Increasing social concern surrounds the potential adverse health effects of precarious employment (PE). In this study, we explored the association between PE and the onset of depressive symptoms.

A total of 11,555 Korean waged workers (5700 females) contributed 62,217 observations from 2009 to 2022. PE was operationalized as a multidimensional construct, including employment insecurity, income inadequacy and lack of rights and protection. Depressive symptoms were evaluated using the Center for Epidemiological Studies-Depression Scale (11-item version). The association between PE and the onset of depressive symptoms in the subsequent year was estimated using generalized estimating equations. Effect sizes were reported as odds ratio (OR) and 95% confidence interval (CI).

The overall incidence of depressive symptoms was 8.3% during the study period. In cross-sectional analysis, daily employment, disguised employment, lower monthly wages and lack of social insurance coverage were associated with concurrent depressive symptoms in both men and women. Longitudinally, fixed-term employment (OR: 1.17, 95% CI: 1.07–1.29), daily employment (OR: 1.64, 95% CI: 1.45–1.85) and disguised employment (OR: 1.36, 95% CI: 1.17–1.57) were associated with the onset of depressive symptoms among the overall sample. Among men, the lowest quartiles of wage were associated with the onset of depressive symptoms (OR: 1.34, 95% CI: 1.13–1.60), while the absence of a trade union was associated among women (OR: 1.18, 95% CI: 1.01–1.39).

Employment insecurity, inadequate income and lack of rights and protection may contribute to depressive symptoms. Therefore, PE serves as a significant social determinant of mental health among workers in Korea. Active policy efforts are warranted to improve the overall quality of employment in the workforce.

Although various clinical indicators of suicide have been recorded, the previous suicide attempt is meaningful as one of the most robust risk factors predicting subsequent suicide attempts but there are lacking in biomarkers for evaluating suicide attempts. This study aimed to analyze the correlation of changes in oxygenated hemoglobin concentration with lifetime suicide attempt during verbal fluency test.

A total of 60 patients with major depressive disorder (MDD) were enrolled. Demographic, clinical, physical, and psychological evaluations were conducted. We evaluated the suicidal behaviors through MINI suicidality item. We indicated verbal fluency test to examine prefrontal activation during the cognitive execution while fNIRS was observed.

54 of enrolled patient with MDD (23 those with a lifetime history of suicide attempt; 31 those without a lifetime history of suicide attempt) are eligible for the subject. The patients were 35.19% of those with a lifetime history of suicide attempt. The values of the changes in oxygenated hemoglobin involving the entire regions of prefrontal cortex were smaller in those with a lifetime history of suicide attempt. The biggest difference is in right VMPFC, the mean score of those with a lifetime history of suicide attempt and those without a lifetime history of suicide attempt were 0.095(SD, 1.032) and 0.610(SD, 1.038) although the statistically non-significance. We discovered that a small value of changes in oxygenated hemoglobin was related to lifetime suicide attempt through multivariable logistic regression analysis. After adjusting for age, sex, years of education, and HAMD, there was a significant difference in the right VMPFC [OR = 0.491(95% CI=0.235~0.916), p = 0.036].

Study result indicated that the values of the changes in oxygenated hemoglobin were smaller in who attempted suicide before during cognitive execution. The adjusted regression analysis was presented significant result in right VMPFC. Therefore, the changes in oxygenated hemoglobin measured by fNIRS can be applied as a biomarker for suicidal behavior such as lifetime suicide attempt.

The effect of long working hours on mental health has drawn great social attention in recent years.

We investigated how work–family conflict mediates the associations between long working hours and sleep disturbance and burnout.

We included 19 159 individuals from a nationally representative sample of workers in South Korea. We decomposed the total effect into a direct effect (long working hours → sleep disturbance or burnout) and an indirect effect (long working hours → work–family conflict → sleep disturbance or burnout). Logistic mediation models were used.

Long working hours were associated with increased risks of work–family conflict, sleep disturbance and burnout. The longer the working hours, the stronger the direct and indirect effects. The odds ratios of the direct effects of long working hours on sleep disturbance were 1.64 (95% CI 1.39–1.95) for 49–54 h/week and 1.66 (95% CI 1.37–2.01) for ≥55 h/week; those of the indirect effects were 1.16 (95% CI 1.12–1.21) for 49–54 h/week and 1.27 (95% CI 1.21–1.33) for ≥ 55 h/week. Similarly, odds ratios of the direct effects of long working hours on burnout were 1.18 (95% CI 1.05–1.33) for 49–54 h/week and 1.20 (95% CI 1.04–1.37) for ≥55 h/week; those of the indirect effects were 1.11 (95% CI 1.09–1.15) for 49–54 h/week and 1.20 (95% CI 1.16–1.24) for ≥55 h/week.

