OBJECTIVE: We aimed to investigate the ability of readout-segmented echo-planar imaging (rs-EPI)-based diffusion tensor imaging (DTI) in assessing the microstructural change of extraocular muscles (EOMs) and optic nerves in patients with thyroid-associated orbitopathy (TAO) as well as in evaluating disease activity.MATERIALS AND METHODS: We enrolled 35 TAO patients and 22 healthy controls (HCs) who underwent pre-treatment rs-EPI-based DTI. Mean, axial, and radial diffusivity (MD, AD, and RD) and fractional anisotropy (FA) of the medial and lateral EOMs and optic nerve for each orbit were calculated and compared between TAO and HC groups and between active and inactive TAO groups. Factors such as age, sex, disease duration, mediation, and smoking history between groups were also compared. Logistic regression analysis was used to evaluate the predictive value of significant variables for disease activity.RESULTS: Disease duration was significantly shorter in active TAOs than in inactive ones (p < 0.001). TAO patients showed significantly lower FA and higher MD, AD, and RD than HCs for both medial and lateral EOMs (p < 0.001), but not the AD value of lateral EOMs (p = 0.619). Active patients had significantly higher FA, MD, and AD than inactive patients for medial EOMs (p < 0.005), whereas only FA differed significantly in the lateral EOMs (p = 0.018). The MD, AD, and RD of optic nerves were significantly lower in TAO patients than HCs (p < 0.05), except for FA (p = 0.129). Multivariate analysis showed that the MD of medial EOMs and disease duration were significant predictors for disease activity. The combination of these two parameters showed optimal diagnostic efficiency for disease activity (area under the curve, 0.855; sensitivity, 68.4%; specificity, 96.9%).CONCLUSION: rs-EPI-based DTI is promising in assessing microstructural changes of EOMs and optic nerves and can help to indicate the disease activity of TAO, especially through the MD of medial EOMs.
Anisotropy ; Diffusion Tensor Imaging ; Diffusion ; Echo-Planar Imaging ; Humans ; Logistic Models ; Multivariate Analysis ; Muscles ; Negotiating ; Optic Nerve ; Orbit ; Sensitivity and Specificity ; Smoke ; Smoking ; Troleandomycin

PURPOSE: The purpose of this study was to construct and test a structural equation model on nursing work outcomes based on Youssef and Luthans' positive psychological capital and integrated conceptual framework of work performance.METHODS: This study used a structured questionnaire administered to 340 nurses. Data were analyzed using structural equation modeling.RESULTS: Positive psychological capital showed indirect and direct effects on job satisfaction, retention intention, organizational citizenship behavior, and nursing performance. While, the nursing work environment had direct and indirect effects on job satisfaction and nursing performance, it only had indirect effects on intention to work and organizational citizenship behavior. Additionally, a mediating effect on retention intention and organizational citizenship behavior was found between job satisfaction and nursing performance variables.CONCLUSION: The nursing organization needs to build a supportive work environment and reinforce positive psychological capital to improve nursing performance. Additionally, it needs to actively manage the necessary parameters involved in the stages of job satisfaction, retention intention, nursing performance, and organizational citizenship behavior of nurses. The findings propose the continuous management of nursing personnel based on nurses' attitude outcome, behavioral intention, behavioral outcome, and stage of role performance.
Attitude of Health Personnel ; Intention ; Job Satisfaction ; Negotiating ; Nursing ; Psychology, Industrial ; Task Performance and Analysis ; Work Performance

The ezrin-radixin-moesin (ERM) proteins are a family of membrane-associated proteins known to play roles in cell-shape determination as well as in signaling pathways. We have previously shown that amphetamine decreases phosphorylation levels of these proteins in the nucleus accumbens (NAcc), an important neuronal substrate mediating rewarding effects of drugs of abuse. In the present study, we further examined what molecular pathways may be involved in this process. By direct microinjection of LY294002, a PI3 kinase inhibitor, or of S9 peptide, a proposed GSK3β activator, into the NAcc core, we found that phosphorylation levels of ERM as well as of GSK3β in this site are simultaneously decreased. These results indicate that ERM proteins are under the regulation of Akt-GSK3β signaling pathway in the NAcc core. The present findings have a significant implication to a novel signal pathway possibly leading to structural plasticity in relation with drug addiction.
Amphetamine ; Animals ; Glycogen Synthase Kinases ; Humans ; Membrane Proteins ; Microinjections ; Negotiating ; Neurons ; Nucleus Accumbens ; Phosphorylation ; Phosphotransferases ; Plastics ; Proto-Oncogene Proteins c-akt ; Rats ; Reward ; Signal Transduction ; Street Drugs ; Substance-Related Disorders

