PURPOSE: The aim of this study was to evaluate the effectiveness of interventions for workplace bullying among nurses. METHODS: First, risk factors of workplace bullying were categorized in order to create analysis criteria. A search of 8 databases, and manual searching resulted in the identification of 3,096 relevant articles. Three of the authors did article selection, data extraction, and quality assessment using the Risk of Bias (RoB) and the Risk of Bias for Nonrandomized studies (ROBANS). RESULTS: Interventions in workplace bullying were classified as individual, interactions, and organizational approach. Twelve intervention studies (10 individual interventions, 1 team approach, 1 multi-level approach) were selected. Four of the individual interventions decreased bullying, but three had no effect. One multi-level intervention reported that bullying did not occur. Individual interventions improved bullying awareness in four articles, decreased turnover intention in two articles, and increased skill and knowledge of bullying management in five articles. One team approach increased nurse interactions and group cohesion. The quality of selected articles was low overall. CONCLUSION: Individual interventions have a possibility to improve awareness and knowledge about bullying, but there is a lack of evidence on preventing bullying. Further research is required on multi-levels interventions with well-designed controlled trials.
Bias (Epidemiology) ; Bullying ; Intention ; Risk Factors

Adenosine (Ado) is an important mediator of the endogenous defense against ischemia-induced injury in the heart. The action of Ado is mediated by activation of G protein-gated inwardly rectifying K+ (GIRK) channels. In turn, GIRK channels are inhibited by reducing phosphatidylinositol 4,5-bisphosphate (PIP2) through Gq protein-coupled receptors (GqPCRs). We previously found that GIRK channels activated by acetylcholine, a muscarinic M2 acetylcholine receptor agonist, are inhibited by GqPCRs in a receptor-specific manner. However, it is not known whether GIRK channels activated by Ado signaling are also regulated by GqPCRs. Presently, this was investigated in mouse atrial myocytes using the patch clamp technique. GIRK channels were activated by 100 micrometer Ado. When Ado was repetitively applied at intervals of 5~6 min, the amplitude of second Ado-activated GIRK currents (I(K(Ado))) was 88.3+/-3.7% of the first I(K(Ado)) in the control. Pretreatment of atrial myocytes with phenylephrine, endothelin-1, or bradykinin prior to a second application of Ado reduced the amplitude of the second I(K(Ado)) to 25.5+/-11.6%, 30.5+/-5.6%, and 96.0+/-2.7%, respectively. The potency of I(K(Ado)) inhibition by GqPCRs was different with that observed in acetylcholine-activated GIRK currents (I(K(ACh))) (endothelin-1>phenylephrine>bradykinin). I(K(Ado)) was almost completely inhibited by 500 micrometer of the PIP2 scavenger neomycin, suggesting low PIP2 affinity of I(K(Ado)). Taken together, these results suggest that the crosstalk between GqPCRs and the Ado-induced signaling pathway is receptor-specific. The differential change in PIP2 affinity of GIRK channels activated by Ado and ACh may underlie, at least in part, their differential responses to GqPCR agonists.
Acetylcholine ; Adenosine ; Animals ; Bradykinin ; Carotenoids ; Endothelin-1 ; Heart ; Mice ; Muscle Cells ; Neomycin ; Oxygenases ; Phenylephrine ; Phosphatidylinositols

During the second half of the 2000s, the significant impact of human microbiome on human diseases and health conditions was found. Since the Human Microbiome Project, many microbiome studies have been reported in domestic and international references. Gastrointestinal tract microbiome has been most investigated so far, and the association with illness has been demonstrated in many diseases. Recently, the range of study was extended to multiple human organs, such as the respiratory tract, skin, and urogenital tract. Given the scale and speed of research and development in recent years, the role of microbiome in many diseases would be established before long. In this review, we aimed to summarize the current status of microbiome studies in Korea and foreign countries with an emphasis on respiratory tract microbiome. The main concept and analytical methods for microbiome research, associations of microbiome and diseases, and research projects on Korean microbiome are reviewed.
Gastrointestinal Microbiome ; Gastrointestinal Tract ; Humans* ; Korea* ; Metagenomics ; Microbiota* ; Pulmonary Ventilation ; Respiratory System ; Skin

