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Objective: Previous studies have suggested that excessive internet use may cause lack of sleep. However, recent studies have hypothesized that lack of sleep may instigate internet use for leisure. To elucidate the potential effects of sleep time on internet use, we explored the different associations between sleep time and internet use according to its purpose. Methods: The population-based, cross-sectional study group from the Korea Youth Risk Behavior Web-based Survey (KYRBWS) collected data from 57,425 middle school students in 2014 and 2015. Sleep time over the past 7 days was classified into the following groups: < 7 h (6 h); ≥ 7 h, < 8 h (7 h); ≥ 8 h, < 9 h (8 h); and ≥ 9 h (9+ h). Internet use time per day was separately surveyed for leisure and for study and categorized as follows: 0 h; > 0 h, ≤ 1 h (1 h); > 1 h, ≤ 2 h (2 h); and > 2 h (2+ h) per day. Information on age, sex, region of residence, body mass index (BMI), economic level, parental education level, stress level, school performance level, and sleep satisfaction were retrieved. The relationships between sleep time and internet use time for leisure/study were analyzed using multinomial logistic regression with complex sampling. In the subgroup analysis according to sleep satisfaction (good, normal, and poor), the associations of sleep time with internet use for leisure were analyzed using the same methods. Results: Compared to 9+ h of sleep, less sleep was related to a long internet use time (2+ h) for leisure (adjusted odds ratio, AOR [95% confidence interval, CI] of sleep: 8 h = 1.23 [1.14–1.32]; 7 h = 1.42 [1.31–1.54]; and 6 h = 1.56 [1.44–1.70]; P < 0.001). Conversely, a relationship between less sleep and a long internet use time (2+ h) for study was evident only for 6 h of sleep (AOR of sleep: 8 h = 0.84 [0.84–1.04]; 7 h = 1.05 [0.94–1.17]; and 6 h = 1.32 [1.27–1.59]; P < 0.001). In the subgroup analysis according to sleep satisfaction, less sleep was associated with a long internet use time for leisure in all sleep satisfaction groups, although the relationship was more significant in the lower sleep satisfaction group. Conclusion: Less sleep was significantly related to long-term use of the internet for leisure, whereas this association was not definite for internet use for study. Furthermore, poor sleep quality potentiated the relationship between less sleep time and internet use for leisure. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to examine the difference between self-reported hearing status and hearing impairment assessed using conventional audiometry. The associated factors were examined when a concordance between self-reported hearing and audiometric measures was lacking. Methods: In total, 19,642 individuals ≥20 years of age who participated in the Korea National Health and Nutrition Examination Surveys conducted from 2009 through 2012 were enrolled. Pure-tone hearing threshold audiometry (PTA) was measured and classified into three levels: <25 dB (normal hearing); ≥25 dB <40 dB (mild hearing impairment); and ≥40 dB (moderate-to-severe hearing impairment). The self-reported hearing loss was categorized into 3 categories. The participants were categorized into three groups: the concordance (matched between self-reported hearing loss and audiometric PTA), overestimation (higher self-reported hearing loss compared to audiometric PTA), and underestimation groups (lower self-reported hearing loss compared to audiometric PTA). The associations of age, sex, education level, stress level, anxiety/depression, tympanic membrane (TM) status, hearing aid use, and tinnitus with the discrepancy between the hearing self-reported hearing loss and audiometric pure tone threshold results were analyzed using multinomial logistic regression analysis with complex sampling. Results: Overall, 80.1%, 7.1%, and 12.8% of the participants were assigned to the concordance, overestimation, and underestimation groups, respectively. Older age (adjusted odds ratios [AORs] = 1.28 [95% confidence interval = 1.19–1.37] and 2.80 [2.62–2.99] for the overestimation and the underestimation groups, respectively), abnormal TM (2.17 [1.46–3.23] and 1.59 [1.17–2.15]), and tinnitus (2.44 [2.10–2.83] and 1.61 [1.38–1.87]) were positively correlated with both the overestimation and underestimation groups. Compared with specialized workers, service workers, manual workers, and the unemployed were more likely to be in the overestimation group (1.48 [1.11–1.98], 1.39 [1.04–1.86], and 1.50 [1.18–1.90], respectively), and service workers were more likely to be in the underestimation group (AOR = 1.42 [1.01–1.99]). Higher education level (0.77 [0.59–1.01] and 