Prediction of suicidal ideation in shift workers compared to non-shift workers using machine learning techniques

BackgroundAlthough hemorrhoids are one of the most common anal diseases among Koreans, risk factors for hemorrhoids have not been well identified.MethodsWe analyzed the data from the 4th Korean National Health and Nutrition Examination Survey (KNHANES) between 2007 and 2009. Study subjects were 17,228 participants of KNHANES who were aged 19 years or older. Logistic regression analysis was conducted to evaluate associations between hemorrhoids and probable risk factors.ResultsOverall prevalence of hemorrhoids among study subjects was 14.4%, being more prevalent among women (15.7%) than among men (13.0%). Obesity and abdominal obesity were associated with a higher risk of hemorrhoids with odds ratio (OR) (95% confidence intervals, 95% CI) of 1.13 (1.01 to 1.26) and 1.16 (1.04 to 1.30), respectively. Both self-reported depression (OR, 1.83; 95% CI, 1.62 to 2.08) and physician diagnosed depression (OR, 1.71; 95% CI, 1.35 to 2.17) were associated with significantly higher risk of hemorrhoids. No regular walking (OR, 1.11; 95% CI, 1.00 to 1.23) and experience of pregnancy (OR, 1.62; 95% CI, 1.17 to 2.25) for women were also associated with higher risk of hemorrhoids. However, educational level, alcohol consumption, physical activities, diabetes mellitus, hypertension, fiber, fat intake, and energy intake were not associated with a risk of hemorrhoids. Low quality of life assessed with EuroQol-5 Dimension and EuroQol-Visual Analogue Scale was significantly associated with hemorrhoids.ConclusionThis nationwide cross-sectional study of Korean adults suggests that obesity, abdominal obesity, depression, and past pregnancy may be risk factors for hemorrhoids and hemorrhoids affect quality of life negatively.

The current study aimed to investigate the association between mental health status and bone mineral density (BMD) using data from the Korean National Health and Nutrition Examination Survey (KNHANES) 2008–2010. We enrolled 15,876 South Korean participants (4,010 postmenopausal females, 4,836 premenopausal females, and 7,016 males, all aged 20 years or older). BMD was measured using dual-energy radiography absorptiometry at the femoral neck (NK), lumbar spine (LSP), and total femur (TFM). Mental health status data were obtained from a self-report questionnaire that assessed psychological stress, depressed mood, and suicidal ideation. Psychological stress was negatively correlated with BMD in the LSP, NK, and TFM for the male group. Depressed mood was associated with lower BMD in the LSP, NK and TFM for the premenopausal female group, and in the LSP for the male group. Suicidal ideation was associated with lower BMD in the NK and TFM for the male group. Mental health problems were associated with lower BMD, especially in premenopausal females and males. Future investigations should focus on the shared pathophysiology between mental health problems and BMD, and the interrelationship between increased BMD and recovery from mental health problems.

Atopic dermatitis is a chronically relapsing inflammatory skin condition that has profound impacts on quality of life of patients and their family. The aim of this study is to investigate the psychological stress in parents of children with atopic dermatitis in Korea, using data from the Korean National Health and Nutrition Examination Survey (KNHANES). This cross-sectional study included parents of participants under 19 years of age (970 with atopic dermatitis and 5,733 without atopic dermatitis after excluding those who meet the exclusion criteria) from the 2009 to 2012 KNHANES. The psychological stress state was evaluated with the following four questionnaire items: self-perception of stress, depressed mood, suicidal ideation, and diagnosis of depression by a physician. After adjusting for age, gender, education level, occupation, and marital status, logistic regression analyses indicated that mothers of children with atopic dermatitis had a higher frequency of stress perception (adjusted odds ratio (aOR) 1.46 (95% confidence interval (95% CI) 1.22–1.74), p < 0.01) and suicidal ideation (aOR 1.40 (95% CI 1.1–1.79), p < 0.01) than those without atopic dermatitis. In contrast, fathers of children with atopic dermatitis did not show a significant difference in all items compared with those of children without atopic dermatitis. Understanding the psychological stress in parents of children with atopic dermatitis is important for clinicians, since evaluation, management and support for parents, especially mothers, of children with atopic dermatitis are required.

