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 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

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

BACKGROUND: Apolipoprotein E (APOE) gene polymorphism is associated with neurodegenerative and cardiovascular diseases. Although the effects of the gene differ by ethnic group, few studies have examined Asians. Therefore, the association between APOE polymorphism and mortality in Koreans was evaluated in this study. METHODS: This study population included participants from the Dong-gu and Namwon Studies. APOE genotypes were categorized as E2 (E2/E2 and E2/E3), E3 (E3/E3), and E4 (E3/E4 and E4/E4). Multivariate Cox proportional hazard models were constructed using the E3 allele as a reference. RESULTS: In the model adjusting for study site, age, gender, and lifestyle, the hazard ratio (HR) of mortality for those with the E4 allele was 1.08 (95% confidence interval [CI], 0.97–1.20), while that for those with the E2 allele was 0.84 (95% CI, 0.74–0.96). After adjusting for blood lipids to evaluate their mediating effects, the HRs of mortality for those with E4 and E2 alleles were 1.08 (95% CI, 0.97–1.20) and 0.80 (95% CI, 0.70–0.92), respectively. These associations were more evident in younger groups, with HRs of 0.70 (95% CI, 0.52–0.92) for the E2 allele and 1.25 (95% CI, 1.03–1.53) for the E4 allele. CONCLUSION: In two large population-based cohort studies, the E2 allele was associated with a lower risk of mortality compared with the E3 allele, whereas the E4 genotype was not associated with mortality in Koreans.
Alleles ; Apolipoproteins E ; Apolipoproteins ; Asian Continental Ancestry Group ; Cardiovascular Diseases ; Cohort Studies ; Ethnic Groups ; Genotype ; Humans ; Jeollabuk-do ; Life Style ; Mortality ; Negotiating ; Proportional Hazards Models

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