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Aim: This study investigated the adjunctive effect of polydeoxyribonucleotide (PDRN) on bone formation in alveolar ridge preservation (ARP) sockets. Materials and Methods: Both mandibular second, third and fourth premolars of eight beagle dogs were randomly divided into ARP and ARP/PDRN groups. Following tooth extraction, ARP procedures were conducted using collagenized alloplastic graft material and bilayer collagen membrane soaked with normal saline (ARP group) or PDRN (ARP/PDRN group) for 10 min before application. Both groups were also randomly allocated to 2‐, 4‐ or 12‐week healing subgroups. The primary endpoint of this study was to compare histomorphometric differences between ARP and ARP/PDRN. The secondary endpoints of this study were to compare micro‐CT analysis and three‐dimensional volumetric measurement between the two groups. Results: In the histomorphometric analysis, the ARP/PDRN group exhibited greater new bone formation at coronal, middle and total position compared with the ARP group at 2‐week healing. The number of newly formed blood vessels was higher in the ARP/PDRN group than in the ARP group at 2‐ and 4‐week healing. In micro‐CT analysis, the mean new bone volume/total bone volume between ARP and ARP/PDRN was statistically significant at 2‐week healing. Ridge volume alterations were significantly decreased in the ARP/PDRN group during entire healing time compared with the ARP group, especially on the buccal side. Conclusions: The application of PDRN in ARP might provide additional benefits for early bone regeneration and maintenance of buccal ridge volume. [ABSTRACT FROM AUTHOR]

Active migration and globalization have led to increased opportunities for critical care nurses to care for patients from diverse racial and cultural backgrounds. This study thus aimed to identify the individual, interpersonal, and organizational factors affecting cultural competence levels among neonatal intensive care unit (NICU) nurses based on an ecological model. This was a cross-sectional descriptive study that included 135 NICU nurses in South Korea. A hierarchical multiple linear regression analysis was conducted using the proposed ecological model, and a regression model for each of the four subdomains of cultural competence was constructed and compared. NICU nurses' cultural competencies were influenced not only by the "necessity of multicultural education" and "ethnocultural empathy" at the individual level but by the "hospital's readiness and support for cultural competencies" at the organizational level. To promote the cultural competence of nurses in critical care settings, environmental and organizational support should be improved, along with developing strategies that focus on nurses' individual characteristics. It is also necessary to investigate the "intersectionality" of the effects of individual and environmental factors on cultural competence. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the effect of the coronavirus disease (COVID‐19) pandemic on Korean adolescents' oral health and identify the influential factors. Methods: The raw data from The Korea Youth Risk Behaviour Web‐based Survey before (2019) and after (2020) the outbreak of COVID‐19 were used in the study. Demographic characteristics and subjective general, mental, and oral health were analysed and compared between the 2 years. Further, the impact of changes in subjective mental health and the duration of indoor activity on oral health were analysed. Data were analysed using IBM SPSS Statistics, and all statistical significance was set at α = 0.05. The analysis was performed using the complex sample analysis module. Results: In 2020, compared with 2019, the proportion of adolescents who rated high on subjective academic performance, smoking, and drinking decreased (p < 0.001). However, there was no difference in the household economic status between 2020 and 2019 (p = 0.917), while subjective mental health improved. In addition, the risk of tooth fracture was 1.321 times higher after the pandemic. After the outbreak of COVID‐19, adolescents who were indoors for >24 h for non‐learning activities on weekends were 2.97 times more likely to have reported gingival pain and bleeding (p < 0.05). Conclusions: After the outbreak of COVID‐19, smoking and drinking decreased in Korean adolescents, while changes occurred in their learning patterns at home, and their mental health improved. Some oral symptoms increased or showed no change. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to identify the factors affecting the prevention of cross‐infection with coronavirus disease‐19 (COVID‐19) among Korean dental hygienists. Methods: The level of knowledge about COVID‐19 (KNWCO), level of awareness of infection control (AWRIC), degree of performance for infection control (PRFIC), and organizational factors for infection control (OFWIC) of clinical dental hygienists in Korea to prevent COVID‐19 transmission were investigated. A self‐written online questionnaire was administered to dental hygienists currently working in dental clinics or hospitals, and the survey results of 263 participants were analysed. Pearson's correlation coefficients were calculated for relationships between the KNWCO, AWRIC, PRFIC, and OFWIC. Multiple linear regression analysis was performed to identify the factors affecting the PRFIC. Statistical significance was set at p < 0.05. Results: Knowledge about COVID‐19, AWRIC, PRFIC, and OFWIC were significantly correlated with each other. OFWIC (β = 0.491, p < 0.001), followed by AWRIC (β = 0.428, p < 0.001) and KNWCO (β = 0.095, p = 0.013), had the greatest impact on PRFIC with regard to the prevention of COVID‐19 transmission. Conclusions: Organizational factors for infection control and AWRIC should be strengthened to improve PRFIC and prevent COVID‐19 transmission during dental care. [ABSTRACT FROM AUTHOR]

