• Journal of Korean Academy of Nursing
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• v.54 no.2
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• pp.193-210
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• 2024

Purpose: The objective of this study was to develop a predictive model for the sexual experiences of adolescents using the random forest method and to identify the "variable importance." Methods: The study utilized data from the 2019 to 2021 Korea Youth Risk Behavior Web-based Survey, which included 86,595 man and 80,504 woman participants. The number of independent variables stood at 44. SPSS was used to conduct Rao-Scott χ² tests and complex sample t-tests. Modeling was performed using the random forest algorithm in Python. Performance evaluation of each model included assessments of precision, recall, F1-score, receiver operating characteristics curve, and area under the curve calculations derived from the confusion matrix. Results: The prevalence of sexual experiences initially decreased during the COVID-19 pandemic, but later increased. "Variable importance" for predicting sexual experiences, ranked in the top six, included week and weekday sedentary time and internet usage time, followed by ease of cigarette purchase, age at first alcohol consumption, smoking initiation, breakfast consumption, and difficulty purchasing alcohol. Conclusion: Education and support programs for promoting adolescent sexual health, based on the top-ranking important variables, should be integrated with health behavior intervention programs addressing internet usage, smoking, and alcohol consumption. We recommend active utilization of the random forest analysis method to develop high-performance predictive models for effective disease prevention, treatment, and nursing care.

• Clinical and Experimental Pediatrics
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• v.52 no.5
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• pp.513-518
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• 2009

In childhood tuberculosis, it is possible to clearly distinguish among three basic stages: exposure, infection, and disease. The incidence of tuberculosis in children is low compared with that in adults, but latent infection is a major concern because children, who are exposed to Mycobacterium tuberculosis especially early in childhood, are at increased risk of developing the disease. Younger children particularly infants have a high relative risk of miliary or meningeal disease. The clinical manifestations of childhood tuberculosis differ noticeably from those of the disease seen in adults. Adolescents with tuberculosis have different demographic and clinical features from those of adults or children. Tuberculosis in adolescents has become relatively more important as the incidence of infection in childhood has decreased.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.5 no.1
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• pp.28-35
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• 1994

Research on biological aspects on adult depression has been subjected to more than 25 years of systematic research, while biologic investigations regarding childhood and adolescent depression are only now being initiated. Although no unifying, explanatory theory of the biologic etiology of childhood depression emerges from the results of studies reviewed above, the findings do support that biological factors may be involved in the genesis of childhood depression. The research reviewed in this paper suggests that age and pubertal factors have major effects in most biological markers of depression. Some of these markers, like sleep EEG and neuroendocrine markers should be broken down by decades during adult life span. Thus, although adult data are very valuable points of departure for biological research on child and adolescent depression, it is very hard to transfer the adult data to prepubertal children and adolescents, ignoring the biological changes that take place in growth and development, pubety and aging. A great deal of work in basic developmental neuroscience remains to be done. It will be crucial for further advances in this field to determine the normal patterns of neurotransmitter interaction in this age group and to study children at high risk for depression. It will be also crucial to use primate models of depressive illness in order to be able to answer the many queations that cannot be investigated in humans for ethical issues. Conclusively, much closer collaboration between developmental and neurobiological and behavioral studies in primates and in humans will be essential for further development.

• Journal of Life Science
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• v.19 no.2
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• pp.198-205
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• 2009

The purpose of this study was to find out the effects of a 12-week aerobic exercise plus lifestyle modification on obese-induced metabolic syndrome in obese adolescent girls. A total of 52 obese adolescent girls (13-14 years old; body mass index (BMI) ${\geq}$95th percentiles for age and sex) purposely assigned to aerobic exercise group (AEG, n=15), aerobic exercise plus lifestyle modification group (ALG, n=18), or control group (CG, n=19). The AEG completed 12 weeks of walking exercise (30-60 min/day, 65-75% HRmax, 6 days/week), the ALG completed 12 weeks of walking exercise (30-60 min/day, 65-75% HRmax, 6 days/week) and behavior modification (60 min/day, 1 day/week), and the CG continued their normal life. The presence of the metabolic syndrome and component risk factors were determined before and after 12-week programs. The total prevalence of the metabolic syndrome was 48.1% in this sample (25/52) of participants at baseline. After the programs the prevalence of the metabolic syndrome was improved in the AEG and ALG 33.3, 27.8%, respectively. Group analyses showed significant difference in risk factors of the metabolic syndrome such that the AEG and ALG had significantly greater improvements in waist circumference, triglycerides, blood glucose and systolic blood pressure than the CG, while there were no significant difference in HDL cholesterol and diastolic blood pressure. Also there was no group difference between AEG and ALG in all measured metabolic risk factors after the programs. These results indicate that the positive changes of the ALG were not associated with lifestyle modification (behavior modification) but associated with aerobic exercise. However, long-term follow up studies are necessary to clarify the additive effect of the behavior modification on the metabolic syndrome.