0.43 [0.33–0.57]) and hearing aid use (0.36 [0.17–0.77] and 0.23 [0.13–0.43]) were negatively associated with being in the underestimation group (0.43 [0.37–0.50]). Compared with males, females were less likely to be assigned to the underestimation group (0.43 [0.37–0.50]). Stress (1.98 [1.32–2.98]) and anxiety/depression (1.30 [1.06–1.59]) were associated with overestimation group. Conclusion: Older age, lower education level, occupation, abnormal TM, non-hearing aid use, and tinnitus were related to both overestimation and underestimation groups. Male gender was related to underestimation, and stress and anxiety/depression were correlated with overestimation group. An understanding of these factors associated with the self-reported hearing loss will be instrumental to identifying and managing hearing-impaired individuals. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to compare the incidence of post-operative depression in breast cancer patients who have undergone mastectomy with the incidence of post-operative depression in non-breast cancer participants (controls). Methods: Using data from the Korean Health Insurance Review and Assessment Service (HIRA), we selected 2,130 patients with breast cancer who have undergone mastectomy for this national cohort study and matched these patients 1:4 with 8,520 control participants according to age, sex, income, region, and pre-operative depression. The incidence of post-operative depression was measured from mastectomy year to post-op year 10. The Mann-Whitney U test was used for data analysis, and the false-discovery rate was applied to determine statistical significance (P < 0.05). Results: The incidence of depression was higher in the breast cancer with mastectomy group than in the control group up to 3 years after mastectomy). However, there was no difference in the incidence of depression between the breast cancer with mastectomy group and the control group after post-op 4 years. The incidence of depression was higher in the breast cancer with mastectomy group than in the control group up to 2 years after mastectomy, and there was no difference in the incidence of depression between the two groups after post-op 3 years in middle-aged and older adults (≥ 40 years old). In young adults (≤ 39 years old), the incidence of depression was significantly higher in the breast cancer with mastectomy group than in the control group in mastectomy year. Conclusion: Patients undergoing mastectomy for breast cancer experience depression more frequently than healthy people. However, patients overcome their depressive mood symptoms during the postoperative period. Young adults overcome their symptoms more quickly than middle-aged and older adults. [ABSTRACT FROM AUTHOR]

Although overuse of the internet has been suggested to be related to poor academic performance, the effects of internet use for education on academic performance showed conflict results in previous studies. Accordingly, the associations of school performance with internet use for study and for general purpose were explored in a large population of Korean adolescents. Cross-sectional data from the 2013 Korean Youth Risk Behaviour Web-based Survey (KYRBWS) were retrieved for 59,105 12- to 18-year-old adolescents. The associations between school performance and internet use were analysed using multinomial logistic regression with complex sampling. Days of physical activity, sex, obesity, region of residence, income level, parental education level, stress, sleep time, smoking, alcohol consumption, drug use, and total study time were recorded and adjusted for as confounders. Higher school performance was positively associated with longer internet use for study (adjusted odds ratio, AOR, of 2+ h [95% confidence interval] = 2.43 [2.10–2.82], 2.02 [1.78–2.30], 1.66 [1.46–1.89], and 1.30 [1.15–1.47] for performance groups A, B, C, and D, respectively, P < 0.001) but negatively associated with longer internet use for general purpose (AOR of 3+ h [95% confidence interval] = 0.68 [0.60–0.78], 0.85 [0.76–0.94], 0.83 [0.75–0.92], and 0.98 [0.89–1.08] for performance groups A, B, C, and D, respectively, P < 0.001). Higher school performance significantly positively correlated with internet use for study but negatively correlated with internet use for general purpose. Academic use of the internet could be a means of achieving good school performance. [ABSTRACT FROM AUTHOR]