Aim: To identify the factors affecting Emergency Department Length of Stay for transferred critically ill patients. Background: The Length of Stay of the transferred patients is an important indicator of Emergency Department service quality; thus, understanding the factors affecting the Emergency Department Length of Stay of transferred critically ill patients is essential. Methods: Using the electronic medical records of 968 transferred critically ill Emergency Department patients of a tertiary hospital in Korea, prediction models for Emergency Department Length of Stay were built using various machine learning algorithms. Results: The logistic regression (AUROC 0.85) models showed the best performance, followed by random forest (AUROC 0.83) and Naive Bayes (AUROC 0.83). The logistic regression model indicated that fewer consultations, the highest acuity level, need for an emergency operation or angiography, need for ICU admission, severe emergency disease and fewer diagnoses were the statistically significant predictors for Emergency Department Length of Stay of 6 h or less. Conclusions: The transferred critically ill patients analysed in this study who required immediate or specialized care tended to receive needed care on time at the study site. Implications for Nursing Management: Understanding the factors affecting the Emergency Department Length of Stay of transferred critically ill patients is crucial for developing strategies to manage the nursing resource of Emergency Department successfully. [ABSTRACT FROM AUTHOR]

Objectives: In this study, we aimed to determine the relationship between oral health status and thyroid dysfunction. Methods: A population‐based cross‐sectional analysis using data from the Korean National Health and Nutrition Examination Survey (KNHNES) was performed. We investigated the association between oral health‐related parameters and the prevalence of thyroid diseases. In addition, the relationship between oral health status and thyroid function test (TFT) results was analyzed. One‐way analysis of variances or chi‐square test was used for comparisons between oral health‐related parameters and presence of thyroid diseases. Univariable and multivariable logistic regression analyses were conducted to evaluate the associations between participants' characteristics including oral health‐related parameters and the abnormal results of TFTs. Results: A total of 18,034 adults were surveyed. Histories of thyroid diseases were found to be more common in people who brushed their teeth frequently or used oral hygiene products. However, histories of periodontitis and community periodontal index (CPI) did not show significant associations with histories of thyroid diseases. Among 14,860 participants without history of thyroid disorders, people having higher CPI values demonstrated higher probabilities of abnormal TFTs (OR 1.381, 95% CI 1.241‒1.537, p <.0001); however, statistical significance was not found after adjusting for the other variables. Conclusions: Our study demonstrated that good oral health‐related behavior was associated with more frequent thyroid disease history. High CPI showed a significant association with TFT abnormalities; however, the significance of this association became lower when other variables such as age and sex were adjusted. Further studies will be needed to determine how the control of oral health‐related conditions actually has a causal relationship with thyroid disease/dysfunction through prospective cohort studies. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate infection control knowledge and its practice of clinical dental hygienists in response to Coronavirus Disease 2019 (COVID‐19) in South Korea. Methods: Nine questions (Q9‐K) on the degree of knowledge acquisition of dental hygienists in response to COVID‐19, and another 9 questions (Q9‐P) on the practices for COVID‐19 infection and spread prevention were prepared. From 500 clinical dental hygienists in South Korea, answers about their general characteristics, Q9‐K, and Q9‐P were collected. 