Purpose: This study aimed to investigate the association between relative muscle strength and serum hemoglobin levels. Methods: In this study, 3,234 adults living in rural areas were surveyed from 2007 to 2014 and the data was analyzed on 1,987 adults. Anemia (＜ 12 g/dL for women and ＜ 13 g/dL for men) was defined by examining serum hemoglobin concentration. Muscle strength was measured by using Takei dynamometer about grip strength and leg strength.To identify the association between relative strength and anemia, odds ratio (OR) and 95% confidence interval (CI) were calculated using logistic regression analysis (p＜ 0.05). Results: As confounding variables were adjusted, relative leg strength (high level: OR, 0.55; 95% CI, 0.34– 0.88) and relative grip strength (middle level: OR, 0.57; 95% CI, 0.37– 0.88; high level: OR, 0.50; 95% CI, 0.30– 0.84) were associated with OR of anemia risk. Relative grip strengths were significantly associated with risk of anemia in the ≥ 65-year age group (middle level: OR, 0.43; 95% CI, 0.23– 0.78; high level: OR, 0.32; 95% CI, 0.14– 0.72), but not in the ＜ 65-year age group. Also, ≥ 65-year age group, who have both high relative grip strength and high relative leg strength (OR, 0.44; 95% CI, 0.21– 0.93) or only high relative grip strength (OR, 0.41; 95% CI, 0.18– 0.96), was only significantly associated with the prevalence of anemia. Conclusion Improvement of relative muscle strength is a key factor that can lower the risk of anemia and it is recommended in order to reduce the health risk of elderly life.

Purpose: Our primary aim was to elucidate the association between relative grip strength levels and the risk of developing diabetes, utilizing longitudinal data. Methods: A total of 1,935 participants in this study comprised general adults aged 51 to 81 years, who had engagedin the survey both in 2013–2014 and during the subsequent follow-up in 2019–2020. The criteria for diagnosingdiabetes included receiving a diabetes diagnosis and treatment. grip strength was converted into relative grip strength by dividing it by body mass index. To validate the relationship between the interaction of relative grip strength and resting heart rate and its impact on risk of developing diabetes, a proportional hazards Cox regression model was used.Subsequently, we computed the hazard ratio (HR) and 95% confidence interval (CI) for risk of developing diabetes. Results: After adjusting for various confounding variables, we observed a significant 46% reduction in the risk of developing diabetes in the high relative grip strength group compared to the low relativegrip strength group (HR,0.54; 95% CI, 0.36–0.80). However, upon additional adjustment for waist circumference, no significant findings couldbe yielded. Furthermore, we found significant differences the relationship between relative grip strength, resting heart rate, and the risk of developing diabetes among different groups. Conclusion This study investigates the relationship between relative grip strength and incidence of diabetes, attributed to the accumulation of body fat. Notably, both resting heart rate and relative grip strength emerge as predictive indicators for assessing the risk of diabetes development.

Purpose: The purpose of this study was to identify the associations between type of moderate-vigorous physical activities (MVPA) and psychological stress in South Korean, based on the Korean Genome and Epidemiology Study. The subjects of this study were 2,891 Korean men and women aged 40 to 69, who completed health examination from 2011 to 2012. Methods: The type of MVPA was measured by using self-reported physical activity questionnaire. A high psychological stress was determined by scoring Psychological Well-being Index Short Form (≥ 27). Logistic regression analysis, adjusting other confounding factors, was conducted to identify the association of type of MVPA level with psychological stress (p＜ 0.05). Results: Participants who leisure-related MVPA of ≥ 150 min/week was less likely have to high psychological stress than ＜ 150 min/week (odds ratio [OR], 0.72; 95% confidence interval [CI], 0.57–0.92). From the analysis of gender, leisure-related (OR, 0.50; 95% CI, 0.35–0.72) and work-related (OR, 0.63; 95% CI, 0.41–0.97) MVPA of ≥ 150min/week were associated with low psychological stress in men, but women was not significantly associated. From the analysis of age, leisure-related MVPA of ≥ 150 min/week were associated with low psychological stress in middle age group (OR, 0.70; 95% CI, 0.53–0.92), but elderly group was not significantly associated. Differences inpsychological stress OR according to type of MVPA time were observed about classification of occupations. Conclusion High level of leisure related physical activity were independently associated with reducing risk for psychological stress. Also, encouraged MVPA by gender, age, classification of occupations could help to improve psychological stress levels in middle-aged or older adults.

