Does Forest Therapy Have Physio-Psychological Benefits? A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Forest therapy involves visiting forests or conducting forest-based treatment activities to improve one's health. Studies have investigated the health benefits of forests, but consensus has not been reached. This study comprised a systematic review and meta-analysis to determine how forest therapy affects the physiological and psychological health of adults. The Cumulative Index to Nursing and Allied Health Literature, Embase, and Medline databases were searched on 31 August 2021. Systematic review and meta-analysis, risk evaluation, GRADE evaluation, and advertisement effect evaluation were performed for each article. The effect size was calculated by dividing blood pressure as a physiological indicator and depression as a psychological indicator. Of the 16,980 retrieved studies, 17 were selected based on the inclusion criteria. Of these, eight studies were included in the meta-analysis. The effect size of forest therapy on improving systolic and diastolic blood pressure was not significant; however, it significantly reduced depression. While the results have limited generalizability due to the inclusion of few studies, the effects of forest therapy on reducing depression have been confirmed. Since the application of forest therapy was heterogeneous in these studies, a moderator effect analysis or subgroup analysis in meta-analysis should be performed in the future.

An improved extraction method for acrylamide determination in fruit and vegetable chips through enzyme addition.

An enzyme-addition method to pretreat fried fruit and vegetable chips for acrylamide analysis is reported, followed by determination of the acrylamide contents in 36 marketed fruit and vegetable chip products using LC-MS/MS. To improve the extraction process, the FDA method was modified. Specifically, digestive enzymes were added, overcoming the clogging of filters (or SPE cartridges) after extraction of vegetable chips using water. Diastase was added to extract high-starch products, including potato chips. Recoveries of 90.3-105.5% acrylamide were obtained at the spiking levels of 25-500 µg/kg. LOD and LOQ were similar between the method with (4.5 and 13.7 µg/kg) and without diastase addition (4.4 and 13.2 µg/kg). Okra chip with high mucin content was extracted after adding pepsin. This method provided a recovery of 99.8-102.2%, LOD of 6.0 µg/kg, and LOQ of 18.1 µg/kg. Both methods could be used for analyzing acrylamide, with critical method parameters satisfying European Union regulations.

Sex Differences in Risk Factors for Metabolic Syndrome in the Korean Population.

With an increase in the obese population, the prevalence of metabolic syndrome is increasing in Korea. This study aimed to identify sex- and age-specific risk factors for metabolic syndrome. A secondary data analysis was performed using the Korean National Health and Nutritional Examination Survey. Participants comprised 6144 adults aged 20-79 years. The prevalence of metabolic syndrome was high in the middle- and old-aged men (31.9% and 34.5%, respectively) and in old-aged women (39.1%). Risk factors for metabolic syndrome showed different patterns for men and women. In men, alcohol drinking was identified as the main risk factor for hypertension (odds ratio (OR); young = 3.3 vs. middle age = 2.0), high triglycerides (young = 2.4 vs. middle age = 2.2), and high fasting blood sugar (middle age = 1.6). In women, the main risk factors were household income and education level, showing different patterns in different age groups. In conclusion, the vulnerable groups at high risk of metabolic syndrome are those of middle-aged men and women. The pattern of risk factors is sex-specific.

Relation between Mother's Taekyo, Prenatal and Postpartum Depression, and Infant's Temperament and Colic: A Longitudinal Prospective Approach.

This longitudinal cohort correlational study aimed to confirm the relation among taekyo or traditional prenatal practice, prenatal depression, postpartum depression, maternal-fetal interaction, and infant temperament and colic using a prospective design. We recruited 212 women 16-20 weeks pregnant from July 2017 to September 2018; they were followed up until six months postpartum. Data from 97 participants were used in the final analysis. We used the Edinburgh Postnatal Depression Scale, Cranley's Maternal-Fetal Attachment Scale, and What My Baby Is Like as measurement tools. We observed a significant correlation between prenatal maternal depression in the first to third trimesters and 6-8 weeks and six months postpartum. In addition, infant temperament at six months old showed a significant negative correlation with prenatal and postpartum depression: the higher the prenatal and postpartum depression level, the more difficult the infant's temperament. Taekyo practice was significantly related to maternal-fetal attachment (r = 0.45-0.68, p < 0.001). Difficult infants showed more colic episodes than any other type of infant (χ2 = 18.18, p < 0.001). Prenatal and postnatal maternal depression affected infants' temperament and colic episodes. The management of mothers' mental health before and after pregnancy is important for infants' and mothers' health.

Pesticide residues in vegetables and risk assessment for consumers in Korea during 2010-2014.

