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 aimed to develop a model for estimating the quality of life mediated by adaptation to changes experienced after stomach cancer diagnosis and surgery in patients with gastrectomy and to verify the model based on the Cancer Survivor Adaptation Model by Naus et al. (2009) and literature reviews. METHODS: Data was collected from 297 gastric cancer patients who underwent a gastrectomy at an outpatient clinic of two university hospitals in Daegu city from May to August, 2016. The exogenous variableswere perceived gastrointestinal symptoms, self-efficacy, anxiety, social support, and spiritual well-being. The endogenous variableswere adaptation and quality of life, and adaptationwas themediating variable. For data analysis, structural equation modeling was performed using IBM SPSS 21.0 and AMOS 18.0. RESULTS: The fitness parameters of the final model showed a reasonable fit to the data. Based on R², the exogenous variables explained 73.9% of the quality of life of stomach cancer patients who underwent surgery, through the mediation of adaptation; adaptation alone explained 73.5% of quality of life. Adaptation of stomach cancer patients with gastrectomy was a factor that strongly influenced their quality of life. CONCLUSION: It is important for gastric cancer patients with gastrectomy to adapt well to changes after surgery in order to improve the quality of life. Nursing interventions to aid successful adaptation would ultimately exert positive influences and improve the patients' quality of life.
Ambulatory Care Facilities ; Anxiety ; Daegu ; Diagnosis ; Gastrectomy ; Hospitals, University ; Humans ; Negotiating ; Nursing ; Quality of Life ; Statistics as Topic ; Stomach Neoplasms ; Survivors

PURPOSE: This study aimed to confirm the mediating effect of job involvement in the relationship between grit and turnover intention among nurses working at university hospitals. METHODS: Participants included 437 nurses from university hospitals located in C city, Gyeongnam. Data were collected from January 8 to 19, 2018, using self-report questionnaires. Data were analyzed using the t-test, analysis of variance, Scheffe's test, Pearson's correlation coefficient, and multiple regression, with the SPSS/22.0 program. A mediation analysis was performed according to the Baron and Kenny, and bootstrapping methods. RESULTS: There were significant relationships between grit and job involvement (r=.40, p<.001), grit and turnover intention (r=−.29, p<.001), and turnover intention and job involvement (r=−.52, p<.001). Job involvement showed partial mediating effects in the relationship between grit and turnover intention. CONCLUSION: Grit increased job involvement and lowered turnover intention. Therefore, to reduce nurses' turnover intention, it is necessary to develop a program and strategies to increase their grit.
Hospitals, University ; Intention ; Job Syndrome ; Negotiating ; Personnel Turnover

OBJECTIVES: Workplace incivility is experienced by dental hygienists, who perform a variety of tasks and roles in dentistry. Therefore, to enhance the performance of dental and medical institutions, it is necessary to identify dental hygienists experiencing incivility that affects the organizational performance. METHODS: Over a two-month period from May 1 to June 30, 2015, dental hygienists from 30 dental and medical institutions in Busan, the North and South Gyeongsang Provinces, Daegu, Seoul, and the Gyeonggi Province were convenience sampled. Data, from a total of 344 participants, were analyzed using the SPSS and AMOS statistical analysis software. RESULTS: Emotional exhaustion had a partial mediating effect on the relationship between patient incivility and job performance, a full mediating effect in relation to job satisfaction, and a partial mediating effect on the association with turnover intention. Meanwhile, emotional exhaustion had a full mediating effect on the relationships between superior incivility and job performance, as well as turnover intention, while a partial mediating effect in relation to job satisfaction. CONCLUSIONS: An in-depth review of interventions that can enable a mutually respectful working environment, and promote a healthy culture among dental hygienists in dental and medical institutions is needed.
Busan ; Daegu ; Dental Hygienists ; Dentistry ; Gyeonggi-do ; Humans ; Intention ; Job Satisfaction ; Negotiating ; Seoul ; Work Performance

