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This study aimed to investigate the mediating effect of the screen media time of young children on the relationship between mothers’ reasons for allowing young children to use screen media and their children’s ability to regulate screen media. The participants consisted of 614 children aged 5-6 (312 boys and 302 girls), and all the survey questions were answered by their mothers. Descriptive statistics, Pearson’s correlation, structural equation modeling, and bootstrapping analysis were employed to analyze the data using SPSS 25.0 and Mplus 8.6. The results were as follows. First, mothers’ educational and ritualized reasons for allowing young children to use screen media and children’s screen media time directly affected young children’s ability to regulate screen media. Second, children’s screen media time mediated the relationship between mothers’ educational and ritualized reasons for allowing their children to use screen media and children’s ability to regulate screen media. When mothers permitted their children to use screen media for educational purposes, their children were likely to spend less time on screen media usage which, in turn, increased their ability to regulate screen media. Conversely, the more mothers allowed their children to use screen media for ceremonial purposes, the more time their children spent on screen media and the less ability they had to regulate screen media usage. These outcomes suggest that, to improve children’s screen media regulation ability, mothers must not routinely allow their children to use screen media and should manage their children’s screen media time.

The study examined the mediating effect of internalized shame on the relationship between affiliate stigma and interpersonal anxiety among adolescents with siblings who had autism spectrum disorder (ASD) and the moderated mediating effect of mother-adolescent communication openness. The participants consisted of 139 adolescents (boys 48.9%, high-school students 79.8%) who had siblings with ASD. Interpersonal anxiety, affiliate stigma, internalized shame, and mother-adolescent communication openness were measured using the Social Anxiety Scale for Adolescents (La Greca & Lopez, 1998), the Affiliate Stigma Scale (Mak & Cheung, 2008), the Internalized Shame Scale (Cook, 1988), and the Parent-Adolescent Communication Scale (Barnes & Olson, 1982), respectively. The data were analyzed using descriptive statistics and Pearson’s correlation coefficients. Process Macro Models 4 and 7 were used to examine the mediating effect and the moderated mediating effect. The results indicated that internalized shame mediated the effect of affiliate stigma on interpersonal anxiety among adolescents who had siblings with ASD. However, there was no significant moderated mediating effect of mother-adolescent communication openness on the relationship between affiliate stigma, internalized shame and interpersonal anxiety. These findings suggest that it is necessary to improve social awareness of individuals with ASD and their family members to prevent adolescents who have siblings with ASD from having affiliate stigma and to help them reduce interpersonal anxiety. The results also highlight the importance of counseling programs for adolescents with siblings with ASD as a way of preventing or alleviating their interpersonal anxiety by reducing internalized shame, even where they experience affiliate stigma.

This study aimed to examine the effect of parental psychological control on adolescents’ non-suicidal selfinjury and verify whether this effect is mediated by depression. In the first survey of 647 middle and high school students, only those who had experiences of non-suicidal self-injury were selected (136 adolescents). For data analysis purposes, descriptive statistics for each measured variable and Pearson’s correlation coefficients among research variables were calculated. In addition, Process Macro - Model 4 by Hayes (2013) was used to investigate the mediating model. Finally, the bootstrapping method was applied to confirm the significance of the mediating effect. The results of this study were as follows. First, parental psychological control and depression directly affected the frequency of non-suicidal self-injury among adolescents. Second, depression mediated the relationship between parental psychological control and non-suicidal selfinjury. In conclusion, the more parents controlled their children’s psychological factors, the higher the level of depression among adolescents, and as a result, the higher the frequency of non-suicidal self-injury. These findings suggest that educational intervention on parental psychological control is important to prevent and reduce non-suicidal self-injury; however, psychotherapy intervention that reduces the levels of depression should also be required.