This study was carried out to assess the exposure to pesticide residues from vegetable consumption of residents in Seoul using data on pesticide residue concentrations and the quantity of vegetables consumed. A total of 34,520 samples of 96 types of vegetables collected from 2010 to 2014 by the Seoul Metropolitan Government Institute of Health and Environment (SIHE) were analysed for 283 different pesticide residues. Among the vegetable samples, 86.1% did not contain any measurable levels of pesticide and 1.4% had residues exceeding Maximum Residue Limits (MRL). A total of 105 different pesticide residues were found and 45 residues exceeded MRLs. The most commonly found residues were azoxystrobin, diethofencarb, procymidone, cypermethrin, and tebufenpyrad. A total of 547 vegetable samples from 37 different types of vegetables had residues exceeding MRLs. From these results, 20 agrochemicals were chosen based on their high level of detection and violation rate of the MRL. The potential health risk associated with exposure to the pesticides through vegetable intake was estimated as a Risk Index (RI, %ADI). For a citizen of Seoul, the RIs of the mean value and 97.5th percentile were shown to be 0.0 ~ 7.4% and 0.4 ~ 73.9% respectively. For citizens of Seoul by age (consumers only), the highest RIs for children (under 6 years old) and the elderly (over 65 years old) were with chlorothalonil, and the estimated daily intakes (EDI) were 56.0%, 112.5%, respectively, of its ADI. For adults (19 ~ 64 years old) the highest RI was for chlorfenapyr and the EDI reached 118.6%. These results show that, despite the high levels of some pesticide residues, they may not be considered as a serious public health problem.

Do the Emotions of Middle-Income Mothers Affect Fetal Development More Than Those of High-Income Mothers?-The Association between Maternal Emotion and Fetal Development.

This study examines the relationship between the emotions of mothers and fetal development and explores the modifying effect that family income has on this relationship. Socio-demographic information, maternal depression, stress, positive and negative emotions, and maternal-fetal attachment data were collected at 16-20 weeks of pregnancy. Data on fetal body weight and biparietal diameter indicating fetal development were collected at 33-35 weeks to observe the longitudinal effects of mothers' emotions on fetal development. We divided subjects into two groups: those with more than 150% of the median income were classified as the high-income group and less than 150% as the middle-income group. T-test, correlation analysis, and multiple regression analysis on maternal emotional status and fetal development were performed for each group. A positive correlation was found between maternal-fetal attachment and negative emotion that was associated with the biparietal diameter and fetal body weight only in the middle-income group. Results of the multiple regression analysis were statistically significant, indicating that maternal-fetal attachment was associated with fetal weight. These results show that the management of subjective emotion is associated with healthy development of the fetus and contributes to health equity.

The Thermal Effects of Water Immersion on Health Outcomes: An Integrative Review.

Hydrotherapy is widely used for the treatment and rehabilitation of patients, but it can also be applied to prevent diseases in healthy people. This review investigates the health effects of water immersion, a form of hydrotherapy, and the mechanisms by which the properties of water elicit such an effect. We searched PubMed, EMBASE, Cochrane Library, and CINAHL to identify relevant articles, of which 13 met the inclusion criteria. Various factors of water immersion were investigated in the 13 selected articles, including water temperature, immersion height, and application area. With respect to health effects, warm and cold water immersion affects the cardiovascular and neuromuscular systems, respectively. Nine articles focused on the effects of warm water immersion, explaining its thermal effect in relation to changes in disease-related serum substance levels and hemodynamic changes. While the sample population in most studies comprised young adults, two articles applied partial water immersion to the legs of elderly subjects to assess its effect on sleep. Because the water immersion protocols applied in the 13 articles were inconsistent, the health benefits could not be clearly explained. However, we expect the present findings to be beneficial for providing research guidelines for studies on the application of water immersion.

Exposure to Adverse Social Behavior in the Workplace and Sickness Presenteeism among Korean Workers: The Mediating Effects of Musculoskeletal Disorders.

Adverse social behavior (ASB) by colleagues or superiors in the workplace is considered highly stressful for workers in South Korea. The authors investigate the mechanism by which ASB reduces productivity (measured in terms of sickness presenteeism (SP)), by examining the potential mediating role of musculoskeletal disorders (MSDs). All data are derived from the fourth Korean Working Conditions Survey, which investigated a representative sample of the working population. The authors analyze their general characteristics (age, gender, income, and education), work-related factors (job type, occupational ergonomic risk, job resource, employment contract, work schedule, working hour, and job demand), and health-related factors (self-rated health and MSDs). The authors use a two-step regression analysis to estimate the direct effect of ASB on SP and the indirect effect of SP via MSDs. The authors find that MSDs mediate 16.7% of the total effect of ASB on SP. When employment type and job conditions are considered, the role of the mediating variable in the group with a permanent contract, no shift or night work, and high working time is greater than the counterpart of each variable. Various strategies are needed to address MSDs according to the working environment, which might help limit the negative impact of ASB on SP.

