PURPOSE: The purpose of this study was to identify the effects of social support and emotional intelligence in the relationship between emotional labor and burnout among clinical nurses. METHODS: The sample for this study consisted of 382 nurses from four hospitals located in Seoul or Gyunggi Province. Data were analyzed using frequency, percentage, mean, standard deviation, t-test, ANOVA, Scheffe test, Pearson Correlation, Hierarchical Multiple Regression, and Path Analysis. RESULTS: It was found that: (a) emotional labor had a positive effect on burnout, while social support and emotional intelligence had negative effects on burnout; (b) social support and emotional intelligence moderated the relationship between emotional labor and burnout, and (c) social support mediated the relationship between emotional labor and burnout, whereas emotional intelligence did not. CONCLUSION: The results of the study indicate that high levels of support had a buffering effect and mitigated the negative effects of the emotional labor on burnout. Therefore, strategies to enhance social support for nurses are needed and further research needs to be done to refine this study.
Emotional Intelligence

OBJECTIVES: We investigated the association between metabolic syndrome (MetS) and the coexistence of insomnia and daytime napping, because limited data have been reported regarding this association. METHODS: The study population was 8,440 participants aged 40-65 years, who were from the Korean Genome and Epidemiology Study. Self-reported information on insomnia symptoms and nap duration was used to define exposure variables. Data on waist circumference (WC), blood pressure (BP), and fasting blood glucose (FBG), triglyceride (TG), and high-density lipoprotein cholesterol levels in blood were used to define MetS. Multivariate logistic regression analysis was performed to obtain odds ratio (OR) and 95% confidence interval (CI). RESULTS: In multivariate logistic regression analysis, the coexistence of insomnia and napping was not significantly associated with MetS. However, the insomnia and non-napping group showed higher ORs of high TG (OR, 1.19; 95% CI, 1.02 to 1.39) and high BP (OR, 1.28; 95% CI, 1.10 to 1.49) than the non-insomnia and non-napping group. The combination of non-insomnia and napping and that of insomnia and napping showed higher ORs of high TG (OR, 1.13; 95% CI, 1.00 to 1.29) and high FBG (OR, 1.59; 95% CI, 1.14 to 2.21), respectively. In analyses of insomnia symptoms, only the combination of difficulty in maintaining sleep (DMS) and non-napping showed a higher OR for MetS (OR, 1.25; 95% CI, 1.03 to 1.52) than the non-DMS and non-napping group. CONCLUSIONS Individuals with insomnia, particularly those who do not take naps, were disproportionately likely to have MetS components, especially TG or BP. Information on these variables may help predict individuals’ vulnerability to specific MetS components.

Objectives: : This study aimed to characteristic the systolic blood pressure (SBP), diastolic pressure, pulse pressure, glucose, creatine, and lipid profile. This study also aimed to investigate the prevalence of hypertension and the relationship between hypertension and the lipid profile in Uzbekistan. Methods: The subjects consisted of 58 Uzbekistan subjects recruited from Ewha Medical Care patients. Blood samples were collected from the patients for the lipid profile and random glucose and creatinine levels. Paired t tests were used for the group means and a chi-square or Fisher’s exact test for categorical variables. A multiple logistic regression analysis was performed. Results: Among the 58 patients constituting the baseline population, hypertension developed in 42 patients. Among them, the triglyceride (TG) level was significantly higher in the hypertension group than normal group (173.19 vs. 127.06 mg/dL, P=0.014). The SBP had a positive correlation with the TG (r=0.979, P<0.01) and creatinine (r=0.002, P<0.05) levels and also, the pulse pressure had a positive correlation with the cholesterol level (r=0.539, P<0.05). A multivariate analysis (adjusted for age and sex) indicated that there was a positive correlation between the SBP and TG level (r=0.941, P<0.05). Conclusion There was a positive correlation between the SBP and TG level in the Uzbekistan population according to this study.

Objectives: : This study aimed to characteristic the systolic blood pressure (SBP), diastolic pressure, pulse pressure, glucose, creatine, and lipid profile. This study also aimed to investigate the prevalence of hypertension and the relationship between hypertension and the lipid profile in Uzbekistan. Methods: The subjects consisted of 58 Uzbekistan subjects recruited from Ewha Medical Care patients. Blood samples were collected from the patients for the lipid profile and random glucose and creatinine levels. Paired t tests were used for the group means and a chi-square or Fisher’s exact test for categorical variables. A multiple logistic regression analysis was performed. Results: Among the 58 patients constituting the baseline population, hypertension developed in 42 patients. Among them, the triglyceride (TG) level was significantly higher in the hypertension group than normal group (173.19 vs. 127.06 mg/dL, P=0.014). The SBP had a positive correlation with the TG (r=0.979, P<0.01) and creatinine (r=0.002, P<0.05) levels and also, the pulse pressure had a positive correlation with the cholesterol level (r=0.539, P<0.05). A multivariate analysis (adjusted for age and sex) indicated that there was a positive correlation between the SBP and TG level (r=0.941, P<0.05). Conclusion There was a positive correlation between the SBP and TG level in the Uzbekistan population according to this study.

