Positive Associations between Body Mass Index and Hematological Parameters, Including RBCs, WBCs, and Platelet Counts, in Korean Children and Adolescents

We conducted this study to investigate the associations between hematological parameters and obesity in children and adolescents. The levels of hematological parameters (including white blood cells [WBCs], red blood cells [RBCs], hemoglobin [Hb], hematocrit [Hct], and platelets) of 7997 participants (4259 boys and 3738 girls) aged 10–18 years were recorded. The parameters were compared among participants with normal weight, overweight, and obesity. Significantly higher mean levels of WBCs (7.16 vs. 6.16 × 103/mm3, p < 0.001), RBCs (4.90 vs. 4.82 × 106/mm3, p < 0.001), Hb (14.07 vs. 13.99 g/dL, p < 0.05), Hct (42.31 vs. 41.91%, p < 0.001), and platelets (311.87 vs. 282.66 × 103/mm3, p < 0.001) were found in the obese than normal weight group, respectively, after adjusting for body mass index (BMI) and sex. BMI SDS had significant positive associations with the levels of WBCs (β = 0.275, p < 0.001), RBCs (β = 0.028, p < 0.001), Hb (β = 0.034, p < 0.001), Hct (β = 0.152, p < 0.001), and platelets (β = 8.372, p < 0.001) after adjusting for age, sex, and socioeconomic factors in a multiple linear regression analysis. A higher BMI was associated with elevated WBC, RBC, Hb, Hct, and platelet counts in children and adolescents. Because higher levels of hematological parameters are potential risk factors for obesity-related diseases, hematological parameters should be evaluated in obese children and adolescents.

Clinical Characteristics of Macrolide-Refractory Mycoplasma pneumoniae Pneumonia in Korean Children: A Multicenter Retrospective Study

Mycoplasma pneumoniae is a major causative pathogen of community-acquired pneumonia in children, and the treatment of choice is macrolides. There is an increasing trend in reports of refractory clinical responses despite macrolide treatment due to the emergence of macrolide-resistant M. pneumoniae. Early discrimination of macrolide-refractory M. pneumoniae pneumonia (MrMP) from macrolide-sensitive M. pneumoniae pneumonia (MSMP) is vital; however, testing for macrolide susceptibility at the time of admission is not feasible. This study aimed to identify the characteristics of MrMP in Korean children, in comparison with those of MSMP. In this multicenter study, board-certified pediatric pulmonologists at 22 tertiary hospitals reviewed the medical records from 2010 to 2015 of 5294 children who were hospitalized with M. pneumoniae pneumonia and administered macrolides as the initial treatment. One-way analysis of variance and the Kruskal-Wallis test were used to compare differences between groups. Of 5294 patients (mean age, 5.6 years) included in this analysis, 240 (4.5%), 925 (17.5%), and 4129 (78.0%) had MrMP, macrolide-less effective M. pneumoniae pneumonia, and MSMP, respectively. Compared with the MSMP group, the MrMP group had a longer fever duration, overall (13.0 days) and after macrolide use (8.0 days). A higher proportion of MrMP patients had respiratory distress, pleural effusion, and lobar pneumonia. The mean aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, and C-reactive protein levels were the highest in the MrMP group, along with higher incidences of extrapulmonary manifestations and atelectasis (during and post infection). Pre-existing conditions were present in 17.4% (n = 725/4159) of patients, with asthma being the most common (n = 334/4811, 6.9%). This study verified that MrMP patients show more severe initial radiographic findings and clinical courses than MSMP patients. MrMP should be promptly managed by agents other than macrolides.

Development of Physical Activity Competence Test Battery and Evaluation Standards for Korean Children

The purpose of this study is to develop a comprehensive and systematic method and standard for evaluating children’s physical activity competency as a solution to the problem of increasing child obesity rates due to a decrease in physical activity among children. This study was used a cross-sectional study design. A literature review and Delphi survey were conducted to develop children’s physical activity competency evaluation. The evaluation criteria were presented based on the measurement data of metropolitan area kindergarten students (228 subjects) on the 2016 winter vacation. Items in the evaluation of children’s physical activity competency test battery include health physical strength, basic movement skills, physical activity habits, and physical activity attitudes. Physical fitness for health consisted of muscle strength and endurance (sit-up), flexibility (sit and reach, trunk lift) and body composition (BMI). Fundamental movement skills consisted of mobility (run, hop, jump), stability (static balance, dynamic balance), and control (throw kick). Physical activity habits consisted of the amount of daily steps (steps), exercise time, screen time, and sleep time. Physical activity attitudes consisted of preference, enjoyment, and confidence. The evaluation criteria for child physical activity competency test battery were presented in five stages, divided by age and gender. With the developed evaluation of children’s physical activity competency, the overall level of physical fitness for health, fundamental movement skills, physical activity habits, and physical activity attitudes of kindergarteners in the metropolitan area could be confirmed, and standards were presented.