Our results suggest that work–family conflict mediates the associations between long working hours and sleep disturbance and burnout. Longitudinal studies should be followed to confirm the causal relationship.

There has been growing interest in protecting workers’ mental health. Identifying social determinants that affect workers’ mental health could play an important role in preventing psychiatric diseases.

We investigated the effects of temporary employment and job dissatisfaction on alcohol use disorder and depressive symptoms.

The Korea Welfare Panel Study data-set (2009–2021) was used, and 9611 participants with 52 639 observations were included. Generalised linear mixed models were employed to estimate odds ratios and 95% confidence intervals. The relative excess risk due to interaction (RERI) was calculated to assess supra-additive interactions between temporary employment and job dissatisfaction.

Increased risks for depressive symptoms were observed among fixed-term workers (odds ratio 1.12, 95% CI 1.00–1.26) and daily labourers (odds ratio 1.68, 95% CI 1.44–1.95). Daily labourers were associated with an increased risk of alcohol use disorder (odds ratio 1.54, 95% CI 1.22–1.95). Job dissatisfaction was associated with alcohol use disorder (odds ratio 1.78, 95% CI 1.52–2.08) and depressive symptoms (odds ratio 4.88, 95% CI 4.36–5.46). This effect became stronger when workers were concurrently exposed to temporary employment and job dissatisfaction. Daily labourers with job dissatisfaction showed the highest risks for alcohol use disorder (odds ratio 2.99, 95% CI 2.21–4.03) and depressive symptoms (odds ratio 9.00, 95% CI 7.36–11.02). RERIs between daily employment and job dissatisfaction were >0 for alcohol use disorder (0.91, 95% CI 0.06–1.76) and depressive symptoms (3.47, 95% CI 1.80–5.14), indicating a supra-additive interaction.

We revealed that temporary employment and job dissatisfaction had detrimental effects on alcohol use disorder and depressive symptoms.

We calculated the human resources required for an antimicrobial stewardship program (ASP) in Korean hospitals.

Multicenter retrospective study.

Eight Korean hospitals ranging in size from 295 to 1,337 beds.

The time required for performing ASP activities for all hospitalized patients under antibiotic therapy was estimated and converted into hours per week. The actual time spent on patient reviews of each ASP activity was measured with a small number of cases, then the total time was estimated by applying the determined times to a larger number of cases. Full-time equivalents (FTEs) were measured according to labor laws in Korea (52 hours per week).

In total, 225 cases were reviewed to measure time spent on patient reviews. The median time spent per patient review for ASP activities ranged from 10 to 16 minutes. The total time spent on the review for all hospitalized patients was estimated using the observed number of ASP activities for 1,534 patients who underwent antibiotic therapy on surveillance days. The most commonly observed ASP activity was ‘review of surgical prophylactic antibiotics’ (32.7%), followed by ‘appropriate antibiotics recommendations for patients with suspected infection without a proven site of infection but without causative pathogens’ (28.6%). The personnel requirement was calculated as 1.20 FTEs (interquartile range [IQR], 1.02–1.38) per 100 beds and 2.28 FTEs (IQR, 1.93–2.62) per 100 patients who underwent antibiotic therapy, respectively.

The estimated time required for human resources performing extensive ASP activities on all hospitalized patients undergoing antibiotic therapy in Korean hospitals was ~1.20 FTEs (IQR, 1.02–1.38) per 100 beds.

The Korea National Health Insurance (K-NHI) has covered medical devices with low cost-effectiveness evidence by what is known as the Selective Benefit (SB) since December of 2013 as a type of conditional coverage. Most medical devices in the SB category are new technology and have higher levels of clinical effectiveness and/or functions than those in the benefit category, but they are characterized as being expensive. We compare the K-NHI medical device coverage system to those in Japan and Taiwan so as to be more informed about how to cover and set prices for new medical devices.

We searched for materials related to medical device coverage or the reimbursement systems of three countries (Korea, Japan, and Taiwan). National health insurance laws, policy reports, and the websites of the Ministries of Health of the respective countries, for instance, were also reviewed.