PURPOSE: The purpose of this study was to examine the mediating effect of alexithmia on the relationship between attachment and depression in early adulthood. METHODS: A convenience sample of 260 young adults responded to the survey. The collected data were analyzed using descriptive statistics, independent t-test, Pearson's correlation coefficients, and path analyses using bootstrapping. RESULTS: The path analysis indicated that anxious attachment and alexithymia was positively related to depression, but there was not a significant relationship between avoidant attachment and depression. In a modified path model, alexithymia mediated the positive effects of anxious attachment and avoidant attachment on depression. CONCLUSION: Our study findings suggest that early adults who have insecure attachments are vulnerable to alexithymia and depression. Targeted interventions to improve emotional expressive ability may reduce depression in early adulthood.
Adult ; Affective Symptoms ; Depression ; Humans ; Negotiating ; Object Attachment ; Young Adult

PURPOSE: This aim of this study was to investigate the mediating effect of interpersonal relations on the association between emotional intelligence and happiness of nursing students. METHODS: Both junior and senior nursing students were selected for this study (N=187). The survey was conducted using self-reported questionnaire between March and May, 2018. The data were analyzed using descriptive statistics, independent t-tests, one-way ANOVA, Pearson's correlation coefficients, and multiple linear regression analysis with Sobel test. RESULTS: The happiness of nursing students had positive correlation with emotional intelligence (r=.70, p<.01) and interpersonal relations (r=.60, p<.01). Emotional intelligence had positive correlation with interpersonal relations (r=.63, p<.01). Interpersonal relations had a partially mediating effect on the relationship between emotional intelligence and happiness of nursing students. CONCLUSION: According to this study, interpersonal relations played an important role to buffer the impact of emotional intelligence on happiness among nursing students. Therefore, it is necessary to develop a psychological program to improve interpersonal relations to enhance the happiness of nursing students.
Emotional Intelligence ; Happiness ; Humans ; Interpersonal Relations ; Linear Models ; Negotiating ; Nursing ; Students, Nursing

PURPOSE: The aims of this study were to evaluate a hypothetical model explaining undergraduates' interpersonal relationship ability associated with the stress of life, self-esteem, and their communication ability and to identify the mediating effect of a smartphone addiction tendency on the identified associations. METHODS: Data were collected from 201 undergraduates using a structured questionnaire from August to September 2017. Data analyses included descriptive statistics, Pearson's correlation coefficients, and structural equation modeling with SPSS AMOS 22.0. RESULTS: The participants' interpersonal relationship ability was 65.9%, explained by the stress of life, self-esteem, communication ability, and smartphone addiction tendency. The factors of undergraduates' interpersonal relationship ability were self-esteem (β=.10, p<.01) and communication ability (β=.14, p<.001). Stress of life (β=.15, p<.01) directly affected the participants' smartphone addiction tendency, which was not associated with interpersonal relationship ability. CONCLUSION: Based on our study findings, self-esteem and communication ability should be considered for developing nursing interventions to improve interpersonal relationship ability. However, a smartphone addiction tendency may be managed for undergraduates who experience excessive stress of life rather than interpersonal relationship ability. Thus, a tailored approach targeting specific needs or competence should be developed based on our data-based framework.
Behavior, Addictive ; Communication ; Humans ; Interpersonal Relations ; Mental Competency ; Negotiating ; Nursing ; Smartphone ; Statistics as Topic ; Stress, Psychological

PURPOSE: The purpose of this study was to examine mediating effects of pleasurable activities on the relationship between depression and suicidal ideation among the elderly moderated by living arrangement such as those living alone (LA) versus those living with others (LWO). METHODS: This study is a cross-sectional and correlational design using secondary data analysis of the 2017 Korean National Survey on the Elderly (2,416 for the LA group, and 6,106 for the LWO group). Logistic regression analysis was conducted comparing effects of pleasurable activities on suicidal ideation between the two groups. RESULTS: For suicidal ideation, there were significant differences in suicidal ideation by sex, religion, and senior center visits in the LA group, while the LWO group had no significant differences identified. Both groups showed significantly different associations of suicidal ideation by socioeconomic status, gathering, meaningful interaction, and depression. Senior center visits were statistically significant in the LA group, while there was not significant in the LWO group. CONCLUSION: Visiting senior centers can reduce suicidal ideation of the LA group. To prevent suicidal ideation of the elderly living alone, mental health specialists should provide community-cooperative environments to address these issues, especially LA elderly.
Aged ; Depression ; Humans ; Leisure Activities ; Logistic Models ; Mental Health ; Negotiating ; Residence Characteristics ; Senior Centers ; Social Class ; Specialization ; Statistics as Topic ; Suicidal Ideation