Objectives: The purpose of this study was to examined the association between unemployment and suicidal ideation in Korea. Methods: We analyzed data from the Korean National Health and Nutrition Examination Surveys (KNHANES) IV, conducted in 2009. Statistical analysis methods used in this study were <TEX>$x^2$</TEX>-test, Hierarchial logistic regression analysis and other basic statistics using SPSS version 19.0. Results: The suicidal ideation of unemployment workers was 24.7% in male and 35.9% in female. After adjusting for sociodemographic characteristics and health-related characteristics, the risk for suicidal ideation of unemployment workers was significantly higher than employment workers. In men, the OR for suicidal ideation of the employed workers compared with the employed was 2.13, and in women, the OR was 1.31. Conclusions: The findings suggest the impact of unemployment status on suicidal ideation and the need for further prospective investigation that lead to interventions should be required to introduce of suicide prevention program for unemployment worker.

Background/Objectives: The purpose of this study was to investigate the effect of physical activity on the health-related quality of life among people with activity limitations for each type of physical activity. Methods/Statistical analysis: The original data used in the research were the health survey data of the Korean National Health and Nutrition Examination Survey (KNHANES) conducted in 2013 and 2014. The research variables of this study were the frequency of participation in each type of physical activity and EQ-5D (Euro Quality of Life-5 Dimensions). Findings: First, in the case of men, there was a difference in the health-related quality of life (HRQL) between the group that did not participate in walking exercise at all and the groups who did so for 3 or 4 days and 5 days or more. For the flexibility exercise, there was a difference in HRQL between the group who did not participate in the exercise at all and the group who participated in it for 1 or 2 days. Second, In the case of women, there was a difference in the HRQL between the group that did not participate in the muscular strength exercise at all and the group that participated in it for 5 days or more. Improvements/Applications: Thus, proper participation in walking and flexibility exercises for males and adequate participation in muscular strength exercises for females are expected to help improve their HRQL.

We aimed to examine the association between shift work types and participation in breast cancer screening (BCS) programs by comparing rates of participation for BCS among regular daytime workers and alternative shift workers using data from a nationally representative, population-based survey conducted in Korea. In addition, the results were analyzed according to sociodemographic factors, including occupation, education, income, private health insurance, age, and number of working hours a week. This secondary cross-sectional analysis used data from the 2012 Korean National Health and Nutritional Examination Survey. The target population included women aged≥40years who responded as to whether they had undergone BCS in the previous year. Accordingly, we analyzed survey data for a total of 1,193 women and used a multivariate logistic regression analysis to evaluate the differences in factors affecting BCS between regular daytime and alternative shift workers. A logistic regression analysis was performed considering private health insurance as a significant sociodemographic factor for BCS among regular daytime shift workers. In contrast, none of the tested variables could significantly predict adherence to BCS among alternative shift workers. The results of this study suggest the need for the development of comprehensive workplace breast cancer prevention programs by considering shift work types. More attention should be given to female workers with low education levels, those who are uninsured, and young workers to improve the participation rate for BCS at the workplace.

Background: The number of shift workers has progressively increased with increasing social needs. Shift work (especially night shift) is known to negatively affect workers’ health and well-being. We aimed to compare shift and non-shift workers in terms of depressive symptoms and related factors. Methods: Data were obtained from the 6th Korea National Health and Nutrition Examination Survey conducted in 2013. Of the 994 participants, 357 were women (all standard workers aged ≥19 years). Based on the information provided by a self-administered questionnaire, subjects were categorized according to work schedule (shift/non-shift). Differences in general characteristics (sociodemographic/health/work factors) between shift and non-shift workers were assessed using the t-test, chi-square test, linear-by-linear association, and Fisher exact test. To evaluate the factors that affect depression, a logistic regression analysis was performed for the general characteristic parameters. Results: Shift workers (9.5%) had higher incidence of depressive symptoms over 2 weeks than the non-shift workers (4.6%; P=0.024). The factors that affected depression were sex (female: odds ratio [OR], 2.94; P=0.001), stress perception (yes: OR, 3.43; P<0.001), suicidal ideation (yes: OR, 15.25; P<0.001), sleep duration (<7 hours/day: OR, 2.16; P=0.021), and occupation class (manual: OR, 2.20; P=0.048) in all subjects. Conclusion: Shift work had a negative effect on workers in terms of depressive symptoms. Shift workers faced harsher conditions than the non-shift workers. Female-sex, stress, suicide ideation, lack of sleep, and manual work were associated with higher depressive symptoms among the workers. Therefore, the working environment should be improved to prevent these depression triggers.

