Purpose: This study aimed to evaluate the feasibility, safety, and immunological outcomes of low-dose cow’s milk oral immunotherapy (CM OIT) in school-aged children and adolescents with severe, persistent cow’s milk allergy (CMA), a group typically considered at a high risk for OIT. Methods: We conducted a retrospective study involving 12 patients (median age, 11.4 years) with immunoglobulin E (IgE)-mediated CMA, who underwent individualized low-dose CM OIT in the outpatient setting at a single tertiary hospital. Baseline and longitudinal clinical and immunological data, including casein-specific IgE and immunoglobulin G4 (IgG4) levels, were analyzed. Patients were classified as either desensitized or unsuccessful based on treatment outcomes. Results: Of the 12 patients with severe CMA, 6 achieved desensitization up to the target dose, while the remaining 6 discontinued treatment because of intolerance or poor adherence. The desensitized and unsuccessful groups showed no significant differences in baseline age, OIT starting dose, or serum casein-specific IgE level. Immunological evaluation revealed a significantly greater increase in serum casein-specific IgG4 (0.87 vs. -0.37 mg/L, P = 0.004) and a significantly lower natural log-transformed fold change in the IgE/IgG4 ratio (-1.38 vs. 0.44, P = 0.008) in the desensitized group. None of the patients required epinephrine during OIT, and adverse events were generally mild. Conclusion In selected high-risk pediatric populations with severe CMA, outpatient-based low-dose OIT using individualized flexible protocols may provide a relatively safe approach that improves tolerability and adherence. Increased casein-specific IgG4 levels and a reduced casein-specific IgE/IgG4 ratio may serve as valuable biomarkers for treatment response.

Purpose: Early adolescence is a pivotal developmental stage characterized by rapid physical, emotional, and social changes. Happiness during this period is crucial as it influences later life outcomes. This study examined 4-year changes in happiness and identified predictors among Korean early adolescents. Methods: A secondary analysis of longitudinal panel data was conducted using latent growth modeling to assess changes in happiness over 4 years, utilizing data from the Panel Study on Korean Children (11th–14th waves) with a total of 1,177 participants. Descriptive statistics were computed using IBM SPSS ver. 29.0, and latent growth modeling, including unconditional and conditional models with associated factors variables, was conducted using IBM AMOS ver. 29.0. Results: A nonlinear trajectory was identified with a sharp decline in happiness, particularly between the ages of 11 and 12 years. Self-esteem, peer attachment, and a creative school environment emerged as protective factors mitigating this decline, whereas parental attachment influenced baseline happiness but not its trajectory. Higher self-esteem, stronger peer attachment, and supportive school environments were associated with a slower decline in happiness. Conclusions Our findings highlight the importance of early interventions beginning around the age of 11 years, a critical period when happiness decreases more steeply. Practical implications include developing school-based and psychosocial programs that strengthen self-esteem and positive peer relationships, and fostering autonomy-supportive, creative educational environments. Coordinated efforts between schools and families are essential to promote adolescents’ emotional well-being and ensure balanced development in academic and socio-emotional domains.

Purpose: This study aimed to investigate the influence of uncertainty-related factors on the health behavior of individuals with coronary artery disease (CAD) based on Mishel’s uncertainty in illness theory (UIT). Methods: We conducted a cross-sectional study and path analysis to investigate uncertainty and factors related to health behavior. The study participants were 228 CAD patients who visited the outpatient cardiology department between September 2020 and June 2021. We used SPSS 25.0 and AMOS 25.0 software to analyze the data. Results: The final model demonstrated a good fit with the data. Eleven of the twelve paths were significant. Uncertainty positively affected danger and negatively affected self-efficacy and opportunity. Danger had a positive effect on perceived risk. Opportunity positively affected social support, self-efficacy, perceived benefit and intention, whereas it negatively affected perceived risk. Social support, self-efficacy, perceived benefit and intention had a positive effect on health behavior. We found that perceived benefit and intention had the most significant direct effects, whereas self-efficacy indirectly affected the relationship between uncertainty and health behavior. Conclusion The path model is suitable for predicting the health behavior of CAD patients who experience uncertainty. When patients experience uncertainty, interventions to increase their self-efficacy are required first. Additionally, we need to develop programs that quickly shift to appraisal uncertainty as an opportunity, increase perceived benefits of health behavior, and improve intentions.