Mass spectrometry methods exhibit higher accuracy and lower variability than immunoassays at low testosterone concentrations. We developed and validated an ultraperformance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) assay for quantifying serum total testosterone.We used an ExionLC UPLC (Sciex, Framingham, MA, USA) system and a Sciex Triple Quad 6500+ (Sciex) MS/MS system in electrospray ionization and positive ion modes with multiple reaction monitoring transitions to evaluate precision, accuracy, linearity, lower limit of quantitation (LLOQ), carryover, ion suppression, stability, and reference intervals. For method comparison, we measured serum testosterone concentrations using this method in 40 subjects whose testosterone concentrations ranged from 0.14 to 55.48 nmol/L as determined using the Architect i2000 immunoassay (Abbott Diagnostics, Abbott Park, IL, USA) and in an additional 160 sera with testosterone concentrations1.67 nmol/L.The intra- and inter-run precision CVs were2.81%, and the accuracy bias values were3.85%, which were all acceptable. The verified linear interval was 0.03-180.84 nmol/L; the LLOQ was 0.03 nmol/L. No significant carryover and ion suppression were observed. The testosterone in serum was stable at 4°C, at -20°C, and after three freeze-thaw cycles. The reference intervals were successfully verified. The correlation was good at testosterone concentrations of 0.14-55.48 nmol/L; however, the Architect assay showed positive percent bias at concentrations1.67 nmol/L.The UPLC-MS/MS assay shows acceptable performance, with a lower LLOQ than the immunoassay. This method will enable the quantitation of low testosterone concentrations.

Objectives: This study aimed to analyze the effects of COVID-19-related stress, parental efficacy, and cognitive flexibility on depression of mothers with school-aged children and to examine a moderated mediation model.Methods: Data on cognitive flexibility, parental efficacy, COVID-19-related stress, and depression were collected from 441 working mothers who had at least one school-aged child using the Cognitive Flexibility Inventory (CFI) and Parenting Sense of Competence (PSOC), COVID Stress/Disruption, and Center for Epidemiologic Studies Depression (CES-D) scales. Data were then analyzed using SPSS 26.0, and PROCESS macro version 4.0.Results: The findings revealed that COVID-19-related stress had a significant positive influence on depression in working mothers, which was mediated by parental efficacy. A moderated mediation analysis further indicated that this indirect effect varied depending upon the mothers’ sense of control a sub-factor of cognitive flexibility. Therefore, when mothers perceived they were unlikely to exercise any control over changes caused by the COVID-19 pandemic, their parental efficacy exerted a greater mediating effect.Conclusion: Results suggest that interventions reducing COVID-19-related stress and increasing parental efficacy could alleviate depression among working mothers with school-aged children. Furthermore, cognitive interventions could be effective in helping those working mothers experiencing a low level of parenting efficacy due to COVID-19-related stress to perceive the demanding situation as within their control.

This study examined the influence of bullying victimization on reactive aggression among upper elementary school students, and the mediating effect of victim justice sensitivity on the relationship between such victimization and aggression. It also investigated whether negative urgency moderates the influence of bullying victimization on reactive aggression. The participants were a group of 262 children (114 boys and 148 girls) who were fourth to sixth-grade students from 10 elementary schools located in Seoul, Gyeong-gi, and Daegu. The data were analyzed with descriptive statistics, Pearson’s correlation coefficients, and SPSS Process Macro Model 5. The results were as follows: First, victim justice sensitivity mediated the influence of bullying victimization on reactive aggression among upper elementary school students. Second, negative urgency moderated the effect of bullying victimization on reactive aggression, whereas the impact of this was greater when the level of negative urgency was high. The results suggest that reactive aggression among upper elementary school students could be effectively decreased by preventing bullying victimization, and reducing the level of victim justice sensitivity and negative urgency.

This study examined the moderated mediating impact of entrapment and emotional support from peers in the relationship between academic stress and suicidal ideation among middle-school students. The participants consisted of 214 middle-school students in the first to third grades from four middle schools located in Seoul, Gyeong-gi, Chun-cheon, and Jeonnam. The data were analyzed using descriptive statistics, Pearson’s correlation coefficients, and the Process Macro Model versions 4, 1, and 14. The results of this study were as follows. First, academic stress did not directly influence suicidal ideation; however, entrapment mediated the relationship between academic stress and suicidal ideation. Second, emotional support from peers moderated the mediating effect of entrapment in the aforementioned relationship. This means that if students perceived emotional support from peers, then academic stress had a smaller impact on suicidal ideation through entrapment. These findings highlight the importance of decreasing levels of academic stress and entrapment to prevent suicidal ideation among middle-school students. They also suggest that enhancing students’ emotional support networks with their peers could be an effective way of reducing suicidal ideation when students feel high levels of entrapment and academic stress.