1 point was given to each question based on the 'yes' answers from Q9‐K and Q9‐P, and Score‐K and Score‐P were calculated, respectively. To identify factors affecting Score‐P, a multiple linear regression analysis was performed. In all analyses, p‐values lower than 0.05 were considered statistically significant. Results: Average scores of Score‐K and Score‐P were 7.36 ± 1.35 and 6.26 ± 2.07, respectively. The regression model of Score‐P was significant (F = 20.788, p < 0.001). Concerning Score‐P, Score‐K (β = 0.385), age (β = 0.275), dental hospital (β = 0.158), monthly income of $2,360~$2,730 (β = 0.104) had a significantly positive correlation, and the total years of career (β = −0.293) are found to have a significantly negative correlation. Conclusions: Infection control knowledge and practice of clinical dental hygienists in South Korea was found to be vulnerable in the group of hygienists who are younger than 27 years old, working in dental clinics, and whose monthly income is less than under $2,000. Also, the factor that influences infection control practice the most was the degree of knowledge. Therefore, continuous infection control education and supplement targeting these vulnerable groups are necessary. [ABSTRACT FROM AUTHOR]

Objectives: We investigated the effects of a web‐based alcohol drinking prevention program among early elementary school students in South Korea using the theory of planned behavior. This study utilized a combined family and school intervention approach. Design: This was a quasi‐experimental study with a non‐equivalent control group. Sample: A total of 251 third graders (experimental group: 170, control group: 81) from four public schools were included. Measurements: A web‐based alcohol drinking prevention program was implemented in five weekly sessions. Students' attitudes, subjective norms, perceived behavioral control (PBC), and intentions toward alcohol drinking prevention behavior were evaluated through pre‐ and post‐tests. Results: The average age of the participants was 9 years in both the experimental (82 male and 88 female students) and control (44 male and 37 female students) groups. A significant improvement in attitudes, PBC, and intentions toward alcohol drinking prevention behaviors was found in the experimental group. Conclusions: A web‐based alcohol drinking prevention program combining family and school interventions for lower elementary school students was effective at increasing intentions toward alcohol drinking prevention behavior. Alcohol drinking prevention programs should target lower elementary school students to effectively postpone the onset of alcohol drinking. [ABSTRACT FROM AUTHOR]

Flipped learning recently gained attention as an effective instructional approach to enhance learning engagement, causing many universities to implement it. To enhance student engagement in large university classes, this study examined the effects of self‐efficacy, self‐regulation and social presence on learning engagement in a large university class using a flipped learning approach. A total of 390 undergraduates who were enrolled in a large general education class using flipped learning at a university in Korea participated in this study. The learners completed an online survey measuring the variables of this study. The research findings indicated that self‐regulation affected social presence as well as learning engagement. Self‐efficacy affected social presence and indirectly affected learning engagement through social presence. Finally, social presence affected learning engagement. Social presence also mediated the relationship between self‐efficacy and learning engagement as well as between self‐regulation and learning engagement. This study confirmed the significant effects of self‐regulation and social presence on students' learning engagement in large university classes. Lay Description: What is already known about this topic: Self‐efficacy is an important influential factor in learning.Self‐regulation plays a major role in the success of flipped learning.The establishment of social presence is an important factor to enhance learning engagement. Learning engagement has a significant impact on learning achievement and attitudes.Many universities still offer large classes despite students' low learning engagement. What this paper adds: Self‐efficacy indirectly affected learning engagement through social presence in flipped learning.Self‐regulation influenced both social presence and learning engagement in flipped learning.Social presence directly and indirectly affected learning engagement in flipped learning.Social presence mediated the relationship between self‐efficacy and learning engagement as well as between self‐regulation and learning engagement in flipped learning. Implications for practice and/or policy: It is important to promote students' self‐regulation for enhancing learning engagement in large university classes with flipped learning.Students' self‐regulation skills should be checked as a prerequisite for enrolling in a large flipped class. [ABSTRACT FROM AUTHOR]