We performed this study to examine lifestyle patterns and dietary behavior based on the level of Internet addiction of Korean adolescents. Data were collected from 853 Korean junior high school students. The level of Internet addiction was determined based on the Korean Internet addiction self-scale short form for youth, and students were classified as high-risk Internet users, potential-risk Internet users, and no risk Internet users. The associations between the students' levels of Internet addiction and lifestyle patterns and dietary behavior were analyzed using a chi-square test. Irregular bedtimes and the use of alcohol and tobacco were higher in high-risk Internet users than no risk Internet users. Moreover, in high-risk Internet users, irregular dietary behavior due to the loss of appetite, a high frequency of skipping meals, and snacking might cause imbalances in nutritional intake. Diet quality in high-risk Internet users was also worse than in potential-risk Internet users and no risk Internet users. We demonstrated in this study that high-risk Internet users have inappropriate dietary behavior and poor diet quality, which could result in stunted growth and development. Therefore, nutrition education targeting high-risk Internet users should be conducted to ensure proper growth and development.
Adolescent ; Appetite ; Diet ; Dietary Sucrose ; Growth and Development ; Humans ; Internet ; Life Style ; Meals ; Snacks ; Tobacco

Korea has the highest suicide rate amongst the OECD countries. Yet, its research on suicidal behaviors has been primitive. While the Interpersonal Psychological Theory of Suicide has gained global attention, there has only been a few researches, which examined its applicability in Korea. In this article, we review the previous studies on suicide and examine the association between the Interpersonal Psychological Theory of Suicide and traditional Korean culture, with an emphasis on Collectivism and Confucianism. We propose that pathways to suicide might vary depending on cultural influences. Clinical implications and suggestions for future research will be discussed.
Confucianism ; Korea* ; Organisation for Economic Co-Operation and Development ; Psychological Theory* ; Suicide*

Purpose: With an increase in the aging population, the number of patients with degenerative spinal diseases undergoing surgery has risen, as has the incidence of postoperative delirium. This study aimed to investigate the risk factors affecting postoperative delirium in older adults who had undergone spine surgery and to identify the associated biomarkers. Methods: This study is a prospective study. Data of 100 patients aged ≥ 70 years who underwent spinal surgery were analyzed. Demographic data, medical history, clinical characteristics, cognitive function, depression symptoms, functional status, frailty, and nutritional status were investigated to identify the risk factors for delirium. The Confusion Assessment Method, Delirium Rating Scale-R-98, and Nursing Delirium Scale were also used for diagnosing deliri-um. To discover the biomarkers, urine extracellular vesicles (EVs) were analyzed for tau, ubiquitin carboxy-terminal hydrolase L1 (UCH-L1),neurofilament light, and glial fibrillary acidic protein using digital immunoassay technology. Results: Nine patients were excluded, and data obtained from the remaining 91 were analyzed. Among them, 18 (19.8%) developed delirium. Differences were observed between partici-pants with and without delirium in the contexts of a history of mental disorder and use of benzodiazepines (p = .005 and p = .026, respectively). Tau and UCH-L1—concentrations of urine EVs—were comparatively higher in participants with severe delirium than that in partici-pants without delirium (p = .002 and p = .001, respectively). Conclusion These findings can assist clinicians in accurately identifying the risk factors before surgery, classifying high-risk patients, and predicting and detecting delirium in older patients. Moreover, urine EV analysis revealed that postoperative delirium following spinal surgery is most likely associated with brain damage.

OBJECTIVE: Based on the constant associations made between major depressive disorder (MDD) and alpha asymmetry, and MDD and suicide, this study aimed to examine the relationship between frontal alpha asymmetry and suicide in MDD patients. METHODS: Sixty-six MDD patients, of whom fifteen were male and fifty-one were female, were recruited. Independent groups were created based on the median score of frontal alpha asymmetry: the left dominant (LD) group and the right dominant (RD) group. The alpha band (8–12 Hz) and its sub-bands (i.e., low alpha band: 8–10 Hz; high alpha band: 10–12 Hz) were of interest. Source level alpha asymmetry was calculated as well. RESULTS: Suicidal behavior was positively correlated with the asymmetry indices of the low alpha band and the alpha band in the LD group and that of the high alpha band in the RD group. Source level analysis revealed positive correlations between suicidal behavior and the asymmetry index of the low alpha band in the LD group. CONCLUSION: Frontal alpha asymmetry, especially that of the low alpha band, might reflect the cognitive deficits associated with suicidal behaviors in MDD patients.
Cognition Disorders ; Depression ; Depressive Disorder, Major ; Electroencephalography ; Female ; Humans ; Male ; Suicide