Background/Aims: There are few studies describing contemporary status of mechanical ventilation in Korea. We investigated changes in management and outcome of mechanical ventilation in Korea.Methods: International, prospective observational cohort studies have been conducted every 6 years since 1998. Korean intensive care units (ICUs) participated in 2010 and 2016 cohorts. We compared 2016 and 2010 Korean data.Results: Two hundred and twenty-six patients from 18 ICUs and 275 patients from 12 ICUs enrolled in 2016 and 2010, respectively. In 2016 compared to 2010, use of non-invasive ventilation outside ICU increased (10.2% vs. 2.5%, p = 0.001). Pressure-control ventilation was the most common mode in both groups. Initial tidal volume (7.1 mL/kg vs. 7.4 mL/kg, p = 0.372) and positive end-expiratory pressure (6 cmH2O vs. 6 cmH2O, p = 0.141) were similar, but peak pressure (22 cmH2O vs. 24 cmH2O, p = 0.011) was lower in 2016. More patients received sedatives (70.7% vs. 57.0%, p = 0.002) and analgesics (86.5% vs. 51.1%, p < 0.001) in 2016. The awakening (48.4% vs. 31.0%, p = 0.002) was more frequently attempted in 2016. The accidental extubation rate decreased to one tenth of what it was in 2010 (1.1% vs. 10.2%, p < 0.001). The ICU mortality did not change (31.4% 35.6%, p = 0.343) but ICU length of stay showed a decreasing trend (9 days vs. 10 days, p = 0.054) in 2016.Conclusions: There were temporal changes in care of patients on mechanical ventilation including better control of pain and agitation, and active attempt of awakening.

This study aimed to understand what factors the mothers of infants consider to be important when choosing screen media programs for their children, and to investigate whether those features differ according to maternal socio-demographic characteristics (i.e., age, education level, employment status, and family income). The study participants comprised 948 mothers who were the primary caregivers and had at least one child aged 4-6. They were asked to select three of the following aspects as critical criteria for determining if a given screen media program is appropriate for infants: (a) contents suitable to the child’s developmental level, (b) behaviors of characters, (c) appearance of characters, (d) visual aspects of program, (e) duration of screen media program, (f) whether the screen media program includes instructive contents, and (g) whether the program leads to opportunities for conversations among family members and activities with children. Multiple response frequency analysis and multiple response cross-analysis were used to analyze the mothers’ responses. The results revealed that the majority of the mothers reported that ‘contents suitable to the child’s developmental level’ represented the first-ranked criterion for selecting screen media programs for their child, which was followed by ‘behaviors of characters,’ and ‘whether the screen media program includes instructive contents.’ However, such criteria for screen media programs for infants differed according to maternal age, education level, employment status, and family income. These outcomes suggest that different information needs to be provided based on maternal characteristics in order to help mothers determine the quality of screen media programs for their infants.

Using a person-centered approach, the current study investigated latent profiles for the emotional and behavioral problems of students in sixth-grade in elementary school and second grade of middle school. The aim was to explore latent transition patterns and verify the factors affecting the transitions. The participants were 1,937 adolescents who responded to the 3rd year (6th grade of elementary school; Time 1), 4th year (1st grade of middle school), and 5th year (2nd grade of middle school; Time 2) of the Korean Children Youth Panel Study. Latent profile and latent transition analyses were performed. The results were as follows: first, the latent profile of emotional and behavioral problems changed from Time 1 to Time 2. The latent groups at Time 1 were classified into low, moderate, high, and externalizing-dominant, whereas at Time 2, five groups were identified: low, moderate, high, externalizing-dominant, and withdrawal-dominant. Second, transition analyses revealed that although 22.3-57.0% of latent groups remained unchanged, there were significant changes over time between groups, as a new group (‘withdrawal-dominant’) emerged in Time 2. Third, different factors influenced the latent profile transition of emotional and behavioral problems depending on the transition pattern. Higher levels of self-esteem, better relationships with peers and teachers, and lower levels of parental inconsistency meant emotional and behavioral problems had not worsened at Time 2. The results suggest that early interventions are needed during the transition from childhood to early adolescence.