• Journal of Trauma and Injury
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• v.19 no.1
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• pp.47-53
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• 2006

Purpose: Recently, the American Heart Association recommended that routine cervical spine protection in submerged patients was not necessary, except in high-energy injury situations. However, until now, this recommendation has few supportive studies and literatures. This retrospective study was performed to demonstrate the risk of cervical spine injury in patients who had been submerged in a river. Methods: Seventy-nine submerged patients who visited St. Mary's Hospital between January 2000 and December 2005 were included in this retrospective study. We investigated and analyzed the victim's age, sex, activity on submersion, mental status and level of severity at admission, prognosis at discharge, associated injuries, and risk group by using the medical records and cervical spine lateral images. According to the activity on submersion, victims were classified into three groups: high risk, low risk, and unknown risk. The reports of radiologic studies were classified into unstable fracture, stable fracture, sprain, degenerative change, and normal. Results: The patients' mean age was 36.8 yrs, and 54% were males. Of the 79 patients, adult and adolescent populations (80%) were dominant. Jumping from a high bridge (48%) was the most common activity on submersion and accounted for 52% of the high-risk group. The Glasgow coma scale at admission and the cerebral performance scale at discharge showed bimodal patterns. The results of the radiologic studies showed one stable fracture, one suspicious stable fracture, and 18 sprains. The incidence of cervical spine fracture in submerged patients was 2.5% in our study. The incidence of cervical spine injury was higher in the high-risk group than it was in the low-risk group, especially in the jumping-from-high-bridge subgroup; however this observation was not statistically significant. No other factors had any significant effect on the incidence of cervical spine injury. Conclusion: Our study showed that even submerged patients in the high risk group had a low incidence of cervical spine fracture and that the prognosis of a patient did not seem to be influenced by the cervical spine fracture itself.

• Clinical and Experimental Pediatrics
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• v.63 no.9
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• pp.368-372
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• 2020

Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder defined by impairments in social interaction and verbal and nonverbal communication. Purpose: Determine the association between use of assisted reproduction technology (ART) and the risk of ASD among children. Methods: This case-control study included 300 participants (100 cases, 200 controls). The control group included women with a child aged 2-10 years without ASD, while the cases were women with a child aged 2-10 years with ASD. We used a researcher-made questionnaire. Data were analyzed using Stata ver. 14 at the 0.05 significance level. Results: In the univariate analysis, there was significant association between child sex, delivery mode, history of preterm delivery, history of using ART, and maternal age at child's birth and the risk of ASD. After the adjustment for other variables, this association was significant for male sex (2.66; 95% confidence interval [CI], 1.11-4.31; P=0.001) and history of using ART (4.03; 95% CI, 1.76-9.21; P=0.001). Therefore, after the adjustment for confounder variables, there was no significant association between ART and the risk of ASD among children (4.98; 95% CI, 0.91-27.30; P=0.065). Conclusion: After the adjustment for other variables, risk factors for ASD were male sex and history preterm delivery. Thus, there was no significant association between ART and the risk of ASD among children.

• Journal of Korean Academy of Nursing
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• v.39 no.3
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• pp.376-385
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• 2009

Purpose: The purposes of this study were(a) to identify smoking behavior by following a cohort representative of the population of 4th grade elementary schoolers in South Korea over a four-year period(2004-2007), and(b) to explore predictors of smoking initiation among non-smokers in Wave 1. Methods: Secondary data, the Korea Youth Panel Study, was analyzed in this study. First, frequencies or percentages were calculated to identify smoking behavior(i.e., smoking initiation, smoking intensity, and smoking duration). Second, binary logistic regression analysis was performed to examine significant factors related to smoking initiation. Results: Smoking initiation and daily smoking were more pronounced when the participants entered middle school. In bivariate analysis, statistically significant predictors of smoking initiation were loneliness at school, self-control, delinquent behavior, depressive symptoms, and stress. However, after controlling for other factors, only a high level of risk-taking tendency and a greater number of delinquent behaviors remained statistically significant. Conclusion: Based on greater involvement in smoking among first-year middle schoolers, smoking prevention strategies should be provided to elementary schoolers rather than middle schoolers. A risk-taking tendency and delinquent behaviors should be considered as proxy measures to detect the high-risk group for smoking initiation.