Cancer immunotherapy has emerged as a promising therapy for a wide variety of tumors. Immune checkpoint inhibitors including anti cytotoxic T lymphocyte antigen 4 (CTLA-4), programmed death 1 (PD-1) and programmed death ligand-1 (PD-L1) monoclonal antibodies have proven to be especially effective in various advanced cancers. However, cancer the immunotherapy disturbs the immune system and may also cause immune related side effects (IRAE) distinguished from cytotoxic chemotherapy toxicity. Among them, endocrine IRAE has been reported with a higher incidence than other organ IRAE. We focus on the most relevant and new aspects related to endocrine IRAE due to cancer immunotherapy in this review.
Antibodies, Monoclonal ; CTLA-4 Antigen ; Drug Therapy ; Immune System ; Immunotherapy ; Incidence

OBJECTIVES: Smoke-free areas have expanded and related campaigns have been implemented since 1995 in Korea. As a result, household secondhand smoke (SHS) exposure has decreased over the past 15 years. We assessed the cohort effect, the effect of a 2008 campaign on household SHS exposure, and the impact of a complete smoking ban in public places along with increased penalties, as implemented in December 2011. METHODS: Nationally representative cross-sectional 15-wave survey data of Korean adolescents were used. The 810,516 participants were classified into 6 grade groups, 15 period groups, and 20 middle school admission cohorts. An age-period-cohort analysis, conducted with the intrinsic estimator method, was used to assess the cohort effect of household SHS exposure, and interrupted-time series analyses were conducted to evaluate the effects of the smoke-free policy and the campaign. RESULTS: For cohorts who entered middle school from 2002 to 2008, the risk of household SHS exposure decreased among both boys and girls. Immediately after implementation of the smoke-free policy, the prevalence of household SHS exposure by period decreased significantly for boys (coefficient, -8.96; p<0.05) and non-significantly for girls (coefficient, -6.99; p=0.07). After the campaign, there was a significant decrease in household SHS exposure by cohort among boys, both immediately and post-intervention (coefficient, -4.84; p=0.03; coefficient, -1.22; p=0.02, respectively). CONCLUSIONS A school-admission-cohort effect was found on household SHS exposure among adolescents, which was associated with the smoke-free policy and the campaign. Anti-smoking interventions should be implemented consistently and simultaneously.

Shift workers often experience problems associated with circadian disruption associated with artificial light at night and nocturia is commonly noted in night-shift workers. Nocturia associated with circadian disruption is due to increased urine production of the kidney and decreased storage function of the bladder. A recent discovery of peripheral clock genes in the bladder and their role in contractile property of the bladder support that micturition is closely related to the circadian rhythm. Moreover, there are clinical studies showed that shift workers more often experienced nocturia due to circadian disruption. However, comparing with other health problems, concerns on nocturia and voiding dysfunction associated with circadian disruption are insufficient. Therefore, further studies about voiding dysfunction associated with the circadian disruption in shift workers are necessary.
Circadian Clocks ; Circadian Rhythm ; Kidney ; Nocturia ; Urinary Bladder ; Urination

Anti-programmed cell death-1 (PD-1) humanized monoclonal antibody inhibits PD-1 activity by binding to the PD-1 receptor on T-cells and blocking PD-1 ligands and induces immune tolerance of cancer cells. It has been widely used for various kinds of cancer treatment. However, many immune-related adverse events (irAEs) have been reported because it modulates our immune system. In this case study, we reported a case of 42-year-old woman with Hashimoto's thyroiditis who showed rapid aggravation of thyroid goiter and acute hyperventilation syndrome after treatment with PD-1 inhibitor as a neoadjuvant chemotherapy for breast cancer.
Adult ; Breast Neoplasms ; Breast ; Drug Therapy ; Female ; Goiter ; Humans ; Hyperventilation ; Immune System ; Immune Tolerance ; Ligands ; Programmed Cell Death 1 Receptor ; T-Lymphocytes ; Thyroid Gland ; Thyroiditis

