Effect of Radiocephalic Anastomotic Length on the Maturation of Arteriovenous Fistula.

BACKGROUND: A radiocephalic arteriovenous fistula (RCAVF) is associated with better long-term patency and fewer complications. However, RCAVF have lower maturation rate for hemodialysis compared with upper AVF or arteriovenous graft. We performed this study to determine the effect of the radiocephalic (RC) anastomotic length on the AVF maturation. METHODS: We reviewed the patients who underwent RCAVF creation with a side-to-end manner from March 2015 to December 2018. AVF maturation was defined as successful hemodialysis (HD) in at least two consecutive sessions. We compared the possible factors including the RC anastomotic length between the initial HD success group and initial HD failure group. RESULTS: A total of 114 patients underwent RCAVF creation: 72 males and 42 females (63.2% and 36.8%, respectively). The mean preoperative arteriotomy length of the AVF was 14.1 mm (range 11.0-16.0 mm). Out of 114 patients, initial HD was executed successfully in 83 patients (72.8%). Among the 31 patients with initial HD failure (27.2%) balloon angioplasty was successfully performed in 17 patients, failed in 4 patients, and not performed in 10 patients. The secondary success rate after balloon angioplasty was 87.7%. After factor analysis, pre-emptive AVF (P = 0.01), vein diameter (P < 0.001), and flow rate (P < 0.001) were revealed significant factors for initial HD success, but not RC anastomotic length of AVF (P = 0.55). CONCLUSION: The length of the radiocephalic anastomosis does not affect the RCAVF maturation rate statistically. However, lengthening of arteriotomy on the radial artery may increase the initial success rate of HD.

Dextroplantation of Left Liver Graft in Infants.

The position of the left side liver graft is important, and it could lead to complications of the hepatic vein (HV) and portal vein (PV), especially in a small child using a variant left lateral section (vLLS) graft. The purpose of this study was to evaluate the outcome of a novel technique for the implantation of a vLLS graft to the right side (dextroplantation) in infants. For 3 years, 10 consecutive infants underwent dextroplantation using a vLLS graft (group D). The graft was implanted to the right side of the recipient after 90° counterclockwise rotation; the left HV graft was anastomosed to inferior vena cava using the extended right and middle HV stump, and PV was reconstructed using oblique anastomosis without angulation. Surgical outcomes were compared with the historical control group (n = 17, group C) who underwent conventional liver transplantation using a vLLS during infancy. Group D recipients were smaller than group C (body weight <6 kg: 50.0% versus 11.8%; P = 0.03). The rate of graft-to-recipient weight ratio >4% was higher in group D (60.0%) than C (11.8%; P = 0.01). Surgical drains were removed earlier in group D than in group C (15 versus 18 postoperative days [PODs]; P = 0.048). Each group had 1 PV complication (10.0% versus 5.9%); no HV complication occurred in group D, but 3 HV complications (17.6%) occurred in group C (P > 0.05). Hospital stay was shorter in group D than in group C (20 versus 31 PODs; P = 0.02). Dextroplantation of a vLLS graft, even a large-for-size one, was successful in small infants without compromising venous outcomes, compared with conventional vLLS transplantation. We could remove the surgical drains earlier and reduce hospital stays in cases of dextroplantation.

Optimal Treatment Strategy and Natural History of Isolated Superior Mesenteric Artery Dissection Based on Long-Term Follow-up CT Findings.

BACKGROUND: Isolated superior mesenteric artery dissection (ISMAD) was previously considered a rare disorder; however, this condition has been increasingly diagnosed as time progressed. Although treatment regimen and treatment outcomes have become clearer, the optimal treatment strategy has not yet been well established. MATERIALS AND METHODS: This study included 54 patients diagnosed with ISMAD by computed tomography (CT) between November 2004 and December 2017. Thirteen patients were excluded from the analysis of natural course as 6 were lost to follow-up, and 7 underwent endovascular therapy. RESULTS: Of the 54 patients included in the study, 50 were male, and 4 were female. The mean age of the patients was 52.3 years (range 40-74). The mean follow-up duration was 18.5 months (range 1.0-131.0). Thirty-eight patients were symptomatic, and 16 were asymptomatic. All aneurysmal changes observed on follow-up CT scans were initially classified as type III or IV. Of these patients, 7 underwent endovascular therapy. The failure rate of conservative treatment was 13%. CONCLUSIONS: Conservative treatment is safe and effective if bowel necrosis or arterial rupture is not present. Symptomatic patients classified as type III or IV on the initial CT scan should be followed up. If there is recurrent pain or aneurysmal progression, endovascular therapy should be performed.