BACKGROUND: Metabolically healthy obese (MHO) is regarded as a transient concept. We examined the effect of the dynamic change of metabolic health status on the incidence of type 2 diabetes mellitus (T2DM) both in obese and normal weight individuals.METHODS: We analyzed 3,479,514 metabolically healthy subjects aged over 20 years from the Korean National Health Screening Program, who underwent health examination between 2009 and 2010, with a follow-up after 4 years. The relative risk for T2DM incidence until the December 2017 was compared among the four groups: stable metabolically healthy normal weight (MHNW), unstable MHNW, stable MHO, and unstable MHO.RESULTS: During the 4 years, 11.1% of subjects in the MHNW group, and 31.5% in the MHO group converted to a metabolically unhealthy phenotype. In the multivariate adjusted model, the unstable MHO group showed the highest risk of T2DM (hazard ratio [HR], 4.67; 95% confidence interval [CI], 4.58 to 4.77). The unstable MHNW group had a higher risk of T2DM than stable MHO group ([HR, 3.23; 95% CI, 3.16 to 3.30] vs. [HR, 1.81; 95% CI, 1.76 to 1.85]). The stable MHO group showed a higher risk of T2DM than the stable MHNW group. The influence of the transition into a metabolically unhealthy phenotype on T2DM incidence was greater in subjects with aged <65 years, women, and those with weight gain.CONCLUSION: Metabolically healthy phenotype was transient both in normal weight and obese individuals. Maintaining metabolic health was critical for the prevention of T2DM, irrespective of their baseline body mass index.
Body Mass Index ; Cohort Studies ; Diabetes Mellitus, Type 2 ; Female ; Follow-Up Studies ; Healthy Volunteers ; Humans ; Incidence ; Mass Screening ; Obesity ; Phenotype ; Weight Gain

The purpose of this study was to propose a method for the effective management of toothbrush contamination. Toothbrush microbial contamination was analyzed according to the duration of toothbrush use, frequency of toothbrush use per day, and toothbrush storage location. We also analyzed the microbial reduction effect of vinegar, antimicrobial mouth rinse, bamboo salt, and baking soda, which are sterilization materials that can be easily used every day. We collected 45 toothbrushes from university dormitories from May to June 2018. To determine the degree of microbiological contamination with general bacteria, coliform bacteria, and Staphylococcus aureus, bristle samples were cultured at 36oC for 24 hours using 3M™ Petrifilm plates and then measured based on Petrifilm evaluation criteria. Toothbrush microorganisms were analyzed according to the duration of use, frequency of use per day, storage location, and effect of each sterilization material. General bacteria, coliforms, and S. aureus contamination increased with frequency and duration of use (p <0.05). In particular, S. aureus showed a statistically significant increase to 36.15 CFU/ml after 1 month, 504.23 CFU/ml after 2 months, and 2,386.67 CFU/ml after 3 months (p <0.05). We found that 1% vinegar was the most effective substance for reducing general bacteria, coliforms, and S. aureus. In addition, 1% antimicrobial mouth rinse solution applied for 5 minutes was the most effective in reducing S. aureus. It is crucial to recognize the importance of toothbrush care and store toothbrushes in a dry place and replace them periodically. We recommend use of vinegar and antimicrobial mouth rinse solution to disinfect toothbrushes. These should be applied as a 1% solution for at least 1 minute. Proper care of toothbrushes is important in maintaining oral health as well as overall health. Instructions on toothbrush care should be given when teaching children or adults how to brush teeth.
Acetic Acid ; Adult ; Bacteria ; Child ; Humans ; Methods ; Mouth ; Oral Health ; Oral Hygiene ; Sodium Bicarbonate ; Staphylococcus aureus ; Sterilization ; Tooth ; Toothbrushing

Purpose: Few studies have investigated the association between smoking and microvascular complications in the Asian population with type 2 diabetes mellitus (T2DM). We aimed to investigate the relationship between smoking status and microvascular complications in Korean patients with T2DM. Materials and Methods: From the Korean National Diabetes Program cohort, we included 2316 Korean male with T2DM who had baseline clinical information available, including their smoking status, and underwent diabetic complication studies. Results: Compared to non-smokers, current smokers had higher odds of any-microvascular complications [adjusted odds ratio (aOR) 1.45, 95% confidence interval (CI) 1.07–1.97, p=0.016]. The odds of neuropathy were significantly higher; however, the odds of retinopathy were significantly lower in current smokers than in nonsmokers (all p<0.05). Among those who underwent repeated complication tests after 3 years, the risk of newly developed retinopathy was significantly increased in ex-smokers [aOR 3.77 (95% CI 1.61–8.87), p=0.002]. Within ex-smokers, long smoking duration and smoking cessation within the recent 5 years were associated with an increased risk of newly developed retinopathy (all p<0.05). Conclusion Male smokers had higher odds of having overall diabetic microvascular complications, including neuropathy. However, the odds of having retinopathy were significantly lower among current smokers. More attention and research are needed regarding the increased risk of retinopathy development in ex-smokers who have recently stopped smoking after a long history of smoking.