The Impact of Weekday-to-Weekend Sleep Differences on Health Outcomes among Adolescent Students

The sleep difference between weekdays and weekends can lead to negative physical and mental health outcomes in adolescents. Thus, this study has attempted to analyze the impact of sleep time differences on various health outcomes, using nationally representative panel data. Data from the junior high school student panel of the Korean Children and Youth Panel Survey were analyzed. The sleep difference was defined as the difference between the average sleep duration on weekdays and that on weekends in minutes. A series of mixed effect linear regression models for continuous variables or mixed effect logit regression for binary variables was utilized. Korean adolescent students reported from 96.8 min to 133.2 min of sleep duration difference between weekdays and weekends. After controlling for gender, parent work status, and type of housing, the weekday-to-weekend sleep differences were associated with various health-related outcomes including concentration difficulty, aggression, somatic symptoms, and withdrawal. Additionally, adolescent student life satisfaction was associated with sleep difference. The sleep differences among adolescent students were more associated with mental health-related outcomes and emotional symptoms than with physical health-related outcomes. The appropriate intervention to reduce the sleep difference gap is an important key to improve health in the adolescence period.

Mediating Effects of Online-Based Leisure Between Parenting Attitudes and Children’s Smartphone Dependency

Objectives: This study investigated the impact of positive and negative parenting attitudes on smartphone dependency in children to examine the mediating effects of online-based leisure such as computer usage, game, and smartphone usage.Methods: Data of 714 children scoring above the top 30% of smartphone dependency among the children in 5th grade in elementary school were collected through the 2nd wave of the Korean Children and Youth Panel Survey (KCYPS 2018). Structural Equation Modeling (SEM) was applied to analyze the mediating effects with the Bootstrapping method by SPSS 21.0 and AMOS 20.0.Results: In the model, online-based leisure significantly mediated the relationship between positive parenting attitudes such as warmth, autonomy support and structure provision, and smartphone dependency showing complete mediation. Also, negative parenting attitudes such as rejection, coercion, and chaos directly negatively affected smartphone dependency, not showing a mediating effect. Results indicate that increased positive parenting attitudes lead to reduced smartphone dependency through decreasing online-based leisure, while negative parenting attitudes lead to increase dependence on the smartphone.Conclusion: While positive parenting attitudes do not directly affect smartphone dependency, they lead to a decrease in online-based leisure. Consequently, as online-based leisure lessens, smartphone dependency subsequently may also be diminished. In addition, although negative parenting attitudes have no mediating effect, they directly influence the growing smartphone dependency. Results confirm that positive parenting mediate the effects of online-based activities in relation to smartphone dependency when parents provide the most structure, autonomy support, and warmth to their children. Practical implications are discussed, and relevant interventions offered for children and parents.

History of insulin treatment of pediatric patients with diabetes in Korea

The year 2021 is the centennial of insulin discovery. The discovery of insulin changes diabetes mellitus from a death sentence to a manageable disease. It became a historical turning point in the lives of people with diabetes. Since the first use of insulin in a patient in 1922, insulin and its analogs have been remarkable in saving the lives of people with diabetes. As insulin began to be used as a drug, it was introduced to, and used in Korea until now. This review briefly summarizes the history of insulin treatment in Korean children and adolescents with diabetes.

A Study on the Longitudinal Relation Between Maternal Parenting Stress, Warmth Parenting, and Children’s Aggressive Behavior Using Autoregressive Cross-Lagged Modeling : a Multigroup Analysis Across Income Levels

Objectives: This study aimed to analyze the longitudinal relationship between maternal parenting stress (MPS), warmth parenting (WP), and children’s aggressive behavior (CAB) in early childhood across income levels.Methods: An autoregressive cross-lagged model was used to assess the mothers and children of 723 families from the Panel Study on Korean Children across the sixth (age 5), seventh (age 6), and eighth (age 7) waves, and bootstrapping was conducted to examine the mediation effects. Further, a multigroup analysis was performed to assess the model’s hypothesized relationships for the low-income and middle-income groups. IBM AMOS 23.0 and SPSS Statistics 26 were used to analyze the data.Results: The results are summarized as follows: First, MPS, WP, and CABs remained unchanged over time. Second, MPS had a significantly negative impact on later WP, and WP negatively affected later MPS. Third, prior WP had a significantly negative impact on CAB. Furthermore, the relationship between MPS and CAB was mediated by WP. Lastly, during the study period, the multi-group analysis found no significant differences in the autoregressive cross-lagged model between the two income groups (the low-income and middle-income groups).Conclusion: The findings revealed that MPS reduced WP, which exacerbated CAB. By illustrating the link between MPS, WP, and CAB, it was highlighted that educational interventions for mothers to minimize parenting stress are likely to have a positive influence on children’s aggressive behavior. More implications are also discussed as a result of these findings.