PURPOSE: This study examined the relationship among the use of food-related content (FRC), dietary behaviors, and dietary self-efficacy to demonstrate the need for nutrition education to help adolescents build healthy eating habits and provide evidence for developing nutrition education programs for adolescents. METHODS: Three hundred and eighty-one high school students in Seoul and Gyeonggi areas participated in the study. The subjects were divided into three groups (low, medium, and high) according to the level of use of the FRC, and their general characteristics, dietary behaviors, and dietary self-efficacy were analyzed. Correlation analysis was performed between FRC usage, dietary behaviors, and dietary self-efficacy, and the mediating effects of dietary self-efficacy on the relationship between the level of the use of FRC and dietary behaviors were estimated. RESULTS: A higher level of FRC usage was associated with an increased daily cost of eating out and snacking, but no difference was observed in the BMI range. The subjects in a group with a high level of FRC usage ate convenience store or instant foods instead of homemade meals (p = 0.033), had a late-night meal or snack (p = 0.024), and turned to emotional eating under stress (p < 0.001) more than those in the low level group. In addition, the high level group checked the nutrition facts label more carefully when purchasing processed foods (p = 0.016) and exercised at least 30 minutes daily, not considering physical education classes (p = 0.057). The higher level of FRC use, the lower the dietary self-efficacy, whereby the subscales ‘environmental stimulus control efficacy’ and ‘affective factor control efficacy’ showed complete mediating effects. CONCLUSION: Given that FRC has been increased recently, adolescents are in need of support to help them control and enhance their dietary self-efficacy as well as develop healthy dietary behaviors through proper nutrition education programs.
Adolescent ; Eating ; Education ; Gyeonggi-do ; Humans ; Meals ; Negotiating ; Physical Education and Training ; Seoul ; Snacks

PURPOSE: This study investigates the effect of pregnant women's growth mindset on the stress of pregnancy through ego-resilience. METHODS: The subjects included 551 pregnant women in Seoul and Gyeonggi area. Data were collected using a structured questionnaire; statistical, frequency, correlation, and structural equation analyses were performed using SPSS21 and M-plus 7.0. RESULTS: First, pregnant women's growth mindset had a direct effect on pregnancy stress. Second, the mediating pathway that influenced pregnancy stress through the ego-resilience of growth mindset was significant. CONCLUSION: These results suggest that it is important to devise and practice a method to improve the growth mindset of pregnant women, enhance ego-resilience, and reduce the negative effects of stress by reducing pregnancy stress.
Female ; Gyeonggi-do ; Humans ; Methods ; Negotiating ; Pregnancy ; Pregnant Women ; Seoul

PURPOSE: This paper is based on an ecological study. From 2008 to 2014, we identified the differences in the Low Birth Weight (LBW) rate according to land use rate among the 25 autonomous regions of Seoul. We also demonstrated the effects of ecological environmental differences on maternal outcomes. METHODS: The National Statistical Office obtained data of residential areas and rates, commercial areas and rates, industrial areas and rates, green areas and rates of the 25 autonomous regions from 2008 to 2014. It also obtained data regarding low birth weight rates for the same region and period. The rate of land use is divided into four stages by residential rate, three by commercial rate, three by industrial rate, and four by green area rate The higher the step, the higher the rate is. The method by Baron and Kenny was used to investigate the mediating effects of the concentration of air pollutants (PM10, PM2.5, SO2, NO2, O3, CO) on LBW and its relationship to land use in each district of Seoul. The relationship between the change of land use and LBW rate in each region was analyzed with general regression analysis and cluster analysis. RESULTS: This study shows that as the rate of green area to overall area increases in Seoul's industrial area, a causal effect is observed with low birth weight, mediated by SO2. Regression analysis revealed that LBW rates were significantly higher in heavily industrial areas (beta=1.27, SE=0.27, p<0.05), while LBW rate was significantly lower in considerably greener areas (beta=−2.21, SE=0.39, p<0.05). CONCLUSION: We confirmed differences in the relationship between residential, commercial, industrial, and green areas, air pollutants, and LBW rate. Areas with high industrial rates have a high LBW rate, while areas with high green rates have a low LBW rate. The autonomous land use ratio includes direct environmental factors. Therefore, pregnant women who are living in highly industrial areas should be especially careful to manage their living environment.
Air Pollutants ; Female ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Methods ; Negotiating ; Pregnant Women ; Seoul