Preformed donor-specific antibodies do not affect the 1-year allograft survival in living donor liver transplantation.

The effect of preformed donor-specific antibodies (DSAs) on liver transplantation (LT) remains unclear, especially in the field of living donor LT (LDLT). Herein, we evaluated the prevalence of preformed DSAs and their effect on graft outcome in LDLT in the first year following surgery. Using the Luminex® Single Antigen assay, we analyzed the preoperative sera of 61 adult LDLT recipients between 2014 and 2015. Clinical outcomes and pathologic findings including complement component 4d (C4d) expression in the first year after LT were retrospectively reviewed. Regardless of the class of DSA, DSAs with mean fluorescence intensity (MFI) ≥1000 were defined as positive and preformed DSA with MFI ≥5000 was defined as strongly positive. Fifteen patients (24.6%) had preformed DSAs, and 8 patients (13.1%) showed strongly positive preformed DSAs. Among 15 DSA positive patients, 2 (13.3%) showed persistent DSAs after LDLT. No de novo DSAs were noted in patients without preformed DSAs. Preformed DSAs were not related to graft dysfunction, laboratory values, or C4d expression or other pathologic findings in the first year of LDLT. In conclusion, preformed DSAs persisted during follow-up in 13.3% of cases and did not have adverse effect on histologic or clinical outcomes in the first year of LDLT.

Delayed transplantation may affect intellectual ability in children.

BACKGROUND: Decline in neurocognitive function is a reported complication in children with chronic illness. Concerns have been increasing that exposure to a major surgery or trauma may negatively affect cognitive performance in children. This study evaluated cognitive function in 43 Korean children who received organ transplantation (Tx), and sought to identify associated clinical factors. METHODS: Pediatric recipients of kidney (KT) or liver Tx (LT) from 1999 to 2011 were recruited for cognitive tests. Cognitive function was evaluated using intelligence quotient (IQ), social quotient (SQ), and Continuous Performance Test using Advanced Test for Attention scores, which reflect attention ability. Intellectual delay was graded as intellectual disability (ID; IQ <70) or low intelligence (LI; IQ<85). Diagnosis for attention-deficit-hyperactivity disorder (ADHD) was made by pediatric psychiatrists. RESULTS: The subjects consisted of 43 pediatric recipients of 28 LT and 15 KT. There were 20 boys (46.5%). Median age was 3.1 years (range, 0.5-15.3 years) at Tx. Median age at cognitive evaluation was 12.9 years (range, 3.4-18.4 years). Median pre-Tx duration of illness was 1.6 years (range, 0-13.5 years). The prevalence of ID, LI, and ADHD was 11.6%, 32.5%, and 32.5%, respectively. On multivariate analysis, longer pre-Tx duration of illness was a significant factor for LI (OR, 1.263; 95%CI: 1.033-1.544, P = 0.023). CONCLUSION: Longer pre-Tx duration may negatively affect intellectual ability in Korean children. Pre-Tx duration was more significant than the age at Tx or total disease duration per se. Early Tx may be beneficial for cognitive function in children.

Effects of Kangaroo Care on Neonatal Pain in South Korea.

Blood sampling for a newborn screening test is necessary for all neonates in South Korea. During the heel stick, an appropriate intervention should be implemented to reduce neonatal pain. This study was conducted to identify the effectiveness of kangaroo care (KC), skin contact with the mother, on pain relief during the neonatal heel stick. Twenty-six neonates undergoing KC and 30 control neonates at a university hospital participated in this study. Physiological responses of neonates, including heart rate, oxygen saturation, duration of crying and Premature Infant Pain Profile (PIPP) scores were measured and compared before, during and 1 min and 2 min after heel sticks. The heart rate of KC neonates was lower at both 1 and 2 min after sampling than those of the control group. Also, PIPP scores of KC neonates were significantly lower both during and after sampling. The duration of crying for KC neonates was around 10% of the duration of the control group. In conclusion, KC might be an effective intervention in a full-term nursery for neonatal pain management.