BACKGROUND The pharmacokinetic profile of vancomycin is highly variable, especially in critically ill patients. Various deep learning models have been successful so far in the decision-making system that predicts the vancomycin therapeutic drug monitoring (TDM) level in patients in the intensive care unit (ICU). OBJECTIVE We aimed to establish an ideal model by comparing and integrating methods in the decision-making system that predicts the vancomycin TDM level in ICU patients. METHODS We proposed novel deep learning model, the joint multilayer perceptron (JointMLP) for predicting vancomycin TDM level and compared the performance of a population pharmacokinetic (PPK) model, extreme gradient boosting, and TabNet, respectively, with data collected from Dongguk University Ilsan Hospital (DUIH) and Kangwon National University Hospital (KNUH). RESULTS Of the 977 DUIH datasets, 97 were used as the test set while the remaining 879 were used as the training data set. The external validation subject was data from 1,429 KNUH subjects. For the external data set, all models were found to have significantly higher predictive power than PPK. However, in internal datasets, the JointMLP model showed significantly better performance in predicting vancomycin TDM than the PPK model (root mean squared error 8.27 vs. 10.38, P < 0.01). The JointMLP model showed better predictive performance than other models, including the PPK model, in the external dataset. The most influential variables in TDM prediction were the vancomycin volume of distribution, sex, and height in both internal and external datasets. These variables consistently had high SHAP values in both datasets CONCLUSIONS JointMLP implementation for clinical use will not only provide optimal vancomycin doses but also provide many improvements in itself as the data are continuously updated, which will result in continued increments in accuracy.

Love is a worldwide known phenomenon that affects many aspects of human life, including considering a romantic partner with whom to bond. Thus, developing a reliable and valid measure of love experiences is crucial. One of the most popular tools to test love levels is Sternberg's 45-item Triangular Love Scale (TLS-45), which measures three love components: Intimacy, Passion, and Commitment. However, our literature review reveals that the majority of studies (64%) use a broad variety of shortened versions of the TLS-45. To achieve scientific consensus and improve the reliability, comparability, and generalizability of results across studies, here, we develop a short version of the scale–the TLS-15–which contains 15 items with a 5-point rather than 9-point response scale. In Study 1 (N = 7,332), we re-analyzed secondary data from a large-scale multinational study that validated the original TLS-45 to establish whether the scale could be truncated. In Study 2 (N = 307), we provided evidence for the three-factor structure of the TLS-15 and its reliability. Study 3 (N = 413) confirmed convergent validity and test-retest stability of the TLS-15. Study 4 (N = 60,311) presented a large-scale validation across 37 linguistic versions of the TLS-15 on a cross-cultural sample spanning every continent of the globe. The overall results provided support for the reliability, validity, and cross-cultural invariance of the TLS-15, which could be used as a measure of love components–separately or jointly as a three-factor measure.

Objectives: This study aimed to examine the mediating effect of evaluative concerns perfectionism on the relationship between parental academic achievement pressure perceived by middle school students and their academic procrastination.Methods: The study participants were 522 middle school students from first to third grade from three middle schools located in Gunsan, Iksan, and Jeonju. All data were analyzed using descriptive statistics and Pearson’s correlation coefficients. Structural equation modeling was also used to investigate the mediating model.Results: The result of this study showed that the level of parental academic achievement pressure perceived by middle school students increased their level of academic procrastination. In addition, the level of students’ evaluative concerns perfectionism increased the level of their academic procrastination. Second, middle school students’ evaluative concerns perfectionism partially mediated the relationship between parental academic achievement pressure perceived by them and their academic procrastination. That is, the higher the level of parental academic achievement pressure, the higher the level of evaluative concerns perfectionism, and consequently, the higher the middle school students’ academic procrastination.Conclusion: The outcomes suggest that it is important for parents to set proper expectations for their children and provide them with sufficient support, such as respecting their autonomy in academic decision-making to prevent students’ academic procrastination. In addition, interventions to change maladaptive cognitive beliefs including evaluation concerns perfectionism would help students reduce their academic procrastination. In conclusion, these findings suggest several ways to prevent and decrease middle school students’ academic procrastination by empirically verifying predictors on academic procrastination.