Objective: Early detection and intervention of developmental disabilities (DDs) are critical to improving the long-term outcomes of afflicted children. In this study, our objective was to utilize facial landmark features from mobile application to distinguish between children with DDs and typically developing (TD) children. Methods: The present study recruited 89 children, including 33 diagnosed with DD, and 56 TD children. The aim was to examine the effectiveness of a deep learning classification model using facial video collected from children through mobile-based application. The study participants underwent comprehensive developmental assessments, which included the child completion of the Korean Psychoeducational Profile-Revised and caregiver completing the Korean versions of Vineland Adaptive Behavior Scale, Korean version of the Childhood Autism Rating Scale, Social Responsiveness Scale, and Child Behavior Checklist. We extracted facial landmarks from recorded videos using mobile application and performed DDs classification using long short-term memory with stratified 5-fold cross-validation. Results: The classification model shows an average accuracy of 0.88 (range: 0.78–1.00), an average precision of 0.91 (range: 0.75–1.00), and an average F1-score of 0.80 (range: 0.60–1.00). Upon interpreting prediction results using SHapley Additive exPlanations (SHAP), we verified that the most crucial variable was the nodding head angle variable, with a median SHAP score of 2.6. All the top 10 contributing variables exhibited significant differences in distribution between children with DD and TD (p<0.05). Conclusion The results of this study provide evidence that facial landmarks, utilizing readily available mobile-based video data, can be used to detect DD at an early stage.

OBJECTIVE: This study evaluated the psychometric properties of the Korean Anxiety Screening Assessment (K-ANX) developed for screening anxiety disorders. METHODS: Data from 613 participants were analyzed. The K-ANX was evaluated for reliability using Cronbach’s alpha, item-total correlation, and test information curve, and for validity using focus group interviews, factor analysis, correlational analysis, and item characteristics based on item response theory (IRT). The diagnostic sensitivity and specificity of the K-ANX were compared with those of the Beck Anxiety Inventory (BAI) and Generalized Anxiety Disorder 7-item scale (GAD-7). RESULTS: The K-ANX showed excellent internal consistency (α=0.97) and item-total coefficients (0.92–0.97), and a one-factor structure was suggested. All items were highly correlated with the total scores of the BAI, GAD-7, and Penn State Worry Questionnaire. IRT analysis indicated the K-ANX was most informative as a screening tool for anxiety disorders at the range between 0.8 and 1.6 (i.e., top 21.2 to 5.5 percentiles). Higher sensitivity (0.795) and specificity (0.937) for identifying anxiety disorders were observed in the K-ANX compared to the BAI and GAD-7. CONCLUSION: The K-ANX is a reliable and valid measure to screen anxiety disorders in a Korean sample, with greater sensitivity and specificity than current measures of anxiety symptoms.
Anxiety Disorders* ; Anxiety* ; Focus Groups ; Mass Screening* ; Psychometrics ; Sensitivity and Specificity

PURPOSE: The aim of the study is to evaluate the current and prospective status of nursing in Korea and develop a strategic framework and plan to accommodate the increased demands on nurses in the changing health-care system. METHODS: This study used a mixed-methods approach including a literature review, an online survey with health-care consumers, expert panel interviews, and an analysis of strengths, weaknesses, opportunities, and threats to develop the strategic plans and framework. RESULTS: The vision of the strategic framework involved improving health and quality of life, and its mission was to elevate the status of Korea's nursing sector as a key health-care profession through high-quality and innovative nursing education, research, and practice. The five values in accordance with the mission and vision were innovation, creation, collaboration, excellence, and authenticity. Three strategic goals, namely, education, research, and practice, were identified, and 31 related strategic tasks were developed. CONCLUSION: In response to the rising social demand for a paradigm shift in nursing care services, there is a need for advancements in nursing education, research, and practice in Korea. This study provide some recommendations to achieve these aims.
Cooperative Behavior ; Education ; Education, Nursing ; Health Policy ; Korea ; Nurse's Role ; Nursing Care ; Nursing ; Prospective Studies ; Quality of Life