and pathological tumor stage, SALL4 remained as a significant independent predictor of decreased overall survival (p= .004). SALL4 expression was positively correlated with EpCAM expression (p = .013) but not with K19 expression. HCCs that expressed both SALL4 and EpCAM were associated with significantly decreased overall survival, compared to those cases which were negative for both of these markers (p = .031). CONCLUSIONS: Although SALL4 expression was not significantly correlated with other clinicopathological parameters suggestive of tumor aggressiveness, SALL4 expression was an independent predictor of poor overall survival in human HCCs, and was also positively correlated with EpCAM expression.
Carcinoma, Hepatocellular* ; Coloring Agents ; Humans ; Immunohistochemistry ; Multivariate Analysis ; Prognosis*

Dandelion (DA) possesses the therapeutic ability to eliminate heat and alleviating swelling, choleresis, dieresis, and inflammation. In order to investigate the anti-arthritic effect of DA, several behavioral parameters such as paw volume, squeaking score, and weight distribution ratio were investigated in a carrageenan-induced arthritis rat model. At the maximum severity of arthritis, the daily administration of DA was initiated and lasted for 9 days. The therapeutic effects of DA were observed on 9th day after the arthritis induction, as compared to saline-treated control group. Oral administration of DA significantly alleviated apparent symptoms of paw volume, squeaking score, and weight distribution ratio in rats. In conclusion, DA was found to be effective in alleviating the inflammatory response and thus arthritic symptoms in carrageenan-induced arthritic rats.
Administration, Oral ; Animals ; Ankle ; Arthritis ; Carrageenan ; Hot Temperature ; Inflammation ; Rats ; Taraxacum