Ophthalmic complications after tooth extraction are rare but discomforting events. This paper reports the rare complications of a 20-year-old male patient who presented with transient blurring of vision after surgical extraction of several teeth under general anesthesia. Additional diagnostic tests were performed to discern the reason for the pseudomyopia. A literature review was carried out by searching for articles published from 1936 to 2019 using the keywords “dental,” “ophthalmic,” “complication,” “blurring of vision,” and “accommodation disturbance” in PubMed. Only six patients with detailed ophthalmic symptoms similar to those of our patient have been reported. If blurred vision or a myopic shift in refraction is present, pseudomyopia should be suspected, and cycloplegic refraction is essential for diagnosis. The condition improves spontaneously.

Purpose: The purpose of this study was to develop and compare the prediction model for suicide attempts by Korean adolescents using logistic regression and decision tree analysis. Methods: This study utilized secondary data drawn from the 2019 Youth Health Risk Behavior web-based survey. A total of 20 items were selected as the explanatory variables (5 of sociodemographic characteristics, 10 of health-related behaviors, and 5 of psychosocial characteristics). For data analysis, descriptive statistics and logistic regression with complex samples and decision tree analysis were performed using IBM SPSS ver. 25.0 and Stata ver. 16.0. Results: A total of 1,731 participants (3.0%) out of 57,303 responded that they had attempted suicide. The most significant predictors of suicide attempts as determined using the logistic regression model were experience of sadness and hopelessness, substance abuse, and violent victimization. Girls who have experience of sadness and hopelessness, and experience of substance abuse have been identified as the most vulnerable group in suicide attempts in the decision tree model. Conclusion Experiences of sadness and hopelessness, experiences of substance abuse, and experiences of violent victimization are the common major predictors of suicide attempts in both logistic regression and decision tree models, and the predict rates of both models were similar. We suggest to provide programs considering combination of high-risk predictors for adolescents to prevent suicide attempt.

Purpose: This study aimed to identify changes in sub-areas of empathy over the 4 years from admission to graduation of nursing college students. Methods: This descriptive survey study was conducted using a longitudinal cohort design. The participants in this study were 158 South Korean nursing students attending a university in Chungcheongbuk Province or Gyeonggi Province, all of whom passed the certification evaluation for the 4-year nursing educational institute. Data from 126 participants were analyzed. The level of empathy was measured five times from March 2012 to December 2015. Empathy was identified using a multi-dimensional measurement tool consisting of four sub-constructs of cognitive and emotional aspects: (1) perspective taking, (2) fantasy, (3) empathic concern, and (4) personal distress. Data were analyzed using SPSS version 25 to provide descriptive statistics of the participants’ general characteristics and empathy level and to perform repeated-measures analysis of variance for the sub-constructs empathy. Results: Perspective taking (F=13.08, p<.001) and personal distress (F=5.24, p=.001), but not fantasy or empathic concern, showed significant differences over time. Conclusion Cognitive empathy (perspective taking) and emotional empathy (personal distress) improved. Intervention programs should be developed to maintain and strengthen changes in empathy in nursing education.

As of April 18, 2020, there have been a total of 10,653 confirmed cases and 232 deaths due to coronavirus disease 2019 (COVID-19) in Korea. The pathogen spread quickly, and the outbreak caused nationwide anxiety and shock. This study presented the anecdotal records that provided a detailed process of the multidisciplinary teamwork in mental health during the COVID-19 outbreak in the country. Psychosocial support is no less important than infection control during an epidemic, and collaboration and networking are at the core of disaster management. Thus, a multidisciplinary team of mental health professionals was immediately established and has collaborated effectively with its internal and external stakeholders for psychosocial support during the COVID-19 outbreak.