PURPOSE: This study was designed to examine both actor and partner effects of perceived marital relationship on quality of life, as well as the mediating effect of holding back cancer-related concerns.METHODS: This was a cross-sectional study in an outpatient setting. Participants were 150 couples consisting of patients with lung cancer and their spouses. Perceived marital relationship, holding back cancer-related concerns, and quality of life were measured with self-report scales. Actor and partner effects on quality of life were analyzed using the actorepartner interdependence mediation model by using structural equation modeling.RESULTS: A couple's quality of life had a significant direct actor effect on the perceived marital relationship. However, the partner effect and the indirect effect of holding back cancer-related concerns on quality of life was not significant.CONCLUSION: When patients with lung cancer and their spouses perceived their marital relationship positively, they assessed their quality of life positively. They were also found to be less hesitant when talking about cancer-related concerns. However, holding back on talking concerns did not have a significant impact on the quality of life (of either oneself or the spouse). Therefore, nurses should first check how they perceive their marital relationship before encouraging communication between patients with lung cancer and their spouses. Nurses can assess these risk factors and intervene if needed, along their cancer trajectory.
Cross-Sectional Studies ; Family Characteristics ; Humans ; Lung Neoplasms ; Lung ; Marriage ; Negotiating ; Outpatients ; Quality of Life ; Risk Factors ; Spouses ; Weights and Measures

PURPOSE: This study examined the mediating effects of self-esteem and resilience on the relationship between internalized stigma and quality of life in people with schizophrenia.METHODS: The participants were 123 people with schizophrenia (mean age = 41.87 years; 62.6% men) recruited from Soonchunhyang university hospital, a mental health center, and daytime rehabilitation facilities located in Seoul and Gyeonggi Province in South Korea. Using a cross-sectional survey, participants completed structured questionnaires with psychometric adequacy. The regression method of Baron and Kenny was used to test the mediating effects of self-esteem and resilience on the relationship between internalized stigma and quality of life.RESULTS: Self-esteem and resilience were found to be full and partial mediators, respectively, in the relationship between internalized stigma and quality of life.CONCLUSION: The findings of this study imply that effective future intervention strategies should target improvements in self-esteem and resilience to reduce the negative impact of internalized stigma on the quality of life of people with schizophrenia.
Cross-Sectional Studies ; Gyeonggi-do ; Korea ; Mental Health ; Methods ; Negotiating ; Psychometrics ; Quality of Life ; Rehabilitation ; Resilience, Psychological ; Schizophrenia ; Seoul ; Social Stigma

PURPOSE: The purpose of this study was to investigate whether the effects of emotional intelligence and working environment on nursing performance of nurses caring for cancer patients in small and medium hospitals were mediated by communication competence.METHODS: The data was collected between Aug. 1 and Aug. 30, 2018 from 240 nurses caring for cancer patients from 11 small and medium hospitals in B city. Variables included in this study were the Wong and Law Emotional Intelligence Scale (WLEIS), the Practice Environment Scale of Nursing Work Index (PES-NWI), the Global Interpersonal Communication Competence (GICC), and nursing performance. The collected data were analyzed by t-tests, ANOVA and Scheffe's test, Pearson's correlation coefficients, and 3 step multiple regression using SPSS/WIN 24.0 and the Sobel test.RESULTS: Communication competence, in the relationship between emotional intelligence and nursing working environment on nursing performance in nurses caring for cancer patients in small and medium hospitals, showed a partial mediating effect (Z=5.24, p < .001; Z=2.44, p=.001 respectively).CONCLUSION: The results of this study showed the effects of emotional intelligence and nursing working environment on nursing performance of nurses caring for cancer patients in small and medium hospitals were mediated by communication competence.
Emotional Intelligence ; Humans ; Jurisprudence ; Mental Competency ; Negotiating ; Nursing

OBJECTIVES: In recent decades, due to the high prevalence of divorce in numerous countries and the detrimental aftermath thereof, it has become increasingly important to study the components of marital stability. The current study explored fundamental protective factors in long-term marriage through a systematic review.METHODS: Searches for relevant publications were conducted in Embase, Web of Science, PubMed, Scopus, Science Direct, Magiran, and Scientific Information Database from their inception through January 30, 2019. Through the keyword search, 1,706 articles were found, of which 25 articles remained after screening based on the eligibility criteria.RESULTS: The extracted protective factors associated with marital stability in long-term marriage were classified as interpersonal and intrapersonal. Notable extracted factors included spirituality and religion, commitment, sexual relationship, communication, children, love and attachment, intimacy, and conflict resolution approach. These findings show that some aspects of relationships, such as commitment, act to preserve the pillars of marriage in critical situations, while other aspects, such as intimacy, help to construct marital identity and satisfaction.CONCLUSIONS: The identified components of marital stability are structures that enhance a couple's identity and sense of togetherness. Identifying the specific aspects of marital relationships that contribute to marital stability may help specialists and researchers to target specific types of marital interaction that may enhance the happiness and longevity of relationships, thereby preventing avoidable divorces.
Child ; Divorce ; Happiness ; Humans ; Longevity ; Love ; Marriage ; Mass Screening ; Negotiating ; Prevalence ; Protective Factors ; Specialization ; Spirituality