Several studies have reported negative relations between allergic diseases and school performance but have not simultaneously considered various allergic diseases, including allergic rhinitis, asthma, and atopic dermatitis, and only examined a limited number of participants. The present study investigated the associations of allergic rhinitis, asthma, and atopic dermatitis with school performance in a large, representative Korean adolescent population. A total of 299,695 7th through 12th grade students participated in the Korea Youth Risk Behaviour Web-based Survey (KYRBWS) from 2009 to 2013. The subjects’ history of allergic rhinitis, asthma, and atopic dermatitis and number of school absences due to these diseases in the previous 12 months were examined and compared. School performance was classified into 5 levels. The relations between allergic disorders and school performance were analyzed using multiple logistic regressions with complex sampling and adjusted for the subjects’ durations of sleep, days of physical activity, body mass indexes (BMIs), regions of residence, economic levels, parents’ education levels, stress levels, smoking status, and alcohol use. A subgroup analysis of the economic groups was performed. Allergic rhinitis was positively correlated with better school performance in a dose-dependent manner (adjusted odds ratios, AOR, [95% confidence interval, CI] = 1.50 [1.43–1.56 > 1.33 [1.28–1.38] > 1.17 [1.13–1.22] > 1.09 [1.05–1.14] for grades A > B > C > D; P < 0.001). Asthma was negatively correlated with better school performance (AOR [95% CI] = 0.74 [0.66–0.83], 0.87 [0.79–0.96], 0.83 [0.75–0.91], 0.93 [0.85–1.02] for performance A, B, C, and D, respectively; P < 0.001). Atopic dermatitis was not significantly correlated with school performance. The subgroup analysis of the students’ economic levels revealed associations between allergic diseases and school performance. Compared to other allergic disorders, the asthma group had more school absences due to their symptoms (P < 0.001). School performance was positively correlated with allergic rhinitis and negatively correlated with asthma in Korean adolescents, even after adjusting for other variables. The asthma group had an increased number of school absence days, which presumably contributes to these students’ poor school performance. [ABSTRACT FROM AUTHOR]

Several reports have demonstrated associations between falls and nocturia in the elderly. However, little information is available regarding other age groups. This study evaluated the relationship between the frequency of nocturia and falls in men using a large, population-based survey in Korea, and the results were adjusted for various confounding factors. Data from a 2011 Korean community health survey (KCHS) were retrieved for 92,660 men aged 19 to 103 years. Information regarding the history of slips or falls in the past year was collected. The frequency of nocturia was classified as 0, 1, 2, 3, 4, and ≥ 5 instances a night. Walking during the day, education, income, body mass index (BMI), smoking, alcohol consumption, sleep time, stress level and medical histories of hypertension, diabetes mellitus, hyperlipidemia, cerebral stroke, angina or myocardial infarction, arthritis, and osteoporosis were adjusted using multiple logistic regression analysis with complex sampling. A subgroup analysis was conducted for young (19–30 years), middle-aged (31–60 years), and elderly individuals (61+ years). Approximately 14.6% of the men had a history of falls. Their mean age was 42.9 years, which was significantly higher than that of the non-faller group (P < 0.001). An increased frequency of nocturia was associated with increased adjusted odds ratio (AOR) for falls (AOR for 1 instance of nocturia/night = 1.41 [95% confidence interval, 1.33–1.50]; AOR for 2 instances = 1.41 [1.33–1.50]; AOR for 3 instances = 2.00 [1.75–2.28]; AOR for 4 instances = 2.12 [1.73–2.61]; AOR for ≥ 5 instances = 2.02 [1.74–2.36], P < 0.001). In the subgroup analysis, the AORs for falls significantly increased in all age groups as the frequency of nocturia increased. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study was to compare post-operative visits for upper respiratory infections (URIs) between tonsillectomy and non-tonsillectomy participants (controls). Methods: Using the national cohort study from the Korean Health Insurance Review and Assessment Service, 1:4 matched (age, sex, income, region, and pre-operative URI visit) tonsillectomy participants (5,831) and control participants (23,324) were selected. Post-operative visits for URI were measured from 1 to 9 years post-op. The equivalence test was used. The margin of equivalence of the difference (Tonsillectomy—Control group group) was set to -0.5 to 0.5. Results: There was no difference between the tonsillectomy and control group in 1- to 9-year post-op visits (-0.5 < 95% CI of difference < 0.5). URI visits gradually decreased from 5.5/2 years (pre-op) to 2.1/year (at 1 year post-op) and 1.4/year (at 9 years post-op) in both tonsillectomy and control groups. In the subgroup analysis (children Vs adolescent and adults; rare Vs frequent pre-operative URI), there was no difference in the number of post-op visits for URI between the tonsillectomy and control groups (-0.5 < 95% CI of difference < 0.5). Conclusion: Tonsillectomy does not provide a decrease in the number of post-operative visits for URI, and URI decreased over time whether or not a tonsillectomy was performed. [ABSTRACT FROM AUTHOR]