The purpose of this study was to examine the mediating effect of middle school students’self-deprecation in the relationship between upward social comparison in social network service (SNS) and depression and the moderated mediating effect of cognitive flexibility. The participants were 288 middle school students, in the first to third grades from four middle schools located in Seoul, Gyeong-gi, and Jeonnam. The date were analyzed with descriptive statistics, Pearson’s correlation coefficients and the Process Macro Model 4, 1, and 14.The results of this study are as follows. First, an upward comparison in SNS has a significant positive influence on students’depression, and students' self-deprecation of students mediated the relation between two. Second, the level of control, which is a sub-factor of cognitive flexibility, moderated the mediating effect of self-deprecation. That is, if students are more likely to perceive difficult situations as controllable, upward social comparison in SNS mediated by self-deprecation has smaller effect on depression.Based on these results, we suggest practical interventions to reduce depression among middle school students by decreasing upward social comparison in SNS and self-deprecation. In addition, helping students perceive difficult situations as controllable could be another effective way of reducing depression among those students who have a high level of self-deprecation in upward social comparison in SNS.

Objective: The aim of this study was to compare in vitro fertilization outcomes between fresh day 3 or day 4 embryo transfer cycles with dual progesterone (P) administration (intramuscular and vaginal) and cycles with single intramuscular P administration for luteal support.Methods: We selected 124 cycles from 100 women (under age 40 years) who underwent oocyte pick-up (number of trials ≤ 3, 4–14 oocytes obtained) and transfer of two or three day 3 or day 4 embryos at two infertility centers from January 2014 to June 2019. Dual P (intramuscular P [50 mg] daily+vaginal P) was used in 52 cycles and a single intramuscular administration of P (50 mg daily) was used in 72 cycles.Results: Women’s age, infertility factors, number of oocytes retrieved, number of transferred embryos, and mean embryo score were similar between the dual P group and the single P group. Although the number of trial cycles was significantly higher (1.9 vs. 1.5), and the mean endometrial thickness on the trigger day (10.0 mm vs. 11.0 mm) was significantly lower in the dual P group, the implantation rate, clinical pregnancy rate, ongoing pregnancy rate, and miscarriage rate for both day 3 and day 4 transfers were similar between the two groups.Conclusion: In fresh day 3 or day 4 embryo transfer cycles, dual P administration did not demonstrate any clinical advantages. Intramuscular P alone appears to be sufficient for luteal support.

This study examined the effects of moral disengagement (cognitive restructuring and blaming the victim) and selfcontrol on cyberbullying perpetration and investigated if self-control moderated the relationship between moral disengagement (cognitive restructuring and blaming the victim) and cyberbullying perpetration. Participants in the study consisted of 551 middle school students (273 boys and 278 girls) from five middle schools in Seoul and Gyeonggi-do. Cyberbullying perpetration, moral disengagement and self-control were measured using the Bullying/ Victimization Questionnaire, the Mechanisms of Moral Disengagement Scale, and the Self-Control Scale for children and adolescents. Data were analyzed by means of descriptive statistics and a hierarchical regression analysis. The moderating effect of self-control was analyzed using procedures proposed by Baron and Kenny (1986). The results indicated that both levels of cognitive restructuring and blaming the victim increased cyberbullying perpetration whereas the level of self-control decreased cyberbullying perpetration. In addition, self-control moderated the effect of cognitive restructuring on cyberbullying perpetration. The influence of cognitive restructuring on cyberbullying perpetration was greater when the level of self-control was low, compared to when it was high.