Increased Prevalence of low High-density Lipoprotein Cholesterol (HDL-C) Levels in Korean Adults: Analysis of the Three Korean National Health and Nutrition Examination Surveys (KNHANES 1998–2005)

Association of Mixed Use of Electronic and Conventional Cigarettes and Exposure to Secondhand Smoke With Prediabetes: Results From National Cross-Sectional Surveys

Purpose: In this study investigated the association between cardio-cerebro vascular disease and depression was examined and factors influencing depression in adults with cardio-cerebro vascular disease were identified. The Korean National Health and Nutrition Examination Survey (KNHANES) data (2014, 2016), which is representative of the Korean population was used.Methods: Data on 9,651 people (male 4,148, female 5,503; age≥19 years old from the KNHANES (Ⅵ-2, Ⅷ-1) were analyzed using frequency, percentage, &lt;i&gt;x&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; test, and logistic regression analysis. Depression is defined as major depression with doctor diagnosis or Patient Health Questionnaire-9 score ≥10. Ischemic heart disease (IHD)(myocardial infarction or angina) and stroke were defined as a doctor diagnosis.Results: The prevalence of depression was 20.4% in the IHD group and 22.9% in stroke group, which were statistically significant. After adjusting by sociodemographic, health-related, and independent variables in a logistic regression analysis, IHD (OR=1.91, 95% CI 1.36~2.69) and stroke (OR=1.83, 95% CI 1.23~2.72) were associated with depression. In addition, IHD was significantly associated with depression in women, people divorced or separated, current smokers, people with perceived stress, and hypercholesterolemia. In addition, stroke was significantly associated with depression in women, under the age of 65, with perceived stress.Conclusion: The results of this study show that cardio-cerebro vascular disease is associated with the depression and influencing factors on depression were socio-demographic and health-related characteristics. Therefore, intensive management of depression risk factors and development and application of a program reducing depression for patients with cardio-cerebro vascular disease should be developed.

Background Diabetes is known to be a strong risk factor for cardiovascular disease (CVD), and controlling salt intake in patients with type 2 diabetes may be a strategy to reduce the risk of CVD. However, the clear interaction between salt intake and glucose homeostasis has yet to be investigated. Our study evaluated the frequency and risk of glucose intolerance (pre-diabetes) according to dietary salt intake in a healthy population in Korea. Methods The Korean National Health and Nutritional Examination Survey (KNHANES) database was utilized for this study (https://knhanes.cdc.go.kr). A total of 72,751 subjects were enrolled in the KNHANES database from 2010 to 2018. The subjects were categorized into the following: normal fasting glucose (i.e., no pre-diabetes; FPG &amp;lt; 100 mg/dL), stage 1 pre-diabetes (FPG 100–109 mg/dL), stage 2 pre-diabetes (FPG 110–125 mg/dL). All subjects were divided into 8-equal groups according to their sodium intake: Group 1: ≤ 3.5 g, Group 2: 3.5 to 5.0 g, Group 3: 5.0 to 6.3 g, Group 4: 6.3 to 7.8 g, Group 5: 7.8 to 9.5 g, Group 6: 9.5 to 11.8 g, Group 7: 11.8 to 15.5 g, Group 8: &amp;gt; 15.5 g. This study is a retrospective cross-sectional study, so future risks cannot be assessed, but only the disease status assessment at the same time. Results Of the total 36,782 healthy adults, 17.6% (6,481 subjects) were pre-diabetic, of which 14.7% (5,397 subjects) were stage I pre-diabetic, and 2.9% (1,084 patients) were stage II pre-diabetic. From the lowest salt intake group (group 1, salt intake &amp;lt;3.5g) to the highest salt intake group (group 8, salt intake&amp;gt;.5g), the pre-diabetes prevalence continuously increased from 9.2% to 22.8%. The range of stage 1 pre-diabetes was 7.3% to 18.3%, and stage 2 diabetes was 1.9% to 4.5%. The odds ratio (OR) of pre-diabetic risk according to salt intake in the non-diabetic population, compared with group 1, group 2 was 1.46 (95% confidence interval [CI]: 1.30-1.68), group 3 was 1.84 (95% CI: 1.62 -2.08), group 4 was 2.24 (95% CI: 1.99-2.54), group 5 was 2.43 (95% CI: 2.15-2.75), group 6 was 2.49 (95% CI: 2.20-2.81), group 7 was 2.83 (95% CI: 2.51-3.19), group 8 was 2.90 (95% CI: 2.57-3.27). Conclusions High salt intake is significantly associated with pre-diabetes prevalence in healthy Korean population.

ObjectivesIt has been suggested that exposure to heavy metal cadmium (Cd) may contribute to a high risk of developing rheumatoid arthritis (RA). This study was to investigate the association of...