Korean Adolescents' Health Behavior and Psychological Status according to Their Mother's Nationality.

OBJECTIVES: This study was conducted to compare adolescents' health behaviors and psychological status according to whether or not their mother was born in Korea. METHODS: This secondary analysis used nationally representative data from the 2015 Korean Youth Risk Behavior Web-based Survey. The self-administered questionnaire included computer measured socio-demographic variables, 15 health behaviors, and psychological status. Data from 65,426 middle school and high school students were analyzed. Multiple logistic regression, adjusting for socio-demographic variables, was used to analyze differences in health behaviors and psychological status between adolescents with a foreign-born mother and those with a Korean mother. RESULTS: Adolescents who have foreign-born mothers had a lower level of current drinking and subjective happiness, but a higher stress level. CONCLUSION: The stress levels of the adolescents with foreign-born mothers could be affected by their multicultural background. It is necessary to analyze stress-influencing factors of multicultural adolescents by comparing them to adolescents from Korean parents. Additionally, our society should pay more attention to the mental health of multicultural adolescents. Schools should also make various efforts to protect multicultural adolescents by adopting mental health management programs led by school nurses and counselors.

Smoking, Physical Activity, and Eating Habits Among Adolescents.

The purpose of this study was to compare physical activity and eating habits of adolescent smokers with those of adolescent non-smokers in South Korea. This was a secondary analysis of data collected from the 2012 Korean Youth Risk Behavior Web-Based Survey. The sample included 72,229 adolescents aged 12 to 18. A multiple logistic regression analysis was performed to examine the association between smoking status and physical activity and between smoking status and eating habits, while controlling for other factors. Boys and girls were analyzed separately for all analyses. The proportion of self-reporting smokers was 11%. Surprisingly, girl smokers exercised significantly more frequently than non-smokers. Adolescent smokers were significantly less likely to consume fruits, vegetables, and milk/dairy products, and they ate significantly more fast-food than non-smokers. Health care professionals who plan smoking cessation programs should pay attention to South Korean adolescents' specific characteristics and cultural values in terms of health behavior.

Application of revised nursing work index to hospital nurses of South Korea.

PURPOSE: Based on the Revised Nursing Work Index (NWI-R), this research aimed to develop a Korean Hospital General Inpatient Unit-Nursing Work Index (KGU-NWI). This study also aimed to compare the common points and differences between the subfactors of the KGU-NWI and the subfactors from previous studies. METHODS: Based on opinions from 3,151 nurses in Korean hospital general inpatient unit, this research used 57 items of NWI-R and the principal axis factor analysis for deriving subfactors. We evaluated the convergent validity through factor analysis and the content validity of KGU-NWI in terms of the association between nurses' job outcome and the subfactors derived. RESULTS: Six subfactors and 26 items for KGU-NWI were derived from NWI-R. Among them, 'physician-nurse relationship', 'adequate nurse staffing' and 'organizational support and management of hospital' were the same with results from previous studies. In addition, two subfactors, 'participation of decision-making processes' and 'education for improving quality of care', which were similar with results from previous Korean studies, were newly added by using Korean hospital cases. In contrast to previous Korean studies, a unique subfactor this study found was 'nursing processes'. This research confirmed that the six subfactors were highly correlated with job satisfaction, intention to leave, and quality of health care, which represented a nurse's job outcome. CONCLUSION: KGU-NWI including six subfactors and 26 items is an applicable instrument to investigate nurse work environment in Korean hospital general inpatient unit.

Smoking cessation intervention using stepwise exercise incentives for male workers in the workplace.

The authors developed a stepwise exercise-incentive-based smoking cessation program as one of the workplace health promotion program. The aim of this study is to evaluate the program offered in an electronics company in Korea. A total of 109 electronics company employees were recruited. Participants were surveyed for smoking history, nicotine dependence, and job stress. They received smoking cessation education and were provided with a stepwise fitness center ticket. Of 109 participants, 58 (53.2%) successfully ceased smoking for 3 months. Significant differences between success and fail groups were apparent in cigarettes smoked per day (P = .002) and nicotine dependence score (P = .049). However, there was no significant difference in job stress between success and fail groups. Based on multiple logistic regression analysis, there were no identifiable factors associated with smoking cessation. In conclusion, a stepwise exercise-incentive-based smoking cessation program was highly effective when applied in a workplace setting.