The present study aimed to investigate mother–teacher discrepancies in reports of preschoolers’ behavior problems and to examine whether maternal attribution to behavior problems, perception of parenting, and behavior management strategies predicted the discrepancies. The mothers and teachers of 384 preschoolers aged 3–6 years from 16 preschools of Seoul, South Korea, completed the Child Behavior Checklist and the Caregiver–Teacher Report Form. Based on their ratings, they were classified into three groups: (a) mother–teacher Agreement Group, (b) Disagreement Group with Mother only reporting at Risk (Disagreement Group-MR), and (c) Disagreement Group with Mother only reporting No Risk (Disagreement Group-MNR). The results showed marginal similarities between mothers’ and teachers’ reports of behavior problems, indicating both low correlations and differences in percentages of at-risk children. Multinomial logistic regressions revealed that maternal attribution and maternal perception of parenting difficulties predicted group membership regarding mother–teacher discrepancies. For both internalizing and externalizing problems, mothers who attributed environmental factors as primary causes of children’s behavior problems were more likely to be in the Agreement Group than the Disagreement Group-MNR. With regard to externalizing problems, the more the mothers perceived parenting difficulties, the more likely they were to belong to either of the Disagreement Groups. The outcomes suggest the importance of considering that mothers’ reports of children’s behavior and mother–teacher discrepancies partly mirror mothers’ beliefs and perceptions regarding children’s behavior and parenting. Professionals need to be aware that information from mother–teacher discrepancies can be of help in understanding mothers as well as children in practice.

People across the world and throughout history have gone to great lengths to enhance their physical appearance. Evolutionary psychologists and ethologists have largely attempted to explain this phenomenon via mating preferences and strategies. Here, we test one of the most popular evolutionary hypotheses for beauty-enhancing behaviors, drawn from mating market and parasite stress perspectives, in a large cross-cultural sample. We also test hypotheses drawn from other influential and non-mutually exclusive theoretical frameworks, from biosocial role theory to a cultural media perspective. Survey data from 93,158 human participants across 93 countries provide evidence that behaviors such as applying makeup or using other cosmetics, hair grooming, clothing style, caring for body hygiene, and exercising or following a specific diet for the specific purpose of improving ones physical attractiveness, are universal. Indeed, 99% of participants reported spending >10 min a day performing beauty-enhancing behaviors. The results largely support evolutionary hypotheses: more time was spent enhancing beauty by women (almost 4 h a day, on average) than by men (3.6 h a day), by the youngest participants (and contrary to predictions, also the oldest), by those with a relatively more severe history of infectious diseases, and by participants currently dating compared to those in established relationships. The strongest predictor of attractiveness-enhancing behaviors was social media usage. Other predictors, in order of effect size, included adhering to traditional gender roles, residing in countries with less gender equality, considering oneself as highly attractive or, conversely, highly unattractive, TV watching time, higher socioeconomic status, right-wing political beliefs, a lower level of education, and personal individualistic attitudes. This study provides novel insight into universal beauty-enhancing behaviors by unifying evolutionary theory with several other complementary perspectives., National Science Center, Poland [2019/33/N/HS6/00054]; Basic Research Program at the National Research University Higher School of Economics (HSE University); Basic Research Program at HSE University, RF; FCT [UID/PSI/03125/2021, SFRH/BD/126304/2016]; UTAR Research Centre Excellence Award; Universiti Tunku Abdul Rahman [2019 -CAP (6401/0019)], This work is the result of the research project funded by the National Science Center, Poland (2019/33/N/HS6/00054). Dmitry Grigoryev was supported by the Basic Research Program at the National Research University Higher School of Economics (HSE University).; Dmitrii Dubrov was supported by the Basic Research Program at HSE University, RF.; Patricia Arriaga was supported by the FCT through funds from the research center UID/PSI/03125/2021. Anabela C. Santos was supported by the FCT through funds from a PhD grant SFRH/BD/126304/2016. Kavitha Nalla Muthu and Chee-Seng Tan were supported by the UTAR Research Centre Excellence Award 2019 -CAP (6401/0019) from the Universiti Tunku Abdul Rahman.