Objective: The use of e‐cigarettes is rapidly increasing in adolescents. Health care providers pay attention to e‐cigarette users because of the risk of developing addiction and problematic behavior. Based on ecological perspective, this study investigated factors influencing continued e‐cigarette use. Methods: We classified 1556 current e‐cigarette users into experimental and continued users using the Korean national representative data. Data were analyzed using the chi‐square test and logistic regression based on a complex sample analysis. Results: Among current e‐cigarette users, 55.1% were continued users. Adolescents who use e‐cigarettes because of the belief that they are less harmful than cigarettes, concealment, easy purchase, and adding various flavors had a high risk of continued use. Continued users were more likely to have a higher weekly allowance, lower rate of living with family, and higher chance of smoking parents and exposure to passive smoking at home. Conclusions: Continued e‐cigarette use was influenced by interpersonal and environmental factors, such as ease of purchase and addition of flavoring substances. Improving the environment of adolescents can prevent continued use of e‐cigarettes. [ABSTRACT FROM AUTHOR]

As a part of Korea's smoking cessation policy, the price of tobacco was increased in January 2015. Initially, the smoking rate among adolescents began to decrease. The current data, however, show that the adolescent smoking rate is on the rise. Alongside price policies, there is a need to further understand additional preventive measures that promote successful smoking cessation by identifying the factors that influence maintenance of smoking cessation in adolescents. This study aimed to identify the factors that influence smoking cessation in adolescents after attempting smoking cessation after increase in tobacco price. The study used large‐scale, nationwide, secondary data obtained from the Korean Youth Risk Behavior Web‐Based Survey. The sample included a total of 627 subjects who reported an attempt to quit smoking after the tobacco price increased. Descriptive statistics, t test, the χ2 test, and multiple logistic regression were used. The results showed that household economic status, school type, suicidal ideation, experience of exposure to secondhand smoke at home, and experience of witnessing teaching staff smoking were significant factors related to maintenance of smoking cessation among adolescents. To increase the success rate of smoking cessation, future intervention programs should include school environment structure and address emotional and psychological issues such as suicide. [ABSTRACT FROM AUTHOR]

Aim: To identify the association between sexual behavior and suicidal ideation among South Korean middle school students. Methods: This study used raw data from the 2013 Korean Youth Risk Behavior Web‐Based Survey. Among the data from 72,435 students, the data from 36,530 individuals in middle school were analyzed. The prevalence of sexual behavior and suicidal ideation, according to the participants' general characteristics, and suicidal ideation, according to sexual behaviors, were assessed by using a complex sample Chi‐squared test. A complex sample logistic regression was used to examine the association between sexual behavior and suicidal ideation. Results: Overall, 3.8% of the students reported having had sexual intercourse and 17.6% of the students reported suicidal ideation during the past 12 months. Having had sexual intercourse was statistically significantly associated with suicidal ideation. The students who had had sexual intercourse usually used contraception and those who had contracted sexually transmitted diseases were more likely to report suicidal ideation in both the unadjusted and adjusted models. Conclusion: This study illustrates the need to develop a prevention program that addresses the common factors between sexual behavior and suicidal ideation in order to effectively reduce both sexual behavior and suicidal ideation in middle school students. [ABSTRACT FROM AUTHOR]