Treatment results for spontaneous isolated superior mesenteric artery dissection according to our previous guidelines and collective literature review.

BACKGROUND: Isolated superior mesenteric artery dissection (ISMAD) is not a rare disease. However, its optimal treatment strategy has not yet been established. METHODS: This study included 13 consecutive patients with ISMAD who were treated between April 2010 and July 2013 according to published treatment guidelines. Through a literature search, 10 studies on treatments and outcomes for ISMAD that were published from 2007 to the present were analyzed. RESULTS: In the present study, 11 patients had acute onset abdominal pain and 2 patients were asymptomatic. Twelve patients were treated with conservative treatment, whereas 1 patient underwent coil embolization. In the literature review, initial conservative treatment, endovascular procedure, and surgical repair were done in 172, 25, and 14 patients, respectively. Bowel resection was done in 8 patients (3.7%) due to bowel necrosis. Conservative treatment failed in 15 patients (6.8%) during follow-up. CONCLUSIONS: If bowel necrosis or arterial rupture was not present, conservative treatment of ISMAD was a safe and effective treatment. Aneurysmal type IV patients on computed tomography scan should be carefully followed up, and if there is a recurrence of pain or aneurysmal progression, an endovascular procedure could be safely performed.

A Structural Model for Aggression in Middle School Students in Korea: Based on Ajzen's Theory of Planned Behavior.

(1) Purpose: The purpose of this study was to construct a hypothetical model for the variables that can explain aggression in middle school students in order to promote mental health and the growth and development of middle school students in Korea. Through this model, we tried to confirm the structural relationship between the variables and their influence. (2) Methods: The subjects of this study were middle school students in the Korean city of D, and the data collection period was from July to September 2016. The data were collected from the final 310 completed copies of the questionnaire, excluding 23 copies with insufficient data. SPSS 26.0 and AMOS 26.0 were used for data analysis. (3) Results: The fit indices of the final model (GFI = 0.88, AGFI = 0.84, IFI = 0.95, CFI = 0.95, SRMR = 0.06, and RMSEA = 0.07) met the acceptable levels. The variables that affected middle school students' aggression were parenting behavior and aggression regulation intention, and together, their explanatory power for aggression was 50.5%. Perceived behavioral control was the most influential variable for aggression regulation intention. (4) Conclusions: The results of this study will be used as a basis for studying aggression and developing aggression control training programs with the aim of reducing aggression in middle school students.

Correlation between Parental Hostility and Child Self-Control and Aggression.

(1) Background: Child aggression is not easily reduced as children grow up, and it is a serious problem that can develop into a life of crime if left unaddressed. (2) Methods: This study was conducted among elementary school children and their parents in C and K provinces and D city. Data were collected through a survey. Pearson's correlation coefficient was used to analyze parental hostility and each child's self-control and aggression. (3) Results: Child aggression had a significant negative correlation with self-control and a significant positive correlation with parental hostility. In particular, there was a significant positive correlation between physical aggression and revenge, which are sub-factors of parental hostility. In addition, the children's self-control was significantly negatively correlated with parental hostility. (4) Conclusions: Since there is a positive correlation between children's aggression and self-control, it is necessary to develop strategies to improve self-control when seeking intervention measures for children's aggression. In addition, since there is a significant quantitative correlation between children's aggression and parental hostility, it is necessary to deal with parental hostility in order to control children's aggression. Since there is a significant negative correlation between parental hostility and children's self-control, it is necessary to emphasize the importance of parental attitudes and behaviors to improve children's self-control.

Effects of a Noncontact Visit Program in the NICU for the Prevention of COVID-19.

BACKGROUND: With the spread of COVID-19, neonatal intensive care units restricted visiting hours to prevent infection. As a result, mothers of high-risk newborns were restricted from making contact with their children. Various problems could be encountered for hospitalized children and mothers of high-risk newborns due to restrictions on visits in the neonatal intensive care unit. Therefore, during the pandemic, continuous nursing support for mothers of high-risk newborns was needed. METHODS: In this study, a nonequivalent control group non-synchronized design was employed. The subjects of the study were 36 mothers of high-risk neonates (20 in the experimental group and 16 in the control group) in E University Hospital, D Metropolitan City, from July to September 2022. The experimental group received a 10 min program performed by a nurse from 7:00 p.m. to 9:00 p.m. three times per week. RESULTS: There were significant differences in nurses' support between the experimental and control groups (F = 25.594, p < 0.001), changes over time (F = 16.178, p < 0.001), and time-group interactions (F = 9.663, p = 0.003). CONCLUSIONS: It was interpreted that the real-time noncontact visitation program could transcend time and space for many mothers of high-risk newborn babies, who suffered psychologically due to restrictions and bans on visitations during the COVID-19 pandemic.