OBJECTIVES Facilitating a high quality of death is an important aspect of comfort care for patients in ICUs. The quality of death in ICUs has been rarely reported in Asian countries. Although Korea is currently in the early stage after the implementation of the "well-dying" law, this seems to have a considerable effect on practice. In this study, we aimed to understand the status of quality of death in Korean ICUs as perceived by medical staff, and to elucidate factors affecting patient quality of death. DESIGN A multicenter cross-sectional survey study. SETTING Medical ICUs of two tertiary-care teaching hospitals and two secondary-care hospitals. PATIENTS Deceased patients from June 2016 to May 2017. INTERVENTIONS Relevant medical staff were asked to complete a translated Quality of Dying and Death questionnaire within 48 hours after a patient's death. A higher Quality of Dying and Death score (ranged from 0 to 100) corresponded to a better quality of death. MEASUREMENTS AND MAIN RESULTS A total of 416 completed questionnaires were obtained from 177 medical staff (66 doctors and 111 nurses) of 255 patients. All 20 items of the Quality of Dying and Death received low scores. Quality of death perceived by nurses was better than that perceived by doctors (33.1 ± 18.4 vs 29.7 ± 15.3; p = 0.042). Performing cardiopulmonary resuscitation and using inotropes within 24 hours before death were associated with poorer quality of death, whereas using analgesics was associated with better quality of death. CONCLUSIONS The quality of death of patients in Korean ICUs was considerably poorer than reported in other countries. Provision of appropriate comfort care, avoidance of unnecessary life-sustaining care, and permission for more frequent visits from patients' families may correspond to better quality of death in Korean medical ICUs. It is also expected that the new legislation would positively affect the quality of death in Korean ICUs.

This study examined the influences of middle school students'' affective empathy and guilt-proneness on defending behavior against bullying and investigated if class climate (teacher support and student support) had moderating effects. The participants consisted of 163 second to third grade students (77 boys and 86 girls) in Seoul and Gyeonggi-do. The data were analyzed with descriptive statistics, Pearson’s correlation, and hierarchical regression. Moderating effects were examined using multiple regression analysis. The results of this study indicated that guilt-proneness, teacher support, and student support had significant effects on the defending behavior of middle school students. The higher the level of guilt-proneness, the higher the level of defending behavior. Defending behavior was also higher when students perceived a belongingness to a classroom where their teacher and students provided support. However, affective empathy had no effect on defending behavior. Second, teacher support moderated the relation between guilt-proneness and defending behavior. The effects of guilt-proneness on defending behavior against bullying were greater when teacher support was high compared to low. The results suggested that guilt-proneness and classroom climate play important roles in increasing defending behavior in middle school students. Some implications for future research were also discussed.

This study investigated the impact of parentification on ambivalence over the emotional expression of early adults who had a sibling with disabilities and examined if rejection sensitivity moderated the relationship of parentification and ambivalence over emotional expression. Participants consisted of 116 siblings in early adulthood who had a sibling with disabilities (45 male; 71 female). The data were collected from 13 centers for family disability, four community rehabilitation centers, three parent societies for people with disabilities, and three self-help groups in Seoul, Busan, and Gyeonggi province. The levels of ambivalence over emotional expression, parentification, and rejecton sensitivity were measured by the Ambivalence over Emotional Expression Questionnaire (King & Emmons, 1990), the Filial Responsibility Scale-Adult (Jurkovic, Thirkield, & Morrell, 2001), and the Rejection Sensitivity Questionnaire (Downey & Feldman, 1996), respectively. The PROCESS Macro program examined the moderating model. The Results indicated that both levels of parentification and rejection sensitivity increased the level of ambivalence over emotional expression of non-disabled siblings. In addition, rejection sensitivity moderated the effect of parentification on ambivalence over emotional expression. The influence of parentification on ambivalence over emotional expression was greater when the level of rejection sensitivity was high, compared to when it was low.