[Factors on the suicidal attempt by gender of middle and high school student].

PURPOSE: The suicide rate of adolescents in Korea is increasing annually. Therefore, this research was done to identify the suicide attempt rate of middle and high school students and to identify factors that influence suicidal attempts. METHODS: The Korea Youth Health Risk Behavior Web-based Survey (2007) was used as data. Discriminant analysis and logistic regression were performed to analyze the data depending on gender to consider the gender difference in assessing the influence of each independent variable on suicidal attempts. RESULTS: Discriminant analysis according on gender showed that 13 factors correlated with suicidal attempts for boys, and 20 factors for girls. The most highly correlated factors were smoking, depression and inhalation experience. For inhalation experience, boys had 2.7 times higher possibility of suicide attempts (95% CI 1.8-3.0) and girls, a 2.4 times higher possibility (95% CI 1.7-3.5). CONCLUSION: The results of the study indicate a need to classify adolescents for expectation of suicide risk and high danger for suicidal attempts through, and introduce suicide prevention programs for these adolescents. In particular, it is necessary to start intervention with students who smoke, have sexual and inhalation experiences and high levels of depression.

Prevalence and risk factors of adolescents smoking: difference between korean and korean-chinese.

PURPOSE: The purpose of this study was to compare smoking prevalence and risk factors of smoking between Korean and Korean-Chinese middle school students. METHODS: Data was collected from seventh and eighth grade students from 12 schools in Korea and 6 schools in China. Descriptive statistics, Chi-square test, and t test were performed. RESULTS: For data analysis 10,002 usable surveys were utilized. The smoking prevalence was higher in Korean-Chinese students than in Korean students. Risk factors, such as father smoking, friends smoking, gender, grade, academic achievement, alcohol use, and family income were associated with current smoking, and the differences in the two samples were significant. Korean-Chinese students were more likely than Korean students to have friends who smoked and a father who smoked. Smokers had a significantly higher rate of friends smoking, father smoking, and alcohol use. Korean-Chinese male students smoking prevalence was more than three times higher than Korean students. Korean students could sense a more anti-tobacco atmosphere in their environment. Korean-Chinese students were more likely than Korean students to perceive that it was easy to buy cigarettes and to smoke cigarettes in a public computer room. CONCLUSION: These results highlight the differences of smoking prevalence and risk factors between Korean-Chinese students and Korean students. The findings may help health educators and researchers to better understand adolescent smoking and risk factors cross culturally and aid in the development of more effective education programs, which could lead to preventing tobacco use among these populations.

Weekly work hours and stress complaints of workers in Korea.

BACKGROUND: Koreans typically work long hours. We herein analyze the relationship between the level of working hours and extent of stress complaints. METHODS: We analyzed stress complaints with respect to hours worked per week, as reported by 7,075 subjects, using data from the 2006 First Korean Working Conditions Survey. Subjects were categorized as those working fewer than 40 hr per week (short working hours, SWH); those working 40-47 hr per week (intermediate working hours, IWH); those working 48-59 hr per week (long working hours, LWH); or those working at least 60 hr per week (very long working hours, VLWH). RESULTS: Male subjects with IWH had an odds ratio (OR) of 0.74 for stress complaints compared to subjects with SWH (95% CI 0.53-1.04), whereas OR = 0.72 (95% CI 0.52-1.02) for stress complaints among females, comparing IWH and SWH. Males with LWH had OR = 1.15 (95% CI 0.82-1.60) for stress complaints compared to subjects with SWH, whereas the OR for females for stress complaints was 1.11 (95% CI 0.79-1.55). Male subjects with VLWH had OR = 1.72 (95% CI 1.24-2.41) for stress complaints compare to those with SWH, whereas for the female workers the OR was 1.35 (95% CI 0.93-1.98). CONCLUSION: Among males, VLWH are associated with a significant increase in stress, compared with SWH.

Subjective fatigue and stress hormone levels in urine according to duration of shiftwork.

To determine the associations between urinary catecholamines and cortisol and subjective complaints of fatigue in shiftworkers, we conducted a field survey of 113 male shiftworkers at a manufacturing company in South Korea from late October to late November in 1999. The shiftwork system in the company was the backward rapidly rotating 4-crew 3-shift, with the morning shift starting at 7:30 AM. Using a self-report questionnaire, we assayed demographic characteristics, past medical history and working hours, as well as subjective complaints of fatigue in 3 categories of questionnaire. We found that, among workers with less than 5 yr of shiftwork experience, the concentrations of norepinephrine, epinephrine (Epi), and dopamine during the afternoon shift were positively correlated with Set II (difficulties in concentration) and Set III (projection of disintegration) of subjective fatigue symptoms. In addition, Epi concentrations were positively correlated with Set I (drowsiness and dullness), II, and III of subjective fatigue symptoms during the night shift. However, among workers with 5 or more years of shiftwork experience, there was no significant positive correlation between urinary catecholamine and subjective fatigue symptoms. In the long term shiftwork experience group, only the complaints scores of Set II fatigue symptoms (difficulties in concentration) during the morning shift were significantly higher than those of the short-term shiftwork experience group within the same shift.