Objective: The study was conducted to develop a theoretical model to comprehensively explain suicidal ideation in Korean college students by including resilience, belongingness, and college life adjustment in addition to depression and stress. Design and Sample: This study was a descriptive survey with 291 college students. Measures: Structural equation modeling was used to the hypotheses on this study. Results: Belongingness and depression showed a statistically significant direct effect, and college life stress and belongingness showed a statistically significant indirect effect. Belongingness was the most influential, and all the predictors in combination had an explanatory power of 37% for suicidal ideation in college students. Conclusions: Findings suggest a model of suicidal ideation focused on perspective, protective factors; previous research provided a negative perspective with focus on risk factors for suicidal ideation. Findings can be used to develop diverse programs to decrease suicidal ideation in college students and help them to adjust to college life. [ABSTRACT FROM AUTHOR]

Background Suboptimal nutrition accompanied by chronic low-grade increases in circulating cytokine levels is more common in elderly people. We explored the improvement in nutritional status, especially in the level of insulin-like growth factor-1 ( IGF-1) and its relationship with changes in circulating cytokine levels, after providing extra protein and energy content to community-dwelling older adults at risk of undernutrition. Methods Sixty nondiabetic subjects, aged ≥65 years and living independently in a community for elderly people, with a serum pre-albumin level ≤30 mg dL−1 and a body mass index <25 kg m−2, were recruited. The subjects were followed for a 2-week pre-intervention period, during which they maintained routine dietary habits. This was followed by an intervention period, during which they received oral nutritional supplementation for 2 weeks. Results Following 2 weeks of intervention, there were significant increases in total lymphocyte count ( TLC) and insulin-like growth factor ( IGF)-1, pre-albumin and transferrin compared to baseline. Body weight and mid-arm circumference significantly increased without alteration of tricep skinfold thickness at the end of the intervention. There was a significant reduction in interleukin ( IL)-6 levels and a trend toward a decrease in the tumor necrosis factor ( TNF)-α levels. At baseline, age was negatively correlated with IGF-1 levels and positively correlated with IL-6 and TNF-α levels. The change (▵, from baseline) in IGF-1 level was positively correlated with age and negatively correlated with ▵ IL-6 and ▵ TNF-α. Conclusions A 2-week intervention with oral nutritional supplementation improved nutritional status and decreased circulating cytokine levels. Specifically, ▵ IGF-1 was negatively correlated with changes in pro-inflammatory cytokine levels in community-dwelling elderly people at risk of undernutrition. (Clinicaltrials.gov: NCT02656186). [ABSTRACT FROM AUTHOR]

Background Previous studies of the health effects of low-fat milk or dairy consumption on the metabolic syndrome have yielded inconsistent results. The present study aimed to investigate the effects of low-fat milk consumption on traits associated with the metabolic syndrome, as well as inflammatory and atherogenic biomarkers, in Korean adults with the metabolic syndrome. Methods Overweight Koreans with the metabolic syndrome ( n = 58) were recruited and randomly assigned to either the low-fat milk or control group. The low-fat milk group was instructed to consume two packs of low-fat milk per day (200 mL twice daily) for 6 weeks, and the control group was instructed to maintain their habitual diet. Clinical investigations were conducted during the screening visit, on study day 0, and after 6 weeks. Results No significant differences in changes in body mass index, blood pressure, lipid profile and adiponectin levels, as well as levels of inflammatory markers, oxidative stress markers and atherogenic markers, were found between the low-fat milk and control groups. However, compared to the controls, significant favourable decreases in serum soluble vascular adhesion molecule-1 and endothelin-1 levels were found in the 12 subjects with high blood pressure and in the 18 subjects with hypertriglyceridaemia in the low-fat milk group. Conclusions The present study did not demonstrate an overall beneficial effect of low-fat milk consumption in subjects with the metabolic syndrome. However, low-fat milk consumption may have a favourable effect on atherogenic markers in subjects with high blood pressure or hypertriglyceridaemia. [ABSTRACT FROM AUTHOR]