The NHI systems of Korea, Japan, and Taiwan have several similarities with regard to their medical device benefit lists. They reimburse listed medical devices separately although they cover them basically by including procedures or a diagnosis-related group (DRG) fee. The K-NHI reimburses for medical devices with low cost-effectiveness using the actual market medical price, similar to other medical devices in the benefit category. However, there are no detailed rules regarding how to set prices for these devices. Every listed medical device is covered at the notified price in Japan, but the prices of new medical devices with improved functions can add 1 -100 percent of the price to the notified price. The prices of devices related to new medical procedures are determined by cost-accounting methods. The NHI service in Taiwan compensates for medical devices which are alternates but clinically improved types through a balance billing method.

The NHI systems in Japan and Taiwan set prices with regard to reimbursements for new medical devices separately, specifically for devices which are advanced clinically or functionally but expensive. The K-NHI must consider establishing a pricing or reimbursement system for new medical devices through the discussion with stakeholders for reasonable reimbursements and decreasing the financial burden on the K-NHI.

Our aim was to examine the prevalence, correlates, and association of depressive and anxiety disorders with quality of life (QoL) and such other outcomes as the need for psychosocial services in cancer patients.

A total of 400 patients participated in a multicenter survey involving five cancer centers located throughout Korea. The Short-Form Health Survey, the MD Anderson Symptom Inventory, the Mini-Mental Adjustment to Cancer (MINI-MAC), and Mini-International Neuropsychiatric Interview were administered.

The prevalence rates for depressive and anxiety disorders were 16 and 17.1%, respectively. Younger age and poor Eastern Cooperative Oncology Group performance status, and all physical symptoms, as well as helplessness/hopelessness, anxious preoccupation (AP), and cognitive avoidance (CA) on the MINI-MAC were found to be significantly related to depressive disorder (DD) in a univariate logistic regression analysis. Metastases, the symptoms of disturbed sleep, dry mouth, and numbness or tingling, as well as AP and CA were significantly correlated with anxiety disorder (AD) in the univariate analysis. In the multivariate analyses, only AP was significant for AD (odds ratio = 2.94, p < 0.001), while none reached statistical significance for DD. Psychiatric comorbidity status had a detrimental effect on various dimensions of QoL. Patients with DD or AD reported a significantly higher need for professional psychosocial services.

Given the substantial prevalence and pervasive impact of DD and AD on various aspects of QoL, its assessment and care should be integrated as a regular part of oncological care throughout the cancer continuum.

Patients with early cognitive impairment (ECI) face the prospect of progressive cognitive decline that impairs their ability to make decisions on financial and personal matters. Advance care planning (ACP) is a process that facilitates decision making on future care and often includes identifying a proxy decision maker. This prospective study explores factors related to completion or non-completion of ACP in patients with ECI.

Patients with ECI (n = 158, Mage = 76.2 ± 7.25 years) at a memory clinic received psycho-education and counseling on the importance of ACP and followed-up longitudinally for up to 12 months to ascertain if ACP had been completed. Univariate and logistic regression were used to analyze factors related to completion and non-completion of ACP.

Seventy-seven patients (48.7%) were initially willing to consider ACP after the counseling and psycho-educational session but only 17 (11.0%) eventually completed ACP. On logistic regression, patients who were single were 8.9 times more likely to complete ACP than those who were married (p = 0.007). Among those initially willing to consider ACP, factors impeding completion of ACP included patient (48.0%), process (31.0%), and family factors (21.0%).

As unmarried patients may not have immediate family members to depend on to make decisions, they may perceive ACP to be more important and relevant. Understanding the barriers to ACP completion can facilitate targeted interventions to improve the uptake of ACP.

To determine the influence of caregiver personality and other factors on the burden of family caregivers of terminally ill cancer patients.

We investigated a wide range of factors related to the patient–family caregiver dyad in a palliative care setting using a cross-sectional design. Caregiver burden was assessed using the seven-item short version of the Zarit Burden Interview (ZBI–7). Caregiver personality was assessed using the 10-item short version of the Big Five Inventory (BFI–10), which measures the following five personality dimensions: extroversion, agreeableness, conscientiousness, neuroticism, and openness. Patient- and caregiver-related sociodemographic and psychological factors were included in the analysis because of their potential association with caregiver burden. Clinical patient data were obtained from medical charts or by using other measures. Multivariate linear regression analysis was performed to identify the independent factors associated with caregiver burden.