A fixed-dose combination of inhaled corticosteroid and long-acting beta agonist (ICS/LABA) may increase the risk of pneumonia in patients with chronic airway diseases including chronic obstructive pulmonary disease and asthma. Although lung deposition of ICS/LABA is dependent on the inhaler device and inhalation technique, there have been few studies comparing the risk for pneumonia according to the type of device used to deliver ICS/LABA in real-world practice. A retrospective cohort study was performed using the National Health Insurance Database of the Korean Health Insurance Review & Assessment Service. New users who began ICS/LABA were selected and followed-up 180 days after ICS/LABA initiation. The risk for pneumonia requiring emergency room (ER) visit or admission was compared according to inhaler device used—pressurized metered-dose inhaler (pMDI) or dry powder inhaler (DPI)—after individual exact matching (1:5). Among the eligible cohort of 245,477 new ICS/LABA users, 7,942 patients who used pMDI only were matched with 39,690 patients who used DPI only. The incidence of pneumonia was higher in the pMDI group (1.6%) than the DPI group (1.1%); the adjusted hazard ratio (HR) for pneumonia was 1.6 (95% CI 1.3–2.0; p

The present study examined the effects of self-concept clarity and stress coping styles on depression in undergraduate students, and whether stress coping styles moderated the relation between self-concept clarity and depression. The participants of this study were 355 students (145 males and 209 females) from 15 universities located in Seoul and Gyeonggi-do. To measure the level of depression, the Center for Epidemiological Studies-Depression(CES-D) Scale was used. The level of self-concept clarity was assessed by the Self-concept Clarity Scale. Also, stress coping styles were measured by Coping Styles Inventory. The data was analyzed by means of descriptive statistics and hierarchical regressions. The moderating effects of stress coping styles were investigated using the analysis procedures proposed by Baron and Kenny . The results indicated that the levels of self-concept clarity and problem-focused coping decreased the level of depression. Moreover, problem-focused coping, emotion-focused coping and aesthetic thinking moderated the effects of self-concept clarity on depression.

This study aimed to examine the effects of socially prescribed perfectionism, sleep duration, and sleep quality on suicidal ideation in Korean high school students and to investigate if sleep duration and quality moderated the relationship between socially prescribed perfectionism and suicidal ideation. The participants of this study were 840 students (544 boys and 296 girls) from six high schools located in Seoul and Gyeonggi-do. The Suicidal Ideation Questionnaire (Reynolds, 1988) was used to measure suicidal ideation. And the socially prescribed perfectionism was assessed by the Multidimensional Perfectionism Scale (Hewitt & Flett, 1991). The students were asked to respond to a question regarding how long they slept a day as well as the Sleep Quality Scale (Yi, 2005). The data were analyzed with descriptive statistics and hierarchical regressions. The moderating effect of sleep duration and quality were investigated using the analysis procedures proposed by Baron and Kenny (1986). The results showed that the level of socially prescribed perfectionism and sleep quality increased the level of suicidal ideation. In addition, sleep quality moderated the relationship between socially prescribed perfectionism and suicidal ideation. The effect of socially prescribed perfectionism on suicidal ideation was greater when sleep quality was poor, compared to when it was good.

This study examined the effects of social comparison orientation and stress coping styles on job-seeking stress experienced by university students. The participants of this study were 324 junior and senior students (151 males and 173 females) from six universities located in Seoul who were preparing for employment. They were asked to respond to a written questionnaire to measure research variables for the Job-Seeking Stress Scale, the Social Comparison Orientation Scale, and the Ways of Coping Checklist. The data were analyzed by means of descriptive statistics and a hierarchical multiple regression. The major findings of this study were as follows. First, social comparison orientation had a positive effect on job-seeking stress of university students, revealing that students with a high level of social comparison orientation were more likely to experience job-seeking stress. Second, both emotion-alleviation coping style and wishful thinking coping style increased level of job-seeking stress. In addition, problem-focused coping style had a negative influence on job-seeking stress, whereas social support seeking coping style had no significant effect on it. The results suggested that it would be possible to reduce job-seeking stress of university students by changing either social comparison or stress coping style.