Development and Effects of Mobile-Application-Based Parenting Support Program for Premature Infants' Mothers.

BACKGROUND: Premature infants are separated from their parents after birth and are admitted to the neonatal intensive care unit. Separation of babies from mothers causes various problems. Therefore, as the number of premature infants increases every year, educational programs to continuously support baby care are needed. METHODS: In this study, a nonequivalent control group non-synchronized design was employed. The subjects of the study were 52 mothers of premature infants (16 in the app-based program group, 18 in the electronic document group, and 18 in the control group) using a portal site for parents from February to April 2023. The app-based program and electronic document group followed a parenting support program for two weeks. RESULTS: There were significant differences in maternal confidence between the app-based, electronic document, and control groups (F = 7.354, p = 0.002). CONCLUSIONS: Providing necessary information and emotional support through professional counseling centers' app-based programs for premature infants' mothers, and providing interaction through member community bulletin boards, are proposed to form an effective educational program.

Effects of aromatherapy on sore throat, nasal symptoms and sleep quality in adults infected with COVID-19: A randomized controlled trial.

Background: Patients with coronavirus disease 2019 (COVID-19) usually complain of fever, cough, and sore throat. This study examined the effects of aromatherapy on sore throat, nasal symptoms, stress, fatigue, and sleep quality by administering it to adults with post-COVID-19 condition. Methods: This study was conducted in a randomised controlled design. Its target population were adults who were released from COVID-19 quarantine treatment within 45 days from infection onset and capable of performing daily activities after isolation treatment. The participants were randomised into aromatherapy group (AG) and control group (CG). To test experimental treatment effects, the levels of sore throat, nasal symptoms, stress, fatigue and sleep quality were measured at the baseline (pre-test) and after the trial (post-test), using the numerical rating scale for sore throat, stress and fatigue, the Total Nasal Symptoms Score for nasal symptoms, and the Korean Version of Modified Leeds Sleep Evaluation Questionnaire for quality of sleep. Results: After experimental treatment, there was a significant difference in sore throat in AG compared to CG on the 3rd day (t=-2.022 p=0.048) and 4th day (t=-2.450, p=0.017) of treatment. There was also a significant difference in fatigue between AG and CG on the 2nd day(t=-2.748, p=0.008), 3rd day (t=-2.948, p=0.005) and 4th day (t=-3.084, p=0.003) of treatment. There was no significant difference in TNSS, stress, and sleep quality between the two groups after the experimental treatment. Conclusion: Inhaling aroma essential oils reduced sore throat and fatigue in adults with post-COVID-19 condition, demonstrating the feasibility of aromatherapy as an effective treatment. Trial registration: The study was registered with Clinical Research Information Service (KCT0008029).

Axillary temperature measurements based on smart wearable thermometers in South Korean children: comparison with tympanic temperature measurements.

PURPOSE: This study explored the validity of a new type of thermometer and parent satisfaction with the new device. This 24-hour continuous monitoring smart wearable wireless thermometer (TempTraq®) uses a very small semiconductor sensor with a thin patch-like shape. METHODS: We obtained 397 sets of TempTraq® axillary temperatures and tympanic temperatures from 44 pediatric patients. Agreement between the axillary and tympanic measurements, as well as the validity of the TempTraq® axillary temperatures, were evaluated. Satisfaction surveys were completed by 41 caregivers after the measurements. RESULTS: The TempTraq® axillary temperatures demonstrated a strong positive correlation with the tympanic temperatures. The Bland-Altman plot and analysis of TempTraq® axillary temperatures and tympanic temperatures showed that the mean difference was +0.45 ℃, the 95% limits of agreement were -0.57 to +1.46 ℃. Based on a tympanic temperature of 38 ℃, the results of validity of fever detection were sensitivity 0.85 and specificity 0.86. Satisfaction scores for TempTraq® temperature measurement were all > 4 points (satisfactory). CONCLUSION: TempTraq® smart axillary temperature measurement is an appropriate method for measuring children's temperatures since it was highly correlated to tympanic temperatures, had a reliable level of sensitivity and specificity, and could be used safely and conveniently.