We analyzed 227 patient–family caregiver dyads. The multivariate analysis revealed that caregiver extroversion was protective against caregiver burden, whereas depressive symptoms in caregivers were related to increased burden. Neuroticism was positively correlated with caregiver burden, but this relationship was nonsignificant following adjustment for depressive symptoms. Patient-related factors were not significantly associated with caregiver burden.

Evaluating caregiver personality traits could facilitate identification of individuals at greater risk of high burden. Furthermore, depression screening and treatment programs for caregivers in palliative care settings are required to decrease caregiver burden.

The present study was performed to investigate whether breast-feeding is associated with early pubertal development among children 7–9 years old in Korea.

Children were divided into those who did and did not receive breast-feeding for 6 months or longer in accordance with the recommendations of the WHO. Pubertal status was determined by clinical examination using Tanner staging.

Prospective observational study.

We conducted a follow-up study of children aged 7–9 years in 2011 who had taken part in the Ewha Birth & Growth Cohort study.

Fifty (22·8 %) of the total of 219 children were in early puberty, with the proportion being slightly higher for girls (24·1 %) than boys (21·4 %). Children who had entered early puberty were taller, weighed more and had a higher concentration of insulin-like growth factor 1. Moreover, the change in weight Z-score from birth to follow-up was significantly lower in children who were breast-fed than in those who were not (weight Z-score change: 0·32 (sd 1·59) v. 0·77 (sd 1·61), respectively, P=0·04). Comparison of breast-feeding by puberty status indicated a preventive association with early puberty in children who were breast-fed for 6 months or longer (OR=0·37; 95 % CI 0·18, 0·74). This association remained significant after adjustment for relevant covariates.

These results demonstrate a beneficial association between breast-feeding and early pubertal development, especially in those breast-fed for 6 months or longer. The study suggests that interventions would need to start early in life to prevent early pubertal development.

There is increasing evidence of a relationship between underweight or obesity and dementia risk. Several studies have investigated the relationship between body weight and brain atrophy, a pathological change preceding dementia, but their results are inconsistent. Therefore, we aimed to evaluate the relationship between body mass index (BMI) and cortical atrophy among cognitively normal participants.

We recruited cognitively normal participants (n = 1,111) who underwent medical checkups and detailed neurologic screening, including magnetic resonance imaging (MRI) in the health screening visits between September 2008 and December 2011. The main outcome was cortical thickness measured using MRI. The number of subjects with five BMI groups in men/women was 9/9, 148/258, 185/128, 149/111, and 64/50 in underweight, normal, overweight, mild obesity, and moderate to severe obesity, respectively. Linear and non-linear relationships between BMI and cortical thickness were examined using multiple linear regression analysis and generalized additive models after adjustment for potential confounders.

Among men, underweight participants showed significant cortical thinning in the frontal and temporal regions compared to normal weight participants, while overweight and mildly obese participants had greater cortical thicknesses in the frontal region and the frontal, temporal, and occipital regions, respectively. However, cortical thickness in each brain region was not significantly different in normal weight and moderate to severe obesity groups. Among women, the association between BMI and cortical thickness was not statistically significant.

Our findings suggested that underweight might be an important risk factor for pathological changes in the brain, while overweight or mild obesity may be inversely associated with cortical atrophy in cognitively normal elderly males.

Epidemiological studies have reported that higher education (HE) is associated with a reduced risk of incident Alzheimer's disease (AD). However, after the clinical onset of AD, patients with HE levels show more rapid cognitive decline than patients with lower education (LE) levels. Although education level and cognition have been linked, there have been few longitudinal studies investigating the relationship between education level and cortical decline in patients with AD. The aim of this study was to compare the topography of cortical atrophy longitudinally between AD patients with HE (HE-AD) and AD patients with LE (LE-AD).

We prospectively recruited 36 patients with early-stage AD and 14 normal controls. The patients were classified into two groups according to educational level, 23 HE-AD (>9 years) and 13 LE-AD (≤9 years).

As AD progressed over the 5-year longitudinal follow-ups, the HE-AD showed a significant group-by-time interaction in the right dorsolateral frontal and precuneus, and the left parahippocampal regions compared to the LE-AD.

Our study reveals that the preliminary longitudinal effect of HE accelerates cortical atrophy in AD patients over time, which underlines the importance of education level for predicting prognosis.