BACKGROUND: Recent evidences indicate that early rapid renal function decline is closely associated with the development and progression of diabetic kidney disease. We have investigated the association between carotid atherosclerosis and rapid renal function decline in patients with type 2 diabetes mellitus and preserved renal function.METHODS: In a prospective, multicenter cohort, a total of 967 patients with type 2 diabetes mellitus and preserved renal function were followed for 6 years with serial estimated glomerular filtration rate (eGFR) measurements. Common carotid intima-media thickness (CIMT) and presence of carotid plaque were assessed at baseline. Rapid renal function decline was defined as an eGFR decline >3.3% per year.RESULTS: Over a median follow-up of 6 years, 158 participants (16.3%) developed rapid renal function decline. While there was no difference in CIMT, the presence of carotid plaque in rapid decliners was significantly higher than in non-decliners (23.2% vs. 12.2%, P<0.001). In multivariable logistic regression analysis, presence of carotid plaque was an independent predictor of rapid renal function decline (odds ratio, 2.33; 95% confidence interval, 1.48 to 3.68; P<0.0001) after adjustment for established risk factors. The model including the carotid plaque had better performance for discrimination of rapid renal function decline than the model without carotid plaque (area under the receiver operating characteristic curve 0.772 vs. 0.744, P=0.016).CONCLUSION: Close monitoring of renal function and early intensive management may be beneficial in patients with type 2 diabetes mellitus and carotid plaques.
Carotid Artery Diseases ; Carotid Intima-Media Thickness ; Carotid Stenosis ; Cohort Studies ; Diabetes Mellitus, Type 2 ; Diabetic Nephropathies ; Discrimination (Psychology) ; Follow-Up Studies ; Glomerular Filtration Rate ; Humans ; Logistic Models ; Prospective Studies ; Risk Factors ; ROC Curve

Background: We aimed to investigate the moderating effects of obesity, age, and sex on the association between sleep duration and the development of diabetes in Asians. Methods: We analyzed data from a cohort of the Korean Genome and Epidemiology Study conducted from 2001 to 2020. After excluding shift workers and those with diabetes at baseline, 7,407 participants were stratified into three groups according to sleep duration: ≤5 hoursight, >5 to 7 hoursight (reference), and >7 hoursight. The Cox proportional hazards analyses were used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for incident type 2 diabetes mellitus (T2DM). Subgroup analyses were performed according to obesity, age, and sex. Results: During 16 years of follow-up, 2,024 cases of T2DM were identified. Individuals who slept ≤5 hight had a higher risk of incident diabetes than the reference group (HR, 1.17; 95% CI, 1.02 to 1.33). The subgroup analysis observed a valid interaction with sleep duration only for obesity. A higher risk of T2DM was observed in the ≤5 hoursight group in non-obese individuals, men, and those aged <60 years, and in the >7 hoursight group in obese individuals (HRs were 1.34 [95% CI, 1.11 to 1.61], 1.22 [95% CI, 1 to 1.49], and 1.18 [95% CI, 1.01 to 1.39], respectively). Conclusion This study confirmed the effect of sleep deprivation on the risk of T2DM throughout the 16-year follow-up period. This impact was confined to non-obese or young individuals and men. We observed a significant interaction between sleep duration and obesity.

BACKGROUND: The aim of the study was to assess the impact of socioeconomic status (SES) on health behaviors, metabolic control, and chronic complications in people with type 2 diabetes mellitus (T2DM) from South Korea, a country with universal health insurance coverage and that has experienced rapid economic and social transition. METHODS: A total of 3,294 Korean men and women with T2DM aged 30 to 65 years, participating in the Korean National Diabetes Program (KNDP) cohort who reported their SES and had baseline clinical evaluation were included in the current cross-sectional analysis. SES included the level of education and monthly household income. RESULTS: Lower education level and lower income level were closely related, and both were associated with older age in men and women. Women and men with lower income and education level had higher carbohydrate and lower fat intake. After adjustment for possible confounding factors, higher education in men significantly lowered the odds of having uncontrolled hyperglycemia (glycosylated hemoglobin ≥7.5%) (odds ratio [OR], 0.63; 95% confidence interval [CI], 0.43 to 0.91 for highest education; P(trend)=0.048), while higher household income in men significantly lowered the odds of having diabetic retinopathy (OR, 0.59; 95% CI, 0.37 to 0.95 for highest income level; P(trend)=0.048). In women, lower income was associated with a higher stress level. CONCLUSION: Men with lower SES had higher odds of having diabetic retinopathy and uncontrolled hyperglycemia, showing the need to improve care targeted to this population.
Cohort Studies ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2* ; Diabetic Retinopathy ; Education ; Family Characteristics ; Female ; Health Behavior* ; Humans ; Hyperglycemia ; Insurance, Health ; Korea ; Male ; Social Class*