Background: Olfactory function can impact food selection. However, few large population-based studies have investigated this effect across different age groups. The objective of this study was to assess the association between subjective olfactory dysfunction (anosmia or hyposmia) and macronutrient intake. Methods: A total of 24,990 participants aged 20 to 98 years were evaluated based on data collected through the Korea National Health and Nutrition Examination Survey from 2008 through 2012. Olfactory dysfunction was surveyed using a self-reported questionnaire, and the nutritional status was assessed through a validated 24-hour recall method. Simple and multiple linear regression analyses with complex sampling were performed to evaluate the relationships between olfactory dysfunction and protein intake (daily protein intake/recommended protein intake [%]), carbohydrate intake (daily carbohydrate intake/total calories [%]), and fat intake (daily fat intake/total calories [%]) after adjusting for age, sex, body mass index, income, smoking history, alcohol consumption, and stress level. Results: Olfactory dysfunction was reported by 5.4% of Korean adults and was found to be associated with decreased fat consumption (estimated value [EV] of fat intake [%] = -0.57, 95% confidence interval [CI] = -1.13 to -0.13, P = 0.045). A subgroup analysis according to age and sex revealed that among young females, olfactory dysfunction was associated with reduced fat consumption (EV = -2.30, 95% CI = -4.16 to -0.43, P = 0.016) and increased carbohydrate intake (EV = 2.80, 95% CI = 0.55 to 5.05, P = 0.015), and that among middle-aged females, olfactory dysfunction was also associated with reduced fat intake (EV = -1.26, 95% CI = -2.37 to -0.16, P = 0.025). In contrast, among young males, olfactory dysfunction was associated with reduced protein intake (EV = -26.41 95% CI = -45.14 to -7.69, P = 0.006). Conclusion: Olfactory dysfunction was associated with reduced fat intake. Moreover, olfactory dysfunction exerted differential effects on eating behavior depending on age and sex. [ABSTRACT FROM AUTHOR]

Background: Numerous studies have suggested that nutritional intake is related to allergic diseases. Although conflicting results exist, fat intake is often associated with allergic diseases. We investigated the relationship between allergic diseases and nutritional intake after adjusting for various demographic and socioeconomic factors in a large, representative sample of Korean children. Methods: A total of 3,040 participants, aged 4 to 13 years old, were enrolled in the present study from the Korean National Health and Nutrition Examination Survey (KNHANES), 2010–2012. Nutritional intake data, including total calories, protein, fat, carbohydrate, vitamin A, vitamin C, thiamine, riboflavin, and niacin, were retrieved from the survey using the complete 24-hour recall method. The associations between each nutritional factor and allergic rhinitis/asthma/atopic dermatitis were analyzed using simple and multiple logistic regression analyses with complex sampling. Age, sex, body mass index (BMI), number of household members, income level, and region of residence were adjusted for as covariates. Results: Of the participants, 22.1%, 6.0%, and 15.5% suffered from allergic rhinitis, asthma, and atopic dermatitis, respectively. Allergic rhinitis was significantly correlated with high-fat and low-carbohydrate diets. The adjusted odds ratio (AOR) was 1.25 (95% CIs = 1.06–1.46, P = 0.007) for fat intake, denoting a 10% increase. Carbohydrate intake (10% increase) was negatively related to allergic rhinitis with an AOR of 0.84 (95% CIs = 0.74–0.95, P = 0.004). No other significant relationships were found between the retrieved nutritional factors and either asthma or atopic dermatitis. Conclusion: Allergic rhinitis was related to high-fat and low-carbohydrate diets. Although the underlying mechanisms and causal relationships remain elusive, the present study provides reliable evidence regarding the associations between nutritional factors and allergic rhinitis by considering numerous factors within a large and representative population. [ABSTRACT FROM AUTHOR]