Effects of Ego-Resiliency on Interpersonal Problems among Nursing Students: The Mediating Effects of Aggression.

(1) Background: Despite that nursing college students are more diverse than those in other majors, many nurses experience interpersonal problems and difficulties in the process of forming relationships and contacting various people. The purpose of this study is to understand the mediating effects of aggression on the process of ego-resilience in interpersonal problems in nursing college students. (2) Methods: The subjects of this study were 182 nursing college students attending university in D metropolitan city. Data were collected from 23 October to 9 November 2018. The measurements were carried out using the Ego-Resiliency Scale, the Aggression Questionnaire-Korean Version (AQ-K), and the short form of the KIIP Complex Scale (KIIP-SC). Data were analyzed using descriptive statistics, t-tests, and ANOVA. The methods of Baron and Kenny were used to verify the significance of the mediating effect. (3) Results: There were significant correlations among ego-resiliency, aggression, and interpersonal problems. Aggression had a partial mediating effect on the relationship between ego-resiliency and interpersonal problems, and aggression was explained to a level of 23%. (4) Conclusions: To lower interpersonal problems among nursing students, it is necessary to develop education and programs to improve ego-resiliency and to control aggression.

Structural Equation Model on the Problem Behavior of Adolescents.

This study aimed to explain direct and indirect relationship between psychological maltreatment, socio-psychological prevention factors, and problem behavior of adolescents based upon Jessor's protective-risk model and Haase's adolescent resilience model (ARM). A convenience sample of 138 Korean adolescents was recruited for the cross-sectional survey design. Using the collected data, the developed model was verified by structural equation modeling analysis using SPSS and AMOS program. Regarding model fit, χ2 = 151.62 (p < 0.001), GFI = 0.908, AGFI = 0.836, CFI = 0.911, SRMR = 0.060, and RMSEA = 0.10, showing acceptable fit levels. Psychological maltreatment explained 11.5% of perceived social support; psychological maltreatment, perceived social support, and self-control explained 89.9% of resilience; psychological maltreatment and perceived social support explained 53.2% of self-control; and psychological maltreatment, perceived social support, resilience, and self-control explained 39.7% of problem behavior. Psychological maltreatment directly and indirectly influenced perceived social support, self-control, and problem behavior. Psychological maltreatment and self-control were the factors that influence problem behavior of adolescents. The findings suggest that psychological maltreatment must be eradicated to reduce problem behavior of adolescents and enhance their socio-psychological protection factors.

Developing and Evaluating a Mobile-based Parental Education Program for Preventing Unintentional Injuries in Early Childhood: A Randomized Controlled Trial.

PURPOSE: This randomized controlled experimental study verified the educational effect of a mobile-based parental education program for preventing unintentional early childhood injuries. DESIGN AND METHODS: From August 2019 to September 2019, 167 participants were recruited from parenting portal sites and randomly assigned to an e-learning group (n = 59), an electronic document distribution (EDD) group (n = 53), and a control group with no intervention (n = 55). Participants self-reported data regarding their safety knowledge and behavior before and after the experiment. Each intervention group received an e-learning program and electronic educational documents for two weeks and a satisfaction survey. Using an ADDIE (Analysis, Design, Development, Implementation, and Evaluation) model, the relevant e-learning contents were developed with the Storyline 360 program. The collected data were analyzed using 1-way ANOVA, 2-way ANOVA, and independent t-test. RESULTS: Results were as follows: (1) Postintervetion, no significant differences regarding safety knowledge were observed between the e-learning group, EDD group, and control group. (2) Postintervention, statistically significant differences regarding safety behaviors were observed between the three groups: 3.52 ± 0.28 (e-learning group), 3.51 ± 0.28 (EDD group), and 3.32 ± 0.25 (control group) (F = 10.091, p < .001). (3) No significant differences regarding education-related satisfaction were observed. CONCLUSIONS: The mobile-based educational program for preventing unintentional injuries positively affected safety behavior in this study. Mobile-based parental education programs could contribute toward effectively preventing unintentional injuries in early childhood because many parents can use these without time and space constraints.