Developing and maintaining a rich safety culture is an important factor in achieving a safe workplace with low injury rates. Safety climate measures provide a snapshot of the safety culture, as they reflect workers' shared perceptions of how management and workers deal with safety on a daily basis. There is however, research evidence that safety may be compromised for shift workers during night shifts. The role of safety culture has been documented in major accidents such as Three Mile Island, Chernobyl and Exxon Valdez, all of which involved work activities at night. There is also evidence that workers who work in close proximity to production lines have increased injury risks. This study investigates whether the level of safety climate is lower among shift workers, who work both days and nights compared to daytime workers. The Nordic Occupational Safety Climate Questionnaire (NOSACQ-50) is used to evaluate the safety climate. The questionnaire contains 50 positively formulated and negated (reversed) items using a four-point Likert scale. The items are distributed across seven scales dealing with: Perceptions of management and worker commitment and priority to safety, safety empowerment from management, safety justice, safety communication and trust in safety systems. Data are derived from workers at two chemical plants in Sweden, both of which employ daytime workers and shift workers. Two-tailed t-tests of the data are carried out in SPSS, and are supplemented with injury data and the type of work with proximity to production lines. The level of safety climate is relatively high at both plants, compared to other international studies using NOSACQ-50. Shift workers at the two plants have significantly lower scores on all seven safety climate scales, compared to daytime workers at the two plants. Separate analyses for each plant reveal that shift workers have significantly lower scores on five safety climate scales at the first plant, whereas there were no differences between shift workers and daytime workers at the second plant. Several of the daytime workers at the first plant are located further away from production lines and laboratories than the other three groups, and they experience fewer direct accidents and/or dangerous situations at work. Greater risk exposure and experience with injury events may play more important roles than shift work itself, in explaining lower ratings of safety climate.

There is inconsistent evidence for a possible carcinogenic effect of shift work. In particular, little is known about the putative association of shift work with prostate cancer. We studied a cohort of 27,828 male industrial production workers residing in the German federal state of Rhineland-Palatinate who worked for at least one year in a chemical company in the period 1995-2005. We obtained data on shift work and potential confounders including age, occupational task, and duration of employment from personnel files and from the records of the occupational health service. New cases of cancer in the period 2000-2009 were ascertained from the state cancer registry. Differences in risk between shift workers and daytime workers were analyzed with Cox regression, stratified by stage of cancer, and adjusted for potential confounding effects. There were 146 new cases of prostate cancer in 12,609 rotating shift workers and 191 in 15,219 daytime workers. The median year of birth was 1960 in the first group and 1959 in the second. The shift workers did not have an elevated hazard ratio for prostate cancer in comparison to the daytime workers (HR = 0.93, 95% confidence interval [CI] 0.73-1.18). Some differences were seen depending on tumor stage. Both groups of workers had a higher incidence of prostate carcinoma than the general population (standardized incidence rate [SIR] = 1.44, 95% CI 1.22-1.70 for daytime workers; SIR = 1.51, 95% CI 1.30-1.74 for shift workers). In this well-documented, large-scale cohort study, the incidence of prostate cancer among shift workers did not differ from that among daytime workers. In the authors' opinion, further follow-up of this relatively young cohort is required.

Symptoms of eating disorders have been established as significant concurrent correlates with suicide ideation and behaviors in adolescent samples, but very few studies have examined eating disorder symptoms as prospective risk factors for suicide. The current study examined eating disorder symptoms as prospective risk factors for suicide ideation in an unselected community sample of adolescents. Data were collected from 436 adolescents in middle and high school at baseline and 6- and 12-month follow-ups. Adolescents completed self-report measures assessing eating disorder symptoms and suicide ideation and behaviors at each time point during school hours. Regression analyses found that body dissatisfaction was a significant prospective predictor of suicide ideation severity at the 6- and 12-month follow-ups, symptoms of bulimia nervosa (binge-eating disorder and purging) predicted suicide ideation severity at the 12-month follow-up only, and symptoms of anorexia nervosa (drive for thinness and restricting) were not significant predictors of suicide ideation at either follow-up. Exploratory analyses found the same pattern of results for the sample of girls only, while no significant predictors were found for boys only. This is the first longitudinal study of disordered eating and suicide ideation in American adolescents. Symptoms of bulimia nervosa and body dissatisfaction seem to be true risk factors for suicidal ideation. The current study demonstrates the importance of disordered eating behaviors in the development of suicidal ideation in adolescents, particularly for adolescent girls.