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 tries to test mediating effects of hope and therapeutic relationship in the relation between general social functions and mental health recovery of community people with mental illness. METHODS: This study was carried out in a cross-sectional research design. The participants included 217 people with mental illnesses who were enrolled at eight Mental Health Welfare Centers in the Gyeonggi Province. Data were collected from February to May, 2018. The collected data were analyzed using a regression analysis, and SPSS PROCESS macro was used to test the mediating effects. RESULTS: This study analyzed the direct effects of general social functions on the hope, therapeutic relationship and mental health recovery. And general social functions had indirect effects on their mental health recovery via hope and therapeutic relationship. Both hope and therapeutic relationship had dual mediating effects in the influence of general social functions on mental health recovery. CONCLUSION: The role of hope and therapeutic relationship in the mental health recovery of community people with mental illness is important, and it is confirmed that hope is a powerful factor influencing mental health recovery.
Gyeonggi-do ; Hope ; Humans ; Mental Health ; Mentally Ill Persons ; Negotiating ; Professional-Patient Relations ; Research Design ; Social Adjustment

PURPOSE: The purpose of this study isto identify the mediating effects of interpersonal problems in the relationship between Social Network Service (SNS) use tendency and depression among university students. METHODS: Data were collected from April 28 to May 7, 2018 and the participants included 222 university students, who responded to the question regarding SNS use tendency, interpersonal problems and depression. The data were analyzed by descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, and multiple regression using the SPSS/WIN 23.0 program. RESULTS: A positive correlation is found between depression and SNS use tendency (r=.24, p<.001), and among interpersonal problems (r=.62, p<.001), SNS use tendency and interpersonal problems (r=.34, p<.001). Interpersonal problems have a full mediating effect on the relationship between SNS use tendency and depression (Sobel test: 5.24, p<.001). CONCLUSION: These results suggest that it is important to manage interpersonal problems to prevent depression caused by SNS use tendency.
Depression ; Humans ; Interpersonal Relations ; Negotiating

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

PURPOSE: The purpose of this study was to determine the mediating effects of self-efficacy and the belief about medication on the association between depression and medication adherence in patients with systemic lupus erythematosus. METHODS: 128 patients aged ≥19 years, who were regular outpatients or admitted patients diagnosed with systemic lupus erythematosus at a tertiary hospital in B city, participated in this study. Data were collected by using a self-administered questionnaire. Testing of mediating effects was analyzed by a parallel redundant mediated model using the PROCESS macro for SPSS version 3.3. RESULTS: They scored an average of 16.71±11.13 for depression, 694.14±170.68 for self-efficacy, 3.05±4.60 for the belief about medication, and 90.14±15.37 for medication adherence. The direct effect of depression on medication adherence was not statistically significant, but the indirect effects of depression mediated with self-efficacy and belief about medication were statistically significant. CONCLUSION: It is necessary to develop and apply a nursing intervention program that can not only relieve depression but also promote self-efficacy and the belief about medication with the objective of improving medication adherence among patients with systemic lupus erythematosus.
Depression ; Humans ; Lupus Erythematosus, Systemic ; Medication Adherence ; Negotiating ; Nursing ; Outpatients ; Tertiary Care Centers

PURPOSE: This study aims to determine the relation among job stress, self-esteem, resilience, and field adaptation of the newly graduated nurses, through which an effective mediation strategy toward field adaptation and basic data on improving nursing quality can be established. METHODS: The subjects were 110 newly graduated nurses who have worked at a tertiary hospital and a general hospital for less than 12 months. The data were collected, using self-reported questionnaires, from July 9 to July 31, 2018, and were analyzed by descriptive statistics, t-test, one-way ANOVA, Scheffé test, Pearson's correlation coefficient and stepwise multiple regression using an SPSS/WIN 24.0 program. RESULTS: The study result showed that the newly graduated nurses' job stress, resilience, job satisfaction, and desired department influenced their field adaptation, explaining 60.2% of the variance in the field adaptation (F=42.14, p<.001). The nurses' job stress had the biggest influence on their field adaptation, explaining 38.7% of the variance. CONCLUSION: Human resource management strategy considering those influencing factors may improve the filed adaptation of newly graduated nurses and help them to retain in their work field.
Hospitals, General ; Humans ; Job Satisfaction ; Negotiating ; Nursing ; Tertiary Care Centers