Association between chronotype, tobacco use or alcohol use, and high-risk drinking by age group: The Seventh Korea National Health and Nutrition Examination Survey (VII: 2016-2017).

OBJECTIVES: To analyze the association between chronotype, tobacco use or alcohol use, and high-risk drinking by age group and examine the differences across groups. METHODS: A cross-sectional descriptive study design was adopted. Data from 12,189 participants aged ≥ 12 years from 2016 to 2017, excluding shift workers, were gathered from the Korea Disease Control and Prevention Agency's Seventh Korea National Health and Nutrition Examination Survey. A general linear model was used to determine the aforementioned associations and differences across age groups. Chronotype was measured using the Munich Chronotype Questionnaire. It was divided into quintiles. We used current tobacco use, monthly alcohol use, and high-risk drinking as indexes of tobacco use and alcohol use. These data were extracted from the national representative data. RESULTS: Among adolescents and adults, both tobacco use and alcohol use showed a linear increasing trend, although it was greatest among adolescents. In older adults, tobacco use showed a linear increasing trend with delayed chronotype. When the chronotypes of all age groups were aggregated, high-risk drinking was higher in both extreme types, Quintiles 1 and 5. CONCLUSIONS: Tobacco use and alcohol use were mostly associated with delayed chronotype. Therefore, interventions to address delayed chronotype at all ages are needed. As the trend of increase in tobacco use and alcohol use in adolescents was higher than in other age groups, a special strategy is required aimed at this population. Moreover, both extreme chronotypes should be considered risk factors for high-risk drinking.

Effectiveness of International Hospice and Palliative Care Training for Health Care Professionals in Countries of the Western Pacific Region.

As hospice and palliative care is a holistic service grounded in spirituality, training in spiritual care is essential. This study aimed to describe an international workforce training program for hospice and palliative care that emphasized spiritual care and evaluate the effectiveness of the training implementation. A quasi-experimental study was conducted with 28 health care professionals from 4 countries in the Western Pacific Region, who attended the international workforce trainings on hospice and palliative care. Data were collected before and after the trainings using a self-reported survey questionnaire. The participants' palliative care knowledge, spiritual well-being, perceived stress, and compassion competency were analyzed to evaluate the training program. Whereas the participants' knowledge of hospice and palliative care ( P < .001) and compassion competency increased ( P = .004), their perceived stress decreased post training ( P = .002). This study provided an extensive description of an international workforce training program of hospice and palliative care for potential replication of the training in other regions of the world. Because training in hospice and palliative care positively influenced health care professionals' spiritual care competency, future training and studies should consider spiritual care factors, along with intellectual aspects.