• Journal of Preventive Medicine and Public Health
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• v.46 no.4
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• pp.173-182
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• 2013

Obesity during childhood is a dominant risk factor for noncommunicable diseases (NCDs), and is itself considered a disease that needs to be treated. Recently, the growth in childhood obesity in Korea has become stagnant; however, two in every ten children are still overweight. In addition, 60% or more of overweight children have at least one metabolic syndrome risk factor. Thus, childhood obesity should be controlled through lifestyle modification. This paper reviews studies of the modifiable risk factors of obesity in Korean children. According to the life-course approach, preschool-aged children (<5 years) are influenced by their parents rather than individual habits because they are under mostly parental care. Elementary school-aged children (6 to 11 years) are affected by overlapping individual and parental effects. This may mean that the establishment of individual behavior patterns begins during this period. The conditions of poor eating habits such as skipping meals, eating out, and high fat intake, along with low physical activity, facilitate increased obesity among adolescents (12 to 18 years). Notably, adolescent girls show high rates of both underweight and obesity, which may lead to the development of NCDs in their offspring. Therefore, the problem of NCDs is no longer limited to adults, but is also prevalent among children. In addition, early intervention offers cost-effective opportunities for preventing NCDs. Thus, children need primary consideration, adequate monitoring, diagnosis, and treatment to reduce the burden of NCDs later in adulthood.

• Journal of the Korean Society of School Health
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• v.31 no.2
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• pp.79-87
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• 2018

Purpose: The purpose of this study was to investigate the relationship between the risk of school bullying victimization and the risk of Internet gaming disorder according to gender in adolescents. Methods: The data of 1,920 middle school students collected at the baseline of the Internet user Cohort for Unbiased Recognition of gaming disorder in Early Adolescence (iCURE) study were analyzed. For statistical analysis, $x^2$ test, t-test and stratified multiple logistic regression analysis were conducted using SAS 9.4. Results: The prevalence rate of Internet gaming disorder of middle school boys was greater than that of girls (Boys: 9.9%, Girls: 6.2%). The greater the risk of school bullying victimization, the greater both the risk of Internet gaming disorder and the average daily time spent on Internet gaming. In girls, the relationship between the experience of being bullied in school and Internet gaming disorder was not statistically significant. However, the boys who had been bullied in school were 3.2 times more vulnerable to the risk of Internet gaming disorder than those without such experience (95% CI: 1.135-8.779). Conclusions: When considering interventions for Internet gaming disorder for adolescents, bullying victimization should be taken into account as well. Particularly, relieving stress related to bullying victimization can be important for boys with Internet gaming disorder.

• The Journal of Korean Society for School & Community Health Education
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• v.5
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• pp.11-23
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• 2004

The purpose of this study was to analyze the internet usage patterns among adolescents and to provide basic data for the development of internet addiction prevention program. The subjects of this study were 1169 students in middle and high school students in Seoul, Korea. Self-administered questionnaires were employed and data were analysed by SPSS 12.0. Major conclusions were as follows: 1. Most of the students were found to be the normal internet users. On the other hand, potential risk group was 8.2% and high risk group was 4.7%. Every students have had an experience of inter use. The 90.6% of the students' households had internet links. The percentage of students who were using internet more than 3 hours a day was 25.7%, and The most popular type of website was entertainment. 2. Male students showed greater percentages of potential risk and high risk group than female students. The students having parents in divorce, remarriage and separation were more likely to be in potential risk group than those having normal parents. The staying alone in home after school and small sleeping time were positively related to high level of internet addiction. 3. The characteristics of the students in potential risk and high risk group were longer duration of the internet use, internet use through the whole week, frequent internet use late at night, frequent use of pornographic site, main purpose of internet use for entertainment and shortage of rest during internet use. This study results had an limitation of generalizing to entire Korean adolescents because the sample of this study was middle and high school students living in Seoul. Future study was needed for the analysis of internet use behavior of the entire Korean adolescents, and for the identification of the accurate predictors for adolescents' internet addiction.