A retrospective cohort study of Parkinson's disease in Korean shipbuilders.

OBJECTIVE: We performed a retrospective cohort study in South Korea to clarify the role of occupational exposure, especially to welding, in the etiology of Parkinson's disease (PD). METHODS: We constructed a database of subjects classified into an exposure group (blue-collar workers) and a non-exposure group (white-collar workers) in two shipbuilding companies. Jobs of blue-collar workers were categorized into the first group of welding, the second group of fitting, grinding and finishing, cutting, and the other group. To determine new cases of PD during the follow-up period (1992-2003), we used the physician billing claims database of the National Health Insurance Corporation. For the detected PD patients in the physician billing claims database, a neurologist in our research team confirmed the appropriateness of each diagnosis by reviewing medical charts. Based on the review, we confirmed the numbers of new cases of PD and calculated the relative risk (RR) and the 95% confidence intervals (CI) by Cox regression analysis. RESULTS: In a backward selection procedure, 'age' was a significant independent variable but exposure was not. Furthermore, the RR in welders (high exposure group) was also insignificant and less than that in others (very low exposure group). CONCLUSION: This longitudinal study of shipbuilding workers supports our previous case-control studies suggesting that exposure to manganese does not increase the risk of PD.

Occupations and Parkinson's disease: a multi-center case-control study in South Korea.

OBJECTIVE: We performed a hospital based case-control study in South Korea (1) to clarify the role of occupational exposure, and especially manganese (Mn) exposure in the etiology of Parkinson's disease (PD) and (2) to discover the association between any occupations and PD. METHODS: We selected two groups, PD patient group (N1) and controls (N2). Three hundred sixty-seven consecutive outpatients with PD (177 men, 190 women) and 309 controls were interviewed about life style, past history, family history, education level, and occupational history etc. We employed a range of industrial categories as defined by section (the most broad category) and division (sub-category) of the Korea Standard Industry Code (KSIC) Manual. Along with KSIC, we also used the Korea Standard Classification of Occupations (KSCO) as proxies of occupational exposure. The odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for age, sex, smoking status, and education level are presented. RESULTS: As regarding the exposure to hazardous materials, especially Mn, more subjects in the control group than the PD patient group have worked in the occupations with potential exposure to Mn (P < 0.001). Ever having worked in 'agriculture, hunting, and forestry' section of industry was positively associated with PD (OR 1.88), and 'agriculture production crops (OR 1.96)' division of industry was positively associated with PD. On the other hand, ever having worked in the 'manufacturing (OR 0.56)', 'transportation (OR 0.28)' section of industry, and 'transporting (OR 0.20)' division of industry were negatively associated with PD. 'Drivers (OR 0.13)' division of occupation also was negatively associated with PD. CONCLUSIONS: To our knowledge, this is the first case-control studies to find an inverse relationship between 'transporting' or 'technicians like machinery engineers' as his/her longest job and PD risk. Because of this unexpected finding, our work should be replicated in various populations.

Occupations and Parkinson's disease: a case-control study in South Korea.

We performed a hospital based case-control study in the southeast region of Korea to clarify the role of occupational exposure, especially manganese (Mn), in the etiology of Parkinson's disease (PD) and to discover the association between any occupation and PD. 105 outpatients with PD and 129 neurological disease controls and 101 healthy controls were interviewed. We employed occupational and industrial categories as defined by Section (the most broad category) and Division (sub-category) of the Korea Standard Industry Code and the Korea Standard Classification of Occupations. There was not a significant association between exposure to hazardous materials, especially Mn and PD. There were not any occupations listed under the Section of Industry Classification as a significant risk factor or protective factor for PD. However, the 'clerk' occupation [Section] was positively associated with PD. There is a decreased risk for PD with a subject ever having worked in the 'agriculture, forestry and fishery' occupational group. Ever having worked in 'sales' also was negatively associated with PD. There were not any Divisions of Industry found as a significant risk factor or protective factor for PD. However, ever having worked in an 'agriculture' Division of Occupation was negatively associated with PD.