Kangaroo care on premature infant growth and maternal attachment and post-partum depression in South Korea.

After births, premature infants need a high level of medical treatments for their survivals in the neonatal intensive care unit (NICU). This separation deprives mothers of the chance to initiate an attachment process. Kangaroo care (KC) can be one of the ways to reunite mothers and their infants in the NICU and improve health outcomes. This study was conducted to investigate the effects of KC on both premature infants and their mothers. Ten sessions of 60-min KC for 3 weeks were practiced at a level III NICU at E university hospital. Infants' body weight, height and head circumference (HC), maternal attachment and depression were measured. As a result, premature infants in KC showed higher in their height and bigger in their HC than infants in control. Maternal attachment scores were higher among the KC mothers. The results supported the beneficial effects of KC on Korean premature infants and their mothers.

Model Construction for Undergraduate Student College Adjustment.

Background: College students are known to struggle with a number of difficulties, such as their future careers and interpersonal relationships, as well as job-seeking stress. This study aimed to develop and test a structural model for undergraduate student college adjustment. Methods: The data collection period ranged from November 2019 to January 2020. A questionnaire was distributed to a total of 300 college students; a total of 290 copies were ultimately used for analysis. Result: The model fit indexes of the final model were χ2 = 427.707 (p < 0.001), DF = 173, χ2/DF = 2.47, GFI = 0.88, Adjusted Goodness of Fit Index (AGFI) = 0.84, Comparative Fit Index (CFI) = 0.91, Incremental Fit Index (IFI) = 0.92, Standardized Root Mean-square Residual (SRMR) = 0.07, and Root Mean-Square Error of Approximation (RMSEA) = 0.07. All of the model fit indexes were acceptable, and seven of the thirteen paths in the final model were significant. The factors that influenced college adjustment were social support (r = 0.39) and ego-identity (ß = 0.73), explaining 57.1% of the variance. Conclusions: To increase college adjustment, it is necessary to consider the relationship of adjustment with college students' surrounding environments, such as their family, friends, and professors, and how students can improve their ego-identity.

Nurses' Workplace Bullying Experiences, Responses, and Ways of Coping.

Workplace bullying is a serious problem that hinders the provision of quality care services by seriously affecting their physical, psychological, and social health status. Workplace bullying experiences refer to verbal and nonverbal harassment, work-related harassment, and external threats. Workplace bullying responses are negative reactions that occur in individuals who have experienced workplace bullying, while coping is the process by which an individual copes with stress. This study aims to analyze the relationship between nurses' workplace bullying experiences, responses, and ways of coping. We studied 113 nurses working in hospitals, analyzed the data using SPSS 25.0. We found that the more positive use of the positive viewpoint, the lower the bullying reaction in the workplace (r = -0.268, p = 0.004). Workplace bullying responses were lower as more positive ways of coping were used (r = -0. 268, p = 0.004). In conclusion, nurses who experience bullying in the workplace should be supported by the hospital organization and within the nursing organization, and a receptive nursing culture should be established. There is also a need for an intervention plan that allows nurses to use positive ways of coping with workplace bullying experiences.

Development and validation of a self-control competency scale for late-school-aged children.

PURPOSE: The aim of this study was to develop a self-control competency scale for school-aged children and to confirm its reliability and validity. METHODS: This study involved methodological research to verify the reliability and validity of a self-control competency scale for school-aged children. Data were collected from 438 students in the fifth and sixth grades of elementary school. RESULTS: The self-control competency scale was composed of 13 items and six subscales (control of relationship with one's teacher, problem-solving, peer empathy, control of relationships with one's peers, impulse control, and emotional control). The internal consistency reliability of the scale was evaluated using Cronbach's α, which was .83 for the entire scale and ranged from .65 to .76 for the subscales. The model of six subscales was validated by CFA (CMIN/df=1.977; p<.001, GFI=.94, SRMR=.050, RMSEA=.065, IFI=.95, TLI=.93, CFI=.95). Concurrent validity was evaluated by comparing this scale to the scale developed by Nam and Ok (2000), and a significant correlation was found (r=.82, p<.001). On this scale, higher scores indicate higher levels of self-control among late-school-aged children. CONCLUSION: This scale can be used as a valid and reliable instrument for examining self-control competency among late-school-aged children.