Purpose: We investigated the relationship between lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH) and chronic periodontitis (CP). Methods: A total of 103 middle-aged men who had received a health checkup were included. All participant data were prospectively collected. CP was defined as a 30% increase in the number of probed sites with a clinical attachment level of ≥4 mm among all probed sites. LUTS/BPH were assessed using transrectal ultrasonography, the International Prostate Symptom Score (IPSS), uroflowmetry, and postvoiding residual urine volume. Results: The median age, IPSS, prostate volume, and maximal flow rate were 55.0 years, 9.0, 29.0 mL, and 20.0 mL/sec, respectively. In addition, the prevalence of CP was 27.2%. The IPSS total, IPSS voiding, IPSS storage, and quality of life (QoL) scores were significantly higher in patients with CP (median [interquartile range, IQR]–IPSS total: 8.0 [5.0–13.5] vs. 12.0 [7.5–20.5], P=0.004; IPSS voiding: 5.0 [2.0–9.0] vs. 8.5 [4.0–15.0], P=0.002; IPSS storage: 3.0 [2.0–5.0] vs. 4.0 [3.0–6.0], P=0.021; QoL: 2.0 [1.0–3.0] vs. 3.0 [2.0–4.0], P=0.015). Additionally, the average flow rate was significantly lower in patients with CP (median [IQR] (mL/sec): 9.0 [8.0–13.0] vs. 8.0 [6.0–11.0], P=0.047). After adjustment for age, testosterone level, prostate volume, glucose level, cholesterol level, and waist circumference, the IPSS total and voiding scores were significantly and positively related to CP (IPSS total: odds ratio [OR], 1.141; 95% confidence interval [CI], 1.045–1.245; P=0.003; IPSS voiding: OR, 1.243; 95% CI, 1.092–1.415; P=0.001). Conclusions Our data suggest that LUTS/BPH is significantly related to CP.

Purpose: We investigated the relationship between lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH) and chronic periodontitis (CP). Methods: A total of 103 middle-aged men who had received a health checkup were included. All participant data were prospectively collected. CP was defined as a 30% increase in the number of probed sites with a clinical attachment level of ≥4 mm among all probed sites. LUTS/BPH were assessed using transrectal ultrasonography, the International Prostate Symptom Score (IPSS), uroflowmetry, and postvoiding residual urine volume. Results: The median age, IPSS, prostate volume, and maximal flow rate were 55.0 years, 9.0, 29.0 mL, and 20.0 mL/sec, respectively. In addition, the prevalence of CP was 27.2%. The IPSS total, IPSS voiding, IPSS storage, and quality of life (QoL) scores were significantly higher in patients with CP (median [interquartile range, IQR]–IPSS total: 8.0 [5.0–13.5] vs. 12.0 [7.5–20.5], P=0.004; IPSS voiding: 5.0 [2.0–9.0] vs. 8.5 [4.0–15.0], P=0.002; IPSS storage: 3.0 [2.0–5.0] vs. 4.0 [3.0–6.0], P=0.021; QoL: 2.0 [1.0–3.0] vs. 3.0 [2.0–4.0], P=0.015). Additionally, the average flow rate was significantly lower in patients with CP (median [IQR] (mL/sec): 9.0 [8.0–13.0] vs. 8.0 [6.0–11.0], P=0.047). After adjustment for age, testosterone level, prostate volume, glucose level, cholesterol level, and waist circumference, the IPSS total and voiding scores were significantly and positively related to CP (IPSS total: odds ratio [OR], 1.141; 95% confidence interval [CI], 1.045–1.245; P=0.003; IPSS voiding: OR, 1.243; 95% CI, 1.092–1.415; P=0.001). Conclusions Our data suggest that LUTS/BPH is significantly related to CP.

Background: Venipuncture is one of the one of the most commonly performed, minimally-invasive procedures; however, it may lead to peripheral nerve injury. Here, we describe the diagnosis, treatment, and prognosis of two self-reported cases of nerve injury during venipuncture with the aim of drawing attention to possible needle-related nerve injuries.Case: Two anesthesiologists in our hospital experienced an injury of the lateral antebrachial cutaneous branch of the musculocutaneous nerve during venipuncture. Immediately, they underwent ultrasound examinations and nerve blocks with oral medication, resulting in full recovery. Conclusions Ultrasonography is important for the early and confirmative diagnosis of a nerve injury during venipuncture, and for immediate treatment with a nerve block. Moreover, it is imperative for both the practitioner and the patient to be aware of the possible complication of nerve injury after venipuncture.